| You are now in your third trimester, which
is defined as 27 - 42 weeks gestation. During the seventh
month of pregnancy your baby can now sucks its thumb, hiccup
and cry. It can taste sweet or sour and can respond
to stimuli such as pain, light and sound. Your baby weighs
about three pounds and is now adding body fat. At eight
months gestation your baby is about 18 inches long and weighs
about 5 pounds. Your baby can see and hear but the lungs
are still immature. Your baby will grow about two more
inches and gain about 2 1/2 pounds during your final month of
pregnancy. The lungs are now mature. As your baby
gets bigger there is less room in the uterus for the baby to
move so it may seem less active. |
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Dr. Khalil
All of our patients
are scheduled to see our consulting physician at about 30 weeks.
Our office will schedule this appointment for you. This
will be an opportunity for you to meet him and for him to meet
you so if there is any complications during your delivery, he
will not be a stranger to you. His office is located at
9173 Route 30 Irwin, Pa. 15642 724-864-3550
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Fetal Movement
It is very important
during the last trimester to pay attention to fetal movement.
You will be given a kick count sheet at about 28 weeks.
If you should experience a remarkable decrease in fetal movement,
lay down and drink some juice. If you have not eaten in
a few hours, eat something now. Babies tend to get sluggish
when it has been a while since you last ate. You should
get 10 good kicks daily. After you have tried the above
and the baby does not perk up, contact the midwife immediately.
She will either evaluate you in the office or send you for a
non-stress test.
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RHOGAM
If you are RH Negative
you will receive your RHOGAM injection at about 28 weeks.
If you would like additional information on the RH factor, the
midwife has handouts available.
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Birth Plan
If your birth plan
is complete, this is a good time to bring it to the office to
discuss it with the midwife. A copy will be sent to the
Family Birth Place and will be placed with your chart so when
you come in during labor, everyone will be aware of your plans.
Refusal forms are available for those desiring to refuse the
Vitamin K or eye drops for the baby at the time of delivery.
Ask the midwife for these forms.
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Glucose Challenge
Test
At about 28 weeks the
midwife will order for you the one hour glucose tolerance test.
You will need to fast before you come in for the test.
When you arrive at the out patient lab area, you will be given
sweet syrup to drink and will need to wait one hour to get your
blood drawn. The results will be available in our office
in a few hours after the test is done. The test will show
how will your body is able to use and break down sugar.
If the levels are too high, you will be scheduled to take a three
hour glucose tolerance test.
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Family Planning
During the last few
weeks of pregnancy, the midwife will discuss the various sorts
of birth controls that are available. If you have any questions
regarding which method is best for you, talk to her during these
visits. Handouts are available.
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CBC
The nurse midwife will
also order a CBC along with your glucose test to check to see
if your anemic. If you are, the midwife will male dietary
suggestions and may put you in additional iron. Remember
it is important to continue with your prenatal vitamins.
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Group B Beta Strep
A Group B Beta Strep
culture will be done at about 36 weeks and is taken from
the lower vagina and rectum using a cotton swab. This is
a common bacteria that may be found in a woman's vagina.
This is not sexually transmitted. Group B however can sometimes
cause serious problems to the baby during birth. If you
test positive, you may be given antibiotics to protect your baby..
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Sexual Intimacy
The feeling of physical,
emotional and sexual well being usually continue into the third
trimester. However, as you get closer to your due date,
you may notice that you are less interested in sex. You
may become tired from activities such as standing, walking, or
lovemaking. The baby may feel so large and low that intercourse
may be uncomfortable. You may need to change positions.
The man on top position may be too uncomfortable because of his
weight on your belly. Try other ways, such as the woman
on top, on your sides, or rear entry. As your baby grows,
you may both worry that sexual activity may hurt the baby.
Remember that your body protects the baby because it is high
up in your pelvis. The amniotic fluid cushions the baby.
Sexual activity is safe for the normal, healthy pregnant woman
up to the time of delivery. Your midwife can discuss any
changes if you are having problems in your pregnancy. If
you notice any bleeding or if your water breaks, do not have
intercourse and call the midwife immediately.
