Third Trimester
The final stretch - Baby is growing rapidly, discomforts peak, and preparations intensify. The third trimester is physically demanding and emotionally complex. Here's what to expect.
What's Happening: Weeks 28–40
The third trimester is primarily a period of growth and maturation. Baby gains approximately 200g per week from Week 28 to Week 40. Brain development, lung maturation, and fat accumulation are the key processes. If you haven't already, use the due date calculator to confirm your estimated delivery date.
Weeks 28–30: Brain and Fat Deposits
Baby
Brain grows rapidly - Its surface becomes more complex (gyri and sulci form). Eyes open and can detect light. Lungs continue maturing. Starts to run out of room to flip - Presentation becoming fixed.
Your Body
Braxton Hicks more frequent. Shortness of breath as uterus pushes against diaphragm. Rib pain common. Fatigue returns.
Weeks 31–32: Rapid Weight Gain
Baby
Baby gaining 200–250g per week. Skin smooths as fat fills in. Most babies settle into head-down position by 32 weeks (but not all yet). Bone marrow fully producing red blood cells.
Your Body
Stretch marks may intensify. Sleep becomes difficult - Can't lie flat, frequent urination. Antenatal classes typically start.
Week 34–35: Lung Maturity Accelerates
Baby
Surfactant production increases significantly. A baby born at 34 weeks has a high survival rate with NICU support. Brain development continues rapidly.
Your Body
Pelvic girdle pain often peaks. Varicose veins or haemorrhoids may appear. GBS test typically offered at 35–37 weeks.
Week 36: Full Term (Early)
Baby
All systems functional. Baby is considered 'early term' from 37 weeks. From 36 weeks, some babies engage (drop into pelvis) - Gives more breathing room but increases pelvic pressure.
Your Body
Lightening (baby drops) may cause sudden ease of breathing but increased pelvic pressure. Some notice increased vaginal discharge.
Weeks 37–38: Full Term
Baby
Officially 'full term'. Lungs, liver, and brain mature. Weight ~2.9–3.3kg on average. Baby gaining about 30g per day. Most of lanugo shed.
Your Body
Cervical changes begin. Cervix softens ('ripening'). Braxton Hicks more intense and frequent. Nesting instinct often peaks.
Week 39–40: Ready to Be Born
Baby
Baby's immune system has developed. Antibodies passed via placenta. Fingernails past fingertips. Head may engage in pelvis. Placenta begins to age.
Your Body
Due date is Week 40 (an estimate - Only 5% deliver on their due date). Labour could begin any time. Signs begin - Show, pre-labour contractions, water breaking.
Week 41–42: Post-Dates
Baby
The placenta continues functioning for most women, but placental efficiency declines after 41 weeks. Foetal monitoring intensifies.
Your Body
Induction discussed at 41 weeks in Singapore. Most maternity units will recommend induction by 41–42 weeks if labour has not started.
Third Trimester Symptoms
Shortness of breath
Uterus pushes up against the diaphragm. Eases after the baby drops (engages) at ~36 weeks.
Sleep propped up. Avoid lying flat. When baby drops, breathing improves noticeably - This is lightening.
Pelvic girdle pain (PGP)
Relaxin hormone loosens pelvic joints. The symphysis pubis or sacroiliac joints become painful. Common in Singapore's heat.
Physiotherapy is effective. A pelvic support belt. Avoid asymmetric positions. Ask your OB for a physio referral.
Frequent urination / leaking
Baby's head on bladder. Pelvic floor weakened by weight and hormones. Stress incontinence on coughing/sneezing.
Pelvic floor exercises started early help. Pads for leaking. Any gush of fluid → go to hospital (waters may have broken).
Swelling (oedema)
Fluid retention peaks in T3. Feet and ankles swell by end of day. Rings may not fit.
Elevate legs. Walk in the morning, not peak heat (1–3pm). If swelling involves your face or is sudden and severe → pre-eclampsia risk, seek medical review.
