Pregnancy Symptoms: The Last 20 Weeks

You’re at least halfway through your pregnancy and your symptoms may be changing. Your growing belly may lead to hints of back and pelvic pain, or you may now be huffing and puffing when climbing a simple set of stairs. Or you may experience extreme heartburn, gas or swelling. What typically causes these common symptoms and how can you minimize the effects?

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Preggie Pals
Pregnancy Symptoms: The Last 20 Weeks

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[Theme Music]

You are halfway through your pregnancy, you may have passed the initial pregnancy symptoms such nausea and swollen breast but a whole other set of symptoms are now on the horizon and part two of your series, we are focusing on specific symptoms you can expect during the last 20 weeks of your pregnancy. What triggers these symptoms? Are there ways to overcome them?

Dr. Nick Capetanakis is our expert once again. He is an OBGYN and right here in San Diego. He is also a featured expert on our show. This is Preggie Pals’ episode 71.

[Theme Music/Intro]

Sunny Gault: Welcome to “Preggie Pals” Broadcasting from the Birth Education Center of San Diego. Preggie Pals is your weekly online on-the-go support group for expecting parents and those hoping to become pregnant. I am you host Sunny Gault. Have you joined our Preggie Pals Club? Our members get bonus content after each new show, plus special give a ways and discounts and you will also get a free subscription “The Pregnancy” magazine, one of our partners. Visit our website www.preggiepals.com for more information. Joining me here in the studio is Stephanie, our Preggie Pals producer.

Stephanie, before we get started, let’s tell our listeners a little bit about our new virtual panelist program.

Stephanie Saalfeld: To be a virtual panelist, all you have to do is like our Preggie Pals’ facebook page and follow us on twitter and you can share your tips for new parents and pregnant mamma and join our conversations anywhere in the world. So basically we will be doing some sneak previews of some questions that we will be asking our expert and you can chime in and we will read your comments on air.

Sunny Gault: And if you are into twitter, I know not all moms and dads are but if you are you can follow #preggiepalsVP, VP stands for Virtual Panelist and we will be tagging some comments from our experts and common questions and stuff like that through that as well. You can find out more information on our website www.preggiepals.com and under the community tab you will be a Virtual Panelist and that will give you all the information you need.

So that is one way you can get involved with our shows, you can be a virtual panelist if you are in the San Diego area then you can be a panelist right here in the studio and we have got three panelist plus Stephanie and I joining us in the studio today.

So Stephanie, I am going to hop back to you, we didn’t get a chance to introduce you in our last show so I want to make sure we get that in. Tell us a little bit about yourself?

Stephanie Saalfeld: My name is Stephanie, I am 30 years old. I am a producer for Preggie Pals. I am not pregnant, I am the only one in the room that is not right now. I do have an almost 8 month-old baby girl. Her name is Savanna and she is our only one.

Sunny Gault: You guys know me, I am actually pregnant with identical twin girls and due date is set for December 16th but when we are having the babies it will be a C-Section and that day is just been scheduled for December 2nd. So looking forward to that and two little boys at home, Sayer who is three years-old and Urban who is about 15 months-old.

Destiny! What about you?

Destiny Bochinski: My name is Destiny, I am 34, I am physical therapist and actually specialize in Pelvic Floor treatment. I am due November 2nd with a baby girl and I have a son at home, he will be three in October so right around his birthday is when we are expecting her. I am planning my second home birth.

Sunny Gault: Very Exciting!

Jessica!

Jessica Blagg: My name is Jessica and I am 29 and I am a medical biller and my due date is March 8th and we are not sure yet of the gender but the soon as we can we absolutely will find out and we one other child, she is eight and this time we are really hoping for VBac.

Sunny Gault: Brigid!

Brigid Santiago: I am Brigid, I am 28. I am a non-profit fundraiser in health care. I am due December 19th with my first baby. It is a little boy and we are planning a natural child birth with a midwife but in a hospital.

Sunny Gault: Okay! Well ladies, thank you so much for joining us today.

[Theme Music]

Sunny Gault: We have a question from one of our facebook friends actually, this comes from Whitney, if you guys want to send us a question feel free to just go ahead and post it on our facebook page and we will check with our expert.

