Episode 31: Down and ups of the 3rd trimester of pregnancy

Dr. Sophia:
Hello everyone. Welcome to the Dr. Sophia ObGyn podcast. I'm an ObGyn practicing for over 15 years in my native New York City. And I love to help women learn about their bodies, empower them, and embrace themselves. On this podcast, we talk openly and with heart about all things affecting women from pregnancy, menopause, periods, sexual health, fertility, and so much more.

Disclaimer: this is general medical information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Hello everyone, and welcome to the Doctor Sophia ObGyn podcast. I am so excited to talk about the third trimester.

Touseef Mirza:
Not the first, not the second, but-

Dr. Sophia:
The third. The third trimester of pregnancy. Of course, as always, there's a patient story. There's a reason why I realized that it was a conversation that we all need to have. I am happy and blessed that I get to do the work that I love every single day, but every single day, there's someone somewhere somehow who brings to light all the things that we need to discuss. And this is one of them. As always, I am here with Touseef Mirza, and I'm so happy to have you in the conversation.

Touseef Mirza:
Thank you so much. And I'm so happy that we have reconnected. I have to share this because Dr. Sophia and I have been pretty excited about this. We just got voted as one of the top menopause podcasts by MIDI Health. We just are so happy that what we are creating here resonates with people, and we really believe in this. And we're so happy that all of you, well, the ones that have listened to us, can see just how much we are willing to be just open and authentic and just talk about true stories in a vulnerable way. So thank you for listening.

Dr. Sophia:
Thank you, community of the Dr. Sophia, ObGyn podcast. And of course, thank you to MIDI Health for listening and for choosing us. For sure. We'd be remiss if we did not have a chance to say how excited we are about this special honor.

Touseef Mirza:
So for today, we're actually not gonna be talking about menopause. We're gonna be talking about pregnancy in the third trimester. So before we go into the third trimester, can you explain why they are called the first, second, third trimester of pregnancy? And what does each mean? Like from an overarching perspective?

Dr. Sophia:
I think the simplest way to think about it is that most people think of pregnancy. And we know that you have a baby at nine months. And so when we think of trimesters, it's kind of like breaking it up by three months at a time. So the quick and dirty is like the first 12 months, then the next 12, then the next 12. But the reality is that a woman is really pregnant for 40 weeks. And so when we think of the end of the first trimester, we're really talking about 13 and a half-ish weeks. So a little bit more than three months. And the second trimester, again, somewhere around 20, somewhere between 26 and 27 weeks. And then from there to the end of the pregnancy is considered the third trimester. For me. I usually say anything after 28 weeks, 'cause we have 12 weeks to go.

Touseef Mirza:
So can I ask you, are the three trimesters delineated because they're very different developmental stages in those three trimesters?

Dr. Sophia:
Yes. So the first trimester, which for the woman can be actually pretty debilitating, it's when they feel the most tired. Oftentimes they feel very nauseous and sick. They have that quote unquote morning sickness. It's when they just have this overwhelming sense of fatigue. And what's happening is you have these very rapidly dividing cells happening with the embryo that then turns into a fetus. And so there's a lot happening at the level of that growing.

Touseef Mirza:
Cellular?

Dr. Sophia:
On a cellular level. Exactly. And that's what's driving all of the energy away from the mom.

Touseef Mirza:
Are the trimesters divided up 1, 2, 3 because of the development stages of the fetus to a baby? Like for the first three months, are there certain aspects of the development of the baby that's just within the first three months, like cellular? And then the second trimester, it's another part of the development of the baby encompassed in the second one. And then the third one is different.

Dr. Sophia:
We have what we call organogenesis, where literally every little part of the baby is being created. A brain limb, buds a heart, the cellular circulation system, the reproductive system, all of those things are happening in those first 12 to 13 weeks of development. By the time you hit 16 weeks, your fetus is pretty much developed. Now it's just a matter of growth.

Touseef Mirza:
And that's when the second trimester starts?

