Pregnancy by Week: Third Trimester (Week 27 - End of Pregnancy)

Pregnant woman holding belly third trimester.jpg

Baby's Growth & Development

Baby gains one and one-half times its weight in the third trimester; weighs about 3 pounds and is about 17 inches long. Fine, soft hair on the baby's body starts to go away, mainly from the face. Skin is still covered by a white creamy coating to protect baby. At this time, the baby is often in the head-down position; you will feel most of the kicks under your ribs. Since there is little room left in the uterus, you may notice more arm and leg movements, but less rolling over movements.

  • Week 27 - He has eyelashes on his eyelids, his eyes can move in their sockets, and he can tell light and dark, but he cannot discern specific objects yet. His senses are becoming fine-tuned and more responsive to light, sound, taste, smell, and touch. His skin is becoming smoother as body fat accumulates beneath the skin. His brain is developing further, and he can direct breathing movements.
  • Week 28 - Your baby is approximately 14.5 inches long and weighs 2-2.5 pounds. Her bone marrow has taken over red blood cell production. Her eyes are opening and closing, and she is turning her head and practicing "looking" movements. She is very active, and movements can be felt inside and outside your abdomen throughout the day and night. The amount of movement varies but typically increases when you are sitting still or after a meal. The convolutions, wrinkles or "gyri" on the surface of the brain appear as it continues rapid growth and contains more brain cells.
  • Week 29 - His growth in height or length will be slower from this point on, but he will continue to gain weight. His skin still looks red and wrinkled, but as he adds more fat, his skin will become more flesh colored and smooth. Lanugo, the fine hair covering his body since the fifth month of pregnancy, is beginning to disappear. If the baby is a boy, sometime between now and birth, the testes will have completely descended.
  • Week 30 - Your baby is approximately 15-16 inches long and weighs 3-4 pounds. She is able to use all five of her senses, hearing sounds and seeing bright lights in your environment, and tasting, touching and even smelling the amniotic fluid surrounding her. Her toenails have grown and are completely formed.
  • Week 31 - His skin color changes from dark red to pinkish as the fat underneath his skin increases. His fingernails have reached the end of his fingertips. He may have scratches or marks on his face at birth from his fingernails. The hair on his head and his eyelashes and his eyebrows grows longer.
  • Week 32 - Your baby is approximately 16-18 inches long and weighs 4-5 pounds. She is beginning to develop her own immunity to mild infections. If she were born now, she could survive outside the womb and resist some disease. Her appearance is similar to that at birth, but she will fill out more in the next few weeks. She may be positioning for birth with her head turned down toward the pelvis.
  • Week 33 - He is beginning to run out of space to move in the uterus and is tucked into the fetal position. His movements in the womb may be less frequent as a result of cramped space, but he is growing and delivering stronger punches and kicks. He will have periods of deep sleep and periods of being actively awake, much like a newborn baby.
  • Week 34 - Your baby is approximately 16-18 inches long and weighs 4-5 pounds. Her arms and legs are continuing to fill out from fat accumulation. She's dimpling at her elbows and knees and forming creases around her wrists and neck. The percentage of fat on her body is 8 percent, compared with only 1 percent of her body weight at 20 weeks. At birth, her body fat will be about 15 percent, helping her to keep warm.
  • Week 35 - As your abdomen stretches thinner, light is visible inside the womb, helping your baby to develop sleep cycles, reactions and responses to her surrounding environment. As he grows and the space gets tighter inside the uterus, his foot, elbow, or other little body part may protrude from your belly.
  • Week 36 - Your baby is approximately 18 inches long and weighs 5-6 pounds. Your baby will be descending even lower into your pelvis; this is called "lightening" or "engagement." As your baby rests her head in the pelvic cavity, your lungs and stomach are less pressured, possibly making breathing easier. Usually, by this point in the pregnancy, a boy's testes have completely descended.
  • Week 37 - Any day now! By the end of this week, your baby is "full-term" and can be born two weeks before or after the expected due date. Meconium, a dark greenish substance, gathers in her digestive tract and will be passed shortly after birth as her first bowel movement. If the meconium begins leaking from your vagina, it could indicate fetal distress. Your baby's skull is not solid and has a "soft spot" on the top and open fissures between the different parts of the skull that allow her head to mold and fit through your pelvis at birth. As a result, her head may be a pointed shape at birth, but will become more rounded a few days afterwards.
  • Week 38 - An average baby at birth is approximately 20-22 inches long and 7.5 pounds. As her lungs are among the last organs to mature, after birth it may take her a few hours to establish normal breathing patterns. Her true eye color will not reveal itself until she is 6-12 months old. At birth, dark-skinned babies may have dark gray or brown eyes, which will become darker, and Caucasian babies usually have dark blue eyes or slate gray eyes, which will change to brown, hazel, green or blue.
  • Weeks 39 - 40 - At birth, the placenta weighs about 1.5 pounds, and the umbilical cord is at least 2 feet long, often longer. A healthy weight for a newborn can range anywhere from 5 pounds, 11.5 ounces to 8 pounds, 5.75 ounces. A pregnancy is considered post-term after 42 weeks and often requires medical intervention. It is common, however, that if a baby is "late" the expected due date was miscalculated.

