A gestation of 39 to 40 weeks is regarded as a full-term pregnancy. Therefore, your little bundle of joy may be due anytime as soon as you complete the 40th week of pregnancy. However, some women may experience the onset of labor before completing these nine months, while some may not experience any such signs even during the 40th week. This post explains the symptoms and signs you may experience in the 40th week of pregnancy, the changes that occur in your body and that of your baby, and tips to help you cope with labor. Also, we address some of the frequently asked questions related to the 40th week of pregnancy.
What Are The Pregnancy Symptoms At 40 Weeks?
In the 40th week of pregnancy, you might have the below symptoms (1) (2) (3) (4): In addition to the pains and discomfort, you witness some changes in your body in this week.
Changes In Your Body In Week 40
Here are some of the physical and emotional changes you may notice in the 40th week: The physical changes mainly occur because your body is getting ready for the delivery, and your baby has grown big.
How Big Is Your Baby At 40 Weeks?
At 40 weeks, your baby reaches full-term and is about the size of a watermelon. The baby measures 19.68 inches (50 cm) from head to toe and weighs about 7.7 pounds (3.5 kg) (8).
Baby’s development at 40 weeks
Let’s see the developmental status of the various parts of your baby’s body (2): The changes in your body and the baby are closely monitored during your regular visit to the doctor.
Your OB/GYN visit
In addition to the regular check-ups, your last prenatal visit might have the following tests:
The physical test includes a pelvic examination to determine the cervical dilation (also called ripening), thinning, and softening. It helps the doctor to ascertain the expected time of labor.
Amniotic fluid index (AFI) will be checked to measure the volume of amniotic fluid. The normal AFI value ranges from 5-25cm and for the third trimester the AFI value is around 7cm on average (9).
The non-stress test (NST) measures the fetal heart rate and movements (10).
A contraction stress test is done when the NST results are not normal. It helps in determining the response of fetal heartbeat during the contractions.
Biophysical profile test (BPP) is a kind of fetal well being test using an ultrasound. It detects the baby’s movements, breathing pattern, level of amniotic fluid and the body tone. This test is performed when NST produces unsatisfactory results or when there are conditions when fetal well being must be monitored.
Note: NST, CST, and BPP can be done at any time during the pregnancy. They will be done if you have health problems or your pregnancy is overdue (longer than 40 weeks). During your last prenatal visit, your doctor will also discuss the possibility of your pregnancy getting over due to induction of labor or C-section. Most importantly, your OB/GYN will advise you to look out for the signs of labor.
Signs Of Labor In The 40th Week
Keep an eye on these signs, and contact your doctor accordingly (7): Contractions get frequent and stronger with time.
Light brown or pinkish mucus discharge (also referred to as bloody show)
Period-like abdominal cramps
Throbbing or dull pain in the lower back
Diarrhea
Amniotic sac rupture – you might experience frequent contractions if the labor is imminent. Water leak
If the leaking water is colorless, odorless and is gushing or leaking slowly, then it indicates the rupture of the amniotic sac. It means your labor will start soon. But even if labour does not start, just let your doctor know.
What Happens After The Water Breaks?
Most women have a water break before the onset of labor. However, some may have it after the contractions begin. The rupture of the amniotic sac exposes your baby to various infections (11). The bacteria can travel from the vagina to the uterus, causing infection to both the mother and the baby. To prevent infections, wear a sanitary pad that will keep you dry and clean. Contact your hospital and see the doctor.
When To Call The Doctor?
You must call a doctor if you (12):
Notice a decreased fetal movement (fewer kick counts)
Have pain while passing urine as this can indicate urinary infection
Experience continuous abdominal pain
Have bright red vaginal bleeding
Have fever and chills
Have no contractions even after the water breaks
Leak yellowish or greenish fluid when the amniotic sac ruptures
Note: If the amniotic fluid appears brown or green, then notify your doctor immediately. It happens when your baby passes meconium in the sac and is an indication that your baby is stressed and needs to be delivered as soon as possible (13). Once you reach the hospital, the doctor may wait for the contractions to begin. If the contraction does not start by itself, then the doctor may induce labor. In some women, the amniotic sac will not rupture until they are into active labor.