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Pre-Labor and Labor
Pregnant women often
have periods of pre labor with contractions that seem to come
and go. This is a time when the cervix is getting soft
and thin (effacing). Contractions can happen anytime during
pregnancy, but are more noticeable after the 37th weeks.
Pregnant women have physical changes as the body gets ready for
labor.
Signs of Pre Labor
1. Spotting of brownish-red
blood with mucous after a vaginal exam or sexual intercourse.
2. Irregular tightening
over the belly every 5 to 20 minutes (Braxton Hicks Contractions).
3. Tightening does
not become stronger, last longer, or occur more frequently.
4. Discomfort felt
low in the back or belly, much like menstrual cramps.
5. Tightening or discomfort
that may be less or goes away with changes in activity or test.
True Labor
1. Strands of mucus
or vaginal discharge tinged with blood that continues and increases.
2. Mucous may be present
two to fourteen days before regular contractions begin.
3. Regular discomfort
that comes every 5 to 10 minutes lasting 30 to 60 seconds.
4. Uncomfortable cramping
may increase. Contractions make the abdomen feel tense
and tight. They may be felt as a pressure in the lower
back and pelvic that gets stronger.
5. Contractions get
stronger, last longer, and gets closer together over time.
6. Contractions will
continue with changes in activity and may even increase with
walking.
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Ruptured Membranes
or Breaking of Water
It is normal to have
a slight increase of thin white discharge at the end of
your pregnancy. Activities such as coughing, sneezing or
laughing may even cause leaking of using in the later months
of pregnancy. you do not need to be concerned about these
events, but should call the midwife immediately if your
water breaks. You may or may not have contractions at this
time and the fluid will look clear, watery and be odorless.
It does not necessarily gush, but may be a slow leaking.
Once the water starts, it will continue until delivery.
The flow of urine can be controlled but the leaking of membranes
can not. If you think your water has broken or is leaking
call the midwife at once.
When to Come to
the Family Birth Place
As your due date comes
near, the midwife will discuss with you the signs of labor as
you might begin experiencing some a few weeks before delivery.
If you feel that you are in labor, call the midwife fore you
start to the hospital. If you should go into labor
during the day, you can enter the hospital at any entrance, but
if it is at night, you will need to go through the emergency
room. Remember the midwife is paged by calling the hospital
operator at 527-3551. Please stay off the phone until the
midwife returns your call.
Perineal Massage
You will be given a
sheet on how to do this massage. This massage is a technique
which slowly and gently stretches the skin and tissues around
the vagina and perineum. The perineum is the area between
your vagina and rectum. This will reduce both the chance
of tearing during birth or the need for an episiotomy.
This will also help you prepare for the feelings of pressure
and stretching that comes as the baby's head is born. Knowing
what some of the sensations will be like can help relax and give
birth instead of tensing up and fighting the sensations.
It can also encourage you to relax when you have a vaginal exam.
In addition it is helpful to learn relaxation techniques, information
about your anatomy and what will happen during labor and
birth.
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Breastfeeding
Remember the nurse
midwife is always available to talk to you should you have any
problems or concerns regarding breastfeeding. Is it best
to pick up some literature in our office during your last few
weeks of pregnancy. The midwives are always available to
speak to you post partum and to help you with any problems.
Breast pumps can be rented or purchased through our office.
If you would like a pump to take home with you when you leave
the hospital, please let us know a week or so before you are
due so that we have one available.
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Moms Group
If you have not already
taken the time to stop by one of the Moms Group Meetings,
this may be a good time to do so. Remember, all babies
and children are welcome to attend.
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After Delivery
The nurse midwife will
call you a few days after your arrive home to see how things
are going. Do not hesitate to call our office if you have
any questions or problems. Sue will be mailing you a birth
announcement sheet. If you would like your birth announced
in our newsletter, please complete it and return it to our office.
Everyone loves birth stories and you are always welcome to write
about your own personal experience to share with others.
DO not forget to schedule your post partum exam.
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If you should
have any additional questions or concerns, please call our office
and the midwife will take the time to discuss them with you.
There is also very valuable information in our patient library. |