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What Happens to Your Body During Each Stage: Third Trimester (Weeks 28 to 42)

12 April 2026

The third trimester is the final stretch of pregnancy, and it is characterized by physical strain alongside emotional and practical preparations for childbirth and parenthood. During this trimester, you will require close medical monitoring to ensure the well-being of both mother and baby.

Physical changes and symptoms

Due to the expanding uterus, many women experience shortness of breath, edema (swelling), heartburn, and sleep difficulties. Another common symptom is pelvic and groin pain (Symphysiolysis-SPD), due to the widening of the pelvis. These are natural symptoms that can be relieved through appropriate physical therapy and proper positioning.

Check-ups and vaccines

The third trimester includes the following essential check-ups and vaccinations:

  • Pertussis (whooping cough) vaccine: It is recommended between weeks 28-36 to help protect your baby.
  • Anti-D injection: For women with an Rh-negative blood type (usually given around week 28).
  • GBS (group B strep) test: A swab done between weeks 36-37 to see if antibiotics are needed during labor.
  • Fetal weight estimation: An ultrasound scan to track your baby's growth.

Childbirth preparation and emotional changes

Now is the time to consider and discuss your birth preferences with the medical team and participate in childbirth education classes. Emotionally, this is a period that combines anticipation and anxiety, which is natural and understandable. If you feel that emotional difficulties interfere with your daily functioning, do not suffer in silence and seek professional help.

Post-term pregnancy (weeks 40 to 42)

If your due date passes, twice-weekly monitoring is recommended including fetal heart rate monitoring, an ultrasound to check amniotic fluid levels, and blood pressure checks, until childbirth or a decision is made regarding induction of labor.

Pregnancy is a period characterized by constant physical and emotional shifts. It is typically divided into three trimesters – each bringing its own unique changes. In this article, we will outline the medical procedures, essential tests, and ways to maintain a healthy lifestyle for both you and your fetus during the third trimester (weeks 28 to 42).

Please note: Certain symptoms, such as heartburn or sleep difficulties, may carry over from the first and second trimesters of your pregnancy. It is recommended to read the articles about the previous trimesters. Even in the third trimester, it is important to maintain a proper diet, take recommended vitamins and dietary supplements, stay within the recommended range of weight gain, take vaccinations as necessary, and monitor fetal movement.

Throughout your pregnancy, you should attend regular prenatal check-ups with your OB-GYN. In addition to these visits, a medical team is available to address your questions, including prenatal care nurses, Tipat Halav (Family Health Centers) nurses and midwives. We recommend checking with your HMO regarding the services that are available to you.

Prenatal follow-up

The medical team will review your blood test results, the ultrasound, and the urinalysis you have performed so far, and as needed, you may be referred for high-risk pregnancy monitoring or additional testing.

Mood, general well-being, constipation, nausea, heartburn, and appetite. You may be referred for appropriate testing or treatments.

From week 26, it is recommended that every woman completes the Edinburgh Questionnaire. This tool aims to identify signs of depression, which can occur during pregnancy and not only after childbirth, and this is a common condition. If your results indicate an increased risk of prenatal depression, or if you have any concerns or anxieties, you will be referred for further care. It is important that you know that prenatal depression is treatable and that treatment is effective. You do not have to go through this alone.

This includes taking dietary supplements, getting vaccinations, dietitian counseling, physical activity, and more. It is important to inform your physician if you encounter any difficulties, such as swallowing pills, or scheduling appointments, so they can provide a suitable alternative for you. 

Vaccinations during pregnancy

  • Pertussis (whooping cough) vaccine: It is recommended to get vaccinated between weeks 28 and 36 of your pregnancy to protect your baby against pertussis after birth. Even if you have not been vaccinated until week 36, it is still advisable and possible to do so as soon as possible before giving birth, or even immediately afterward.
  • Anti-D injection: If your blood type is Rh negative, and the father's blood type is positive or unknown, it is recommended to receive an Anti-D injection during week 28 of your pregnancy. This injection provides antibodies that help prevent rare complications for the baby in both your current pregnancy and future pregnancies, if there is a mismatch between your blood type and that of your fetus.
    If you have already received an Anti-D injection during this pregnancy, your physician will determine if and when another dose is required.

For more information about vaccinations during pregnancy

Physical changes

In the third trimester the physical strain reaches its peak; the uterus presses the internal organs and causes symptoms such as light shortness of breath, edema, heartburn, and frequent urination. In addition, you may experience sleep difficulties as well as pelvic and groin pain (Symphysiolysis-SPD).

Increasing fatigue and stronger fetal movements add to the feeling of heaviness and may often limit your daily activity.

While this may be the most challenging stage of your pregnancy, remember that you are in the home stretch.

Furthermore, some common symptoms from the first and second trimesters may carry over into the final trimester of your pregnancy. Certain symptoms, such as extreme fatigue and mood swings, may even intensify as the fetus grows. If these symptoms do not improve or interfere with your daily functioning, continue utilizing dietary solutions and consult your healthcare team regarding safe medication options.

