YOUR BABY:
The baby is making final preparations for life outside the womb. Reflexes are coordinated so the baby can blink, close its eyes, turn its head, grasp firmly and respond to sound. By the 38th week, most of the baby's lanugo (downy hair) and the vernix (whitish coating) are disappearing. The baby's intestines are accumulating a lot of meconium (baby's first bowel movement). The baby's head will drop into the mother's pelvis if he/she is head-down. For first time moms, this "lightening" may not occur until after she goes into labor. Moms that have had previous babies may have this happen during the last few weeks of pregnancy. At 38 to 40 weeks, the baby is full-term. By the end of the month, the baby weighs about 7-1/2 pounds and is over 21 inches long. A normal fetal weight can vary from 6 lbs to 10 lbs, depending on family genetics, the mother's diet and individual differences between babies. The length of the baby can vary between 18 inches and about 22 inches or so.
The big day is just about here! For the last few weeks, your uterus may remain the same size and your weight gain should level off around 25 to 35 pounds. However, depending on individual differences and diet, you may gain more than 35 pounds. This may be extra "baby fat" that you will gain and need to work off after the birth to regain your former weight. If you are breastfeeding, these extra pounds will be easier to lose than if you are not breastfeeding since you burn extra calories when you breastfeed your baby (besides giving him or her the best possible start in his or her life). If you are expecting twins, you will be encouraged to gain more than 35 lbs to maintain a multiple pregnancy. Midwives are not so concerned about weight gain as many other health care providers as long as your diet is good and you are not indulging in excessive fast foods or unhealthy eating patterns.
You may not be getting much bigger, but you will feel more uncomfortable and perhaps a little anxious to hurry and "get it over with". Backache, constipation, heartburn and swelling of the ankles and feet may continue, as well as swelling of the hands and feet. Take frequent breaks during the day and put your feet up. Do not spend long periods of time standing on your feet. Don't over-do activities. Conserve energy and take it a little easier on yourself at this stage of pregnancy. You will need your energy reserves for your upcoming labor and birth.
You may find yourself having to urinate frequently since your uterus is pushing on your bladder. If you are experiencing urinary leakage, you may want to wear some protective pads in your underwear to help you from having an embarrassing moment.
You may experience difficulty sleeping at night, as it is hard to find a comfortable position. This is normal. Try propping your shoulders, neck, legs and belly up with lots of pillows for support. Rest as much as you can. If you are tired, try taking a nap during the day. Find activities that will help you to fall asleep (reading my chemistry or physics textbook always put me to sleep, whether I was pregnant or not). Drink a warm glass of milk before bedtime, an warm herbal tea such as chamomile may help. Just keep in mind, you do not have much longer before you will have your body back to yourself (with the exception of breastfeeding) and you will be able to find a comfortable sleeping position after the baby is born, although you may still not get much sleep due to nighttime feedings. If you still have problems and are becoming over-tired, discuss it with your midwife.
Vaginal discharge may be heavier now and will have more cervical mucous in it as your body prepares for labor. Sometimes you will have a mucous discharge tinged with a little blood. This means you are losing your cervical plug that has closed off your uterus from your vagina during your pregnancy. This is normal and usually indicates that your labor will start soon and your cervix is beginning to open up.
Braxton Hicks contractions are irregular and can be very uncomfortable. Use the contractions as a time to practice your breathing and relaxation techniques you will be using during the labor and birth. Your uterus is practicing and preparing for your delivery and although they may not be regular and may stop and go, they are still performing a function. Some women are dilated to 2 to 4 centimeters before they actually go into labor. This is normal.
You may notice you have a bit of diarrhea or really soft stools just prior to starting labor. This is nature's way of cleaning out your bowels for the birth and usually means labor will be starting soon. If you have had problems with constipation, be sure to drink plenty of fluids and consume plenty of fiber in your diet to prevent late-date constipation issues. Do not use laxatives or stool softeners without discussing it with your midwife. Try to relieve any constipation issues with your diet. If you have problems with hemorrhoids, try using pads soaked in witch hazel to soothe them and help them to shrink. Do not strain when moving your bowels. You may use a stool for your feet to help take the pressure off hemorrhoids when you need to use the bathroom.
