Katelyn Twist, MD

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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.

  • In the third trimester, babies typically move about 10 times within 2 hours
  • Babies can sleep for up to 90 minutes at a time
  • If movement feels decreased, try drinking something cold or sweet and lying on your left side

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

Cervical Exams & Group B Strep

  • Group B strep testing is typically performed around 36 weeks
  • Cervical exams may begin around this time as well
  • 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.

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 Counting

CDC – Pregnancy Weight Gain

CDC – Healthy pregnancy guidance

ACOG – Pregnancy & Medication Safety

CDC – Medication Use During Pregnancy

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