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Pregnancy

Doctor Tips, Weeks 27-40

Jennifer Lincoln, MD, IBCLC, Board Certified OB/GYN
January 3, 2019 . 44 min read

1. Week 27

While developing your birth plan, you might want to think of it as your birth “preferences.” So much can be unknown before you give birth for the first time and if you get hung up on very strict birth plan “rules,” you might end up with unnecessary guilt or disappointment afterward. For example, if you plan on not having an epidural but change your mind, it’s OK and doesn’t make you a failure. It means you thought things through ahead of time, but modified your decisions as you needed! Always bring a copy of your birth plan to a prenatal appointment to review it and make sure your provider is agreeable to your wishes well before you go into labor, and bring multiple copies to the hospital in case they get lost when the time finally comes.

Read more about week 27.

2. Week 28

Now is the time that your doctor or midwife will talk about doing fetal kick counts. Most providers agree that if you feel your baby move 10 times in 2 hours, your baby is good to go. If you don’t get that many movements, try lying on your side in a quiet room with no distractions. You might be surprised that you actually do notice more movement when you are more focused. Try to drink something with sugar in it to wake your baby up. If your baby is still sleepy, you should call your doctor or midwife, and they may bring you in to monitor your baby. Often it is nothing, but better safe than sorry.

Read more about week 28.

3. Week 29

Two things you might want to start thinking about is who your baby’s doctor will be, and how you plan to feed your little one. Ask around for pediatrician recommendations from friends and family, and consider making a prenatal appointment with them to see if you are a good fit. This is your time to get your questions answered, such as are there evening or weekend clinic appointments, and if I need breastfeeding help, do you have a lactation consultant? Speaking of lactation, if you plan to breastfeed (or aren’t sure and want more info), sign up for a breastfeeding class now! These prenatal courses can be so helpful in getting you off to the right start with nursing, and can help ease your anxiety if you’ve never done it before.

Read more about week 29.

4. Week 30

The good news: babies truly need very little. The bad news: baby stores are notorious for being overwhelming and convincing you that you need every last item under the sun to keep your bundle of joy safe. Use your common sense, do your research ahead of time, and poll your friends for what worked and what didn’t. If you are inheriting any items, make sure they’ve not been recalled. Now is the time to think about purchasing a car seat, getting it installed, and making sure it’s in correctly. Ask your doctor’s office where you can get your installation checked locally, which is often done for free.

Read more about week 30.

5. Week 31

All leading medical organizations recommend breastfeeding as the optimal way to feed your baby, and so many reasons exist as to why this is a baby’s perfect first food. But are you worried about your partner feeling left out if you nurse? Rest assured that there are so many ways they can be involved other than directly feeding, such as supporting your decision to bringing baby to you for evening feeds, and bonding with your baby in other ways. If they seem hesitant, make sure to include them in a breastfeeding class so they can get their questions answered and feel ready to help out when the time comes.

Read more about week 31.

6. Week 32

One way to conquer the unknown is to take a good childbirth preparation class. How will you know if it’s any good? Get some recommendations from your OB/GYN or midwife’s office and ask your friends about their own experiences. If you take a class and you find that the teacher is very dogmatic (i.e. she says you are a failure if you end up needing an epidural), you may need to question the reliability of the information and try another class. The best childbirth classes focus on birth as a normal process, discuss what to expect in labor and after, address some complications that may arise, and let you ask whatever questions you need. Going on a tour of Labor and Delivery is also a great idea, so you know where to go on the big day and what to expect when you get there!

Read more about week 32.

7. Week 33

Preterm labor can be scary and so can be giving birth to a premature infant who needs to go to the Neonatal Intensive Care Unit (NICU) for specialized medical care. If you find yourself in this situation, know that is normal to feel completely stressed out and out of control. A few things can help in this scenario: finding other parents who’ve been in your shoes, establishing open lines of communication with your baby’s doctors and nurses, and asking for (and accepting!) help wherever you need it. Know that things like skin-to-skin and breastfeeding can absolutely be done when your baby is in the NICU, and have actually been shown to get your baby healthier more quickly.

