Pregnancy in 38th week

Your baby is considered to be a full-term baby by now (babies who reach the end of the 36th week of gestation are considered full-term). This is considered to be an important landmark in your pregnancy, as preterm birth may be linked with low birth weight and other complications. 

Your baby is expected to be about the size of a leek at this stage of pregnancy. Your baby must be weighing around 3 kg. The tip to toe length of your baby will be around 50-51cms. These numbers should keep rising till the expected date of your delivery.

The following changes in the baby’s body can be observed in the 38th week of pregnancy:

• The organ systems along with their functioning capacities continue to increase in the 38th week of pregnancy. 
• Further refinement of your baby’s organ functions will occur during this week of pregnancy. 
• Your baby’s nervous system, including the brain, is almost fully developed right now which helps in the breathing, digestion and heart functions. 
• The rate at which your baby gains weight will slow down due to limited space in the uterus
• Your baby will gain some amount of fat, which will fill out his/her loose and wrinkled skin. This fat also acts as insulation, to maintain your baby’s body temperature post-birth. 
• The skull of your baby continues to be soft while the other bones harden. As the skull is the largest part of the baby’s body, this phenomenon makes the skull pliable enough to pass through the birth canal.
• Formation or passage of meconium before delivery. Meconium basically forms the contents of your baby’s fecal matter. This meconium is composed of the lanugo (insulating hair coating) along with the vernix (protective layer on the skin). If your water breaks or leaks and if it is greenish in colour, this means that this leakage contains meconium. Meconium indicates fetal distress.

The 38th week of your pregnancy can be associated with some changes in your body. These may include the following:

• Expansion of the uterus from the pubic area till the ribs. 
• Engagement or lightening: Engagement or lightening is defined as a process by which the baby descends into your pelvis. This can start anytime after the 34th week of pregnancy. It basically signifies that your body is preparing for delivery. It usually feels like your tummy has shifted downwards and forwards. The good part about the engagement is that it relieves certain symptoms like pregnancy heartburn.
• As the baby descends into your pelvis, it may result in excessive pressure applied on the urinary bladder which could lead to excessive urination that may even disturb your sleep. This is absolutely normal. If you find any of these symptoms uncomfortable, you can read a book, talk to your family about it or practice relaxation techniques. 
• In case your labour starts, you should know that the following symptoms may be seen: dilatation of the cervix, water breaking, pregnancy contractions that are severe, persistent and spaced at regular intervals, diarrhoea and nausea. 
• It might have become easier for you to breathe as the baby has now descended into your pelvis, therefore allowing your lungs to expand fully. 
• Softening of your body tissues and joints, which helps in the delivery process.
• Balancing issues: The considerable increase in body mass makes it difficult for a pregnant female to balance her body. Therefore, if you are not already practising it, try wearing shoes with flat soles and get support bars installed in your washrooms.

It is recommended that you should be aware of the major issues that you might face this week and have an idea about basic solutions to relieve the discomfort. In case these features persist, you should go to the hospital. The following symptoms might be observed in the 38th week of pregnancy:

• Sciatic nerve pain: Pregnancy-related sciatic nerve pain may extend to the 38th week of pregnancy. This pain occurs due to the compression of the sciatic nerve by the enlarged uterus. Sciatic nerve pain extends to the back, groin and lower limbs. (This pain should go away once the baby has descended into the pelvis.) If this pain persists, apply a warm compress to the painful region or ask your doctor if you can take paracetamol for the pain. 
• Round ligament pain: Sometimes, patients might experience pain in the lower abdomen or groin which is caused by pain in the round ligament. It is usually a stabbing kind of pain. It can be unilateral (on one side of the body) or diffusely spread all over the abdomen. If this pain radiates or becomes unbearable, inform your doctor as soon as possible. 
• Varicose veins: There is still a possibility of developing varicose veins, even in the 38th week of pregnancy. It occurs due to excessive pressure exerted by the uterus on the inferior vena cava (the blood vessel that carries deoxygenated blood away from the peripheries). These varicose veins appear as bluish clusters of veins that are painful and hard. Most common sites of varicose veins include the vulva, anus and the lower limbs.  
• Fatigue: Towards the end of pregnancy, you must be feeling exhausted all the time. There is another life inside you. It is a good idea to take adequate rest and remind yourself that this fatigue isn’t permanent. You will regain all your stamina. Consuming adequate fluids and nutrients will help you feel less tired.  
• Sleep problems: Pregnant women are prone to experiencing sleeplessness. Sleeping problems during pregnancy may be a result of the discomfort you experience in the form of digestive issues, generalised pain or excessive urination. Your hormone levels are also not in complete balance during the pregnancy. If you experience vivid dreams then try communicating with your partner and family. If negative thoughts and feelings persist then seek professional help. It is recommended that you sleep for at least 12 hours a day during this time and this target can be achieved by sleeping in the afternoon for a few hours.
• Digestive issues: Heartburn, bloating, belching, nausea, vomiting and acid reflux are some of the most common complaints during pregnancy. If you have a difficult time dealing with any of these, consult with your doctor. They may prescribe some antacids or proton pump inhibitors. 

The following complications may be seen during the 38th week of pregnancy: 

• Stillbirth: If a fetus dies after the 20th week of pregnancy, it is termed as a stillbirth. Whereas, if this death occurs before the 20th week of pregnancy it is defined as a miscarriage. In case you experience vaginal bleeding, abdominal pain or unbearable contractions then go to the hospital as soon as you can. If caught early, stillbirths can be prevented. 
• Hypertensive diseases: Pregnant women who develop high blood pressure after the 20th week of pregnancy are said to be suffering from gestational hypertension. If urine testing shows the presence of proteins then it is defined as preeclampsia. Preeclampsia associated with seizures is termed as eclampsia. 
• Subchorionic haemorrhage: The placenta can get separated partially from its original site of attachment, resulting in disastrous vaginal bleeding. This condition is called subchorionic haemorrhage.  
• Infections: Pregnancy is a state of immunosuppression (low immunity). Therefore, pregnant women are prone to developing all kinds of infections. Bacterial infections such as bacterial vaginosis caused by G.vaginalis or urinary tract infections caused by E.coli are very common. If exposed, patients might develop viral infections such as hepatitis or genital herpes. 
• Placenta previa: A low lying placenta that covers the cervix completely or partially is termed as a placenta previa. Normally, it can be identified early on in pregnancy and is expected to resolve as the placenta migrates upwards. But, if it persists till the third trimester, then your doctor might request more frequent ultrasound scans and may recommend a C-section as a normal vaginal delivery might lead to a large amount of bleeding.  

Now that you have reached the 38th week of your pregnancy, you must make sure you tick all the items off on the following checklist: 

• Gather information about how you should proceed when the labour actually begins. You can ask a doctor or a midwife about this as they will provide you with various tips such as when to go to the hospital in case contractions start or you notice that your water has broken. 
• Educate yourself on the three stages of labour. This awareness will help you get ready mentally for your delivery and make you feel more confident compared to somebody who goes into labour unprepared. 
• In case you have children, you should tell them about their new sibling who will arrive soon. Also, make sure that you have arranged for someone to take care of your children and/or any other dependants while you are delivering your baby.
• Make sure you have gathered all essential goods such as food, pantry staples, toiletries, diapers and medicines that you might need in the weeks after delivery.
• Recheck if your delivery kit is ready for the big day. It should contain a change of clothes, your charger(s), all your medical records of the current pregnancy and any other essentials.