Dr. Sophia:
And we're in the second trimester, not necessarily starting, but certainly we're in the second trimester where we're in the growth stage, we're now growing. And then that growth phase, we have other things that can be happening. And it's where we look to see, you know, like right around 20 weeks is typically when we do something called an anatomy scan, which is to look, to make sure that the baby has 10 fingers, 10 toes, nose, lips, what the heart looks like, that it has four chambers, what the back looks like, that the spine is fully formed, that the legs are fully formed, you know, so we are looking that this is a fully formed fetus and it's just gonna continue to grow.

But all of the developmental aspects have been developed. That they're formed. You're right, different things are happening in different trimesters. And then when we think about the last trimester, again, it's literally just, well, let me not put it as just, I don't wanna oversimplify things, but the baby is gaining a lot of weight at the end. And so not just the baby, but also mom. And so for some women, it's when they have the most growth, the most pounds that they put on is towards the end. And it can also be a part of the more challenging in terms of trimesters.

Touseef Mirza:
And then would you say that the third trimester is when the baby is probably moving the most?

Dr. Sophia:
Actually, no, I wouldn't say that. That's when the baby's moving the most. The baby should be moving throughout. Now even in the first trimester, I mean that little, what seems like a tadpole, is jumping around in there. Most women start to feel what we call fetal flutters, probably somewhere between 21 and 22 weeks. And then from there on it just becomes, you know, a lot of movement. And then the baby definitely turns to go into its own pattern, so to speak. And so the second trimester, I think, and early third trimester is probably when women tend to feel real kicks and punches. And then towards the end, late third trimester, like when they're closer to delivery, sometimes they feel more like what feels like stretching movements just because the baby has now moved, you know, lost some room. You know, and can't do somersaults, but other babies are able to still really kick you in your ribs,

So yes, things do change from many different levels, but this particular topic and conversation is going to be related to mom.

Touseef Mirza:
So one of the things that you talked about when we were thinking about doing this episode was this concept of the golden age of pregnancy. So can you tell a little bit about what you mean by that?

Dr. Sophia:
So the golden age of pregnancy for me typically happens around 20 weeks, and is usually when women tend to feel like they're back to being themselves. They are not as nauseous for sure. They're not as tired. They know that they're pregnant and they have something to feel kind of excited for sure about, but they feel more normal in their bodies.

Touseef Mirza:
Versus the first trimester?

Dr. Sophia:
Versus the first trimester where they feel like they're on the floor. Like they're so fatigued oftentimes. And they may be experiencing morning sickness, which is of course all day sickness. They may be experiencing headaches. There's so many other things that can happen in that first trimester related to how that fetus is rapidly developing. That really takes a lot of energy. And so women tend to feel it, but mostly once the woman gets the 18 to 22 week zone, they tend to like, have their energy really come back and they feel, like I said, just more normal. And so I liken it to the golden age because that's when they're like, oh, I feel like I have a glow. And if not even for the glow, but more so that they can actually see, perhaps that baby bump, but they can still see their toes. And like I said, they still have energy and they still want to just kind of be around people and do things. And they feel like they can.

Touseef Mirza:
They feel a little bit more energized than in the first trimester.

Dr. Sophia:
They feel more just, I think the best way to put it is more like themselves, but with the added bonus of knowing that they're pregnant if they're, you know, and especially if they're very excited about the pregnancy, it's like, wow, my, my body's changing, but I still feel like myself. I think it's a good time when women really make a good connection also just with their pregnancy. It's when they first start to feel fetal movement, like, you know, of course, like I said, the the baby's moving all the time, but when it's actually big enough or strong enough for, you know, a woman to actually feel it is after about 21, maybe 20, 20 weeks early on the earlier side, 22, 23 weeks, probably on the more average, especially for a first timer.

Touseef Mirza:
So when a woman is going through that phase of the golden age of pregnancy, like you call it, do they normally stay that way until the end of the pregnancy? Or does that change?

Dr. Sophia:
No, that definitely changes. And that's the reason why I felt compelled to want to be very specific and talk about the third trimester, which is definitely not necessarily the golden age. This is where things also, again, there's a shift. Why did I even want to have this conversation? It was because of a patient who I saw just a few days ago who's like, oh my gosh, I feel so ugly, I feel so fat. And she's about like, I don't know, I think she was like 35 and changed 35 weeks and a few days. And she was like, I can't see my feet. I can't, my feet are swollen. Like, she just had what felt like every complaint. In the sense of everything hurt, everything felt big. She felt super heavy. And the thing that resonated the most with me was that she's like, I just feel so ugly.

