Week 32 of pregnancy (Days 224-230)

Baby

The fetus now weighs around 1.8kg and measures approximately 42cm from crown to heel. The final growth spurt is continuing, with weight gain occurring rapidly. Babies born at 32 weeks or later have a very good chance of surviving and will require considerably less medical intervention than babies born before 32 weeks. They will however still require help with breathing and feeding.

The lungs are still developing at this stage and will not be fully matured until just before birth. The fetus continues to inhale amniotic fluid to prepare the lungs for breathing air after birth. Other skills essential for life outside the uterus are also being practiced. These include swallowing and sucking.

The skin is losing its translucent appearance and becomes more smooth and opaque as body fat continues to accumulate beneath it.

If the baby is male, the testicles are likely to have now fully descended into the scrotum. In some cases however the testicles remain in the pelvic cavity at and after birth. Undescended testicles usually resolve during the first year of life with no need for medical intervention.

You

Weight gain continues at a steady rate, with most women gaining around 450g each week until they give birth. This weight gain is normal and is largely the result of your baby’s final growth spurt before birth. As throughout your pregnancy, eating a healthy, balanced diet is important for both you and your baby and there is no reason to be concerned about your weight gain if you are eating healthily. Your midwife will monitor your weight throughout your pregnancy and will advise you if necessary.

You may start to, or continue to experience Braxton Hicks. These are ‘practice’ contractions, during which you may feel your uterus clench or harden periodically. Women describe the sensation as a tightening at the top of the uterus that spreads downwards. The length of time that the sensation lasts varies between 15 seconds to two minutes and is a normal part of your body’s preparation for labour and delivery.

Many women start to feel uncomfortably large at this stage in their pregnancy and most find it hard to get comfortable in bed at night. If you are struggling to sleep because you can’t get comfortable, you could try sleeping on your side, with your knees bent and using an additional pillow as support underneath them. Cramping muscles can also disrupt sleep and are especially common in the lower leg and toes. Rubbing the cramping muscle and walking around can help. Some practitioners believe that there is a link between muscle cramps and low levels of calcium. Ensuring that you are eating plenty of dairy e.g. milk, cheese and yoghurt may be helpful in reducing the frequency of cramps. Your Doctor can advise you further on this matter.

Varicose veins are another common symptom during pregnancy. Some women choose to wear maternity support stockings or tights that contain strong elastic and can help to relieve achiness in the legs.

Symptoms to watch out for

Pre-eclampsia, vaginal bleeding, premature birth and obstetric cholestasis are important complications in late pregnancy. Pre-eclampsia manifests as headaches, disturbances of vision, swelling particularly of the legs and face and upper abdominal pain. It can result in a small baby and the tummy being smaller than it should be. Vaginal haemorrhage (bleeding) is abnormal in late pregnancy. Painful contractions can result in premature birth. Itching of the palms of the hands and the soles of the feet may be due to obstetric cholestasis which is a threat to the baby. More generalized itching is common and usually harmless.

What is routinely offered on NHS

Visits to the midwife or GP become more frequent in later pregnancy. She will ask about symptoms take the blood pressure and check the urine. The midwife will measure the tummy with a tape measure. This is a crude, basic method of estimating the size of the baby. Referral will be made to the consultant as necessary. If there is a serious threat of early birth then an injection of steroids is given to the mother which will help to protect the baby from respiratory distress.

What other care is available

In a private self referral clinic additional blood tests and ultrasound scans can be done at short notice with rapid reporting of results. This is important if the baby is smaller than it should be or not moving enough. The woman and her partner can see a consultant for opinion and advice. This is done at a convenient time and with plenty time for discussion.

Appointments with a senior midwife can be arranged on the same day if needed. Antenatal Classes for small groups and couples are available at a time that suits you.