Katelyn Twist, MD, FACOG

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Third Trimester

Welcome to the final stretch of pregnancy — you’re almost there.

The third trimester brings more frequent visits, preparation for delivery, and lots of questions. Our goal is to help you feel informed, supported, and confident as you get closer to meeting your baby.

What to Expect in the Third Trimester

The third trimester begins at 28 weeks of pregnancy.

During this time, you can expect:

  • More frequent prenatal visits
  • Monitoring of fetal growth and well‑being
  • Discussion of labor, delivery, and birth preferences
  • Preparation for your hospital stay and postpartum care

Most patients are seen:

  • Every 2 weeks: 28–36 weeks
  • Weekly visits: 36 weeks until delivery

Fetal Movement

As your baby grows, movements may feel different but should remain regular.

  • Fetal movement – Kick counts can start at 28 weeks, but only if you are worried about movement. If baby is moving normally, you do not need to count.
  • Kick counts – If movement feels less than usual:
    • Lie down and relax
    • Eat or drink something
    • Count movements
      You should feel 10 movements within 2 hours. Any movement counts.
  • Baby sleep cycles – Babies can sleep for about 30 minutes. By the end of that time, you should feel some movement.
  • When to call – If you are unsure or concerned, do not wait. Call your provider or go to Labor and Delivery at Wesley Medical Center for evaluation.

If you are concerned about your baby’s movement, please call the office or go to Labor & Delivery at Wesley Medical Center.

Cervical Exams & Group B Strep

  • Group B Strep (GBS) – This is a common bacteria that some people carry on their skin or in the body. It usually does not cause problems for the mother but can affect the baby during birth.
  • Testing – A swab test is done around 36 weeks to check for GBS.
  • If positive – You will receive antibiotics during labor to help protect the baby from infection.
  • Cervical exams are optional unless medically indicated
  • If you prefer not to have an exam, that is completely acceptable

We’ll talk through the purpose of each exam and make decisions together.

Membrane Sweeping

Membrane sweeping is an optional procedure that may help prepare your cervix for labor.

  • Can be offered beginning at 37 weeks
  • It is your choice whether or not to proceed
  • The procedure can be uncomfortable and may cause cramping or spotting
  • It is safe for both parent and baby

When Will Labor Start?

Unfortunately, it’s not possible to predict exactly when labor will begin.

Things that may help encourage labor (though evidence varies) include:

  • Walking or curb walking
  • Dates, pineapple, or red raspberry leaf tea
  • Nipple stimulation or sex

We do not recommend routine castor oil use.

When Is Induction Recommended?

Every pregnancy is unique.

  • In uncomplicated pregnancies, we often wait until 41–42 weeks
  • If medical conditions such as hypertension or gestational diabetes are present, earlier induction may be discussed

Your specific situation and preferences will always guide the plan.

When to Go to Labor & Delivery

Please present to Labor & Delivery if you experience:

  • Vaginal bleeding like a period
  • Leaking fluid suggesting your water may have broken
  • Contractions every 3–5 minutes lasting 1 minute for 1–2 hours
  • Decreased fetal movement

If you’re unsure, it’s always okay to call.

Preparing for the Hospital

As you approach delivery, we’ll help you with:

  • Hospital pre‑registration
  • Pre‑admission planning appointments at Wesley
  • Childbirth education classes
  • BirthCare Center tours

Wesley provides most essentials for delivery and postpartum — a simple hospital bag is usually sufficient.

Breast Pumps

  • Breast pumps – Many insurance plans will cover a breast pump with each pregnancy. You can order through:
  • Colostrum collection – This is optional. Do not start pumping until you are full term (37 weeks). If you have natural leakage before then, you may collect it if you choose. You can discuss this further at your appointment.

Birth Preferences & Communication

You’ll have the opportunity to discuss birth goals and preferences, including:

  • Labor support and pain management
  • Monitoring preferences
  • Vaginal delivery or cesarean delivery considerations

All interventions are discussed and require your consent. Clear communication and shared decision‑making are central to our care.

Trusted Medical Resources – Third Trimester

Cleveland Clinic – Baby movement and kick counts

Stanford Medicine Children’s Health – Fetal Movement Countin

ACOG – Pregnancy & Medication Safety

If something doesn’t feel right — even if you’re unsure why — reach out. We’re here to support you through this final stretch.