Women's Healthcare Topics

36 Weeks Pregnant

Reviewed by James Brann, M.D.

At 36 weeks pregnant, your uterus is rather “huge”. You may think that you can't get any bigger, but keep in mind that you have four more weeks until your due date. Your belly will get larger in the next month.

The capacity of a woman's uterus and abdomen to stretch during pregnancy is truly a remarkable phenomenon.

At no other time in your life will the body transform at such a rapid rate than in pregnancy.

Amazingly, while it takes nine months for the uterus to stretch to many times its normal size (from the size of a small pear to being able to hold a seven pound baby), by your six-week postpartum checkup your uterus will already be back to its normal pre-pregnancy size.

Your uterus continues to crowd your internal organs, and you may be ready for the day that your baby drops into your pelvis. For first time moms, "lightening," or the descent of your baby into the pelvis usually occurs a few weeks before labor begins. Your baby might drop this week, or next, or the following week.

Clumsiness is a common pregnancy symptom now. When you consider how large your belly is, it's no surprise that you're stumbling into things, more clumsy than usual. Hormonal changes are causing your pelvic joints to loosen, and it's also loosening the joints in your fingers and toes. Your balance isn't the same, either.

Hip pain can be a troublesome pregnancy symptom, and it's caused by the same hormonal changes that make you clumsier. In the third trimester, the hormone relaxin is released in high levels to soften and relax the joints in your pelvis (which helps your baby's body fit through the birth canal easily). This hormonal change, combined with the increased pressure of carrying around 20-plus additional pounds, can lead you to experience hip pain and discomfort.

Swimming may give you some relief from your hip pain. Standing in a pool renders you weightless, which can take the stress of your joints and make you feel better. Prenatal massage also may help you feel better.

Another change you may have noticed is more vaginal discharge. The discharge may be increasing and even getting thicker. Don't worry about the discharge – it's absolutely normal. At this late stage in pregnancy, your mucus may be pink, red, or even brownish.

Also, your discharge may be related to the fact that your mucus plug is starting to dislodge itself – a sign that labor is on its way.

Once your baby "drops" (a process called "lightning"), you will feel increasingly uncomfortable. You will feel pressure in your lower abdomen, and you'll notice that you have to urinate very often - even more frequently than you did in your first trimester! If your baby is positioned very low in your pelvis, you may also feel vaginal pressure and discomfort.

Luckily, you will only have to feel these uncomfortable sensations for a few more weeks. Your due date is only four weeks away!

Weight Gain

If you are like most women, you probably can't wait until your baby arrives. Your pregnancy weight gain at 36 weeks pregnant may be 29 to 30 pounds. Waddling is a way of life these days, as your baby has probably already descended into your pelvis.

Pregnancy Health Section

Lightening (Baby "Drops" into the Pelvis)

Your baby may drop into your pelvis this week. This is called lightening, and it's a normal occurrence in the final weeks of pregnancy. It's a sign that your baby is getting ready to be born; however, it may be a few more weeks until your labor kicks into full swing.

After your baby drops, you'll have less pressure in your abdomen, so you'll be feeling relief from a few pregnancy symptoms – such as heartburn, shortness of breath, and rib pain and discomfort.

Unfortunately, once lightening occurs, you may start to waddle. Some women experience pelvic discomfort when they walk. Frequent urination is going to be a huge problem after your baby drops. Because your baby is taking up more space in your pelvic area, you may be running to the bathroom every five or ten minutes to empty your bladder. You may have the urge to urinate, even when your bladder is nearly empty.

Fortunately, this won't last too long. Only four weeks to go until your baby is due!

Vaginal Birth after Cesarean Delivery (VBAC)

If you are planning a vaginal birth after previously delivering by C-section you may be surprised to learn that your hospital may no longer allow the practice. Many hospitals are not able to comply with the guidelines the American College of Obstetrics and Gynecologists developed in 1999.

