Third Trimester FAQs and Tips with an L&D Nurse

All right third trimester mamas, this one is for you! If you don’t know me, I’m an L&D nurse and the face behind @mommy.labornurse over on Instagram. And every week we do Q&As in stories related to pregnancy and birth.

Over the past month or so, I’ve been gathering up all of the most common (but less answered) third-trimester questions to create this little round-up for you guys!

I know when it comes to the third trimester there is a TON of topics to cover – and I’ve got a lot of informational articles you can check out in the third-trimester section of the blog.

But here we’re going to answer some common third trimester FAQs. I will also sprinkle in some tips to help ease your mind and discomforts in the final trimester before birth!

If you haven’t already, please feel free to join over 400k new moms and follow me here on Instagram for awesome pregnancy + birth tips!

When does the third trimester start?

This question is actually a lot more common than you’d think, and it might have something to do with differing answers out there. MOST sources agree that the third trimester begins with week 28 and lasts until you give birth. But some sources say it starts in week 27, and that’s based on the assumption that each trimester is exactly 13 weeks.

And while it’s true that the other trimesters last between 13-14 weeks, the third trimester is less definitive in that sense too because due dates are rarely accurate in predicting when your baby will arrive.

A quick look at due dates

Whenever due dates come up, I like to take a look at the stats and averages on when babies actually make their appearance. According to birth data put out by the CDC in 2017:

  • 10% of babies were born before 37 weeks
  • 26% were born in weeks 37-38
  • 57% were born in weeks 39 to 40
  • 6% in week 41
  • Less than 1% at week 42+

Most interesting to me is that in 1997 the percentage of births at 42+ weeks was 57%!! That’s probably for a few reasons: dating ultrasounds weren’t as good, which meant less accurate due dates, and the rates of inductions and scheduled/elective C-sections are far higher these days.

Related: Third Trimester Must-Haves

Third trimester nausea: What’s the deal?

Okay, now that we’ve determined the general window of the third trimester, let’s talk about nausea. Most often nausea and the first trimester go hand in hand, but a surprising amount of women also complain about pregnancy nausea in the third trimester as well.

For some of you, this might be the exact same nausea from the first trimester that never went away. This is because there is a small subset of women who do experience nausea for their entire pregnancy, and an even smaller subset experience severe nausea that’s known as Hyperemesis Gravidarum.

But if your nausea did disappear and now it’s back – it might actually be rooted in something besides those rising hormones. And that’s your growing uterus and baby! Basically, as your baby and uterus grow they begin to put more and more pressure on your stomach leading to nausea.

With so much less space in your stomach, it also means that you might feel fuller faster and get that nauseous, overly full feeling more quickly and easily than you did before you were pregnant.

The best thing you can do to prevent third-trimester nausea is to eat smaller, more frequent meals to try to avoid that overly full feeling. Keeping yourself “regular” in the bathroom will also go a long way. Often, staying well-hydrated, and incorporating a daily cup of tea and movement into your day can really help with this!

What should I know about traveling in the third trimester?

There is a common myth out there about traveling during the third trimester of pregnancy – especially airplane travel! But the bottom line is that most domestic airlines will let you fly until 36 weeks, and car travel further than 2 hours from your hospital usually follows the same cut-off. But let’s break this down a little bit.

First off, make sure you talk to your provider about traveling anywhere as far in advance as possible. This is true for both car and air travel! If you’ve got a higher risk pregnancy, your provider may recommend you stop travel well before 36 weeks, so it’s important to have a chat with them.

It’s true that most domestic airlines allow low-risk pregnant women to fly up to the 36th week of their pregnancy but be aware that many airlines do request a travel certificate from your provider, so make sure to check if they need one!

International flights may differ. Be sure to check with the individual airline for more details.

It’s also important to know where you are going too! For example, travel isn’t recommended for pregnant women in areas where Zika outbreaks are ongoing. Zika is an illness spread by mosquitoes that can cause serious birth defects. Malaria is a risk too. Check the CDC website for more info on high-outbreak countries.

