Third Trimester of Pregnancy: Find all the Facts here

The third trimester of pregnancy is the most happening last three months of pregnancy. Starting from week 28 to 40 weeks, this phase seems long and a bit exhausting. The first 3 months of excitement and the second trimester of pregnancy glow along with the high of the baby’s kicks gradually lands you in the most important phase of your pregnancy. Though happy to welcome the bundle of joy in their life, the to-be-mothers feel anxious about the future course of labour and delivery.

An increase in body weight with increasing baby weight makes them a bit clumsy. Nausea and vomiting may return in this trimester after its occurrence in the first trimester of pregnancy. The key to keep happy and going is continuing exercises and meditation which will relax them mentally as well as physically. Family support goes in a long way to make them confident and happy.

Important tests to be done in the third trimester of pregnancy

Most of the tests done this trimester are to check the baby’s growth as well as the mother’s being.

• Hemoglobin and a complete blood count of the mother

Before women go into labour, this is the final check of Hb levels. As normal delivery or cesarean, both can decrease Hb level to some extent, doctor wants to ensure that the patient lands in labour with adequate Hb. If still low, one has to resort to injectable iron and in severe cases blood transfusion.

• Urine microscopy and culture

Simple and important tests to avoid preterm delivery as asymptomatic urine infections are a major cause of preterm pains. It also detects albumin or protein in the urine, if present along with high BP is a sign of pre-eclampsia of pregnancy. Sugar in urine can help to detect diabetes which is common in elderly and obese pregnant ladies.

• Sonography obstetrics with colour doppler

This is done around 34 to 35 weeks to know about liquor amni, fetal weight, and placental grading. It can also detect if there is a loop of cord around the neck. Colour doppler tells us whether adequate blood is reaching the baby through the placenta.

• Non-stress test ( NST )

This is a very important test of monitoring fetal heart rate with fetal movements. Done around 35 to 37 weeks. This monitoring is also used during labor to monitor the baby’s heartbeat.

 Physiological changes during the third trimester of pregnancy

Weight Gain

The increasing weight in this trimester makes daily activities a bit difficult for women. Watch out, ladies! You should not gain too much weight. If you have sudden swelling on your feet or whole body, consult your gynecologist immediately as it may be an early sign of pre-eclampsia.

 Breast changes

A gradual increase in the size of the breast in later months may make you a bit uncomfortable. The area around the nipple darkens and the nipple becomes tender. Ask your doctor now about breast care.

 An increase in abdominal girth

This may put a strain on your spinal cord and back and may change your posture. Don’t be tough on your body. Be gentle and slow in exercises.

 Breathing difficulties

An increase in blood volume, as well as an increase in abdomen size, may put a strain on your lungs and make you breathless occasionally.  Start doing breathing exercises.

 Leg cramps

Leg cramps are common in this trimester. Please, continue stretching of legs and light massage before going to bed. Keep the salt and water intake adequate.

 Back pains

A pregnancy bump puts a strain on the abdomen as well as paraspinal muscles. Spinal curvature also changes in later pregnancy giving back muscle spasm and back pain. Doing exercises and stretching makes those muscles strong and can reduce pain. Hot fomentation and light back massage can help.

Vaginal Discharge

Though mucous and white discharge is common this time, anything liquidy or watery discharge, pink or red discharge to be urgently notified to your doctor.

Nausea / Vomiting 

May return in the latter part of this trimester.

Emotional changes  in the third trimester of pregnancy

1)  Most of the first time mom-to-be’s feels anxious about labour and delivery. Counseling sessions with the doctor will ease anxiety.

2)Changes in the body especially increase in weight and swelling over the body give stress about whether they will be able to lose weight. Worry not ladies! You will do it. For now, just take care and be happy.

3) Young moms worry about how they will take care of their newborn especially those having a nuclear family. As I said maternal instinct takes over once you deliver. You are strong enough to take care of your baby.

4) On the happier side, a sense of belonging and pride to be a mother’s feeling is always there. Even if they are anxious about the course of labour , they feel at the top of the world feeling a strong movement of life inside them.

Fetal development week by week in the Third Trimester of pregnancy 

Week 28 

Your baby’s eyelids can partially open and eyelashes have formed. By now baby is 10 inches long from crown to rump and 1000 gms in weight.

Week 29 

Did you feel that? Your baby can kick hard and stretch and can make grasping movements.

Week 30 

The baby’s eyes can open wide. Some babies have good hair on the head by this week.

The baby is 10 and a half-inch long and approx 1300 gms in weight at this stage.

Week 31 

Major development finishes. Now its time for rapid weight gain.

Week 32 

Baby practices breathing from this week. Toenails are visible. The baby is 11 inches tall and 1700 gms in weight.

