Week 38 of pregnancy (Days 266-272)

Baby

Now weighing between 3kg and 3.2kg, fat deposits are continuing to build up under the skin and weight gain will continue until birth. Although all major organs and systems are now in place and fully developed, the lungs are still maturing and the respiratory system is the last to mature. It may take a few hours for your baby to establish a regular breathing pattern, even after birth, but health professionals will closely monitor this.

The vernix (the protective coating that covers the body) and the lanugo (the fine covering of hair), both continue to shed during this week, although some babies may still have a little of the vernix on their skin at birth. Production of surfactant also increases during this week. Surfactant is a substance that helps to lubricate the air sacs within the lungs and makes breathing easier after birth. Small, but significant developments are also still occurring in the brain and central nervous system.

A good volume of amniotic is important as an indicator of the health of the baby. The most reliable way to check this is by ultrasound scan.

You

You are unlikely to gain any more weight between now and giving birth. Carrying the extra weight is likely to be causing you some aches and pains, and back pain is especially common during late pregnancy. Getting plenty of rest and putting your feet up can help and many women find that a massage – using pregnancy-safe oil – is beneficial. If your baby’s head is engaged, and is now sitting in your pelvis, you may find that it is putting pressure on your bladder and causing you to urinate more frequently. Although this may be inconvenient, you should not reduce the amount that you drink as staying hydrated in important throughout pregnancy. Avoiding diuretics such as caffeine can help.

Some women experience a bout of diarrhoea before they go into labour. This is the body’s way of ensuring that the bowel is empty during delivery to create more space for the baby to pass through. If you do suffer from loose bowel movements, it may help to avoid fatty foods and eat light meals. Another sign that labour may be imminent is a ‘show’. This is a pinkish or brownish mucous that is discharged from the vagina and is a signal that the cervix is starting to dilate.

You are likely to be producing colostrum by now. Colostrum is the first breast milk and is a creamy, yellowish colour. You may find that it leaks from your breasts and you may notice staining in your bra. You may want to wear breast pads to avoid this. Colostrum is higher in protein and lower in fat than subsequent breast milk. This makes it more easily digestible. It also contains antibodies that will help to boost your baby’s immune system.

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 becoming 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. When the midiwfe examines you she will feel for the level of the head engaging. She will also try to judge the size of the baby and the amount of amniotic fluid. 

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. Good movements, normal amniotic fluid and normal Doppler on ultrasound scan are very reassuring. In a private clinic you can have a swab to screen for Group B Streptococcus.

A private midwife can offer a one to one birth preparation session including relaxation techniques for labour.

You may like a reflexology session to relax your body and mind, it is important to choose a pregnancy safe practitioner.