Here are a few tips to consider:

  • Drink LOTS of fluids while you fly, wear loose clothing, and walk around frequently once you are able to move in the air! Many women have difficulties with swelling while flying and this can help decrease swelling (and DVT’s too!)
  • Book an aisle seat if available – just more leg room and ease of access to getting up and using the bathroom as needed 😊
  • Avoid foods & drinks that cause gas and bring some gas medication with you on the flight. Gas can be quite uncomfortable, and it expands with low air pressure in airplane cabins making it even worse!
  • Bring hand sanitizer and wash your hands frequently 🙂 Airplanes can be icky lol (that’s a tip for anyone regardless of if you’re pregnant or not lol)

Third trimester baby movement: what’s normal and what’s not?

Baby movement in the third trimester is a hot topic and one that I like to shed light on whenever possible! So as far as feeling baby move, by week 28 of pregnancy all pregnant women should regularly be feeling their baby kick, move, and roll around in there.

And this is a great time to start doing kick counts as a way of noting your baby’s movement and learning what’s normal for them in terms of movement (because it does vary from baby to baby!). Research shows that kick counting is a free and SUPER effective way for mamas to track baby’s wellbeing in the womb, spot potential problems, and prevent stillbirth!

Kick counting

How to kick count?

  • Set aside time once per day to lie or recline in a quiet place and focus on baby’s movements
  • Try to do your kick counting when baby is usually active, for most this is at night or after meals
  • According to ACOG, you should feel 10 movements in two hours
  • Movements can be kicks, flutters, swishes, rolls, jabs, or anything in between
  • All babies are different, some mamas will feel 10 movements in 10 minutes, others might take the full two hours
  • Kick counting regularly helps you notice YOUR baby’s unique movement patterns, which will make it easier to spot a change
  • If baby doesn’t seem to be moving, try laying on your left side or having an ice-cold drink

Alert your doctor if:

  • You don’t feel 10 movements in two hours
  • The strength of the movements is different
  • For ANY reason you think something might be up

Remember – we’d MUCH rather you call and come in for a false alarm than have an emergency go unnoticed!

Babies don’t move less the bigger they get!

Many times, women hear the statement, “As your baby gets bigger, he/she might move less because there is less room.” This can be from a provider, friend, your mom, sister, etc.

While this is SORT OF true for some, it can get misconstrued making women think that when their baby is not moving normally, it’s simply normal because “they are running out of room in there”. And this can prevent us from spotting red flags and other issues.

It’s really important that if you are nearing term and your baby is not moving as frequently that you CALL YOUR PROVIDER! Or really at any point from here on out for that matter.

As baby gets bigger, movements may be more DULLED….you might feel “rolls” instead of sharp “jabs”, BUT baby should be moving just as much, and you should still keep track by doing fetal kick counts!

If your baby is moving less than normal, we will have you come in for some monitoring so that we can determine if there are any problems! You can read more about what that’s all about in the article, Non Stress Tests During Pregnancy.

Pregnancy exercises for the third trimester

Did you know that exercising during pregnancy provides you with a TON of benefits? Let’s look at some!

  • Shorter labor and delivery (a 2018 study showed a link between regular aerobic exercise and shorter duration of the first and second phase of labor!)
  • Higher chance of unmedicated birth (the same study found a link between regular exercise and fewer instances of epidural use)
  • Keeps mood swings at bay
  • Boosts energy
  • Can help you achieve a healthy weight gain for your body
  • Minimizes pregnancy discomforts
  • Easier postpartum recovery

In fact, it’s so important and beneficial, the American College of Obstetricians and Gynecologists (ACOG) recommends getting about 30 minutes of activity a day! Here are a few GREAT exercises to do during your pregnancy that are all safe for the third trimester:

  • Brisk walking
  • Yoga
  • Ball exercises (an exercise ball can be great to use during labor too!)
  • Squats/Pliés (also great for getting baby engaged for labor!)
  • Swimming
  • Biking on a stationary bike (regular biking isn’t recommended because you are more likely to fall)
  • Low impact aerobics
  • Elliptical
  • Jogging (if you were running before pregnancy)

Related: Interview with a Prenatal Yoga Expert

Can I definitely work out during my third trimester?

