Third Trimester of Pregnancy: What to Expect, What to Do, and What to Avoid
Welcome to the final stretch of your pregnancy journey—the third trimester! Spanning from week 28 to the birth of your baby (usually around week 40), this is a time of rapid growth, anticipation, and preparation. Physically, emotionally, and practically—this trimester is all about getting ready for labor, birth, and postpartum.
As both a doctor and a mother, I know how crucial this phase is—not just for your baby’s final development, but also for your own well-being and peace of mind.
Changes in the Mother's Body
As the baby grows and the body prepares for birth, several new symptoms may emerge or intensify:
Common Physical Changes:
✔️Shortness of Breath & Heartburn: As the uterus expands, it pushes up against the lungs and stomach, making breathing more difficult and causing heartburn or nausea. Sitting upright and stretching gently can help. When the baby drops lower into the pelvis (aided by pre-labor contractions), breathing often becomes easier.
✔️Frequent Urination: The growing baby puts pressure on the bladder, increasing the need to pee more often.
✔️Belly Button Protrusion: Many women find that their belly button pops out near the end of pregnancy and may become sensitive.
✔️Stretch Marks: As the skin stretches, some women develop stretch marks on the belly, breasts, and thighs. Regular moisturizing and healthy weight management can help reduce their appearance.
✔️Colostrum Leakage: Some mothers may notice a few drops of colostrum (early milk) leaking from their breasts. Gentle cleaning and nursing pads can help with comfort.
✔️Heavy Legs & Hemorrhoids: Increased pressure in the lower body can cause varicose veins, swollen legs, or hemorrhoids. Supportive measures like leg elevation, gentle movement, compression stockings, and cooling treatments can offer relief.
✔️Back and Hip Pain: as the body is preparing for the birth.
Braxton Hicks Contractions
These practice contractions are common in late pregnancy and help the uterus prepare for labor. They do not cause the cervix to open but help improve blood flow and strengthen the uterine muscles. If contractions become very strong, regular, or painful, it’s worth consulting your healthcare provider.
Sleep and Emotional Health
✔️Restless Nights: Hormonal changes, physical discomfort, and anxiety can disrupt sleep. Intense dreams, frequent bathroom trips, and difficulty finding a comfortable position are all normal. Using extra pillows (such as a nursing pillow) and sleeping on your side—especially the left—can help.
✔️Emotional Swings: The excitement of meeting your baby mixes with worries about labor and parenthood. Talking with your partner, friends, or other mothers can provide reassurance. A birth preparation course and hospital tour can also help reduce fear and increase confidence.
Pelvic Floor & Posture
The pelvic floor carries increasing weight. Simple exercises like pelvic tilts or “cat-cow” stretches, and being mindful of upright posture, can ease back pain and prepare the body for delivery.
Preparing the Breasts
By the third trimester, breasts may feel heavy and full. Consider purchasing a nursing bra for support and comfort.
Developmental Milestones for the Baby
Your baby is now doing some serious growing and developing:
✔️Weight Gain: Most of the baby’s weight gain happens now. This added fat helps regulate body temperature after birth.
✔️Lung Maturation: The lungs begin producing surfactant, a substance that prevents lung collapse and is critical for breathing outside the womb.
✔️Brain Development: Myelin, the protective coating around nerves, is forming, allowing faster communication within the baby’s nervous system.
✔️Refining the Senses: Babies can hear, recognize voices, and react to light and touch. They often grab the umbilical cord and stretch out their limbs.
✔️Positioning for Birth: Most babies move into the head-down position by week 36. Don’t worry if yours hasn’t yet—there’s still time.
✔️Eye Color: At birth, most babies have blue eyes, but the color may change in the months following birth as pigmentation settles.
Important Medical Checkups in the Third Trimester
Regular Prenatal Visits (usually every 2 weeks, then weekly after week 36) include:
✔️Blood pressure monitoring
✔️Checking for edema (swelling)
✔️Fetal heartbeat monitoring
✔️Belly measurements to track fetal growth
✔️Urine testing (to detect protein or sugar)
Between Week 25–28 – if not already done in the second trimester:
✔️OGTT (Oral Glucose Tolerance Test): Screens for gestational diabetes, which can affect the baby’s size and increase the risk of complications at birth.
✔️HBs-Antigen Test: Screens for hepatitis B infection to prevent mother-to-child transmission. If positive, your baby can receive immediate protection at birth.