Dr. Sophia:
And I was like, why? You are not ugly. She's like, but I'm so swollen and I'm so big and I'm, you know, and, and I realized that it's not the first time that I'd heard it, but I recognized how much more reassurance and the need to shift perspective perhaps. And I was happy that I could help do that. And I thought about it and I said, wow, there's so many people who feel this way when they enter into the part of the pregnancy where things start to get a lot more challenging. You're not sleeping, you're urinating all the time, and definitely you get to feel a lot heavier because this baby has, is really growing and grows a lot more rapidly. Toward the last couple of months and weeks, she just felt defeated. She felt like her body had been taken over. And she just wanted her body back. She has, you know, like four more weeks to go. But so many things happened during that time.

Touseef Mirza:
What's interesting with that is in the society we live in, you know, obviously everybody says you have to be skinny and stuff like that, you know, and then Lizzo comes in and, you know, we have all about body positivity and everything, and that obviously there's nothing wrong with a person having more weight aside from health issues, which is like another ball game. But it's true that in the society that we live in, especially if you are not a person that has usually had weight in their lives, and then all of a sudden you have it because of a child, it might feel a little like-

Dr. Sophia:
Jarring.

Touseef Mirza:
Yeah. And what's happening. But at the same time, in this situation, it's literally for the purpose of having a healthy child. Like I think we're so brainwashed that the weight means something, but we're not understanding the context in our minds to switch gears and say, no, actually this is actually totally normal.

Dr. Sophia:
Right. And don't get me wrong, I mean, for sure we say we expect women to gain somewhere between 20 and 25 pounds if you're a normal weight woman in her pregnancy. And that's in total. But some, some women definitely gain anywhere from 40, 60 pounds in their pregnancy. And so I understand that sentiment of feeling like, oh my God, I am so heavy, or I am so big, or I don't recognize myself. It's very different than just having, let's say that baby bump or just saying, okay, I just have a big belly and you know, that's it. It's like for some, they gain weight and they gain it all over. But that's definitely, we need to say and normalize. It's okay. You know? Your nose may feel like it looks a little bigger and your fingers definitely swell a little bit.

Dr. Sophia:
Your feet may become swollen a little bit, you know, and that's more because of water retention or that is because of water retention. Yes. I mean, in the first trimester you gain 50% more fluid in terms of your blood volume. So you need to be hydrated, so you really need to be hydrated. That is correct. You really, really need to be hydrated. And so I just, when she was just like, I just felt so ugly, and I was just like, wow, how do we turn this around? How do we turn around that sentiment or that feeling? And actually before turning it around is to validate it. You've gained some weight. That's true. But that doesn't necessarily make you ugly, but I understand how you're feeling.

But now let's turn it around and like you said, let's be more focused on the end game. On to the end goal here. And what we're gonna have at the end is this, you know, beautiful baby that you've now created and housed and grown and birth and the beauty in that. So just to, to really look at the beauty of that whole process and what your body has just gone through and which is quite spectacular, is very much fantastic and fascinating, but that you were able to even do it. Because there are so many who can't. And so to kind of flip the conversation, so that way, looking at your body in the third trimester, which can be very jarring even because you just don't recognize yourself, but to say, this is who I am in this moment, and that, that's beautiful.

Touseef Mirza:
Did that help her? Like was she able to receive it or was it more difficult for her to accept a different view at that point? Maybe afterwards she did.

Dr. Sophia:
So I would say that yes, it was a little difficult for her to accept that as a viewpoint. She's like, what are you talking about? Do you see my sausage fingers?

Touseef Mirza:
This is my reality.

Dr. Sophia:
My reality is that I feel like I have sausage fingers and I cannot see my vagina under any circumstance. And I just feel like my face is just fat. So what am I supposed to do with that? And I said, put a little blush, do the things that you would normally do that help you to just kind of feel a little bit more sexy or a little bit more beautiful.

Touseef Mirza:
And would you say a lot of women who like your patients, like you've seen that women are just, just from you know, how they feel about themselves, that it really impacts them in the third trimester.

