After around 28 weeks of the pregnancy, your pregnancy visits will be scheduled a little more frequently. However, the timing of each visit can vary, depending on when your last visit was (26, 27, 28 or 29 weeks), your individual needs and your caregiver’s preferences. In the past, pregnancy visits during the 3rd trimester were routinely scheduled as follows:
- Every 2 weeks from about 28 weeks until about 36 weeks.
- Every week from about 36 weeks until the birth.
However, recent research has shown that antenatal visits can be performed less often (3 weekly, earlier on and 2 weekly later on), being acceptable for women whose pregnancies are progressing normally. This has led to an increasing trend for caregivers and hospitals to space out routine pregnancy visits. Some examples of the timing of visits can be:
- 27, 30, 33, 36, 38, 39, 40 and 41 weeks.
- 28, 31, 34, 36, 38, 39 40 and 41 weeks.
- 29, 32, 35, 37, 38, 39, 40 and 41 weeks.
Even so, many caregivers still see women at the standard 2 weekly intervals until 36 weeks and then weekly after that and some women will request to be seen this often because they prefer to have more contact with their caregiver. However, other women prefer less frequent contact, especially if this is not their first baby.
There are some circumstances that make it more likely for a woman to be seen at more standard intervals, or perhaps even more often than expected during the later phase of their pregnancy. These include:
- Women with medical conditions who require closer monitoring. Conditions such as diabetes, epilepsy, thyroid conditions, metabolic disorders, mood disorders, blood disorders, heart or kidney disease.
- Women having twins, triplets or more.
- Women experiencing pregnancy complications such as high blood pressure, cholestasis, bleeding during their pregnancy, threatened premature labour, or having a baby that is suspected of being unusually small.
- Women who have experienced a stillbirth with a previous baby.
- Women going past their due date.
Visits after 28 weeks are generally similar in length to previous visits. Depending on your choice of caregiver, an average visit will last from 10 to 30 minutes (or more), with the length of time varying, depending on how many questions you have, what you and your caregiver need to discuss and if there are any specific health concerns that require attention.
You may want to take your partner (if you have one) or a close relative or friend (perhaps someone who will support you at the birth) with you to your pregnancy visits. This can be a good way for them to become more involved in your pregnancy and to help you prepare with a united approach for the birth, especially during the final months. Many parents will also take an older sibling to their pregnancy visits. Sometimes this is out of necessity, but in doing so your child(ren) can be involved in a positive way and participate in the process, perhaps being able to listen to their little brother or sister’s heart beat during the visit!
The main aims of your pregnancy visits during the 3rd trimester are to monitor your blood pressure, check the growth of your baby and the position they are lying in the womb and to discuss your personal well-being on both a physical and emotional level. The visits also provide ongoing opportunities for you to discuss your plans for the birth and any current concerns you may have. If you think of specific things you wish to ask your caregiver between pregnancy visits, write them down take with you, so you remember everything you need to ask.
After the 28 week visit most women do not require any more testing, with only a few women needing another ultrasound after the routine scan at around 18 to 20 weeks.
Your pregnancy visits during the 3rd trimester will basically involve:
Talking over issues and obtaining information
A large part of a woman’s pregnancy visits are devoted to talking over specific issues and obtaining information. What is covered during your consultations will depend on your personal needs and what stage of the pregnancy you are at. You will most likely have many questions for your caregiver and your caregiver may bring up issues they feel are important for you to know. The following is guide as to what you may talk about with your caregiver during your pregnancy visits. However, all these may not be relevant at every visit.
- How your pregnancy is going in general. If you have been feeling well and if you have noticed any physical signs that concerned you or you need explaining.
- The normal physical signs of pregnancy you are experiencing, particularly ones you are finding annoying or unmanageable. You may discuss possible therapies, treatments and support strategies to assist you in dealing with them.
- Explaining any tests or ultrasounds you may require and going over the results of these after they are performed.
- Asking you about your sensations of your baby moving.
- If appropriate, going over how you may be dealing with certain lifestyle changes such as cutting back or quitting smoking, caffeine, alcohol or using recreational drugs.
- Perhaps talking over issues relating to financial, relationship and/or emotional difficulties.
- Discussing things you may have read or heard about that need to be explained or clarified.
You may think of other things you want to discuss and your partner or support person may also have questions of their own. Many women and caregivers also use the final weeks of the pregnancy to focus on planning for the birth, discussed next.
Planning for the birth
As the baby’s due date draws nearer, most women and their partners begin to focus more intensely on their plans for birth of their baby. Part of this preparation is using your pregnancy visits to discuss the relevant issues.
Aspects you may want to talk about will depend on your individual circumstances, how your pregnancy is progressing and if there are any health concerns or complications that have arisen so far (or are likely to eventuate). The following is a list of things you may want to discuss in relation to planning for your birth:
- Preparing or discussing a birth plan.
- Finding out what you need to pack or prepare for the labour and your stay in hospital.
- Talking about who will be with you during the birth and/or who will support you while labouring.
- Looking at issues around the pain of labour and how you would like to manage this.
- Asking about when you should contact your caregiver or the hospital’s delivery suite when labour starts or your waters break. Making sure you have right phone number to ring.
- Asking about induction of labour and the likelihood that this may be required and how it may be carried out.
- Talking about the possibility of a Caesarean birth and/or making a birth plan for an elective Caesarean.
- Planning your care for a vaginal birth after Caesarean (or VBAC), if applicable
- Asking your caregiver about the possibility of a waterbirth and if they are happy to facilitate this.
- Being given information about the use of a Syntocinon injection at the birth to help with bleeding and delivering the placenta for the woman (discussed here) and the use of vitamin K and the hepatitis B vaccine for the baby soon after birth.
- Finding out under what circumstances your baby could be taken to the intensive care nursery, bearing in mind that some hospitals do this to routinely observe babies ‘just in case’ they become unwell.
- Discussing how you wish to feed your baby.
Other issues may include the likelihood of your baby being born premature and/or what will happen if you go past your due date. Many women and their partners gain much of their information from attending childbirth education classes and reading books (or using this website). However, practices and policies vary between different caregivers and hospitals and it is important to gain an understanding of how your caregiver will approach your individual birth and what you can expect in various circumstances.
A physical examination
Once you and your caregiver have discussed everything you need to, you will then have a physical examination. This involves taking your blood pressure, feeling your pregnant belly and listening to your baby’s heart beat.
Feeling your belly. The main aims of feeling your belly after 28 weeks are to ensure that your baby is growing at the expected rate and to start determining the position your baby is lying in. During the last few weeks, your caregiver will also feel for the engagement of your baby’s head. You can read more in feeling your baby. Your caregiver may also continue to use a measuring tape to estimate your fundal height.
Listening to your baby. Your caregiver will listen to your baby’s heartbeat at each visit with a Doppler machine or a Pinard’s stethoscope.
NOTE: You should not need to undress to have your pregnant belly felt by your caregiver, but it may be helpful if you wear clothes that allow easy access to your belly, as this procedure is not usually done through clothing.
At the end of each pregnancy visit, your caregiver should let you know when they expect to see you next and if they expect you to require any further tests.