Third Trimester Overview

Third trimester: you, your baby, your appointments

Weeks 27 through 40 may be the home stretch, but they can also feel like the slowest weeks ever. Here are some common complaints during the third trimester, and what you can do about them:

Heartburn. That burning sensation near your heart is the result of acid from your stomach leaking up into the bottom of your esophagus. This is caused by a combination of hormones and your baby putting pressure on your stomach. Try smaller meals and avoid spicy, fatty foods. Try not to lie down right after eating. Your provider might recommend antacids, too.

Constipation. Again, hormones and pressure from the baby are to blame, as well as iron supplements (if your provider has recommended them). Constipation can also lead to hemorrhoids, which are varicose veins around the rectum and anus, caused by pushing too hard for too long during a bowel movement. To stay regular, get more fiber by eating more fruits, vegetables and whole grains, drink more water, and try regular exercise like walking.

Sleep difficulties. You’re probably more tired now, although not as fatigued as during your first trimester. Your sleep positions are very limited at this point. To get a little more comfortable, try resting with pillows under your belly and between your knees. Your baby is also putting pressure on your bladder, causing you to have to go to the bathroom more often, especially at night. Worries about the upcoming birth and your role as a mother may keep you awake at night, too. Try relaxation techniques like meditation or deep breathing, or a shower, warm bath or reading a good book before bed. 

Swelling. A bit of swelling in your lower legs, ankles and feet is normal in late pregnancy, especially in hot weather or if you’ve been standing or sitting for a while. You can lessen it with moderate exercise, loose clothing, resting with your legs and hips elevated, or even wearing support stockings. However, if your swelling is sudden or severe, or if you gain more than two to three pounds in a week, contact your provider right away.

Leg cramps. Pressure from the baby on your nerves, or changing levels of calcium and phosphorous in your blood, can cause leg cramps. Try applying heat over the affected area, pointing your toes upward, and massage. You may want to ask your doctor or midwife about taking calcium supplements or other medications.

Braxton-Hicks contractions. These mild, irregular contractions feel like your belly is tightening and releasing, and are just your body’s way of preparing for labor. They don’t mean labor is about to happen, unless the contractions grow stronger, painful and more regular, in which case you should contact your provider. If the Braxton-Hicks contractions bother you, try drinking more water, changing positions or lying on your left side.

Some signs of concern that you’ll want to let your provider know about right away include:

• Unusual vaginal discharge, itching or sores
• Severe vomiting or continued morning sickness
• A temperature of 101 degrees or higher
• Pain or burning when you urinate
• Sudden weight gain
• Swelling of your hands, feet, face or ankles
• A definite decrease in urination
• Severe or persistent headaches
• Dizziness or blurred vision

You should also watch out for signs of premature labor (before 37 weeks), and contact your provider right away if you experience any of these symptoms:

• Vaginal bleeding (except light spotting after a pelvic exam)
• A gush or uncontrolled leaking of fluid from your vagina
• Sharp, constant abdominal pain
• Cramps along with a low, dull backache that last more than an hour

The third trimester means a big growth spurt for your baby, who is starting to gain about half a pound each week. Her organs continue to develop, and she’ll have noticeable active and restful periods. She will most likely have settled into a head-down position, ready for birth.

Your appointments will take place more often now — every two weeks starting at about weeks 28 to 32, then every week from 36 weeks on. In addition to the usual routine, your doctor or midwife may give you a pelvic exam to check the baby’s position and the status of your cervix.

At 28 weeks, you will probably undergo a glucose tolerance test to check for gestational diabetes. It involves drinking a sugary liquid over a five-minute period, followed by a blood test an hour later. If your results are abnormal, you’ll have a follow-up test.

Your doctor or midwife might also ask you to keep track of your baby’s movements, called a fetal movement count. It will help you get a sense of what is normal for your baby, so you can be alert to anything that suddenly seems different.

If you are past your due date, have complications or a low fetal movement count, your provider may have you do a non-stress test to measure your baby’s heart rate in response to her own movements. You may also have an ultrasound to check on your baby’s size and activity level, the placenta and the amount of amniotic fluid.

View third trimester checklist