Your baby is now considered to be fullterm. By now your baby will be curled into the “fetal” position, filling the whole of your uterus. His range of movements will be restricted to a kicking and a bit of stretching and maybe attempts at rotating. Your baby will continue to lay down fat deposits under his skin and will be practicing all the movements you’ll see after he is born, e.g. breathing, suckling, swallowing, blinking, grasping and clasping her hands, head turning, kicking and stretching, maybe even sucking his fist or thumb. You may notice a slight reduction in the number of movements you feel – your baby is likely to have quite distinct periods of activity and longer periods of sleep. (If you do not feel your baby moving regularly and you are concerned, you can drink a glass of iced water and see if this stimulates movements, if not, you should arrange an appointment for your LMC midwife or doctor to listen to your baby’s heartbeat a.s.a.p. ) Your baby will now probably weigh 3- 4kg and measure approximately 51cm tall.
Your body: By now, lots of women are feeling completely over being pregnant and impatient to meet their babies. Remind yourself and others, that the due date you’ve been given is only an average and it is completely normal for a baby to arrive after the estimated due date as long as mother and baby are well.
It is usual for you to see your LMC midwife or doctor for a check-up each week during this time.
Postdates or overdue?: The normal length of pregnancy is between 37 and 42+weeks. Your Expected Due Date (EDD) is 40weeks right in the middle of this normal range. Despite commonly used terminology, your baby is not overdue simply because he has not been born on his EDD. In most cases pregnancies that continue past the EDD represent a completely normal variation of the average. Although it is hard not to be disappointed about your baby’s “no show” and completely “fed up” with being pregnant, it can help you (and your relations and friends), to be aware that 60% of babies are born after their EDDs.
The best time for your baby to be born is when he is fullterm and this is not necessarily on the EDD you have been given. Some babies do remain in utero (in the womb) past the best time for them to be born. Your baby’s placenta has a limited life span and this is different for every mother and baby. If your pregnancy continues past your placenta’s “use by” date, it will no longer efficiently transfer oxygen and nutrients to your baby and your baby will exhibit symptoms of postmaturity e.g. slow growth, reduced movements, reduced amniotic fluid volume etc. This can happen before or after the EDD and this is one of the reasons why your visits to your LMC become more frequent as you approach your EDD. If your pregnancy lasts more than one week past your estimated due date (or if your LMC midwife or doctor is concerned that your placenta might not be functioning efficiently at any stage of pregnancy), s/he will probably recommend that you have a test called a Fetal Biophysical Profile. This test uses ultrasonic technologies to assess fetal movement, tone, reactivity, breathing movements and amniotic fluid volume and gives your baby a score out of 10. If your baby gets a score of 8 or more, it indicates that your placenta is still providing adequate nourishment for your baby, i.e. if you have passed your EDD your baby is probably postdates rather than postmature and, in the absence of any other problems, you can safely and normally remain pregnant till your labour starts spontaneously.
Stop Work: If you are in paid employment you should have started your maternity leave by week 37. Even if you have a really cruisey job/boss and can come in late, leave early etc, you should reduce your working week down to around 3 part-time days around now. You need plenty of time to prepare physically, mentally and emotionally for the huge transition that is ahead. Take time to enjoy these last days/weeks of pregnancy and if it is your first baby, to enjoy doing whatever you feel like. If you already have a child or children you will have less self time and probably less time to rest – try to organize regular childcare and/or playdates for your other child(ren) so that you can focus on yourself and your nearly newborn baby for a few hours and get a daytime nap, or at least some uninterrupted relaxing time.
Pack your bag: If you are planning to give birth in a maternity unit or hospital, around now you can celebrate by packing the non-perishable items you want to have on hand for your labour and will need during the first 12+hours after your baby is born. Use the list below as a guideline.
Clothing – you can wear your own clothes during labour or a hospital gown. If you would prefer to wear your own clothes pack a couple of comfy tops or T.shirts. You may also want to pack a bikini top and/or a couple of crop tops to wear in the pool if you don’t fancy being totally naked.
