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Prenatal care: Third-trimester visits
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/prenatal-care/PR00094
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Pregnancy and prenatal care go hand in hand, even as your due date approaches. During the third trimester, prenatal care includes vaginal exams to check the baby's position.
By Mayo Clinic staffPrenatal care is an important part of a healthy pregnancy, especially as your due date approaches. During the last month of pregnancy, expect weekly checkups.
Repeat the usual drill
Your health care provider will continue to monitor your blood pressure and weight, as well as your baby's heartbeat and movements. Your health care provider may ask you to keep track of how often you feel the baby move — and to alert your health care team if the baby stops moving as much as usual.
Test for group B strep
Most pregnant women are screened for group B streptococcus (GBS) during the third trimester. GBS is a common bacterium that's usually harmless in adults — but babies who become infected with GBS can become seriously ill. If swabs from your vagina and rectal area test positive for GBS, you'll be given intravenous antibiotics during labor to protect your baby from the bacterium.
Resume pelvic exams
As your due date approaches, your prenatal visits may include pelvic exams. These exams help your health care provider:
- Check the baby's position. Near the end of pregnancy, your health care provider can feel your baby's head in your lower abdomen or at the top of the birth canal. If your baby is positioned headfirst, you're good to go. If your baby is positioned rump-first or feet-first (breech), your health care provider may recommend trying to turn the baby by applying pressure to your abdomen. This procedure is called an external version. If your baby remains in a breech position, you may need a C-section delivery.
- Detect cervical changes. As your body prepares for birth, your cervix will begin to soften, open (dilate) and thin (efface). Progress is typically expressed in centimeters (cm) and percentages. For example, your cervix may be 3 centimeters dilated and 30 percent effaced. When you're ready to push your baby out, your cervix will be 10 centimeters dilated and 100 percent effaced. Sometimes effacement is also measured in centimeters, to reflect the thickness of the cervical tissue. Resist the temptation to put much stock in these numbers, though. You may be dilated to 3 centimeters for weeks — or you may go into labor without any dilation or effacement at all.
Keep asking questions
You may have plenty of questions as your due date approaches. Is it OK to have sex? How will I know when I'm in labor? What's the best way to manage the pain? Ask away! Also discuss a birthing plan with your health care provider. Feeling prepared can help calm your nerves before delivery.
- Lockwood C, et al. The initial prenatal assessment and routine prenatal care. http://www.uptodate.com/home/index.html. Accessed Feb. 17, 2010.
- You and your baby: Prenatal care, labor and delivery, and postpartum care. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/ab005.cfm. Accessed Feb. 19, 2010.
- Cunningham FG, et al. Prenatal care. In: Cunningham FG, et al. Williams Obstetrics. 22nd ed. New York, N.Y.: McGraw-Hill Companies Inc.; 2005. http://www.accessmedicine.com/content.aspx?aID=6052187. Accessed Feb. 19, 2010.
- Puopolo KM, et al. Group B streptococcal infection in pregnant women. http://www.uptodate.com/home/index.html. Accessed Feb. 19, 2010.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 3, 2010.
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