Read more about week 33.

8. Week 34

With the homestretch of pregnancy in site, you might be wondering when you should stop working. Some work until they go into labor, while others stop around now to have time to rest and finish up preparations. Whatever you decide, take into account a few considerations: Will you still be paid or have insurance coverage when you stop working? How much leave do you have total, and do you want to use it now or after your baby is here? Can you cut back hours instead of stopping completely so you don’t use up your time off? Can you financially swing it? Thinking about this ahead of time can help you plan better and decrease your stress and worry.

Read more about week 34.

9. Week 35

While you’re busy packing your labor bag, it’s also time to consider who you want with you at the hospital…or who you don’t. Check on your hospital’s visitor policy as some limit it to a certain number of support people. Identify who will be your primary support person. Usually this is your partner, but for some women it may be their mother, sister, or close friend. Do you want a doula present to help coach you? If there are people you specifically don’t want in your labor room or to visit afterwards, you need to set those ground rules now. Make sure your partner and labor nurse know in case an uninvited guest shows up. Don’t feel bad about your choices; this is your big day, and you need to feel comfortable with those around you!

Read more about week 35.

10. Week 36

Have you thought about how to make life after delivery a little bit simpler? Prepping now can definitely make those sleep-deprived days run more smoothly. Stocking the freezer with meals that are easy to heat up can help cut down on dinnertime stress, and if friends are asking how they can help after baby arrives, letting them know that some meal deliveries would be most welcome! If you’ve never used the services of a housecleaner, now may be a great time to line one up so you don’t have to worry about cleaning or laundry for those tiring first few weeks (or let a family member or friend do this for you!). If you plan on sending birth announcements, address the envelopes now so it’s one last thing you need to do when all you want is a nap.

Read more about week 36.

 

11. Week 37

True labor is not based on a single cervical measurement. So if you go to the hospital and are sent home because you weren’t in active labor, don’t feel bad. It can sometimes be hard to know, especially with your first baby! Keep in mind that many old wives’ tales exist when it comes to spurring on labor, from eating spicy foods to bouncing on birthing balls. Membrane stripping and nipple stimulation have been shown to work, but you should talk with your provider about whether you really need this or should just wait for things to start on their own.

Read more about week 37.

12. Week 38

Going past your due date is very normal and, as long as there are no concerning signs for you or your little one, is no reason to be induced the day after you were told you’d be giving birth. Very few babies actually check their calendar and show up when they are “due.” In fact, going to 42 weeks of pregnancy can be safe as long as your doctor or midwife does some basic monitoring of your baby. Remember, an induction of labor does put you at a higher risk of needing a C-section, so if you can hold out until labor begins on its own, you’ve got a higher chance of delivering vaginally.

Read more about week 38.

13. Week 39

Have you thought about how you want to manage your pain in labor? A few different options exist. Some women have unmedicated labors, where they use alternate techniques to deal with contractions. These can include deep breathing, position changes, massage, getting in the shower or tub, or guided imagery. Other moms will use intravenous (IV) pain medication to help ease their pain. These medications usually provide some relief, but cannot be used right before your baby delivers because they can make him or her sleepy. Others opt for epidurals—medication that is placed in your back that can make you entirely numb from the waist down, or at least numb enough to feel no or very little pain. Each option has its own risks and benefits, so it is worth thinking about and looking into now so you can be prepared.

Read more about week 39.

14. Week 40

Unless a medical complication exists, your baby should be kept in close contact with you in the first hour after birth. This is called skin-to-skin, and is when your baby is placed chest-to-chest with you directly on each other’s skin. Babies who are placed in immediate skin-to-skin contact with their moms have less stress of being born, hold their body temperature better, have higher breastfeeding rates, have more stable blood sugars, cry less, have less signs of pain, and have improved bonding with their parents.

Read more about week 40.

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