36 Week Appointment: What to Expect During Your Prenatal Visit

As you enter the final stretch of your pregnancy, your 36-week prenatal appointment marks an important milestone. This visit is typically more comprehensive than earlier checkups, as your healthcare provider prepares both you and your baby for the upcoming delivery. Understanding what to expect can help ease any anxiety and ensure you’re well-prepared for this crucial stage of your pregnancy journey.

Standard Checkups at 36 Weeks

Your 36-week appointment includes several routine assessments that monitor both your health and your baby’s wellbeing. Your healthcare provider will check your blood pressure, measure your weight gain, and assess any swelling in your hands, feet, or face. These measurements help identify potential complications such as preeclampsia or gestational diabetes.

Your provider will also measure your fundal height, which is the distance from your pubic bone to the top of your uterus. This measurement helps ensure your baby is growing appropriately. Additionally, your baby’s heart rate will be monitored using a Doppler device or electronic fetal monitor to confirm a healthy heartbeat pattern.

Group B Streptococcus Testing

One of the most important procedures during your 36-week visit is testing for Group B Streptococcus (GBS). This is a routine screening that involves taking a swab from your vagina and rectum. The process is quick and typically causes minimal discomfort.

GBS is a type of bacteria that naturally occurs in about 25% of healthy women. While it usually doesn’t cause problems for adults, it can be dangerous for newborns if transmitted during delivery. If your test comes back positive, your healthcare provider will recommend receiving antibiotics through an IV during labor to protect your baby from infection.

The test results usually take a few days to come back, and your provider will discuss the findings with you before delivery. Some healthcare facilities now offer the option for patients to perform their own swab collection after receiving proper instructions.

Baby’s Position Assessment

At 36 weeks, your healthcare provider will determine your baby’s position in the uterus. Ideally, your baby should be in a head-down position, also called vertex or cephalic presentation, which is optimal for vaginal delivery.

However, approximately 3-4% of babies remain in a breech position at this stage. Breech positions include frank breech (bottom first with legs extended), complete breech (bottom first with legs crossed), or footling breech (one or both feet pointing down).

Your provider may use palpation, where they feel your abdomen to determine the baby’s position, or they might use ultrasound for a more accurate assessment. If your baby is breech, your provider may discuss options including external cephalic version (ECV), a procedure where they attempt to manually turn the baby by applying pressure to your abdomen. If the baby cannot be turned or if ECV is not recommended for your situation, a cesarean delivery may be planned.

Fetal Movement Monitoring

Your healthcare provider will ask about your baby’s movement patterns. At this stage, you should continue feeling regular movements throughout the day, though they may feel different as your baby has less room to move around.

Many providers recommend performing kick counts daily. A common method is to count 10 movements within a two-hour period while lying on your side. Movements can include kicks, rolls, or jabs. If you notice a significant decrease in movement or if your baby isn’t moving as expected, contact your healthcare provider immediately, as this could indicate fetal distress.

Important Vaccinations

Your 36-week appointment is an opportunity to ensure you’ve received all recommended vaccinations for this stage of pregnancy. If you haven’t already received the Tdap vaccine (tetanus, diphtheria, and pertussis), it’s ideally given between 27 and 36 weeks of each pregnancy.

The Tdap vaccine is crucial because it helps protect your newborn from whooping cough during their first few months of life before they can receive their own vaccinations. Your provider may also discuss other recommended vaccines such as the flu shot, COVID-19 vaccine, or RSV vaccine, depending on the season and current recommendations.

Physical Symptoms Discussion

Your healthcare provider will ask about any symptoms you’re experiencing. Common concerns at 36 weeks include:

• Braxton Hicks contractions or true labor contractions
• Vaginal discharge changes
• Pelvic pressure or pain
• Swelling in extremities
• Shortness of breath
• Difficulty sleeping
• Back pain
• Frequent urination

Be honest about any discomfort or unusual symptoms you’re experiencing. Your provider can help distinguish between normal pregnancy discomforts and warning signs that require medical attention.

Cervical Examination

While not always performed at every 36-week appointment, your healthcare provider may offer a cervical exam to check for early signs of labor. This internal examination assesses cervical dilation (how open your cervix is), effacement (how thin your cervix is), and the baby’s station (how low the baby has dropped into your pelvis).

It’s important to know that cervical exams are optional, and you can decline if you prefer. Some women may be dilated for weeks before labor begins, while others don’t dilate until active labor starts. The exam provides information but doesn’t necessarily predict when labor will begin.

Birth Plan Discussion

Your 36-week appointment is an ideal time to discuss your birth plan with your healthcare provider. Topics to cover include:

• Your preferences for pain management during labor
• Who you want present during delivery
• Your preferences regarding interventions like episiotomy or continuous fetal monitoring
• Immediate postpartum preferences such as delayed cord clamping or skin-to-skin contact
• Feeding preferences for your baby

Remember that while having a birth plan is helpful, flexibility is important as circumstances during labor may require adjustments to ensure the safety of you and your baby.

