Week 38 - Bounty a reassuring world for parents

38 Weeks Pregnant

What’s happening this week

Your baby…

regular movements are reassuring signs of a healthy baby, so it is important to be aware of your baby’s movements and report and alteration in pattern.
has now lost most of the fine downy hair (lanugo) and protective white substance, vernix.

You…

may feel impatient
may worry that every twinge is a sign of imminent labour
may feel very tired one minute, full of energy the next.

Try to rest as much as you can this week and get ready for labour. Over the next two weeks, we’ll be running through the stages of labour,

The stages of labour

Labour usually starts slowly and then speeds up. There are three distinct stages:

First stage – contractions open up the cervix – your baby’s exit route!
Second stage – the actual birth, where you push your baby out.
Third stage – the delivery of the ‘afterbirth’ – the placenta.

In the very early part of the first stage you may have small contractions every 20 minutes or so. As labour progresses, the contractions will get longer and stronger and closer together; the contractions may come every ten minutes. Towards the end of the first stage you may have them every four or five minutes and, finally, every two to three minutes. Midwives and obstetricians may say that you’re not in labour until you have reached ‘established’ or ‘active’ labour, when the contractions are strong and frequent, and your cervix is dilating well. Anything before this is seen as the build-up to labour and is called the latent phase.

Established labour can take around 6–12 hours; you may feel that you have been in labour a lot longer if you count the latent phase as well. The total length of labour is generally from when the active phases start. If you manage to sleep through the first few hours of latent labour, it will seem much shorter than if you wake up at the first twinge. It is exciting that the time is finally here but try to stay relaxed.

Six things to do in early labour

Try to keep busy at home if you can. Labour will pass more quickly then.

if it’s the middle of the night, rest!
if it’s daytime, keep active, but don’t exhaust yourself.
eat and drink.
empty your bladder regularly (2 hourly)
check that you’ve got everything ready.
ring your LMC and let her know things have started.

When to call the midwife or go into the maternity unit

Stay at home as long as you can. Contact your LMC and talk things through. If your waters break you may be advised to go in. If you are coping well at home, keep reasonably busy and active. Go to the maternity unit when the contractions are regular, long and strong. Some midwives suggest when the contractions last 50–60 seconds and come every five to six minutes. Remember to take into account the length of the journey to the maternity unit.

Going to hospital

Your LMC will work with you to decide when you need to go to the maternity unit. In most cases she will ring them to tell them you are on the way. When she sees you, either at home or in the hospital, she will ask you what’s been happening so far. It helps if you can write down when contractions first began and roughly how often they are coming now.

Your LMC will check your notes, take a urine sample and take your blood pressure. She will then check the position of your baby by feeling your abdomen, and may do an internal examination to see how much the cervix has opened. She will listen to the baby’s heartbeat with a hand-held monitor. If you have had problems in pregnancy, if your baby is in an awkward position, or if anything needs double-checking, your LMC may ask another midwife or doctor to examine you as well.