- Massage oil or massage wax
- Extra pillows in coloured pillowcases so you remember to take them home
- Hotpacks (Wheat/rice pack or gel pad) and cold packs (a bottle of frozen water wrapped in flannel makes a passable cold pack)
- Drinks including bottled water
- Lip Balm or moisturizer
- Camera – fully charged
- Music – CD player or Ipod and dock etc
- Soap, shampoo & conditioner, toothbrush and toothpaste
- Maternity/nursing bra
- Extra knickers
- Dressing gown or robe or coat
- Shawl or cardigan
- Slippers and shoes
- Baby clothes – most hospitals provide nappies and possibly some kind of shirt for the duration of your post birth stay but at the very least, you will need a full set of clothes for your baby for coming home. i.e.
- Vest or singlet
- Socks or booties
- Cardigan or jacket
- Hat that covers your baby’s ears
- Rug or blanket to put over your baby in her carseat
- Baby carseat
Signs of Labour: A number of things can happen that will indicate that you will soon be in labour, but you are not in labour until you are having regular contractions.
Contractions: You know you are having a labour contraction when your uterus (and abdomen) go hard (like a tightly pumped up ball) and you feel some sort of low abdominal sensation usually at the level of your pubic bone in the front and occasionally in your lower back instead or as well. Both of these things (uterine tightenings and pelvic twinges/pains) have to be happening at the same time for you to be having a labour contraction. These sensations can be very mild to start with – a twinge or feeling of pressure, or period-like pain – but they will grow to become a pulling, stretching or tightening sensation that gets stronger as time goes by. Contractions are intermittent not continuous i.e. they come and go. As your contractions become more established you will probably notice that they have a wave-like pattern i.e. they start fairly mildly build to a peak of intensity then slowly fade away giving you a period of minutes when your body feels as relaxed as usual.
Prelabour contractions can feel the same but they are more random in terms of their intensity and frequency and disappear before establishing into a pattern of being longer and stronger and closer together . Prelabour contractions often come and go depending on what you’re doing e.g. if you might be up and moving and notice that you are having contractions then you lie down and they disappear or vice versa. Or, you are having contractions then you get into a warm bath and they disappear. Or, you notice them later in the day when you are tired but if you have a sleep they disappear etc etc.
Active labour contractions get longer, stronger and closer together over a period of time. Active labour contractions require all your attention – they will stop you mid-sentence or mid stride. You will need to focus to keep your breathing regular and you will probably be needing to use some labour coping techniques to help you to stay relaxed and allow these contractions to do their work. You are not considered to be in active labour until your contractions last for at least one minute and are 5 minutes or less apart and have been at this frequency for at least one hour. This is called the 1 – 5 – 1 rule. When your contractions are coming at this level of frequency your LMC midwife or doctor will usually advise you to go the hospital or will come to your home if you are planning a homebirth.
Waters breaking: For about 10% of women the first sign of labour is sudden loss of fluid from the vagina – this usually means that the amniotic sac has torn and amniotic fluid is draining out. Note the time, and the amount and colour of the amniotic fluid that is leaking out. Wear a sanitary pad and keep any sanitary pads for your LMC to see. If the fluid loss is clear, contact your LMC during regular working hours. If the fluid loss is dirty-looking, greenish or brown, contact your LMC immediately. The time between waters breaking and the onset of contractions is enormously variable. Some women’s waters will break and within 5 minutes they will have had their first labour contraction, while other women will wait hours before they have their first contraction.
Warning Signs: You should call your LMC midwife or doctor immediately
if you experience any of the following:
- Any vaginal bleeding (not the “show” which is often blood stained mucus). Wear a sanitary pad (keep any sanitary pads for your LMC to see)
- Sharp stomach pain or severe cramping
- Persistent or severe headache.
- Dizziness or visual disturbances (fuzzy vision, seeing spots or flashes)
- Persistent vomiting (cannot keep water down)
- Pain or burning sensation while urinating or inability to urinate.
Eat well: Your uterus is a muscle that will function more efficiently if it is well nourished and well hydrated. Labour (first labour especially) is a bit like a marathon, you need to be physically and mentally well-prepared and you need to have a good amount of energy on board so that you last the distance. Eat small meals approximately every four or five hours so that your energy levels are high but you are not “weighed down with food or using excessive amounts of energy to digest large/heavy meals. You also need to drink regularly. Try to remember to drink at least one cup of fluid every two hours between meals. Your labour will establish (and progress) more efficiently if your muscles are well-hydrated.
Exercise: Continue with regular gentle exercise. This will help you to maintain strength and stamina and reduce the intensity of the common discomforts of late pregnancy. Do some stretching exercises each day at home as well as continuing to attend a pregnancy exercise class if you’re still able. Go for short, leisurely walks once or twice each day if your pelvis allows. Swim or water walk regularly, especially if you are unable to do any other form of exercise.
