Week 36 of pregnancy (Days 252-258)

Ultrasound image of the femur of a fetus at 36 weeks gestation.

Baby

Babies born at 36 weeks tend to be smaller that full-term babies but are generally healthy and require only minimal medical support or intervention.

By the end of this week, the fetus is classed as being full-term, and labour usually begins at some point between 37 and 42 weeks. By week 36 of pregnancy fetal weight is approximately 2.7kg and fetal length is around 47.5cm from crown to heel. Weight gain is continuing steadily at a rate of around 25g per day Although bones and cartilage have been hardening over the past few weeks, they will remain relatively soft and pliable, allowing greater flexibility and ease of passage during the birthing process. All major organs and systems, such as the circulatory system are now fully developed and functional and the digestive and intestinal systems are fully matured and will start to function during the first feed after birth.

You

You may notice that the position of your bump is altering and appears lower. This could be a sign that the baby is engaged, ready for birth. Engagement means that the baby has turned head-down, with its head pressing against your cervix. Your midwife will be able to confirm the position of your baby by feeling your stomach and should be able to tell you if the baby is engaged. If your baby is engaged, you may find it easier to breathe and have less digestive discomfort as more of the baby is now housed in your pelvic area and your lungs and stomach now have more room to move and function normally. However, you may also find that walking is somewhat more uncomfortable due to the added pressure in your pelvic area.

The increased pressure in you pelvis and lower abdomen can also lead to constipation – or worse constipation if you are already suffering from it. Eating several smaller ‘mini meals’ can help, as it will place lower demands on your digestive system. It can also help to alleviate digestive discomfort such as heartburn and trapped wind. Ensuring that you drink plenty of fluids can also help to manage constipation. Ensuring that you keep up your fluid intake can also help to lessen any swelling that you may be experiencing in your legs, ankles and feet by helping to flush out any excess sodium and other waste products from your system.

Many women find that, by this point in their pregnancy, their breasts have started to leak a little colostrum. Colostrum is the rich, first breast milk that will help to boost your baby’s immune system. Production of colostrum before your baby is born is normal for many women and is part of your body’s preparations for looking after your baby after birth.

You may also be experiencing Braxton Hicks or ‘practice’ contractions. Although they are common during the third trimester, many women are concerned that they are actually the beginning of labour. Braxton Hicks differ from actual contractions because they are not usually painful and they do not increase in length and intensity over time. ‘Real’ contractions, as opposed to Braxton Hicks, will become increasingly strong and more painful and will occur more frequently (become closer together) over time.

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.

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.

You can have a private, one to one birth preparation session with an experienced midwife, including relaxation techniques for labour.