Signs of Labor to Watch For

Your healthcare provider will review the signs of labor and when to contact them or head to the hospital. Important signs include:

• Regular contractions that increase in intensity and frequency
• Your water breaking (rupture of membranes)
• Bloody show (thick mucus discharge tinged with blood)
• Severe abdominal or back pain
• Vaginal bleeding
• Decreased fetal movement

Make sure you understand when to call your provider versus when to go directly to the hospital. Get clear instructions on how to time contractions and what frequency warrants a call or visit.

Questions About Labor and Delivery

Don’t hesitate to ask any questions you have about the upcoming labor and delivery. Common questions at this stage include:

• Is it safe to have sexual intercourse?
• What are the stages of labor?
• What pain relief options are available?
• Under what circumstances would a cesarean section be necessary?
• Can I eat or drink during labor?
• What happens immediately after delivery?
• How long is the typical hospital stay?

Having these discussions now can help reduce anxiety and ensure you feel prepared when labor begins.

Additional Testing

Depending on your individual health history and pregnancy course, your provider may order additional tests at your 36-week appointment. These might include:

• Ultrasound to check baby’s size, position, and amniotic fluid levels
• Non-stress test to monitor baby’s heart rate patterns
• Biophysical profile combining ultrasound and non-stress test
• Blood tests to check for anemia or other conditions
• Urine test to screen for protein or infection

These additional tests are more common if you have conditions like gestational diabetes, high blood pressure, or if you’re past your due date, though at 36 weeks this timing is typically for preparing rather than concerns about being overdue.

Preparing Your Home and Hospital Bag

Your healthcare provider may discuss practical preparations for the coming weeks. This is a good time to ensure your hospital bag is packed and ready. Essential items include:

• Identification and insurance cards
• Comfortable clothing for labor and postpartum
• Toiletries and personal items
• Phone charger
• Going-home outfits for you and baby
• Infant car seat properly installed

Your provider may also remind you to prepare your home with baby essentials and ensure you have support lined up for after delivery.

Frequency of Upcoming Appointments

After your 36-week appointment, you’ll likely transition to weekly prenatal visits until you deliver. These more frequent appointments allow your healthcare team to closely monitor you and your baby during these final weeks.

Each weekly visit will include similar assessments: blood pressure, weight, fundal height measurement, fetal heart rate monitoring, and discussion of any symptoms or concerns. Your provider will continue to assess your baby’s position and watch for signs that labor may be approaching.

When to Contact Your Healthcare Provider

Before leaving your 36-week appointment, make sure you have clear instructions on when to contact your healthcare team. You should call immediately if you experience:

• Heavy vaginal bleeding
• Severe abdominal pain
• Sudden swelling of face, hands, or feet
• Severe headache or vision changes
• Fluid leaking from your vagina
• Significant decrease in fetal movement
• Fever over 100.4°F
• Painful urination or inability to urinate

Ensure you have after-hours contact information and know which hospital or birthing center to go to when labor begins.

Mental Health and Emotional Wellbeing

Your 36-week appointment is also an appropriate time to discuss your emotional wellbeing. Many women experience a range of emotions as delivery approaches, including excitement, anxiety, fear, or mood swings.

Talk to your provider if you’re experiencing symptoms of prenatal depression or anxiety, such as persistent sadness, loss of interest in activities, excessive worry, difficulty sleeping beyond normal pregnancy discomfort, or thoughts of harming yourself or your baby. Your healthcare team can connect you with appropriate resources and support.

Postpartum Planning

While the focus is often on labor and delivery, your 36-week appointment is a good time to begin discussing postpartum care. Topics might include:

• Choosing a pediatrician for your baby
• Plans for feeding your baby (breastfeeding, formula, or combination)
• Birth control options after delivery
• Postpartum warning signs to watch for
• When to schedule your postpartum follow-up appointment
• Support systems available after you go home

Planning ahead for the postpartum period can help ensure a smoother transition once your baby arrives.

Your 36-week prenatal appointment is a comprehensive visit that ensures you and your baby are healthy and ready for the approaching delivery. By understanding what to expect, preparing questions in advance, and following your healthcare provider’s recommendations, you can approach the final weeks of pregnancy with confidence. Remember that every pregnancy is unique, and your provider will tailor care to your specific needs and circumstances. Don’t hesitate to reach out to your healthcare team with any concerns or questions between appointments as you prepare for this exciting milestone.

Sources:

• Mayo Clinic – Prenatal Care: Third Trimester
• American College of Obstetricians and Gynecologists – Pregnancy FAQ
• CDC – Group B Strep Prevention
• March of Dimes – Prenatal Care and Tests
• Johns Hopkins Medicine – The Third Trimester