38 Weeks Pregnant
Preparing to breastfeed
38 weeks pregnant:
placentaPlacentaAt this point, the placenta is mature enough to take over as the main support system and the site of your hormone production. It is responsible for bringing oxygen and nourishment to your baby, then taking away waste products.
bowelsBowelsBaby's digestive system is ramping up, and the intestines have been accumulating waste material known as meconium. This will be your baby's first bowel movement after delivery, but in some case a baby will release it into the amniotic fluid before birth.
What's happening with you:
Are your nipples larger and your breasts heavier these days? Your body is preparing to breastfeed, so you may notice some tenderness and sensitivity around your areola. From now on, just use warm water to clean your nipples, since soap can dry them out and even crack the skin. Continue to moisturize your breasts and wear a supportive bra to sidestep major discomfort during these last weeks and avoid sore or cracked nipples after delivery.
Since labor is just around the corner, you're likely feeling stronger and more frequent Braxton Hicks contractions, but they don't necessarily mean that you're going into labor. For many first-time mothers, the baby will engage, or drop down into the pelvis, around now and mild contractions could continue for quite a while before true labor sets in. Your uterus is filling your abdomen, and everything from your stomach to your bladder is suffering: indigestion, gas and frequent urination are a few of the more irritating symptoms of late pregnancy, but they won't be around for much longer. Sleeping on your left side with as many pillows as you need for support is your best bet for a peaceful slumber.
What's happening with your baby:
At over 6 ½ pounds and around 20 inches, your baby is in excellent form for the outside world. And you may be greeting him earlier than you expect, since it's surprisingly common for a baby to come up to two weeks before your due date. On the other hand, a two-week-late baby is not out of the ordinary, either. In any case, your baby is plump and active, and that could translate into bigger and stronger movements.
Your placenta has begun to disintegrate, and this means it's not transferring nutrients as quickly, but your baby is still getting all the oxygen and nourishment he needs to thrive. Just a couple of months ago, your little one was relying entirely on your body to fight infections, but now his immune system is beginning to develop (it will continue to develop at an impressive pace after birth, especially if you breastfeed). Hormonal responses are also in full swing by week 38 of pregnancy, and some experts believe that your baby reacts to her tight surroundings by producing hormones that help to trigger the first real contractions of labor.
Things to do this week:
You may have heard that you'll have trouble breastfeeding if have flat or inverted nipples. Well, that may be true, but it's no reason not to breastfeed! Since your baby will need to take a good deal of nipple into her mouth to feed, you'll need to stimulate the adhesions on your nipple to loosen and allow the tip to protrude. Breast shells with a small hole will help to draw out the nipple by pressing gently on the base, while the version with larger holes will protect sore nipples from rubbing. You can start using the shells a few weeks before delivery, and then 30 minutes before each feeding, to press the nipple outwards. Don't use them for longer than suggested or too frequently, as they can cause leaks and other problems if kept on for too long.
Another handy accessory is the breast pump, which can create enough of a vacuum to coax your nipple out if you use it right before breastfeeding. In fact, breast pumps are a good investment for every new mom, as there will likely be a time when you cannot provide your breast and will need to have some milk bottled to feed your baby. There are manual pumps and battery operated or electric pumps, and the right one for you will depend on how often and for how long you will use it. If you're planning on pumping occasionally, a manual or battery-powered pump may be your best bet, but go with electric if you expect to pump frequently.
You've probably been paying close attention to your baby's kicks for some time now, and they may seem to slow down this week. In the last weeks of pregnancy, your baby will be too big to kick and punch, so you may feel movement less often, but that doesn't mean he's completely still. However, if your baby becomes strangely silent, your doctor or midwife might decide to give you a biophysical profile (or BPP) to make sure everything is alright.
Although a BPP is often reserved for women who have gone past their due date, there are some cases where it can help before you've reached the end of your pregnancy. For instance, if you've had problems in a previous pregnancy, your doctor has confirmed that you have low amniotic fluid, your baby is less active or you have high blood pressure, a BPP is a safe way to get a close look at how your baby is moving, breathing and reacting. First you'll have a detailed ultrasound, then a nonstress test to judge how your baby performs in several categories: muscle tone, body movements, breathing movements, amniotic fluid levels and heart rate. An abnormal or poor result does not mean that your baby is in immediate danger, but it will direct your doctor or midwife's decision on how to proceed with labor and delivery.
Tips for your partner:
If you've just found out that your partner is scheduled for a c section, you may be wondering what role you could possibly play in the delivery room. Before you get disappointed, talk to your partner's doctor about hospital policy: many hospitals not only allow partners into the operating room, they'll also have them sit right next to Mom's head. And although your view of a c section will be physically blocked (with the help of a large screen that covers the lower part of the mother's body), there are a couple of advantages that come with attending a cesarean birth.
Perhaps the most significant reward is being able to hold your baby almost immediately after he's taken from your partner's belly. In fact, you'll probably become the physical connection between mom and baby in those first moments of life: once your baby is stable, the doctor will hand him over to you and you'll then bring him up to his mother's face. In many cases, you'll also be an indispensible assistant for mom's first nursing attempt. As you can see, a c section could actually improve your experience and your role in the birth.
This week's FAQS:
If I don't recognize my labor pains right away, will I be able to make it to the hospital on time?
One of the most common fears among pregnant women is that they'll deliver the baby in the backseat of a taxi, the middle of the office or another public place. However, unless there's a medical reason to suspect an exceptionally short labor, you can count on labor to last between 10 and 18 hours if this is your first pregnancy (the average labor for a subsequent pregnancy is around seven hours). In either case, you should have plenty of time to get to the hospital or settled in your home birth room!
Of course, where you live will determine just how much time you have to play with. If you live an hour or two away from the hospital or find yourself in the middle of the season's worst snowstorm, it's better to be safe than sorry -- you should head into the hospital (or alert your midwives if you're having a homebirth) even if you're not absolutely sure that you're experiencing labor. Of course, being able to recognize true labor contractions will be extremely helpful, so familiarize yourself with the differences between Braxton Hicks contractions and signs that labor is beginning (while you're at it, read up on signs of danger during labor so you can react to any problem quickly).
What will labor be like?
This is not an easy question to answer, mostly due to the unique feelings that labor brings. One woman's experience of labor is often drastically different than another's, so it would be unfortunate to go into the delivery room expecting a specific sensation and experiencing something completely different. The best way to prepare is by learning about the different phases of labor, the common symptoms that many women will feel and key facts that mothers before you have learned from experience.
You'll experience a period when your Braxton Hicks contractions escalate and your cervix begins to soften, which is known as "false" labor or "prelabor". The list of prelabor signs is fairly long, but cramping, back pain, diarrhea and loss of amniotic fluid are all fairly reliable indicators that labor is about to begin. Once labor really sets in, you may have distinct contractions or your waves of pain may sort of blend together, but one thing is for sure: you will have contractions, and they will get stronger until your baby is born.
Your body isn't the only part of you that is affected during the active part of labor. Many women describe feeling delusional or spacey during the most intense part of labor, and that's really no surprise, since labor takes a huge emotional toll that can surface in a number of ways. Practice your relaxation routine, breathing techniques and pelvic floor exercises to prepare as best you can, but keep an open mind and expect an experience like no other!
If this is your second child, there's a good chance that you'll have a quicker labor than you had the first time around. Your vagina and uterus will stretch and contract more easily, which will make the pushing phase of labor about half as long as it would be in a first pregnancy. But don't assume this delivery will be the same -- or drastically different -- than the last. Different babies bring different labor experiences, after all!