The third trimester, beginning at week 28 of pregnancy, is a period of significant fetal growth and maturation leading up to delivery. Monitoring the baby’s well-being becomes increasingly important for both healthcare providers and expectant parents. While most pregnancies progress without complication, recognizing specific warning signs allows for timely medical intervention if the baby is experiencing distress. Understanding these indicators is a proactive step toward a healthy outcome, but this information should always supplement direct medical advice.
Changes in Fetal Movement
Changes in the baby’s typical movement pattern are often the first noticeable sign of distress in the uterine environment. The strength and frequency of movement should remain consistent throughout the third trimester, contrary to the misconception that babies move less because they are running out of room. A significant decrease in the number of movements felt over a specific period warrants immediate attention.
Healthcare providers often recommend “kick counting” or fetal movement counting, typically starting around 28 weeks. This involves tracking how long it takes to feel ten distinct movements, such as kicks, rolls, or swishes. A general guideline is to contact a provider if it takes longer than two hours to feel ten movements.
The baby’s usual pattern serves as the most important baseline, so any sustained deviation should be reported. Concern is not limited only to reduced activity. A sudden, frantic burst of movement followed by a period of unusual silence can also be a sign of distress and should be treated with the same urgency as reduced movement.
Other Urgent Physical Indicators
Beyond fetal movement, several physical symptoms experienced by the pregnant person can signal an urgent issue with the pregnancy or the baby’s environment.
Vaginal Bleeding and Abdominal Pain
Vaginal bleeding, particularly bright red or heavy flow, requires immediate medical evaluation as it may indicate a problem with the placenta. This bleeding can be associated with placental abruption, where the placenta prematurely separates from the uterine wall, compromising the baby’s oxygen supply. Placental separation often causes severe, persistent abdominal pain that does not subside, distinct from typical contractions. The abdomen may feel hard or rigid to the touch. In some cases of abruption, there may be no visible external bleeding (concealed hemorrhage), making acute pain the primary warning sign.
Rupture of Membranes
A sudden gush or steady leak of fluid from the vagina before labor begins may signal a rupture of the membranes. Normal amniotic fluid is typically clear or a pale straw color. If the fluid is tinted green or brown, it suggests the baby has passed meconium (first stool). The presence of meconium in the fluid necessitates prompt medical assessment due to the risk of inhalation.
Preeclampsia Symptoms
A cluster of symptoms may point toward severe preeclampsia, a blood pressure disorder affecting multiple organ systems. These symptoms include a persistent, severe headache that does not respond to typical pain relief medication. Visual changes, such as blurred vision, double vision, or seeing flashing lights or spots, are also concerning. Pain in the upper right side of the abdomen, located under the ribs, can indicate liver involvement associated with this condition.
When and How to Seek Medical Help
If any of these concerning signs appear, the first and most appropriate action is to contact the healthcare provider immediately. This may be the obstetrician, midwife, or the labor and delivery unit at the nearest hospital, as they are equipped for urgent assessment and continuous fetal monitoring. Avoid attempting home remedies, such as drinking cold juice or lying down to stimulate movement, before seeking professional advice.
Do not wait for a scheduled appointment or attempt to self-diagnose the symptom. If the primary provider cannot be reached promptly, proceed directly to the hospital’s labor and delivery triage unit. Triage staff can begin immediate fetal monitoring tests, such as a non-stress test or ultrasound, to check the baby’s heart rate and overall well-being.
When speaking with the medical team, be prepared to provide precise details about the symptom observed. This includes when the symptom began, its severity, and whether it is constant or intermittent. For movement changes, relay the exact time it took to feel ten movements or describe how the current activity differs from the baby’s established pattern.