Signs of early labor

  • Labor between 20 and 37 weeks of gestation
  • Your cervix softens and open earlier than normal and causes regular, often painful contractions
  • Premature labor can occur in any pregnancy and may occur without you knowing that your uterus is contracting or tightening

You should know the warning signs of preterm labor. Notify your health care provider as soon as you have these warning signs:

  • Menstrual-like cramps in the lower abdomen that comes and goes in a regular pattern or is constant.
  • Low, dull pain in your back that you feel below your waist that comes and goes in a regular pattern or is constant.
  • Pelvic pressure or intermittent pains that come and go in the lower abdomen which may feel like heaviness in your pelvis.
  • Cramping in your gut (intestinal) without diarrhea
  • Increase or change in vaginal discharge that becomes thicker (mucous-like), watery, or blood tinged.
  • Contractions - A contraction is a tightening of the uterus, which may be painless. Although you may feel contractions on occasion during pregnancy, frequent contractions (every 10 minutes lasting 1 minute) before 37 weeks' gestation may be the start of preterm labor and should never be ignored.

Difference between a True Contraction and Braxton-Hicks Contraction

A Braxton-Hicks Contraction

  • An overall tightness or slight cramping in your abdomen
  • May be felt very high up, or you may feel them across the middle
  • Often brought on by lots of motion or being active
  • May start out of nowhere, last a short time, and go away
  • No gradual increase or "peak" to them
  • Do not cause pain, just tightness
  • Tend to go away if you drink water or sit down for a while

A True Contraction

  • Feels very low, either in front or back, and sometimes wraps around
  • A strong tightness that grows in strength, peaks, and drops off again
  • Do not go away or change if you move around, sit down, or drink water

When to Call Your Provider

If you have contractions, pressure or cramping every 10 minutes or closer that continue for 2 hours, even though you have followed the previous directions. If you have other warning signs of preterm labor that do not go away after 1 hour of rest.

Fetal Movement

  • For a few weeks now, baby has been able to twist, turn, stretch, roll, and kick.
  • Baby may stay in the same position, and may be active at the same times each day.
  • You will start to notice patterns of activity and sleep, each baby will have its own pattern of movements.
  • Baby may have a certain time when they are very active, often this is your bedtime. You may feel a series of jerks or jolts, this may be the baby's hiccups.
  • You will feel more turns and twists with less kicks and jabs.
  • Movement should be felt each day and changes as baby gets into position to be born.
  • Baby will sleep 20 to 45 minutes at a time; this is when they are quiet.
  • Baby may suck their thumb.
  • Since an active baby is a sign of health, your provider will ask about this at each visit.

How to monitor fetal movements

  • Empty your bladder.
  • Lie down on your left side in a quiet place with few distractions (television, phone, kids).
  • Pay attention to your baby's kicks and movements. Count each move you feel for 1 hour.
  • If you feel tightness, place your hands on your abdomen to check for a contraction.
     - Is it firm all over?
     - Does it feel firm for 60 seconds or more?
     - If you have 4 or more contractions per hour, you could be starting preterm labor.
  • If your baby has not moved 10 times at the end of 1 hour, or has not moved at all, you need to call the office (515) 574-6870 and say that you have decreased fetal movement.

