Pregnancy in 31st week

At this stage of your pregnancy, your baby should be about 41.1cm (over 16 inches) from head to heel, which is approximately the same length as a tender coconut. The baby’s weight should be around 1.5kg, and it’s going to continue to increase—your baby’s wrinkly skin will become smooth with the addition of some muscles and fat as a result.

Your baby is very active this week, and is likely to do somersaults, suck his or her thumb, kick and move around. It’s likely your baby is peeing several cups of urine into the amniotic fluid at this stage, which increases the volume of the amniotic fluid in the sac until the baby swallows it all over again. Thus a balance in the amniotic fluid is made. If the amount of amniotic fluid in the amniotic sac increases too much (polyhydramnios) or if there is too little of it (oligohydramnios), it can indicate gastrointestinal or urinary problems with the baby. These issues can be revealed when you go in for your routine ultrasound between weeks 32 and 34 of pregnancy.

Your baby will continue to grow, which essentially means that so will your weight and your baby bump. This might make you feel a little wobbly or awkward on your feet, and can often cause swollen legs, back pain, round ligament pain and sciatic nerve pain. If you also have varicose veins on your legs, vulva or rectum then you should talk to your doctor about pain-relieving mechanisms and remedies. (Read more: Home remedies for varicose veins)

You might experience colostrum leak from your breasts this week if you didn’t occasionally during the second trimester (you can start using nursing pads if this causes you embarrassment). Braxton-Hicks contractions are also likely to show up this week. Both of these symptoms are indications that your body is preparing for delivery. If you haven’t gotten your baby’s position identified before, you might want to get it done this week. 

A breech position and birth can be complicated, so if you have this issue then your doctor can show you ways to try and turn your baby—make sure you never do these alone. If your baby is unable to turn or there are other complications, then your doctor might discuss caesarean or C-section delivery with you.

Vaginal delivery might have been your choice, but if your doctor recommends C-section delivery, then you should definitely consider it because your and your baby’s safety comes first.

The third trimester can be very uncomfortable for some women, while others may experience minimal symptoms.

Many women experience symptoms like melasma, bleeding gums, swollen gums, headaches, nosebleeds, mood swings and other issues as well.

The following are some of the key symptoms that you might experience in the 31st week of pregnancy. 

• Round ligament pain: Round ligament affects the lower abdomen and groin region. As the baby keeps growing throughout the gestation and the weight of the uterus keeps increasing, the ligament starts to get more and more stretched. As a result, even slight movement (coughing or laughing, for example) can cause pain in the lower abdomen or hip area. Round ligament pain begins in the second trimester and may reduce in the third trimester, but some women experience it throughout. Warm applications or holding the area before moving are suggested to reduce and avoid the pain.
• Sciatic nerve pain: A lot of women experience pain along their sciatic nerve during the third trimester of pregnancy. The sciatic nerve begins in your lower back and runs down your hips and legs. It passes below the uterus and as the weight of the uterus increases (due to the growing baby), it increases the pressure on the sciatic nerve. This pressure manifests in the form of pain along the length of the nerve. The American Pregnancy Association suggests lying down on the opposite side to where the pain occurs to avoid the discomfort.
• Varicose veins: Varicose veins during pregnancy are quite common. And once they arrive, they don’t ever go away completely. Varicose veins that appear on the vulva or rectum (also known as haemorrhoids) can burst during childbirth. So you should definitely talk to the doctor about them and discuss the best way to manage varicose veins during pregnancy.
• Braxton-Hicks contractions: Braxton-Hicks contractions are false labour pains that occur in the later phases of pregnancy, especially the third trimester. These can be uncomfortable. Try sitting down or changing positions to see if the pain reduces. Unlike labour pain, Braxton-Hicks contractions are not rhythmic. Their intensity also tends to reduce (rather than increase) with time. Keep a watch on these contractions and contact your doctor at the earliest in case you think it’s real labour.
• Sleep problems: Sleeping problems are the worst during the last trimester of the pregnancy, thanks to the back pain, frequent urination during pregnancy, and exhaustion. Also, some women start to snore during this time as their uterus pushes against their diaphragm and nasal swelling occurs in some cases. Studies show that more than 60% of women report sleeping difficulties in this phase despite not having a sleeping disorder. If you have been snoring a lot, it is best to talk to a doctor since snoring and difficulty sleeping may increase your blood pressure and increase the risk of complications. (Read more: Sleep during pregnancy)
• Fatigue: With all the sleep issues, frequent urination and having to manage a normal routine, all the while when your body is working double-time to support the baby’s growth, it is normal to feel tired. The best way to deal with fatigue is to take enough rest. Also, a balanced diet and some physical activity may help.
• Digestive issues: During pregnancy, your body releases a hormone called relaxin to relax your pelvic muscles and cervix to prepare you for childbirth. However, this hormone also relaxes the muscles in your intestines and slows down the passage of food through your gut. Also, studies show that pregnant women tend to drink less water and eat more which ultimately leads to constipation. Doctors suggest a higher intake of dietary fibre and drinking at least 8-10 glasses of water every day to avoid constipation. Indigestion, acidity and gas might also coincide with constipation at this stage of your pregnancy.
• Colostrum or breast pre-milk leak: You might notice your breasts leaking colostrum now, which is basically a type of pre-milk that provides essential nutrients and antibodies to your baby in the first few days after birth. Colostrum can be thin and watery or thick and yellowish, but in any case, this is an important development because it shows that your body is prepared for breastfeeding. If the leak is too intense, you should get disposable or reusable breast pads to handle them.
• Increase in shoe size: This is a minor inconvenience compared with everything else that is going on in your life right now, but keep in mind that some women's feet can grow during pregnancy—the relaxin hormone in the system and growing weight can flatten the arch of the foot, causing a small but permanent change in shoe size.

