Your Essential Third Trimester Doctor's Visit Checklist
Expectations & Concerns
You’re down to the final few weeks of your pregnancy, and you’re almost ready to meet your little one. At your third trimester, you should be increasing your check-ups to once every 2 weeks (between 27 – 36 weeks) and switching to once-a-week until your delivery date.
This handy checklist will keep you on track during this final homestretch to ensure you have all bases covered for a smooth delivery. We’ve put together a list of essential things to check with your doctor as your due date draws near.
☑ Get Your Tdap Shot
Whooping cough is a respiratory infection that is life-threatening for infants, especially within their first 6 months, as it may lead to pneumonia and brain injury. Most young babies with whooping cough are likely to be admitted to hospital and they may be at the risk of dying from the disease. 1,2
Did you know that mothers can pass on their antibodies to their babies during pregnancy?3 This helps protect newborns from these infectious diseases during their first few months, as they cannot get vaccinated until they are 3 months old.4
The Ministry of Health Singapore strongly recommends influenza and pertussis vaccination in pregnancy, in line with international guideline recommendations from the United Kingdom, the United States and other countries. In 2017, the Ministry extended the use of Medisave for vaccines under the National Adult Immunisation Schedule, which include the vaccine against influenza and pertussis.4 Remember, you can help protect your unborn baby against whooping cough by getting vaccinated with Tdap Vaccine during the 3rd trimester (between 27 – 36 weeks) of your pregnancy.5
☑ Protecting your baby from flu
Influenza is a highly infectious respiratory viral illness that is transmitted from person to person via respiratory droplets propelled by coughing or sneezing. While most infected people will recover within 1 to 2 weeks, pregnant women, at any stage of pregnancy, are more likely to develop severe illness and are therefore at a higher risk of morbidity, and even mortality. 4,6,7,8 Getting the common cold while you’re pregnant could cause severe problems like early labour and may increase the likelihood of birth defects. 7,9
The flu shot is safe at any stage of pregnancy, and also poses no risk for women who are breastfeeding. What’s more, it can also provide protection to newborns when vaccinated during pregnancy, as mothers can pass on antibodies to their developing baby. 4
Newborns are very likely to catch the flu from family members and caregivers, so be sure that everyone at home is up-to-date with their annual flu vaccinations before coming into close contact with the baby.10
☑ Check the baby’s position
Nearing your delivery date, an ultrasound would be done to determine if your baby is positioned headfirst in the uterus for safe delivery.11 Don’t worry if your baby is positioned feet-first, you might just have a very active baby and most babies would naturally turn to a head down position by 37 weeks.12
Some mothers may turn to a chiropractor, a prenatal massage or home exercises to help reposition their baby before delivery. Always check with your gynaecologist on the suitability of these options first. Even if your baby is still in breech position, it is not the end of the world, and your doctor may simply recommend a C-section delivery for your safety.13
☑ Group B Streptococcus Screening
Most females carry group B strep bacteria in our bowel, rectum, bladder and vagina, and usually does not cause any problem for adults but it can cause potentially fatal infections in newborns.14
A simple vaginal and rectum swab will be done in week 35 - 37, and if tested positive for the bacteria, you will be given antibiotics before delivery to reduce the risk of exposure of group B strep to your baby.15
☑ Checking on Your Baby’s Heart Rate
A Nonstress Test (NST) is a simple and non-invasive way of checking on your baby’s heart rate and it can also detect if the placenta is healthy.16
Unlike a stress test for adults that purposefully applies stress to the heart, a NST simply involves placing a fetal monitor over your baby bump for 20-30 minutes to record your baby’s heart rate. 16
This screening test is mostly done for mothers who are past their due dates (40 weeks onwards), or for women who have existing health conditions or have high-risk pregnancies.17
☑ Gestation Diabetes
Gestational diabetes refers to high blood sugar that usually develops in the second trimester of pregnancy. 1 in 5 pregnant women develops diabetes during pregnancy.18
To determine your blood glucose reading, pregnant mothers are advised by the OB-Gynes to undergo a screening test called the oral glucose tolerance test (OGT). A healthy blood glucose reading should stay below 5.00mol//L before meals and below 7,0mmol/L two hours after meals.18
Pregnant women should eat healthily, exercise regularly, and if necessary, take medication to curb with gestational diabetes. 19 It is important to manage one's blood sugar to prevent a difficult birth and keep you and your baby healthy. Blood sugar level generally returns to normal soon after delivery, but if one is at risk for type 2 diabetes, then it is important to keep an eye out for normal blood sugar level even after pregnancy. 19
You are likely to have plenty of questions nearing your due date, never be afraid to speak up when it comes to voicing any health concerns you may have. Be sure to discuss any symptoms with your doctor, no matter how insignificant you think they are. This will make all the difference in the world, especially when it comes to helping your doctor detect pregnancy complications early on before they become serious.
If something doesn’t feel right, always trust your instincts and make sure you are reassured of any concerns that you may have. Feeling prepared and ready is vital in giving you the peace of mind you need before delivery.
For more information on Tdap vaccinations & flu shots, please consult your doctor or pharmacist.
A public awareness initiative brought to you by GlaxoSmithKine Pte Ltd.
For further information, please consult a doctor.
All images used in this material are for illustration purposes only.