Your third trimester pregnancy guide and checklist
Learn about everything that happens during the third trimester – and use this checklist to stay organized and healthy.
What is the third trimester?
The third trimester is the last phase of pregnancy, when your belly will grow bigger than you may have ever imagined. Your baby is packing on pounds, and by 40 weeks will be the size of a pumpkin!
No wonder you're feeling exhausted. In late pregnancy, many expecting moms feel uncomfortable and clumsy, and struggle to bend over to pick things up or tie their shoes. You may also start waddling. As your baby grows and crowds your organs, it may be hard to take deep breaths and get comfortable in bed, and you may need to pee constantly. You may notice stretch marks appearing on your breasts, behind, and belly and have leg cramps and swelling, among other symptoms.
For some expecting moms, the third trimester is a waiting game. By late pregnancy, there may be a lot of unknowns making you nervous – like when your labor will start, how it will go, whether your baby will be okay, and how you'll adjust to being a parent. These fears are normal – but nerve-wracking. To get support, check in with your provider and other moms-to-be in your Birth Club. You can also try using positive affirmations and self-care to ease your mind and feel better.
Not all moms suffer in the third trimester, though. You may still have energy, be savoring time with friends and family, and enjoy preparing for your baby's arrival (the so-called "nesting instinct" is real).
In your womb, your baby's brain, kidneys, and lungs are maturing. Your baby can see and hear your voice and other sounds from the outside world. During the last few weeks of pregnancy, your baby's head will likely "drop," or descend into your pelvis in preparation for birth. For more on your baby's amazing development, see our article showing fetal development by week.
When does the third trimester start?
The third trimester starts at the beginning of week 28 of pregnancy and lasts until you give birth around week 40. This corresponds to months seven, eight, and nine of pregnancy. For more detail, check out our pregnancy weeks to months chart.
Of course, women often don't give birth exactly on their due date, so it can be hard to say when your third trimester will actually end. It's fairly common that after months of anticipation, your due date rolls around, and ... you're still pregnant. If you go one or two weeks past your due date, though, your provider will use medication or other techniques to induce labor.
Third trimester symptoms
Unfortunately, serious pregnancy complications can surface in the third trimester – including premature labor and preeclampsia. Be on the lookout for symptoms that warrant a call to your doctor or midwife.
There are also strange sensations that pop up toward the end of pregnancy, including Braxton Hicks contractions, leaking breasts, and "lightning crotch."
Headaches
The usual pregnancy headache culprits in the first and second trimesters may continue to plague you in the third. Hormones, lack of sleep, and stressing about your new baby could all make your head hurt.
Swelling
Swelling in the third trimester is normal, especially in your ankles and feet, because you're retaining more water. But watch out for sudden or excessive swelling of your feet or ankles, facial swelling, puffiness around your eyes, and more than moderate swelling of your hands. These can be signs of preeclampsia, a serious pregnancy complication.
Nausea
Third trimester Nausea usually wanes around week 15, but may reappear in the last few months of pregnancy. Nausea often comes with heartburn, bloating, and gas – all common symptoms in the third trimester. But if you have nausea and vomiting late in the third trimester, reach out to your doctor or midwife since this can be a sign of preeclampsia.
Cramping in the third trimester
As you approach your due date, you may notice an increase in cramping, which could be a sign of early labor. Check out our visual guide to when to call your provider if you're having cramps during pregnancy.
Braxton Hicks contractions
Braxton Hicks are "false" labor pains that mimic contractions. They usually show up in the second or third trimester. It's helpful to know the difference between Braxton Hicks contractions and the real thing.
Pelvic pain
You may experience pelvic pain in the third trimester as ligaments loosen or pull and stretch to support your growing uterus. Also, when your baby's head starts to rest lower in your pelvis, the pressure on your cervix and nerves around your lower uterus can cause sharp, shooting pains some call "lightening crotch."
Third trimester fatigue
It's normal for your energy levels to take a dive, since carrying extra weight, breathing harder, and sleep problems can all contribute to fatigue.
Insomnia
By now, a number of things are probably disrupting your sleep and can cause insomnia in the third trimester. Focus on resting whenever you can. Guided imagery, extra pillows, and a very dark room may help you get better sleep.
Diarrhea in the third trimester
Some women have diarrhea in late pregnancy right before they go into labor. Call your doctor or midwife if you have diarrhea that lasts more than two days, or if yours is coupled with vaginal discharge, cramps, and contractions.
Back pain
In the third trimester, back pain may now seem constant. Hang on – you should get relief after delivery. Try these tips to relieve lower back pain.
Discharge
Close to labor, you may lose your mucus plug and have discharge that's watery, bloody, or mucus-like. If you've been having a lot of vaginal discharge during pregnancy you may not notice when the plug comes out.