Dr. Sophia:
I have another patient who in terms of being in the third trimester, was frustrated that the one thing that frustrated her the most was the fact that she couldn't wear her wedding ring because her hands were getting so swollen that she couldn't wear her rings. And I was like, but why? It's okay. You know? She's like, yes, but I did a lot to get married. I want everybody to know that I'm married.

Touseef Mirza:
I'm wearing that ring. Yeah.

Dr. Sophia:
I'm wearing that ring. And I said, this is easy. You can get the most blinged out ring for five bucks on Amazon. Just get it two sizes bigger. It's okay. It'll symbolize the same thing, you know, but it's so funny. What are the things that really bother women in the third trimester? And there's a lot of reasons why, A, you're really not sleeping, so let's just start there. Just the lack of sleep that can happen.

Touseef Mirza:
Your perspective is not always there,

Dr. Sophia:
Right? Because you're like you're, you're just so exhausted. So that could be happening next. You literally can be swollen. You know, all aspects of you can be swollen, and it doesn't even mean that there's something wrong. I'm not talking about women who get swollen because of very serious medical concerns, such as something like preeclampsia, but just the water retention that can happen in pregnancy. The flow, the circulation and flow of your blood is different because you have this big uterus and a baby who's weighing on you, who's literally sitting on your big vessels. So, just the circulation of your blood is a little slower. You have the opportunity for fluid to just sit in places. Okay. Like your legs, like your feet. Especially if you have to be on your feet all day long. Especially if you are just sitting at a desk all day long, you know?

Touseef Mirza:
So walking is good.

Dr. Sophia:
Walking is great. Okay. Walking is great. Now, is it comfortable, not necessarily. Because you feel all this pressure or pelvic pressure? Oh boy, I am really not making pregnancy sound fun at all. That's not the purpose of this. I just wanna actually have some comradery with the women who are feeling some of these symptoms to say that it gets better. You're not alone. And it is definitely temporary.

Touseef Mirza:
Yes. And then you have a spectacular ending for it.

Dr. Sophia:
The end result is this bundle of joy that you bring into the world.

Touseef Mirza:
So just to balance things out, like what are certain things in the third trimester that women are more like just surprised about and amazed about in terms of what's happening?

Dr. Sophia:
I definitely will say that just again, the connection with their baby. Perhaps how the baby may kick when their significant other comes into the room or speaks. Because even then the baby already knows what's happening in the outside world to some extent, you know? And whose affect, who has influence and effect on the baby. You know, so that's something that's actually pretty cool. Other things to think about as I definitely think the third trimester is the timeframe when women start to really hone in on, ooh, I have to deliver the baby. So there is a heightened sense of anxiousness, perhaps that is happening around you, see.

Touseef Mirza:
Your tummy and you're just, this is so huge, this is supposed to come out of me.

Dr. Sophia:
Right. Where's it, where is it gonna come out? How is it coming out again, from where, how I wanna acknowledge all of these feelings. That is happening. They are experiencing things called Braxton Hicks contractions, which are like the practice contractions, your uterus is trying to get ready for the big day. And for some women, they're just like, oh no, the baby's just kind of balling up. And for other women, they're like, oh, it feels a little bit like period cramps. And then for other women, it stops them in their tracks, you know, they're like, whoa, I was walking and I just got this cramp. And all of those things can still be considered a Braxton Hicks contraction.

Touseef Mirza:
And why does that happen?

Dr. Sophia:
Like I said, it's like the uterus practicing.

Touseef Mirza:
Okay.

Dr. Sophia:
Yeah. It gives this little contraction or this little squeeze. Or you know, like a cramp.

Touseef Mirza:
I mean, practicing for the real thing.

Dr. Sophia:
Practicing for the real thing. Got it. Practicing for the real thing. Some of it's happening just because the uterus itself is on stretch. Meaning that because the uterus is actually growing almost like a I like to think of it as a little rubber band. So this is not very scientific. But certainly we know that it's affected by dehydration, like any other muscle in your body. If it's dehydrated, it may have small spasms or things of that nature because the uterus is just one big muscle.

