Welcome to the home stretch! Week 28 of pregnancy marks the start of the third trimester. Now that you’re here, it’s almost time to finally meet your little one. Your baby will be considered full-term once you reach week 39, and the big day typically arrives around week 40. Remember, your due date is an estimation – you may deliver a bit after or before the exact 40-week mark.
In the meantime, read on to learn what you can expect during the next few weeks that make up your third and final trimester. We’ve also provided answers to some of the most common questions parents-to-be have about the third trimester.
Common third trimester symptoms
Every pregnancy is different, but there are a few common changes to your body that you can expect during the third trimester. For one thing, your baby will gain a lot of weight in the third trimester – three or four times what they weigh at the beginning of the trimester. Between that and the hormonal changes you’ve been experiencing throughout pregnancy, you may find that symptoms you experienced in previous trimesters continue and become more intense.
Aches and pains
Among the many hormonal changes during pregnancy, an increase in the hormone relaxin prepares your body for childbirth by loosening the ligaments in your pelvis and, eventually, softening and widening your cervix. While this helps make childbirth easier, it means that your muscles have to work harder to support your baby’s increasing weight. This can lead to more discomfort, particularly in your back, pelvis and legs.
Sleeping problems
You may have experienced pregnancy fatigue in the first trimester while your body went through hormone changes and began to grow the placenta and fetus. Fatigue is also a common symptom in the third trimester, but it’s usually because you may not be sleeping as well or as comfortably as before. There are a lot of things that may be waking you up throughout the night, including various aches and pains, frequent urination and heartburn.
Heartburn
Those relaxation hormones also relax your stomach valve, which makes it easier for stomach acid to get through and cause heartburn. Now, as your growing baby presses up from underneath your stomach, this may become more frequent.
Heartburn can be reduced by avoiding fatty and spicy foods, citrus, caffeine and carbonated drinks, and by eating smaller, more frequent meals. You can also take oral antacids, but if those aren’t enough to relieve your heartburn, talk to your care provider. They may be able to prescribe an anti-heartburn medication that’s safe for your baby.
Braxton Hicks contractions
Braxton Hicks contractions are false labor contractions. These cramp-like sensations can happen throughout pregnancy, but they typically become more common and intense in your third trimester. Some people may not feel these contractions at all, or they may be strong enough to be mistaken for true labor contractions.
Braxton Hicks contractions usually have irregular intervals and stay relatively consistent in strength. They also subside over time, especially with changes in position or after drinking water. This is different from true labor contractions, which become stronger and more frequent as they progress.
If you aren’t sure about what you’re feeling, or you experience contractions with other signs that labor is starting, call your care provider and be prepared to go to a hospital if needed.
Frequent urination or incontinence
The bigger your baby gets, the more pressure they put on your bladder. So in the third trimester, you may find that you’re making more trips to the bathroom. You may also find that the added pressure causes urine to leak when you do things like laugh, cough, bend over or pick things up. This is a form of pelvic floor dysfunction called stress incontinence. It often goes away in the months following childbirth but may require strengthening the pelvic floor muscles.
Swelling
When you’re pregnant, your body’s blood volume increases substantially and retains fluids differently to support your baby. So, it’s normal to experience some mild swelling in your hands, face, legs, ankles or feet – especially as you get closer to childbirth.
Swelling may increase after long periods of standing, activity or spending time in hot environments (such as being in the sun during summer). However, contact your care provider if you notice sudden swelling in your hands or face, as it may be a sign of preeclampsia, a pregnancy complication involving high blood pressure and possible organ damage if left untreated.
Skin changes
As your skin continues to stretch, you may notice stretch marks appearing on your breasts, stomach and thighs. This may come with itchiness. In addition, the pigmentation of your skin may become more pronounced, leading to color patches around your body.
Varicose veins
It’s common to develop swollen varicose veins during pregnancy as a result of increased blood volume and the pressure the baby puts on blood vessels in your pelvic region. Varicose veins may be blue or purple, and appear twisted and “raised” against the skin around them. They’re most common around the legs, genitals and rectum – and you may feel pressure, discomfort or itchiness. Most of the time, they’ll go away within a few months after childbirth.
Mood changes
Your emotions in the third trimester might seem a bit all over the place. Your hormones are still fluctuating, you may be experiencing sleep disturbances or other discomforts, and you’re closer than ever to giving birth and meeting your baby. Both excitement and anxiety – as well as sudden switches between the two – are normal during this time. But if you find that you’re feeling overwhelmed, let your partner and other loved ones know. You can also make an appointment with your doctor. It’s important to look after your mental health just as much as your physical health.
What fetal development occurs in the third trimester?
The third and final trimester sees a lot of growth for your baby. Over the next few weeks, they’re not only putting on weight – their organs will continue to mature, their bones will harden, and their hair will begin to grow in, along with their fingernails and toenails. They’ll also continue to practice taking breaths and grasping.
How much should the baby move in the third trimester?
Your baby’s growth will leave them with less space to move around, but you’ll continue to notice their movement – your baby may be especially active after meals and in the evening. If your baby seems quieter than usual, try counting their movements. Generally, somewhere around 10 movements within an hour is normal.