Acid reflux in the third trimester
As your baby continues to grow, they crowd your internal organs and move your stomach contents upward. This can cause heartburn. You'll probably find relief after giving birth, but in the meantime try these heartburn relief tips.
Dizziness
Don't be surprised if you sometimes feel dizzy during your third trimester. Normal pregnancy-related cardiovascular changes are probably the cause.
Labial swelling
If your vagina feels swollen, full, and even itchy, it's probably due to increased blood flow to the labia. This feeling should go away a few weeks after giving birth. For now, these home remedies may help relieve the pressure of third trimester labial swelling.
Bloating
Gas and bloating may peak in the third trimester, and can make it difficult to eat a full meal. Dietary changes can help banish the bloat, as can some over-the-counter medications.
Leaking breasts
In the third trimester, it's fairly common to have leaking breasts. The hormone prolactin is becoming active and getting your body ready to feed your baby. The liquid you see isn't full-blown breast milk, but colostrum – a nutrient-dense substance your body produces before your breast milk comes in.
Weight gain in the third trimester
In the third trimester, aim for a steady weight gain of about a pound each week. You need about 450 extra calories per day to support your pregnancy – here are some healthy pregnancy foods and pregnancy snacks to help you meet that goal.
In the third trimester, some women find that their appetite decreases. It may be harder to eat meals (because your baby is crowding your internal organs), and you may find it easier to eat small meals and snacks.
If you're concerned about your weight gain, or if you have any weight loss during the last few months of pregnancy, talk to your doctor or midwife. They'll monitor your pregnancy weight to make sure you're in a healthy range and gaining at an appropriate pace. You can also use our Pregnancy Weight Gain Calculator to stay on track.
Sex during the third trimester
Generally, it's safe to have sex during the third trimester. If you're having a healthy, uncomplicated pregnancy, you can probably continue to have sex right up until your water breaks or you go into labor. You may have to get creative about pregnancy sex positions as your belly expands!
However, your doctor or midwife may advise you to avoid sex in the third trimester if you have:
Third trimester pregnancy checklist
Use this list to keep track of all your third-trimester tasks, from making a birth plan to deciding on a baby name.
Keep track of your baby's movements
Pay attention to your baby's kicks, twitches, and rolls and let your doctor or midwife know right away if you notice a decrease in movement. Here's how to do kick counts.
Complete third-trimester prenatal visits and tests
You'll most likely have a checkup every two weeks from 28 to 36 weeks, then switch to once-a-week visits until you deliver. As you and your provider get to know each other better and as your due date draws near, you can expect a mix of regular physical exams, late-pregnancy tests, and discussions about your labor and birth. Find out more about third-trimester prenatal visits.
Consider more classes
In addition to a birth class, you may want to consider classes on baby care, breastfeeding, and infant CPR. Many hospitals offer these, and you can also ask your provider for a recommendation.
BabyCenter Courses also offer virtual classes on infant CPROpens a new window, baby sleepOpens a new window, and physical milestonesOpens a new window that have great information from members of our Medical Advisory Board.
Choose a doctor for your baby
Get names of pediatricians or family practitioners from friends, co-workers, neighbors, or your prenatal caregiver. Make sure the doctor accepts your health insurance, keeps hours that work with your schedule, and has an office that's convenient for you. If your baby's doctor has staffing privileges where you deliver, they'll see your baby while you two are in the hospital. (If not, the hospital will provide another pediatrician during your stay.) Learn more about choosing a doctor for your baby.
Tour your hospital or birth center
For COVID safety reasons, you may visit the hospital or birth center online via video tour. If you're in person, you might get to see labor and recovery rooms and the nursery. You'll also get an overview of basic policies. Ask if you can preregister in the weeks before your delivery to get it out of the way.
Decide whether to hire a professional labor coach (doula)
A doula is a trained labor coach who assists you during labor and delivery. They provide you with continuous emotional support, as well as assistance with other non-medical aspects of your care. If you're interested in hiring a doula, it's a good idea to start your search early in the third trimester. Find out more about doulas.
Learn about coping with labor pain
There's no one right way to deliver a baby: Every woman's experience with pain is different and every labor is different. But whether you know you want pain medication during childbirth or an unmedicated vaginal delivery, it's good to learn about your options now. If you want to have an unmedicated ("natural") birth, you can help set yourself up for success by taking birth classes specifically for that goal, and by preparing yourself mentally and physically.
Know what to do when labor starts
Long before the first contractions hit, your doctor or midwife should give you a clear set of guidelines for when to call and – unless you're having a home birth – when to head to the hospital or birth center. Decide who will take you there, and have a few back-up folks lined up to help if you need it. (If you have older kids at home, make a plan for who will care for them during your delivery, too.) You'll also want to know these early signs of labor.
