Third Trimester Symptoms and How to Manage Them

The third trimester (weeks 28-40) is the home stretch. Your baby is growing rapidly, your body is working harder than ever, and the finish line is in sight. Here's what to expect and what actually helps.

The common symptoms

Back pain. Your centre of gravity has shifted, your ligaments are loosened by the hormone Relaxin, and you're carrying significantly more weight than usual. Lower back pain affects around two-thirds of pregnant women in the third trimester. A pregnancy support belt, gentle swimming, and prenatal yoga can help. Avoid standing for long periods and sleep with a pillow between your knees.

Insomnia. The irony of pregnancy insomnia is cruel - you're more tired than ever but can't sleep. Over half of women in late pregnancy report poor sleep. A consistent bedtime routine, a cool room, pregnancy pillow, and avoiding screens before bed can help. If anxiety is the main cause, talk to your midwife or a councillor/therapist.

Braxton Hicks contractions. These practice contractions become more frequent and noticeable in the third trimester. Your uterus tightens for 30-60 seconds, then relaxes. They're irregular, don't increase in intensity, and stop when you change position. If they become regular, painful, and progressively stronger, that's the real thing - contact your maternity unit.

Heartburn and indigestion. Your growing uterus pushes your stomach upwards, and progesterone relaxes the valve between your oesophagus and stomach. Eat smaller meals, avoid lying down straight after eating, prop yourself up with pillows in bed, and keep antacids handy (Gaviscon is safe in pregnancy and Tums are recommended by many pregnant women).

Swollen feet and ankles. Fluid retention is very common, especially in warm weather or after standing. Elevate your feet when you can, stay hydrated, wear comfortable shoes, and keep moving gently. If swelling is sudden, severe, or accompanied by headache or visual changes, contact your midwife urgently as this can be a sign of pre-eclampsia.

Breathlessness. Your uterus is pressing upwards against your diaphragm, reducing lung capacity. This is normal and eases when baby drops lower in the pelvis (usually around week 36-37 for first pregnancies). Sit upright and take things slowly.

Pelvic pain (SPD/PGP). Symphysis pubis dysfunction or pelvic girdle pain affects around 1 in 5 pregnant women. A maternity support belt, physiotherapy (ask your midwife for a referral), and keeping knees together when turning in bed can help.

Frequent urination (again). As baby descends into the pelvis, pressure returns to your bladder. Stay hydrated during the day, cut back slightly in the evening, and do your pelvic floor exercises.

When to call your midwife

Most third trimester symptoms are uncomfortable but normal. However, contact your maternity unit if you experience: reduced baby movements or a change in your baby's normal pattern, sudden severe headache with visual disturbances or swelling, regular painful contractions before 37 weeks, a gush or trickle of fluid, vaginal bleeding, severe abdominal pain, itching all over your body especially hands and feet (could be obstetric cholestasis), or feeling very unwell with a temperature above 38 degrees C.

Trust your instincts, female intuition isn't a myth. If something feels wrong, it's always better to call and be reassured than to wait.

The emotional landscape

The third trimester brings a unique emotional cocktail. Excitement about meeting your baby sits alongside anxiety about labour, impatience with the wait, and the strange liminal feeling of being between one identity and another.

Nesting instincts kick in. You might suddenly need to deep-clean the house, organise every cupboard, and wash tiny clothes on repeat. Go with it if it feels good. It's your body's way of preparing.

If anxiety becomes overwhelming or you're experiencing persistent low mood, reach out to your midwife. Antenatal anxiety and depression are common, treatable, and nothing to be ashamed of.

The finish line

The third trimester is hard. There's no way around that. But every uncomfortable night, every trip to the bathroom, every Braxton Hicks contraction is your body doing exactly what it needs to do. You're nearly there.