The Home Stretch!!
38 weeks is considered full-term so you are definitely in the home stretch! I hope your bags are packed for the hospital and ready to go. At this point, you will be going through all kinds of emotions. You’re more than likely tired of being pregnant. You're probably having some anxiety about labor. Excited to meet your new baby. Some mothers crave solitude. You may be more sensitive. You might be worried that everything isn’t perfectly ready at home for the arrival of the baby. You may feel tired and you may have trouble getting comfortable. You may feel new pelvic pressure, feeling different kicks and have general aches and pain. Don’t freak if you begin to lose a 1 - 2 lbs. It’s normal.
In 2013, ACOG redefined what it means for a woman to carry her baby to term, in an effort to prevent non-medically necessary inductions before 39 weeks.
- Babies born between 37 weeks and 38 weeks and six days are now considered "early term."
- Babies born between 39 weeks and 40 weeks and six days are considered "full term."
- Babies delivered between 41 weeks and 41 weeks and six days are considered "late term,"
- Babies born after 42 weeks or more are considered "postterm."
Did you know that...
- Babies born at 40 weeks are better able to suck and swallow because of their advanced muscle development. And this sucking and swallowing will aid breastfeeding.
- Generally speaking, more time in the womb equals less time in hospital.
- Brain development accelerates during the last five weeks of pregnancy.
- Babies bulk up during the last few weeks of pregnancy, this extra fat allows them to prepare for birth and the first few days of life.
- Babies born at 40 weeks are better able to control their own temperature, partly due to the extra fat they have.
What starts labor?
Recent research has suggested that labor actually begins when the baby’s lungs mature enough and secrete a protein called surfactant. Surfactant is essential for breathing outside the womb. The release of this protein signals a cascade of hormones in the mother telling the mother’s body to initiate labor.(Dr. Carole Mendelson, Dr. Jennifer Condon and Dr. Pancharatnam Jeyasuria, 2004). Also as the baby prepares and lowers in the mother’s body it puts pressure on the cervix causing a release in the hormone, oxytocin. Oxytocin is a very important hormone for labor and delivery. It thins and dilates the cervix, causes contractions, and moves the baby down and out of the birth canal. It also releases breast milk and triggers nurturing and bonding feelings between mother and baby.
Are these contractions? Am I in labor???
True labor contractions have a definite pattern. If you think you’re in labor apply the 5 – 1 – 1 Rule. If your contractions are 5 minutes apart, 1 minute long, and continue for 1 hour, you are most likely in labor. This is when you would call your doctor or midwife. When you’re in early labor do something to take your mind off it. Go to the movies, watch a movie, cook and freeze meals, go out to eat, do anything that is distracting. As time passes you’ll notice your contractions get closer and longer. But try not to focus on them too long. Contractions feel like a wave and you will have a break in between each one. Surrender, relax and conserve your energy between contractions.
Check out my blog on Signs of Labor - What You Should Know If You're Pregnant
What if you go past your due date?
Your due date is a guess date. You can give birth 2 weeks before or 2 weeks after your due date. Going past your due date is not uncommon, especially for first time moms. Studies show that women who take omega 3 supplements during pregnancy have an increase in the duration of their pregnancy by 3 – 6 days and reduce the risk of delivering a premature baby. The baby will come! Keep taking your omega 3’s even if you are tired of being pregnant! Your baby’s eyes and brain need it! You will go into your doctor’s office twice a week for check ups! Try to enjoy this time and get as much rest and sleep as possible because when the baby comes you will be very sleep deprived. Believe me...you don't want to go into labor tired!
Keep in mind that the following six steps must take place before a vaginal birth. The first three usually begin weeks or days before labor, the last three during labor.
- The cervix moves forward
- The cervix ripens, or softens.
- The cervix effaces, thins, or shortens.
- The cervix dilates, or opens.
- The fetal head flexes, molds, and rotates.
- The fetus descends through the pelvis.
Lets talk about inductions, just in case.
You should be aware of AGOG new standards for induction:
- Induction should not be done prior to 41 weeks without medical necessity.
- Cervical ripening with induction can decrease the risk of "failed induction” and cesarean.
- Combining cervical ripening agents (such as a Foley bulb and prostaglandin gel) can facilitate cervical ripening and reduce the risk of failed induction.