Rest: Your night-time sleep is likely to be quite interrupted by now so you need to make sure that you have a nap or at least a substantial rest at some point each day. Your labour could start at any time, day or night. You will be better able to cope if you are as well rested as possible.
Relax: Labour is a series of big muscle stretches. During labour the neck (cervix) of your uterus, then your pelvic muscles and vagina stretch open to let your baby out. Your muscles will not stretch if you are not able to relax. Practising relaxation during your pregnancy will help “train” your subconscious mind to instigate a relaxation response to whatever stimuli (a word or phrase, an idea, a visualization, a piece of music, a certain type of touch) you have practiced relaxing to. You need to be able relax actively (e.g. propped up in a labour enhancing position, maybe rocking or some other repetitive movement), or passively sitting or lying supported in some labour enhancing position and doing nothing except breathing and consciously releasing tension from all your muscles so that you feel as soft and flopsy as a rag doll. All relaxation requires even breathing so you need to continue to practise breathing gently and evenly, focusing on lengthening your exhalations. Relaxing to the same music each day will have the added benefit that this music is heard by your baby and the hormones and he will become accustomed to the hormonal state that you induce when you relax. After he is born it is likely that this same music will help your baby to relax.
Baby movements: Your baby is now very tightly packed in your body and has less and less space for movement, so you may notice a change in both the quality and frequency of her movements. You could make a fetal kick /movement chart so that you become consciously aware of your baby’s active times. You can download a fetal kick chart at www.babypartner.com/tools/charts/pregnancy/fetal-kick-chart.pdf Although you may feel less frequent movements now that your baby has entered your pelvis you should be feeling some vigorous kicks and movements each day (your placenta is attached to the front of your uterus). If you are concerned that you haven’t felt any strong movements for 12 – 24 hours, drink a glass of iced water. The sensation of cold will usually get your baby moving. You can also try lying quietly on your left side for 1 hour then rolling over onto your right side, if you still don’t feel any movements. If neither of these tests result in obvious baby movements, you should contact your LMC midwife or doctor.
Breastfeeding: If this is your first baby and you have attended a birth preparation course, you should have got some basic information to help you establish successful breastfeeding. However, since breastfeeding will be the equivalent of a full-time job it can be a good idea to get as much information as possible and have a refresher now that your birth is imminent. Attending a La Leche League “meeting” will give you a chance to observe and chat with breastfeeding mothers. Check out your local group for information and support with breastfeeding before and after your baby is born on www.lalecheleague.org.nz Many hospitals and maternity units also offer a one-off breastfeeding class for women booked to give birth in their facilities – ask your LMC for information about these sessions or contact your local maternity unit for times and bookings.
Baby clothes and bedding: All the clothes and bedding you have bought or gathered for your baby needs to be washed before your baby is born. Choose natural fibre clothes and bedding e.g. cotton, wool (including merino), linen, bamboo etc. Your baby’s skin is her biggest organ so it needs to be wrapped in breathable fabrics. Also your baby’s ability to regulate her own temperature is very immature, natural fibre clothes and bedding will help ensure that she stays comfortably warm and that moisture is wicked away from her skin and evaporates instead of staying on her skin and making her cold. Click here to check out the natural fibre clothing and bedding available from MAMA. Wash your baby’s clothes and bedding in a mild, biodegradable laundry powder/detergent and rinse well. Your baby’s clothes and bedding should be well enough rinsed that they not smell of the laundry powder you have used. Take advantage of any fine days to line dry your baby’s washing, the ultraviolet rays of the sun are a natural germicide.
Making Love: Remember it was loving that got your baby in so loving will help get your baby too. The hormones released during lovemaking help soften your cervix getting it ready to stretch open during labour and the hormones that cause orgasm also cause uterine contractions. (Nipple stimulation also encourages your body to release the hormone oxytocin that causes your uterus to contract.) If you’re not feeling like full-on, orgasmic lovemaking, just hanging out with your partner, kissing, cuddling, having massages, enjoying your baby’s movements, speculating about what your baby is going to be like, what its going to be like to have this new and absorbing focus in your relationship, sharing your excitement about becoming parents or enlarging your family. Taking the time to be together feeling loved and loving and bonded with your partner and your baby will help instigate the onset of your labour.