So Whitney says, “I have two natural births and I am beginning to think about the third one (she is pregnant with her third) with the first two I pushed in bed on my back, my doctors and I had discussed pushing positions and advance and they said they would let me lead the way and find a comfortable pushing position. However, in both births I was already on my back for an internal exam, they told me I could push and I just pushed where I was, it didn’t even occur to me to change positions. I didn’t push very long, twenty minutes with the first, about two minutes with the second and I had second degree tears both times. I read that different positions my decrease my chances of tearing”.

Karen Martin: Hi Whitney, my name Karen Martin, I am a dower and a chopper’s educator. Your pushing stages are quick, that is great and there are some other positions that can reduce tearing but also keep in mind that factors such as good nutrition and genetics can also play a role, in attending birth I found that positions as well as the method of pushing can really affect whether you tear or not.

First always go with your natural instinct, if all force feels right to push then go with, all force or hands and knees can take pressure of the perineum and flow a fast baby down. Seems like you may have some fast babies with those short pushing phases. But the next method is how you are pushing, you can ease your baby down by blowing or making pha-pha-pha sound when the urge to push is there, this will allows your tissues to slowly stretch with the baby instead of using extra force to push the baby or force the baby out.

Your body is equipped with a natural explosion reflex, which is designed to expel your baby gently when it’s ready to enter the world. Also by holding your hand on the top of the baby’s head your natural instinct will let the baby ease down and you can offer little counter pressure to slow it down. I also have my mom’s visualize strong tissues that move and flux like a rubber band, never tearing and always back to the original shape. Its different for every mom, but slowing things down and letting your gut being your guide have always show me the best results. Hope that helps good luck with baby #3.

[Theme Music]

Sunny Gault: Today we are continuing our discussion on pregnancy symptoms, last week we focused on the first 20 weeks of pregnancy, and this week we will focus on the last 20 weeks of pregnancy, Dr. Nick Capetanakis is a featured expert on our show, he is an OBGYN, and he is joining us via phone, So Dr. Cap welcome to Preggie Pals.

Dr. Nick Capetanakis: Good morning! Thank you for having me!

Sunny Gault: Absolutely! So, as far as timing’s are concerned every pregnancy is different, it’s not that like ride it 20 weeks, you are going to start feelings all these symptoms, but we at least want to touch on some other things that you might be experiencing towards the end or the latter half of your pregnancy. So the first symptom is insomnia. I know a lot of women including myself, we were getting up a lot in the middle of night to pee and do a bunch of other things but just being able to find a position that is comfortable enough I think that kind of fits into this insomnia as well. And then just being able to sleep in general, so Dr. Cap do your patience’s come to you with issues with insomnia.

Dr. Nick Capetanakis: Absolutely! Towards the end of pregnancy once the uterus is grown quite a bit you get a lot of different symptoms and those symptoms can prevent you from sleeping. Not only you getting up to urinate a lot because you are giving that pressure on that bladder and you are feeling that sensation of fullness which you are starting to have the back pain that comes along with pregnancy.

Some people also have a little bit of shortness of breath that comes along with pregnancy and you add all those together along with feeling hot and not being able to get comfortable and women generally have a tougher times sleeping. I mean some of the things that we talk about are if you are running a little bit hot may be try to sleep with a little fan on to keep your body temperature a little bit lower.

The other thing is pillows, pillows, pillows, I mean, I don’t know how many time like I kicked off the bed just because of the numerous pillows that were in the bed but if you put a pillow between your legs when you lie on your side it will help to alien the spine and that will kind of cause you a little bit less back pain.

I mean, some time putting pillows behind you but if you tend to rollover, you don’t rollover, let’s say laying on your back completely flat, that can help and sometimes I do have some patients tending to sleep in a reclined position, the lady put numerous pillows and kind of ramp themselves up, or they sleep in a recliner which lets them get a little bit more comfortable and allows them to sleep but unfortunately when you add all of the symptoms (unclear) it can make for some sleepless nights.

Sunny Gault: So ladies, how many of you guys are in the last 20 weeks of your pregnancy?

Destiny Bochinski: Me!

Sunny Gault: Me too! So Jessica you are the only one that is not.

Jessica Blagg: But I have been there before.

Sunny Gault: But you have been there! That’s right. So insomnia; not being able to sleep, did you guys experience this and then with that, what was your experience like?

