The Third Trimester

Congratulations, you have reached your third trimester!

It feels good to finally reach this third and final trimester of pregnancy! This is the trimester that you will get to meet your sweet baby. Even though there are many decisions to be made during this time, don’t be overwhelmed! We’ll walk through some of these decisions together and break them down into bite-sized pieces.

The third trimester is weeks 28-42. During this time, your baby is growing rapidly, expanding until you feel like there is absolutely NO more room. His brain is developing along with his senses. He is adding fat layers to his body. The lungs are also growing and maturing, though they are among the last of the organs to mature (they are usually fully developed by 37 weeks). By 36 weeks, most babies are head down but do not be alarmed if he isn’t. Spinning Babies is an excellent resource for turning babies into an optimal position for birth. You might also notice that your baby sleeps and is awake throughout the day. Loud noises might startle him. Take this trimester to continue bonding with your baby by talking, singing, reading, and caressing him through your belly.

As you move through this trimester, you will also notice changes in your body. As your baby expands in the uterus, you might find yourself getting short of breath. Around two weeks prior to your birth, the baby will often drop down or engage in the pelvis, allowing you to breathe more easily. This can put pressure on your bladder, however, leading you to urinate more frequently. You might also struggle with indigestion, hemorrhoids, and water retention causing swollen fingers and ankles. Some women will have stretch marks on their bellies. Stretch mark cream can help alleviate some discomfort caused by them.

What to consider during this stage:

As you move through this final trimester, it is a good idea to think through and research what options you want for your labor and birth. Some birth settings may not offer all the options you’re considering so knowing this ahead of time will help alleviate disappointment during labor. Utilize books and websites that provide evidence-based, unbiased information regarding options in care during labor and birth. Have a list of non-negotiables (unless in extreme cases for emergencies) and stick to that list. And finally, use your BRAIN to make informed decisions during labor and birth.
In the first trimester, we talked about choosing a healthcare provider that you feel comfortable with. You might be in a practice that has multiple providers on call for your birth. Maybe as you have moved through your pregnancy you realize your values don’t line up with your provider’s after all. These situations can be stressful, so make it a point to have open communication with your provider from Day 1. Let them know your birth philosophy and find out what theirs is to know if they are aligned. Many times, a simple lack of communication can cause hurt feelings or frustration on either side. Be an active participant in your care plan. Bring any questions, concerns, and ideas to them. Be respectful but also know that you might have to be firm in some of your decisions. Most providers want what’s best for mom and baby, but if you find that your provider is unwilling to take your wishes into consideration during your pregnancy, find another provider (if possible) who will.
As you get closer to your birth, you might experience many different emotions. It is normal to feel fearful or anxious about your labor and birth. You might be worried about the pain after hearing horror stories from your family and friends. You might be scared that you won’t have any autonomy in your birth. Maybe you’re doubting your ability to give birth or be a good parent or you don’t feel ready to bring your baby home. Here are some tips for working through these emotions:
Get Educated: Find a quality childbirth education class that covers labor, birth, breastfeeding, and newborn care. If possible, attend an in-person childbirth class that allows you to connect with other pregnant moms in your area. Many hospitals offer their own childbirth classes to couples who will be giving birth there. Be aware when attending these classes that many of them do not emphasize natural, low-intervention childbirth. Some doulas also offer childbirth classes as part of their packages. Reading books and listening to podcasts can also educate you about your birth.
Be Prepared: As you near the end of your pregnancy be prepared for your labor, birth, and bringing your baby home. Get your nursery set up, pack your hospital bags, and install the car seat. All of these can give you peace of mind as your due date nears. Prepare and go over your birth plan with your birth team. Hire a doula. Identify roles that each member of your birth team will have. Line up your birth photographer if you’re planning to have one.
Know Your Rights: Your birth team works for YOU. You are in charge of your birth. It is imperative to dialogue with your healthcare provider ahead of your birth to let them know what your expectations are. Talk to them about any concerns you might have regarding your birth. Familiarize yourself with evidence-based practices in birth versus what your hospital policies might be (hospital policies should never trump evidence-based practices). Find out if your hospital has a patient bill of rights and bring it to your birth.