3RD TRIMESTER

You've reached your third trimester.....here's some useful information.

Advice for Expectant Fathers
Your Baby's Health and Development
Taking Care of Yourself
Planning for Your Delivery
After Your Delivery
Links for Everyone

THIRD TRIMESTER - ADVICE FOR EXPECTANT FATHERS

Ways to be supportive during labor
Bringing baby home: what Dads can do

Ways to be Supportive during Labor
Labor has different stages and each stage requires different types of support. Throughout labor be responsive and aware of her needs, moods and changes.

• Ask if she'd like you to hold her or massage her back.
• Make sure her bags are packed
• Suggest a bath or shower.
• Time her contractions.
• Contact the doctor/midwife.
• Sit close to her or let her lean on you.
• Use a calm soothing voice to help her relax.
• Make her comfortable - whether sitting, lying on her side, resting on her hands or knees, or squatting. Encourage her to move around whenever possible.
• Create a peaceful environment. Shut the curtains or dim the lights. Play soft relaxing music.
• Encourage her to breathe and moan.
• Help keep others out of the room.
• Keep her spirits up. When she says it is hard, remind her of the progress she has made.
• Ask if she wants you to hold a mirror to watch the birth.

Witness the birth of your baby with awe.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Bringing Baby Home: What Dads Can Do

• Straighten the house before Mom comes home.
• Fluff the pillows on her bed.
• Bring her something to drink while she is nursing.
• Run to the store for things she and the baby need.
• Get dinner ready.
• Soothe baby when she cries by holding or walking her or patting her back.
• Massage her back. Oh yes...
• Answer the phone. Turn the ringer down or off while she is sleeping.
• Control the number of visitors when mom and baby first come home. Tell those who ask how they can help, "We'd love a dinner for tomorrow night." Or, "How about doing our laundry?"

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention

THIRD TRIMESTER - YOUR BABY'S HEALTH AND DEVELOPMENT

Changes during your third trimester of pregnancy
What are kick counts
How can I help my baby develop?

Changes During Your Third Trimester of Pregnancy

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
© 1999 Florida State University Center for Prevention and Early Intervention Policy

What are Kick Counts?

Counting your baby's kicks, twists or turns can help you know your baby is healthy. Every day you should count how many hours it takes for your baby to move 10 times. Start when you are about seven months pregnant.

When do I Count?

• During your baby's most active time of day.
• After you have walked for 5 minutes.
• After you have had something to eat or drink.
Most healthy babies move at least 4 times in the hour after you eat.

How do I count Baby's Kicks?

• Start in the morning as soon as you get up.
• Write down the time you start.
• Put a check each time your baby kicks, twists, or turns.
• After your baby has moved 10 times write down the time again.
• After counting 10 movements you don't need to count again that day.
• Try to do kick counts the same time everyday.

Call Your Midwife Or Doctor Right Away If:

• Your baby takes two hours longer than usual to move 10 times.
• Your baby kicks less than 10 times in 12 hours.
• You feel something is not right. Trust your instincts and make that call. Ask to be seen TODAY.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families ©1999 Florida State University Center for Prevention and Early Intervention Policy

How Can I Help My Baby Develop?

Continue to eat healthy foods
Your baby is growing quickly these last three months. His weight may go from almost 3 pounds to 6-9 pounds at delivery.

If you're still smoking, stop or cut down now
The more you smoke, the less oxygen your baby will receive. Your baby may be born too soon or too small. When they grow up, babies of smokers aren't as smart, and have more behavior problems than babies of nonsmokers.

Monitor your baby's movements
Your baby lets you know when he is awake by kicking and moving around. He may seem less active, because there's less room to move. Be sure to count your baby's kicks to make sure he is okay.

Sing and rub your belly
By now your baby's organs are all well developed except for the lungs. these may not be fully developed until the 9th month. Your baby can quiet to your voice or touch. Try listening to your favorite music or singing to see how your baby responds. Your baby's eyelid's are now open and he can see as well as he can at birth.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families ©1999 Florida State University Center for Prevention and Early Intervention Policy

THIRD TRIMESTER - TAKING CARE OF YOURSELF

Concerns about sex in the third trimester
Intimacy without intercourse

Concerns about Sex in the Third Trimester

Your changing Shape
Don't pressure yourself to feel sexy when you're feeling lousy or tired. Making love now may feel awkward or uncomfortable. You may try different positions to find one that is comfortable.

