What’s happening this week

Your baby…

• is still gaining weight
• may weigh about 2.9kg
• could measure about 51 cm.

You…

• may find walking more uncomfortable if your baby’s head presses on your pelvic floor
• may have more frequent Braxton Hicks contractions could have dreams about the birth, or about the baby.

Everyone worries about whether they will know they are in labour. Our checklist this week will help you decide whether it’s the real thing.

How will I know I am in labour?

If this is your first baby, it’s easy to think ‘this is it’, only to find you are just getting ready for labour.

In the week or so before labour you may notice:

• an increase in vaginal discharge
• the appearance of the ‘show’, the jelly-like plug of mucus that seals the cervix during pregnancy
• a need to get things finished and ready – the so-called nesting instinct
• feeling quite emotional; crying for no real reason as your hormones get to you
• a sense that you don’t want to be far from home
• an upset stomach with a need to go to the toilet often. This is nature’s way of clearing out your bowel before labour begins
• Braxton Hicks contractions that feel like tightenings or period pains.

When you go into labour you may notice:

• the ‘show’ (if it has not come away earlier)
• low back pain as the baby settles well down
• regular contractions that could feel like period pains or tightening pains across your bump
• the waters breaking, either in a gush or a gradual trickle.

The waters

Your unborn baby floats in amniotic fluid, a straw-coloured liquid, mainly consisting of water. Labour begins, for some women, with the waters breaking. If the waters go with a gush, contact your LMC or maternity unit. You may be asked to go into the unit so that they can check that the baby is well. It will help your LMC if you can remember when the waters broke, roughly how much fluid there was (an egg cup full, a coffee cup full?) and what colour it was. Amniotic fluid is usually pale. If it is green or has black bits in it, this may show that the baby is in distress.

If the waters trickle out, it can be hard to decide if they have gone. Put a sanitary pad on and, if it is wet after an hour, it’s probably the waters leaking. Smell the pad; urine smells, amniotic fluid doesn’t. If you are still not sure, contact your LMC or the hospital. Your midwife can do a vaginal examination and test the fluid.

Call your LMC if you have:

• bleeding like a period (this would be heavier than a ‘show’, which may be lightly bloodstained; heavy bleeding is a cause for concern)
• constant abdominal pain (contractions tend to come and go; a constant pain needs checking out)
• sudden severe headaches or vision disturbances as this could be a sign of dangerously high blood pressure
• reason to think the baby has not moved recently or the movements are much less than usual
• any worries or if you get upset; your LMC will have spoken to plenty of women in labour and will be able to tell a great deal from how you sound and what you describe to her.

Breech babies

A few babies will be breech or bottom down at this stage. It’s now usual to deliver a breech baby by caesarean section. Some doctors try to turn breech babies using a procedure called External Cephalic Version (ECV). It sounds complicated, but it just means that a doctor will put her hands on your bump, find your baby’s head and bottom, and ‘follow the baby’s nose’ in order to turn him so he’s head down. ECV is generally carried out at about 37-38 weeks of pregnancy under ultrasound guidance in hospital. This works for around half of all breech babies, who then go on to be born in the normal way.

5 ways to cope with backache

If you have backache in early labour, try these self-help tips

1. hold a covered hot water bottle against your lower back, or try an ice pack to numb the area. A wheat pack (when heated correctly) can also be useful for backache.
2. use hot water – use a flannel or get in the bath or shower and direct the shower head over the painful area.
3. ask your partner to massage your back with firm steady movements.
4. kneel on all fours, lean over the seat of a chair or sit cowboy-style on a chair, using pillows to make yourself comfortable.
5. using a TENS machine can be helpful.