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Third Trimester Overview — Week 27 to Delivery

The baby is almost here,
what should I expect?

Congratulations, you're in the home stretch!

You may be feeling a mixture of excitement and apprehension as you approach the end of your pregnancy. Some women sail through the whole nine months symptom-free, while others watch their bodies grow and change in ways they never thought possible. On the other hand, some women may have some discomforts that may creep up during this trimester.

Third trimester discomforts may include:

  • Shortness of breath: From the decrease in the space your lungs have to expand due to the growth of your uterus.
  • Problems sleeping: Usually due to not being able to find a comfortable position with the size of your belly, excitement, and, sometimes, a baby who decides to be active while you are trying to sleep!
  • Minor aches and pains in your hips, buttocks, thighs: Usually due to pressure from your uterus on the sciatic nerves.
  • Minor vaginal pain: Sometimes this pain is thought to be from your cervix slowly starting to dilate or getting ready to dilate.
  • Skin discomforts or changes: Such as dry skin on abdomen that itches, worsening stretch marks, varicose veins and vascular spiders (all from the growth of the baby and pressure from your uterus enlarging).
  • Bouts with leaking urine: From the pressure of your uterus on the bladder.
  • Hemorrhoids: Sometimes worsen in this trimester due to the pressure from your uterus.
  • Breast colostrum leaking: This is normal, and it signals that your breasts are preparing for breastfeeding.*

Remember this is a special time for you and your partner. So try to enjoy as you begin the final countdown for the day when you and your baby finally meet face-to-face!

Nesting
You've heard about it, but is it real? That flurry of activity in late pregnancy-an urge to wash curtains, scrub floors, and sort drawers-is called the "nesting instinct." While there's no scientific evidence for this surge of energy, many mothers feel a sensible need to get organized before their baby arrives.

If you haven't already started planning for your baby's arrival, now is the time to start.

  • Take a tour of the hospital where you're delivering. Bring a list of questions. To schedule a tour at a Texas Health Hospital, call 1-877-THR-WELL.
  • Take a childbirth education class if you haven't already done so. Find a list of class offerings here.
  • Create your birth plan. A birthing plan simply outlines and clarifies your preferences for labor and delivery. The process of thinking through your options and discussing them with your doctor beforehand is much more important than actually showing up at the hospital with an itemized list. Your coach or partner can help make sure your wishes, where possible, are carried out on the delivery day.
  • Figure out baby supplies you'll need. If someone's throwing you a shower, get registered for baby gear. Here's a list of some essentials.
  • Make sure you pick a pediatrician before the baby arrives. To find a physician, click here.
  • Create a checklist of items to bring to the hospital for the day of delivery.
  • If the baby will need child care during the day, start looking at your options.

Braxton-Hicks contractions
You may have felt an occasional squeezing or tightening across your abdomen in the last few weeks. As you enter your third trimester, this feeling, called a Braxton-Hicks contraction, may get stronger and more frequent. As you near the end of your pregnancy, you may wonder how you can tell the difference between a Braxton-Hicks contraction and a true labor contraction.

  • The uterus is a large muscle, and a Braxton-Hicks contraction is an irregular, involuntary flexing of that muscle-a gentle workout to prepare it for the hard work of labor. Usually, women feel them begin near the pubic bone and move up toward the top of the uterus.
  • True contractions that kick off labor tend to be felt much lower and deeper. Many women describe them as a strong pulling around the vagina that rises toward the pubic bone. True contractions may be intense yet rarely exceed one minute. In real labor you usually see a pink- or red-tinged plug of mucus from the cervix, the "bloody show."
  • Braxton-Hicks contractions can be strong enough to require deep breathing and can occur more than three to four times in an hour, like labor contractions. They are especially likely to be strong and frequent if you are a little dehydrated or running a fever. If they are Braxton-Hicks, drinking four to six glasses of water and lying on the left side usually calms them down, while true labor contractions will increase in frequency and strength.
  • Braxton-Hicks contractions may also occur after a sudden burst of activity, like running up the stairs, or first thing in the morning when you awaken with a full bladder, or following sex.
  • Fetal movement can also mimic a contraction. You can tell the difference by placing your hands on the top and sides of the uterus. If it's a contraction, the uterus will feel hard all over and tight to your pressed fingertips. If the uterus feels hard in some places and soft in others, your baby's movements are probably causing the sensation.

Tips for the third trimester:

  • If backaches and heartburn are keeping you from getting a good night's sleep, a few extra pillows can help. While lying on your side, try placing one pillow between your knees, another at the small of your back, and two under your head so that your shoulders and chest are raised at an angle along with your head. You may wish to hug a pillow in front of your chest as well. The pillows at your legs, back, and chest will lessen the strain on your back, and the pillows under your shoulders and head will allow gravity to keep your stomach acids where they belong. If you tend to lose your pillows during sleep, you can raise the head of the mattress by putting a pillow under it.**
  • Before your baby is born, talk to your doctor or midwife about what will happen right after the birth of your new baby. In uncomplicated births and cesarean sections, it is usually possible and helpful for new parents to spend a quiet hour or so holding and getting to know their new baby. If a mother can hold her newborn skin-to-skin during this period, on her chest with a light blanket over both mother and baby for warmth, research suggests that the benefits are even greater.**
  • Take care of yourself while at work. If you are on your feet working all day, consider resting one foot on a stool or something low (to relieve some of the pressure off your back) at frequent periods throughout the day. You may need to modify some of your activities at work later in the pregnancy if the activity requires you to lift or maintain balance because your weight change may affect your ability to perform certain activities. (It could also be dangerous to you and the baby.)*
  • Learn about breastfeeding. Your breasts have been preparing to feed your baby since you conceived, growing larger as milk-making structures develop within them. Since the fifth or sixth month of pregnancy, your breasts have been able to produce milk for your baby. You may have already noticed beads of deep yellow fluid on your nipples. This "liquid gold" is colostrum, your baby's first food, and it usually appears sometime in the third trimester. This special, early milk is crammed with elements that protect your baby from bacteria and viruses. It is high in nutrition and easy to digest. If you nurse your baby early and often in the first days after birth, the colostrum will soon turn to mature milk, tailor-made to provide your baby with all the nutrients he needs until he is 5 to 6 months old, and beyond. The only preparation for breastfeeding you need to do during pregnancy (other than learning as much as you can about how and why it is so good for your baby) is to check that your nipples can extend outward. To do so, squeeze gently just behind the nipple with your thumb and forefinger. This imitates the motion your baby will make while nursing. Do your nipples extend, or do they fold inward? If they do not point out when squeezed, let your doctor, midwife, or a lactation consultant at the hospital know and they can show you a few ways to encourage them to extend.
  • Plan to have help when you return home from the hospital. When you return home from the hospital after you have your baby, your new baby will need care but so will you. Discuss these needs now and if your partner or a family member cannot be there make sure you enlist someone who can. It's important for you to rest and take breaks. The hospital staff will ask you about the help available to you before you leave.
  • Pack your bags. Check that everything you might need at the hospital is packed and ready to go. Include supplies you and your partner will need during labor.**
  • Make sure you get a car seat before the big day. Car seats come with lots of bells and whistles and it can be hard to know for sure if you've got the right strap in the right place. Texas Health is here to help. Our Child Passenger Safety Technicians can provide free car seat checks. To schedule a free check at the nearest location to you, call 1-877-THR-WELL.

*Source: A.D.A.M.

**Source: TPR Media