“Everything grows rounder and wider and weirder, and I sit here in the middle of it all and wonder who in the world you will turn out to be”*

By the third trimester the now rapidly expanding bump can bring with it a host of symptoms which are difficult to cope with while working hard at work and home.

From the start of your day, when you absent-mindedly wedge your precious load between two cars while trying to slip inconspicuously out of the car park to sleepless nights and organising parenting classes to fit in with clinics, this final 3 months can take it’s toll.

Remember if you’re finding the balancing act too tough, speak to your Clinical Supervisor and Occupational Health Department.  You are entitled to come off long shifts and nights at any point in your pregnancy.  This may affect your pay and the time may not count towards training but nothing is worth risking the health of you or your child.

Here’s my guide to coping with some of those third trimester troubles..

1.  Heartburn

The increased pressure on your stomach and general relaxation effects of progesterone mean that, even from quite early in pregnancy, heartburn can be a major pain!  From burny chest discomfort to waking up with a mouthful of acid, gaviscon can become your new best friend.  Rennies, gaviscon and H2 antagonists eg.  Ranitidine are frequently prescribed in pregnancy and there is no evidence that they are harmful.  Remember to look after your teeth and brush them 2-3 times per day as acid reflux over a few months can take it’s toll.  Eat small, regular meals and avoid eating 3-4 hours prior to bed time.  Tea, coffee and acidic foods such as citrus and tomatoes are major triggers while milk and yoghurts can be soothing while giving you and baby a good boost of calcium.

2. Breast growth and pain

Having frequent bra measurements and wearing a comfortable & supportive maternity/nursing bra day and night can prevent breast discomfort.  Avoid underwire from early pregnancy as this can impede the development of your milk supply.  Some mothers experience colostrum leakage in late pregnancy.  I found Lansinoh nursing pads the most comfortable, discrete and secure.

3.  Back and Pelvic pain

Back and pelvic pain can be a normal symptom of pregnancy.  Rest when possible and choose supportive seats with backs and lumbar support.  Ask your partner for regular massages and invest in a good heat pack (or hot water bottle!)  Think about your posture and, if you are in a lot of discomfort or are not coping seek advice from Occupational Health or your GP.  If you have a friendly physiotherapist in your Department they are often happy to give advice and possibly fit you for a pelvic brace which can improve symptoms.  As your ligaments relax these symptoms are common but an unfortunate number (approx 1 in 4) will suffer from Symphysis Pubis Dysfunction (SPD).  This can range from mild symptoms to severe debilitation and it is essential that the condition is recognised and managed early with referral to physiotherapy and occupational therapy.   Symptoms normally resolve after delivery.  Don’t suffer in silence!

4.  Ergonometry

Your baby may literally ‘come between’ you and your work as, previously simple tasks become near impossible due to your growing bump.  Procedures such as intubation, IV access and Surgery can become tricky as you find you cannot get close enough to your patient, can’t kneel down to secure IV access or perhaps even find driving to work difficult.  Stools should be easy to find in theatre and

5.  ‘Swellings’ from bump and below;  Many women will have problems associated with the increased pressure of having a baby sitting on your pelvic organs and blood vessels.  From swollen ankles to varicose veins, haemorrhoids and urinary frequency, this can lead to a lot of discomfort.  Try to avoid prolonged standing and don’t be shy to ask for a seat whenever possible…even on ward rounds.  Support stockings can be prescribed by your GP and, although not very haute couture, can reduce the discomfort of heavy ankles and varicose veins.  Unfortunately there’s no miracle cure for these problems but just remember that it’s only temporary and should improve drastically once baby arrives!  The best advice is to put your feet up (literally) whenever possible.

6.  Sleep problems & lethargy

Often unavoidable in later pregnancy due to all of the above, getting comfortable may be near impossible and mountains of pillows may be required to balance bumps and boobs, meaning not much room for your Partner to squeeze into bed.  If it’s your first baby you may have opportunities to nap and please take them!  I’m a firm believer in stocking up on sleep and you will need these stores in the first few months, even if you have a “Good Sleeper”, night feeds are unavoidable and take their toll.  The usual sleep advice applies, screen free time, calming teas and avoiding caffeinated drinks or eating close to bedtime which can bring on the dreaded heartburn.

 

*Carrie Fisher