What To Expect In The 3rd Trimester

You're nearing the end of your pregnancy journey and at the beginning of a new chapter in your life, so this can also feel like a huge accomplishment…. and rightly so!! 

For the last 15 weeks you’ve most likely felt more energised, but this next stage of pregnancy can be physically challenging, maybe seeing a return of the fatigue you experienced in the 1st trimester. I often see the 3rd trimester being emotionally fulfilling as attachment with baby grows from feeling their stronger movements, especially as they start to respond to touch and interaction!

So, as you approach the final stretch of your pregnancy, let me help you understand what to expect and help you manage this period with confidence and readiness.

Physical Changes And Symptoms

There will be more physical changes appear as your body accommodates your growing baby and although I’m sure you’re expecting it, your ability to carry out those usual day to day tasks can sometimes feel hard. 

As your baby continues to grow and your uterus expands, it pushes against your internal organs which may cause some discomfort. That ongoing heartburn which we visited in our 2nd Trimester blog can worsen, and you’ll notice an increase in trips to the toilet….and no its not a good idea to reduce the amount of water you take in, hydration is so important!! 

You may also notice a shortness of breath, which can mean your growing uterus is pressing against your diaphragm, making breathing deeply a little harder. Having an awareness of holding a good posture and sleeping propped up with pillows can really help, but I do think it’s a good idea to share your symptoms with your midwife, who will be able to give you more personalised advice. Shortness of breath along with fatigue, feeling lightheaded and dizziness can be a sign of low iron levels so may need investigating.

As your body moves closer to birthing it produces one last surge of the hormone Relaxin. This not only softens and widens the cervix but also relaxes the muscles and ligaments in your pelvis a little bit more, enabling it to widen, so you may start to feel aching or cramping in your lower back area and hips. This late change gives baby the room to change position and helps the head to move lower into the pelvis, ready for birth. Check out our tips for management of pelvic girdle pain in our 2nd Trimester blog.

Swelling in the feet, ankles and hands is common towards the end of the pregnancy, and this is due to increased fluid retention and pressure on blood vessels. It can feel very uncomfortable so to help reduce the swelling, try to stay hydrated, elevate your legs when possible and avoid standing for long periods.

Varicose veins are common in this stage of pregnancy, especially in the legs, ankles and vulva. Now they’re usually not harmful but they can be pretty uncomfortable, especially towards the end of pregnancy when the growing uterus is putting pressure on your pelvic veins. I just want to point out that Haemorrhoids are a type of varicose vein, so you are more likely to suffer in late pregnancy. Not nice I know but to reassure you, they will typically go away 6-12 weeks after birth. If you are worried at any stage, it’s a good idea to visit your doctor to have a review, especially if you notice skin changes around the vein, pain or notice a tendency to bleed.  

Breast changes are more noticeable heading towards the end of the third trimester. You may notice a heaviness and increase in size as the milk producing cells grow, with the areola appearing darker and veins under the skin seeming more prominent. You may have already noticed leaking breasts, but this may happen a little more, with 'colostrum harvesting' being something to think about at 36 weeks. And remember wearing a well-fitting bra can help with any discomfort.

Vaginal discharge increases towards the end of the pregnancy, but don’t worry this is all perfectly normal. It’s helping to keep your birth canal clean and free from infection, in readiness for your birth. Now this can sometimes be mistaken for urine, or a feeling that your waters have broken. If you’re unsure it’s always a good idea to get checked out with your Midwife or health professional. You can also check out "How Will I Know I Am In Labour" blog to find out more about your mucous plug and Braxton hicks.

Emotional Changes

It's normal to feel a mix of excitement and anxiety as you prepare for labour and the arrival of your baby. These emotions are of course heightened by the physical discomforts and the anticipation of becoming a parent.

How will I know what my baby needs?  Will I be a good parent? are some of the most common thoughts and worries you may have, but I just want to reassure you that this is to be expected.  There’s a lot to think about and prepare for, after all this is a big life change!

But It’s always good to talk these thoughts and feelings through, so maybe connect with a friend who’s had a baby and remember, your gynaecologist is there for reassurance too.

You may find towards the end of the third trimester you have a burst of energy…known as the ‘nesting instinct’. A time when you may feel the need to clean everything in sight and organise everything at home! It’s not really known what causes it, but it’s believed to be linked to hormonal changes and a way to establish control during an anxiety inducing or uncertain time.  Personally, I do think it’s only natural that you’ll want to prepare your home for welcoming your baby, just like you most probably do when expecting visitors, so go with it. It can give a great sense of accomplishment and can help you to relax and enjoy the last few weeks of pregnancy.

Around 31 weeks, your baby’s weight begins to increase rapidly, gaining approximately half a pound each week. Your baby’s hair has started to grow, and its eyes can now open wide, so around week 33 your baby can detect light from outside the womb. Pretty amazing hey!

The baby's lungs continue to mature, preparing for breathing outside the womb and the baby’s brain is rapidly developing, with significant growth in size and complexity. At this stage they now have the ability to respond to touch, which is why interaction with your baby is even more important. Responding to their movements and kicks with your partner is a great way to share this special time.  Their hearing fully develops in this last trimester too, so don’t be afraid to actually talk to baby, and you could even play them your favourite tunes!

In the final 4 weeks, your baby will generally move into a head-down position in preparation for birth, but sometimes this actually doesn’t happen. It may be that your baby remains with its bottom down, which is called a Breech position. Your healthcare provider will check your baby’s position during each of your antenatal visits, so if this is the case there are things you can do to try and help baby move.

