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Managing third trimester pain

Managing third trimester pain

Doctors advise expectant mothers to avoid prolonged standing, abnormal posture, heavy exercise and vigorous activities
Pregnant women undergo severe pain during final stages. The third trimester pain varies from the abdominal, breast, hip, and lower back.
Avoiding vigorous activities, and practicing yoga or meditation can help to manage third trimester pain. Photo by Anantha Subramanyam K

After the completion of 27 weeks of pregnancy, begins the third and last trimester. It is usually considered the most anticipated and exciting phase for a woman who is looking forward to giving birth. Along with the excitement, there can be some uncomfortable moments too. Expectant mothers have to bear various aches (third trimester pain) during the most crucial third trimester.

Garima Sipani, 33, a mother of two and a homemaker from Noida, recalls her struggles during her second pregnancy. “My third trimester was an extremely uncomfortable phase. I felt the belly had fully protruded, even more than usual. I had difficulty sleeping or getting up from the bed or chair. When the baby would turn in my belly, it would result in pain sometimes. There was immense pressure on my bladder. I had to frequently go to the washroom at night, so my sleep went for a toss.”


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Sipani wanted to sleep on her back. However, during pregnancy, women are only supposed to sleep on their sides which becomes extremely unbearable in the last trimester.

“My back would hurt because of water retention and baby weight. My feet were swollen and painful most of the time, making it difficult to fit into my footwear. To distract my mind from these discomforts, I walked daily in the park for an hour, started my day with yoga asanas and got massages on my legs and back for some relief,” says Sipani.

During this period, women can experience pain all over their bodies as they have to carry the weight of their baby, which increases as the due date approaches.

Swati Sharma, 34, a banker, who had a baby three months ago, agrees. “The heaviness in the body and the swollen feet were very painful. I was advised to have a high protein diet and regular massages to ease the pain,” says Sharma.

Common pains during the third trimester

Abdominal pain can include gas, constipation and Braxton-Hicks contractions (false labour). Severe pain could mean a urinary tract infection (UTI), preeclampsia (high blood pressure during pregnancy) and placental abruption (when the placenta separates from the uterus too early).

Breast pain is caused by sore breasts due to hormonal changes. It is common during this time. The size of breasts may increase as they gear up to feed the baby and that can cause pain too.

Hip and lower back pain can happen because of an increase in hormone levels at this time as the connective tissue loosens and stretches. Sleeping on the side with a pillow in between the legs can help.

Sciatica during pregnancy is common because the enlarged uterus presses down on the sciatic nerve; this can cause pain, tingling or numbness in the lower back, buttocks and thighs.

Vaginal pain can be sharp and piercing and can potentially indicate that the cervix is dilating in preparation for delivery.

Restless leg syndrome (RLS) and leg cramping can also happen due to an excess of phosphorus and too little calcium in the body. RLS is an overwhelming urge to constantly move legs. It could signal an iron or folic acid deficiency.

When to call the doctor

  • If there is vaginal bleeding, vomiting, nausea, chills, dizziness, severe pain, cramping or abnormal vaginal discharge.
  • If there is pressure radiating toward the thighs; this is a sign of preterm labour.

Ways to manage the pain

To reduce pain and fatigue during the third trimester of pregnancy, Dr Karnika Tiwari, senior consultant, obstetrics and gynecology, Motherland Hospital, Noida, says, “most patients come with complaints of pain in the groin line which is because of the pressure of the baby’s head. They need to be counselled regarding the hormonal changes which contribute to some amount of pain.”

“Other things that can be done to minimise the pain are to avoid prolonged standing, abnormal posture, heavy work, exercise and vigorous activities. Yoga, meditation or some light exercises can also help,” adds Dr Tiwari.

Pregnant women feel fatigued because of hormonal changes. However, conditions like heart disease, hypothyroidism and anemia also should not be ruled out. Experts advise eating a balanced diet and a daily intake of iron and calcium supplements.

Doctors say weight gain during pregnancy should be optimal. It should neither be too much nor too less because either can cause fatigue and pain. “Some patients usually complain of leg pain during the third trimester which can be due to swelling in the legs or normal physiological changes,” says Dr Tiwari.

Sometimes physiotherapy can help in managing the pain.

Dr P S Khatana, senior physiotherapist, Motherland Hospital, Noida says, “one could do guided stretching, transcutaneous electrical nerve stimulation (TENS – a method that involves the use of a mild electrical current to reduce pain) and apply moist heat under supervision to manage pain during the third trimester.”

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