Pregnancy leads to significant physiological changes, including adaptations in the endocrine system that support fetal development and prepare the body for childbirth. Cortisol levels naturally rise during pregnancy, primarily due to increased estrogen. However, psychological stress and heightened HPA axis activity can further elevate maternal cortisol beyond normal physiological levels. This descriptive study aimed to descript cortisol levels in the third trimester among pregnant women at Rejang Lebong District in 2025. Thirty participants were selected through simple random sampling. Data were collected using questionnaires and afternoon saliva samples (0.5-1 cc), and analyzed using percentage distributions. Most respondents were aged 20-35 (86.7%), over half were primigravida (63.3%), and 66.7% were employed. The average afternoon cortisol level was 0.18, exceeding the reference value of 0.15. While increased cortisol is a normal adaptation in pregnancy, levels above the physiological range may result from factors such as stress, anxiety, depression, or poor sleep, potentially affecting maternal and fetal health. It is essential for healthcare providers, particularly midwives, to offer comprehensive antenatal care, encompassing stress and anxiety monitoring, as well as education, counseling, and psychosocial support.

Anxiety, Cortisol Level, Pregnancy, Midwife