A Third Trimester Survival Guide: Preparing for Labour

You’ve managed to waddle as far as the third trimester.  Preparing for labour can feel both exciting and daunting. By the third trimester, you may be carrying more than just your baby—you may also be carrying advice, expectations, questions, and perhaps a little anxiety. After decades of practising gynaecology, I have learnt that knowledge, preparation, humour, and perspective can make a remarkable difference. So, as your friendly gynaecologist, let me share a practical third trimester survival guide to help you prepare for labour with confidence.

The Social Side of Preparing for Labour

As you enter the third trimester, suddenly all your wonderful friends will feel the need to impart gruesome, forensic details of their own births, with you.

Breathe – you are going to be doing lots of that on the day, so you may as well practise now.

You know that knowledge is power!  And feeling empowered reduces anxiety.  And with less anxiety, you experience reduced pain.  Oh, and humour.  Try and keep or find a large dose of humour as part of your survival guide. So let those friends prattle on and practise discernment.

The natural physical preparation for Labour

The third trimester offers wonderful symptoms like Reflux and Insomnia. The reflux is real.  The insomnia is preparation for labour in the months ahead! 

Braxton Hicks Contractions

Furthermore, your uterus has been preparing for this trimester for all these months.  It has plans afoot to propel your baby into the world.  Braxton Hicks contractions are simply the warming up of that fabulous muscle powerhouse.  (I really should know who Braxton Hicks was).  Relaxin hormone levels peak and the ligaments begin to, well, relax!

Cervical Ripening and Physical Preparation

In preparation of labour, the pubic joint can take major strain. It needs to be ‘extendable’ to allow the passage of the baby’s head.  The cervix begins to soften, often termed ripening. Why do they call it ‘ripening’?  It seems wrong to liken this to a fruit somehow…. This is your body rehearsing.

Preparing Your Pelvic Floor for Birth

Pelvic floor preparation is a thing.  But, again, moderation in all things.  Overzealous Kegel exercises can hinder pushing in the second stage of labour.  Learning to relax the pelvic floor is also important. There are pelvic floor physios, but pilates instructors can also be very helpful. Take care not to concentrate on the pelvic floor too much. A quick Amazon search yields 132 items that may help you to prepare your pelvic floor!  Be careful out there it is a merch minefield.  At Mothersaid, we recommend Perineum Area massage oil for prenatal massage to improve the elasticity of the area.

Exercise During the Third Trimester

Preparation at this stage involves gentle exercise—walking, swimming, prenatal yoga—all may well improve stamina, reduce back pain, and possibly shorten labour. Moderation in all things is the mantra. It means keep moving in ways that feel kind, not punishing.

Why Antenatal Classes Matter

Antenatal classes are an essential component of pregnancy.  It is a source of education and an outlet for questions as well as a support structure going forward.  Many a book club started with a few women bonding on mats practising their breathing!  The classes will empower you to feel more in control during labour. You will learn about the stages of labour (see FAQs) and about the options for pain control (see FAQs).  This understanding of what is happening can transform your labour from something potentially terrifying into a much more manageable physiological process. Fear is well known to increase pain, so knowledge reduces fear and so reduces pain.  It’s a win, win……

The Truth About Birth Plans

I can’t skip a mention of the BIRTH PLAN.  Whilst having some idea of your preferences is important, it is so much more important to realise that what unfolds on the day may be totally different from your expectations and, fairly, out of your control.  I have spent a lifetime gaining the trust of my pregnant patients to be able to talk into those situations that require intervention when none is desired, but the baby needs it. 

Also, please remember that using pain relief does not mean you have failed, taken a shortcut, or disappointed your ancestors. Many times, an epidural has resulted in a vaginal birth where a C/S seemed like the only likely outcome.

Preparing Your Mind for Labour

Mind preparation is obviously key. Women have done this forever because the body is capable, not because it is easy. Labour is intense, very intense.  It is unpredictable, but it is also temporary.  You will give birth.  One contraction at a time.  Breathe in and breathe out and repeat……

About Sheana Jones

Dr Sheana Jones is a highly experienced gynaecologist based at Vincent Pallotti Hospital in Pinelands, Cape Town. Originally from Scotland, she has spent more than 40 years caring for women through every stage of life. Through MotherSaid, she shares practical, compassionate advice drawn from decades of clinical experience, helping women make informed decisions about their health, pregnancy, motherhood, and wellbeing.