Touseef Mirza:
And then what else happens in the third trimester that doesn't occur before? Like, for example, I believe that women will have a tendency maybe to be less hungry because of the pressure.

Dr. Sophia:
So other things that can be happening, there's just so much, and I don't wanna make it sound like it's all doom and gloom. It's not, we're happy, we're excited, we're pregnant!

Touseef Mirza:
Yeah. We're just explaining why that's what we are doing. We are just saying this is why it happens.

Dr. Sophia:
But what else could be happening? Heartburn certainly decreases appetite at times.

Touseef Mirza:
And so why the decrease in appetite?

Dr. Sophia:
'Cause your growing belly is actually pushing up on all of your intestines, your stomach, your organs, and it's just a space issue. . At the end of the day, that's one. And then two, the hormones that your body is releasing throughout pregnancy relax certain parts of your body. So, for example, your esophagus and the opening to your stomach is also kind of relaxed and allowed, therefore allowing for there to be more in the sense of acid reflux.

Touseef Mirza:
I didn't realize that they would be more relaxed. Why is that?

Dr. Sophia:
Progesterone.

Touseef Mirza:
Okay. And then when you say that you have less appetite, but at the same time, you should be eating pretty well, considering your baby requires more. Because it's growing. And at the same time, your stomach's being pressed, so you feel that you're full, but you're not, and you have to eat. So that's an oxymoron. That's not a great situation.

Dr. Sophia:
So, oh, what else is happening? Do you feel short of breath when you walk? Sometimes, all of this is just a space issue.

Touseef Mirza:
Why?

Dr. Sophia:
Your lungs literally cannot expand. Sometimes, though, it just, your tidal volume goes down. Like you just don't have the space with which to expand your lungs the way you normally would.

Touseef Mirza:
Okay. So, but that's not pushing. Is it really because it's pushing up, or is it just because of hormone differences that don't enable us to have a bigger breath?

Dr. Sophia:
You literally cannot take a bigger breath because your baby is occupying space. When you're 39 weeks, 40 weeks, your uterus is up here, your lungs can come all the way down to here. But now this is all occupied by a uterus and baby.

Touseef Mirza:
So occupation, uterus, occupation-

Dr. Sophia:
Uterus and occupation, baby. It goes up, it goes out, it grows all, it's pressing everything, it presses on everything. So low back pain is a very common complaint.

Touseef Mirza:
And then it also affects your bladder,

Dr. Sophia:
The peeing every five minutes. So of course, anyone who comes into my office is gonna hear me say and drink more water, and then drink more water. And then no matter how much you drink, I want you to drink more. And did you drink more? And then they are like, I can't stand this Doctor. Where, where does she want me to drink? I'm already peeing every three minutes. So this is where there's an art to drinking water in pregnancy. And it really, it's not just in pregnancy, to be honest. We know we need to, instead of guzzling our water, to really take small sips. So that same eight ounces that we would drink in 30 seconds, I would like you to drink it over 10 or 15 minutes, and just so-

Touseef Mirza:
Just little sips.

Dr. Sophia:
10, 15, just small sips. Yeah. 10 minutes, small sips. And the reason why is because it allows your body to actually absorb the liquid as opposed to what feels like it's going right through you. Yeah. Pregnant women need to drink a hell of a lot more water, but when they do. They also urinate a hell of a lot. So they have a lot more losses, which is again, why we keep saying, and then drink some more. Because-

Touseef Mirza:
You're losing more?

Dr. Sophia:
Losing more. That's correct.

Touseef Mirza:
And why are you losing more?

Dr. Sophia:
Remember, you have increased your blood volume by 50% at least. So you have a lot more blood that's circulating. So that's being filtered through your kidneys, so you're peeing more.

Touseef Mirza:
Okay. Okay.

Dr. Sophia:
And then your bladder is, it's like being pressed like a pancake. So any little amount of water that gets in there, any amount of urine that gets in there, your bladder is like I can't hold it. It's gotta come out.

Touseef Mirza:
All right. Well that's another one. And then what about just strength in general? Like, how is strength? Is it harder to lift things? Is it normal to

Dr. Sophia:
No, your whole center of gravity is now changed. Your body amazingly accommodates it, though. I mean, pregnant women should be falling flat on their faces, but we don't,

Touseef Mirza:
You know, even if we all have more weight in front.

