From Bump to Beyond: A guide to the third trimester

The end of pregnancy has a feeling all its own. After navigating the fatigue and nausea of the first trimester and settling into the rhythm of the second trimester, the third trimester brings a mix of excitement, anticipation and the very real physical demands of carrying a growing baby.

Most days, knowing how close you are to welcoming the newest member of your family is energizing. Some days it can be a little overwhelming. The third trimester has a way of making everything feel more immediate. That sense of urgency is your mind and body preparing you and is one of the more remarkable things about this final phase of pregnancy.

In part three of our four-part series, From Bump to Beyond, we're covering all the things you need to know about the third trimester, from symptoms and body changes to preparing for labor, delivery and the moment you've been working toward all along.

The third trimester begins at week 28 and runs through week 40, or whenever your baby arrives, spanning roughly the seventh, eighth and ninth months of pregnancy.

These final weeks are defined by rapid growth and preparation, both for your baby and for you.

Your baby is:

• Gaining weight
• Developing lung function
• Building fat stores
• Moving into position for delivery

Your body is doing its own preparation:

• Softening ligaments
• Shifting your center of gravity further
• Beginning the gradual process of getting ready for labor

Prenatal visits become more frequent during this trimester, typically every two weeks until week 36 and then weekly after that.

The third trimester also brings a renewed sense of purpose. The to-do list becomes a reality and conversations about labor and pediatricians move from someday to now.

Third trimester weeks 28 – 40: Preparing for your baby’s arrival

By week 28, your baby still has a lot of growing left to do, and these final weeks are where much of it happens. The work happening in these final weeks is specific and purposeful, and your body is matching that effort with preparations of its own.

Here's a look at what these final weeks have in store during the third trimester:

• Weeks 28 – 30: Movements become stronger and more noticeable as your baby grows and space inside your uterus tightens. Your OBGYN may recommend tracking kick counts around this time (even if you were already feeling them in the second trimester), which will help you get familiar with what's normal for your baby.
• Weeks 31 – 32: Your baby is practicing breathing movements and continuing to gain weight. You may notice more rolling and stretching sensations, and the pressure in your ribs and pelvis may increase as space becomes limited.
• Weeks 33 – 34: Brain development is accelerating and lung maturation continues. You could feel more abdominal pressure as the baby continues to grow.
• Weeks 35 – 36: Your baby begins moving into a head-down position in preparation for birth. Your provider may check their position at some visits, discussing with you what to expect as delivery gets closer.
• Weeks 36 – 37: Additional screenings become part of your visits, including a Group B strep test (to detect common bacteria that can affect the baby). Some providers may begin cervical checks to assess how your body is beginning to prepare for labor.
• Weeks 38 – 40: Your baby is considered term after 37 weeks, fully developed, and is ready to arrive at any time. Visits move to weekly, with a closer focus on labor, delivery and the final days of your pregnancy.

Pregnancy rarely follows an exact timeline. Some babies arrive a little early, others take their time. As you move through these final weeks, your body will continue to give you cues. The partnership you’ve built with your OBGYN and your maternity care team will help you feel informed, supported and ready for what’s ahead.

The third trimester brings the most physically noticeable time of your pregnancy. Your baby is getting larger, your body is working harder and the symptoms and sensations you experience during these weeks reflect both of those realities.

Some of what you felt in the second trimester may intensify and new sensations will appear. A few symptoms that made their presence known early in pregnancy have a tendency to reappear as your growing baby puts pressure on surrounding organs.

Not everyone feels everything, and the intensity can vary. What matters most is knowing what's considered normal so you can recognize it, manage it and know when something deserves a call to your provider.

Lower back, hip and pelvic pain

By the third trimester, your body has been accommodating a growing baby for months, and the effect on your back, hips and pelvis is hard to ignore. Your center of gravity continues shifting forward, a hormone known as relaxin has been loosening your joints and ligaments in preparation for delivery, and your baby's position is putting direct pressure on the pelvic floor and surrounding structures. Back pain is very common in the third trimester and can intensify as delivery approaches.

You may also experience sudden, sharp shooting pain deep in your pelvis or down your inner thighs, sometimes referred to as "lightning crotch." While the name sounds alarming, it's a recognized pregnancy sensation caused by nerve pressure as your baby descends and shifts position. It comes and goes quickly and is not a sign that something is wrong.

Hemorrhoids

Hemorrhoids are common during pregnancy, and the third trimester is when they are more likely to develop. Increased pressure from a growing baby, higher blood volume and the natural slowing of digestion all contribute to swollen veins in the rectal area.

It’s helpful to know that hemorrhoids typically improve after delivery. To minimize discomfort from hemorrhoids:

• Stay hydrated
• Eat enough fiber to keep bowel movements regular
• Avoid prolonged sitting
• Try not to strain during bowel movements

Discharge and spotting

Increased vaginal discharge is common in the third trimester. Hormonal changes and increased blood flow can cause discharge to become more noticeable in both volume and consistency. Toward the end of your pregnancy, you may also notice the passage of your mucus plug, which is a thick discharge that has been sealing the cervix throughout pregnancy. This can happen days or even weeks before labor begins. Light spotting after a cervical check is also common.

However, if you experience any of the following, contact your doctor:

• Heavy bleeding
• A strong or foul-smelling discharge
• Green or yellow discharge
• Possible leaking of fluid
• Anything that feels significantly different from your normal pattern

Leaking breasts

You may notice that your breasts are beginning to leak a small amount of thick, yellowish fluid called colostrum. This is a nutrient-dense early form of breast milk that is produced in preparation for feeding your baby after delivery. Not everyone experiences breast leakage before birth, and the absence of it is not a cause for concern. Nursing pads worn inside a bra can help manage any leakage comfortably.