Fear of Hurting the Baby
In normal pregnancies, sexual intercourse will not hurt the baby. You may notice milk leaking from your breasts or experience contractions during orgasm, but these are not dangerous.

Fear of infection
As long as your partner doesn't have a sexual transmitted disease, sexual intercourse will not cause you or your baby to get an infection. Condoms can protect you if you are not sure.

You should avoid sex when:
1. Your doctor/midwife says so
2. Any time your vagina is bleeding
3. If your water has broken
4. In the last three months, if carrying more than one baby
Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families

©1999 Florida State University Center for Prevention and Early Intervention Policy

Intimacy Without Intercourse
Most women can continue to have sexual intercourse throughout pregnancy. but, if your doctor says no intercourse or if you don't feel like it, there are other ways to be close and affectionate with your partner. You may still enjoy:

• Touching and kissing
• Rubbing each other's head, feet and back
• Hiding love notes for your partner to find
• Watching a sunset together
• Cuddling in bed together at night or in the mornings
• Preparing your favorite foods together and having candlelight dinners
• Listening to your favorite music and slow dancing
• Taking baths or showers together
• Saying how much you love and appreciate each other

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

THIRD TRIMESTER - PLANNING FOR YOUR DELIVERY

Birthing Plan
Cesarean Delivery
Options for managing pain
Helping other children prepare for the new baby
Am I in labor?
When to go to the hospital
Things to take to the hospital
What to expect when you go to the hospital
How your body opens up for Baby

Birthing Plan
You may control some parts of your delivery if you learn about your options and plan ahead. Consider these things:

• Do you want a "natural" childbirth or do you want medication to ease the pain?
• Do you want an epidural?
• Do you want to walk around during labor?
• Would you like to squat during delivery?
• Or lie in the bed? Be in a tub of water?
• Do you want to have an episiotomy?
• Do you plan to breast feed?
• Do you want your partner to be first to hold your baby? Or would you like to?
• Would you like your partner to cut the cord?
• Do you want to have the baby "room-in" with you, or stay in the nursery and be brought to you for feeding?

There are no right answers to these questions. Talk about theses choices with your doctor/midwife. Write down what you decide. Don't be afraid to change your mind as your due date approaches.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
© 1999 Florida State University Center for Prevention and Early Intervention Policy

Cesarean Delivery
Why Do Some Women Need A C-Section?
Most babies are born through the vagina. Birth through a cut in your belly is called a C-Section. Your doctor or midwife may decide that you cannot deliver your baby vaginally for several reasons such as:

• The baby is too big
• The baby's heartbeat is slowing down
• You are bleeding
• You have active herpes or other diseases that could infect the baby
• The baby is breech or in another unsafe position

What Happens During A C-Section?
You may be put to sleep during the delivery or you may be awake but numb from an epidural. Either way, you will have a needle in your arm and a small tube in your bladder during surgery. A cut will be made below your belly button so the scar won't be so easily seen.

Can I deliver Vaginally After A C-Section?
Even if you have a cesarean birth before, you may deliver vaginally this time. Vaginal delivery is less risky and you will recover quicker. Your doctor will help you decide if vaginal birth is safe for you.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Options for Managing Pain
There are several ways to help you relax during labor.

• Sit or lie on your side with your eyes closed. Relax all your muscles, starting with those in your feet and work upward slowly through your legs, chest, neck and face. Breathe in and out slowly and deeply through your nose. As you breathe out, repeat the word "peace" (or any other simple word) to yourself. continue the deep breathing through your contractions.
• Have your partner or friend gently massage your shoulders and back between contractions.
• Imagine being in your favorite place - at a lake, the mountains or a garden. think of each contraction as a wave or waterfall.
• Arrange in advance for an epidural to numb your lower body and reduce pain during labor.
• Ask your doctor to give you medication to relieve the pain.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Helping Other Children Prepare for the New Baby

• Talk to your children about what they were like when they were babies. Explain that the baby will need care just like they did when they were born.
• Let older children help plan for this new baby.
• When you bring your baby home, ask someone else to carry the baby so your arms will be open to greet your children.
• Wrap a small toy or gift to give to your older child.
• Expect older children to go back to some babyish behavior.
• Older children can help by bringing diapers or toys or helping to care for the baby.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Am I in Labor?

False Labor

• Contractions are usually irregular.
• Contractions are short and don't get longer.
• Contractions are usually not very painful.
• Contractions may stop if you get up and walk or lie down.
• Cervix does not thin or open (dilate).