Baby Movement - Kick Counts

After pregnancy week 27 or 28, a weekly fetal "kick count" is an easy way to track and monitor your baby's individual pattern of movement. Fetuses make an average of four to six detectable motions per hour. A kick count of ten or more within 90 minutes suggests your baby's activity level is normal and healthy. A decrease in a baby's normal pattern of fetal movements may indicate the fetus is under stress and should be checked by a doctor.

How to keep a "kick count:"

  • Choose a time of day or evening when your baby seems to be most active. Perform every kick count at about the same time on subsequent days.
  • Lie down on your left side, and pay close attention to the movements of your baby.
  • The first time you feel your baby move, check your watch and write the time down. Then count every movement or kick until your baby has moved ten times. When you feel the tenth movement, write down the time again. After repeating the process for several days, you may find the baby usually moves about the same number of times per hour; this becomes your baseline number.
  • If no movements are felt within 1 to 2 hours, or if the movements total less than half the number of your baseline, contact your health care provider immediately. They may wish to listen to your baby's heart or perform an ultrasound that can detect small movements not felt by the mother. A non-stress test, an additional way to check on your baby's well-being by use of an electronic fetal monitor, may also be performed.

While monitoring fetal movement can be a helpful guide to fetal health, it is not the only way. As long as your baby has good fetal heart tones with each visit to your doctor, and your doctor is satisfied with the progressive increase in the size of your uterus, or fundal height, you can rest easy that all's well.


  • Pregnancy causes fluid to build up in your body.
  • Your feet, ankles, hands and finger may swell.
  • This is most common at the end of the day.
  • Much of the swelling should go away after a good night's sleep.

To help with swelling

  • Don't stand in place for long amounts of time.
  • Avoid foods that are high in salt (foods like potato chips).
  • Walk and flex muscles in your lower legs.
  • Prop up your feet when you can.
  • Try to sleep with your feet slightly higher than your heart. Place pillows under your legs.
  • Wear support socks and good, supportive shoes. Make sure stockings and shoes are not too tight.
  • If your fingers are puffy, remove your rings before they get too tight.
  • Lying on your left side will help move extra fluid.
  • Let your provider know if:
     - you have a sudden increase in swelling
     - your face becomes very puffy
     - swelling does not get better after a night's rest

Stress and Nervous Feelings

  • It is common to have feel stress and nervous when you are pregnant. This is true for most women, no matter how much they have planned and wanted to be pregnant.
  • Your body is making many changes you must adjust to.
  • People in your life also feel stress
     - Your partner may be worried about you, the baby and about being a parent.
     - Your parents may feel concern as well.
     - Your older children may be nervous about what a new baby will do to their bond with you.

Talking with your health care provider about your worries and fears can be helpful. 

A Doctor for your baby

There are very good Pediatricians and Family Practice Doctors within UnityPoint Clinic to care for your baby. Family Practice doctors have training in caring for all ages. Pediatricians train in the care of children and adolescents. Some things to think about in making your choice:

  1. Which doctors are covered by my insurance plan?
  2. Word of mouth from people you work with, to church friends and neighbors. Also, your OB doctor may be able to suggest someone.
  3. How far will you need to travel? 

Well Baby Care

Each doctor has his or her own time frame for check-ups but most visits looks like this:

  1. First visit within 1 week of birth
  2. Follow up visit 2 weeks after birth
  3. Visits at 2, 4, and 6 months
  4. Visits at 9,12,15,18, & 24 months.

During these visits, the doctor or nurse will:

  1. Give immunizations
  2. Check your baby's physical, motor & cognitive developments
  3. Measure height, weight, and head circumference
  4. Order tests if needed
  5. Check eye sight and hearing
  6. Talk about any problems and answer your questions

Taking care of a new baby can be hard. Sleep when your baby sleeps. Ask for help from family and friends. Relax and enjoy this special time. Try to keep things calm. Of course, if you have more than one child, all of the above may be "out the window." 

