During the third trimester (weeks 28-40 of pregnancy), you’ll experience increased fetal movements and begin finalizing plans for your big day. In this exciting time, it’s natural to find yourself asking new questions. Don’t rely on the internet for answers!
In this third installment of a four-part video series, Max Holtz, MD, MPH, an obstetrician-gynecologist in Women’s Health, a clinical partnership between Ascension Seton and UT Health Austin, answers the most commonly searched questions about the third trimester of pregnancy.
“Swelling in the hands and feet is very normal, particularly in the third trimester of pregnancy,” explains Dr. Holtz. “For most women, this is a completely normal occurrence. However, if this is something that’s new to you or concerning, always talk to your doctor about it.”
“If you’re concerned about a change in the movement of your baby, particularly a decrease in the movement in the third trimester, we recommend that you do what we call kick counts,” shares Dr. Holtz. “What I recommend doing is you set a timer on your phone for about 2 hours, and you want to feel at least 10 movements in those 2 hours. If your baby doesn’t meet those movements, you should let your doctor know or you may proceed directly to the hospital triage where further monitoring can be done.”
“You should definitely be able to feel strong fetal movement in the third trimester,” says Dr. Holtz. “However, if this is a new finding for you or something that’s concerning or associated with labor pains, contractions, vaginal bleeding, or other things that seem complicated to you, your doctor needs to know about that.”
“We recommend that people don’t travel past the 36th week of pregnancy,” shares Dr. Holtz. “Generally, airlines won’t allow you to travel after that if you are flying. Traveling smaller trips by personal vehicle, some people may continue to do so. What I recommend in those cases is that you have your prenatal records available with you should you, unfortunately, go into labor or need care somewhere else outside of where you live. What I also tell people is when they travel, they should make sure that they get up and walk around every couple of hours to prevent the risk of having blood clots in their legs.”
“The glucose tolerance test is commonly done between 24 and 28 weeks,” says Dr. Holtz, “and it’s a test to look for and diagnose the potential for gestational diabetes.
“Braxton Hicks contractions, we kind of talk about as being practice contractions for labor,” shares Dr. Holtz. “But what they are is they are basically a gentle squeezing of the uterus. They are not associated with labor, and they can occur several times per day for women. Sometimes, they can be painful, but they are not associated typically with labor.”
“Oftentimes, people who are starting to prepare for labor might experience some small amounts of vaginal bleeding that may or may not be associated with a little bit of cervical mucus,” says Dr. Holtz, “and sometimes, people call that the mucus plug. This could be a sign that your body is preparing for labor. If you’re not feeling any symptoms, so if you’re not having contractions or you don’t think your water’s broken, and otherwise you’re feeling well, this might just be a sign that the body is slowly preparing for the inevitable.”
“If you’re term, your contractions should be about five minutes apart, getting stronger and closer together,” shares Dr. Hotlz. “That would be a pretty good sign that you’re going into labor. What I tell my patients who are before term, so that’s before 37 weeks, is to start timing them, and if they are about 10 minutes apart and getting closer together, then you should call your doctor. And if they are definitely five minutes apart, you should consider being seen in the triage.”
“The biggest things that you’re going to encounter in the third trimester are going to be symptoms of labor, which we talked about a little bit before,” says Dr. Holtz. “The other thing that we always need to be mindful of would be signs of things like preeclampsia. Preeclampsia is a condition that’s caused by the placenta that causes elevated blood pressure in pregnancy and requires delivery. The signs of preeclampsia could be things like a headache that doesn’t go away with rest or Tylenol; headaches that may or may not be associated with vision changes, particularly black spots in your vision; severe pain on the upper right side of your belly, where your liver is. If you’re experiencing those symptoms, you should tell your doctor. If you’re able to check your blood pressure, you should check your blood pressure and tell your doctor. Or, if you’re unable to do any of those things, you should present to the hospital.”
At Ascension Seton, which is where we deliver the majority of our patients, there are wonderful resources and breast specialists who will come and meet with you after you have your baby,” shares Dr. Holtz. “If there are additional needs or additional need for ongoing support for breastfeeding from our lactation consultants, they can help set you up for additional appointments and additional resources to make sure that your breastfeeding is as successful as possible. Otherwise, later, if you’re having additional issues, you should bring them up with your physician or your provider, who can help get you in to see a lactation consultant.”
“A birth plan is a very personal plan that everybody is going to have different needs for,” explains Dr. Holtz. “What I would say is that a lot of things that appear in a birth plan. So, for example, delayed cord clamping, skin-to-skin bonding with your baby, early latching, are things that we’re already doing and are a part of our standard of care within the hospital. We do the best that we can to avoid unnecessary C-sections as well and work to ensure everybody has an empowered and positive birth experience. Some people may have very specific religious requests, so if that’s the case, you should include that. Some people have very specific requests on who’s going to be in the room, who’s going to cut the baby’s cord, and what bonding will look like. I encourage you to reach out to any family members or to our staff and we are happy to provide you with a sample birth plan. Or, there are organizations, for example, doula services in Austin, that could help you with that.”
Please remember to contact your ob-gyn with any questions you have related to your pregnancy to ensure you receive answers specific to you and your pregnancy.
Explore answers to the most commonly searched questions about the first trimester of pregnancy (VIDEO).
Explore answers to the most commonly searched questions about the second trimester of pregnancy (VIDEO).
Coming Soon: Stay tuned for answers to the most commonly searched questions about the “fourth” trimester of pregnancy.
For more information about Women’s Health or to schedule an appointment, visit here.