True Labor
• Contractions are usually regular .
• Contractions become stronger and last longer over time.
• Contractions become more powerful.
• Contractions become stronger if you walk and they do not go away if you lay down.
• Cervix thins or opens (dilates).

Frequency of contractions are timed from the beginning of one to the beginning of the next one. If a contraction begins at 12:00, another begins at 12:05, and another begins at 12:10, contractions are five minutes apart. The duration of the contraction is how long it lasts.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

When to Go to the Hospital
• If this is your first baby, go to the hospital when your contractions are about five minutes apart, last 40 seconds or more, and are regular for one hour. If you have had a baby before, go when the contractions are about 7 to 8 minutes apart.
• If your bag of water breaks.
• If you have any bleeding from the vagina.
If you are unsure, call your doctor or midwife.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Things to Take to the Hospital
• Your birth plan, pregnancy passport, insurance or medicaid card.
• Nightgowns (if you want to wear your own instead of what the hospital provides.) Gowns that open in the front are easier if you plan to breast feed. Good nightgowns may be ruined with blood stains.
• Nursing or firm bra support.
• Robe and slippers.
• Make-up and toilet articles such as toothpaste, toothbrush, comb and brush.
• A pair of socks (your feet may be cold during labor.)
• Telephone numbers of the people you want to call, including your home visitor.
• Change to pay for snacks and telephone.
• Loose, comfortable clothes to wear home. (Remember your figure won't yet be back to your pre-pregnancy shape.)
• Baby clothes for trip home.
• Infant car seat.
• Other items that you might want: hard candy to suck on during labor, camera, magazines, or radio.
Don't forget to arrange a ride home!

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

What to Expect When You Go to the Hospital
If you're pre-registered (it's best if you have), hospital admission will be brief; if you're in active labor, your coach or partner can take care of it.
• Once you arrive at the hospital , you will be taken to a birthing room. Your family may be asked to wait outside while you are being admitted.
• A nurse will ask when the contractions started, how far apart they are, whether your bag of water has broken, and when you last ate.
• A nurse will check your urine, pulse, blood pressure, breathing, and temperature; time your contractions;look for leaking amniotic fluid or bleeding; and hook up a fetal monitor to listen to the baby's heartbeat.
• A needle may be placed in a vein in your arm to give you extra sugar water.
• Your doctor/midwife may speed up labor with drugs or by breaking the bag of water if it is going too slowly.
• Your doctor/midwife may give you pain relievers or an epidural if you want.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

How Your Body Opens Up for Baby
Nature works miracles to help your baby be born! During Childbirth your baby must make the journey from your uterus through the cervix to your vagina. The opening of your vagina will change from being thick and firm, like your nose to being soft and thin like your lips. Contractions are nature's way of helping your cervix to thin (efface) and open (dilate).
Your baby is protected inside the uterus by a bag of waters. When the waters break it helps the baby move down the birth canal. This may happen several hours before labor begins or not until later during labor. Sometimes the doctor/midwife will gently break the bag of waters to speed up your labor.
During labor, contractions pull on the cervix to widen it. The doctor/midwife will examine your cervix during labor to check how much progress you have made.
When the cervix opens to 10cm (about 4 inches), it is fully dilated - open enough for the widest part of the baby's head to come through.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

THIRD TRIMESTER - AFTER YOUR DELIVERY
Breastfeeding Basics
Car seat safety
Baby Blues
Family planning methods

Breastfeeding Basics
It takes time to learn to breast feed, so keep trying. Relax and enjoy it! Ask for help if you need it. Your newborn should be fed when hungry, rather than on any set schedule. When your baby starts to fuss, or you see her bringing her fist to her mouth, or making sucking noises, get ready to feed her:

• Wash your hands and get a drink of water, juice or milk to give you the extra fluids you need.
• Get into a comfortable sitting position. Use pillows and prop your feet, or lie on your side.
• Turn your baby so she faces your nipple and gently tickle your baby's lip with your nipple.
• Wait until her mouth is wide as when she cries, then pull her mouth to cover as much of the dark area around your nipple as possible. Your baby's nose and chin should be touching your breast.
• Remove your breast by putting your finger in the corner of the baby's mouth and break the suction.
• At first, nurse eight times over a 24-hour day. If baby sleeps more than five hours without nursing, tickle her cheek to awaken her.
• Nurse on both breasts at each feeding approximately 10 -15 minutes on each side.
• Softly caress and talk with your baby during feedings - this is as important as the milk you give her.