Destiny Bochinski: Yeah, I love my sleep! I missed my sleep when my son was less than two, for first two years after he was born, and then I just feel like I just got it back and then I got pregnant.

My insomnia actually didn’t start until recently and I had a couple of bad weeks where I was just tossing and turning and I would go to sleep for a little while and then I think I would just wake up uncomfortable and it got a lot better when I just got body pillow. It was mostly position and I think I was waking up, my hips were uncomfortable and I have to change and then I think the baby also started getting in a better position for me to and so – I have been a lot more comfortable lately and it hasn’t been, the baby in the side waking me up, it’s been my son waking me up lately.

Sunny Gault: I am actually borderline thinking about getting one of those body pillows. Last night was actually really difficult night for me, I woke up and I had like this really like weird back pain, not like back pain I mean labor, but like back pain like I slept on something wrong and my perinatologist was told me you can’t just sleep on your back because I mean, I am already I look like I am 30+ weeks, even further along in that and I am only you know, just 24 or so weeks.

So things are progressing a lot further because there is two of them in there and so I have already found myself not being able to – I can’t even lay on my side, like everything feels squished on my side and she was telling just you can’t lay on your back. I was able to sleep, I don’t really necessarily insomnia but I woke up in the middle of night where there is extreme back pain and I just said “What am I going to do?” My first thought was maybe I just get one of those pillows or something, it kind of positions me a little bit better.

Destiny Bochinski: They have got the pregnancy body pillows, I only need just a regular body pillow, just because we already have one but it know for a lot of people the horseshoes U shaped ones those really help them a lot.

Jessica Blagg: The husband blockers! But you already have a husband blocker in front anyway. So he might as well be comfortable.
Sunny Gault: So many ways! Yes! Exactly! So let’s move on to the next one, “back pain”; have you ladies experienced back pain and that increases obviously the more pregnant you are and further when you are in your third trimester that you got, so Dr. Cap talk a little about back pain, what’s triggering this in our bodies?

Dr. Nick Capetanakis: As you grow old the center of gravity changes and that lower back spine actually arches back a little bit more and you get a lot of little pressure in your lower lumbar region, that is physiologic, as the belly grows the back half of them bend so that the center of gravity kind of stays where it needs to be so that you just not falling over on it all the time and unfortunately that can cause a little back pain.

Things that I talk to my patients are about how we fell that core exercise are extremely important. I am not talking about laying on your back and trying to do a 1000 crunches, I am talking about yoga, I am talking about swimming, I am talking about plaids, I am talking about just strengthening the oblique’s below back and all the muscles that are needed for posture and that will help kind of prevent and some of the backing by strengthening those muscles.

Other things you can do (unclear) are excellent and help adjust behind the spine, acupuncture can help, some people put a little heat on the muscles at the end of the day, some people like a little ice on the muscles at the end of the day. Stretching during the day can help, it’s all little spills, there are on the clinical belts that you can wear over the shoulders that will help to rest the uterus, just enough to kind of take some of that pressure off that little back to relive that pressure and unfortunately some people strain – take a little bit of tough you know, which is okay, if your pain is not bad but a really important factor firstly my patient to be physically active and strengthening those muscles and help through pregnancy.

Sunny Gault: Ladies experience with back pain, anything you want to share, any stories?

Destiny Bochinski: Like early in the second trimester I had one week of severe back pain and I ended up deciding it was just all baby position or growth spur, or something related to that because in a way, and I – you know, I treated it unfortunately because I am physical therapist I work with a lot of physical therapist and I had free treatment so and I got in the pool a lot and that’s one of the things I have discovered with all my patience is the pool is the best thing. You feel so good and it help so much back pain, and it’s my plug for physical therapy as well, and but I had one week of really bad back pain and I had some pelvic pain issues, but it’s all been pretty manageable.

Sunny Gault: What about you guys?

Jessica Blagg: I definitely had some back pain, it started, probably around of beginning of my second trimester, and I – to had my first prenatal massage a few weeks ago and that really helped and I really need to do that more often. I am going to have another one next week, because I already – I mean, I feel a lot better still even and I think I am partly paying more attention to my posture I think that’s a lot of it is – paying attention to my posture and doing more stretches. I think it’s really help to and I am trying to make myself good opinion overcast just has not happen yet.

