Understanding Third Trimester Nausea and Fatigue: Causes, Remedies, and Tips

Understanding Third Trimester Nausea and Fatigue: Causes, Remedies, and Tips


Pregnancy is a unique journey, filled with its share of joys, anticipations, and challenges. While most expectant mothers are familiar with the morning sickness that often marks the first trimester, many are disappointed that vomiting in your third trimester can make an unwelcome return in the later stages of pregnancy. Coupled with intensified fatigue beyond usual, the third trimester can be a trying period for many. But why do these symptoms reappear, and how can they be managed?

In this guide, we’re diving into the reasons behind third-trimester nausea and fatigue. No myths, just facts. If you’re pregnant or supporting someone who is, stick around! We’ve got practical tips to make this stage easier for everyone.

Why Nausea Returns in the Third Trimester

While the first trimester is often associated with morning sickness, many are surprised to learn that nausea can come back in the third trimester. But why?

  1. The Expanding Uterus: As your baby grows, your uterus expands, putting pressure on your stomach and intestines. This can lead to slowed digestion and cause feelings of nausea.
  2. Hormonal Changes: Pregnancy is a rollercoaster of hormonal shifts. As you approach the final months, specific hormonal changes can trigger the digestive system to slow down, leading to nausea.
  3. Digestive System Shifts: The increased uterus size can push the stomach upwards, resulting in acid reflux or heartburn. This can often manifest as nausea or a general feeling of unease.

While it’s not universal for every pregnant person, it’s not uncommon to experience a resurgence of nausea in the later stages. And while nausea at 35 weeks pregnant isn’t unusual, it’s always essential to discuss any concerns or severe symptoms with your healthcare provider to ensure both your and your baby’s well-being.

The Expanding Uterus in the Third Trimester and Its Impact on Nausea

As the baby grows and prepares for its journey into the world, the uterus expands to accommodate this growth. This expansion brings about several changes that can contribute to feelings of nausea:

  1. Stomach Compression: The growing uterus begins to press against the stomach. This compression reduces the stomach’s volume, making it challenging to eat large meals. As a result, the stomach can feel full or overloaded even after consuming small amounts, leading to discomfort and sometimes nausea.
  2. Intestinal Displacement: Beyond just the stomach, the intestines also face pressure and are somewhat displaced due to the expanding uterus. This displacement can lead to irregular bowel movements, bloating, and gas, which can cause a nauseous feeling.
  3. Diaphragm Pressure: The diaphragm, a primary muscle involved in breathing, can also experience pressure from the growing uterus. This pressure can sometimes cause shortness of breath and a feeling of tightness or fullness in the chest area, accompanied by nausea, especially after meals.
  4. Increased Blood Flow: As the uterus expands, there’s an increase in blood flow to support both mother and baby. This surge in blood volume and circulation might indirectly contribute to feelings of lightheadedness or dizziness, potentially leading to nausea.
  5. Pelvic Pressure and Fluid Retention: In the third trimester, as the baby starts to position itself head-down, there can be increased pressure on the pelvic region. This pressure, combined with general fluid retention in pregnancy, can lead to a sensation of heaviness and discomfort, indirectly contributing to feelings of unease or nausea.

The expansion of the uterus is a natural and essential process to support the baby’s growth. However, its impact on the mother’s body can lead to various discomforts, including nausea. Awareness of these changes and their potential effects can help better manage and seek timely remedies or interventions.

Hormonal Changes in the Third Trimester and Nausea

During pregnancy, your body undergoes a series of hormonal shifts to support the growing fetus and prepare for childbirth. By the third trimester, some of these hormones can influence the digestive process and contribute to feelings of nausea:

  1. Progesterone: One of the main pregnancy hormones, progesterone, helps maintain the uterine lining for a fertilized egg to implant and supports the placenta and fetal development. However, an elevated progesterone level can relax the stomach and intestines, leading to slower digestion and increased chances of heartburn and nausea.
  2. Human Chorionic Gonadotropin (hCG): While hCG levels tend to peak during the first trimester and are often linked to morning sickness, some women experience a secondary surge in the third trimester. Although not as sharp as in the early stages of pregnancy, this rise might contribute to nausea for some women.
  3. 0estrogen: This hormone increases significantly throughout pregnancy. Elevated oestrogen levels can sometimes lead to slowed gastric emptying, making some women more susceptible to nausea.
  4. Relaxin: While its primary function is to relax uterine muscles, preventing contractions in early pregnancy and preparing the cervix for childbirth, relaxin also affects gastrointestinal muscles. Relaxing these muscles can lead to slowed digestion and increased chances of heartburn, which can contribute to nausea.

