Although around half of all pregnancies exceed 40 weeks, there is little fetal development from this point onwards. Weight gain and gain in length are both minimal from this point, although a small gain of around 100g is usual.
The placenta is still fully functioning and supplying antibodies that will help strengthen the baby’s immune system and aid in fighting infections during the first few months of life. Breast milk also contains antibodies and will continue to boost the immune system after birth.
Enough subcutaneous fat has now accumulated to allow the baby to control its own body temperature after birth. The greasy white coating that has been protecting the delicate skin continues to shed during this week and will be absorbed into the amniotic fluid.
Although it is common for pregnancies to go beyond 40 weeks, it is extremely likely that your baby will be born at or before 42 weeks, as most doctors will induce a baby at this point.
A clear indication that labour is imminent is the rupturing of the amniotic membranes; also known as your waters breaking. Although this is not usually as dramatic as it sounds; you may notice a pale liquid leaking from your vagina. Some women do experience a gush of fluid. If you think that your waters have broken, you should contact your midwife. The majority of women do not experience a rupture of the membranes before the onset of labour however, and most women are in hospital when their membranes actually break.
Fetal movement is likely to have slowed down by this point due to restricted space in the uterus. You should still be able to feel wiggles and flutters though and, during periods of wakefulness, your baby will make an average of 10 movements an hour.
Symptoms to watch out for
It is normal to be swollen and tired, lacking sleep. There can still be signs of pre-eclampsia and obstetric cholestasis at this time.
Painless Contractions, increasing discharge with bloody show or water breakage are signs that labour may be about to commence. Labour does not begin at a particular point. It begins over time. It is like a plane at the airport going around the taxi ways waiting to go on the runway to take off. It can speed up and slow down before it goes on the runway and finally takes off. It can even speed up and slow down on the runway, several times. Passage of blood mucus or breakage of the waters is contributory evidence to the process become established. It is important not to go to the hospital until the evidence is well developed.
What is routinely offered on NHS
You will be seen at any time by the midwife at this stage. Ideally she can check your cervix at home so that you can avoid going to hospital too early if you think you are in labour.
What other care is available
An additional scan, midwife or consultant opinion can be accessed in a private clinic. There is no need for a referral letter. This can help you with decisions about delivery. You can have more time to discuss. In a private clinic you can have a swab to screen for Group B Streptococcus.
If you are delivering privately you will see a private doctor or midwife whenever you need to. The doctor will periodically use ultrasound to check your baby's growth, amount of amniotic fluid and that the placenta is working well.
You can book a private breastfeeding consultation to help with your newborn's feeding.