Updated: March 1, 2025

Pregnancy enters its third phase at week 28 when delivery generally happens in the forty weeks. The expected due date passes all pregnant women in approximately half of all cases. The third pregnancy trimester carries immense anticipation due to your upcoming child's delivery. Insomnia, along with discomfort, presents itself as a common symptom when you enter the final weeks of pregnancy. It is vital to determine if these pregnancy symptoms are ordinary or need medical intervention because they impact your general health.

Fatigue

During the third trimester, women experience fatigue again because their bodies have to support a weight of 20 to 30 pounds, and the enlarged uterus strains internal organs. Cutting back on activity remains essential, but you must preserve enough energy throughout this time. Research from the Journal of Obstetric Gynecologic & Neonatal Nursing reveals that through physiological and hormonal factors, most pregnant women face exhaustion in their last trimester of pregnancy at rates between 60-70%.

Recommended approaches to managing fatigue,

• The key to managing fatigue is to practice gentle walking exercises and prenatal yoga when your body allows it.

• You should take short relaxing breaks during the day while your feet remain elevated.

• Small-sized, consistent meals with protein and complex carbohydrates represent recommended nutrition for pregnant women.

• Medical consultation is essential if your fatigue worsens because anemia may need supplementation.

Back Pain

When labor approaches the hormones in your body activate while your connective tissues become elastic for your baby to pass through the birth canal. The physical transformation enables your pelvis to get ready for your baby to move through the birth canal. Many women develop hip and lower back pain because their body tissues become loose during this time. The American College of Obstetricians and Gynecologists indicates that back pain affects between 70% of expectant women during their third trimester.

Pain management strategies include:

• The combination of side sleeping position with leg-supporting pillows helps minimize pelvic pressure.

• Additional base support cushions should be put underneath your back at rest times.

• Pregnant individuals should choose specialized prenatal massage treatment from expert practitioners who provide certification.

Frequent Urination

The uterus presses on your bladder throughout the third trimester of pregnancy, which leads to an increased need for toilet visits. A majority of expectant mothers, including more than half of first-time mothers, will face an unexpectedly strong and uncontrollable need to urinate during their third trimester.

The American Pregnancy Association recommends:

• You should create a consistent schedule for bladder emptying that should occur every 1-2 hours.

• Despite any inconvenience, women should hydrate their bodies daily with 8-10 water glasses.

• Fiber intake should remain sufficient to stop constipation because constipation magnifies bladder pressure.

• The consumption of caffeine should be restricted because it functions as a diuretic.

Heartburn

Heartburn develops in almost half of expecting mothers and commonly affects them in their last trimester of pregnancy. The combination of pregnancy hormones and the expanding uterus creates these conditions because both functions slow down digestive tract muscles and increase stomach pressure. Healthcare professionals at The New England Journal of Medicine tested dietary adjustments and behavior modifications to help treat pregnancy-related heartburn and success rates reached between 70-85%.

Recommended interventions include:

• Patients should eliminate trigger foods, which include spicy, oily, acidic, and fatty food types.

• The worsening of symptoms happens when patients reduce their consumption of caffeine together with carbonated beverages, dry, citrus fruits, and dairy products.

• Avoiding late evening meals

• Patients should stay seated upright for thirty to sixty minutes directly after their meals.

Edema (Swelling)

Edema, the medical term for swollen extremities, results from fluid retention in the lower body. The weakening of vein valves in legs enables blood to stay stagnant which forms swollen and uncomfortable varicose veins. Public health institution Mayo Clinic reports that edema affects 75 percent of pregnant women in the third trimester.

Edema management strategies include:

• Elevating the feet regularly

• People with swollen legs should alternate between periods of rest on a chair and periods on their feet.

• Crossed legs restrict circulation and, therefore, should be avoided.

• Side-lying rest should be used as an option whenever feasible People should ask their healthcare providers about using compression stockings if their condition is serious.

Braxton-Hicks Contractions

Most expecting mothers have Braxton-Hicks contractions through their eighth or ninth month of pregnancy, which naturally prepares the body for birth. Differentiation between normal practice contractions and actual labor requires proper identification.

According to Obstetrics & Gynecology research it has been found that false contractions exclusively appear in the anterior part of the stomach region. True labor contractions initiate from the back before moving toward the front area. The intensity of original contractions can escalate while a woman is active. A person's change in posture allows them to discover if their contractions suggest actual labor.

Vaginal Discomfort

Vaginal pain during the third trimester can cause significant anxiety. The discomfort may result from pressure on pelvic nerves or early cervical dilation in preparation for delivery.

The American College of Obstetricians and Gynecologists advises contacting your healthcare provider if vaginal pain is accompanied by:

• Vaginal bleeding

• Amniotic fluid leakage

• Regular, intensifying contractions

• Reduced fetal movement

• Severe pain that interferes with daily functioning

Sleep Disturbances and Snoring

The sleep quality of pregnant women tends to decrease in the third trimester of their pregnancy. Raised respiratory muscle pressure and nasal inflammation cause women who never snored previously to develop the habit. The research in Sleep Medicine Reviews discovered that sleep disturbances affect 76% of women during late pregnancy, yet 35% of these women started experiencing pregnancy-associated snoring. The presence of persistent heavy snoring should trigger a discussion between you and your doctor to check whether it shows symptoms of gestational sleep apnea.

Managing Insomnia

Insomnia stands as a frequent issue among women in their third trimester of pregnancy. A Journal of Clinical Sleep Medicine investigation reveals that sleep disturbances happen to 78 percent of pregnant women near the end of their pregnancy.

Evidence-based recommendations include:

• The left-side sleeping position and supportive pillows beneath your abdomen represent a strategy to enhance fetal blood supply. Additional pillows placed under the upper body help reduce symptoms of reflux for pregnant women.

• Your right-side sleeping position is beneficial since it avoids restricting blood vessels that run through major veins.

• Avoid drinking fluids which cause both leg cramps and increased need to urinate.

• Daily hydration in advance of bedtime reduces the risk of leg cramps.

• A nighttime routine should include soft stretches of your legs just before resting for sleep.

• Relax with calm activities when sleep becomes impossible during night hours.

Clinical Significance of Third-Trimester Symptoms

While the discomforts described are typically normal aspects of late pregnancy, they serve important physiological purposes. You should notify your healthcare provider about any symptoms which persist or become severe because these signs might need medical attention.

According to the American Academy of Family Physicians, patients must regularly attend their prenatal visits in the third trimester to check both maternal and fetal health statuses. The visits enable patients to share their concerning symptoms while obtaining proper guidance. During the third period of pregnancy, your baby undergoes important developmental milestones such as brain growth, lung development, and fat storage for postnatal health. Conscious awareness about the relationship of your physical issues to your baby's developmental progress can help you make sense of difficult pregnancy periods. Each pregnancy flows differently from others and produces separate symptoms among distinct people. Keep in touch with your healthcare professionals and follow their recommended care practices while recognizing these temporary discomforts will pass. This will build your confidence in navigating the important transition after birth.

To know more, please refer to the following resources:

• Your Pregnancy Week by Week: Weeks 35–40

• Third Trimester of Pregnancy

• Third Trimester Concerns and Tips