Understanding these hormonal changes can help demystify some of the challenges faced in the third trimester. It’s essential to keep in mind that every pregnancy is unique. What one woman experiences might differ from another. Regular check-ins with a healthcare provider can help navigate and manage any discomforts experienced during this phase.

Digestive System Shifts in the Third Trimester and Nausea

As pregnancy progresses, the physical and physiological changes that occur can have a direct impact on the digestive system, leading to various discomforts, including nausea:

  1. Physical Displacement: The most evident change in the third trimester is the growing baby and, consequently, the expanding uterus. As the uterus grows, it pushes against the stomach and other digestive organs, displacing it physically. This displacement can reduce the stomach’s capacity, causing feelings of fullness after eating only a small amount and potentially leading to nausea.
  2. Acid Reflux and Heartburn: Due to the displacement of the stomach and the relaxation of the lower oesophagal sphincter (a muscle that separates the oesophagus and stomach) – largely thanks to the hormone progesterone – there’s an increased chance of stomach acid moving up into the oesophagus. This condition, known as acid reflux or GERD (gastroesophageal reflux disease), can cause a burning sensation known as heartburn. For many, the sensation of acid can also result in nausea.
  3. Slowed Gastric Emptying: Hormonal changes can slow food movement through the digestive system. This means food stays in the stomach longer, which can lead to bloating, gas, and increased nausea.
  4. Increased Pressure on Intestines: The expanding uterus impacts the stomach and puts pressure on the intestines. This can slow down bowel movements, leading to constipation and further contributing to feelings of bloating and nausea.
  5. Changes in Gallbladder Function: Some pregnant women experience changes in gallbladder function, leading to a thickening of bile and the potential formation of gallstones. These stones can cause pain and nausea, especially after meals.

Recognising these digestive system shifts and their potential symptoms can help expectant mothers better understand the changes they’re undergoing. While some digestive discomforts might be inevitable, there are ways to manage and alleviate these symptoms. As always, communication with a healthcare provider is essential, ensuring that any persistent or severe symptoms are appropriately addressed.

Fatigue in the Third Trimester: Why It’s More Than Just Tiredness

The third trimester can be both an exciting and exhausting phase of pregnancy. While many expectant mothers might anticipate some tiredness, the depth of fatigue experienced during this period often catches many off-guard. Let’s explore the factors that go beyond mere tiredness:

Physical Demands of Carrying Extra Weight

As the baby grows and gains weight, so does the expectant mother. This additional weight stresses the body, especially the back, legs, and feet. The increased effort required for simple daily activities can lead to muscle fatigue and exhaustion.

Hormonal Factors That Affect Sleep

Progesterone, a hormone high during pregnancy, is known for its sleep-inducing properties. However, it can also cause frequent urination and restless leg syndrome, interrupting sleep. Additionally, the rise in other hormones can result in sleep disturbances, leading to fragmented sleep and a lack of deep restorative rest.

Emotional Stressors and Anticipation of Childbirth

The emotional rollercoaster that comes with approaching childbirth can’t be underestimated. From worries about labour to the anticipation of becoming a new parent, these feelings can lead to both mental and physical fatigue. Coupled with potential anxieties related to work, finances, or changes in family dynamics, these stressors can contribute significantly to feelings of exhaustion.

Electrolyte Imbalance and Its Role in Fatigue

Electrolytes, which include sodium, potassium, calcium, and magnesium, play a pivotal role in ensuring our muscles and nerves function correctly. During pregnancy, changes in blood volume, increased kidney function, and shifting hormones can affect electrolyte levels. An imbalance in these essential minerals can lead to muscle cramps, weakness, and fatigue. Moreover, as the body demands more fluid and nutrients to support both mother and baby, it’s easy for electrolytes to become skewed if not replenished, adding another layer to the fatigue experienced.

