What’s happening this week

Your baby…

• may weigh around 2.7kg
• could measure around 50 cm from head to toe
• sleeps, dreams, wakes and kicks
• may start to move further down into your pelvis, getting ready to be born (this is called lightening)
• the bones that make up your baby’s skull can move relative to one another and overlap each other while your baby’s head is inside your pelvis – it helps the baby pass through the birth canal.

You…

• may be able to breathe a little easier as the baby moves down into your pelvis
• could need to use the toilet a lot from the pressure on your bladder
• heartburn may improve due to the baby’s movement downward too.

You’re into the final month – and probably glad to have the finishing line in sight! We’ll help you get ready to cross it!

Induction

Occasionally, labour is started early by medical staff. Your baby may be safer being delivered, rather than staying in the uterus if there are signs of a serious problem for you or your baby. This may happen if you have high blood pressure or a condition such as diabetes.

Special deliveries

Some babies need a little help to be born. Forceps or ventouse may be used during the birth if your baby gets into a difficult position, shows signs of distress, or if you and your baby get very tired.

• forceps are curved metal tongs that are used to hold the baby’s head
• a ventouse is a vacuum cap that attaches to the baby’s head.

Both can be used to help pull the baby out as you push. If they’re used, you will have to lie on the bed with your feet in stirrups. A cut may be made to your perineum (called an episiotomy) which makes more room for the doctor to work and for the baby to come out. The forceps or ventouse are fitted, then with each contraction, while you push the baby out, the doctor will pull gently and steadily to help the baby progress. Your baby may have marks from the assisted, (sometimes called instrumental), delivery but these fade over the first days.

You may have stitches and bruising after an assisted delivery. Take things easy and ask your midwife for painkillers if you need them.

Episiotomies explained

An episiotomy is a cut made in the perineum to make it easier for your baby to come out. It may be used if:

• the baby is distressed
• a forceps or ventouse delivery is needed
• there is a problem delivering the baby’s shoulders
• you have had previous surgery involving your pelvic floor muscles.

You can try to avoid episiotomy by:

• using different positions during labour
• using an upright position for giving birth
• listening to your body and pushing when you want to
• listening carefully to your LMC when she tells you to stop pushing and pant as the baby’s head is being born.

The build-up to labour

In the final days, many women begin to notice signs that labour will soon begin.  Some even go into hospital thinking they’re in labour, only to be told they’re not – what a disappointment.  Signs can include:

• fewer big movements as the baby has less space to move around
• feeling tired and heavy – perhaps a bit depressed
• more Braxton Hicks contractions – they’re probably softening your cervix, so they are good news!
• diarrhoea – emptying the bowel to make the baby’s journey through the pelvis easier.  See your LMC if this continues for more than a day, you might have a bug.

Vitamin K

This is a vitamin that helps blood to clot.  All babies are born with low levels of vitamin K but in a very small percentage, these low levels may result in a bleeding disorder known as vitamin K Deficiency Bleeding (VKDB).  It is usually given as an injection (preferred route), but can also be given orally.  As parents, it is your choice whether to give vitamin K or not, discuss this with your LMC.

Thinking ahead:

The birth (and afterwards)

It’s worth making some plans for the birth and afterwards; the more you can get organised now the easier it will be.

Before the birth:

• keep emergency contact numbers by the telephone including: your LMC and the maternity unit
• make sure you have plenty of easy food in the house, like baked beans, soup, and pasta
• check that you have all the things you are likely to need (see checklist in Week 32).

For the birth:

• make sure you can contact your partner at all times.
• have a reserve labour partner ready, just in case your birth partner is miles away
• plan how you will get to the maternity unit; if by car, get to know the route and car parks
• if you need to ask a friend or relative for a lift, make sure you know how to contact them.

After the birth:

• have some clothes for your baby to wear home
• if coming home by car, make sure you have a properly fitted baby car seat ready
• have some loose and comfortable clothes ready for you to wear home
• ring friends and family!