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Since Your Baby Doesn’t Come with an Owner’s Manual Chapter 3:  The Third Trimester

7/18/2017

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As we enter the latter part of pregnancy, a number of important milestones occur during the third trimester.  The one that patients are often most excited about is their due date (at 40 weeks)!  That being said, anytime after 37 weeks is considered a “full term” pregnancy, so once labor starts beyond that time, it’s “go time”!  Some babies are a little slower to make their grand entry (particularly for first-time moms), though, so don’t be discouraged if it takes a little longer for you.  If it seems to really be taking awhile for you (hello third trimester during the hottest part of summer!), then inductions can be considered at 39 weeks or beyond in most cases.

There are also a number of visit highlights in the third trimester.  At the beginning of the third trimester (28 weeks), we give any mom with an Rh negative blood type a medication called rhogam.  This medication can help prevent formation of maternal antibodies that can attack the growing baby’s blood and cause anemia.  It’s especially important for moms who are planning future pregnancies because if that interaction occurs, it’s often even more significant in later pregnancies (for those who are interested, you can check out our archives for more information on rhogam http://www.tetonobgyn.com/blog/archives/08-2016).  We also offer every mom vaccination for pertussis (whooping cough) between 27-36 weeks.  Maternal vaccination during this time can help provide your baby with protection until he/she starts their vaccination series.  This vaccine has become particularly important as there have been as many as 50,000 cases per year over the last few years, and this number is on the rise, particularly in the 0-3 month age range.

Next, we increase the frequency of your visits.  Instead of every 4 weeks, we now see you every 2 weeks until around 35-36 weeks, and then we see you on a weekly basis until you deliver.  As we begin the weekly visits, we begin checking for cervical dilation, and we also do a test for group B streptococcus (GBS).  Between 15-25% of women are carriers for GBS, and while it’s not harmful to mother’s, babies exposed to the bacteria can develop sepsis, pneumonia, meningitis, heart, GI or kidney problems that can require admission to the neonatal ICU.  Fortunately, mothers who receive antibiotics during labor dramatically decrease the risk for newborn infection with GBS.

Congratulations!  You’ve now entered the home stretch, and your baby is only about 3 months away!  While the third trimester may seem like the longest to many moms-to-be, there’s a lot to do to help you get ready for your new baby.  We generally suggest pre-registering at the hospital where you’re planning to delivery and also taking a tour of the facility.  During that tour, it’s often beneficial to bring your significant other, too, because the last thing you want is to take the “scenic route” to labor and delivery while you’re having contractions.  You may also find it useful to pack a bag of things you’ll need in the hospital (if you’re wondering what to bring, Dr. Pam did a blog with a list in the archives http://www.tetonobgyn.com/blog/archives/08-2016).  Good luck, and remember you’re almost there!  It sounds cheesy, but you’ll be bringing your bundle of joy home with you before you know it!

Dr. Nick
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