Lara’s Tips for breech babies: natural remedies are always my first suggestion, being non-invasive and safe for mum and baby. You could try moxibustion, reiki or bodywork techniques from a qualified practitioner. 

Flip A Breech - How to Turn a Breech Baby - Spinning Babies

What To Expect From Your Care Provider

In the 3rd trimester visits to your health care provider will be more frequent, providing reassurance and support as your due date approaches. For most people, visits will be every 2-3 weeks, becoming more frequent towards the end of your pregnancy. Each appointment will be structured to check your well-being with your blood pressure and urine checked, to identify any early of signs of pre-eclampsia, infection or gestational diabetes. Baby’s wellbeing is also checked by measuring the fundal height to monitor baby’s growth with a listen to baby’s heartbeat for 1 minute. This is definitely the thing that parents find most reassuring….and exciting too! Its also an opportunity to ask questions and for your health provider to share necessary information as your birth approaches.

Your care pathway may be a little different especially if you’re having regular scans, but you should still check in regularly with your health care team. They’ll be able to guide you through making a birthing plan, give you details of local antenatal and parent education classes and help guide you towards local support services. 

Your birth plan is really your personal preferences for your labour, birth and the immediate postnatal period. That can include pain management options, who you want present as birth support, skin to skin and delayed cord clamping, as well as any specific cultural or personal wishes. I do think this is important, to discuss this prior to birth, mainly because it can help you feel more informed about your options and included in the decisions. Here is guidance for your birth plan with a template to follow  https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/how-to-make-a-birth-plan/

Thoughts of the birth and not knowing what to expect can cause extreme anxiety and apprehension as the time draws closer. Antenatal education classes can provide valuable information, helping to reduce anxiety about the birthing process. Face to face sessions are great from a connection point of view and meeting like-minded parents to be, can give extra support and reassurance.  Being educated about the body in labour and birth really can help to have a positive impact on your experience. I know I say it a lot, but education is power! Specific parenting education classes can really help you feel prepared for welcoming baby, giving you an insight into what your baby’s needs are in the first few days and weeks. They can really help with the transition to becoming a parent, which can be a challenging time if you don’t know what to expect.

One thing I do recommend to every one of my families is to create a postnatal plan it helps to put boundaries in place in those early days and will help you to feel you have some control during a time of change and uncertainty.

When Should I Seek Help

It’s crucial to be aware of symptoms that may require immediate medical attention, for issues such as Pre-Eclampsia or Obstetric Cholestasis, so please contact your doctor, gynaecologist or hospital immediately if you experience any of the following symptoms:

• Vaginal bleeding or constant, clear watery vaginal discharge.
• Severe nausea, vomiting or abdominal pain.
• Sudden blurry vision or a severe headache.
• Sudden swelling of the face, fingers or ankles.
• Sudden difficulty in breathing with pain or tightness in your chest.
• Pain, swelling, tenderness, redness or heat in your calf.
• Itching to hands and feet.
• Fever
• Regular, painful contractions before 37 weeks of pregnancy.
• A change in your baby's movements.

Baby’s Movements

Now one thing I do want to reiterate, (and I know your doctor would have mentioned this at every visit!) is baby’s movements. It is NOT normal for your baby to move less as you reach the last few weeks of pregnancy. Yes, room is a little tight in there now, so the type of movements may be different, but the number of movements should remain the same. So, if you think your baby’s movements have reduced, then please contact the hospital at which you’re booked, or your health care provider. 

Self-Care And Wellness

Prioritising self-care and relaxation will really help you make the most of the 3^rd trimester. Take time to rest and engage in activities that make you feel happy and relaxed. Listen to your body more and always try to put ‘you’ first. This is a great time to bond with your partner so arrange things to do together to welcome baby, such as birthing preparation classes and getting the nursery prepared.

Eating a well-balanced diet should continue into the 3rd trimester.  Foods high in Vitamin D and Calcium are crucial for the growth of baby’s bones and teeth during this last trimester, with Vitamin C playing an important role in the absorption of Iron.  Small, frequent meals can help manage the dreaded heartburn and maintain your energy levels too!

Unfortunately, due to the changing internal body systems and those fluctuating hormones, poor sleep in the third trimester can be a common occurrence. Whether that’s regular awakenings or full-on insomnia, it’s not fun and really can impact our mood and ability to function at a normal level.  Either way, good sleep is crucial for a mother’s health and wellbeing and for baby too. 

So, here’s my tips to help you improve the chances of getting a good night’s sleep:

• Set yourself a regular bedtime and waking up time.
• Create a peaceful and cool sleeping environment.
• Wind down before bed with a warm bath, deep breathing or meditation.
• Empty your mind of worries and ‘To-Do’s’ by writing them down before bed.
• Avoid using electronic devices a couple of hours before bed.
• Lying on your left side, pop a pillow in between your legs to align your spine.
• Avoid foods that can trigger heartburn and don’t eat close to bedtime.
• Try deep breathing and meditation before bed.
• Use a lavender sleep mist.

The third trimester is a time of preparation, excitement, and significant change. By understanding your baby’s development, managing the physical changes in your body, and planning for the future, you can navigate this final stage of pregnancy with confidence and joy. Embrace the journey and look forward to the incredible moment of meeting your baby for the first time.