Diet and Digestion

The enlarged, growing womb presses on the intestines and slows the digestion and movement of food; the hormones of pregnancy cause the digestive tract to relax and to function more slowly. Hard stools are likely to happen and may get worse. Ways to help:

  • Exercise daily.
  • Try not to eat gas-forming food such as cabbage, beans, and fatty fried foods. Chew your food slowly and drink more fluids.
  • Try a non-caffeine hot drink first thing in the morning to ease hard stools (herbal tea, or lemon water).
  • Add whole grains such as bran, fresh and dried fruits, and raw vegetables in your diet If the above do not work, you can buy an over-the-counter stool softener such as Colace (also called DOSS or DSS), Metamucil, or Citrucel that may be safely taken during pregnancy.


Leg cramps, hard breathing, painless contractions, a pressing need to go the bathroom, and a kicking baby may make it hard to sleep. Try using extra pillows to support your back and legs.

Feel Faint? Sit Down.

If you become overly hot and tired you may feel faint. Sit down or lay down on your left side. The feeling should not last long and it is often not a big problem.

Leaking Urine

Stress incontinence, which is leaking urine when you laugh, sneeze or cough, is caused by the increased pressure on the bladder. Kegel's pelvic floor exercises may help this problem. Firmly tighten the muscles of the pelvic floor as you would to stop urinating midstream. Hold for a slow count of 3, then slowly release the muscles, relax, and repeat. Breathe slowly; do not hold your breath. Repeat 25 times, 2 to 3 times a day. Kegel exercises can be done anytime, standing or sitting.

Drinking less will not keep you from leaking urine or help you sleep through the night. It is important to drink enough fluids (6-8 glasses a day) when you are pregnant. If you need a pad to keep your panties dry due to the leakage, you may have a leak in your bag of waters, which should be checked by your doctor.

Short of Breath

Though you breathe more air in and out of your lungs during pregnancy, you may sometimes feel as if you cannot get your breath. This feeling comes from the womb pressing up on the diaphragm and crowding the lungs. Relief comes when the baby settles low in the pelvis. Until then, sit up straight and sleep with your shoulders propped up. Avoid working yourself too hard.

Baby's Activity and Position

At this point in your pregnancy your baby's kicks and twists are strong and sometimes painful and you may find that your baby settles in a position that is painful for you. At times you may get relief by changing your position: also the baby may change position too and give relief. In the last month of pregnancy, you may notice fewer kicks and more squirmy movements as your baby runs out of room. You may even notice jerking motions (like hiccups) that can last a few minutes. There is nothing you need to do. It will stop shortly and will not hurt either of you.

Pelvic Pressure and Pain

Groin pain can be due to stretching of the round ligaments that help support the womb. Pelvic pressure can be from the baby's head being low in the pelvis.


Heartburn, along with a sour taste in your mouth, is common in pregnancy.

  • Do not overfill the stomach. Eat 6 small meals
  • Try not to eat fatty, fried, or spicy foods
  • Drink less with meals
  • Try not to bend over or lying down after meals; try a walk
  • If heartburn is bad at night, do not eat just before bedtime and sleep propped up with pillows
  • Antacids like tums, Rolaids or Mylanta may help


Hemorrhoids are dilated, twisted blood vessels in and around the rectum. You may notice more in the last month of pregnancy. They can cause pain, itching, and bleeding during a bowel movement. To treat:

  • Lie on your side with your hips on a pillow.
  • Keep soothing Witch Hazel pads, ice packs, or Tucks in the fridge and use them when needed.
  • Keep your stools soft: drink more, and add fruits, vegetables, and fiber to your diet. If your stool is hard, use an over-the-counter stool softener (DSS,DOSS,Colace or Metamucil),and take as told on the label.

Hemorrhoids often get better without treatment shortly after birth.


As your pregnancy progresses your posture changes to make room for your expanding womb, making lower backache common. To make the problem better:

  • Squat rather than bend to lift objects
  • Wear good low-heeled shoes
  • Always roll to your side before sitting up from a lying position
  • Try putting heat or cold on your back
  • Have your partner or support person rub your back
  • A maternity belt may add support and shift your weight
  • A hard bed board under the mattress may offer support
  • Do the pelvic rock which helps strengthen your lower back muscles