But don’t worry if your baby doesn’t move that much – they may just be sleeping. Try eating or drinking something, then counting for another hour. Call your care provider if your baby doesn’t move 10 times within two hours, or if you notice a sudden or dramatic change in your baby’s movements.
What to expect at your third trimester prenatal appointments
Your third trimester prenatal appointments will be similar to what you experienced in your previous batch of appointments, but with some additional tests and more frequent visits as you approach your due date. The exact frequency of your prenatal appointment schedule will depend on whether your pregnancy is low or high risk, and where you have your appointments. Generally, you can expect to have visits at least once every four weeks until week 36 of pregnancy, then weekly until birth.
In addition to routine prenatal tests, third trimester tests will include a screening for Group B Streptococcus (Strep) when you’re closer to your due date. Group B Strep bacteria are common and naturally cycle through the body, but they have the potential to cause serious infections in newborns. If they’re present, you’ll have to go to the hospital as soon as your water breaks, because that makes it possible for bacteria to enter the uterus and increases the likelihood of infection. At the hospital, you’ll start on antibiotics and continue them throughout labor.
At around 36 weeks, your doctor or midwife may also do another pelvic exam to check your baby’s position. If your baby isn’t positioned for a head-first delivery, they may recommend methods for getting the baby into the correct position. If it doesn’t look like this will be possible, your care provider will discuss the possibility of a C-section with you.
When to talk to your doctor in the third trimester: Signs to watch for
In the third trimester, it’s more important than ever to pay attention to your body and the signals it’s sending you. Don’t hesitate to reach out to your care team if you have questions about how you’re feeling or the symptoms you’re experiencing. Your care team is expecting to be in closer contact with you during these final weeks, and they can tell you whether something is normal or worth a visit to get evaluated.
How to tell if you’re going into labor
The most common signs that it’s time to go to the hospital are regular contractions that are five minutes apart for at least an hour (if it’s your first baby) or your water breaking. However, there are a few other signs that labor might be starting, including lower abdominal pain and losing your mucus plug.
Other reasons to call your doctor
Along with signs of labor, it’s important to be aware of symptoms that could indicate a potential pregnancy complication. Call your doctor right away if you experience:
- Changes in your vision, like seeing spots or lights
- Chest pain or a sudden, rapid heart rate
- Constant pain between contractions
- Dizziness, fainting or trouble breathing
- A headache that doesn’t go away or gets worse over time
- Sudden or extreme swelling in your face, hands, arms or legs
- Severe nausea or vomiting
- Severe redness or pain in an arm or leg
- Vaginal bleeding
- Your baby’s movement slows significantly or stops
- Your water breaks without contractions
Other frequently asked questions about the third trimester of pregnancy
Is nausea during the third trimester normal?
Morning sickness tends to fade around 14 weeks of pregnancy, but not always. It’s still very possible – and normal – to experience pregnancy-related nausea during the third trimester. It may intensify as your growing baby competes for space with everything else in your abdomen.
How should you sleep during the third trimester of pregnancy?
By this time, your baby bump will likely be too big for you to sleep on your stomach comfortably. It’s important to avoid sleeping on your back for extended periods of time because the weight of the baby could reduce blood flow through your abdomen.
Sleeping on either side with pillows between your legs and under your stomach is often a comfortable solution and helps promote circulation. But if you wake up on your back, it’s usually nothing to worry about. Just make sure to roll back onto your side.
Is it safe to have intercourse during the third trimester of pregnancy?
As long as it’s comfortable and your care provider hasn’t told you to avoid it, it’s safe to have sex during the third trimester. However, it’s generally recommended to avoid sex after your water has broken, if you lose your mucus plug, or if contractions start earlier than 37 weeks. Talk to your care provider if you have any questions or concerns about sex during this time.
Also, keep in mind that it’s normal not to feel like having sex in the third trimester – your libido will likely ebb and flow throughout your pregnancy.
How much weight do you gain in the third trimester?
If you were at a healthy weight pre-pregnancy, you’ll likely continue to gain weight at the same rate you did during your second trimester. Your personal recommended weight gain will depend on your starting weight and how much you’ve gained up to this point.
What can you do to stay healthy during the third trimester?
As long as you’re staying on top of your prenatal appointments and following your care team’s recommendations, there won’t be many new things to do or not do during the third trimester. You’ll still need to avoid environmental risks like excessive heat exposure and toxins like cigarette smoke and cleaning agents, and you’ll need to keep eating healthy pregnancy foods.
It’s also important to stay active throughout pregnancy, including the third trimester. However, because of the increasing weight of your baby, your joints loosening and a possible dip in your overall energy levels, you may need to scale back your workouts.
Can you fly in your third trimester?
If you have a low-risk pregnancy, air travel is usually fine until around week 36 of pregnancy. But it’s best to talk to your care provider before traveling in your third trimester.
Get ready for the big day and beyond
The third trimester of pregnancy is a perfect time to start channeling your excitement toward preparations. If you haven’t yet, start thinking about how you want labor and delivery to go. What kind of atmosphere do you want? Do you want to try for an unmedicated birth or use an epidural? You can answer these questions and others by putting together a birth plan.
It can also be helpful to start learning about postpartum recovery and breastfeeding. There’s a lot of advice for new parents out there that can help prepare you for the days after delivery and your first experiences with your newborn.