What to expect as you move closer and closer to completing your pregnancy and experiencing the wonderful moment of your baby’s birth!
The third trimester of pregnancy can be physically and emotionally challenging.
The size and position of your baby may now start making it harder for you to feel comfortable. You may feel tired from the pregnancy and wish to move forward more quickly to the final stage. Try to stay positive as you look forward to the end of your pregnancy. Soon you will be holding your baby in your arms!
Your body and its final changes
As your pregnancy progresses, your baby’s movements will become more noticeable. These exciting, stronger movements are often accompanied by increasing physical and breathing discomfort, as well as other symptoms, such as:
Braxton Hicks preparatory contractions
You may feel these mild, irregular contractions as a slight tightening in your abdomen. They are more likely to appear in the late afternoon or evening, after increased physical activity or sex. These contractions tend to become more frequent and stronger as you approach your expected due date.
Back pain
Pregnancy hormones loosen the connective tissues that hold your bones in place, especially in the pelvic area. These changes can be challenging for your back and often lead to discomfort during the third trimester of pregnancy. When sitting or lying down, choose chairs or pillows that provide good back support.
Shortness of breath
During the third trimester of your pregnancy, you may find yourself getting tired much more easily. Practice good posture to give your lungs more room to expand.
Heartburn
Pregnancy hormones relax the valve between your stomach and esophagus. This can allow stomach acids to flow back into your esophagus and cause heartburn. To help prevent severe heartburn, eat small, frequent meals. Also, avoid fried foods, citrus fruits, chocolate, and spicy or greasy foods.
Spider veins, varicose veins, and hemorrhoids
Increased blood circulation can cause tiny red-purple veins (spider-like in appearance) to develop on your face, neck, and hands. This redness usually fades after childbirth. You may also notice swollen veins (varicose veins) in your legs. Painful, itchy varicose veins can also appear in the rectal area (hemorrhoids). To relieve swelling, exercise regularly and elevate your legs often, include plenty of fiber in your diet, and drink plenty of fluids. To ease hemorrhoid discomfort, soak in a warm bath or apply soothing pads to the area.
Frequent urination
As your baby moves down and settles into your pelvis, you will feel increased pressure on your bladder. You may notice that you need to urinate more and more often. This extra pressure may also cause urine leakage — especially when you laugh, cough, sneeze, bend, or stand up.
Your emotions
As anticipation grows, fears about labor may become more persistent.
How much will it hurt? How long will it last? How will I cope? If you haven’t already, consider attending childbirth classes with your midwife. You’ll learn in detail what to expect — and you’ll meet other expectant mothers and couples who share your excitement, worries, and concerns. To stay calm, write your thoughts in a journal, read uplifting books, and engage in gentle exercise.
Prenatal care
During the third trimester, your doctor will ask you to come in more frequently for your ultrasound check-ups — possibly every two weeks starting at week 32, and every week starting at week 36. As in previous visits, your doctor or midwife will check your weight and blood pressure, ask about any signs or symptoms you are experiencing, and recommend vaginal cultures. They will also check your baby’s size and heart rate, its position in your pelvis, and ask in detail about your baby’s movements. During these weeks, weekly non-stress tests (NSTs) also begin for more complete and thorough monitoring. You will also discuss your preferences regarding labor and pain management as you prepare for childbirth. If you have specific wishes for your birth — such as a water birth or avoiding medication — outline them in a birth plan. Review the plan with your doctor and midwife, but keep in mind that certain complications during labor may require adjustments. As your due date approaches, gather all necessary information and don’t hesitate to ask questions. Knowing what to expect can help you have the most positive labor experience and a truly unique and beautiful birth of your baby!
In the third trimester, pressure in the pelvis is expected. See when lower abdominal pain in pregnancy needs to be checked.
Third trimester of pregnancy: how your baby grows week by week
In the third trimester the baby does not form new organs. It grows, puts on fat and matures, especially the lungs and brain. The weights below are approximate averages, and every baby has its own growth curve.
- Week 28: around one kilogram (about 2.2 lb). The eyes open and the baby reacts to sounds and light.
- Week 32: about one and a half to two kilograms (about 3.3 to 4.4 lb). Movements feel “fuller”: fewer kicks, more rolling and turning.
- Weeks 34 to 36: the lungs mature significantly. Most babies have now settled head down.
- Week 37: the pregnancy is considered full term. However, weeks 39 and 40 remain valuable for maturation, so delivery is not scheduled earlier without a medical reason.
- Week 40: the average birth weight is about 3.3 to 3.5 kilograms (about 7.3 to 7.7 lb).
For the full picture of pregnancy from the beginning, see the stages of pregnancy week by week.
Vaccines and special tests in the third trimester
Beyond routine tests, the third trimester is the time when you protect your baby even before birth.
- Whooping cough vaccine (Tdap): recommended in every pregnancy, ideally between 27 and 36 weeks. The antibodies pass to the baby and protect it in the first months, before its own vaccinations.
- Respiratory syncytial virus (RSV) vaccine: where offered, it is usually given between 32 and 36 weeks and lowers the risk of severe bronchiolitis in the newborn.
- Flu vaccine: in any trimester, during flu season.
- Anti-D immunoglobulin: for Rh-negative women, usually around 28 weeks.
- Hemoglobin and ferritin: anemia is common in the third trimester and is easier to correct if it is caught early.
- Growth ultrasound with Doppler: as part of obstetric ultrasounds, usually between 30 and 34 weeks.
