3rd Trimester Pregnancy Concerns

3rd Trimester

• Most comfortable stage for many women during pregnancy.
• Common fears include labor pain, mutilation, and death.
• Anxiety often arises from anticipated responsibilities as a parent.
• Nesting behavior and role-playing become prevalent as preparation for birth.

Factors Contributing to Difficulty Accepting Pregnancy

• Unintended pregnancy can lead to emotional distress.
• Discovering a multiple pregnancy may complicate feelings.
• Developmental abnormalities in the fetus can cause significant anxiety.
• Close spacing of pregnancies (less than one year apart) can add pressure.
• Relocation during pregnancy necessitates finding new support systems.
• Role reversals in family dynamics can create tension.
• Job loss in primary support person impacts emotional stability.
• Partner infidelity may lead to relationship dissolution.
• Significant illness in oneself, partner, or family members adds stress.

Menstrual Health

• Basal body temperature decreases slightly before ovulation and increases after.
• Mittelschmerz is localized pain associated with ovulation.
• The menstrual cycle varies in the first fourteen days, while the last fourteen days are more predictable.
• Ovulation typically occurs on the 14th day of a 28-day cycle.

Exercise and Well-Being During Menses

• Moderate exercise can enhance well-being during menstruation.
• Excessive sustained exercise can lead to amenorrhea.

Sexual Relations and Menstrual Cycle

• Sexual activity is not contraindicated during menstruation; condoms are recommended.
• Orgasms may increase menstrual flow, and conception, while rare, is possible during menstruation.
• Activities like running or bathing are generally safe during menses.

Pain Management

• Prostaglandin inhibitors (e.g., ibuprofen) are effective for menstrual pain relief.
• Local heat application can offer additional comfort.
• Avoid aspirin in adolescents due to Reye syndrome risk.
• Rest is beneficial if dysmenorrhea disrupts sleep.
• Iron supplementation may be necessary to replenish losses during menses.

Sexuality Aspects

• Fetishism: Sexual arousal from specific objects or situations.
• Transvestism: Dressing as the opposite sex to adopt that role.
• Voyeurism: Sexual arousal from observing others undress.
• Sadomasochism: Inflicting or receiving pain for sexual pleasure.
• Pedophilia: Sexual attraction to children.
• Exhibitionism: Publicly exposing one's genitals.

Sexual Disorders

• Erectile Dysfunction: Difficulty achieving or maintaining an erection.
• Premature Ejaculation: Ejaculating prior to vaginal penetration.
• Vaginismus: Involuntary muscle contractions during attempted coitus.
• Dyspareunia: Painful intercourse, often linked to vestibulitis.

Endocrine System Changes During Pregnancy

• Hormonal changes impact physical balance and processes.
• HCG hormone levels peak during the third month and then decline.

Integumentary Changes

• Striae Gravidarum: Stretch marks develop from skin stretching.
• Linea Nigra: Dark line from the symphysis pubis to the umbilicus.
• Chloasma: Pigmented facial patches known as the "mask of pregnancy."
• Vascular spiders may appear on the skin.

Reproductive System Changes

• Amenorrhea results from sustained high levels of estrogen and progesterone.
• Signs of pregnancy include:
  • Chadwick's Sign: Bluish coloration of the cervix and vaginal mucosa.
  • Goodell's Sign: Softening of the cervix indicating pregnancy.
  • Hegar's Sign: Softening of the lower uterine segment.

Uterine Changes During Pregnancy

• Length increases significantly, from approximately 6.5 cm to 32 cm.
• Depth grows from 2.5 cm to 22 cm.
• Width expands from 4 cm to 24 cm.
• Weight increases markedly from 50 g to 1,000 g.