Third Trimester Checklist for a Birth Center Birth

By Igel Cudiera

In the third trimester, preparing for a birth center birth comes down to keeping up with your prenatal visits and tests, planning for labor and a possible hospital transfer, lining up your support team and your baby's pediatrician, and getting ready to go home within hours of the birth. Starting around 28 weeks, you can work through it in rough stages so nothing important is left for the last few days.

This third trimester checklist is grouped by time, but treat the timing as general guidance, not a rigid schedule. Every pregnancy is different, and your midwife or care team may suggest a different order. Where something applies specifically to Birthing Center Long Island, we say so.

Why a Birth Center Checklist Looks Different

Most third trimester checklists assume a hospital birth. A few things work differently when you're planning an out-of-hospital birth with a midwifery team:

• Eligibility continues to be checked. Birth centers care for low-risk pregnancies. ACOG and the Society for Maternal-Fetal Medicine describe birth centers as caring for "low-risk women with uncomplicated singleton term vertex pregnancies" (a single, full-term baby in a head-down position) who are expected to have an uncomplicated birth. If something changes late in pregnancy, your plan may change too.
• There's a plan for hospital care if it's needed. National birth center standards call for each birth center to have an established consultation, collaboration, or referral system.
• You usually go home sooner. At Birthing Center Long Island, families usually stay about 6 to 12 hours after the birth, depending on how parent and baby are doing. That means more of your preparation happens at home before labor.

Around 28 to 32 Weeks

The third trimester begins around 28 weeks. This is a good time to take care of tasks that need some lead time.

• Keep up with prenatal visits. How often you're seen depends on your pregnancy and your care team's plan. MedlinePlus describes a common pattern of visits every 2 weeks until 36 weeks, then weekly. At Birthing Center Long Island, visits are scheduled every two to three weeks until 36 weeks, then weekly until birth.
• Ask about the Tdap vaccine. ACOG and the CDC recommend the Tdap vaccine during each pregnancy, between 27 and 36 weeks, as early in that window as possible, to help protect your newborn from whooping cough.
• Take childbirth and breastfeeding classes. The Office on Women's Health notes that pregnant women who learn about breastfeeding are more likely to breastfeed. Our guide on when to start childbirth classes can help you plan the timing.
• Start looking for a pediatrician. The AAP recommends that parents-to-be visit a pediatrician during the third trimester. Our guide on how to choose a pediatrician covers what to ask.
• Review your maternity coverage. Ask your insurer how birth center care, your baby's care, and a possible hospital transfer would be covered, whether the midwives and the center are in network for your plan, and what you might pay out of pocket, such as your deductible and coinsurance. Our guide on how to verify your maternity benefits lists the questions to ask. Birthing Center Long Island lists several insurance plans it may work with, including Aetna, Cigna, EmblemHealth Medicaid, Empire BCBS HealthPlus, Healthfirst, MCO (Medicaid Managed Care Organization) plans, Oscar, Oxford, and UnitedHealthcare. Coverage, benefits, network status, and what you'll owe can vary by individual plan, so verify your own coverage with both your insurance provider and Birthing Center Long Island. You can find the current list in our insurance information, and the center's front office can help if anything is unclear.
• Look into leave. Under the federal Family and Medical Leave Act (FMLA), eligible employees of covered employers can take up to 12 workweeks of unpaid, job-protected leave for the birth of a child. New York Paid Family Leave offers eligible employees up to 12 weeks of job-protected, paid leave to bond with a new child.

Around 32 to 36 Weeks

These weeks are about planning for labor, for a possible change of plans, and for coming home.

Talk through your birth preferences

Use your prenatal visits to talk about what matters to you in labor: who will be there, how you'd like to move and cope with contractions, and whether you're interested in laboring in water. Writing your preferences down helps your support people know them too. If you're considering a water birth, ask your midwife how that fits your pregnancy.

Line up your support team

• Decide who will be with you in labor, and make sure they know how to reach you and your midwife
• If you'd like extra support, look into doula support
• Share ideas with your partner about how a birth partner can help in labor
• Arrange care for older children and pets for when labor starts, with a backup person

Make a hospital transfer plan

It's wise to plan for the possibility of hospital care, just as you'd plan for any other part of labor. Ask your care team:

• Which hospital you would go to if a transfer were needed, and how you'd get there
• Whether your midwife stays involved if you transfer
• How your records would be shared with the hospital team
• Whether that hospital is in network for your plan

Keep your ID and insurance card somewhere easy to grab. At Birthing Center Long Island, our hospital affiliation provides a pathway for transfer to a higher level of care when appropriate. If a hospital becomes the safer setting during labor, your midwife arranges the transfer and hands over your history to the hospital team. Our midwifery care page explains how care works across pregnancy, birth, and postpartum.