How To Stop Feeling Sick in Third Trimester

The third trimester can come with unique challenges, and for many, nausea returns. While it might be daunting, there are practical ways to manage and potentially lessen this discomfort:

Eating Smaller, Frequent Meals

Instead of the traditional three large meals, consider breaking your food intake into smaller, more frequent meals throughout the day. This approach can prevent the stomach from becoming too full, reducing the chances of nausea. Plus, it can ensure a steady stream of energy, preventing dips in blood sugar levels that could contribute to feelings of nausea.

Prioritising Hydration

Staying hydrated is key, especially during pregnancy. Water aids digestion, ensuring food moves smoothly through the digestive tract, reducing the potential for nausea. Aim for at least 8-10 glasses of water daily, but always consult your healthcare provider for personalised recommendations.

Ginger, Peppermint, and Natural Remedies

Many women find relief in natural remedies. Ginger, whether in tea, candy, or raw, has been used for centuries to alleviate nausea. Similarly, peppermint tea or peppermint oil can be soothing for some. Always check with a doctor or midwife before incorporating new remedies to ensure they’re safe during pregnancy.

Adjusting Posture and Movement

Being mindful of how you move can make a difference. Avoiding sudden movements and ensuring you rise slowly from a sitting or lying position can prevent blood pressure drops, reducing dizziness and nausea. Moreover, maintaining an upright posture after meals can help prevent acid reflux, a common nausea trigger.

Incorporating Electrolyte Pregnancy Drinks

One often overlooked remedy is the use of electrolyte pregnancy drinks. During pregnancy, maintaining a balance of electrolytes is vital for both the mother’s and baby’s well-being. With the body’s increased fluid needs and the potential for imbalances leading to symptoms like cramps and nausea, electrolyte-infused drinks designed for pregnancy can be beneficial. These beverages provide a mix of essential minerals like potassium, sodium, and magnesium to ensure muscle and nerve functions are optimal. When choosing a drink, always opt for ones without excessive sugar or artificial additives and consult a healthcare provider for the best recommendations.

Avoid Eating Right Before Bed

Eating too close to bedtime can exacerbate nausea for several reasons. Firstly, lying down after eating can make it easier for stomach acid to move into the oesophagus, causing acid reflux or heartburn, which often brings along nausea. Secondly, digestion slows during sleep, meaning the food will sit in the stomach longer, potentially causing discomfort and heightened nausea. It’s recommended to have your last meal at least 2-3 hours before hitting the sack to allow ample digestion time.

Type of Carbohydrates

Not all carbs are created equal. It’s beneficial to prioritise complex carbohydrates in whole grains, vegetables, and legumes. These digest slower, providing a steady energy source and helping to prevent those rapid spikes and dips in blood sugar, which can exacerbate nausea.

Foods and Habits to Avoid

Certain foods and habits can amplify nausea during pregnancy, especially in the third trimester. To keep your digestive system happy, try to avoid the following:

  • Fatty and Fried Foods: These can be harder to digest and remain in the stomach longer, triggering or worsening nausea.
  • Spicy Foods: Some pregnant women find that spicy foods can irritate the stomach or lead to heartburn, which can cause nausea.
  • Caffeine: This should be avoided in pregnancy, but even a small amount can lead to dehydration and an irritated stomach, which can induce nausea.
  • Lying Down After Eating: As mentioned earlier, this can lead to acid reflux. Always give yourself some upright time after meals to aid digestion.
  • Skipping Meals: Avoid skipping meals even if you don’t feel like eating. An empty stomach can produce excess acid, leading to feelings of nausea. 
  • Simple Carbs and Sugar: Simple carbohydrates, like those found in sugary snacks, desserts, and sodas, can cause quick spikes in blood sugar. Rapid increases followed by sudden drops in blood sugar can contribute to feelings of nausea and dizziness. Limiting these, especially on an empty stomach, might help manage nausea.

Tips to Combat Fatigue

As the third trimester progresses, fatigue often becomes a familiar companion for many expectant mothers. While it’s a natural part of pregnancy, there are proactive steps one can take to feel more energised and manage this fatigue better:

Establishing a Consistent Sleep Routine

Sleep is crucial during pregnancy, not only for rest but for fetal development. Setting a regular sleep schedule, ensuring a comfortable sleeping environment, and creating pre-sleep rituals (like reading or gentle stretches) can enhance sleep quality. While frequent trips to the bathroom or discomfort might interrupt sleep, a consistent routine can help achieve more restful hours.