Sunny Gault: Kind of something that kind of go along with this a little bit, but in addition, to the pain we are feeling in our back and perhaps in our tendon areas leg cramps, I just have this for the first time the other day, I am talking more about like Charlie horses that you get, is this something Dr. Cap that’s common in pregnancy?

Dr. Nick Capetanakis: Absolutely! Leg cramps are very common, we are not 100% sure what causes the nature, one thing is obviously the extra weight causing anxious pressure on the caps. The other concerns we always talk about the dehydration, and sometimes electrolyte, both magnesium and potassium are very important as we run I will tell you. So leg cramps can happen for a multitude of reasons.
Ways to avoid them, I will talk to patients about making sure that they are taking some magnesium and extra potassium and also the stretch at night, it sounds kind of funny, before you go to bed if you stretch your calf even during the day and mostly at night and that can hopefully prevent that. The other important thing is also water, you make sure you are well hydrated and take care of yourself and hopefully that will help leg cramps.

Jessica Blagg: I even had knee Charlie horses, I am still like 23 weeks, so I don’t there is plenty of time probably but I do take it daily magnesium supplement because of I get migraines and that helps with that and so I haven’t had any – I have had foot cramps though that are the same kind of thing where your foot like tenses up and me God – God what’s happening to me like back when I use to dance, that’s crazy.

Sunny Gault: So the last one on our list before we take a quick break is that a lot of people experience this seems like a com, this is like my mantra when I am pregnant, heartburn and then it kind of go along with that, belching in gas but I think – that’s the sexiest thing ever.
Stephanie Saalfeld: My husband and I had burping contest, it was funny.

Jessica Blagg: You won, you won.

Destiny Bochinski: I am sure. He would look at me like “who are you?”

Sunny Gault: But the heartburn thing, that I mean, that has hit me with every pregnancy and that one you don’t really want to have a competition for but anyways let’s start with heart burn, anyone experience heartburn?

Brigid Santiago: I was so fortunate; I think I am like the only pregnant person that doesn’t get heartburn.

Jessica Blagg: So bad that my last trimester with my daughter I just could not even lay down, I had to sleep sitting up and chug milk and toms –

Brigid Santiago: No, I ate toms like there were candies.

Sunny Gault: Toms just not work for me.

Brigid Santiago: And then it was stopped working, so then I had to do the …

Sunny Gault: I had to do Zantac, I had to use hyrosack. One thing worked for me and I didn’t even know about it but my perinatologist told me about for this pregnancy, Pepcid – have you guys – you know, what Pepcid is? I literally though it was like a liquid form, I don’t if it used to be liquid, but now they’ve got these tablets, they kind of look Toms and I guess all these medications they work differently with different people.
So they really isn’t want to fix it for everybody, but we are tireless and if Toms aren’t working and we don’t want to get on medication I mean, talk to your OB or your medical provider but Toms is something you can buy over the counter and it really worked for me. Its’ like the first thing other than regular medication like Zantacs that actually worked.

Dr. Nick Capetanakis: Progesterone is increased in pregnancy, progesterone is kind of slows down the intestine in the GI track. Also progesterone makes the valve that closes esophagus to the stomach, a little bit kind of leaky, so you have more reflux during pregnancy, you probably a little bit more sensitive also to triggers.

Triggers usually are tomatoes, spicy foods, sometimes caffeine all can make that reflux a little bit worst. One thing you can try to do is eat and not lay down within two hours, like your stomach kind of empty so that they will increase as much when the acidic environment you kind of get that reflux going. If you lay down too quickly that valve increases kind of that leakiness and the heartburns kind of increase.

As far as the belching and burping I am sure you guys do it all the time you know, I am not just blaming on pregnancy, however its probably also related to the progesterone and that seems it’s just slowing down. Ways to avoid the heartburn like I said is try to not eating and lay down and avoid your triggers again spicy foods, and usually tomatoes or anything acidic.

Toms usage in pregnancy, you can also just try chewing up a couple of Toms to avoid heartburn and then we also have medicine like you know, like Pepcid which is the(inaudible) and that you can try but you can always again try to avoid your triggers and do these little tricks and if all those fails there is medicine.

Sunny Gault: So that’s heartburn, belching and gas, any other comments – anyone else contest with their spouses like Stephaney so that you can burp the offer better or whatever?

Stephanie Saalfeld: There is no contest.

Jessica Blagg: And the gas, I mean, let’s face it, let’s be real, you know.