Dr. Sophia:
Even though we have all of this weight in the front. But we don't. But as far as just yeah. Strength and being able to carry things. I mean, this is the time when I say to women, certainly don't start some brand new exercise regimen. In pregnancy, I would say to you, it's good to continue what you were already doing, and maybe you can start off very slow or lightly, but you're not gonna, in your third trimester of your pregnancy now decide you wanna train for a marathon, you will likely fall on your face. And I, I like to tell women, I want you exercising, I want you moving, I want you to increase your flexibility, but understand that it shouldn't be with things that you have an increased chance of falling. So maybe not kickboxing.

It's one thing if you were a marathon runner and you're training and you're pregnant and you're still continuing to train, it's the same training you were doing, you know, three weeks before you found out you were pregnant. Okay. Continue that you can run. I have actually about three patients of mine who are marathon runners and have run their marathons while pregnant, you know, training while pregnant, but their bodies are conditioned to that kind of level of activity. As opposed to a patient who comes in who's, doesn't even walk a half a block. I don't want that patient to now say, oh yeah, I wanna run a 5K. Right. And I'm gonna do this when I, you know, start at 26 weeks of pregnancy.

Touseef Mirza:
So, you know, the patient that we talked about was feeling overweight, and she was saying, I'm fat. Like having women say to themselves, oh, you know, I have to lose weight now in the third trimester, which doesn't make any sense.

Dr. Sophia:
Oh my goodness. They are like, oh, I'm gonna just stop eating. I'm gonna go on a diet. I'm like, what?

Touseef Mirza:
That's scary. That's so bad to think like that

Dr. Sophia:
At that point. But it's true because like you said, societal norms or what we think is beautiful or what we think is acceptable is so different from and far from reality. But our brains then latch onto these things and make it seem as if it's an end all be all. When that's not the case at all, we should be able to totally embrace every part of our pregnancy journey. That includes the weight gain, that includes the discomfort, that includes the, you know, lack of sleep. All of it is for the purpose of this new bundle of joy that you're bringing into the world. And if we're not embracing it, then that means that we are on the flip side, creating a lot of stress around it.

Touseef Mirza:
Well, stress for ourselves and then stress for the fetus.

Dr. Sophia:
That's right.

Touseef Mirza:
Because it's feeling everything you're feeling.

Dr. Sophia:
So I just like to change again, change the narrative, change the perspective. I'm not taking anything away. There is suffering, there is real suffering that can be happening. You know, that feeling of heavy, that feeling of pressure, that feeling of having to go to the bathroom every moment. The sense of not being able to get into a comfortable position when they wanna sleep. All of those things are real. And so how do we actually deal with it? It might be, hopefully, you have a family member or partner, your husband, your wife, who, whoever it is that's in the house with you, who can, you know, give you a nice massage at night.

Put your feet up, drink a glass, have a cup of tea, a chamomile tea, and relax. Sipping your water instead of guzzling your water so that maybe you're not going to the bathroom every three minutes. Instead, it's like every seven. And then that feels like a vacation. Some of the just back pain, doing some definite stretching exercises to help alleviate some of the tight feeling in, in your back. That can happen just because everything is on stretch and everything is in spasm mode at the same time. But doing some, you know, pregnancy yoga can help relieve some of that, like back pain and discomfort that women tend to have later on in pregnancy.

Dr. Sophia:
I think when it comes to the third trimester, the important part is knowing that there are all of these things that can happen. And then kind of prepare yourself for like, okay, I know that if I start to feel like I am retaining water, maybe I need to do a little bit more walking. Maybe there are some natural remedies such as celery juice with parsley that can help me to get rid of some of the extra water or fluid. Certainly, maybe wearing compression stockings so that I don't have the swelling in my ankles, and my feet wearing a brace or an abdominal binder so that I don't feel as much pelvic pressure. Towards the end.

Touseef Mirza:
I just wanna say also, I just think, you know, everything that you are naming obviously will provide some type of support and help. And at the same time, to realize that most of these things are just normal.

Dr. Sophia:
Yes.

