You powered through that challenging first trimester, you sailed through the refreshing and energizing second trimester (I hope!) and now you’ve entered the final lap of this pregnancy marathon- the third trimester! What do we expect from this trimester? A baby! Finally! But just like the others, this trimester will last about 12-13 weeks so we have a few other things to be expecting before baby makes their grand entrance. The third trimester begins at week 28 and lasts until your baby arrives which in theory will be somewhere around week 40.

However if you caught the first installment of our pregnancy myths you’ll remember that only a small percentage of babies come on their due date. So while it’s tempting to hit 28 weeks and begin counting down the days to 40 weeks exactly, just remember it is totally normal, especially for a first time mama, to go past that due date. But rest assured, no woman has ever been pregnant forever so your baby is coming! In the meantime, what should you expect from these last three months?

Symptoms:

The third trimester often brings with it a mixture of symptoms from earlier trimesters, not necessarily a bunch of new ones. Although, if you’ve been relatively symptom free, you may find that new symptoms pop up on you as you near the end of your pregnancy. Some of the common symptoms we’ve discussed that can increase as the third trimester goes along would be heartburn, aches and pains, especially in your hips and back (that belly is putting added strain on these areas), and fluctuation in your moods and emotions.

You may also find that the frequent urination you experienced in the first trimester has returned- this typically happens as the baby gets lower in your belly putting added pressure on your bladder. Another common report of third trimester ladies is shortness of breath. The bigger that baby gets, the more pressure they put on your diaphragm making it easier for you to become winded.

Swelling in the feet and ankles can also pop up in this trimester, so kick those feet up when you can! If you find that you have any sudden swelling particularly in your face or hands be sure to call your provider right away as that can sometimes be a sign of preeclampsia.

Finally, Braxton Hicks contractions. You may have been feeling these earlier in your second trimester as well but many women begin noticing them, or notice an increase in frequency during the third trimester. These typically feel like a tightening of your abdomen- the first time I felt one I would have described it like the baby had curled into a tight ball right at the top of my bump. They last for 30 seconds or so and then dissipate. They aren’t painful but can be a bit uncomfortable. They don’t come in regular intervals like labor contractions either so if you’re having painful, regular contractions that could be a sign of labor rather than Braxton Hicks and you should call your provider for guidance. Also, some women don’t feel them at all so don’t worry if you don’t experience these.

The third trimester, particularly towards the end is a lot of…”What was that feeling? Was it a contraction? Could this be a sign of labor? Hm, I don’t feel quite right today- maybe it’s today!” The nerves and excitement of anticipating “labor day” can be overwhelming so I encourage you to rest, remain calm and know that your baby will come when they’re ready and I assure you, you won’t miss it when it happens!

Baby Development:

As you move into this trimester your baby continues to mature and develop and get ready for life outside of the womb. They can see and hear, which is pretty cool. Try holding a flashlight to your belly, you’ll often notice your baby will begin moving at that spot. It’s also great to be talking to or reading to your baby- they can hear you! And your voice is soothing to them.

At 28 weeks you can also begin doing kick counts. While you’ve most likely been feeling baby move for several weeks now, it’s agreed that by week 28 their movements should be fairly consistent. So your provider may have you pick a time of day to count movements aiming to feel at least 10 in a 2 hour time period.

Baby’s brain, kidneys and lungs continue to develop as well, with most babies’ lungs maturing completely around week 38-40. Your provider will also be looking for your baby to turn into a head down position by around 36 weeks. And your baby may “drop” somewhere between 36 and 40 weeks as well. This is called lightening and it’s just the process of them beginning to descend further into your pelvis.

It can mean you breathe a bit easier though, with less pressure on your diaphragm so it’s often a welcome development for women. And of course your baby is getting bigger and bigger each week. Baby’s grow at different rates but by the end of the third trimester average babies will be between 6-9 pounds and 19-21 inches long.

Prenatal Appointments:

Around the 28th week, your provider will most likely begin seeing you more frequently. Up until this point, most mamas have been going to one prenatal appointment a month. Now you get to double it! You’ll start seeing your provider every other week, but aside from the change in frequency the appointments themselves don’t change much.

You’ll still get the usual measurements and tests like blood pressure, weight and fundal height and have time to ask questions that have come up as your due date approaches. This is a great time to begin discussing your birth preferences with your provider if you haven’t already, and giving them a copy of your birth plan if you’ve written one.

A bit farther along in the third trimester, usually around 35-36 weeks, you’ll be given a Group B Strep (GBS) swab. Sometimes this is a self swab, sometimes the provider will do it for you but it’s quick and painless so don’t fret! If you’re positive for GBS you will most likely receive a course of antibiotics during your labor. Your provider will share more about this depending on your results. At 36 weeks most providers will increase your appointments again and begin seeing you every week.

Another potential addition to your late third trimester appointments would be a growth scan somewhere between 36 and 38 weeks usually. Not all providers do this, but some choose to do an ultrasound at this time to check on how baby is measuring, and get a weight estimate. Just keep in mind there can be a pretty good margin of error with these so take that weight estimate as what it is…an estimate.

The last thing you’ll want to consider about these final appointments is the addition of cervical checks. These tend to be offered beginning in week 36, depending on your provider. Some don’t offer them until later, some only do them if asked, some prefer not to do them until labor etc. so just ask your doctor to see what their practice is.

This check consists of the doctor doing an internal exam with two fingers to check for dilation and effacement of your cervix. While most women describe them as painless, some do report some discomfort and many would describe them as being at the same comfort level as a pap smear if you’re looking for a frame of reference. You are always able to decline these if you don’t want one or, if you’re curious, they can help give you an idea of what might be going on. One thing to keep in mind is these checks can’t tell you when or how soon you’ll go into labor- I know! When are they inventing that test?

Labor and Delivery:

Something you definitely should expect from this trimester is to deliver your baby. I can’t give too many details on what to expect here because birth is so unique to every mama and baby. But I do want to share just a few things that can be expected across the board. 

• You will either have your baby vaginally or via C-section. Sometimes this is known ahead of time, sometimes things change once the process gets started. It’s good to have a plan, but just know that birth can be unpredictable and things may not go according to the plan you make and that’s ok!   
• Be aware of labor signs. No matter what kind of birth you plan on having, you definitely want to know what some common signs of labor are so that you’re prepared if/when they begin for you. Some things to watch for are contractions that are regular and increasing in frequency and intensity, your water leaking/breaking and any bleeding. Keep in mind that your water breaking probably won’t be like the movies with a giant gush in the supermarket. So if you feel like you’re leaking fluid, give your doctor a call.
• Have a plan with your provider for when to come into the hospital. If you’re having a planned induction or C-section they’ll give you very specific instructions on when to come in. However, if you’re planning a spontaneous vaginal birth the guidelines will be different and they vary doctor to doctor so be sure you know what your plan will be.
• Your primary doctor may not be the one to deliver your baby. I think a lot of women can be surprised by this and I don’t want that to be you. Babies come at all hours of the day and night and we can’t expect our doctor to be available for every single one. Most doctors share a call schedule between several doctors so depending on what time of day or which day of the week you deliver, your primary doctor may not be the one in the delivery room. If you’re curious about this, go ahead and ask your doctor how their practice handles calls so you’re not caught off guard if a stranger walks in the room.
• Your baby is waiting at the end of it- keep that in the forefront of your mind no matter how you’re planning to deliver. Once things get rolling, baby is almost here and these long months of waiting, dealing with symptom after symptom are coming to a close and you’ll be holding baby soon.

As always, we’ve included a list of possible things you may want to check off your list during these last few weeks of pregnancy.