Sunny Gault: When it comes to my husband like I just, you know, he just has to understand, like I kind of did a caviar like in the beginning of the pregnancy and I just like okay I am getting to that point where I can’t control a lot of stuff and it’s really embarrassing when it happens like in the middle of night and then he will me the next day like – “Oh my God you did this and that”, and I am like first of all I was sleeping, thank goodness I was sleeping and it wasn’t that insomnia moment, right, but I think that – you know, I just was the thing that could apologizing, for I try to control it when I am around other people but if I am just at the house, I am not going to – I just not – it takes too much effort.

Jessica Blagg: The worst is when you are at work, after lunch and you get tired, so don’t really feel like holding things back anyway, but you got to work with people I mean, I don’t have a cubical job, I would love to at that moment because.

Brigid Santiago: I listen to – actually Preggie Pals that works well, I still can hear myself, so its fine!

Sunny Gault: If you can’t hear it, then it doesn’t matter. When we come back we will wrap up our list of common pregnancy symptoms during the last 20 weeks of pregnancy we will be right back.

[Theme Music]

Sunny Gault: Welcome back, today we are breaking down the most common pregnancy, symptoms you may notice within the last 20 weeks of pregnancy Dr. Nick Capetanakis is an OBGYN and a featured expert for Preggie pals’ is on our show today, he is joining us via phone. So let’s continue with our list here, “shortness of breath”.

Dr. Cap, why typically causes the shortness of breath. I feel like this increases, the bigger the belly you get sign I know I have looked at some diagrams of how much the baby impacts the body as the baby is growing and man it’s really up against your lungs, so is that what’s primarily causing the shortness of breath?

Dr. Nick Capetanakis: What usually happens is actually the diaphragm which kind of controls your breathing and your lung expansion; it gets pushed up in pregnancy because of the space issue. So you don’t have very much space and the diaphragm gets pushed up and then the lung can’t expand as much.

One way the body tries to compensate for that is trying to increase the diameter of the rib gauge and some people will have that sharp pain up in the right side or the left side as those ribs you open up and you will notice that your rib gauge size actually increase in pregnancy to try to compensate to allow that extra volume.

So the uterus pushes that diaphragm up you can get some sensation of shortness of the breath. I would say 99% of the time shortness of breath in pregnancy is not that much of a concern but when you start having shortness of breath, increase in swelling and that shortness of breath is occurring at rest and it’s not necessarily like going upstairs or even walking to the bathroom, when you start having it more so and again the state of rest then we do kind of get concerned a little bit.

We may send to cardiologist just to make sure your heart is fine because the heart does work a little more in pregnancy. Your heart rates goes up and try to move more volume. So rarely can there be something else that is causing that shortness of breath. But again it is very rare and if you are having shortness of breath while at rest you probably should let your OB know.

Sunny Gault: Ladies, shortness of breath; now this could be triggered by something or just in general just kind of doing your daily activities. But when – I am sure you guys did experience this so I guess the question is at what point in your pregnancy does this usually happen?

Destiny Bochinski: I feel like it was like pretty much right at the end we just get so vague if you like – there is no room for your lung…

Sunny Gault: That’s what I feel like, yeah, for sure.

Jessica Blagg: Well for me I felt like it was almost towards the end of my second trimester with like all the blood volume changes and everything like it was harder for me to push all the blood and I got swelling early on too. So I had a lot of blood flow, lot of fluid in my body, it looks like I got harder for my circulatory system to push all that and so the shortness of breath came on early I think.

Brigid Santiago: For me it was in the beginning and then towards the end, towards the end and I don’t know if this probably goes along with it but like you wove and wove every move you make, sitting down, standing up just anything.

Sunny Gault: I think too, you know, I think we talked about this in our last episode but when you are caring for more than child like I think that really provokers it too, because my little guys are running around constantly and find myself things that could easily do before and just like there is no way.

Thankfully there are starting to get little bit older and they are starting to listen to my commands a little bit more so instead of me having to hunt them down because they are running around without their underwear on, they can come to me and I can put their underwear back on them but that’s – and that in steps because I’ve got – I have a two story and there is no like middle landing or anything like that so every time we go down for like lunch or breakfast or whatever the kids stay something down the stairs and I have to go get it and I am just like huffing and puffing of the stairs that’s the another time when I notices that.

