Third Trimester Prenatal Visits
Tests, ultrasound, physical exams, complete check-up on a last stage of a pregnancy.
In your 3rd trimester (28 weeks through completion of your pregnancy), you’ll more than likely have a checkup every two weeks from 28 to 36 weeks, then change to once-a-week visits up until you deliver.
Third Trimester Check-up
As you and your healthcare practitioner get to know each other much better and as your due date draws near, you can expect a mix of routine physical examinations, late-pregnancy tests, and conversations about the coming birth. Here are some of the things your caregiver will do at these consultations.
Ask how you’re feeling
As previously, your caretaker will probably begin your check out by asking how you’re doing, acting on any concerns raised at your last appointment, and evaluating the outcomes of any tests you’ve had ever since. She’ll ask whether you’ve had any contractions, swelling, headaches, or have other concerns.
Whether or not she asks, let your specialist learn about any symptoms you’re having, even if they appear like the normal tiredness, moodiness, or aches and pains. Don’t be put off by a too-busy-to-talk feeling: Your practitioner may see lots of patients a day, but your pregnancy is still the most crucial thing on the planet to you.
Your professional will ask how much you’re feeling your baby move and remind you to call at any time if your baby appears less active than usual. She’ll advise you to take notice of your baby’s motions and may ask you to begin counting your baby’s motions for a set time period every day.
Do a physical exam
As in the second trimester, you’ll be weighed and your blood pressure will be taken. You may be asked to provide a urine sample to check for signs of preeclampsia, urinary tract infections, and other problems. Your ankles, hands, and face will be looked for swelling, which can be a sign of preeclampsia.
Your professional will examine your baby’s heartbeat and feel your belly to estimate your baby’s size. She’ll also measure the distance in between your pubic bone and the top of your uterus (this is called your fundal height) and compare it to your baby’s gestational age– as well as to the measurement from your previous go to– to make sure your baby’s development rate appears normal. If he seems either too big or too little, you’ll likely have an ultrasound to examine his growth and to inspect your amniotic fluid levels.
Your professional will probably be able to inform whether your baby remains in the head-down position or breech (bottom down). At 36 weeks or two, if she believes the baby is breech (or can’t inform for sure), she’ll purchase an ultrasound to validate her findings. If he is, you may be offered a procedure called an external cephalic variation to aim to turn the baby.
You probably won’t have routine pelvic tests at your prenatal visits, even in the third trimester. Lots of specialists don’t do them unless they have a particular issue, such as preterm labor or to double check your baby’s position (if you’re nearing your due date and his position isn’t clear from the abdominal test).
However if you’re previous your due date, your professional will probably examine your cervix to see if it’s softening, effacing (thinning out), and dilating (opening). This may assist her decide if when to induce labor.
She may likewise attempt to identify whether your baby has actually “dropped”– that is, moved down into your pelvic cavity in preparation for birth. If his head is quite low, it can be hard for your practitioner to feel it abdominally. She will probably have the ability to easily tell with a vaginal test, though.
If your caretaker does not regularly do vaginal examinations but you’re near your due date and excited to know what’s happening, you can certainly request for one. (If you do have a pelvic exam late in pregnancy, you might have a little spotting afterward.)
Offer you a shot of Rh immune globulin, if you need one.
If you’re Rh-negative and the baby’s daddy isn’t (or you don’t know for sure), you’ll have a blood test to check for antibodies to your baby’s potentially Rh-positive blood. (This test, called an antibody screen, is often done near the end of the 2nd trimester, when you have blood drawn for the glucose screening test.)
An injection of Rh immune globulin at 28 weeks will prevent your body from producing these antibodies for the last part of your pregnancy.
There’s no need for the Rh immune globulin shot in the not likely event that the blood test shows that you’re already producing antibodies. If antibodies exist, your baby will be kept an eye on for associated problems for the rest of your pregnancy.
If you didn’t have the antibody screen previously, your practitioner may do the blood test and give the injection at the same 28-week check out. (While the shot won’t do any great if you’re currently producing antibodies, there’s also no damage in getting it.)
