In-depth reviews guided by a Pediatrician

Pregnancy Essentials: Third Trimester

By Juliet Spurrier, MD ⋅ Mom-in-Chief
Friday July 20, 2018

Third Trimester


The third trimester is when reality sets in and your body can get uncomfortable. This period includes swelling, shortness of breath, aches, pains, and temperature fluctuations. Sleeping is definitely a problem, and you'll be waddling more than walking. It is a time for thinking ahead about the big day while you take it day-by-day.

Here, we run through helpful comfort aids and discuss a few topics to help you prepare for baby's arrival and beyond.

Helpful Aids


As your body grows, you'll find that support above and below is very welcome. There are a plethora of aids to help with the discomfort including:
  • Maternity Support Belts — A basic orthopedic maternity belt like the adjustable Gabrialla Elastic Maternity Support Belt by ITA-MED goes around the low back and below the belly strapping around the pelvis with Velcro. By providing the belly with support, this type of belt can help relieve the load from the lower back. The Gabrialla is a popular choice for those who run during pregnancy. It's You Babe Best Cradle is an adjustable strap system with hook and eye closures that eases abdominal and back strain by lifting the weight off the pelvis, improving posture and reducing leg and ankle swelling. It is soft and flexible with an open abdominal design for comfort and ventilation. This company also has a pelvic floor support system called the It's You Babe V2 Supporter which helps reduce swelling of vulvar varicose veins, perineal edema, and incontinence during pregnancy.

  • Panty Liners — You may not want to talk about, but its something almost every mother-to-be experiences. As the baby gets bigger, your bladder gets smaller, and the muscles in your pelvic floor relax in anticipation of giving birth, you may find yourself getting a little leaky. If urine leakage is a problem, you can invest in some quality panty liners specifically for this purpose such as Poise Maximum Absorbency Incontinence Pads. Avoid using period liners as they don't absorb quickly enough and aren't equipped to neutralize odor-causing ammonia. If embarrassment has you resisting buying them, order them online, and no one is the wiser!
Bamboobies Regular Nursing Pad
Bamboobies Regular Nursing Pad
  • Breast Pads — Nothing says you've joined motherhood quite like leaky boobs. As your due date approaches and you rage with hormones, your nipples could start leaking colostrum before the baby arrives. Using washable and reusable breast pads, such as Bamboobies Washable Nursing Pads, can help prevent embarrassing stains on your clothing. Take it from us, it happens, and it's embarrassing no matter how chill you are.
  • Big Blue Disposable Underpads — This sounds silly, but right before you are about to pop, it's a good idea to line your bed with Chux, the massive blue pads used in medical clinics and hospitals. This way, if your water breaks while you are sleeping, you won't ruin your bed or have a mess to clean up. NorthShore Premium Blue Disposable Underpads are easy to use and give you peace of mind while protecting your mattress.

Educational Forums for Learning How to Birth and Parent a New Baby



Childbirth Class


For new parents, taking a childbirth preparation class or series can be a useful part of readiness for the big day. A good course covers the stages of labor and delivery and relaxation techniques you can use during labor, as well as appropriate postpartum and newborn care.

Newborn Care Class


Babies aren't born with instruction tags and you don't need a license to have one. There is a lot of information you should know about how to care for your new baby that probably isn't second nature. From feeding and changing diapers to bathing, swaddling and sleeping, to infant car seats and immunizations, a newborn class can help prepare you for the next steps once you are holding your little one in your arms.

Infant and Child Basic First Aid and CPR Class


It is crucial for parents and baby's care providers to know the basics of infant and child first-aid and CPR, cardiopulmonary resuscitation. BabyGearLab highly recommends attending a class before having a baby. With the knowledge you'll gain, you'll be able to provide appropriate care in the event of an emergency in those critical moments before first responders arrive.

Breastfeeding Class


While nurses and lactation consultants are available in the hospital to help through your first days of breastfeeding, there is a lot to know apart from the technique of latching baby onto the breast. From pumping and storing expressed breastmilk to the basics of establishing and maintaining an adequate supply to what to do when problems arise, a good breastfeeding class can be the key to a successful mother-baby nursing pair as well as an appropriate introduction to a certified lactation consultant.

Choosing Your Baby's Doctor


If this is your first baby, who your baby's doctor will be is an important decision you should decide on before labor kicks in. We have compiled a list of helpful questions to aid you during this process. The first two questions can easily be answered by calling the office's reception. If answers to both are "Yes," then we recommend scheduling an appointment to get to know a particular pediatrician to see if they might be the right fit.