Kind of to go along with shortness of breath is “exhaustion”, ladies at what point did you really feel exhaustion in your pregnancies and what was that experience like for you?

Destiny Bochinski: I think it’s totally different, last time it didn’t happen until the end. I worked up to the day before I went into labour. Not planned, he was two weeks early but and so I didn’t really have that major exhaustion but this time with a two your-old it’s totally different, because I am spending way more energy so I feel like I already moments of exhaustion every evening.

Stephanie Saalfeld: I had really bad fatigue in my first trimester and now I am like the sweet spot where I am like, yeah, life is great, pregnancy is the best. But I do find that I get exhausted more easily obviously than I would before I was pregnant, so like – I was on vacation a few weeks ago and I went for a really long walk and normally that be no big deal but I came back to the hotel and I was like Oh, alright, that time I am going lay here for a while and not go anywhere…

Sunny Gault: You are completely exhausted, naps whether a half hour or 15 whatever, that can really help. Dr. Cap are there ways that you typically, when you have a patient come in and they are complaining of extreme exhaustion what are some of the ways that you recommend trying to prevent that or even manage a little bit better?

Dr. Nick Capetanakis: Take naps, that’s a tough one, so you should be chasing around little ones I would say take advantage of when they are taking nap just try to take a nap for half an hour. Some people do really with those power naps. Again exhaustion is part of the whole last part of pregnancy, and so it’s the part of the first part of pregnancy but there is really a magical trick to it.

I wish I could tell you there was some vitamin deficiency or something like that, you know, iron as your knee and neck that definitely can cause some when you are in your OB, you should check your hemoglobin around 28 weeks but other than that again its kind of one of those symptoms that you just try to manage the best you can try to take naps, drink plenty of water and try to take care of yourself.

Sunny Gault: So the next symptom of our list is “contractions”, I actually had a scar with this last weekend. I have never had contractions other than when I have been in labor, where cramping – I am just been really fortunate in that area and woke up a couple of days ago, it’s like 4:30 in the morning and I am starting to feel little crampy and I wasn’t sure if it was into indigestion, I just had to go to bathroom or what was going on there.

So I though okay I am going to wake up, I am going to monitor myself a little bit and in a couple of hours go by and there was nothing I could time, nothing like that but it was just like menstrual cramps. I really started to freak out and then came in like some lower back pain issue, and I am going okay, I know some signs of pre-term labor, and these kind of fall in that category and I actually called Triage and went in and they checked me and I was fine.

But I never had that happened before. Braxton Hicks I think kind of falls into this category as well, it’s kind of an overall tightening that you feel and I’ve been having that already, which totally fix me out because I am just over halfway thought the pregnancy and obviously babies aren’t viable yet. So I am like… at every little symptom thing I am like “Oh my gosh what’s going on”, and it’s so hard to compare a singleton pregnancy to a twin pregnancy.

So I know things that are going to happen much faster, but that’s been my experience with contractions, I know some people on facebook, Stephanie were kind of chatting about contractions, so what are they saying?

Stephanie Saalfeld: One of our virtual panelist questions, I asked if anyone had experienced contractions in the latter half of their pregnancy and how they dealt with them, and our facebook friend Doseria said she contracted a lot during all of her pregnancies and with her second son she contracted every 3 to 5 minutes for the last month.

Sunny Gault: “Oh my gosh”, see that will totally freaked me out.

Stephanie Saalfeld: Well, and she says, so when she went to be induced, they thought she was ready in labor because of the contraction. So to deal with them she said would lay down on her side and put her feet up, drink lots of water or sometimes, in a bath and so I think that’s pretty typical. Right, I mean, not the frequency in which she was contracting but like the way to deal with it.

Sunny Gault: The way to deal with it! Dr. Cap what do you think about that, when it comes to contractions what are some good ways to deal with those to… obviously we are trying to prevent any kind of pre-term labor and just take of ourselves, so what are things you recommend your patients?

Dr. Nick Capetanakis: The uterus is a big muscle and sometimes dehydration can cause some irritability or some contraction. If you are feeling on occasional contraction very normal, if you have any more than 5 in an hour I would say and they are somewhat painful I would let your OB know like you said or labor and delivering them. But contractions within themselves, for the most part are fairly common, if your exhaust at the end of the day, you will be hydrated, you are tired, those can all cause contractions.

