The third trimester is an exciting and sometimes challenging phase of pregnancy. It’s important to understand what to expect in these final weeks and how to manage the physical and emotional changes. This will enable you to feel confident and excited about your baby’s arrival.
This article outlines what you can expect to happen in the final trimester and how to manage natural changes, as well as any concerns you may have.
Increased belly size: Your baby continues to grow rapidly, leading to a noticeable increase in the size of your belly. You might feel more cumbersome and find it challenging to move around comfortably.
Braxton Hicks contractions: These practice contractions are irregular and usually painless. They help prepare your body for labour. If they become regular or painful, contact your healthcare team, as this could be a sign of pre-term labour.
Shortness of breath: As the baby grows, your uterus can press against your diaphragm, making it harder to breathe deeply. Practise good posture and take regular rest breaks.
Frequent urination
The increased size of your uterus can put pressure on your bladder, leading to more frequent trips to the bathroom. Although this can be inconvenient, especially at night, it is normal.
Back pain: The extra weight and shifting centre of gravity can strain your back muscles. To reduce any discomfort, try to maintain good posture, wear supportive shoes, and consider prenatal yoga or stretching exercises.
Swelling: Mild swelling in the feet, ankles and hands is common, due to increased fluid retention. Elevate your feet, stay hydrated, and avoid standing for long periods to minimise swelling.
Fatigue: As your body works hard to support your growing baby, you may feel more tired than usual. Listen to your body and rest when you feel the need.
Heartburn and indigestion: Hormonal changes and the pressure of your growing uterus can cause heartburn and indigestion. Eat smaller, more frequent meals, avoid spicy foods, and remain upright after eating.
Nesting instinct: Many women experience a surge of energy and the urge to prepare their home for the baby. Use this time to organise, clean, and set up the nursery, but try not to overexert yourself.
Anxiety and excitement: It’s normal to feel a mix of excitement and anxiety as the due date approaches. Talk to your partner, friends, or your healthcare team about these feelings for support and reassurance.
Mood swings: Hormonal fluctuations can lead to mood swings. To help manage your emotions, practise self-care, try some relaxing activities, and tell loved ones how you’re feeling.
Additional healthcare appointments
You will need to attend more frequent prenatal check-ups in the third trimester. These visits help monitor your baby’s growth, check your blood pressure, and address any concerns.
Agree a birth plan
Every woman is entitled to care that is kind, safe and personal. You will have a personalised care and support plan. It will includes aspects that are particularly important to you, as well as the recommendations from your care provider. The personalised care and support plan will cover the antenatal, birth and postnatal period, and will be discussed with you. It’s a good idea to write down your birth preferences/birth plan so your care provider clearly understands your needs, which will help you have a positive experience. Head to the birth plan collection for more on this topic.
Hospital bag
This is the time to pack a hospital bag with essentials like comfortable clothing, toiletries, baby clothes, and important documents. Having everything ready will give you peace of mind when labour begins. You should be given a list of items to bring in your antenatal notes; if not, ask your midwife for one. Try not to overpack and keep any valuables safe.
Prenatal classes
It’s definitely a good idea for all prospective parents to attend these classes because they will help you to start thinking about your birth plan, labour, postnatal care and feeding your infant. Most healthcare providers will provide prenatal classes by 32 weeks.
Labour is the process by which your baby is born and may take from anything up to 18 hours. It could take longer if you are having your first baby, compared with subsequent births. There are 3 main stages of labour:
As your labour starts you may notice some “shows”. During pregnancy a plug of thick mucus forms in the cervix and as your body prepares for labour this mucus plug may pass out through the vagina. It appears as a clear or slightly bloodstained mucous substance. This can happen 1 or 2 weeks before labour begins, at the start of labour, or during labour. You may also start to experience tightenings or contractions, backache, an urge to go to the toilet, or your waters may break.
During early labour it is advisable to stay at home for as long as you can, have regular snacks to maintain your energy, take a bath or shower to help relax, rest as much as possible, and go to the toilet regularly. If you are less than 37 weeks pregnant and you think you might be in labour, or if your waters break, you start having regular and painful contractions or bleeding from your vagina (which is not a show), you notice your baby’s movements have reduced, or you have any concerns, talk to your maternity care provider straight away.
In some circumstances your care provider may want to discuss induction of labour with you. They will tell you their reason for recommending induction, including the benefits, risks, the process and your options. You may be offered induction of labour because:
Nutrition
Continue to eat a balanced diet that’s rich in essential nutrients. Focus on foods that are high in protein, calcium, iron, and fibre to support your baby’s development and maintain your energy levels. To find out more about this, go to the section on Nutrition in trimester 3.
Hydration
Drink plenty of water to stay hydrated and help reduce swelling.
Exercise
Engage in gentle exercises, such as walking or prenatal yoga, to stay active and prepare your body for labour. Always talk to your healthcare team before starting any new exercise routine. Head to the trimester 3 exercise content for more guidance.
Rest
Prioritise rest and sleep. As your due date approaches, you may find it harder to get comfortable at night. Use pillows to support your body and try different sleeping positions to find what works best for you.
Perineal massage
The perineum is the area between your vagina and back passage (anus). During birth the perineum stretches to make room for the baby, and about 85% of women will tear as the baby is born. To reduce the risk of perineal tears, perineal massage is recommended to help soften and increase elasticity of the perineal tissue.
You can start perineal massage at 34 weeks. Do not massage your perineum if you have genital herpes, thrush or other vaginal infections, because this may spread the infection. Although it can be embarrassing to talk about perineal massage, do speak to the midwife if you have any questions. To find out more, read our article on perineal massage or watch a video demonstration.
Reduced foetal movement
Your baby’s movements are the most important indicator of your baby’s wellbeing. While it’s normal for movements to change as it grows, the baby must continue to move even in labour. If you notice a decrease in activity please contact your maternity unit or care provider straight away, day or night. Do not wait until the next day or your next antenatal appointment to report reduced foetal movements.
Pre-term labour
Signs of pre-term labour include regular contractions, pelvic pressure, lower back pain, and fluid leakage. Contact your healthcare team if you experience any of these symptoms.
High blood pressure
This may be a sign of pre-eclampsia, which is a serious condition. Other symptoms of pre-eclampsia include severe headaches, visual disturbances, and swelling in the face or hands. Seek medical attention if you notice these symptoms.
Bleeding
Any vaginal bleeding should be reported to your healthcare team immediately.
Severe abdominal pain
Make sure you tell your healthcare provider if you have persistent or severe abdominal pain, so they can evaluate it to rule out complications.
More information
These websites offer more advice and information about what to expect during the third trimester:
NHS–Week-by-week pregnancy guide
NHS–Signs that labour has begun
NICE—Antenatal care
NICE—Intrapartum care
NICE—Postnatal care
