Pregnancy Week by Week: Week 33

THIRD TRIMESTER

WEEK 33

33 weeks pregnant means you are almost in the middle of the third trimester, with a mere 7 weeks left to go. Your baby is the size of a butternut and probably already the length he will be at birth, which is about 44cm, but he is still putting on weight and fattening up.

As the end of pregnancy draws closer your prenatal visits will ramp up to more frequent appointments, until eventually you will see your doctor weekly. This is helpful for your as at this stage, you probably have lots of questions about what is happening to your body and about the birth process itself, so make lists of questions for each visit and take these opportunities to discuss them with your healthcare provider.

Your blood pressure, weight and urine will be checked as you are monitored for signs of complications like gestational diabetes, placenta previa, pre-eclampsia or any infections.

If you are expecting twins (or more!) your healthcare provider may wish to do a biophysical profile assessment (BPP) test. This assessment is usually only done towards the end of the third trimester if you are deemed ‘high risk’.  The most common factors for a high-risk pregnancy include existing or underlying health conditions, mother’s age and having a multiple pregnancy.

The BPP test assesses the baby’s movement, amniotic fluid, muscle tone and heart rate changes that occur during physical activity or contractions. The main aim of doing a BPP test is to assure you and your healthcare provider that your baby is on track and progressing well.

Baby’s development at 33 weeks pregnant

After weeks of rapid growth and change the brain and nervous system are now almost as fully developed as they will be at birth. Your baby’s breathing and sucking are starting to work in tandem, preparing for the essential skills needed at birth. Baby’s lungs are the last organ to mature and have now almost completely developed. Breathing movements are being practiced in readiness for the real thing at birth!

The fat layers are continuing to form, and your baby’s weight will increase significantly in these last few weeks before birth. This cushion of fat is essential for protection and warmth. Baby’s skin is smoothing out evenly and looking less wrinkly as the padding of fat builds up. As the skin loses its transparent look, it takes on a healthy pinkish colour.

If you could look inside your uterus you would see that your baby keeps the eyes wide open while awake, tracking movement and noticing light and dark shapes. The pupils can dilate and constrict in response to a bright light shining on your abdomen. The wake/sleep pattern is now quite noticeable, and you will realise that your baby spends long periods of time fast asleep – but usually not at night when you also want to sleep!

The skeleton up until recently has consisted mainly of cartilage but is now hardening and becoming denser as it absorbs calcium, although the skull will remain flexible, soft, and malleable to facilitate the head’s progress down the birth canal during delivery. The pressure on the head is quite extreme during birth, resulting in many babies being born with elongated or pointed heads. This is nothing to worry about and will normalise in time. The skull bones continue to accommodate the baby’s growing brain and will only fuse fully at about 18 months.

You and your body at 33 weeks pregnant

The third trimester of pregnancy can come with a plethora of nasty symptoms, some of which you may not have thought of before. Some of them could have been evident in the first trimester, and perhaps you thought they were over and done with but alas! They are back!

Frequent urination

The frequent need to pee is a common symptom but it becomes worse as your pregnancy progresses and your growing baby presses on your bladder. It can be very annoying, disturbing your sleep and your workday.   No matter what you do or where you go, you need to ensure that there is a toilet nearby! Try to cut back on beverages well before bedtime and avoid caffeinated drinks.

Swollen labia

This symptom may catch you by surprise as it is not often discussed in relation to pregnancy, but the increased blood volume, hormonal changes and the growing uterus can all contribute to this uncomfortable and unpleasant condition, which can cause itchiness and tenderness but should not be unduly painful. Try to avoid standing or sitting in one position for too long and put your feet up as frequently as possible during the day. A cold compress placed on the affected area can offer some relief.

A word on sleep during late pregnancy

Unfortunately sleeping problems in the last few weeks of pregnancy are extremely common - and just when you need your rest the most!

You may find your growing bump gets in the way of finding a comfortable position; you might feel overheated; you need to visit the bathroom often; your back could be sore, and your legs ache just as you try to relax and fall asleep. You may be feeling stressed and anxious about giving birth, or perhaps you are worrying about what happens after birth regarding work, childcare, finances. All these factors conspire to disturb your sleep, but even though it is annoying and tiring, rest assured that your baby is well cocooned from discomfort and no harm will come to him or you because of your lack of sleep.

There is no easy remedy for sleeplessness as most sleeping tablets are deemed unsafe during pregnancy. But there are some self-help strategies you can adopt to assist with getting a better night’s sleep:

• Develop a restful routine before bed – take a warm, relaxing bath or shower.
• Try some relaxing gentle exercises before bed that should include deep breathing.
• Avoid caffeine in the evening. This includes coffee, tea, chocolate, energy drinks and some sodas. 200mg of caffeine a day should be your limit during pregnancy.
• Make sure you get some exercise during each day; yoga, swimming and walking are gentle and suitable during this stage of pregnancy.
• Find a comfortable sleep position on your side and support your back with pillows and place one between your knees to keep your hips neutral.
• Avoid screens at least an hour before bed as the blue light can stimulate the brain and negatively affect sleep. Screens include television, computer, laptop, tablet, cellphone.

If you are not managing any sleep at all and it is affecting your mental health, speak to your doctor as sleeplessness can be a sign of depression and help is available.

Be prepared!

You are undoubtedly feeling quite exhausted by now, but this is not surprising as you are carrying around all those extra kilograms. You may be feeling stressed about when you will go into labour, as statistics show only 1 in 20 babies arrive on the due date. In addition, you could be experiencing Braxton Hicks contractions, which are confusing and sometimes difficult to tell apart from actual labour.

To help reduce stress and worry, pack a bag well before your due date, so if baby does decide to make an early appearance everything will be ready. Once you are in labour, your mind will not be on what to bring to hospital, and early preparation for this is something that can be done in peace and quiet well in advance.

Guidelines on what to pack for yourself:

• Loose and comfortable clothing to wear during labour
• Loose clothes to wear home
• Nightclothes
• Nursing bras and breast pads and nipple cream
• Underwear
• Plenty of sanitary pads
• Toothbrush, toothpaste, soap, shampoo, face and body lotions
• Chronic medications
• Lip balm
• Towel
• Book or magazine
• Cell phone recharger

Guidelines on what to pack for baby:

• Disposable nappies
• Bodysuits, vests, sleepsuits
• Shawl or blanket
• Receiving blanket
• Cap, mittens, bootees
• ‘Burp’ cloths
• Car seat for the journey home

With such a lot going on in your life right now, keep track of everything by writing lists or download a digital app on your phone.