So one thing we talk about are fluids, drink in two big glasses of water, go lay down, got off your feet, and see it they do work, if they don’t go away let your OB know. We use the term Braxton Hicks as you know, who practice contractions or I guess practice contractions but in essence that’s kind of what the uterus does when you normally contract.

When you go on to labor they are all contractions, the Braxton Hicks that you saw are painful and then usually when you don’t let tie up at your service. So we kind of use it as a term as a practice contraction and again if you are having more than 5 an hour and they are painful you should let your OB know, get off your feet, drink some fluids and see how you do.

Sunny Gault: So we talked about the next symptom actually in last week’s episode its wearing its ugly hat again, you are in frequency which I guess like in the first 20 weeks that there is a lot your body is going thought but I think towards the end its really about baby pressing down on bladder and really again the baby is just taking up so much room in your body your other organs just aren’t functioning in the same way.

Destiny Bochinski: My baby is doing this fun little thing and she loves to like grind her head on bladder, it’s like she is looking around for something inside my pelvic and so I just feel like twisty little torque on my bladder and –

Stephanie Saalfeld: She is looking for a pillow.

Sunny Gault: May be you have a very comfortable bladder.

Destiny Bochinski: So the frequency or the urge to go kind of comes and go with just how she is moving her head, it’s not like a really regular frequent urge it’s just every moment its’ like “Oh my goodness I really got to go” and then she will stop and then it will go away. But there is nothing more infuriating then having you really bad and then sitting around the toilet and like not having anything to go because you just got weight on your bladder.

Dr. Nick Capetanakis: The real thing is just try to void more frequently, sometimes if you void on your own every 2 or 3 hours keeps the bladder little bit smaller so you are not over expanding it and then having that urge to going to the bathroom. I know it sound kind of vague but I wouldn’t wake up to urinate because you probably do on your own but if you try to keep your bladder a little bit less expanded during the day and don’t go on those long stretches of 5 to 6 hours sometimes that can kind of help keep that bladder a little bit smaller and those symptoms a little bit less.

The other thing is caffeine, overall caffeine is believed to be safe in pregnancy, American college of OBGYN says couple of coffee a day is fine but that can also make you as a diuretic, have to urinate more, cutting out mass amount of fluid after 8 pm before you go to bed, probably a little bit helpful. Big uterus and small bladder and you can get that frequency.

Sunny Gault: Let’s talk about “swelling a little bit”, I think we talked about this just a little bit in the past but swelling, bloating all kind of comes together, just over all just kind of feeling like you are one big stay puff marshmallow women. I have already, I mean, usually that doesn’t hit me until like weeks may be I don’t know after 30 weeks.

I have had it with both of my boys and I get like hobbit feet like it’s really, really ugly. But I start to getting at a couple of weeks ago already with the twin and I guess I should have expected that. I have heard a lot mom’s who have had twins that practically at the end it’s so uncomfortable you can’t even really move.

But one of the things is the swelling, so but what about you ladies, did you experience a lot of swelling, not just in your feet, and that’s kind of the first thing I go to but even in your hands like not being able to wear your wedding rings and stuff like that, what your experience?

Destiny Bochinski: I had the most beautiful crinkles in my first pregnancy. I still do. I mean. Mine started early with my son, mine started early in the second trimester the first time and I was swollen the entire time, and this time its way better and I am doing different things to manage it. It’s so much better, I still get swollen and sitting too long I found is the number one thing that will make my legs and my ankle swell up is to sitting long time sitting long periods of time.

Brigid Santiago: I am glad to hear that leg your second time is not as bad if you manage it because for me like around 24 weeks I would say I started getting really bad carpal tunnel, and that’s from swelling so I retained so much fluid, in the end I had gained 45 pounds and I lost 30 within 2 weeks so that was all fluid. So really I can say I only gained 15 pounds.

The rest of my…I didn’t look super swollen I mean, I could wear my rings, my feet looked okay, but now that I look my feet, I am like “Oh yeah they were swollen”. But like it happen gradually I guess, so I didn’t really noticed it as much and my mom said that my nose has got bigger and I think that’s from swelling too.