Sleep changes and returning fatigue

Fatigue in the third trimester feels different from the fatigue you felt in the first trimester. While hormones still play a role, in the third trimester, it’s more commonly tied to physical factors such as disrupted sleep, your body being under increased strain and a baby whose activity may not match your schedule.

Physical discomfort, frequent trips to the bathroom, heartburn and even vivid dreams can contribute to sleep that doesn’t feel as restorative as you’d like.

Rest during the third trimester is important. Your body is doing significant preparation for labor and delivery, and making time for rest can help support your energy levels.

A few suggestions that may help with getting some sleep:

• Try to sleep on your left side to support circulation
• Use a pregnancy pillow or extra pillows to support your belly, hips and lower back
• Keep evening meals light to reduce nighttime heartburn
• Limit fluids right before bed, but stay well hydrated during the day
• Rest during the day when you can, even if it’s for a short period

Swelling

Some degree of swelling in the feet, ankles and hands is a normal and expected part of the third trimester. As blood volume increases and your body retains more fluid to support your growing baby, changes in circulation can cause this fluid to collect in the extremities, often becoming more noticeable later in the day. Warm weather and long periods of standing can also make swelling more pronounced.

Tips to help keep swelling manageable include:

• Elevate your feet, especially in the evenings
• Stay hydrated throughout the day
• Avoid sitting or standing in one position for long periods
• Wear comfortable, supportive footwear and avoid tight socks or waistbands
• Gentle movement, like walking, can help encourage circulation

Contact your care team if swelling comes on suddenly, becomes severe, or is accompanied by headaches, vision changes or pain in the upper abdomen. These can be signs of preeclampsia, a condition that requires prompt medical attention.

Braxton Hicks contractions

One of the new sensations of the third trimester is a sudden, temporary tightening across the abdomen that seems to come out of nowhere, known as Braxton Hicks contractions.

Often referred to as “practice contractions,” Braxton Hicks are thought to be the uterine muscle flexing and toning itself in preparation for labor. They can be triggered by physical activity, dehydration, a full bladder or changes in position.

Braxton Hicks tend to be irregular, unpredictable and short-lived. They typically don’t become stronger or closer together and often ease with rest, hydration or a change in your position. While they can be uncomfortable, they are less intense than true labor contractions.

Knowing the difference between Braxton Hicks vs. labor contractions matters as your due date gets closer. True labor contractions grow longer, stronger and closer together over time and don't let up with rest or movement. If you're unsure of the type of contraction you’re experiencing, call your doctor.

Related article: The stages of labor: What to expect during childbirth

Unfortunately, nausea can and often does return in the third trimester. Unlike the hormone-driven nausea of the first trimester, what you feel in the third is largely caused by your growing baby pressing upward on your stomach and slowing digestion.

As your uterus expands, it displaces surrounding organs, leaving your stomach with less room. Food that once settled comfortably can now trigger nausea, particularly after larger meals or when lying down too soon after eating. If your nausea is severe enough to affect your ability to eat or stay hydrated, let your provider know.

Similar strategies that helped with nausea in the first trimester can apply in the third trimester as well:

• Eat smaller, more frequent meals
• Stay upright after eating
• Avoid rich or spicy foods in the evening
• Keep something light on hand to snack on when nausea appears

One very common question is whether flying in the third trimester is safe, and for low-risk pregnancies, it generally is. However, timing, individual airline policies and your own health circumstances should all be factored in when making the decision to fly in the third trimester.

Many providers discourage air travel after 32- 36 weeks, so be sure to talk with your OBGYN if you are planning to travel. They can discuss what’s appropriate for you, especially if there are any possible complications or higher-risk factors.

Here are five things to consider when flying in the third trimester:

• Check airline policies early. Many airlines allow travel up to 36 weeks for single pregnancies, but policies vary. International flights might be more restrictive. Some require documentation from your provider.
• Keep moving during the flight. Pregnancy increases the risk of blood clots. Walking the aisle periodically and doing simple foot and ankle exercises can help with circulation.
• Stay hydrated. Cabin air is dry, so drinking water regularly can help you stay comfortable and hydrated.
• Consider compression socks. Compression socks can help reduce swelling and encourage healthy blood flow during longer flights.
• Know your destination and carry your records. When traveling, identify a hospital or care facility near where you’ll be staying in case you need care. Bring a summary of your prenatal care and any relevant medical history in case you need attention while away.

The third trimester of pregnancy moves faster than you expect. One week you're tracking kick counts and the next you're wondering if what you're feeling might actually be labor.

A few final things worth getting in order during the third trimester before your due date:

• Your birth preferences: Thinking through your preferences for labor, delivery and immediate postpartum care helps your care team support you the way you want to be supported. Start with this birth plan checklist as a guide.
• Your hospital bag: Packing early takes one thing off your plate when the time comes. Here's what to pack in your hospital bag, and a separate list of hospital bag essentials for dad, so your support person is ready too.
• Know your hospital: Familiarize yourself with where you'll be delivering, including where to enter, where to park and what to expect when you arrive.

As the third trimester gives way to delivery, the story doesn’t end; in fact, a new chapter—the fourth trimester—is just beginning!

Feel supported with guidance, care and tools for every stage of your pregnancy and enroll in our virtual pregnancy program.

From Bump to Beyond: A trimester-by-trimester guide

Continue learning about your pregnancy journey with “From Bump to Beyond.”

The first trimester

The second trimester

The fourth trimester