Most of the time YES! Generally, if you were physically active before your pregnancy, you should be able to continue your activity in moderation as long as it’s a no-contact activity. But it’s ALWAYS a good idea to check with your provider first.

Also! Don’t feel like you HAVE to exercise at your former level; instead, do what’s most comfortable for you now. And if you WEREN’T physically active in your pregnancy up until now – it’s not too late! Just start slow and work up your endurance. Remember any movement helps!

Related: The Best Prenatal Fitness App

Why am I thirstier during the third trimester of pregnancy?

During pregnancy, hydration is super important for a number of reasons. The general recommendation is ten 8oz glasses of water per day, but if it’s especially hot, you exercise regularly, or you still feel thirsty, aim higher!

Basically, you may feel thirstier because your body knows it NEEDS water. So listen to your thirst-cues and always drink enough to quench your thirst, the amount is going to look different for different women.

Here are some of the important jobs water and hydration do during pregnancy:

  • Transports nutrients: Water is responsible for carrying oxygen and nutrients to our cells, tissues, and organs. Staying hydrated ensures that essential nutrients are being transported to meet the developmental needs of baby as he/she grows
  • Amniotic fluid levels: Drinking water also helps preserve an adequate level of amniotic fluid, and even aids fetal kidney function by facilitating the amount of waste baby’s kidneys filter
  • May help with swelling: If water retention has caused you to look more swollen than normal lately, drinking water can help prevent the amount of water you retain throughout the course your pregnancy
  • Prevent Braxton Hicks: Dehydration can cause cramping and is a huge trigger for those pesky Braxton hicks contractions you may be feeling as your pregnancy progresses
  • Prepares you for labor: Water intake and proper hydration becomes especially important at the very end of pregnancy. You want to be properly hydrated at all times so you are ready for labor and delivery. Being well-hydrated will give you more energy and you may even experience a shorter labor! (source)

Related: A Complete Guide to Amniotic Fluid Levels During Pregnancy

Itchy feet during pregnancy – what’s going on?

Hopefully, by the third trimester, you feel familiar with the reasons to call your provider. We already talked about baby movements above, but bleeding, severe abdominal pain, symptoms of preeclampsia, and preterm labor are also frequently talked about.

One thing I don’t hear as often? To call your provider if you have itchy palms and soles of your feet during pregnancy (or any abnormal itchiness to be honest!). Here’s why:

Itchy hands and feet can be a symptom of a scary condition called Intrahepatic Cholestasis of Pregnancy (ICP). In fact, itchy hands, itchy feet, itchy body – if you are feeling itchy and your provider hasn’t ruled this out, let them know!

What is cholestasis?

Cholestasis is a condition where the flow of bile is affected by the increased amounts of pregnancy hormones. Cholestasis is more common in the last trimester of pregnancy when hormones are at their peak, but it usually goes away within a few days after delivery.

It’s a big deal because it increases the risk for fetal distress, preterm birth, or stillbirth. A developing baby relies on mama’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on baby’s liver. Women with cholestasis should be monitored closely and serious consideration should be given to inducing labor once the baby’s lungs have reached maturity. (source)

But, don’t get too nervous. Many women who have cholestasis go on to have perfectly healthy babies! Your birth just might be a bit sooner or a little different than you previously imagined. The bottom line on itchy feet? Bring it up to your provider ASAP!

How to deal with hip pain in the third trimester?

Hip pain during the third trimester is a super common discomfort that affects most women to at least some degree. It’s mostly caused by that growing belly, and your need to move in different ways to accommodate that belly! All of the pulling, tightening, and shifting that’s happening with the muscles, ligaments, etc. surrounding your pelvis also add to the perfect storm, hah.