Now that you’ve made it so far in your pregnancy, many difficult-to-deal-with issues are behind you. However, the third trimester is a critical phase of your pregnancy and you will need to keep an eye out for the following complications during the 31st week of pregnancy.

• Stillbirth: The sudden and spontaneous loss of the baby after the first 20 weeks of pregnancy is known as stillbirth. It can be quite traumatic for parents-to-be, especially at such a late stage of pregnancy. If stillbirth occurs in the 31st week of pregnancy, it’s known as a late stillbirth. The causes of stillbirth in the third trimester are usually maternal infections, underlying health conditions or sudden accidents. Regular check-ups and proper prenatal care can reduce the risks of stillbirth. But if you do see any symptoms starting, contact your doctor immediately—early diagnosis improves the chances of saving the baby.
• Hypertensive diseases: A lot of women have high blood pressure even before their pregnancy, and their condition is properly monitored by the doctors, keeping in mind the risks involved. However, women who develop gestational hypertension (pregnancy-linked high blood pressure) may be at risk of complications too. This is the reason why getting your blood pressure checked regularly, especially during the third trimester, is of vital importance. If blood pressure issues are left unchecked at this stage, they might cause complications like placental abruption, pre-eclampsia and eclampsia.
• Subchorionic haemorrhage: The baby needs protection and support while in the womb, and four fetal membranes provide this support throughout the pregnancy. The chorionic membrane is one of these membranes—it also helps in the development of the placenta, the new organ all pregnant women develop to support the baby’s life. If there are any complications with the placenta, it can cause a rupture in the chorionic membrane, which in turn can cause bleeding during pregnancy. Since it’s linked to the function of the placenta and fetal membranes, this complication needs immediate medical attention to ensure the safety of the baby.
• Infections: Pregnant women in their third trimester are more susceptible to infections like bacterial vaginosis, urinary tract infection (UTI), hepatitis B, hepatitis C, genital herpes and group B streptococcus or GBS bacterial infection. Whether these infections are viral, bacterial or fungal, the risk of passing them on to the baby in the womb through the placenta is quite high. Taking ample precautions against all types of infections, including salmonella and listeriosis, is therefore very important. Most pregnant women with infections are given medications immediately—don't worry, doctors weigh the benefits and side effects of the medicines for the baby before prescribing the drugs for you. Some infections like hepatitis B can be transmitted from mom to baby, and affect the baby's liver health. In the case of hepatitis, vaccinations are given to the mother and the child immediately or soon after birth to ensure safety.
• Obstetric cholestasis: Itchy palms and soles of your feet, especially during the night, might be a symptom of obstetric cholestasis. This disease might be rare, but Indian women are at a higher risk of developing this issue. Obstetric cholestasis occurs due to the effect of pregnancy hormones on the liver, and there’s no medication or treatment that can get rid of this issue during pregnancy. As the hormone levels go back to normal after pregnancy, this issue resolves on its own and the itching disappears. In the meantime, talk to your doctor about managing the symptoms of cholestasis during pregnancy.
• Placenta previa: If you have been diagnosed with placenta previa (in which the placenta covers part or all of the cervix) and the issue has not resolved on its own, there's a good chance that your doctor will recommend bed rest and C-section delivery for you. You may also need to go for extra ultrasounds during pregnancy to monitor the condition, too.
  Do as your doctor says, as placenta previa this late in the pregnancy can increase the risk of bleeding. If you do have some bleeding, do not use a tampon—use a sanitary napkin instead and go to see your doctor immediately.
  Water breaking can be dangerous for you in this condition; if you feel your water has broken, call your doctor immediately.

Nine more weeks and you’ll finally get to the date when your baby should be in your arms. In the meantime, you’re likely to be getting more exhausted and the work might just be piling up. Enlist the help of family and friends to get your home ready for your baby. You must remember to do the following things during the 31st week of pregnancy.

• Before you yield to your nesting instincts and shop for your baby, make a list of things you will need, too.
  Get breast pads, a good nursing bra and comfortable clothes as well as shoes for yourself.
  Ask your doctor about provisions, medications and supplements you will need immediately after giving birth and make sure you get them.
  Ensure that you pack a go-bag full of all your immediate essentials and pregnancy paperwork, ready for your trip to the hospital.
• Whether you have a baby shower or not, getting the necessities for your baby ready should be your priority right now. The right size diapers, washcloths, oilcloths, cribs, tub for bathing or cleaning, etc., will all have to be arranged beforehand. If you have friends who have young children, you could source both lists of essentials and the essentials from them—this could be a good way to get guidance and get your necessities met as well.
• If your baby is in breech position and your doctor has shown you the remedies to try at home, you might want to give them a try this week. If they don’t work, you should prepare for a breech birth or go for a C-section. 
• While strenuous exercise is not recommended at this stage of pregnancy, you might want to stay active by walking, doing some light yoga, etc., after consulting your doctor.

Following everything your doctor says at this stage of your pregnancy is of vital importance. You might feel like there’s a lot to do, but if your doctor suggests that you take rest and put your feet up, then listen to him or her. Sticking to your diet and medication or supplement dosages is also very important.

Your mental health may not be on your mind right now, but it’s important to keep a track of how you’re feeling—talk to someone close to you and get support or help when you need it. Being vocal about your needs might seem selfish, but you need to put your health very high on your priority list right now because your baby is depending on you.