Third trimester pregnancy

Human gestation is niftily divided into three major growth segments, or trimesters, of about twelve weeks. The final three months of a textbook full term pregnancy is referred to as the third trimester.

By this point most women are more than well aware that they are pregnant, with all and sundry asking when they are due and how do they feel? While many women appear to breeze through pregnancy, by the 28th week the growth of the baby is noticeable. While the best thing to do at this time is to continue suitable forms of exercise such as walking, yoga, pilates, swimming etc, eating well and getting adequate sleep (which may not always be as easy as it sounds) – complementary therapies may be useful to help with some of the common health issue of this time.

Cramps and restless legs

While this often occurs in the later stages of pregnancy, a frequent cause is really no big mystery (as some popular texts allude). As the baby has been getting first dibs on the mother’s nutrition over the last six or so months, at this point if supply is not meeting demand, deficiency symptoms occur. Cramps and restless legs are often a sign of not having enough magnesium. So much of the information about calcium directs women to eat more dairy products, which are comparatively low in magnesium. Low magnesium is sometimes a factor in pre-eclampsia.

Good sources of magnesium include: nuts, avocado, bran, unrefined grains (eg, brown rice) and bananas. The celloid or tissue salt form of magnesium phosphate (MP, mag phos), a cross between a homoeopathic and mineral dose, is one of the safest forms of magnesium to take in pregnancy. Take two tablets before bed.

Other deficiencies can also cause restless legs – especially iron and zinc (see the link above for more details).

Backache

While niggling aches and pains are common in pregnancy it doesn’t mean there is nothing you can do to help ease them. Sciatica (a shooting pain, often from the buttocks down the legs) and other musculo-skeletal discomfort can be helped with a couple of osteopathic treatments, acupuncture, physiotherapy or pilates. (For more information and links about these therapies go to the show on aches and pains). Yoga and pilates can also help prevent and treat some back problems. Unless you are advised not to, keep as active as possible throughout this stage of pregnancy.

Try to be aware of your posture as the baby grows. Slumping on the couch not only increases your chance of musculo-skeletal problems but many midwives connect this with a higher chance of a posterior presentation at birth (this is where the baby is head down but facing towards the mother’s spine, so the largest part of the head is prominent.) This often leads to a longer labour.

Swelling/Fluid retention

Standing on your feet all day or being in a warm environment can make the struggling circulation system leak fluid into the tissues. This might present as rings becoming too tight to wear on the usual fingers or swollen ankles, legs or feet. As this can also be a symptom of pre-eclampsia, it is important that your blood pressure is being monitored as well.

For simple fluid retention avoid unnecessary salt. This means cutting out processed foods, avoiding pre-made and restaurant meals and keeping away from the saltshaker. Fresh vegetables, brown rice and steamed or baked fish make a great basic diet, especially if your blood pressure is starting to rise.

If you are working with a herbalist who is helping you with your pregnancy, it is usually safe to have a couple of simple, nutritive diuretic herbs. The two favoured in traditional herbalism are nettle and dandelion leaves (not roots). Half to one teaspoon each per cup, three cups a day is the dosage. Always choose organic, loose-leaf green herbs.

Keeping your legs cool also helps – sitting with your feet in a tub of cool water or using a cold compress gives a little, instant relief.

Varicose veins and haemorrhoids

Cool water can also help raised or bulging veins. Using a shower attachment, spray cold water on the area twice a day.

For haemorrhoids (enlarged, sometimes protruding, swollen veins in the rectum) keeping the bowels working well is an absolute priority. Make sure you drink at least 2 litres of water a day, avoid caffeine and soft drinks and try to get more than the required 5 serves of vegetables and 2 fruits a day. Brown rice, beans, figs, prunes and kiwi fruit are also great to include but pull back on dairy, bread and red meat.

A cream or ointment made from witch hazel, applied to the area, may also be effective.