Your baby's position and what happens if it is breech
Until 32 weeks, many babies change position often. By 36 weeks the vast majority have turned head down. At the end of pregnancy, about three to four babies in a hundred remain in breech position.
If your baby is breech at 36 weeks, you will discuss the options:
- External cephalic version (ECV): the obstetrician tries to turn the baby by gently pressing on the abdomen, under continuous ultrasound monitoring. It succeeds in about one in two women.
- Planned cesarean section, usually after 39 weeks.
- Vaginal breech birth, only in selected cases and with an experienced team.
Sleep, travel and daily life in the final weeks
Sleep
From 28 weeks, try to fall asleep on your side, left or right. Studies have shown that sleeping on your back in the third trimester is linked to a higher risk for the baby, because the uterus presses on the major blood vessels. If you wake up on your back, do not worry. Simply turn onto your side. A pillow between your knees and one behind your back make the position more comfortable.
Travel
- Most airlines accept pregnant women with an uncomplicated single pregnancy up to about 36 weeks. After 28 weeks they often ask for a medical certificate.
- On trips longer than four hours, get up, walk around, drink water and ask your doctor about graduated compression stockings.
- In the car, always wear your seat belt: the lap belt below your belly, across your hips, and the diagonal strap between your breasts.
- Do not travel too far from your maternity hospital after 36 weeks.
Exercise and sex life
Walking, swimming and gentle pregnancy exercise can continue as long as there is no contraindication. Sex is safe unless your doctor has advised against it, for example with placenta previa, bleeding or ruptured membranes.
Birth preparation checklist
The last weeks go by faster than you think. A simple timeline helps:
- By 34 weeks: choose a pediatrician, register at the maternity hospital, and discuss your birth plan and pain relief.
- By 36 weeks: a packed bag for you and the baby, a folder with your test results, and a baby car seat installed correctly.
- Learning about breastfeeding: a session with a lactation consultant or midwife before the birth makes the first days much easier.
- Organizing your home: who will look after older children, who will drive you, who will help in the first weeks.
Signs that labor is approaching
- The belly “dropping”, making breathing easier but putting more pressure on the pelvis.
- Loss of the mucus plug, often slightly pink or brownish.
- Contractions that become regular, closer together and stronger.
- Rupture of the membranes (your water breaking).
When your due date has passed
Only about one in twenty women gives birth exactly on the due date. A pregnancy that reaches 41 weeks is common, especially with a first baby. After 40 weeks, monitoring becomes more frequent, with a non-stress test (NST) and measurement of the amniotic fluid.
- Membrane sweep: a simple procedure during a vaginal exam that increases the chance of labor starting on its own.
- Labor induction: usually offered between 41 and 42 weeks, because after that the risk to the baby increases. Earlier induction is discussed when there is a medical reason, such as high blood pressure in pregnancy, diabetes or restricted fetal growth.
In any case, reduced baby movements, bleeding or a severe headache should not wait for your next appointment, however close it is.
Other common third-trimester discomforts and how to relieve them
- Swollen ankles: common at the end of the day and in hot weather. Put your feet up and avoid standing for long periods. Sudden swelling of the face and hands, however, needs a blood pressure check.
- Leg cramps at night: stretching before bed and staying well hydrated help. Pain and swelling in only one calf is not a cramp and needs to be examined.
- Numbness or tingling in the fingers: often caused by pressure on the nerve in the wrist due to fluid retention. A wrist splint at night brings relief, and the symptom usually goes away after the birth.
- Insomnia: your belly, frequent urination and anxiety interrupt sleep. A regular routine, fewer fluids late in the evening and short afternoon naps help.
For a personalized assessment of your case, book an appointment with Dr. Panagiotis Polyzos at his office in Athens or Volos.
Frequently Asked Questions
When does the third trimester start?
It starts at week 28 of pregnancy and lasts until delivery, around week 40. See the stages of pregnancy week by week.
Which tests are done in the third trimester?
Growth ultrasound with Doppler, blood tests, a group B strep culture at around 35 to 37 weeks and, toward the end, cardiotocography (NST).
How do I tell Braxton Hicks contractions from labor?
Braxton Hicks contractions are irregular, do not get stronger and ease with rest or a change of position. Labor contractions come at regular intervals, get closer together and become more and more intense.
How many baby movements should I feel?
There is no single number for everyone. What matters is your own baby's usual pattern. If movements decrease noticeably or stop, contact your doctor right away.
When should I go to the maternity hospital?
When contractions come every 5 minutes for an hour, if your water breaks, if you see blood or if you feel fewer movements. A severe headache, blurred vision or sudden swelling also need urgent assessment.
What position should I sleep in during the third trimester?
Try to fall asleep on your side, left or right. Sleeping on your back after 28 weeks puts pressure on the major blood vessels and has been linked to a higher risk for the baby. If you wake up on your back, simply turn onto your side.
Can I fly in the third trimester?
In an uncomplicated single pregnancy, most airlines accept pregnant women up to about 36 weeks, often with a medical certificate after 28 weeks. In a twin pregnancy the limit is earlier. Discuss the trip with your doctor before booking tickets.
When should my hospital bag be ready?
Ideally by 36 weeks, along with your folder of test results and the documents the maternity hospital requires. If you have risk factors for preterm birth, get it ready earlier.
Do I need vaccines in the third trimester?
The whooping cough vaccine is recommended in every pregnancy, usually between 27 and 36 weeks, and, where offered, the RSV vaccine between 32 and 36 weeks. The flu vaccine can be given in any trimester during flu season.
