Third Trimester Guide: Pregnancy Weeks 28 to 40

The third trimester runs from week 28 until your baby is born, usually around weeks 39 to 40. Your baby gains weight quickly, your body prepares for labour, and your visits become more frequent.

This guide explains how the baby develops, how to count movements, what to pack and plan, and which signs mean you should call or go to hospital. Use our due date calculator to check your dates.

Changes in Your Body

Cleveland Clinic and the NHS list these common experiences:

• Shortness of breath, which may ease once the baby drops into the pelvis, called lightening
• Needing to pass urine often, and leaking when you cough, sneeze or laugh
• Heartburn and indigestion
• Swollen ankles and feet. Raising your legs helps
• Piles, varicose veins and spider veins
• Backache, round ligament pain and trouble sleeping
• Braxton Hicks contractions, which are mild, irregular tightenings that do not progress
• Leaking of early milk, called colostrum

Sudden swelling of the face or hands, severe headache or vision changes may point to preeclampsia, so do not ignore them. See preeclampsia warning signs.

How Your Baby Grows

Cleveland Clinic says the baby gains more than half of its birth weight in this trimester, its organs mature, and it usually settles head down. The NHS gives some milestones:

• **Week 36:** About 47 cm from head to heel. The lungs are probably mature enough for breathing outside the womb, and the baby can suck and digest milk. The baby may already be head down in the pelvis, although labour could still be weeks away.
• **Week 28 and onwards:** The heartbeat is around 140 beats a minute, and falls to about 130 at birth.

Cleveland Clinic considers 39 weeks to be full term. Babies born earlier may need extra care, so see our article on premature babies.

Checkups and Tests

According to Cleveland Clinic:

• Visits are every two weeks until week 36 and weekly for the final four weeks, unless your doctor advises otherwise.
• Checks include blood pressure, weight, urine, the baby's heartbeat, the baby's position and size, and the height of the top of your womb.
• A group B strep swab is done around 36 weeks in some places, and extra monitoring may be arranged if your pregnancy is high risk or overdue. Practice differs, so follow your doctor.
• Near the end, some doctors check the cervix.

The NHS says that if the baby is not head down, you may be offered a gentle manual turning method, which works about half the time. Ask your doctor whether it applies to you. Read our month-by-month checkup guide for more.

Counting Your Baby's Movements

Cleveland Clinic says kick counting matters most in the third trimester, when you usually notice a regular pattern. Ask your doctor when to start. A common method:

1. Choose a quiet time, such as after a meal.
2. Lie on your left side or sit with your feet up.
3. Count each movement until you reach 10, and note how many minutes it took.
4. If you do not reach 10 in an hour, keep counting up to two hours.
5. If you still do not feel 10, try again later and call your doctor if movement is still low.

You can note this on our kick counter. The most important point is to know your baby's usual pattern. Our guide to reduced baby movements explains what to do when it changes.

Tip: Pack your hospital bag by about week 36 and keep your files, scan reports and contact numbers in one place. See our hospital bag checklist.

Eating, Rest and Mood

The NHS says you need roughly 200 extra calories a day in this trimester, which is a small snack and not a second meal. Keep eating varied, balanced food, drink water, and ask your doctor about iron or other supplements instead of buying them yourself. Try short rests with your feet up, sleep on your side, and keep gentle walking in your day if your doctor agrees. It is common to feel tired, impatient or anxious as the due date nears. Talk to your doctor if worries are heavy, and ask family for practical help so that you can rest.

Planning the Birth

• **Learn the birth options.** The NHS describes vaginal birth, assisted birth with forceps or suction, and caesarean birth. Our guide to normal vs caesarean delivery compares them. If you have had a caesarean before, read about VBAC.
• **Write a flexible birth plan.** Note your preferences for pain relief, support people and newborn care, but accept that plans can change for safety.
• **Know the stages.** See stages of labour and pain relief options.
• **Arrange transport and a helper** for any time of day or night.
• **Plan the early weeks.** Think about feeding, newborn care and your own recovery. Read newborn care tips.

Signs of Labour

MedlinePlus and Cleveland Clinic list these signs:

• Contractions that come regularly, about 5 to 10 minutes apart, last 30 to 70 seconds, grow stronger and do not ease when you change position
• A gush or trickle of fluid, meaning the waters may have broken
• A bloody or brownish discharge (bloody show)
• Loss of the mucus plug, which does not always mean labour starts that day

MedlinePlus says term labour can begin from about 3 weeks before to 2 weeks after your due date. Read signs of labour and when to go to the hospital.

When to be cautious: Do not wait at home if your waters break, you notice bleeding beyond light spotting, or your baby moves less. Contact your doctor straight away, even at night.

When to See a Doctor

Contact your doctor or go to hospital if you have:

• Painful contractions every 5 to 10 minutes for an hour, or contractions before 37 weeks
• Leaking fluid or a gush of water
• Vaginal bleeding
• Reduced baby movements
• Severe tummy pain, severe headache, dizziness or vomiting
• Sudden swelling or vision changes

Delivery and emergency care at Chaitanya Hospital in Kadapa is open 24/7. See our emergency page.

Talk to a Doctor

Use the last weeks to ask every question you have. Book an appointment or call +91 944 103 0587. You can read about our normal and C-section deliveries care and, if your pregnancy is higher risk, high-risk pregnancy care.

This article is for general awareness and is not a substitute for a doctor's advice.