Sleep problems
Can't get comfortable. Baby kicking at night. Frequent bathroom trips. Restless legs.
Pregnancy pillow (long body pillow). Left lateral position. Keep room cool (Singapore heat disrupts sleep significantly).
Haemorrhoids
Increased blood volume, constipation, and baby's weight on pelvic veins. Very common in T3.
High fibre diet, hydration. Sitz baths. Ice packs. Witch hazel pads. Tell your OB - Prescription creams available.
Braxton Hicks contractions
Irregular uterine tightening, typically painless. Increase in frequency and intensity toward term.
Drink water (dehydration triggers BH). Walk around. If contractions become regular, painful, or are accompanied by leaking fluid or bleeding → call your hospital.
Carpal tunnel syndrome
Fluid retention compresses the median nerve in the wrist. Worse at night.
Wrist splints at night. Hand elevation. Usually resolves postpartum. Severe cases: referral to hand physiotherapist.
Pre-Eclampsia Warning Signs - Call Now
Pre-eclampsia is a serious condition affecting ~5% of pregnancies, more common in first pregnancies, multiple pregnancies, and women with hypertension. It can develop rapidly.
- ⚠Sudden severe headache that does not respond to paracetamol
- ⚠Visual disturbances - Flashing lights, blurring, or loss of vision
- ⚠Severe swelling of hands, face, or legs that appears suddenly
- ⚠Pain under the ribs on the right side (HELLP syndrome)
- ⚠Nausea and vomiting in T3 (after it had resolved)
Tests and Monitoring in the Third Trimester
Repeat FBC + iron studies
Check for anaemia - Particularly important given increased blood volume and if previously borderline.
If positive/abnormal: Iron supplementation if needed. Repeat at 36 weeks if anaemic.
Anti-D prophylaxis injection
Prevents Rh sensitisation if mother is Rh-negative. Standard practice in Singapore.
If positive/abnormal: Administered by nurse or midwife. Second dose given after delivery if baby is Rh-positive.
Growth scan (if indicated)
Checks foetal size, placental function, amniotic fluid volume. Not routine - Typically for high-risk, GDM, or previous IUGR.
If positive/abnormal: If growth is restricted or excessive, monitoring frequency increases.
Group B Streptococcus (GBS) swab
GBS is present in the vagina of ~15–25% of women - Usually harmless to the mother but can cause serious infection in the newborn during birth.
If positive/abnormal: GBS positive: IV antibiotics in labour to protect baby. GBS negative: no prophylaxis needed.
Antenatal visits every 2 weeks
Blood pressure, urine protein, fundal height, foetal presentation, CTG if indicated.
If positive/abnormal: Increasing frequency means closer monitoring - Not a sign of concern.
CTG (cardiotocography)
Foetal heart rate monitoring - Assesses foetal wellbeing when pregnancy goes beyond due date.
If positive/abnormal: If non-reactive CTG or oligohydramnios: induction discussion.
Hospital Bag - What to Pack
Pack your hospital bag by Week 36. In Singapore's climate, lightweight breathable fabrics for both mum and baby. Most hospitals provide basic toiletries and nappies for the first night.
🤱 For Labour
- Your ID card + partner's IC
- Maternity notes / green book
- Birth plan (if prepared)
- Phone charger + portable battery
- Comfortable slippers
- Snacks and drinks for partner
- Lip balm (mouth breathing in labour)
- Tens machine if using
👩 For Mum (Stay)
- 2–3 nursing bras
- Breast pads
- Button-front nightgowns (2–3)
- Disposable maternity underwear
- Maternity pads (extra thick)
- Toiletries
- Comfortable going-home outfit
- Slippers with back support
👶 For Baby
- 3–4 onesies or sleepsuits
- Hat (hospitals are cold)
- Swaddle or muslin wrap
- Approved infant car seat - Installed before admission
- Nappies (hospital usually provides first pack)
- Going-home outfit
Birth Plan
A birth plan is a document (typically 1 page) that communicates your preferences to the birth team. It does not guarantee anything - Labour is unpredictable - But it ensures your preferences are considered and reduces miscommunication under pressure. Read more about your birth options in Singapore, including epidurals, water birth, and home birth eligibility.
