Third Trimester Pregnancy Guide

You're Almost Through Pregnancy! Get Ready

The third trimester of pregnancy begins when you are 28 weeks pregnant, and whether you feel like the time has flown by or it’s dragging, you’re closer than ever to holding your baby in your arms. The third trimester is a time to get ready for giving birth and bringing your baby home, so make sure to check the following items off your before-baby to-do list:

• Pick up any essential items that haven’t been purchased from your baby registry, such as the car seat, stroller, swing, bouncy seat, nursing pillow, and a playpen or bassinet.
• Install the car seat, and be sure you know how to use it.
• Schedule appointments for any last-minute self-care you’d like done, such as car maintenance, a mani-pedi, waxing, or haircut before giving birth.
• Make a plan now against PPD—It’s extremely important that you communicate with your partner now about a plan for how they will help you should you experience postpartum depression (PPD). Often times, it’s difficult for a mother going through postpartum depression to recognize that it is happening to her, so that’s why you should both be educated on the signs and symptoms of postpartum depression and have a plan in place for what to do and who to reach out to if you experience them.

And of course, you will want to make sure your hospital bag is packed and ready to go (and that your partner knows where it’s located, for any middle-of-the night wake-up calls!). We recommend packing your bag as early as possible, just in case, but don’t worry—should you go into labor without it, the hospital really will have everything you need. But, to stay prepped, here’s what to pack in your hospital bag:

• A comfy, stretchy nursing bra
• A robe or other outfit that you feel comfortable in for after delivery
• Slippers or flip-flops that you don’t mind throwing out after your stay (hospital floors can be gross)
• Chapstick, lotion, deodorant, and any other grooming supplies you may want
• A few take-home outfit options for baby
• A baby blanket
• A folder or Ziploc bag to keep paperwork and baby mementos, like footprints, bracelets, etc.
• Any special snacks you’d like
• A water bottle

During your third trimester you will also have some important tests done by your doctor to prepare for delivery:

• Glucose testing—done sometime around 28 weeks
• GBS testing—this is a swab done of your vaginal and rectal area that tests for bacteria called group B strep around 35-37 weeks. If you have the bacteria, you will be given two doses of IV antibiotics during labor to protect your baby from getting it, and you may have to stay in the hospital an extra day to have your baby monitored as well, as the bacteria can be very serious for newborns.
• Third trimester ultrasound—depending on how your pregnancy is progressing, and if you have any complications, your doctor may schedule a third trimester ultrasound to check on your baby’s growth.

Third Trimester Symptoms

With all those changes happening in your body, you will probably notice some major third trimester symptoms happen in the upcoming weeks, such as:

Growing Belly and Tender Breasts in the Third Trimester

Your baby is packing on the pounds during the end of your pregnancy—about ½ pound every week in the last month alone. As a result, you’ll notice a lot of growth in your belly. That sudden growth may cause some itchiness as your skin stretches and of course, stretch marks. And while you can use lotion or cream to ease the itchiness, stretch marks are genetic, so there’s not a lot you can do to prevent them. Your breasts may also grow even more as you approach your due date, and will most likely start to have more visible veins, bigger and darker nipples and areolas, and leak colostrum (you’ll notice this by how yellow it is), to get ready for breastfeeding. You can use disposable or reusable breast pads to catch the colostrum, and if it’s a significant amount, talk to your doctor about if you should be saving it for your baby.

Braxton Hicks Contractions and Recognizing Labor Symptoms

You will probably notice an increase in Braxton Hicks contractions in your third trimester, especially if this is not your first baby. Braxton Hicks occur when the uterus muscles tighten, as a “warm-up” for labor, but they are not real contractions that mean you’re in labor. Here’s how you can identify real contractions vs. Braxton Hicks and know when to head to the hospital. Real contractions:

• Will typically follow a regular pattern
• Increase in intensity and frequency over time
• Will not disappear when you change positions, or will increase in intensity when you change positions or hydrate
• Tend to be wrap around your body, and might be felt in your back, pelvic area, and even in your bottom

Braxton Hicks:

• Do not follow a regular pattern
• Do not increase in intensity or frequency
• Disappear or decrease when you change positions or hydrate
• Tend to only be felt in the front of the stomach

It can be difficult to know when to go to the hospital, and you should always follow the advice of your doctor, but in general, it’s recommended that you head to the hospital to be evaluated for labor when:

• You have had regular contractions lasting 45-60 seconds every 3-4 minutes for at least 2 hours if this is your first baby
• You have had regular contractions every 5 minutes for 1 hour if this is not your first baby

