New Health Guide
Your third trimester starts from the beginning of your 28th week and lasts till the end of your pregnancy. During the period of 28 to 36 weeks, checkups are recommended twice every week, which afterwards can be reduced to once-a-week visits until delivery.
If you know what to expect during these visits and what issues to discuss with your healthcare practitioner, you will be in a better position to understand the third trimester related health issues and even develop a level of trust with the practitioner.
Typically, third trimester prenatal visits involve a combination of regular physical checkups, late-pregnancy tests and discussions about delivery, postpartum considerations and prenatal health issues. Provided below is an explanation of the various practices you can expect at such appointments.
Your caregiver will most likely begin the visit by asking how you are feeling and particularly if you have had any headaches, feelings of contraction or swelling. Try to be communicative about any concerns you have about your health or any other issues you might have noticed, even if you dismissed them at the time as normal aches or pains, fatigue or mood changes.
Don’t get discouraged by a seemingly dismissive or unconcerned attitude of the practitioner; they understand the importance of giving due attention to each patient even if they see dozens of them every day. Your caregiver may also review your concerns from previous visits and the results of any tests they might have recommended on your last visit.
At these visits, your practitioner will inquire about the frequency and duration of your baby’s movements and remind you to call if there is a decrease in usual activity of the baby. The caregiver will recommend that you take note of your baby’s movement and record the number of movements made each day for a given period of time.
| Exams | Description |
|---|---|
| Weight and Blood Pressure |
Similar to your second trimester visits, your blood pressure and weight will be monitored and the practitioner will order urine tests to check for signs of preeclampsia, urinary tract infections or other related issues. You will also be checked for any swellings of ankles, hands and face. |
| Baby’s Heartbeat and Fundal Height |
To ensure that your baby’s growth rate is normal, the practitioner may check the baby’s heartbeat, feel your belly and measure your fundal height (distance between pubic bone and top of the uterus). She will compare this height to baby’s gestational age and the measurements from your previous visits and if the baby’s growth rate does not seem right, she will order ultrasounds to check on it and your amniotic fluid levels. |
| Position of Baby |
The position of the baby, whether head-down or breech (bottom-down), will need to be determined by the 36th week. If the ultrasound confirms a breech position you might be offered a procedure called external cephalic version for turning the baby. |
| Pelvic and Cervix Exam |
Routine pelvic exams are not carried out unless your practitioner has a specific concern that needs to be checked out. If you are past your due date, a cervix examination may be carried out to check if it’s softening, thinning out or opening so the practitioner may decide on inducing labor. |
| Vaginal Exam |
Also, if your baby has moved down into your pelvic cavity, a vaginal exam may be needed to confirm. You can ask your practitioner for a pelvic exam if you are near your due date and need to know what’s happening. Spotting after a pelvic exam late in pregnancy is not unnatural. |
To prevent your body from producing potentially harmful antibodies you might need an Rh immune globulin shot. If your screening during the 28 week visit shows that your body is already producing these antibodies then the injection is not necessary. But in either case the shot is not harmful.
Your health giver will swab your vagina and rectum to check if you have group B strep, which is a common infection that may endanger your baby. Depending on your test result, you will be given antibiotics to ensure the disease is not passed on to the child. If you have had group B strep (or a related infection) previously, then you won’t need the test to determine the administration of antibiotics.
Important Notes: Depending on the practitioner’s concerns or the status of your pregnancy, your caregiver may order other tests to ensure that your baby is thriving. In the event that you go past your due date, even though your pregnancy is normal, the practitioner may order a combination of biophysical profile test, non-stress test and ultrasounds to keep tabs on your baby’s growth and determine if labor needs to be induced, particularly if you have reached your 42nd week of pregnancy.
During the early part of your third trimester, you will receive information from your practitioner about signs of preterm labor and preeclampsia, in addition to information about other warning signs like vaginal bleeding or decrease in fetal movement. She will also inform you of the normal changes that occur during this period and discuss any specific concerns she might have about your condition.
If there are any warning symptoms or anything you feel you need to discuss, don’t hesitate to call her. As your due date approaches your practitioner will discuss signs of labor and tell you when you should call her about it.
If you have any questions about labor and how your baby will be delivered, ask the practitioner now. Common issues that might be troubling you could be about the presence of your practitioner and nurses throughout labor and what to do if your water breaks and you go into labor at night. Forming a birth plan will help you clarify your preferences.
It’s a good idea to discuss any postpartum concerns you have with your practitioner. For example, whether you intend to breastfeed, use contraceptives or get your baby boy circumcised. Also, this is the time to find a doctor for the baby, so ask your practitioner if they can help out.