Between Week 30–34:
✔️Third major ultrasound (Organwachstum / Biometrie): Checks your baby’s growth, position, amniotic fluid levels, and placenta.
✔️CTG (Cardiotocography): From around week 36, a CTG may be performed regularly to monitor uterine activity and your baby’s heart rate.
Preparing for Birth
As you approach the final weeks of pregnancy, it’s time to start actively preparing for the big day—and the first days with your baby.
What to do now:
✔️Start Your Maternity Leave: In Austria, Mutterschutz (maternity leave) starts 8 weeks before your due date. Use this time to rest, prepare, and mentally get ready for the big day.
✔️Choose your place of birth – whether it’s a public hospital, private clinic, or Geburtshaus (birth center). Register in advance if required – many private hospitals and birth centers have limited spots and require early registration.
✔️Pack your hospital bag (ideally by week 35) – include essentials for you, your baby, and your birth partner.
✔️Prepare for a Home or Outpatient Birth: If you’re not planning to stay long in the hospital, make sure your home is stocked with meals, baby supplies, and postpartum care items. Also, choose your pediatrician and check if they offer home visits for early baby check-ups.
✔️Choose a pediatrician and organize childcare if you have older kids.
✔️Consider perineal massages, raspberry leaf tea, or acupressure to prepare your body.
✔️Cut back on sugar and refined carbs – this supports the hormone prostaglandin, which helps soften the cervix and prepare for labor.
Nutrition Tip
Reducing sugar and refined carbohydrates may help improve hormonal balance before birth. High blood sugar levels can affect prostaglandin receptors, potentially making labor more painful and less efficient.
Optional Support & Courses
✔️Birthing classes (Geburtsvorbereitungskurse)
These help you and your partner prepare mentally and physically for labor, pain management, and postpartum recovery.
✔️Breastfeeding workshops
Learn what to expect in the first hours and days, how to get a good latch, and what to do if challenges arise.
✔️Baby care and parenting classes
Especially useful for first-time parents to feel more confident with newborn care (e.g., bathing, dressing, safe sleep).
✔️Partner courses
Teach your partner how to be actively supportive during labor and early baby care.
The Role of a Midwife
In Austria, every pregnant woman is entitled to midwifery support. A freelance midwife can guide you through:
✔️Pregnancy consultations and emotional support
✔️Assistance during birth (at some birth centers or if you choose a home birth)
✔️Postpartum care – including help with:
- Breastfeeding
- Umbilical cord care
- Monitoring your baby’s weight
- Emotional support during recovery
Tip: It’s best to book a Hebamme early in pregnancy, as their schedules fill up fast—especially in larger cities. For Austria you can look for a midwife here: https://hebammen.at/.
Hospital Info Nights
Many private hospitals offer:
- Online info evenings (often live webinars), where you can ask questions in real time.
- In-person info sessions or personal consultations, where you can tour the facility, meet the team, and discuss your birth preferences.
These sessions are especially valuable to help reduce anxiety and understand how things work at your chosen place of birth.
What to Avoid in the Third Trimester
✔️Strenuous activity or heavy lifting
✔️Long travel (especially flights after 36 weeks) – many airlines won’t let you fly without a medical certificate
✔️Lying flat on your back for extended periods – can impair circulation
✔️Unpasteurized foods or raw meats – to avoid infections like listeriosis or toxoplasmosis
✔️Excessive salt and caffeine – to prevent blood pressure spikes
✔️Overheating in saunas, hot baths, or thermal spas – this can still pose risks in late pregnancy
Watch Out For Warning Signs
Immediately contact your doctor or go to the hospital if you notice:
- Vaginal bleeding
- Severe abdominal pain
- High fever
- Intense itching (especially on hands and feet)
- Sudden swelling of face or limbs
- Severe headache or visual disturbances
- Painful or frequent contractions before week 37
These could be signs of preterm labor, preeclampsia, or other complications.
Baby's Movement
You should now be very familiar with your baby’s movement pattern. If you notice a significant decrease in strength or frequency of movements, consult your midwife or doctor to check on the baby’s well-being.
Final Thoughts
The last few weeks of pregnancy can be physically demanding and emotionally intense, but they’re also a time to bond with your baby, prepare your environment, and embrace the transformation ahead. Trust your body, stay in close contact with your healthcare team, and And remember: every day brings you closer to meeting your little one. 💛