You’ll also want to be on the lookout for any signs of labor that occur before you are considered full-term at 37 weeks, because your baby is considered premature and may have complications if you go into labor. If you are less than 37 weeks pregnant, you call your doctor or seek medical attention, if you experience any premature labor symptoms such as:

• Any bleeding
• Any fluid leaking or an unusual change in vaginal discharge that looks watery, like mucus, or bloody
• Lower abdominal or pelvic pressure
• Constant, low, dull backache
• Contractions
• Your water breaks (it might be a small trickle of fluid)
• Abdominal cramps

Heartburn, Hemorrhoids, and Other Changes

The third trimester may bring along some less-than-pleasant symptoms, such as:

• Digestive changes. In the third trimester, you may experience an increase in the amount of heartburn you are experiencing. This is due to an increase in the hormone relaxin, which helps loosen your joints and ligaments in preparation for giving birth (it “relaxes” them, get it?), as well as in the increased pressure from your growing baby pushing on your stomach.

Sitting upright after meals, eating smaller, more frequent meals, and avoiding common heartburn triggers, like spicy foods, tomatoes, and dairy, might help. Some women also experience a reoccurrence of third trimester nausea, vomiting, or constipation, again related to how hormones slow your digestive system, as well as the size and pressure of the baby. You might also notice a loss of appetite during the third trimester, which is normal and as long as your baby and you are healthy, is nothing to stress about.

• Hemorrhoids. All that extra blood in your body + increased pressure in your bottom half + constipation from slowed digestion can = hemorrhoids. Hemorrhoids are just swollen blood vessels that protrude from the skin, and while they can be uncomfortable, they usually go away after delivery. For now, ask your doctor about a stool softener and a sitz bath for comfort. (Also, don’t stress about your birthing team seeing your hemorrhoids—totally not a big deal at all, promise!)
• Vaginal discharge. The amount and consistency of your vaginal discharge will increase as you get closer to you due date and your body prepares for birth. Most often, this discharge is thin and looks clear or white, but especially near your due date, you may notice it becomes blood-tinged or resembles mucus, which could be your bloody show and mucus plug. Your mucus plug blocks your cervix, but loosens as you approach delivery—you can use your mucus plug all at once, or slowly, over time as it loosens. If you notice any consistent or a lot of bleeding, thick, odorous discharge, or fluid leaking, however, always call your doctor.

What Happens to your Baby During the Third Trimester?

There are a lot of exciting developments that occur in the third trimester of pregnancy. Here’s a week-by-week breakdown of what happens to your baby in the third trimester:

• Week 28 - Is able to open their eyes and see changes in light
• Week 29 - Can kick and stretch
• Week 30 - Respond to sounds
• Week 31 - All 5 senses are developed.
• Week 32 - Gains rapid weight and fat accumulates
• Week 33 - Has a sleep pattern
• Week 34—Turns to a head-down position to prepare for birth
• Week 35— Your baby is beginning to shed some of the lanugo, or fine hair he or she is covered in
• Week 36- Lung maturity deepens
• Week 37—Your baby is officially considered “full-term”

During the last trimester, every single day counts for your baby’s development, which is why it’s so important to follow your doctor’s advice about going full-term and letting labor occur on its own, unless you have a medical complication that warrants an induction or C-section.

Your Little One is Almost Here

The third trimester—especially in the last few weeks—can feel like the longest waiting game of your life. As your belly gets bigger in the last days of pregnancy (you know that moment when you thought it couldn’t possibly get bigger? Yeah, that’s just when it will!), you might start to get more physically uncomfortable and just plain old tired of being pregnant. And that’s OK! Motherhood is not all sunshine and roses and you’re allowed to admit that it’s not always easy. As much as you are able, try to use the last few weeks of pregnancy to rest as much as you can, distract yourself with “last” outings, like your last baby-free nap, a spa day with friends, or one-on-one time if you have other children. You’ll also want to focus on wrapping up any big tasks you have at work and be sure to have a plan for if you go into labor early, including childcare for your other kids. You might find that you get that infamous “nesting” urge and a big surge of energy near your due date, so if you do, take advantage of it to finish up any lingering projects you’d like done before the big day. We suggest prepping now to make things a little easier for you postpartum. Some suggestions:

• Prepare a few freezer meals to have on hand.
• Schedule Amazon subscription deliveries for baby essentials, such as diapers, wipes, formula if you’re not breastfeeding, and (ahem) coffee.
• Prep a “baby station” in your room, with a phone charger, water bottle, robe, tissues, remote, e-reader, snacks, etc.—anything you’d like within an arm’s reach while you’re holding a baby!