38 Weeks, 2 Days - The 39th Week

My Symptoms
I resisted the urge to clean out the refrigerator, but I still think I've been nesting. Saturday had me cleaning all day. I even washed down the walls in the dining room. My house is nice and clean (except for the refrigerator) and now I won't feel bad when my parents come out. Before I would have been humiliated had they seen my bathroom. I'm looking forward to this weeks appointment. I don't think I've dropped yet, but I still feel like I could go "any time." I kind of think I've been losing my mucus plug slowly. Meaning no big chunks, but I've had lots of really gross gooey stuff showing up. I know it's common for more discharge, but this is really ridiculous. I can't think of much else. I have trouble getting comfortable, I'm always hot and I can tell my hands are swollen. I feel better about work now. I brought home a project this weekend that I got mostly finished. I've now accepted that I probably won't get everything finished at work and I just do the best I can and make sure everything is in it's place when I leave at night and I have notes everywhere! Sorry friends that I haven't been e-mailing, no good excuse really, except I really am working constantly. I stayed until 6:30 p.m. tonight. No one can say I've been slacking off because of this pregnancy.

The Baby
Your baby weighs a littl more than 7 pounds. By this point in your pregnancy, crown-to-rump length is about 14.4 inches. The baby's total length is 21.5 inches. Your baby continues to gain weight, even up to the last week or two of pregnancy. It doesn't have much room to move inside your uterus. At this point, all organ systems are developed and in place. The last organ to mature is the lungs.

Birth could happen at any time. The baby's bowels are filled with meconium, a black, tarry substance which will become baby’s first bowel movement.

Your baby's ready to greet the world! He continues to build a layer of fat to help control his body temperature after birth, but it's likely he already measures about 20 inches and weighs a bit over 7 pounds. (Boys tend to be slightly heavier than girls.) Your baby's organs are fully developed and in place, and the outer layers of skin are sloughing off as new skin forms underneath.

Did you know that the amniotic fluid is continually replaced, even in labor, at the rate of every three hours? Pretty amazing stuff! We really don't know where amniotic fluid comes from, although it is partially comprised of urine, sweat and other fluids from the baby. Your baby has been practicing breathing the amniotic fluid for many weeks in preparation for the big event! The meconium in the baby's intestines will be shed as the first movement that the bowels make after birth. Meconium is a black, thick, tarry substance that is hard to get off of their rear ends! About 30% of the time, the baby will actually pass this stool before birth. This can cause problems if the baby swallows the meconium, however, that is not likely if the proper suctioning is done at birth. This can be done by a doctor or a midwife, even in a homebirth situation.

The Mom
If you measure from the pubic symphysis to the top of the uterus, the distance is 6.4 to 8 inches. You're almost at the end of your pregnancy. Your weight should not increase much from this point. It should remain between 25 and 35 pounds until delivery. It would be unusual for you not to be uncomfortable and feel huge at this time. Your uterus has filled your pelvis and most of your abdomen. It has pushed everything else out of the way. At this point in pregnancy, you may think you'll never want to be pregnant again because you're so uncomfortable.

Use this time to rest, prepare for baby, and consider the future. Long slow walks may help to bring on labor. Many women lose their mucus plug a week or two before delivery (though for others it doesn’t happen until right before delivery). If the mucus is pink or streaked with blood, it is known as the "bloody show" and usually means labor will begin within the next day. You may feel more fatigue or increased energy. Both are normal. With that heavy baby lodged deep in your pelvis, you may be running to the bathroom every two minutes! Notify your care provider immediately if you pass amniotic fluid!

At each visit, your midwife or doctor will do an abdominal exam to check your baby's growth and position. She might also do an internal exam to see whether you've started effacing (when the cervix thins out) or dilating (when the cervix opens). If the week passes and your baby stays put, don't panic. Only 5 percent of babies are born on their scheduled due date. And your baby can't make you wait indefinitely for his arrival. If you go past your due date, your provider will schedule you for fetal testing (usually a sonogram) after 40 weeks to ensure that it's safe to continue the pregnancy. If you don't go into labor on your own, most practitioners will induce labor when you're between one and two weeks overdue. Pregnant women on television sitcoms always have their water break dramatically — in the middle of a crowded room, of course — just before going into labor. Don't worry about a similar scenario happening to you. Membranes rupture before the beginning of labor in less than 15 percent of pregnancies, and it's not normally an enormous gush — usually a small gush or a slow leak. In any case, if your water does break (or you even suspect you might have a leak), call your doctor or midwife right away, but stay calm — it may be hours before your first contraction. (If you're a GBS carrier, you'll be asked to go to the hospital so you can start getting IV antibiotics and will likely be induced at the same time if you don't start contracting on your own.) Also call your practitioner right away if you notice that your baby's movements have slowed, whether or not you're leaking fluid. There are more common signs of impending labor than water breaking. You may notice your mucus plug — the small amount of thick mucus that blocks your cervical canal — in your undies or in the toilet. It might be tinged with a small bit of brownish, pink, or red blood (which is why it's called "bloody show"). (If you have vaginal spotting or bleeding other than mucus tinged with a tiny amount of blood, call your caregiver without delay.) Labor usually starts within a day or two of seeing the mucus plug. Another sign of labor is contractions at regular — but increasingly shorter — intervals. If you've been having Braxton Hicks contractions, you'll now realize that these were just practice. Your doctor or midwife will tell you when to give her a call, but it will likely be once your contractions last about a minute each and arrive every five minutes for about an hour. (Time the contractions from the beginning of one to the beginning of the next one.) If you're unsure about your progress, go ahead and give your practitioner a call. Your practitioner may have you count fetal movements. Even if you aren't asked to formally count movements, call her immediately if you notice a decrease in your baby's activity. Your baby should remain as active as ever right up to delivery, and a decrease in activity could be a sign of a problem — meaning that you need to deliver now rather than later.

Now that you know how to tell if you are really in labor, let's talk about some of the ways your body prepares for labor. It is really neat to examine all of the changes that take place in your body as the pregnancy continues. Your baby will descend into your pelvis, sometimes called engagement or lightening, usually before labor in first time moms and during labor in subsequent births. Your cervix, the mouth of your uterus, will begin to soften and possibly dilate. Some practitioners will do routine vaginal exams towards the end of pregnancy. Contrary to popular belief, you can't predict when labor will start by the details of your cervix. Some practitioners will also strip the membranes in an attempt to "get things going." If you feel strongly about this mention it to your practitioner before any physical exams. In the days before labor begins you may also experience the following, although they are not always accurate predictors of when labor will begin: bloody show, loss of mucous plug, nesting instinct, loose stools, loss of weight, increase in appetite. Hang in there! You are almost done!