Third trimester checklist (weeks 28-40)

The third trimester is the busy one. Tests get tighter, appointments more frequent, and the pre-baby logistics suddenly all need to happen at once. The list below is sequenced by what most needs attention at each point in the trimester so you can pace yourself instead of cramming it into the last 2 weeks.

Weeks 28-31: tests, vaccines, and decisions

Medical

• Glucose tolerance test result. Done late in the second trimester (weeks 24-28). If you failed the one-hour and have not yet done the 3-hour, this is when to schedule it. Full glucose test guide here.
• Tdap vaccine. The CDC and ACOG recommend Tdap (tetanus, diphtheria, acellular pertussis — protects baby from whooping cough) between weeks 27 and 36, ideally as early as possible in that window to maximize antibody transfer. Done at a prenatal visit, takes 30 seconds.
• Flu vaccine and COVID booster if in season. Both safe in pregnancy and recommended.
• Rh immune globulin (RhoGAM) if Rh-negative. Given at 28 weeks. Your OB will have flagged this earlier if you are Rh-negative.
• Kick counts start. 10 movements in 2 hours, daily, after week 28. Pick a time you eat (often after dinner) when the baby is most active. Track in a notes app or paper journal.

Decisions

• Choose a pediatrician. Most hospitals require the pediatrician's name at delivery. Tour 1-2 practices, interview the doctor or NP, confirm they take your insurance, and confirm they have hospital privileges at your delivery hospital.
• Decide on cord blood / cord tissue. Public donation (free), private banking (~$1,500-2,000 upfront, ~$200/year storage), or skip. The medical-utility debate is real and worth a 30-minute conversation with your OB or a genetic counselor.
• Decide on circumcision if you are having a boy. Either decision is fine. The AAP says benefits modestly outweigh risks but does not universally recommend it. Done before hospital discharge if you choose it.

Logistics

• Hospital pre-registration. Most US hospitals let you pre-register starting at week 28. Saves 30 minutes at admission.
• Confirm maternity leave plan with HR. FMLA, short-term disability, PTO stacking. Stacking guide here.
• Pediatrician interview list. Your insurance directory, hospital affiliation directory, recommendations from your OB.

Weeks 32-35: prep mode

Medical

• Prenatal visits move to every 2 weeks. Standard from week 32 to week 36 in most US practices.
• Continue kick counts daily. A noticeable decrease from your baby's normal pattern is a same-day call.
• Anti-D shot if Rh-negative (RhoGAM) may have been given earlier; if not, week 28 is the standard timing.

Big purchases and setup

• Install the car seat by week 35. The hospital may not let you leave without one, and the install is harder than it looks. Most fire stations and police stations offer free check-ups. Find a Certified Passenger Safety Technician (CPST) at safekids.org.
• Wash baby clothes and bedding in fragrance-free detergent. Newborn skin reacts to the residues in most adult detergent. Dreft, All Free & Clear, Seventh Generation Free & Clear.
• Set up the nursery basics — crib or bassinet, changing area, diaper supplies. Full essentials list here.
• Stock the diaper inventory. Start with 2 packs of newborn size, 4-5 packs of size 1. Most babies move out of newborn within 4-8 weeks; do not over-buy. Diaper calculator here.

Pack the hospital bag

• For you: comfortable nightgown or button-down PJs, robe, slippers, ID and insurance, phone charger with extra-long cable, lip balm, hair ties.
• For your partner: change of clothes, snacks, phone charger, comfortable shoes.
• For the baby: going-home outfit, hat, blanket, infant car seat in the car.
• Skip the diapers and pads — the hospital provides industrial-quality versions you will want anyway. Full hospital bag list.

Decisions

• Draft a birth plan. Pain management preferences (epidural, IV meds, no medication), monitoring preferences, eating/drinking during labor, who is in the room, immediate-postpartum preferences (delayed cord clamping, skin-to-skin, breastfeeding right away). Keep it to one page. Discuss with your OB at week 36 visit. Note: birth plans are starting points, not contracts. The actual labor often deviates and that is fine.
• Pick a postpartum support plan. Who is coming over the first 2 weeks. Who is bringing meals. Who is on standby for emergencies. This is the most-skipped piece of pregnancy planning and the one most parents wish they had done.

