The Third Trimester (29-40 Weeks)

Prenatal visits during the third trimester:
During the second and third trimester prenatal visits, your physician may check the following, depending on your current medical condition and the health of the fetus:

• any current symptoms or discomforts

• mother’s weight

• mother’s blood pressure

• urine test - to detect albumin (a protein) which may indicate preeclampsia or toxemia, and sugar (which may indicate hyperglycemia)

• position, growth, and development of the fetus

• height of the fundus (top of the uterus)

• fetal heartbeat

After approximately the 29^th week, your physician/certified nurse midwife may change the schedule of your prenatal visits from monthly to every two weeks. After approximately the 36^th week, your prenatal visits may be scheduled once every week. This schedule will depend upon the medical condition of the mother-to-be, the growth and development of the fetus, and your healthcare provider's preference.

Toward the later weeks of the pregnancy (started at approximately the 38^th week), a pelvic examination will be performed to determine the dilation and effacement of the cervix. Your physician will also check for Braxton Hicks contractions (a kind of prelabor "practice" contraction) and discuss labor and delivery procedures.

What to expect during the third trimester:
The third trimester marks the home stretch, as the mother-to-be prepares for the birth of her baby. The fetus is continuing to grow only in weight and size now. The mother may feel more uncomfortable now as she continues to gain weight and begins to have pre-labor contractions (called Braxton Hicks contractions).

During the third trimester, it is a good idea to start taking childbirth classes in preparation for the big day -- especially in the case of first pregnancies. If you plan to breastfeed, taking a breastfeeding class may be helpful.

During the third trimester, both the mother’s body and fetus continue to grow and change.

Fetal development during the third trimester (29-40 weeks):
During the third trimester, the fetus continues to grow in size and weight. The lungs are still maturing and the fetus begins to position itself head-down. By the end of the third trimester, the fetus is about 19 to 21 inches long and weighs, on average, six to nine pounds. Fetal development during the third trimester includes:

• The fetus can see and hear.

• The brain continues to develop.

• The kidneys and lungs continue to mature.

• By the 36^th week, the head may "engage" (drop into the pelvic area) -- a process called "lightening".

• The bones of the skull remain soft to make it easier to pass through the birth canal.

• For many babies, the irises of the eyes are slate blue. The permanent eye color will not appear until several days or weeks after birth,

• The fetus can suck its thumb and cry.

• By 38 to 40 weeks, the fetus' lanugo has disappeared almost completely.

• By 38 to 40 weeks, the lungs have matured completely.

• The baby is covered in vernix caseosa (or simply called vernix), a creamy, protective coating on the skin.

• The head will usually turn downward during the last couple of weeks of pregnancy.

Changes in the mother's body:
In the third trimester, some women become increasingly uncomfortable as their due date nears. As the fetus grows in size and crowds the abdominal cavity, some mothers-to-be have difficulty taking deep breaths or getting comfortable at night for sleep, while others are free from any discomfort as they anxiously await the arrival of their new son or daughter.

The following is a list of changes and symptoms that a woman may experience during the third trimester and includes:

• Increased skin temperature as the fetus radiates body heat, causing the mother to feel hot.

• The increased frequency of the need to urinate occurs due to increased pressure being placed on the bladder.

• Swelling of the ankles, hands, and face may occur (called edema), as the mother continues to retain fluids.

• Hair may begin to grow on a woman's arms, legs, and face due to increase hormone stimulation of hair follicles. Hair may also feel courser.

• Leg cramps may become more frequent.

• Braxton Hicks contractions (pre-labor) may begin to occur at irregular intervals in preparation for childbirth.

• Stretch marks may appear on the abdomen, breast, thighs, and buttocks.

• Colostrum (a fluid in the breasts that nourishes the baby until the breast milk becomes available) may begin to leak from the nipples.

• Dry, itchy skin may persist, particularly on the abdomen, as the skin continues to grow and stretch.

• A woman's libido (sexual drive) may decrease.

• Skin pigmentation may become more apparent, especially dark patches of skin on the face.

• Constipation, heartburn, and indigestion may continue.

• Increased white-colored vaginal discharge (leukorrhea) which may contain more mucus.

• Backaches may persist and increase in intensity.

• Hemorrhoids may persist and increase in severity.

• Varicose veins in the legs may persist and increase in severity.

As demonstrated above, each woman carries her baby differently,
depending upon her body structure and amount of weight gain.

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