It is common in this meeting to ask the doctor where they did their training and what certifications he/she holds. In addition, this is a good opportunity to ask specific questions such as those related to in-hospital care once your baby is born and child vaccinations. It is likely that the pediatrician will offer you great anticipatory guidance and perhaps literature, as well as address other topics or concerns you may have.
  • Accepting New Patients — If you have a particular physician you'd like your baby to see, this is your first question. If they aren't available, they can usually recommend one. If the doctor isn't accepting new patients, but you really want to see them, try to get on a waiting list. Unfortunately, you need to continue calling doctors until you find someone who is accepting new patients.
  • Insurance Participation-- Second, it is crucial to research if the clinic or physician participates in your specific insurance plan.
  • Basics — You want to ask about hours of operation and after-hours care plan. Being able to make convenient appointments is a must and baby is likely to need after hours are at some point, so you want to make sure you know what that will look like should you need it.
  • Education, Training, and Certifications — You might want to ask prospective doctors about which medical school they attended, where they did their residency and fellowship, any board certification and FAAP (Fellow of the American Academy of Pediatrics) membership. While it might not be important where they accomplished everything, it opens a dialogue of understanding their background and experience.
  • Hospital Privileges — Not all doctors work with all hospitals. If hospitals matter to you, double check that your doctor works with the hospital you plan to use.
  • In-Hospital Care of Baby — Let the pediatrician know who your obstetrician is and which hospital you will be delivering your baby. Your baby should be examined immediately after birth and every day he/she is in the hospital by a physician. Would this be the baby's pediatrician or someone else?
  • In-Hospital Procedures for Baby — This is the opportune time to review the preventive care procedures that your baby will have once he/she is born. During the interview, the doctor can explain each to you and why each of the following is important, Vitamin K injection, ophthalmic ointment, hepatitis B vaccine, 24-hour bilirubin level, newborn screen, hearing screen, and pulse oximeter reading.

Routine visits in the first 2 months
Your baby needs an appointment with his/her doctor 2-3 days after discharge from the hospital. This appointment is routine newborn care, and it is important to check on baby's weight, feeding, and screen for potential jaundice. If there are concerns or issues related to breastfeeding, this is the time to address them, and the doctor can decide if a visit with a lactation consultant would be beneficial.

Cord Blood Banking


Many parents pursue banking their newborn's umbilical cord blood at birth. Why? Because your newborn's cord blood, which traditionally is thrown away, contains stem cells that can play a vital role in the treatment of cancer, and may even hold the key to an eventual cure. As a result, today there are several different ways to save cord blood.

We recommend discussing cord blood with your obstetrician between 28 to 34 weeks of gestation as arrangements must be made in advance. If you are going to bank cord blood, you'll need to work the process with your OB and remind your labor and delivery nurse of your wishes.

This video provides a high-level overview of one method, called public cord banking, which we recommend you consider. You can learn more here on the Be The Match website:


Cord Blood Banking can be confusing, particularly with a lack of information on public banking versus the overload of ads about private cord banking. The AAP's policy statement on the matter issued in the January 2007 issue of the Journal of Pediatrics, recommends public banking of a newborn's cord blood. Though this statement is now dated, the AAP's stance remains the same.

If you are interested in learning more, you might consider reading this in-depth article written by a pediatrician or take a look at the United State's National Marrow Donor Program called Be the Match. And, if you need to find out the hospital where you will deliver participates in the collection of public cord blood, visit Parents Guide to Cord Blood Foundation.

Circumcision


If you're having a little a boy, you'll be asked about circumcision. This procedure surgically removes the foreskin from the penis to expose the "head" or glans. it is typically done with local anesthetic (1% lidocaine without epinephrine) via a dorsal penile nerve block. Some practitioners choose to give the baby a pacifier dipped in glucose water during the nerve block. Alternatively, a topical numbing agent may go on the skin about 1 hour before the procedure, but this is not a common practice.

The 2012 American Academy of Pediatrics (AAP) policy acknowledges that the health benefits of circumcision outweigh the risks of the procedure. However, the benefits aren't enough to make a universal recommendation. Therefore, parents must decide what is best for their infant.

What are the benefits? Improved hygiene and a decreased risk of urinary tract infection and penile cancer, as well as a reduction in sexually transmitted diseases including HIV and HPV. Subsequently, this also contributes to the decreased incidence of cervical cancer in women.

Any surgical procedure carries risks, but with circumcision, they are rare and typically minor. However, they include bleeding (1:3,000), infection (1:1000), penile adhesions, and a hidden penis. Some opponents of circumcision express concern about possible reduced sexual pleasure due to the removal of sensitive nerve fibers contained in the foreskin. However, data based on men who have a circumcision as adults remains conflicting.

Circumcision performed in the neonatal period carries less risk than waiting until adulthood, and it is more likely that insurance will cover the procedure if it's done within the hospital before discharge than if done later as an outpatient.


Packing Your Hospital Bag


Having your essentials packed and ready before baby's arrival can help relieve stress when your baby decides it is time to arrive. You'll want to focus on necessities and mother's and baby's comfort while keeping it all to a reasonable size.

For in-depth advice, tips, and specific product recommendations for your hospital bag, we invite you to read BabyGearLab's Baby Essentials, specifically the In Hospital With Baby article. Baby Essentials focuses on gear recommendations and valuable parenting pearls that help from labor through baby's first year. We divide all of the stuff into must have and nice-to-have sections so you can focus on your goals and keep your budget in line.

NEXT: Baby Essentials: In the Hospital

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