Dr. Nick Capetanakis: Unfortunately yeah, a lot of the swelling issues are just kind of your body’s make up. Some people get varicose veins, some people get spider veins things like that and swelling is part of that. We think that fluid from the lower extremity is just doesn’t make it back to the heart and it backs up and actual vessels and goes out into the tissue and cause you that swelling.

So a few things, well just making sure that you are well hydrated, it sounds kind of backwards but actually more fluid will help more circulation and hopefully get that smoothly out of your body. So if you just in order to sit in a chair and raise your leg that can help and unfortunately some people need where what’ called ted hose or stockings that help kind of compress the legs they are quite tight and help move that fluid.
Staying active sometimes it can help because as your caps squeeze and it also propellers some of that fluid back to the heart and gets processed through the kidneys so, all those things can kind of help.

Jessica Blagg: Weird things, my midwife actually said eat more salt. Sea salt which is like contradictory to what they tell you when you are not pregnant that it makes a huge difference. If I eat more sea salt and put things that may be interesting pressure for that electrolyte type of thing.
It’s because your blood volume is increasing, so because you have increased blood volume and you need increase salt and if you don’t have that increased salt then you start leeching fluid out of your blood vessels into the space and in between so you start swelling more. So that was one of the things that made the biggest difference for me was eating more salt on a really regular bases.

Brigid Santiago: Yeah, my birth education class recommended salting your food to taste in everything but didn’t said why, so that makes sense.

Dr. Nick Capetanakis: I have never heard of that, I guess it is to believe that the salt will then pull some of the fluid back into the vessels but I have never heard that necessarily it will treat for swelling parse.

Sunny Gault: Well, thanks to Dr. Cap for joining us today, this conversation continues for members of our Preggie Pals Club. After the show we will discuss how your pregnancy symptom can change during each subsequent pregnancy. So for more information about our club visitor website www.preggiepals.com

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Sunny Gault: Before we rape up today’s show here is Dr. Danny Singley, with tips on becoming a new Dad.

Dr. Danny Singley: Hi Preggie Pals, My name is Dr. Daniel Singley, I am a licensed clinical psychologist, specializing in men’s issues and founder of Basic Training for New Dads. Let’s take a couple of minutes to focus on how expected couples can approach the process of birth planning. People approach birth in very different ways and there is no one size approach that will work for everyone.

Many expecting couples choose to develop a plan for how they want to handle the period from immediately prior to the birth to the point of which they leave the hospital or birthing center. The point of a birth plan is to have a road map regarding your preferences for the process of having your child, keep it simple, one page of info is plenty so need to pick out the linen to your delivery room.

Common considerations include weather to have a virginal birth versus a C-section, pain management options, what medications and immunizations to have administered to the baby and to mom and whether mom should be uptown by mom’s head or alternately downtown.
The list of considerations will be unique to any couple but you can access a list of key questions and templates at the birth plan page of the American Pregnancy Associations website. Childbirth.com and The Bumper are other examples of online resources that offer free customizable templates to help you guide the planning process.

So take a look at those examples. Because Dad’s often aren’t sure how to be involved in the planning and birth process having him tick point on identifying a template and charting information about the plan is a great way to get him to understand his integral to the pregnancy and birth process.

Finally, its critical that once you and your partner have developed the plan with you are comfortable you also need to be flexible if the plan needs to change during the actual birth process. Even more importantly you, your partner and your health care provider need to have discussed what plans A, B and C might look like.

So if you are completely against in apteral and spinal block or C-section, specific vaccinations or other types of procedures rather than simply ignore the possibility that you might need to use one of them its critically important that you and your partner have discussed how you would handle this type of option should it come up.

The last thing you want do during the birth of your child is try to ash out this decision on the fly.

Thanks very much for listening. I hope this information is helpful I am Dr. Daniel Singley at www.newdadsclass.com and be sure to keep listening to Preggie Pals for more tips on how new dads can hit the ground running in their transition to fatherhood.

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Sunny Gault: That wraps up our show for today, we appreciate you are listening to Preggie Pals, don’t forget to check out our sister show Parent Savers, for Parents with New Born, Infants and Toddlers and our show The Boob Group for Moms Who Breastfeed Their Babies. Next week we have another episode in our getting pregnant series for those of you who have the tough time conserving you may be considering a basic infertility evaluation. We are going to explain what that means and what you can expect. This is Preggie Pals; “Your Pregnancy Your Way”.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts.

Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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