Touseef Mirza:
This is how the body was designed to best carry a baby in the most healthy way to term. So if it's happening, there's a reason for it, you know, and to really say, oh yes, it might suck to do this and that, but really this is what my body needs to do in order to make this a successful journey.

Dr. Sophia:
I also think that there's a part of it, you know, like the sleeping part of it, not really getting comfortable, making it hard. I wonder how much of that is just your body being prepped for when this little baby comes out and is like crying. Two in the morning, three in the morning, five in the morning, you know? And you have to be ready and up to take care of it. It's just like, I just think your body is preparing you for so much that's on the other side of delivery.

Touseef Mirza:
On the flip side, I'm sure there's women also there on their third trimester and they're super excited.

Dr. Sophia:
Oh, they're killing it. They are doing fantastically. I have so many patients too, who are in their third trimester, and the third trimester for them tends to be their golden age, you know? . It's not everybody who goes through their trimester and is like, I'm over being pregnant. Some women love it so much that they want to stay, they almost want to stay pregnant. It's wild. They're like, no, I just love carrying and I feel so good and I just have so much energy. I do think those women are a little bit rare. But it's not impossible. And carrying at a healthier weight, perhaps. Certainly staying active throughout the pregnancy, I do think that that does have a big impact. How we eat always has a major impact. So just being nutritionally more conscious.

Touseef Mirza:
But I'm sure there's certain women in their last trimester where even if they have gained weight, that's not really their focal point. They're just like I'm pregnant, I can eat whatever the hell I want.

Dr. Sophia:
Then there's that part.

Touseef Mirza:
And then just go to town.

Dr. Sophia:
That's true. But you know, you don't need to have like three milkshakes.

Touseef Mirza:
Maybe just sometimes. Yeah. But you know, you can, you can find a little bit more levity to it.

Dr. Sophia:
I think, like I said, the average weight gain in pregnancy, we like to quote, is somewhere between 20 and 25 pounds. But what's the reality? It could be more, some women it's more like 40 pounds and, and they're still fine. Their babies are still fine. So if you're one of those women who's a little bit more, you know, who gains a little bit more weight and then we can, we gain, we tend to gain more weight with, let's say a subsequent pregnancy. So where women tend to be like, oh, I'm a little bit more trim or what have you in their first pregnancy, the second pregnancy, everything happens so much faster.

Touseef Mirza:
What do you mean by that?

Dr. Sophia:
You feel like you get bigger faster, you show quicker. You, you put the pounds on way faster. Everything starts, you just start to feel the fatigue and the tiredness and the, you know, it's like your body's like, oh yeah, I remember this.

Touseef Mirza:
Been there, done that,

Dr. Sophia:
Been there, done that. I know, oh, I know what we're supposed to do here. I know how this is gonna work. Okay. You know, the familiarity of it in terms of your body, and then it just kind of goes to town.

Touseef Mirza:
That's interesting. And, does that happen to a lot of women?

Dr. Sophia:
Yeah. I mean, I remember it even for myself. I remember my second pregnancy, I was like showing at four months when with Tyler, I didn't show until I was almost giving birth. It was crazy.

Touseef Mirza:
I mean, maybe the uterus was already elasticized or something.

Dr. Sophia:
I'm telling you, everything felt like it got really big really fast. The real goal here in this conversation was to acknowledge that as wonderful as pregnancy is, I just know that there are so many women out there who are approaching this part of their pregnancy and seeing all these changes in their bodies and feeling like they just don't recognize themselves. And the reality is it's still you. It's still you. You are still beautiful. You're going through a beautiful journey, and yes, with some, I guess what I'll call growing pains, but it's worth it. And you're not alone. So even in the third trimester of pregnancy, we have to embrace our bodies and embrace ourselves and embrace the baby and embrace the baby. But we have to remember that we have to look at that time as a moment in time. And to make the best of those moments, we have to embrace the journey. And it is beautiful.

Thank you for joining us on the Dr. Sophia ObGyn podcast. I hope you had fun listening as much as we had fun sharing this podcast with you. Have a wonderful, wonderful day. Until next time, see you later.

This is General Medical Information based on my professional opinion and experience. For specific medical advice, please refer to your physician. Until next time, embrace your body. Embrace yourself.