Week 33 

Attention ladies! Your baby can detect light and his /her pupil can change size in response to the stimulus of light. Bones are hardening though the skull remains soft.

Week 34 

Baby’s fingernails have reached fingertips in this week. Your bundle of love is 12 inches in length from crown to rump and 2100 gms in weight.

Week 35 

Along with chubby appearance, the skin is becoming smooth.

Week 36 

The baby takes the whole of amniotic space and you still feel lots of kicks and stretches. You may feel heavy in the lower abdomen.

Week 37 

The baby’s head starts descending in the pelvis and you may have difficulty walking.

Week 38 

38 weeks into pregnancy and your baby’s head circumference is nearly equal to your pelvis circumference. Toenails have reached the tip of toes. Weight might vary between 2500 gms to 2900 gms.

Week 39 

Fat is being added to keep the body of the baby warm. For boys, testes continue to descend into the scrotum. Your baby’s chest is becoming more prominent.

Week 40 

Congratulations! Your due date arrives. The baby is 14 inches long with an approx weight of 3000 gm to 3400 gms.

You may deliver any time. It is ok to go past few days of your due date if all fetal parameters are normal.

Diet in the third trimester of pregnancy  

Foods to eat

• Take a diet which includes Protein, Complex Carbohydrates, healthy fats, vitamins, and Minerals
• Add eggs, lean meat, Paneer, Tofu, boiled sprouts, pulses, and beans to the diet
• For calcium add dairy products, cheese, milk, broccoli, etc.
• Drink enough water.
• Eat 2 to 3 fruits daily.
• Add carrots, beetroot, cabbage, and bell peppers in the diet along with green leafy vegetables.

Foods to avoid 

• Unpasteurized products
• Raw fish
• Raw sprouts
• Caffeine…not more than one or two cups of tea coffee
• Smoking
• Alcohol

Common ailments in the third trimester of pregnancy 

• Frequent urination

The increasing weight of the uterus puts pressure on the bladder making it difficult for them to completely evacuate the bladder.

• Breathing difficulties

An increase in blood volume plus large abdominal girth pushes the diaphragm up giving difficulties in breathing.

• Preterm pain in the abdomen

If you have mild pain or tightness of the abdomen, urgently notify your doc. Timely medication can prevent preterm delivery.

• Preterm rupture of membrane (PROM)

Rupture of the membrane before the delivery date is one symptom the Gynaec is scared of. It can lead to infection and further complications. Visit your doctor on an urgent basis if you have leaked.

• Bleeding or spotting from the vagina

It may be due to low lying placenta or in some cases. It’s an indication of the start of labor. Require checkup by doc.

• Preeclampsia of pregnancy

It is an important disorder to know about. It causes swelling on the feet, hands, and body of a pregnant patient with an increase in blood pressure. If untreated, it can be dangerous not only for the fetus but the mother too can have convulsions.

• Skin changes in the third trimester of pregnancy

Most females this time can have itching and dryness over the abdomen. Oil applications and keeping skin moisturized can help.

• Backache, leg Cramps, not getting sleep at night, unable to eat and indigestion are few hitches one may face.

What can be expected from a doctor in the third trimester of pregnancy?

• You will have every fortnightly visit with your doctor. Apart from BP, weight check, growth, fetal movements can be checked. You may need to monitor fetal movements at home too.
• The doctor may do a vaginal examination to check the opening of the cervix as well as to assess the pelvis for normal vaginal delivery.
• Few additional pelvic exercises to help you deliver may be explained to you.
• The importance of a healthy diet with all the nutrition required for the baby especially in the third trimester of pregnancy may be stressed upon by your doctor.
• Keep on doing breathing exercises as explained by your doctor.
• Discuss the option of Epidural Analgesia (painless delivery) and its pros and cons.
• If your Gynaecologist is planning for an elective Cesarean section ( due to condition in which vaginal delivery is not possible), discuss the anesthesia they are going to give.
• Your doctor will discuss breast care and the importance of breastfeeding with you. They may explain to you the ways and postures of breastfeeding.

Congratulations on the completion of pregnancy and be ready to take on the next beautiful phase of your life.

Happy Parenting!

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About the author

Dr. Meenal Dhabalia, M.D (Gynaecologist & Obstetrician) 

She has a robust experience of 25 years as an Infertility Consultant, Obstetrician, and Gynaecologist,

Laparoscopic surgeon. Her expertise in Infertility treatment, High-risk pregnancy, and Gynaec endoscopy is well known. She is the Medical Director of Aditi IVF and Medical Centre, Dattani Park, Kandivali East, Mumbai. She is also the Chief Consultant in Aditi Superspeciality Hospital, Asha Nagar, Kandivali East Mumbai.

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