Pregnancy

THIRD TRIMESTER DOCTOR VISITS

By Julianne Deveraux

Frequent office visits
In your third trimester, your visits to the doctor or midwife will increase from once a month to once every other week, until your 36th week. The doctor will:

• Monitor your weight gain. During your third trimester, you should be gaining three-quarters to one pound a week.
  
  
• Monitor your blood pressure.
  
  
• Screen for diabetes at 28 weeks.
  
  
• Check your urine sample for sugar and protein.
  
  
• Listen to the baby's heartbeat.
  
  
• Check the size and position of the baby by feeling your abdomen.
  
  
• Examine your feet, ankles and hands for signs of swelling.

Writing your birth plan
Of course, you want everything to go smoothly once you start labor and begin delivering your baby. A birth plan can help make this special time even more meaningful. A birth plan is an informal agreement that represents an understanding between you and your doctor, and nurse, about your choice of anesthesia, whom you want present during delivery and whether or not you'll breastfeed. Ask your prospective doctor if he or she will abide by such a plan, provided your birth is a normal, uncomplicated vaginal delivery.


When will labor start?
It can be difficult to tell when labor begins, particularly if this is your first child. Here are some warning signs labor will begin within days:

• You see an increased and thickened vaginal discharge.
  
  
• The mucus plug that has sealed off the opening of the uterus is expelled.
  
  
• You experience an intensification of Braxton-Hicks contractions, those spasms you may have been feeling in your lower abdomen.

It's time to call the doctor when:

• You see a "show" or blood-tinged mucus discharge from the vagina.
  
  
• Your waters break, either in a gush or a trickle.
  
  
• You feel contractions at regular intervals, and the intervals gradually shorten.
  
  
• The intensity of the contractions gradually increases.
  
  
• You feel discomfort in your back and abdomen.
  

Your doctor will probably tell you to start for the hospital when your uterine contractions: 

• Are repetitive.
  
  
• Are coming five to six minutes apart.
  
  
• Have persisted for an hour or more (depending on your distance from the hospital and your previous labor history).

How to tell if it's false labor
The contractions you feel may not be the real thing. In false labor, you're having Braxton-Hicks contractions, which decrease and go away. They're real (not false) contractions, but they're not the productive contractions of true labor that result in the necessary uterine or cervical changes. Braxton-Hicks contractions usually stop when you get up and move around. Showing up at the hospital with false labor is fairly common for first time mothers, so don't be embarrassed if you make the trip and then get sent home. Just consider it a practice run!

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