Actor Deepika Padukone has shared her pregnancy difficulties in a recent interview, saying the third trimester was particularly challenging as she experienced rib pains and aches. Although many women focus on the initial months of pregnancy, the last trimester of pregnancy -- week 27 to 40 -- may become difficult to negotiate for some as the developing foetus puts pressure on the mother’s body. “Such complications are quite common and there is no need to build anxieties. Only additional care and monitoring are required to ensure the safest outcome for both mother and child. Women over 35, who are pregnant the first time, are more likely to experience complications,” says Dr Anita Kaul, senior consultant of foetal medicine and gynaecology, Apollo Hospital, Delhi. Pre-existing medical conditions such as diabetes, hypertension, thyroid issues, kidney disease, and autoimmune disorders can increase the risk. “It’s important for intending mothers to assess these conditions in the pre-conception stage,” she advises. Why does physical discomfort increase in the last trimester? Physical discomfort, such as shortness of breath, frequent urination, swelling and back pain, can increase as the baby grows and puts more pressure on the mother’s organs. The expanding uterus may even slow down the blood flow to the heart, causing palpitations. Pregnancy hormones slow down digestion, and the growing uterus presses on the intestines. So in the third trimester, expect heartburns and constipation. Your veins may swell up, triggering pain. Backaches and sharp jabs in the rib cage are pretty common as pregnancy hormones relax the tissues around the pelvic bones to allow space to the foetus. The expanding uterus also stretches out muscles in the stomach area, stressing the back. Sometimes you may feel like the baby is dropping, with waves of contractions. These tend to get stronger closer to the delivery date. Contact your gynaecologist if there are more than six contractions an hour and they get stronger. What about gestational diabetes? This manifests in the third trimester. The placenta produces hormones like lactogen, estrogen and cortisol, which impair the body’s ability to use insulin effectively. But the mother needs more insulin to manage the increased blood sugar from food she has for foetal development. This unmanaged sugar leads to gestational diabetes. What about potential complications? High blood pressure disorders like preeclampsia are common concerns during the third trimester. The blood vessels in the placenta may develop abnormally, become constricted, restrict blood flow and elevate blood pressure. There could be placenta previa, when the placenta lies low in the uterus as it expands and obstructs the cervix. The placental blood vessels could tear a bit, causing bleeding. A bed rest is recommended. Sometimes the placenta prematurely separates from the wall of the uterus before the baby is born. Then doctors prescribe medication to stop contractions or go for an emergency C-section. Foetal growth complications could arise where the baby doesn’t grow at the expected rate. But all of these can be controlled with regular check-ups and consulting your doctors.
