Week 37 of pregnancy (Days 259-265)

Baby

Now weighing approximately 2.9kg and measuring around 47.5cm from crown to heel, the final growth spurt is continuing and will do so until delivery. It is likely that the fetal position will not change from now on and, most commonly, the fetus will now be head-down with the head resting in your pelvic cavity and surrounded by your pelvic bones.

Fetal movements are becoming more limited due to restricted space in the uterus. It is now less likely that the fetus will kick, however there will still wriggles, and squirms. Amniotic fluid continues to be inhaled and exhaled to prepare the lungs to take their first breath.

Although all babies will now have eyebrows and eyelashes, the amount of hair on the head varies from baby to baby. Some babies are born with no hair at all, while others have a full head of hair with a length of up to 3.5cm. The lanugo – the downy body hair – and vernix – the greasy protective coating – that previously covered the entire body, will now have almost completely been shed.

Some babies are born with a little of the vernix remaining on their body, but this is no cause for concern. Both the lanugo and the vernix will be shed into the amniotic fluid and will be swallowed by the baby. They will be digested, stored in the bowel and will form part of the meconium – the first bowel movement – after birth.

You

Getting plenty of rest and trying to relax as much as possible are important during the final weeks of pregnancy. Resting can help to alleviate common symptoms such as varicose veins and swelling in the legs, ankles and feet and relaxing can help to combat stress headaches, which many women suffer throughout their pregnancy.

During your routine antenatal appointments, your midwife may examine you to check for signs that your cervix is beginning to dilate (open) and if effacement –thinning of the cervix - is occurring. These are both signs that your body is preparing for labour, but they do not necessarily mean that labour is imminent. In some women, these processes occur very gradually and take place over a number of days or even weeks, while in other women, labour can follow within hours of the beginning of the dilation of the cervix.

A key sign that labour is imminent that some women experience is a ‘show’. The blood vessels of the cervix may begin to rupture as it dilates, causing a pinkish or brownish mucous to be discharged from the vagina. Having a ‘show’ is a strong indication of the onset of labour.

Labour could start at any time from now on so many women like to make sure that they are well prepared. Having a bag packed with all the things that you and your baby will need, making sure that you can contact your birthing partner if you have one, and ensuring that you have a plan of how to get to the hospital, if you are having a hospital birth, are all ways in which you can prepare.

Symptoms to watch out for

Movement of the baby remains very important. There should be ten movements a day which are changing from kicking to rolling. Headache, swelling, disturbances of vision and swelling of the ankles and face remain as possible signs of pre-eclampsia. Itching of the hands and feet suggests obstetric cholestasis. Contractions of the tummy may become more frequent and painful. This may be associated with change in vaginal discharge. There may be pressure in the pelvis when upright and walking. If your waters break you should tell the midwife especially if it is not a normal straw coloured fluid.

What is routinely offered on NHS

Any of the above symptoms should prompt a review by the midwife or doctor. Serious concern might prompt admission to hospital for observation.

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.

In preparation for the first few days with your newborn baby, you can have a consultation with a breastfeeding consultant.When choosing a breastfeeding consultant, look for one that is accredited by the International Board of Certified Lactation Consultants (IBCLC) as a measure of experience.

Women who are having a private Caesarean section may book this at this time.