Your Guide to the Third Trimester of Pregnancy

The third trimester, weeks 28 to 40, is an exciting time. You are weeks away from meeting your baby, and the anticipation begins to set in! Dr. Therese Tran, OB/GYN at The Iowa Clinic, explains what happens, what third trimester feels like, and how to prepare for the big day.

Posted by Featured Provider Therese Tran on Friday, December 16, 2022

What Happens in the Third Trimester?

In the third trimester, the final changes are happening with baby — lungs are maturing, hair is growing, eyes detecting changes in light, most bones have hardened, and the brain and nervous system have finished developing. Most babies turn head down by 36 weeks in preparation for delivery.

At your 28-week visit, marking the beginning of the third trimester, you will undergo a screen for gestational diabetes, check blood count, and discuss fetal kick counts, which should start at 28 weeks, advises Dr. Therese Tran, OB/GYN at The Iowa Clinic. After 32 weeks, appointments will occur every two weeks, and after 36 weeks, every week until delivery.

During each visit, baby’s heartbeat, blood pressure, weight, and fetal movement will be measured. Your fundal height and urine will be checked, as well as check for any signs of preterm labor.

Third Trimester Difficulties

While the homestretch brings uncomfortable symptoms for the expecting mother, there are ways to manage discomfort.

Increasing Pelvic Pressure
A common symptom in the third trimester can include increasing pelvic pressure, especially in the last month of pregnancy. This is due to the fetal head descending in the pelvis. Using a maternity support belt can relieve the pelvic pressure and associated symptoms, which can be found online or at a medical supply store.

Urinary Frequency
You may experience occasional leakage of urine during the third trimester. To help prevent this, consider doing daily Kegel exercises to strengthen your pelvic floor. Continue to hydrate well.

Low Back Pain
Some women experience additional low back pain, groin, and hip pain in the third trimester. Remedies to reduce pain and discomfort include:

Tylenol use as directed
Stretching
Heating pad
Prenatal massage
Chiropractor or Osteopathic Manipulative Therapy
Physical Therapy

Other
Some women also lose their mucus plug in the last few months as the cervix starts to soften. It can come out in one piece, or multiple smaller pieces — and can come out weeks before you deliver. The mucus may appear yellow, brown, or slightly blood tinged. Watch for signs of labor, call if you are preterm, experiencing leakage of amniotic fluid, have regular painful contractions, or bleed like a period.

Preterm Labor or Third Trimester Symptoms?

Preterm labor occurs when you begin to have contractions before 37 weeks of pregnancy. Some of the symptoms can be like third trimester symptoms, so it is important to know the difference.

False labor is mild — you can usually walk, talk, and sleep through most Braxton Hicks contractions. They may feel like tightening or mild menstrual cramps. If you are hydrated and rest, and symptoms decrease or go away, then it is not real labor. If you are experiencing regular, uncomfortable contractions that are uncomfortable and less than 10 minutes apart between 28 – 34 weeks, you should call to be evaluated for preterm labor. If you are over 34 weeks, experiencing painful contractions every five minutes for one hour, you should make your way to the hospital for labor evaluation.

10% of patients’ water break before onset of contractions. If that happens at any gestational age, you should immediately proceed to the hospital, regardless of whether you have contractions. The Iowa Clinic OB/GYN providers practice at several locations around Des Moines.

Methodist West – In labor and >35 weeks
Mercy West Lakes – In labor and >32 weeks
Methodist Downtown – In active preterm labor or ruptured and <32 weeks, due to neonatal facilities.

Be Prepared for the Big Day

It is important to know where you will be delivering your baby before the time comes. Staying busy as you anxiously await delivery day is a great way to prepare. It is recommended to do the following:

Set up a tour of the hospital a few months before your due date to learn where to park, where to enter, and how to get to labor and delivery on your big day.
Sign up for prenatal classes to learn about labor and delivery, baby care, breastfeeding, and more.
Pre-register for the hospital — this can be done online on the hospital website, or in office.
Find a pediatrician to take care of your baby after delivery. The Iowa Clinic has a team of pediatricians in four convenient locations around Des Moines. We also offer FREE new parent consultations to meet your pediatrician prior to baby’s arrival to discuss their practice and expectations for the first year.
Get your car seat installed and checked by a certified car seat specialist and learn about car seat safety.
Get a breast pump if you plan to breastfeed. The Iowa Clinic has a medical supply store that offers breast pumps, conveniently located at our West Lakes location.
Pack and prep for delivery day — In the last month of pregnancy, be prepared for baby to arrive at any time. Ensure that you have all personal items you want for the hospital packed, and plan for family or friends to take care of children or pets while you are in the hospital giving birth.

No matter what stage you are in your pregnancy, The Iowa Clinic OB/Gyn department is here for all of it. Visit our website or call 515.875.9290 to learn more.

Meet This Featured Provider

Therese Tran, DO

Learn More About:
Obstetrics & Gynecology, Women's Center

Therese Tran, DO joined The Iowa Clinic in 2009 because she wanted to join a physician owned, multispecialty clinic that collectively makes decisions to improve patient care. Dr. Tran chose OB/GYN because of her passion for women’s health and taking care of women through all phases of life.... Read More

Accepting New Patients