Your baby now has a good proportion of fat on their body, increasing from only 30 grams at 30 weeks, to around 430 grams at term (approximately 16% of their total body weight). Some physical signs that indicate your baby is born on time is having small pads of breast tissue under their nipples (in both boys and girls) and fingernails reaching the tips of the fingers, often looking manicured!
Your baby’s overall growth slows down considerably now. They do not grow as much in length and put on approximately 230 grams per week (about an ounce a day). Also, the amount of amniotic fluid around your baby slightly decreases from around 37 weeks.
Physical changes
Is it water or fluid?
Towards the end of pregnancy it is not unusual to produce extra mucus and fluid, which can pool and sometimes trickle away when you get up in the mornings. This can be mistaken for the waters breaking. If you are not sure, go to the toilet and empty your bladder (just to rule out that one as well!) and put on a white pad (to see any colour in the fluid). If fluid continues to come away within the next few hours, it is probably your waters and you need to contact your caregiver or hospital for advice. You can read more here.
Is it a show?
During the last couple of weeks of pregnancy, or a few days before labour begins, the mucus show (or plug) may come away as the cervix starts to soften and ripen in preparation for labour. Bear in mind that having a show is not necessary before labour starts and many women pass their show during the birth process. Also, you don’t necessarily need to have a show before the waters break.
A show is generally very thick and can be clear or grey, pink, brown or blood-stained in colour. It can come away in small dribs and drabs over a few days, perhaps noticed when you wipe yourself with toilet paper. Or it may come out in one large blob, sometimes large enough to fill your hand. Both these are normal. In some cases labour starts within 24 hours or so (but not always!).
Labour starting?
The question of how labour starts is not yet completely answered, but there are a few schools of thought including:
The baby releasing hormones when they realise it is ‘time’ as the uterine space becomes smaller (with lessening amniotic fluid) and/or the placenta starting to function at less than its peak.
Hormones being released by both mother and baby.
Hormonal feedback from the placenta.
A number of the above factors, or something else we haven’t discovered yet!
There is some research that supports the theory that an unborn baby’s brain sends chemical messages to their mother’s body when they are ready to be born. It is still unclear how this actually works, or what triggers the messages to be sent. When labour does begin, the woman releases the hormone oxytocin from her brain, which makes her uterus contract in a rhythmic pattern.
Did you know? A woman’s uterus is much more sensitive to her natural oxytocin hormone at night. Hence the reason why most labours start once the sun goes down!
Emotional reactions
Conflicting emotions are quite normal just before the birth. You may feel relieved because you have had enough of being pregnant and the discomforts that go with it. Or you may feel comfortable with your known state and perhaps unsure about moving forward into the labour and birth (or even parenting). If this is your first baby, the birth can present many questions and concerns about the unknown path that lies ahead.
Talk about your feelings with your caregiver and/or partner (if you have one), or with someone else you trust. Sometimes labour does not start until you feel you have resolved your feelings to some degree and are emotionally ready to have your baby. You can read more about emotions during late pregnancy here and partners can read about some common emotions here.
Other considerations
Sweeping the membranes
Some caregivers suggest performing internal examinations at each pregnancy visit during the final weeks to ‘sweep’ (or strip) the membranes, sometimes referred to as a ‘strip and stretch’. This aims to ripen the cervix and make it more favourable, in the hope of preventing an induction of labour. Sweeping the membranes is an old induction method that was first documented in 1810. Studies show there is some statistical advantage to having this performed routinely (for about 15% of women), although the benefits are small and unpredictable. This must be weighed against the discomfort it can cause and an increased chance of accidentally breaking the waters. Not every caregiver does it and you can decline it if you wish. You can read more sweeping the membranes here and internal examinations in general here.
Your new baby
Baby soon after birth
The first moments after birth are monumental for your baby. As soon as they leave the womb, they ‘switch over’ to adjust to life independently from their mother’s body. You can read more about the amazing physiological adjustments that enable your baby to adapt to life in the outside world here and all about your baby’s first 24 hours here.
The Apgar score was designed to standardise the way caregivers evaluated the baby’s physical well-being at birth. They use five physical signs and give each a possible score of 0, 1 or 2, to reach a total assessment of up to 10 points. The score is usually given when the baby is 1 minute old and again at 5 minutes of age. However, if the baby takes longer to fully breathe and respond the scoring may continue, given again at 7 minutes and possibly also at 10 minutes. You can read more about the Apgar scoring system here.
Newborn appearance and behaviour
Seeing your baby for the first time can bring up many emotions including awe, love and sometimes surprise. Many parents are unprepared for the image of a possibly red, puffy, swollen face of their new creation. If you have had little exposure to newborns, you should prepare yourself for the fact that your baby may initially look very different from the perfect cherub. You can read more about the normal appearances and behaviours of newborns here.
Routine procedures
Most newborns are born healthy, however some require interventions to help them adjust to independent life. You can read about some routine procedures and possible interventions for your baby at birth here.
Weighing, measuring and bathing
When a baby is born and excitement fills the room there is often an urge to ring everyone with the good news! Apart from “Congratulations!” the inevitable question comes, “How heavy is he or she?” This prompts parents to ask for their baby to be weighed. You can read about weighing and measuring your baby here and when your baby may be first bathed here.
Observations for baby
A few babies are born well and healthy, but may require further observations because they have certain risk factors that caregivers consider could increase their chances of becoming unwell in the first 24 to 48 hours after birth. You can read more about why some healthy babies may need routine observations here, or if your baby is unwell and requires medical attention here.