Common symptoms

Symphysiolysis

This is a common pain during the third trimester of pregnancy caused by the natural expansion of the pelvis in preparation for birth. You will primarily feel the pain in the groin area, and it may intensify while walking, climbing stairs, or changing positions. While this pain can be quite difficult to bear, as it has no medication-based solutions, it is important to know that it does not put you or your baby at risk.

Discuss this pain with your OB-GYN. Sometimes it can be relieved through guidance on facilitating positions and tailored physical therapy exercises.

Changes in the breasts

Your breasts continue to grow, and you may experience sensitivity in the nipples. Please note: if you are considering breastfeeding, or have doubts about it, now is the time to learn more.

For more information about the advantages of breastfeeding and breast milk

Edema (swelling)

Swelling, especially in the legs, is a frequent symptom during the second and third trimesters of pregnancy. This is due to fluid retention and the pressure of the uterus on your veins. To help reduce the swelling, it is recommended to keep your legs raised while resting, and, as necessary, consult your primary care physician regarding the use of compression stockings.

Please note

Please note

If swelling appears unusually fast, or if there is a sudden and heavy swelling in the legs, hands, or face, it could be an early sign of preeclampsia. In such a case, it is essential to contact your OB-GYN or an Obstetric Emergency Room without delay for immediate clinical diagnosis and treatment.

Medical check-ups

  • Until the end of week 28 of pregnancy: Complete Blood Count (CBC) and Glucose Tolerance Test (GTT) to diagnose anemia or suspected gestational diabetes (if not performed during the second trimester).
  • Blood tests: Depending on your medical condition and previous test results, you may receive a referral for additional blood tests.
  • GBS test: This test is performed between weeks 36 and 37 of your pregnancy (it can also be done later if you were unable to do so on time). It can be performed by a physician or independently by yourself, using a vaginal and rectal swab. It is intended to determine if you are carrying the GBS bacteria and whether antibiotic treatment will be necessary during labor.
  • Fetal weight assessment: An ultrasound scan intended to measure the size of the fetus in order to estimate its weight.
  • If you are Rh-negative: you will be referred to a follow-up COOMBS test.

When to seek immediate medical care

In the following cases, seek an immediate medical care:

  • Heavy bleeding (more than a typical period).
  • Severe abdominal pain.
  • Persistent vomiting.
  • Loss of consciousness or fainting.
  • Regular contractions or pressure occurring before week 37.
  • Decreased fetal movement.
  • Suspected leaking of amniotic fluid (water breaking).
  • Direct abdominal trauma or car accident.
  • Unusual sense of physical distress.

Emotional changes

The approach of childbirth arouses a combination of anticipation, excitement and fear, sometimes alongside impatience and counting the days until the end of pregnancy. Thoughts about labor, recovery and the transition to parenthood appear more frequently, affecting the relationship, the sense of control, and the level of anxiety. If these feelings persist for more than two weeks, it is important to seek help. Getting help early can provide relief and protect both you and your baby.

For further information on emotional changes during pregnancy

It is recommended to participate in a childbirth preparation course

It is recommended to participate in a childbirth preparation course

It is recommended to participate in a childbirth preparation course to help you understand the process of childbirth. Even if you have given birth before, a refresher course is recommended because we tend to forget from one birth to the next.

For more information about childbirth preparation courses

Method of delivery

It is recommended to discuss the timing, location and method of birth with your physician, taking into account your wishes, medical condition, and pregnancy data. The Ministry of Health recommends a hospital birth, where there is a skilled team for managing any unusual situations that may arise. If you are interested in a natural labor, please note that all hospitals in Israel now offer options for a natural birth without medical intervention; furthermore, many delivery rooms provide natural birth centers or water birth facilities within the hospital, subject to availability.

If you wish to give birth at home, it is important to make sure that your health condition, the course of your pregnancy, and the place chosen for birth are suitable for such a birth. You can review the recommended conditions for this on the Ministry of Health website. In addition, it is important to have a doctor or a qualified home midwife with you to accompany the birth. A doula can provide you with support, but she is not qualified to accompany a birth professionally.

Post-term pregnancy: Weeks 40-42

The period starting from week 40, following the estimated due date (EDD), is referred to as post-term pregnancy. During these weeks, it is recommended to undergo post-term monitoring twice a week. The follow-up is conducted at the clinic or Women's Health Center, depending on your HMO.

At this stage, the pregnancy follow-up includes:

  • An ultrasound scan to assess fetal position, vitality, and the amniotic fluid volume.
  • A fetal monitor for the fetal heart rate and contractions.
  • Testing maternal blood pressure and pulse.
  • Monitoring for edema (swelling) in the face and hands (if present).
  • Referrals for further laboratory testing, such as protein and leukocytes in urine.
  • Based on the results of the vital signs and the monitor to be reviewed by the physician, the date for your next follow-up will be determined, or you will receive a referral for induction of labor, if necessary.