Healthy Pregnancy: Your Third Trimester Guide

You’re in the home stretch of pregnancy, but there’s still plenty of growing to do. Get the facts on the third trimester, including how your body is preparing for the big (labor) day.

If you have what’s considered a high-risk pregnancy—because you are older than 35, have a history of preeclampsia, or have conditions such as diabetes, obesity, or high blood pressure—you’ll probably have seen a maternal-fetal medicine (MFM) specialist along the way in addition to your regular healthcare provider (HCP).

Review the first trimester guide.
Review the second trimester guide.

Key developments: Eyelashes have formed and the eyelids can begin to open. Meanwhile, the central nervous system has begun to direct crucial functions, such as steady breathing and body temperature.

What you need to know: You’ll want to visit your HCP every two weeks (or more often if your pregnancy is considered high-risk). Your HCP can probably tell if the fetus is positioned head- or feet-first. Don’t worry about a breech (bottom down) position right now because that is likely to change in the next couple of months.

That burst of energy you experienced in the second trimester may be long gone now that you’re in the third trimester. “You’re getting bigger and probably uncomfortable,” says Mindy Luck, MD, an OBGYN with Trinity Park Surgery Center in Arlington, Texas. Hang in there!

Key developments: The fetus continues to be very active, stretching, grasping, and kicking. Make sure you’re eating plenty of healthy foods rich in protein, calcium, folic acid, and vitamins to help fuel that activity.

What you need to know: You may experience constipation, heartburn, and hemorrhoids this trimester. Eat lots of fiber-rich foods to keep your bowels moving and avoid or limit spicy and greasy foods to reduce your risk of heartburn.

It’s time to sign up for a birthing class if you haven’t taken one before, says Dr. Luck. Make sure you start no later than 34 to 36 weeks, so that you complete all the classes before your baby arrives.

Key developments: The fetus’ eyes can open wide and begin to focus, a skill that will come in handy after birth. Lanugo—the fine, furry hair that covers the fetus’ body—will start to disappear, to be replaced be more substantial hair on the head.

What you need to know: Don’t be surprised if you go up a shoe size. Your ligaments may have softened thanks to hormone changes, causing your feet to spread out, sometimes permanently.

You’ll gain most of your weight during the third trimester. “It’s typical to gain about a pound a week during these last 12 weeks,” Luck says.

Key developments: The fetus is growing rapidly and moving a lot more these days, too. You’re probably feeling lots of wiggles and kicks.

What you need to know: Colostrum, or pre-milk, may leak from your breasts. If it doesn’t, it’s nothing to worry about. Your body is making it even if you don’t see it.

Hopefully you’ve been counting kicks. “Babies that are healthy and happy are active, and babies that are sick don’t move very much or at all,” explains Luck. Count kicks a couple hours after dinner and if it’s fewer than 10 kicks over the course of two hours, call your HCP, she says. Note that the position of your fetus or placenta may affect your ability to feel movement. Check with your HCP, either way.

Key developments: The fetus will gain up to half of its birth weight during these last two months. Taste buds have developed—which comes in handy because the foods you eat make their way to the fetus via amniotic fluid.

What you need to know: Feeling lightheaded or dizzy? Low blood sugar may be the cause. Keep snacks high in carbs and protein with you during the day to eat when you feel lightheaded.

You’ll definitely feel more back, hip, and pelvic pain and pressure these days, says Luck. You may feel like you have to go to the bathroom all the time, too.

Key developments: The brain and nervous system are now fully formed. The bones in the skeleton are becoming harder, too, although the skull still needs to remain flexible to facilitate passage through the birth canal.

What you need to know: Your walk may have turned into a waddle, and it may feel impossible to find a comfortable position to relax. Low back pain that is persistent is probably normal pregnancy back pain. But if you experience back pain that comes and goes in a regular pattern, you may be in labor, Luck warns. Tell your HCP about these symptoms.

Key developments: Cheeks and legs are getting chunky as more fat fills out the body. These fat layers will help control body temperature after birth.

What you need to know: You’re probably feeling more sluggish these days, but it shouldn’t be as intense as it was in the first trimester. You may also notice stretch marks and extra body hair.

You may feel false contractions—typically a few in the morning and a few at night. “Let your doctor know if the contractions are closer than every 15 minutes or if they are consistent for more than an hour,” Luck says.

Key developments: There’s not much room left in the womb, though that won’t prevent a fair bit of wiggling and kicking. The skin is smoothing out and taking on a chubby appearance.

What you need to know: From this point on, you’ll want to visit your HCP every week. Expect to take lots of bathroom breaks during these final weeks of pregnancy, as the fetus gets bigger and puts pressure on your bladder, says Luck.

Key developments: In addition to shedding lanugo, the waxy, greasy substance called vernix caseosa slides off the skin into the amniotic fluid. The fetus swallows these and they become part of the baby’s first bowel movement (also known as meconium).

What you need to know: The fetus may drop down to your pelvis around this week, especially if it’s your first baby. When this happens, it should ease heartburn symptoms and make it easier for you to breathe.

Your HCP will check for group B strep (GBS) in your vagina and to see if your baby is positioned head down or breech. If it’s a breech situation, your HCP will determine whether or not they can be repositioned. If that’s not possible, your HCP will schedule a C-section, says Luck.

Key developments: Key organ development—including heart, muscles, and bones—is complete. A regular sleeping and waking routine is in place as well, in preparation for life outside the womb.

What you need to know: You may notice an increase in vaginal discharge in the last weeks of your pregnancy. If you see a heavier discharge tinged with a small amount of blood or mucous, labor is probably only a few days away.

“Contractions for labor can vary but generally occur every three to five minutes from the beginning of one to the next,” Luck says. If they last for one minute and come every five minutes for an hour, and/or increase in intensity, it’s time to go to the hospital, she adds.

Key developments: Head hair may be thick and fingernails and toenails may soon need clipping!

What you need to know: It’s normal to experience some swelling in your feet or ankles toward the end of pregnancy. But if you develop swelling in your hands and face and have a headache that doesn’t respond to medicine, you should call your HCP immediately, as you may have preeclampsia. “Preeclampsia is a disease only of pregnancy and the only cure is delivery,” Luck says. It may cause hypertension, kidney problems, and seizures.

Key developments: You’re full term! It’s quite possible your little one will debut this week. Regular movement should continue. If not, contact your HCP right away.

What you need to know: You may experience more noticeable Braxton Hicks contractions as your uterus practices labor. If you feel more consistent contractions or if your water breaks, you’re in labor.

“Water breaking is different for every person,” Luck explains. “Some women may feel or hear a pop and others may feel just a trickle that keeps coming.” If you have a discharge that is enough to soak multiple sanitary napkins, call your HCP, she says.

Key developments: The bones of the skull are separated so that the baby can fit through the birth canal during labor. Don’t be alarmed if your baby comes out with a cone-shaped head. The head will reshape after a few hours or days.

What you need to know: Congratulations on making it to your due date! If you don’t go into labor within a week, your HCP may recommend giving you a non-stress test to check on the baby.

“It’s really common for women to go past 40 weeks,” Luck says. But, don’t worry. Your HCP won’t let you go past 42 weeks and will probably talk to you about induction between weeks 41 and 42.