The Third Trimester of Pregnancy: Pain & Insomnia

Written by the Healthline Editorial Team | Published on March 15, 2012
Medically Reviewed by Joan Lingen, Department of Obstetrics and Gynecology,
Onley Community Health Center, Onancock, VA
on March 15, 2012


Pain is common during the third trimester of pregnancy. Your body is under a lot of stress, both because of the added weight and the effect of pregnancy hormones. Back pain, hip pain, pain running down the buttocks, hip and thigh pain, and vaginal pain are all common concerns of women in the late months of pregnancy. Learning what causes these types of pain and what you can do to feel better will help you get through this final stretch.

Lower Back and Hip Pain

Your uterus is big and heavy, and this changes the way you carry yourself. Changes in your center of gravity put strain on your lower back and hips, causing pain, which may be more severe on one side than the other. The pregnancy hormones that loosen the pelvic joints so that you can deliver the baby also contribute to lower back and hip pain.

The best way to make your hip and back pain better is to exercise. Getting your back and abdomen into better shape can help reduce pain. You may also want to apply heat to the region with a compress or warm bath.


Sciatica (pain down your buttocks, hip, and thigh) is caused by the compression of the sciatic nerve. The sciatic nerve runs from your lower back, down your leg, and all the way to your feet on both sides. In pregnancy, the likely cause is your enlarged uterus pressing on this nerve - causing you to feel anything from tingling and numbness to outright pain. Because pregnancy is not the only cause of sciatica, you should tell your doctor if you think you have sciatica.

Ways you can ease sciatic pain include applying heat, taking warm baths, and sleeping on the side opposite the pain. In the weeks close to delivery, the baby's position changes and the uterus is less likely to compress the nerve.

Vaginal Pain

If your cervix starts to dilate early (hours, days, or weeks before delivery), you may experience a sharp pain in the vagina. It is not a major cause for concern but you should mention it to your doctor. If you feel severe pain in either the vagina or lower abdomen, contact your doctor immediately.


You may find that you have insomnia this trimester. Perhaps because you are thinking about your baby's entry into the world. Or maybe you can't find a comfortable position because your belly is so big. Fetal movements and muscle cramps can also disturb your sleep. This is normal. To help you get a good night's sleep:

  • Sleep on your side instead of your back and bend your knees. Place a pillow under your abdomen and in between your legs to balance the weight of your belly.
  • Drink a cup of warm milk or take a warm bath before going to bed.
  • Practice relaxation exercises before bedtime.
  • Get enough exercise, but not right before going to bed.
  • Eat slowly at dinner.
  • Develop a bedtime routine.
  • Clear your mind; create a worry list to write down all your worries and leave them on the page.
  • Focus on your breathing.
  • Limit fluids before bed if your sleep is interrupted by frequent trips to the bathroom. Avoid caffeine.
  • Don't take any medication unless specifically approved by your obstetrician.
  • Don't focus on the time (move the clock where you can't see it).
  • Don't worry - insomnia won't hurt the baby.
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