At Your Checkup
Your prenatal visits will now occur more often. Starting in your 28th to 32nd week, you will probably see your doctor every two weeks, and then once a week starting at about 36 weeks. In addition to what has been routinely checked, your doctor may do a pelvic exam at about 37 weeks to check the position of your baby and the condition of your cervix. You may want to use some of these visits to meet your doctor’s partners if there is a chance one of them will be on call when you deliver.
Your birth plan
Now is the time to review plans for the birth with your doctor. A written birth plan is a tool that lets your health-care team know what options are most important to you.
Tests and screenings
Depending on your specific needs and your doctor’s style of practice, a variety of tests and screenings may be done during this last trimester. A Glucose Tolerance Test (GTT) is usually done at about 28 weeks to screen for a condition known as gestational diabetes. This simple test involves drinking a bottle of sugar solution over a five-minute period, followed by a blood test one hour later. If the results are abnormal, more testing will be done.
Changes in your baby’s movements may reflect changes in her well-being. Some doctors recommend doing Fetal Movement Counts, which involves keeping a record of the number of times your baby moves during the later part of your pregnancy. Because each baby has an individual pattern of activity, the normal range can vary widely from 20 to 200 movements per day. Your doctor may ask you to keep a record of the number of times your baby moves during the day. Here is one suggested method:
When you arise in the morning, begin counting the number of movements you experience. Three simultaneous kicks would be counted as three movements.
If you have not felt 20 fetal movements by noon, have lunch and sit in a quiet location to continue your movement count.
If, by early to mid-afternoon, you still have not reached a count of 20, call your health-care provider. Also, call if you feel no movement during an eight-hour period or if you think that the pattern of fetal movement has changed significantly from what it usually is (a lot more movement, or a lot less).
Check with your provider for his or her specific recommendations.
If you are beyond your due date, have complications or low Fetal Movement Counts, your doctor may order a Non-Stress Test (NST) to measure your baby’s heart rate in response to her own movements. An NST usually takes 20-30 minutes, but can take longer if your baby is asleep during the test. In addition, an ultrasound screening may be ordered to check your baby’s size and activity level, the amount of amniotic fluid and the placenta.
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One Patient's Story
Amazingly, her twin boys were born three weeks apart.