Learn the stages of labor
For first-time moms, labor takes an average of 15 hours, though it's not uncommon to last more than 20. (For women who've previously had a vaginal birth, it averages eight hours.) Labor and birth is divided into three main stages – learn about them so you'll feel prepared.
Create a birth plan
Childbirth is unpredictable, and focusing on flexibility and safety is important. Chances are you won't follow your birth plan to the letter. But it can be helpful to figure out your preferences beforehand. What pain management techniques do you want to use? Who'll be present during your delivery? Fill out our handy Birth Plan Worksheet and discuss it with your provider.
Pack your bag for the hospital or birth center
Key things to bring include your insurance card, toiletries, comfy clothing, a going-home outfit for your baby, your phone and charger, and snacks for after labor. You may also want to bring a box of chocolates or other treat for the nurses (not required, but appreciated!). See our full list of what to pack for the hospital or birth center.
Think about big decisions
Would you like to stay home with your baby full- or part-time? If you're having a boy, would you like him to be circumcised? Will you have a religious ceremony after your baby's born? What about banking your baby's cord blood? These are some of the big decisions to think and talk about now.
Decide on baby names
If you don't have a few great baby names picked out, check out our Baby Names Finder to see name popularity, origin, and meanings. Try this exercise to narrow your list and get on the same page with your partner: Make a list of ten names you like. Have your partner do the same. Trade lists and each cross out one name on the other's list that you don't love. Keep taking turns until you have a set of names you can both live with.
Read up on baby care
If you haven't already, the third trimester is the perfect time to switch reading gears from pregnancy to baby. You won't have as much time to read after your baby's born, so learn all you can about the first few weeks now. A good place to start is BabyCenter's newborn area.
Learn about newborn screening tests
All states require newborn screening tests for rare but serious conditions, including hearing loss, congenital heart defects, and metabolic disorders. These tests detect disorders that can cause long-term health problems, or even be fatal, if not diagnosed and treated promptly. Find out which screening tests your baby will have and what's involved.
Talk to your baby
Your baby can hear you now, and talking to them is a great way to start the bonding process. If having an actual conversation with your bump seems odd, try narrating your daily activities; reading a book, magazine, or newspaper aloud; or sharing your secret wishes for your child. This is great practice for after your baby's born, too. Talking to babies is one of the best ways to help them develop language skills.
Assemble your baby gear
Once you have your baby gear must-haves, it's time to set them up! This is the perfect job for your partner or a friend who wants to help. Cribs, bassinets, and strollers can be tricky to put together, especially when you're sleep-deprived, so get started now. Swings, mobiles, and monitors often require batteries, so make sure you have enough on hand.
Install your baby's car seat
You can't drive your baby home without a car seat, and they can be more complicated to install than you'd think. So don't wait until the last minute. If you're having trouble, some car seat manufacturers have a toll-free number for you to call so an expert can walk you through the process. Or get a car seat safety inspector to help you. To find one in your area, go to the National Highway Traffic Safety Administration's website.
Wash your baby's clothing and bedding
You know all those adorable, pristine newborn outfits and blankies you bought or received as gifts? It's time to throw them in the laundry. You should wash anything that will go near your newborn's skin to remove any irritants in the fabrics. The gentlest detergents are those designed for babies and those that are labeled hypoallergenic or good for sensitive skin.
Ask for help
If friends and family can pitch in after your baby's born, set up a schedule so each person has a specific task and date to do it. (Or ask a friend or relative to create this.) Tasks could include bringing your family a meal, picking up groceries, taking care of your older children, doing the dishes, cleaning up, taking out the garbage, or walking your dog.
Commemorate your pregnancy
Splurge on some professional maternity photos. Or, celebrate your amazing pregnant belly by decorating it with beautiful designs (you can use regular face paint), getting a henna "tattoo" applied (go to an artist who uses the pure, natural kind), or making a belly cast.
Stock up on household and personal supplies
It's a good idea to stock up now on pantry staples, frozen food, medicine, toilet paper, sanitary pads for postpartum bleeding, shampoo … even extra pairs of comfy underwear. And of course, make sure you have newborn necessities like diapers, wipes, baby clothes, and bottles and formula if you plan to use these.
Write down your pregnancy memories
Whether you keep a formal journal or just jot down a few notes when the spirit moves you, you'll love sharing these pregnancy stories with your child someday. Learn more about journaling during pregnancy.
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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.
ACOG. 2021. Nutrition during pregnancy. American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancyOpens a new window [Accessed September 2021]
Johns Hopkins Medicine. Undated. The third trimester. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-third-trimesterOpens a new window [Accessed September 2021]
