WEEKS 33 – 37

These are the last few weeks of your pregnancy before the foetus achieves what is called "maturity" i.e.: by the end of 37 weeks, the foetus is fully-grown and all the systems are capable of functioning normally. the foetus by the end of this period is ready for delivery to the outside world. Now is the time when you start your dress rehearsals for the delivery time.

Common Complaints

Apart from the complaints mentioned in the earlier weeks,       .    One thing, which is most significant, is "LIGHTENING" OR "DROPPING DOWN" of the baby.    

• In first times, this usually happens by the 36^th week. In others it may happen as late as in labour
• Lightening means that the head of the baby which was in the abdomen has now drooped in to the pelvis in preparation for labour.
• Due to this the height of the uterus reduces easing some pressure of the chest ( diaphragm and lungs) making breathing easier and providing welcome relief to the mother.
• The baby’s head is now fixed and its movement may seem reduced. Instead of active movement of the whole body, you may just experience the movements of the legs and perhaps the arms.
• The head which is fixed in the pelvis, may press on the urinary bladder and this may lead to difficulty in urination or increase frequency of urination.
• You may have noticed an increase in the discharge through your vagina. This is OK as long as it is colourless and sticky. Watery / blood stained or discharge of blood has to be reported to your doctor immediately.

Foetus / Your Baby Inside

There is an acceleration of the "maturity" process of all the organ-systems in your baby, especially the lungs. At the end of 37 weeks your baby is completely formed and mature.At this stage it may be around 45 – 50 cms (18 – 20") in length and anywhere more than 2.5kg in weight.

PICTURE OF FOETUS:

You will have put on around 10 – 11 kgs over you pre-pregnant state. If you have put an little less weight, you need not worry as long as the foetus / baby has grown well (according to your doctor). The foetus is like a parasite and will take all the nutrition it needs at the expense of the mother.If your weight gain is more than 2 pounds/week or 3 kg/month then you need to be careful regarding PIH .     .   By 36 weeks, the uterus has reached up to your breastbone and you may experience difficulty in breathing. This will reduce after "lightening".The varicosities in your legs may have increased.Your abdomen is stretched including your navel and stretch marks may be more prominent.Your Blood Pressure may be slightly higher than in the earlier weeks.

Visit to your Doctor      

Possible Problems      

Important / Useful Instructions:

1. You have been following all the instructions given to you and now it is only a matter of few more weeks.
2. During this period you can make a "BIRTHING PLAN" and get to know about various aspects of labour and delivery and discuss it with your doctor like for instance:

• Whom do you want as your labour partner? In west usually the spouse is the partner, but in India, the spouse may not be allowed to be with you till the end.
• Diet and position during labour.
• When to report to your doctor in labour.
• About ambulation / walking around in labour.
• Transport facility for you once you are in labour.
• Wearing contact lenses during labour. It is better to substitute it with your old spectacles.
• Whether you will be allowed to record the event with a still/video camera.
• Various medical procedures during labour like:
• enema,
• sharing pubic hair,
• being on IV drip,
• use of pain relief medication and their effects on you and baby,       
• urinary catheterisation,
• delivery positions,
• episiotomy/ Forceps/ vacuum and Caesarean section.
• foetal investigations and monitoring in labour
• Whether your partner can cut the cord ?
• Details regarding holding and feeding the baby after delivery.

All these things and other doubts that you have should be discussed and clarified with your doctor beforehand. In the present day norm of "Nuclear Family" you may not get / afford a 2^nd chance.

Your doctor’s judgement and hospital policies may to a certain extent influence the above decisions.

1. Sex during this month is preferably avoided though not contra-indicated especially in women with

• previous preterm delivery,
• previous cesarean delivery,
• leaking per vaginum,
• bleeding per vaginum

As such sex might be a bit troublesome because of the protruding abdomen.

2. Carry your medical records with you as much as possible, just in case there is an emergency.
3. Monitor your baby’s status by keeping a tab on its movement.
   Either count total number of movements from 10:00am – 10:00pm and make a daily record. Or count foetal movements in 1 hour period 3 times a day (after breakfast lunch and dinner). If you detect any abnormality report to your doctor.
4. Report to your doctor in case of earlier mentioned alerts (warning signals).    

Next