Pregnancy Calendar: Third Trimester

Now that your baby is moving in your belly on a regular basis, you may want to perform kick tests every few days. These tests can help identify potential problems and prevent a stillbirth.

The American Congress of Obstetricians and Gynecologists (ACOG) recommends you track how long it takes you to feel 10 kicks, flutters, swishes or rolls. Ideally you should feel at least 10 movements in 2 hours. It will likely take less than 120 minutes to feel 10 movements. Talk to your doctor if you have any questions or notice significant deviations from your baby’s regular pattern over three to four days.

Your baby’s movements should not be the only questions you have for your medical care team this trimester. Be sure to ask any questions you have regarding these months as well as labor and delivery. Cover topics such as further testing, weight gain, signs of labor and methods of delivery.

At 32 weeks of pregnancy, most medical care professionals will insist on seeing mothers-to-be on a bi-weekly basis rather than once a month. This will only continue until about week 36 of pregnancy, when your doctor will want to see you once a week. This will give you plenty of time to ask all those lingering questions.

Around the beginning of the third trimester, you may start hearing the terms premature and preterm. Premature refers to a baby born with immature lungs who cannot function without intervention. Preterm refers to a baby born between 32 and 37 weeks gestation but who has mature lung function at birth. Your medical care team will be able to help you understand your risks for these conditions and how your baby will be affected.

One of the first steps your body takes in preparation for delivery is your baby “dropping” or “lightening.” This means your baby’s head actually drops lower into your pelvis, residing between your pubic bones. The timeline of baby dropping is different for every woman. It may occur several weeks before labor begins or just a few hours.

Additionally, your uterus is constantly contracting in preparation for labor. Most of these contractions, known as Braxton-Hicks contractions, are painless and go unnoticed. Sometimes in later pregnancy, they may become more intense and be mistaken for labor. They will subside on their own; lie on your side and drink a glass of water. If your contractions last for more than an hour, call your doctor.

When your body does start true labor, it will be helpful to track frequency and duration of contractions. Count from the beginning of one contraction and continue counting until the beginning of the next contraction. This is known as the frequency. Count from the beginning of a contraction to the end of that contraction to determine duration.

Another sign of labor is water breaking. This can happen in many ways: with a sudden gush, an ongoing flow or a slow trickle. It is important the rupture is identified and treated within 24 hours. Otherwise, there is a heightened risk of infection and other serious complications, so call your doctor if you suspect your water has broken then head to the hospital.

When you arrive at the hospital, you will need to provide a urine sample and change into a birthing gown. A nurse will check your vital signs and review your medical chart. Two monitors will be wrapped around your belly to observe contractions and baby’s heart rate. Finally, a physician will examine your cervix for dilation and effacement.

You may find yourself in the room you will remain in for the entirety of your stay, or you may be moved around several times before you head home. Here are the three main room setups you may experience: one room from start to finish called a labor, delivery, recovery and postpartum (LDRP) room; a room for labor and delivery called a birthing room followed by a recovery room; one room for labor, one room for delivery and yet another for postpartum care.

No matter the room(s) you are in, you will experience three phases of labor. Labor officially begins when the uterus contracts with enough intensity, duration and frequency to soften and dilate the cervix. This first stage of labor ends when your cervix is 10 cm (about 4 inches) in diameter. It is impossible to predict how long the first stage of labor will last for you, but the average length of active labor is between 6 and 12 hours.

The second phase of labor is the actual delivery of your baby. It can last anywhere from 30 minutes to three hours. Most physicians will not allow women to push for more than three hours. If your baby has not emerged during this timeframe, you medical care team may reassess the situation and recommend a Cesarean delivery. Stage three of labor is the passing of the placenta and membranes that surround your baby during pregnancy.

Cesarean delivery may end up being the safest way to bring your baby into the world. As you labor, your medical team will monitor your baby’s heartbeat. If it signals distress, your physician may choose to perform a C-section. Other reasons may include having had a previous Cesarean delivery, preeclampsia, a compressed umbilical cord or active herpes. Placental abruption, placenta previa or a baby in breech position are all conditions that may also require a C-section.

If you would like, inquire about your pain management options during labor, including narcotic opiates and epidural anesthesia. You may also want to review breastfeeding materials as you labor so you are prepared for baby’s first meal.

Once baby arrives, keep in mind it will take a while for your body (and mind) to recover from giving birth. Most women may feel back to normal in just six weeks while other report not feeling 100 percent back to normal for an entire year. Both situations are normal, so try not to be too hard on yourself.

While many mothers experience mood swings from the surge of hormones for a few days or weeks following delivery (known as “baby blues”), postpartum depression is a more severe, long-lasting condition. It is ideal to treat depression before it keeps you from properly caring for your baby. The following symptoms may occur a few weeks after giving birth or up to six months later: severe mood swings, excessive crying or sadness and a the inability or unwillingness to bond with your baby. If you experience any of these symptoms for longer than two weeks, don’t hesitate to make an appointment with your healthcare provider. If you feel you or your baby are in danger, seek help from a friend or family member and call your doctor immediately.

Should you have any questions regarding your third trimester, labor, delivery or caring for your child, never hesitate to reach out to your medical care team. They are available to assist you in any way necessary to ensure you and baby thrive.