Labor At 40 Weeks Pregnancy
As you enter labor, the pain grows intense and stronger till the cervix opens completely. You may also have cramps. Your doctor will check if you need epidural anesthesia when the pain becomes unbearable. The average labor time is six hours (14). In some cases, labor begins naturally but in some other cases, the doctor may induce it.
Inducing Labor At 40 Weeks Pregnancy
Labor induction helps start the birthing process through medical intervention. Labor is induced in the following cases (15):
You have a water break, and the contractions are delayed. Inducing labor will help prevent infections to you and the baby.
You have high blood pressure at full-term.
Prolonging the pregnancy poses risks to you or your baby.
The amniotic fluid is insufficient.
You have long crossed your due date. However, at 40 weeks, you would be advised to wait for a few more days.
How is labor induced?
Labor can be induced through traditional methods such as:
Sexual intercourse Nipple stimulation Walking Acupuncture
However, there is little scientific evidence to prove their effectiveness (16). Medical techniques for inducing labor include include (17):
Membrane stripping or sweeping Oral or vaginal medication Oxytocin administered through IV Rupturing the amniotic sac
Discuss with your doctor about the benefits and risks before you agree for induced labor. Your delivery will be smooth if your baby is in the right position that is head-down. But if the baby is in a breech position, a normal delivery could become a problem.
What If The Baby Is In A Breech Position?
By the time you enter labor, the baby moves down into the pelvis with its head down for easy passage through the vagina. But if the baby has its buttocks or legs down, it is called a breech presentation. Such a situation arises in some cases of twin pregnancies, in the absence of sufficient amniotic fluid, the presence of uterine fibroids, and also due to physical abnormalities in the baby (18). In the case of breech presentation, your OB/GYN will do a pelvic examination or an ultrasound scan to confirm the breech. Once it is confirmed, they might suggest a C-section or external cephalic version (ECV), where the doctor would change the baby’s position manually. The ECV method helps in getting the baby to head-down position (19). However, in the 40th week, this method is not encouraged by the doctors as there is no room for the baby to move inside. The breech position will definitely increase your anxiety levels, and anxiety is exactly what you should not have during labor.
Tips To Help You Cope With Labor
Whether it is a breech position or a head-down, you need to know how to face the situation without getting tensed. Here are some tips you can follow: Not just presence, the dad-to-be should also participate in the event with all the contribution he can make.
Tips For Dads-To-Be
Dads, let’s tell you that you will have your own moments of fear and anxiety. So, here are some tips you can follow to ease your emotions: Know your stuff: Understand what your partner is going through. Make a note of the instructions given by your doctor. Prepare yourself for the D-day so that you can act wisely rather than be terrified when your partner’s water breaks. As you help your partner to deliver, you both will realize that it is not too long before you become parents to a lovely little baby.
What Happens Immediately After The Baby Is Born?
This information will prepare you for a series of events that will happen after the birth of your baby.
In babies:
Soon after the baby is out, he/she may cry out loudly or stay unconscious due to the medicinal effect.
The umbilical cord is cut and clamped.
The doctor uses an aspirator to suction the baby’s mouth and throat to remove any traces of fluid. The newborn will be wiped dry and covered in a blanket to provide warmth. The blood sample taken from the umbilical cord will be tested for identifying your baby’s blood group and several other factors.
The infant will be administered the necessary vaccinations. Your baby will be given Apgar score based on their physical and health conditions. The doctor will check for the heartbeat, muscle tone, response to stimuli, breathing rate and color of skin for the score.
In mothers:
The doctor will first try to stop excess bleeding.
She will check the placenta to ensure that no fragments are left inside the uterus because it can cause bleeding or infections. The internal and external stitches, if any, are left to heal on their own.