Pack your bag

Ask what the center provides and what you should bring, since this varies from center to center. For a full packing list, see this guide to what to pack for a birth center birth from our sister center, Birthing Center NYC. If you're planning to labor in water at our Hewlett center, our water birth page suggests bringing a swim top if you'd like to wear one, a hair tie, and a water bottle.

Get the car seat ready

Because you'll go home within hours, have the car seat ready well before labor. The AAP says all infants should ride rear-facing, starting with their first ride home, and suggests that expectant parents consider working with a certified child passenger safety technician before the baby is born. NHTSA also recommends having a certified technician check that the seat is installed and used correctly. Follow your car seat manual and your vehicle owner's manual, and use NHTSA's car seat installation guidance for step-by-step instructions.

Plan for postpartum and a safe sleep space

• Line up help with meals, laundry, and errands for the first weeks at home
• Set up a safe sleep space. The AAP recommends placing your baby on their back for all naps and at night, on a firm, flat sleep surface, and sharing a room but never a bed.
• Plan your postpartum care. ACOG recommends contact with your obstetric care provider within the first 3 weeks after birth, and describes postpartum care as an ongoing process rather than a single visit.
• Read about preparing for postpartum care at a birth center

Around 36 to 37 Weeks

• Expect more frequent visits. Many care plans move to weekly visits from about 36 weeks. Ask your care team what your schedule will be.
• Group B strep screening. The CDC says pregnant people should be screened for group B strep bacteria during the 36th or 37th week of each pregnancy. The test is a simple swab of the vagina and rectum.
• Confirm when to call. ACOG suggests talking with your care team about when to call and whether to call first or go in directly. Ask your midwife how and when to reach them in labor, and save the number in your phone and your support person's phone.
• Finish your pediatrician plans. Keep the practice's name, address, and phone number handy. New York's Newborn Screening Program advises choosing a primary care provider for your baby before birth if possible.

From 37 Weeks Until Birth

ACOG defines 37 weeks through 38 weeks and 6 days as "early term," and 39 weeks through 40 weeks and 6 days as "full term." From here, keep your bag and car seat ready, and review what to watch for.

Signs that labor may be starting

ACOG lists these signs, though you may or may not notice them before labor begins:

• Lightening, the feeling that the baby has dropped lower into your pelvis
• Loss of the mucus plug
• Rupture of membranes (your water breaking)
• Contractions

Follow the instructions your midwife gives you about when to call and when to come in.

Warning signs that need a call right away

Contact your midwife or care team right away if you notice any of these. ACOG lists them as reasons to seek care:

• Your water has broken and you are not having contractions
• You are bleeding heavily from the vagina
• You have constant, severe pain with no relief between contractions
• You notice the baby is moving less often

Pay attention to your baby's usual pattern of movement. ACOG notes that your health care professional will tell you how often to count movements and when to contact them. MedlinePlus advises calling your doctor or midwife if your baby suddenly seems to be moving less.

The CDC's urgent maternal warning signs also need prompt care: a headache that won't go away or gets worse, dizziness or fainting, changes in your vision, a fever of 100.4°F or higher, extreme swelling of your hands or face, thoughts about harming yourself or your baby, trouble breathing, chest pain or a fast-beating heart, severe nausea and throwing up, severe belly pain that doesn't go away, your baby's movement stopping or slowing, vaginal bleeding or fluid leaking, severe swelling, redness, or pain of your leg or arm, and overwhelming tiredness. In an emergency, call 911.

Questions to Ask Your Midwife in the Third Trimester

• Is my pregnancy still a good fit for a birth center birth, and what could change that?
• How often will I be seen from now until birth?
• When should I call you in labor, and when should I come in?
• What does the birth center provide, and what should I bring?
• Which hospital would I go to if I needed to transfer, and what would happen?
• When will you check on me and my baby after we go home?
• Who should I call with questions in the first days at home?

Getting Ready to Go Home Within Hours

After this kind of birth, much of your recovery and your baby's first days happen at home. Before labor:

• Set up the baby's sleep space and a place for diaper changes and feeding
• Stock simple meals and arrange help for the first few days
• Make sure your baby's first checkup is planned. The AAP recommends that newborns be evaluated within 3 to 5 days of birth.
• Learn the newborn warning signs that need a call

At Birthing Center Long Island, your midwife checks on you and your baby in the first 24 to 48 hours after birth, with a newborn assessment, newborn screening, and lactation support. Care continues with a postpartum home visit and ongoing check-ins in the days and weeks ahead.

A Note From Our Midwifery Practice

The third trimester can feel like a long to-do list. Most of it is simply about knowing your plan, your people, and your route, so labor day feels familiar when it comes. You don't need to finish everything at once.

Bring this third trimester checklist to your next prenatal visit and ask your midwife which items matter most for your pregnancy. If something changes along the way, your care team will explain what it means and help you adjust your plan.