”Partus Prep”

For centuries traditional herbalists have used plants that help ‘prepare’ for birth. These are herbs that don’t necessarily make stronger contractions, rather they encourage the uterus to contract and relax properly.

Raspberry leaf is the most well known. Research suggests that it has a paradoxical relationship with the smooth muscle of the uterus – astringing it (helping it tighten or contract) as well as relaxing the fibres. This may aid recovery between contractions, helping an active birth.

A “partus prep” is best prescribed by a well trained herbalist, however good quality, organic raspberry leaf tea can be taken at one teaspoon per cup, three times a day from week 28.

More birth preparation

As it is now not unusual for a woman to head into having her first child having never been present at a birth before, it is not unusual that the fear factor can start to grow. We all need mentors in life and having witnessed a positive birthing is useful preparation, as is having a support group around you of people you trust. If you are unable to have a close friend or mother who makes you feel strong and calm with you, consider working with a doula (a professional birth support person).

Hypnosis for a calm, active birth is becoming increasingly popular. One form of training is “hypnobirthing” but others forms exist. As this is a growing, unregistered industry ask around and speak to a few practitioners if you are interested. If interested in hypnotherapy for birth it is often recommended you start as early as possible in pregnancy to get the best results.

Certainly talking through your concerns or fears is important for some women. Midwives are your ally in pregnancy, birth and beyond so get to know who you will be working with. They are the experts, so make use of them during your prenatal check ups. If you are seeing a private obstetrician, you can hire your own midwife or ask to speak to one in the practice if you wish.

Birth preparation classes are usually held in most public and private hospitals. There are also some other excellent private providers, like Lina Clerk who now works in the UK, as well as Melbourne.

Breech presentation

By about weeks 36-37 the baby has settled into position for the last bit of its gestation. If the head is not down, there is a small window of opportunity at this point to try to encourage it to turn around. Increasingly few obstetricians offer manual turning now. If this is not an option or seems risky, try acupuncture and moxibustion. In Victoria you can search for a registered Chinese medicine practitioner at the registration board website

Homoeopathy for birth

Homoeopathic remedies are safe to take to help instigate labour, through the birthing process and after a vaginal delivery or caesarean. The biggest issue is knowing what to take and this requires some knowledge for the birth partner (rather than the woman in labour). A useful guide is available from the Society of Homoeopaths (UK).

If nothing else, the all-purpose remedy is arnica (at a 30 c or higher potency). This helps ease bruising like pain and is useful during and after birth. It is also used for shock.

Planned and emergency caesareans

While complementary medicine aims to support active, natural births – this is not always possible. Sometimes a C-Section is planned as it is the best option for both mother and child, for a wide variety of medical reasons. At other times the baby is in distress or the labour too long for it to safely continue. When you know in advance that a caesarean is planned there are things you can do to help. Certainly pack the homoeopathic arnica and continue to eat well. A multi-vitamin may also be useful.

When a C-Section is unplanned some women experience shock, for which the flower essence formula Rescue Remedy may be useful.

There are some great suggestions about making a caesarean a postive experience at the CARES (SA) site.

While the first six weeks of care post partum is crucial for all women after birth, it is even more so when combined with major surgery. All women should avoid exercise until their ligaments have returned to normal. Post-caeser all abdominal strength is lost, so more hands on help is needed for lifting, doing the washing and so many aspects of daily life. This is even more reason to ask for help from those who are practical and to put a sign on the door to not be disturbed when you and the baby are sleeping during the day. It is normal to be tired, listen to your body and say no to extra activities until you feel ready.

…and some help for the non-pregnant parent

At this time it is not unusual for the non-pregnant parent to have a few of their own health issues, something I tend to think of as “Third Trimester Father Syndrome”. The non-pregnant partner (be it a man or woman) may also be experiencing some stresses and fears, which naturopathy can help support. I’ve written a short article with lots of links, that may be useful.

Gay and lesbian parenting is booming. Rainbow families is the peak support group and offers a range of resources.


For more pregnancy resources check out this previous show, which includes some links to local midwives and doulas.