- Latent phase in an induction can be up to 24 hours or longer. Pitocin should be administered for at least 12-18 hours after rupture of membranes before the induction can be considered as having failed.
The Bishop Score is a pre-labor scoring system that helps in predicting whether induction of labor will be required. It has also been used to assess the odds of spontaneous preterm delivery. You have great chances of a successful induction if your Bishop’s Score is greater than 9. Be sure to ask your caregiver what your Bishop Score is if you do end up needing to be induced medically. I talk more about the Bishop Score in this blog, Tips for Weeks 33 - 37: Hang In There!!! You're Almost There!!
Check out this video regarding inductions. It has all my favorite people in it, Aviva Rohm, Christiane Northrup, Sarah Buckley, Ina May Gaskin and others as they discuss the risks of labor induction?
As a birth doula and certified childbirth educator, I get asked all the time about "natural" ways to get labor started. So for non-pharmaceutical inductions methods, check out my blog Past Your Due Date? Here are 8 Ways To Get Labor Started.
Appointment tips. Things that need to get done!
- Make 2 weeks worth of meals that you can freeze so you can quickly and easily warm up something nutritious and healthy after the baby arrives home.
- Make sure you have a car seat that is installed properly. To find a child passenger safety technician go to: cert.safekids.org or check out the National Highway Traffic Safety Administration – travel safety and car seat installation instructions nhtsa.gov or http://www.seatcheck.org/
- Do early registration at the hospital. You do not want to be filling out paper work while you are in active labor!
- Make a list of all the things you want to get done and get it done!!
- Enjoy these last few weeks with your partner and friends. It’s okay to want to stay close to home!
- Hopefully you packed your bags by now but if not, do it now and leave it by your front door. Gearing Up for Labor? What You Should Pack And Bring To The Hospital…
Check out three of my most popular blogs on how to help you get ready:
Ultra wellness tips for weeks 38 - 40+ (do what seems appealing to you)
- It will be very important for you to do things that give you pleasure. Say no to things that stress you out and/or make you tired.
- Eat 6 dates a day unless you have gestational diabetes. Studies show that women who ate date fruit in the last 4 weeks before labour significantly reduced the need for induction and augmentation of labor, and produced a more favorable delivery outcome.
- Watch funny movies. (I recommend two of my favorites…17 Again or Bringing Down The House)
- Rest, nap and rest!!! You will need to be rested for labor. Learning to relax is of great importance to you!
- Be nourished. Eat well and hydrate!! When labor starts you’ll want to eat before you go to the hospital! Eat a complex carbohydrate meal so you’ll have stored up energy. Eat small, stomach friendly, snacks during labor. Bring stomach friendly foods that you liked in the early stages of pregnancy when you had morning sickness.
- Drink, Drink, Drink during labor. Dehydration depletes your energy and can slow your labor down. Coconut water is great. Sports drinks also work well but are loaded with food dyes.
- Have your partner read The Birth Partner by Penny Simkin
Know that your body was designed and meant to have a baby. Your body and baby know exactly what to do during labor. You can’t think your baby out. You need to let go, surrender and trust!!! Be curious during each contraction and let it happen. Talk to your baby during labor.
Remember that all you need during labor is a warm, quiet, dark room. You'll need to not feel like you’re being observed. You'll need to feel safe and you'll need to be able to move around. There is no right or wrong way to give birth. Go with the flow, be open and surrender to the incredible power of birthing your baby. I'm wishing you a magical, yummy and loving birth experience no matter what way your baby decided to be born! Trust in your body's wisdom but also in your baby's wisdom.
You may want to consider creating a postpartum wellness kit for yourself. Here is what you'll need.
Make sure to watch Baby Behavior 101 - Understanding Your Baby's Sleep and Cues
QUESTION - EXERCISE. In the comment box below please share with me.... (if you don't want to share it with me, try writing it in a journal). This is a very powerful exercise. So don't hold back. Feel it!
1.) Tell me what you want out of your birth experience.
Write - I want....
2.) Tell me why you want it and give me 3 reasons why.
Write - Why I want... Here are the 3 reason why I want.... 1.) 2.) 3.)
3.) Tell me why you believe you will get.... give me 3 reasons why.
Write - Why I believe I will get... Here are the 3 reason why I believe I will get... 1.) 2.) 3.)
If you find this information useful please feel free to share it with your friends and loved ones.