What to expect when you're expecting (112 page)

Questions and problems you want to discuss—have a list ready

“I was feeling really energetic for the last few months, and now I’m starting to drag again. Is this what I have to look forward to in the third trimester?”

Pregnancy is full of ups and downs—not only when it comes to moods (and libidos) but when it comes to energy levels. That trademark first-trimester fatigue is often followed by a second-trimester energy high, making those typically comfortable middle months the ideal time to pursue just about any activity (Exercise! Sex! Travel! All three in one weekend!). But by the third trimester, many moms-to-be find themselves once again dragging—and eyeing the sofa longingly.

And that’s not surprising. Though some women continue to sprint as they
close in on the pregnancy finish line (remember, every pregnancy is different, even when it comes to energy levels), there are lots more good reasons why you might be lagging behind. The best reason can be found around your midsection. After all, you’re carrying much more weight there (and other places) than you were earlier on—and carting those extra pounds can be exhausting. Another reason: These days, that extra bulk may be lying (literally) between you and a good night’s sleep, leaving you less rested each morning. Your baby-overloaded mind (jam-packed with shopping lists, to-do lists, baby-name lists, questions-to-ask-the-doctor lists) may also be costing you z’s—and energy. Add other, unrelated life responsibilities to the mix—a job, the care and feeding of other children, and so on—and the fatigue factors multiply exponentially.

But just because fatigue often comes with the third-trimester territory doesn’t mean you have to resign yourself to three months of exhaustion—or relocate yourself to the sofa for the duration. As always, fatigue is a signal from your body, so pay attention. If you’ve been living life in the fast lane (too much baby prep, not enough rest), slow down the pace a bit. Cut back on any nonessential essentials (no fair calling them all essential), and start building some R&R into your daily schedule. Get some exercise, but make sure it’s the right kind (a 30-minute walk may leave you energized, an hour run will have you running for the sofa), at the right time (not too close to bedtime, so it’ll induce sleep, not prevent it). And since running on empty can bench you in a hurry, don’t forget to fuel your energy levels. Keeping your blood sugar levels up with frequent healthy snacks (cheese and crackers, trail mix, a yogurt smoothie) will give those levels a longer lasting boost than caffeine or sugar. Most of all, remember that third-trimester fatigue is nature’s way of telling mothers-to-be to conserve their energy. You’ll need every bit of strength you can save up now for labor, delivery, and, more important, what follows. For more energy-saving tips, revisit the ones on
page 128
.

If you do get the extra rest your body is calling for but you still feel consistently run-down, talk to your practitioner. Sometimes, extreme fatigue that doesn’t ease up is triggered by third- trimester anemia (see
page 208
), which is why most practitioners repeat a routine blood test for it in the seventh month.

“My ankles and feet seem to be swollen, especially at the end of the day. What’s going on?”

Your belly’s not the only thing that’s swelling these days. That puff mama look often extends to the extremities, too. And although all that swelling’s not so swell—especially as your shoes and watch get uncomfortably tight and your rings become harder and harder to pry off your fingers—mild swelling (aka edema) of the ankles, feet, and hands is completely normal, related to the necessary increase in body fluids in pregnancy. In fact, 75 percent of women develop such swelling at some point in their pregnancies, usually around this point (the other 25 percent never notice any at all, which is normal, too). As you’ve probably already noticed, the puffiness is likely to be more pronounced late in the day, in warm weather, or after spending too much time sitting or standing. In fact, you may find that much of the swelling disappears overnight or after several hours spent lying down (another good reason to get that rest).

Generally, this type of swelling means nothing more than a little discom
fort—and a few fashion compromises if you can no longer squeeze your ankles into stylish shoes. Still, you’ll want to find ways to deflate, if you can. To spell swell relief, keep these tips in mind:

Stay off your feet and off your butt. If long periods of standing or sitting are part of your job description—at home or at the office—take periodic breaks. Have a seat if you’ve been standing, and get up if you’ve been sitting. Or for best results, take a brisk 5-minute walk to rev up your circulation (which should get those pooled fluids flowing).

Put ’em up—your legs, that is. Elevate them when you’re sitting. If anyone deserves to put her feet up, it’s you.

Get some rest on your side. If you’re not already in the side-lying habit, time to try it now. Lying on your side helps keep your kidneys working at peak efficiency, enhancing waste elimination and reducing swelling.

Choose comfort. Now’s the time to make a comfort statement, not a fashion statement. Favor shoes that are accommodating (those slinky slingbacks don’t fit now, anyway), and once home, switch to soft slippers.

Move it. Keeping up your exercise routine (if your practitioner has green-lighted one) will actually keep down the swelling. Walking (you’ll probably soon call it waddling) is swell for swollen feet since it’ll keep the blood flowing instead of pooling. Swimming or water aerobics are even better because the water pressure pushes tissue fluid back into your veins; from there it goes into your kidneys, after which you’ll be able to pee it out.

Wash away that water weight. Though it sounds counterintuitive, it’s true: The more water you drink, the less you’ll retain. Drinking at least eight to ten 8-ounce glasses of liquid a day will help your system flush out waste products. Restricting fluid intake, on the other (puffy) hand, will
not
decrease swelling.

Use salt to taste. It used to be believed that salt restriction would help keep the swelling down, but it is now known that limiting salt increases swelling. So salt to taste, but as with most everything, moderation is key.