So what can you do about hip pain in the third trimester? Here are my suggestions:

  • Movement/Stretching: Regularly moving and doing stretches that target your hips during pregnancy can be some of the best ways to find relief! Prenatal yoga for third trimester mamas almost always incorporate tons of awesome hip stretches and openers. Spending time on your yoga ball, in a low, supported squat, or moving in water can all help too!
  • Heating pad: Heat can help so much with common pains and discomforts. Applying a heating pad or hot water bottle to your sore hips can actually go a long way in providing some relief
  • Pregnancy pillow: A lot of pregnant women experience achy hips as they try to fall asleep. Putting a pillow between your legs while you lie on your side can help with this. A pregnancy sleeping pillow can be even better!
  • Pregnancy support belt: A pregnancy support belt lifts and supports your growing belly to help relieve some of the pressure on the lower back, hips, and pelvis. I LOVED using one when with my second pregnancy – it made a huge difference!

Is labial swelling normal during the third trimester?

Unfortunately, yes. Vaginal swelling in general, including the labia and vulva, is really normal during pregnancy, but that doesn’t make it any less alarming. If you’re experiencing this, your vagina and labia likely look or feel a lot puffier or fuller than they typically do. Just like how swelling happens in other parts of the body, it can totally happen down there too.

Here are some reasons for labial swelling in the third trimester:

  • Fluid retention: Just like your swollen ankles or feet that are due to fluid retention, sometimes that excess fluid lands in the tissue of your vagina causing a puffy, swollen sensation
  • Increased blood volume: By weeks 34-36 you will reach peak blood volume during your pregnancy – which on average is 45% higher than your pre-pregnancy levels (source)! All of that extra volume can result in increased blood flow and blood pressure in and around your pelvis, which leads to swelling
  • Added pressure: Building on the first two reasons, as your belly grows it starts to put a lot more pressure on your pelvis, which is another reason that excess fluid can build up in your vaginal area
  • Varicose veins: We most often think about varicose veins on the legs and feet, but they can actually show up in your labia or vulva too! These can catch women off guard, but they aren’t anything to worry too much about and usually resolve after birth

The way you’ll treat vaginal swelling is similar to how you’d treat any other swelling. I want you to stay super hydrated to help flush out excess water and apply perineal ice packs to your vagina to help reduce inflammation. Padsicles work great too!

You can also ask your provider about wearing compression garments/support wear that are designed to increase blood circulation down there.

Why do I have tightness across my stomach during pregnancy?

I get this question all the time – and I think it’s because mamas just don’t know what the phenomenon is! A sudden tightening across your stomach during pregnancy is most likely a Braxton Hicks contraction.

A lot of women experience them and don’t even realize that’s what they are. You can learn more in our article, What Do Braxton Hick Contractions Feel Like?

And if you’re referring to a more constant sense of tightness, it could definitely just be your growing belly kind of stretching your skin beyond its elasticity. Often this creates a sense of tightness and sometimes itchiness on the stomach too! My best advice for dealing with this is lathering on a nice thick belly butter or belly oil to try to get some relief.

Related: Best Stretch Mark Cream for Pregnancy

Toothaches during the third trimester and other teeth troubles in pregnancy

A lot of pregnant women don’t realize that pregnancy increases your risk for dental issues! Issues with your gums, including gingivitis, are far more common, and you have an increased risk for cavities too.

This happens for a number of reasons, the main two being your changing hormones and a change in habits/dietary preferences. This can include changes in diet due to cravings, an increase in vomiting leading to plaque build-up, an increase in swelling in the gums (swelling can happen everywhere!), which exacerbates gum disease, and more.

It’s recommended to keep your regular dental check-ups during pregnancy (every 6 months), and if for some reason a regularly scheduled visit doesn’t fall during your pregnancy, it might be a good idea to plan an extra cleaning!

And of course, if you’re experiencing tooth pain or abnormal gum bleeding you should definitely give your dentist a call!

Read more from the CDC about pregnancy and oral health.

Third trimester questions, answered!

Well, mama, I’m guessing you learned something new about what to expect during the third trimester, and hopefully gained some coping tips too! I wanted to point you towards some other awesome resources and content to help make your third trimester (and preparation for birth!) a little bit smoother.

free birth plan

Liesel Teen, BSN-RN
Founder, Mommy Labor Nurse

Meet Liesel Teen

Hi there. I’m Liesel!

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

When you know what to expect and have the tools to navigate the experience, you’ll feel confident and in control.

I believe you deserve a better birth — no matter how you deliver.