Another sign that labor may start soon is a "nesting instinct" that may occur with most women. They get a sudden burst of energy in preparation for the birth of their baby. They may want to re-decorate the nursery or clean house. This is fine as long as it is not overdone. Leave any lifting or moving of objects, ladder climbing, or other major tasks to your partner to do. This is not the time to have an accident or fall. Pulled muscles and ligaments/tendons can cause a great deal of unnecessary discomfort and may inhibit you during your labor. Supervise a re-decoration effort or housecleaning endeavor rather than getting into the middle of the activity.
It is normal for women to deliver their babies sometime between the 37th week and the 42nd week of pregnancy. Your baby and your body determine when labor starts. Do not get anxious or worried if you should happen to see your due date come and go and still no labor. Labor starts when labor starts. Call your midwife when you feel contractions start and become fairly regular. Don't become worried that it may be a false alarm. As a midwife, I would prefer to come to a false alarm (considering it to be a trial labor run) than to miss the birth because the mother wasn't sure she was in real labor and waited too long. Call your midwife if your water breaks, with or without labor.
The more prepared you are (physically, mentally, emotionally, and spiritually), the better your experience will be. Trust in your body and your baby's ability to go through labor together. You were made for each other and to go through this process together.
HAPPY BIRTHING!
MoonDragon's Pregnancy Information: Backache During Pregnancy
You will be seeing your midwife or health care provider weekly. Your weight and blood pressure will be recorded. Urine testing is also performed to check for the presence of sugar and protein. The height of the uterus and fetal growth will be measured to evaluate the overall growth of the baby. If your uterine height lessens, this may mean that your baby has dropped into the pelvis. If this happens, you will be able to breathe better, but you will have more pressure on your bladder and in the pelvis region. I often equate this to feeling like you are having a watermelon stuck between your legs. You may walk differently (more of a waddle than a stride). You can discuss any symptoms or discomforts you may be experiencing with your midwife. Fetal heart monitoring is performed. Late in the pregnancy, your midwife may check to see how far the baby's head has dropped into your pelvis. You may be checked to see whether your cervix has begun to stretch and open (cervical effacement and dilation). A fetal non-stress test may be performed to ensure the baby is still doing well.
Continue learning all you can about labor, birth, postpartum and newborns! If you are having a son, now is the time make the decision regarding circumcision. Enjoy these last few moments as a couple or as a family. Make sure you have made arrangements for childcare for any older children, if they are not attending the birth.
BIRTH PREPARATION
Stock the freezer with foods that can easily be popped in the oven or microwave after the baby is born. This is helpful no matter where you are planning on having your baby and can be a real time saver the first few weeks after the baby is born. If you are planning a homebirth, plan to have ice cubes/ice chips frozen and prepared for the labor. Soups, juices, herbal tea, and light snacks may be prepared and stored for your labor at home to keep your energy up and provide you with nutrition during labor. Your digestion slows or even stops during late labor so it is important to keep liquids and snacks light and non-acidic in case you have problems with stomach upset during labor. A good juice to have on hand is apple juice since it is easy on the stomach and provides natural sugars for energy.
Pack your labor bag for the hospital. This should be done whether you are planning a homebirth or a hospital/birth center birth. Most homebirths go along smoothly, but occasionally something comes up in during a labor or birth that requires a transport to a medical facility for delivery. If you are planning a hospital or birth center birth, make sure you have completed the pre-admission forms for the facility.
Make sure you have collected all of the necessary baby items - clothes, car seat, furniture and other things you may need. If you are planning a homebirth, make sure you have all the supplies you need for your delivery. Your midwife will have given you a list for needed items. Talk with your midwife about the delivery. You will learn the signs to predict labor and how far apart contractions should be before calling your midwife or heading to the hospital or birth center for your delivery. If you are having a homebirth, you will need to let your midwife know when contractions have started or if your water has broken (with or without contractions) and allow her travel time to get to your home. Your midwife may do a home visit, if she hasn't already, to do a "dry run" and be sure she can find your home without problems and to check on your supplies and become familiar with your home. If you are planning on having children or other family members present at your homebirth, your midwife may want to discuss your plans with your birth guests and let them know what to expect for your labor and birth. They may be assigned tasks during the labor and birth to help out (such as taking pictures, labor support, fetching foods or supplies, childcare).