Include your preferences on:
Pain management
Epidural yes/no, when you want it offered, any non-pharmacological preferences first (gas, TENS, water)
Labour position
Walking, birthing ball, pool birth (if available at your hospital), preferred delivery position
Foetal monitoring
Continuous CTG (required for epidural) vs intermittent auscultation
Cord clamping
Immediate vs delayed (30–60 seconds). Cord blood banking - If so, private kit should be with you.
Skin-to-skin
Immediate skin-to-skin requested, for how long, before routine checks if baby is well
Feeding
Breastfeeding intention - Direct latch immediately, no formula without consent unless medically necessary
If caesarean is needed
Gentle/family-centred caesarean preferences - Screen lowered for birth, skin-to-skin on table
Visitors
Who is allowed in the room, photography preferences
Signs of Labour - When to Go In
The 'show'
Pink or blood-tinged mucus plug discharge. The cervical seal releasing.
Labour may start hours to days later. No need to rush to hospital unless contractions start or waters break.
Waters breaking (SROM)
Gush or slow trickle of clear/straw-coloured fluid. Often described as 'like wetting yourself but warm and can't stop it.'
Call your maternity unit immediately. Go to hospital within 1–2 hours. Do not put anything in the vagina. If fluid is green/brown (meconium) → go in immediately.
Regular contractions
Tightening that comes and goes in a pattern. Increases in frequency and intensity. Doesn't ease with walking or position change.
The 4-1-1 rule: contractions every 4 minutes, lasting 1 minute, for 1 hour → go in. Use our <a href="/tools/contraction-timer/" class="text-primary underline hover:no-underline font-medium">contraction timer</a> to track timing. For subsequent pregnancies, 5-1-1 or go earlier.
Back labour
Persistent severe lower back pain that comes in waves. Often accompanies a posterior baby (facing forward instead of backward).
Same rule as contractions. Can be more painful and harder to manage. Counter-pressure and all-fours position can help.
Postpartum Planning - Do This Before You Deliver
Arrange confinement support
Book by Week 28–30Traditional <a href="/faq/confinement-singapore/" class="text-primary underline hover:no-underline font-medium">confinement</a> (坐月子 / pantang) typically lasts 28–44 days. Decide: confinement nanny, confinement centre, or family support? Confinement nannies in Singapore book out 6–9 months in advance for popular periods.
Register at a paediatric clinic
By Week 36Your baby will need a first visit within 3–5 days of discharge, then at 1 month. Polyclinics offer subsidised child health checks. Many parents also see a private paediatrician - Register before delivery.
Plan feeding support
Identify before deliveryIf breastfeeding: identify a lactation consultant. LCs can do home visits in Singapore. KKH and NUH have in-hospital LC support post-delivery. BMSG (Breastfeeding Mothers' Support Group) peer support hotline: 6339 3558.
Discuss postnatal mental health
Before delivery<a href="/faq/postpartum-singapore/" class="text-primary underline hover:no-underline font-medium">Postnatal depression</a> and anxiety affect 10–15% of Singapore mothers. Tell your partner what to watch for. Know the support resources (IMH, SAMH, KKH perinatal psychiatry).
Maternity leave paperwork
As early as Week 30Submit <a href="/tools/parental-leave-calculator/" class="text-primary underline hover:no-underline font-medium">maternity leave</a> notice to employer. In Singapore: 16 weeks government-paid maternity leave for eligible employees (child must be a Singapore citizen). Check CPF paternity leave entitlement for partner.
Baby-proof the home
By Week 36Cot, bassinet, or co-sleeper set up. Car seat installed. Medications stored safely. Temperature of hot water tap reduced to < 50°C.
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