Week 33 of Your Pregnancy

Welcome to week 33 of your pregnancy. The discomfort of being in your third trimester is likely really kicking in about now. A new or perhaps more prominent issue you’re facing? Your own personal heat wave. Your baby also turns a pivotal corner in terms of lung development now.

Your Trimester: Third trimester

Weeks to Go: 7

It’s not uncommon for women in the third trimester to become overheated easily, no matter the season. This is due to hormonal shifts, increased blood volume, and a faster metabolism. Adding to the temperature rise: The baby you’re growing gives off body heat too, which in turn makes you feel even hotter.

At the same time, you may be experiencing specific hot spots on your abdomen. “This is caused by nerve compression, either from uterine pressure or tissue swelling, and it can be accompanied by numbness, too,” says Allison Hill, M.D., author of Your Pregnancy, Your Way and co-author of The Mommy Docs’ Ultimate Guide to Pregnancy and Birth.

Finally, by week’s close, your uterus will likely be a bit over 5 inches above your belly button, and you’ll probably have gained between 22 and 28 pounds total.

Your baby is getting so big, likely weighing between 4½ to 5 pounds and measuring about 16½ inches long by the end of week 33. Baby’s bones are fully developed, but still a bit soft and malleable, especially the plates in baby’s skull. These bones need to remain pliable in order to pass through the narrow birth canal. In fact, one or two spots will remain soft even up to a year after your baby is born. These areas, called fontanelles, are normal gaps that allow room for baby’s brain to continue developing.

Baby’s lungs and central nervous system have almost reached full maturity. This often means that if your baby were to make an early appearance, there’s a very good chance that he or she would have no long-term health problems related to prematurity.

If you find yourself at your healthcare provider’s office this week, it may be because your physician or midwife has ordered a biophysical profile (BPP). This test is only offered after 32 weeks, and it’s for high-risk pregnancies and those experiencing complications. (It’s also given to women who’ve passed their due date.)

BPP is painless and begins with a detailed ultrasound where the technician assesses your amniotic fluid levels, baby’s muscle tone, and baby’s body and breathing movements. Since digestion can stimulate these movements, you may be advised to eat a meal prior to coming in.

The ultrasound is generally followed by a non-stress test, where baby's heart rate and possible uterine contractions are monitored. For this portion, you’ll be asked to lay on your side while two monitoring belts are secured around your abdomen.

After your physician or midwife reviews the results, he or she will determine if it’s in your baby’s best interest to deliver earlier than planned.

Right now, there’s a lot of focus on your impending labor and delivery, and of course, caring for your new arrival. But it’s very important to remember that you need to take care of yourself so you can properly look after your baby. That means thinking ahead to your postpartum period.

If you end up having a vaginal delivery, these items and practices can make your recovery time easier:

• Peri bottle: Fill this plastic squirt container with lukewarm water and indirectly spray your vaginal area while urinating. This quells the sting of urine and soothes delicate tissue.
• Anesthetic spray: Use pain-relieving spray after bathroom visits or after changing a pad to numb your vaginal area.
• Sitz bath: This shallow basin sits atop your toilet. Fill it with warm water and soak your bottom to ease pain.
• Doughnut pillow: Sitting on this type of a cushion takes pressure off your sensitive perineum, the area between your vagina and rectum.
• Stool softener: Having your first postnatal bowel movement can be frightening, especially if you have hemorrhoids on top of everything else. Ask your healthcare provider to recommend a gentle stool softener that can make the experience easier.

Consider the following regardless of what kind of delivery you have:

• Heavy-flow maxi pads: Whether you birth vaginally or via C-section, you will experience postpartum vaginal bleeding for up to six weeks. You can also use the pads to create soothing ice packs: Simply unfold a pad; squirt aloe vera gel down the center; soak with witch hazel; refold; and place it in a zip-closure bag inside the freezer.
• Ibuprofen: This anti-inflammatory helps with perineal pain, cramping, and post-birth bleeding. Speak to your healthcare provider about an optimal dose for you.
• Nursing pads: These will prevent your breasts from leaking when you’re not actively nursing and protect sore nipples from rubbing.
• Nursing or pumping bra: The former allows for easy access for breastfeeding, while the latter can hold pump flanges in place.
• Nipple cream: Massaging a small amount of modified lanolin ointment after nursing can help stave off and heal sore your nipples. (Applying expressed breastmilk can do the same.)
• Comfy clothes: Make sure you have comfy lounge pants to put on at home post-birth. You may prefer those with a loose-fitting or adjustable waist if you have a C-section.

If you haven’t begun it already, talk to your physician or midwife about if and when you should start perineal massage. This practice involves gently massaging the perineum to soften it and improve its elasticity. The goal? To reduce your chances of both tearing during delivery and having an episiotomy. The massage itself involves inserting two fingers about an inch inside the vagina, pressing downward, and pulling toward the sides.

It’s worth making sure you’re there when your partner talks to her healthcare provider about perineal massage this week, since pregnant women often turn to their partners to help with this daily practice. While the above can give you a sense of what’s involved, you’ll undoubtedly find it helpful to have full instructions explained to you during the visit, if you’re so inclined to help with this (and your partner asks you to).