Pregnancy Week 38

What does my baby look like?

Your baby is now about the size of a leek.

Most of the fine, soft hair (lanugo) that covered your baby's body in the second trimester has now shed. Even so, some babies are born with small patches of hair on their shoulders or back.

Meconium continues to build up in your baby's intestines. Meconium is the dark, sticky first stool made up of amniotic fluid, shed cells, and other swallowed materials. It usually passes after birth. Passing meconium during labor, however, may call for closer monitoring.

Eyes, nails, lungs

By this week, the fingernails and toenails are fully formed. The fingernails may even reach past the tips of the fingers.

Your baby's lungs keep getting stronger, and the vocal cords are developed enough to cry after birth. The lungs also continue producing the substance that keeps their tiny air sacs from sticking together.

Your baby's brain and nervous system keep fine-tuning right up until birth. Fat is building up under the skin, especially around the knees, elbows, and shoulders.

How many months pregnant?

This week, you're getting close to the middle of your ninth month.

What's happening in my body?

At this week's checkup, your doctor may measure the size of your belly, check your blood pressure, and test your urine for protein. Protein in the urine along with high blood pressure is evaluated for possible preeclampsia.

If a planned cesarean is scheduled, it's often recommended for no earlier than 39 weeks. The goal is to wait for the best possible time for your baby's lung development.

If your pregnancy goes past 41 weeks, your options can be discussed:

• membrane sweeping,
• induction,
• or waiting a little longer for labor to start on its own.

RSV vaccine

If you haven't gotten the RSV vaccine yet, it may still be an option up until birth; talk it over with your doctor.

Signs of labor should now be watched more closely

Labor could begin at any moment. That's why it's important to recognize these signs:

• regular contractions that keep getting stronger,
• losing your mucus plug,
• your water breaking,
• noticeable pelvic pressure,
• increasing back pain.

Your water breaking

Your water breaking doesn't have to be a big gush like in the movies. It can also be a small trickle or a slow drip.

If labor hasn't started within 24 hours after your water breaks, induction may be considered to lower the risk of infection.

Swelling

Swelling in the ankles and feet is common this week. As your uterus grows, the pressure it puts on your blood vessels can affect circulation in your legs.

To ease the discomfort:

• wear comfortable shoes and loose socks,
• put your feet up,
• try not to stand for long stretches,
• and drink plenty of water.

If you notice sudden swelling in your face, hands, or feet, take it seriously; it can be a sign of preeclampsia.

How you're feeling

This week you might also feel impatient, worn out, or a little let down. That's a natural emotional weight that comes from being so close to labor while it still hasn't started.

Symptoms you might notice this week include:

• Braxton Hicks contractions
• trouble sleeping
• back pain
• heartburn and indigestion
• bloating and constipation
• leg cramps
• feeling hot
• dizziness
• swelling in the hands and feet
• signs of a urinary tract infection
• signs of a vaginal infection
• darkening of the face, or the “mask of pregnancy”
• oilier skin and breakouts
• colostrum leaking from your breasts
• losing your mucus plug

There's no special nutrition rule for this week, but staying hydrated is especially important for swelling and overall comfort. If your appetite has dropped, smaller, more frequent meals may feel easier.

• Keep tracking your baby's movements right up until birth.
• If you notice fewer movements, call your doctor right away.
• Make sure your hospital bag is packed and ready.
• Whether you're planning a home birth or a hospital birth, put together a flexible backup plan.
• If you have swelling, a headache, or vision changes, don't wait to get checked.
• Stay active with short walks, but only if you're feeling up to it.
• If you're feeling impatient or on edge, make time to rest.

Reviewing your birth plan

A birth plan is a framework that helps you think through your preferences for labor and delivery ahead of time. It can cover things like pain management options, who you'd like with you during the birth, movement and position preferences, and how you intend to feed your baby.

It helps to see your birth plan as a starting point rather than a set of hard rules. Because circumstances can change during labor, staying flexible is important. You can go over your plan with your doctor this week.

Telling false labor from the real thing

Braxton Hicks contractions, or false labor, are irregular, don't clearly get stronger over time, and may ease up when you rest, change position, or take a walk.

True labor contractions, on the other hand, come at regular intervals, grow more frequent and stronger over time, and don't go away with rest. As a general guideline, if your contractions come about every 5 minutes, each lasts about 1 minute, and this keeps up for about 1 hour, true labor may have begun.

How do you time contractions?

When timing contractions, you measure from the start of one contraction to the start of the next. That way you can see whether they're getting closer together and settling into a pattern.

When should you go to the hospital?

You should contact your doctor when regular contractions that keep getting stronger begin, when you think your water has broken, or when you notice a decrease in your baby's movements. Heavy bleeding like a menstrual period should also be evaluated without delay.

A severe headache that won't go away, blurred vision or flashes of light, and sudden swelling in the face, hands, or feet can be signs of preeclampsia. In these cases, it's important to seek medical help right away.