The “Home Stretch” for You and Your Surrogate: Third Trimester Tests

Multiple medical tests and doctor appointments are normal throughout a pregnancy. As your surrogate enters the third trimester of pregnancy, this becomes even more evident. To ease any concerns that arise when the word “testing” is brought up, we’ve compiled a list of typical tests and appointments that may take place during this stage of the journey.

People in your support network may note that they weren’t exposed to as many tests as your surrogate has been during her pregnancy. Keep in mind that technology continues to evolve and new tests are being ordered as they become available. It’s a great way to monitor your surrogate’s pregnancy and doesn’t mean anything is wrong.

Office Visits

As the birth of your child nears, standard office visits will increase. Most doctors will move from once-a-month visits to bi-monthly visits at the start of the third trimester. These will increase around the 36-week mark. If your surrogate is carrying multiples, she may have more frequent appointments than someone carrying a singleton.

Office Tests

At every visit, the staff will ask your surrogate to provide a urine sample. Doctors screen the urine for protein, sugar, bacteria and possible dehydration. If present, these things could indicate gestational diabetes, pre-eclampsia or infection. You can also expect your surrogate’s doctor to track her blood pressure, uterine growth and the baby’s heartbeat.

Amniocentesis

While this test typically happens in the second trimester, following a poor result on a non-invasive chromosome screening, a  is sometimes recommended in the third trimester. This may happen if your surrogate is at risk of premature delivery as the result of a certain type of uterine bacterial infection. A doctor could also order a third-trimester amniocentesis if the fetus may have prenatal anemia. For the procedure, the doctor will insert a long needle through the abdomen and into the uterus. The goal is to remove a small amount of fluid that will contain cells shed by the fetus. The process is generally brief and presents only minor discomfort for your surrogate.

Movement Test

Doctors typically order this test also called a “kick-count” test if your surrogate is past her due date, indicates that she doesn’t notice much fetal movement or is carrying multiples. The test is simple. Your surrogate will lie on her side and monitor how long it takes to feel 10 movements. Generally, this takes anywhere from 10 minutes to 2 hours.

Non-Stress Test

Typically ordered after a poor kick-count test, a non-stress test can be routine for women carrying multiples or who have been diagnosed with gestational diabetes. In these cases, non-stress tests can become a part of the routine office visit as early as 26 weeks. For this test, doctors use a monitor to watch how the baby’s heartbeat responds as he/she moves around. Your surrogate will have a trigger to indicate when she feels motion, and doctors will reference that against the heart rate. Generally, this test takes about 20 to 40 minutes.

Group B Streptococcus Test

Up to 30 percent of women carry the Group B Strep bacteria without any symptoms. However, your surrogate can pass it along to your baby during childbirth. If that happens, it can be quite serious for the newborn. As a result, doctors will screen for GBS around the 28-week mark of the pregnancy. Since anyone can pick up the bacteria at any time in their life, doctors will test your surrogate even if she has never tested positive before. If she does test positive, think of it as a “common cold” scenario. She didn’t do anything wrong to catch it. Doctors will monitor her and test again closer to delivery. The bacteria can clear up on its own and may not be an issue later. If it is still present when she goes into labor, her doctor she will likely treat her with penicillin.

Cervical Change

Generally, around 34-36 weeks, your surrogate’s doctor will begin conducting exams on her pelvis by inserting a gloved hand into her vagina to check for changes to her cervix. As labor approaches, the cervix may begin to shorten, thin out or open. While these changes do not mean that labor is impending, it can be an indicator of when labor will onset.

Biophysical Profile

This test is done in the event of an overdue pregnancy or in the instance of other complications. Examples include if your surrogate has low amniotic fluid, decreased movement or other problems with the placenta. The test is a hybrid of a standard ultrasound test and a non-stress test. When considered together, the composite results can indicate if the baby is in any distress that could prompt an induction of labor.

See your baby’s growth – week by week

If you have additional questions, be sure to pass them along to your surrogate so that she can ask her doctor. Generally, it’s best to send these questions in writing so she knows exactly what you’d like to know.. She’s likely tired, sore and just as ready as you are for the birth to happen and you don’t want any of your questions to be forgotten. Also remember that the only person who knows exactly when your baby will be born is your baby. Your surrogate can only share with you what she feels and what her doctor says.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.