Between 35 and 37 weeks, your professional will swab your vagina and anus to look for a typical infection called group B strep. If your test is positive, you’ll be given antibiotics during labor to help keep you from passing it on to your baby.
If you’ve had a group B strep urinary tract infection during this pregnancy, you will not need this test due to the fact that despite the fact that the infection was dealt with, you’ll automatically get antibiotics during labor. Similarly, you’ll be immediately dealt with during labor if you’ve previously had a baby infected with group B strep.
Discuss any other tests or care you may need.
Here are some other tests and care you might receive in the 3rd trimester:
- If your blood sugar level rose when you took your glucose obstacle test and you have not yet had a glucose tolerance test to figure out whether you have gestational diabetes, the test will be done early in this trimester.Your blood might be examined once again for anemia, particularly if you were anemic previously in your pregnancy.
- If you’re at risk for sexually transmitted infections, you’ll be evaluated once again for syphilis, chlamydia, gonorrhea, and HIV.
- If you were discovered to have placenta previa or a low-lying placenta during an earlier ultrasound, you’ll have another ultrasound early in this trimester to examine the place of your placenta.
- If your pregnancy is high risk or your professional becomes concerned about particular issues, she’ll purchase tests (such as a biophysical profile or a nonstress test) to make sure your baby’s prospering. When and how typically you choose these tests will depend upon the factor for the testing. If your caretaker is concerned about your baby’s growth, she’ll purchase periodic ultrasounds to determine him and check your amniotic fluid level.
- If your pregnancy is normal but you go past your due date, you’ll need screening to make sure your baby is still succeeding. In between 40 and 41 weeks, you might get a full biophysical profile or a modified one, that includes a nonstress test to examine your baby’s heart rate and an ultrasound to examine your amniotic fluid level. These tests are typically performed twice a week and will help your professional choose whether it’s safe to continue awaiting your labor to begin by itself. Even if whatever looks normal, your specialist will induce labor if you do not have your baby by 41 or 42 weeks. After that point, the health threats for both you and your baby rise considerably. (If your cervix is ripe, you may be induced even faster.)
- You must get the Tdap vaccine to help protect you and your baby from pertussis (whooping cough). Even if you’ve been immunized before, the United States Centers for Disease Control and Prevention suggest all pregnant women get a booster in between 27 and 36 weeks.
- If influenza season is here or approaching, your practitioner ought to talk with you about the advantages of getting an influenza shot if you have not currently had one.
Offer pregnancy counseling
If your specialist hasn’t already done so, she’ll talk to you early this trimester about the signs of preterm labor and preeclampsia and review other indication (such as vaginal bleeding or reduced fetal motion) that must trigger a call to her. She’ll review the normal changes to anticipate between now and your next visit, and let you understand if she has any particular concerns.
As you near your due date, she’ll talk about the signs of labor and let you understand when you should connect with her.
Answer labor and delivery questions
This is the time to resolve any sticking around issues you have about the method your labor and delivery will be managed.
Typical questions consist of:
- “Will you be there throughout my labor?”
- “Are the nurses a continuous existence or does every one take care of lots of patients at the same time?”
- “What takes place if my water breaks or I enter into labor in the middle of the night?”
A few of these problems will be attended to in your childbirth preparation class, however don’t be shy about asking your professional to discuss your issues. Producing a birth plan can assist you clarify your choices.
Go over postpartum considerations
Considering that you might not remain in any shape to make essential decisions right after delivery, now’s the time to begin speaking about whether you want your baby boy circumcised, whether you plan to breastfeed, and what you’d like to do for birth control after you have your baby. (Of course, you can constantly change your mind between once in a while.)
And if you have not discovered a doctor for your baby, it’s time to get started. Your practitioner can offer you some names.
Finally, your professional might screen you for signs of depression during pregnancy. However do not wait to be asked. If you’re feeling depressed or distressed, let your caretaker know. She can refer you to somebody who can help.
She might also ask you about your support network at home after you’ve given birth and discuss the signs of postpartum depression (PPD). It’s handy to understand how to identify normal “baby blues” caused by tiredness and hormones from true postpartum depression. If you believe you may be struggling with anxiety or anxiety, it’s important to get assist instantly.
Last modified: February 8, 2017