Don't give up on breastfeeding just because things aren't going well right away. . if your breasts are sore and don't get better within a few days, ask for help from a breastfeeding specialist. Or call La Leche League International
1-800-LALECHE (525-3243)

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Car Seat Safety
An infant car seat is critical to keep your baby safe. No matter how tightly you think you can hold your baby, if you have an accident , your baby could be thrown from your arms and badly hurt.

An infant carrier is not the same as a car seat and will not protect your baby in the car. Car seats for older children are not safe for newborns. Your baby needs an infant safety seat with a five point harness.

• Read the labels on your car's seat belts or sun visor.
• Follow the directions on how to install the infant's car seat in the back seat facing backwards and firmly secured. the car seat should be angled slightly backwards so baby's head doesn't flop forward. Try a rolled towel tucked under the front of the car seat to tip it back a little.
• An airbag can kill your baby even if she is in the infant seat, so never put baby or older children in the front seat.
• Follow the directions on how to put your baby in the harness. Adjust it to be snug. If the straps are twisted or the harness is missing, your baby will not be safe.
• If it's cold outside, put baby in harness first, than add any covers.
• If your baby cries, do not take her out of the infant car seat until you pull over and stop the car. Then care for your baby.
• If you have question's call the Auto Safety Hotline at their toll-free number:
1-800-424-9393

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Baby Blues
Feeling sad or overwhelmed? Feel like crying a lot? Remember that most new moms get the blues. It will only last a few days.

• If you are worried about your baby, don't hesitate to call your baby's health care provider s much as you need to. You deserve to have the peace of mind this will bring.
• Take time out for yourself every day - even if it's only for a few minutes.
• Talk to a friend about how you feel - especially one with children.
• Get as much rest as possible. Turn off the telephone and nap while your baby is sleeping.
• Go outside for some fresh air.
• Let someone else do the cooking and cleaning.
• Ask someone to watch your baby for a while so you can pamper yourself: Eat your favorite food. Get your hair done. Cuddle up with your partner. Listen to music. Watch your favorite movie or TV show.
• Have fun with your baby: Take baby for a walk. Sing to your baby. Read to your baby.

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

Family Planning Methods
Listed from most effect to least effective methods:

• Abstinence
• Tubal ligation/Vasectomy
• Birth Control Pills
• Norplant
• IUD
• Depo-Provera
• Diaphragm
• Condoms with foam
• Natural family planning (or Rhythm method)

Partners for a Healthy Baby: Home Visiting Curriculum for Expectant Families
©1999 Florida State University Center for Prevention and Early Intervention Policy

FOR EVERYONE
We hope you will find the following links informative:

Children's Defense Fund Parent Resource Network (PRN)
provides access to a variety of national Web sites offering parents information on caring for their own children and on getting involved in group efforts to help children in their own communities or states.
http://www.cdfny.org/About/AboutCdf_nationwide.htm

Child Trends, Inc.
Is a nonprofit, nonpartisan research organization that conducts basic research and evaluation studies in several critical areas: teenage pregnancy and childbearing, the effects of welfare and poverty on children, issues related to parenting, family structure, and family processes, including fatherhood and male fertility.
http://www.voices.org/pages/page.asp?page_id=22807

Child Welfare League of America (CWLA)
Is the nation's oldest and largest organization devoted entirely to the well-being of America's vulnerable children and their families.
http://www.cwla.org/splash.htm

FamilyFirst
Is a non-profit research and communication organization dedicated to strengthening the family.

Kids Count
Is a national and state-by-state effort to track the status of children in the United States and enrich local, state, and national discussions on how to secure better futures for all children. http://www.aecf.org/Majorinitiatives/kidscount.aspx

The National Association of Child Advocates (NACA)
Is a nationwide network of child advocacy organizations working at the increasingly critical level of America's statehouses, county commissions, and city councils.
http:.www.childadvocacy.org

National Campaign To Prevent Teen Pregnancy
Works to prevent teen pregnancy by supporting values and stimulating actions that are consistent with a pregnancy-free adolescence. Its goal is to reduce the teen pregnancy rate by one-third by the year 2005. http://www.thenationalcampaign.org/default.aspx

Urban Institute
A nonpartisan economic, social, and policy research organization, investigates the social and economic problems confronting the nation and analyzes efforts to solve these problems.
http://www.urban.org

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