Prenatal Yoga and Gentle Exercises

Engaging in gentle exercises, like prenatal yoga, can boost energy levels. These exercises promote better circulation flexibility and can even improve sleep. The focus on breathing and relaxation techniques can also provide tools to manage labour and postpartum challenges.

Listening to the Body and Taking Breaks

It’s essential to acknowledge the body’s signals. If you are feeling tired, allow yourself short naps or rest breaks. These brief rest periods can recharge you, making it easier to get through the day without feeling exhausted.

Seeking Support: Talking to Others, Joining Prenatal Classes

Sharing feelings, experiences, and concerns with others can be therapeutic. Joining prenatal classes can offer not only educational benefits but also emotional support from peers going through the same journey. The camaraderie and understanding can be a real energy booster.

Electrolyte Balance to Combat Fatigue

Ensuring a proper balance of electrolytes in the body can significantly aid in managing fatigue. Electrolytes, such as sodium, potassium, and magnesium, play a vital role in muscle function, nerve function, and maintaining hydration levels. Pregnancy-specific electrolyte drinks can help maintain this balance, especially when fatigue results from dehydration or muscle cramps. Always opt for drinks free from excessive sugars or artificial additives, and consult your healthcare provider for recommendations suitable for your needs.

When to Seek Medical Attention

While nausea and fatigue are common experiences during the third trimester, it’s essential to recognise when these symptoms go beyond the typical boundaries of pregnancy discomforts. Understanding when to reach out to a healthcare provider can ensure both the mother’s and baby’s safety.

Signs of Severe Nausea or Hyperemesis Gravidarum

While some level of nausea is expected during pregnancy, persistent and severe nausea, especially when accompanied by vomiting, can indicate hyperemesis gravidarum. This condition is a more extreme form of morning sickness that can lead to dehydration, malnutrition, and weight loss. Key signs include:

  • Vomiting multiple times a day, rendering the intake of food and liquids difficult.
  • Dehydration symptoms such as dark urine, dizziness, and rapid heartbeat.
  • Noticeable weight loss.

If you experience these symptoms, it’s crucial to consult with your healthcare provider immediately.

Understanding the Difference Between Normal Fatigue and Extreme Exhaustion

While it’s natural to feel more tired as the pregnancy progresses, extreme exhaustion can cause concern. If the fatigue prevents daily functioning or if rest and sleep do not alleviate the tiredness, it might indicate underlying issues such as anaemia or thyroid imbalances. 

Other Symptoms to Watch Out For

In addition to the above, there are other symptoms that, if experienced alongside nausea or fatigue, warrant immediate medical attention:

  • Swelling in the hands, face, or legs that appear suddenly.
  • Persistent headaches or visual disturbances like seeing spots.
  • Pain or cramps in the lower abdomen.
  • Reduced or absent baby movements.
  • Any vaginal bleeding or unusual discharge.
  • Persistent or severe pelvic pain.
  • Any signs of a fever or chills.

Always trust your intuition. If something doesn’t feel right, even if not listed above, contact your healthcare provider for advice and ask for a medical review.

It’s essential always to prioritise your health and well-being during pregnancy. Recognising when to seek medical attention ensures that you and your baby remain safe and well-taken care of throughout the journey.

In Conclusion

The journey through the third trimester is a blend of anticipation and challenges. While nausea and fatigue often make a comeback, it’s heartening to know that there are practical solutions to manage these discomforts. From understanding the root causes of these symptoms to incorporating remedies like electrolyte-balanced drinks and prenatal yoga, there’s much an expectant mother can do to navigate this period with greater ease.

However, it’s equally vital to recognise when these symptoms might be pointing towards more significant concerns. Being in tune with one’s body and seeking medical advice when something doesn’t feel right is paramount for the health and safety of both mother and baby.

As the finish line approaches, remember that every journey is unique. Embrace the changes, lean on your support system, and always prioritise your well-being. The culmination of this adventure is the arrival of a new life, and every step taken ensures a safer, healthier, and more joyful beginning for both.

Wishing all expectant mothers strength, joy, and a beautiful birthing experience!

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