Weeks 36-37: final medical checks

• Group B Strep (GBS) swab at 35-37 weeks. A vaginal/rectal swab that screens for a bacteria that is harmless to adults but can infect a newborn during delivery. About 25 percent of pregnancies are GBS-positive. Positive results mean you get IV antibiotics during labor. The test takes 60 seconds.
• Cervical check (sometimes). Some OBs do a cervical exam at 36 or 37 weeks to check for early dilation or effacement. This is optional and does not predict when labor will start. You can decline.
• Ultrasound for baby's position (sometimes). If the baby has been flipping or is suspected breech, an ultrasound confirms position. If breech at 37 weeks, your OB will discuss external cephalic version (a manual flip), planned cesarean, or other options.
• Switch to weekly prenatal visits from week 36 onward.

Logistics for the last 4 weeks

• Freezer-stock 2 to 4 weeks of meals. The most useful pre-baby preparation. Lasagnas, soups, baked pasta, casseroles. Easy reheats. Plus 1 to 2 quick-meal staples (rotisserie chicken, frozen pizza, breakfast bars) for nights you cannot manage the freezer.
• Confirm postpartum support arrivals. Who arrives when. Where they sleep. What groceries they bring.
• Set up the bedside spot. Burp cloths, water bottle with straw, snack basket, phone charger, lamp on a low setting. The 3 AM feeding station.
• If breastfeeding: pre-buy nursing pads, nipple cream (lanolin or hypoallergenic alternatives), and a manual or single electric pump. You can rent a hospital-grade pump if cluster feeding gets intense in week 1-2.
• Plan how older kids will be cared for during labor if applicable.
• Plan how pets will be cared for during the hospital stay.

Weeks 38-40: waiting

About 5 percent of babies are born on the due date. About 50 percent before and 50 percent after. The week-38-to-week-40 stretch is a lot of waiting and watching.

Medical

• Weekly prenatal visits. Each visit usually includes a cervical exam (if you want one), fetal heart rate check, and sometimes a non-stress test (NST) or biophysical profile.
• Membrane sweep (optional). Sometimes offered at 39 or 40 weeks to potentially trigger labor. About 50 percent of people go into labor within 48 hours after a sweep. Uncomfortable but brief.
• Discuss induction timing if applicable. The ARRIVE trial (2018) showed that elective induction at 39 weeks for low-risk first pregnancies does not increase cesarean rates and may decrease them. Many US practices now offer this option.

Self-care

• Walk daily if comfortable. Does not specifically induce labor but maintains general fitness and can help with positioning.
• Sleep when you can. Naps are not lazy at this point.
• Skip the "natural induction" methods that have no evidence. Eggplant parmesan, spicy food, bouncy balls — none of these meaningfully induces labor. The methods with weak evidence (nipple stimulation, sex, walking) may help if the body is already on the verge. Skip the pineapple/castor oil/dates myths.

Past the due date

Going past the due date is normal. The official "post-term" threshold is 42 weeks. Between 40 and 42 weeks, your OB will increase monitoring (often biweekly NSTs and amniotic fluid checks) and discuss induction timing.

Induction is typically recommended by 41 weeks in the US to reduce risks associated with prolonged pregnancy (placental aging, decreasing amniotic fluid, increased risk of stillbirth past 42 weeks). The specific timing is individualized.

The "what to bring to the hospital" mental list

For the moment when it actually happens:

• The hospital bag (already packed)
• Your phone and charger
• Your insurance card and photo ID
• Your birth plan (if you have one)
• The car seat in the car (already installed)
• The pediatrician's name on hand
• A list of people to text once the baby is here

Everything else can be brought later by your partner or support person. You do not need to remember 50 small items at 3 AM.

General checklist only. Your prenatal care plan is tailored by your OB or midwife to your specific health picture — this article does not replace their guidance.