Continue taking your prenatal supplements as recommended by your midwife or health care provider. Often a prenatal vitamin supplement may be recommended in addition to a good prenatal nutritional program with adequate protein, vitamins, minerals (including sodium) and calories.
A diet with adequate protein is important to help prevent toxemia of pregnancy, called preeclampsia/eclampsia. Although researchers and practitioners do not know exactly why toxemia occurs, it has been show that a good nutritional program with sufficient protein and salt has helped to prevent or reduce symptoms associated with the disorder. Salt your food to taste. Your expanded blood volume requires a certain amount of salt to maintain your bodily fluid. Nutrition is important to help your baby put on the weight it needs for survival outside the uterus. As the uterus grows, it may be more difficult to eat a full meal because of the upward pressure of the uterus against the stomach and intestines. Break your meals up into 6 to 8 smaller meals throughout the day instead of 3 larger ones. Not only will this help with your digestion issues, but it will help keep your blood sugar on a more even level to help fatigue. Be sure to include dark green leafy vegetables and other iron-rich foods in your diet if you have problems with anemia. It is important that your blood has sufficient iron and other necessary components for clotting to prevent problems with hemorrhaging after your baby is born.
PREGNANCY TEA
Some midwives (including MoonDragon) will recommend an herbal Pregnancy Tea to be taken during pregnancy. This may be especially important in late pregnancy for women having problems with anemia or need a little dietary boost in their nutrition. The pregnancy tea helps to provide not only fluids, but also important iron, calcium and other necessary dietary components that a mother will need to prepare for labor and delivery.
MOONDRAGON PREGNANCY TEA
2 parts Red Raspberry Leaf
1 part Nettle Leaf
1 part Alfalfa Leaf
1 part Peppermint Leaf
Mix dried herbs well and make into a tea that can be consumed hot or cold. It makes a great sun tea that can be refrigerated and used throughout the day. I usually recommend at least a quart of this tea daily. The red raspberry leaf is a good all around female herb and uterine toner. The nettle and alfalfa are high in iron and calcium. The peppermint leaf is good to soothe digestive problems and provides a nice minty flavor to an otherwise "green" tea flavor. During labor, having this tea available to drink keeps the mom's fluids up and her body hydrated, easing labor pain. It also provides a good tea base for adding any herbal tinctures that may need to be given during labor or after the birth. The tea can be frozen into ice cubes or ice chips to be used during labor. If you need a little sweetener or an extra boost of fast energy during labor, a bit of honey may be added to the tea, but I find it tastes fine unsweetened. If your midwife is adding tinctures to the tea during your labor and birth, many tinctures do not have a great flavor, so a little honey may be necessary to be able to drink the tea. Mountainrose Herbs (see link near bottom of this page) has an excellent organic herb selection that can be purchased in bulk at very reasonable prices.
Some midwives may recommend an herbal "6 week formula" that should only be taken the last 4 to 6 weeks of your pregnancy. This formula contains herbs that should not be taken at any other time during the pregnancy. They prepare you and your body for delivery. Consult with your midwife about whether or not she will want you to take this formulation.
EXERCISE & RELAXATION
Continue to get daily moderate exercise, such as walking, which is good for the muscles you will be using during labor, and swimming. As your uterus grows, your center of balance shifts, You may want to avoid high heeled shoes and instead wear shoes with small wider heels to help with balance and to prevent falls. Be careful how you move since your ligaments are being stretched in your abdomen. A wrong move can prove to be very painful if you pull your ligaments while trying to move or stretch. If you must bend or lift something, do it with your legs and not your back. Consider learning prenatal yoga to help you with stretching and moving your body and breathing control as well as meditation and relaxation.
Ask your midwife or health care provider before taking any prescription drugs or over-the-counter products. You should not be smoking and drinking alcohol or using street drugs.
Maintain and positive lifestyle and outlook. Keep stress down since it has a negative effect on your baby. Practice your relaxation and breathing techniques that you are learning or have learned in a childbirth class.
MoonDragon's Pregnancy Information: Pregnancy Calendar Index
Photos obtained from A Child Is Born by Lennart Nilsson
and Pregnancy - in anatomical illustrations by the Carnation Company
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