Third Trimester Pregnancy Care — Preparing for Birth
Weeks 28 to 40 — The Final Stretch
For the mother, this is often the most physically demanding phase. The bump is large, sleep is disrupted, and the body is actively preparing for labour.
- Reduced or absent fetal movements
- Severe headache unresponsive to paracetamol
- Visual disturbances (blurring, flashing lights)
- Sudden, severe abdominal pain
- Heavy vaginal bleeding
- Signs of ruptured membranes (gush or continuous trickle of clear fluid)
- High fever
- Severe swelling of face, hands, or feet
Symptoms in the Third Trimester
Breathlessness
The growing uterus pushes the diaphragm upward. Breathlessness on mild exertion is common and normal. However, sudden or severe breathlessness needs immediate medical evaluation.
Leg Oedema (Swelling)
Mild ankle and foot swelling — particularly toward the end of the day — is very common. Sudden, significant swelling of the face, hands, or feet — especially with headache or visual changes — may indicate pre-eclampsia. Seek medical attention promptly.
Braxton Hicks Contractions
Irregular, painless tightening of the uterus — the body's "practice contractions." Unlike true labour contractions, they are irregular, don't increase in intensity, and resolve with movement or rest.
Back and Pelvic Pain
The baby's weight and shifting posture put significant strain on the lower back and pelvis. Pelvic girdle pain (symphysis pubis dysfunction) affects many women.
Insomnia
Finding a comfortable sleep position becomes increasingly difficult. Sleep on the left side — this improves blood flow to the uterus and kidneys.
Frequent Urination Returns
As the baby descends into the pelvis (engagement), bladder pressure increases again.
Colostrum Leaking
Some women notice colostrum (early breast milk) leaking from the nipples. Normal.
Tests and Appointments in the Third Trimester
| Test or Check | When and Why |
|---|---|
| Growth scans | Weeks 28, 32, 36 — monitor fetal growth, position, amniotic fluid and placental function; identify growth restriction (baby measuring small) or macrosomia (baby measuring large, common in gestational diabetes) |
| Group B Streptococcus (GBS) screening | A vaginal and rectal swab around weeks 35–37. GBS is a normal part of the vaginal flora in some women but can be harmful if passed to the baby during delivery. Positive women receive antibiotics in labour. |
| Fetal position assessment | Around week 36 the baby should ideally be head-down. A breech presentation (bottom-first) may require external cephalic version (ECV) — an attempt to turn the baby externally — or planning for a caesarean. |
| Pre-eclampsia monitoring | Blood pressure and urine protein at every visit |
| Blood tests | Repeat haemoglobin, and blood group — if Rh negative, repeat anti-D antibody screening |
Understanding Pre-eclampsia
Pre-eclampsia — characterised by elevated blood pressure and protein in urine after 20 weeks — can progress to eclampsia (seizures) if not managed. Watch for severe headache, visual disturbances, pain under the right ribs, and sudden severe swelling.
Preparing for Delivery?
Regular third trimester monitoring catches problems early and makes the final weeks far less anxious. Consult Dr. Dipesh Sorathiya at Khushhi IVF, Thaltej, Ahmedabad for growth scans, screening and birth planning.
Book an Appointment Learn About the ClinicBirth Preparation
Antenatal Classes
Discussing pain management options, stages of labour, when to go to hospital, caesarean versus vaginal birth, and newborn care.
Birth Plan
Discussing preferences with your doctor — pain relief options, who should be present, preferences regarding interventions. Be flexible — birth rarely follows a script.
Hospital Bag
Ready by week 36 for singleton pregnancies. Include documents, comfortable clothing, maternity pads, newborn clothes, and your birth plan.
Frequently Asked Questions
When should I go to hospital during labour?
For first-time mothers: contractions 5 minutes apart, lasting 1 minute, for at least 1 hour (the 5-1-1 rule). If your waters break, go regardless of contractions.
Is it safe to have sex in the third trimester?
In a normal, low-risk pregnancy, yes — unless your doctor has specifically advised against it (e.g. placenta praevia, ruptured membranes, preterm labour risk).
What does "the baby has engaged" mean?
The baby's head has dropped into the pelvis in preparation for birth. This often happens in the final weeks for first-time mothers, sometimes not until labour begins in subsequent pregnancies.
Khushhi IVF 5th Floor, Soham Pristine, Off Sindhubhavan Road, Thaltej, Ahmedabad, Gujarat 380054, India.
