What’s happening this week

Your baby…

• measures about 25cm (CRL) – but if the legs were extended (they’re tucked up while inside you) could measure nearly 38cm long!
• is going through a fast and furious phase of brain development
• may begin to open eyes
• may suck a finger or a thumb
• a substance called surfactant forms in the lungs so they can function independently at birth.

You…

• may feel your baby’s hiccups – sometimes it feels like they are in your bottom!
• leg and muscle cramps may be annoying (particularly at night)
• may be plagued by constipation.

Around now you may need to move to maternity clothes, even if you’ve managed with stretchy skirts and pants so far. This week we also look at pelvic joint pain and backache, and continue with some things to think about for your birth plan (see week 32).

Pelvic joint pain

Pregnancy hormones cause the joints in your pelvis to loosen – it’s part of your body’s preparation for labour. For some women this becomes painful. Talk to your LMC. Since the problem is caused by pregnancy hormones, it does usually clear up quickly after the baby is born.

Thinking ahead: birth plans

In New Zealand, every LMC is required to discuss and develop a care plan with each of their clients.  A care plan ensures that all aspects of care are fully discussed, questions answered and gives the woman and family members an opportunity to know what may be discussed at the next antenatal/postnatal check. It also includes decisions after the labour and birth you may have made before.  Ask for information about screening programmes for your baby.  The care plan should be written down, and updated as necessary.  A copy should always be in your maternity notes if you change carers, your care plan goes with you.

Before you start on your birth plan:

• gather all the information you need – from this guide, from antenatal classes, talking to other women, talking to your LMC.
• talk to your labour partner about his or her ideas on the best ways to approach the labour and birth; see Week 32 for more about choosing a labour partner
• read your maternity unit’s leaflets to find out what’s on offer
• consider your circumstances and beliefs, eg on religious grounds would you refuse medication or blood transfusion if it was required?

Here are some topics you might like to include (you don’t have to include all of these, just the ones that are important to you):

Optimal fetal positioning

The position of the baby in a woman’s pelvis at the end of her pregnancy will have an influence on the kind of labour she has and even the way the baby may be born.  Women may be able to encourage their babies into a more favourable position decreasing the likelihood of medical intervention.  By regularly using upright and forward-leaning postures, particularly during the last six weeks of pregnancy the baby is given a better chance of positioning itself into the preferred anterior (OA) position.  These postures usually involve keeping the knees lower than the hips and many can be incorporated into your daily routine.  Ask your LMC for more information.

Labour

Choice of birth companion:
Say who you want to be with you; will they stay all the time or leave for certain procedures?

Choice of carers:
Is it important to you to have only female staff caring for you during labour? Do you need an interpreter or someone to sign for you?

Comfort:
Say if you want to move around during labour, do you want beanbags and floor cushions in the birthing room? Do you want to use a birthing bath for pain relief?

Special needs:
If you have a disability, write down what kind of equipment you will need and how the staff can help you. If you have particular religious or cultural needs, write these down.

Coping with pain: (see our pain relief pros-and-cons chart on Week 28)

Interventions:
This is the place to think about assisted deliveries (see Special Deliveries, Week 36) and caesarean sections (see Week 31).

After the birth

Baby:
Your baby will be delivered into your arms/onto your abdomen where possible.  (See Week 31 for more about the benefits of early skin-to-skin contact.)

Brothers and sisters:
Do you want them to come into the birthing room to see the baby straight away?

Feeding:
Do you want to breastfeed your baby – helped by the skin to skin contact – and not want him given any bottle feeds? Have a look at our Breastfeeding basics to get off to a good start more.

Your diet:
Do you need a special diet while in the maternity unit?