These rules require that a doctor be immediately available throughout active labor in case a woman needs an emergency cesarean section. For a hospital to comply fully, an entire operating crew, OB, and anesthesiologists would need to be available 24/7. With the exception of larger medical facilities, this often puts a strain on resources for smaller hospitals.

Vaginal Birth after Cesarean Delivery.

The guidelines were established recognizing that many women attempting to deliver vaginally after a C-section are more at risk for complications including uterine rupture. This condition is life threatening for the mom and baby. Many women are aware of the risks associated with VBAC but still want to give it a try. This causes controversy when they realize they may not have a choice at their chosen facility. Most doctors argue their position is based on concern for the safety of the mother and baby.

What is of concern is that these women may attempt home births in order to avoid repeat cesareans. While vaginal births after cesarean are possible, there are also very serious risks involved. It is vital that women take control of their health but also recognize the dangers of not having access to a medical staff that is capable of performing an emergency cesarean surgery, if it is needed.

Civil rights also come into play with this issue. Most activists would agree a woman should have the right to select the type of delivery. Many women feel this right is crushed under laws that limit doctors the ability to grant patients' wishes. One thing is certain; the controversy is likely to continue. The best step you can take if considering a vaginal birth after a C-section is discuss your situation with your doctor or healthcare provider. Together the two of you can likely come up with a safe and accommodating plan of action.

Pain Relief Options during Labor and Delivery

Pain mangement  in labor.

You are most likely ready for this baby to be born. With your due date looming in less than a month, your thoughts are often drifting to your labor and delivery. If this is your first pregnancy, you may be nervous about the pain of childbirth.

To alleviate many of your fears, you should take some time this week to research your pain relief options. Call your hospital to see what they offer, and discuss this with your doctor or healthcare provider.

As you are doing your research, keep in mind that every woman experiences and tolerates pain very differently. Some women have a high pain threshold and only require focused breathing and relaxation techniques to get through their labor and delivery. Other women will require pain medication to help them cope.

Pain Relieving Drugs Available During Labor and Delivery
There are two categories of pain-relieving drugs:

  • Analgesics
  • These drugs offer pain relief without a total loss of feeling. They reduce your pain, but don't always completely stop it.

    Systemic analgesics are given as injections into one of your muscles or a vein. They lessen your pain and you will not lose consciousness. They affect your entire nervous system, rather than targeting a specific area.

    Regional analgesics are often the most effective form of pain relief during labor and delivery. They include epidural blocks, spinal blocks, and combined spinal-epidural blocks.

    With an epidural block, you will lose some feeling in the lower areas of the body, but you will stay alert and awake. You may receive an epidural block after your contractions begin, or later in your labor. An epidural block is given in your lower back. Pain relief typically begins ten to twenty minutes after the medicine has been injected.

    During a spinal block, you will get an injection in the lower back to numb the lower half of your body. It offers good and immediate pain relief, but it only lasts for an hour or two.

  • Anesthesia
  • These medications block all feeling and sensations, including pain. They also block muscle movement. If you receive local anesthesia, you will have numbness and loss of feeling in a small area. With general anesthesia, you will lose consciousness and feel no pain. In most cases, anesthesia is only used at the time of surgery.

Talk to Your Doctor About the Best Pain Relief Option
You should have a conversation with your doctor or healthcare provider about the best pain relief option for you. Make sure to learn about the pros and cons of each choice.

Remember that although pain relief during labor and delivery is generally safe, it does come with some risks and side effects.

Is a Medicated Labor Right for You?
You may decide that a medicated labor and delivery is not right for you. You may want to attempt drug-free methods first. These include relaxation and breathing techniques, hypnosis, and acupuncture.

Keep in mind that even if you have made up your mind about a natural childbirth experience, it's okay to change your mind at the last minute. Don't feel disappointed if you decide to have a medicated labor and delivery. All that matters is that you deliver a healthy baby!

Traveling by Plane

Air travel during late pregnancy.

At 36 weeks pregnant, your doctor or healthcare provider will warn you against air travel. You will want to avoid traveling by plane, since your baby can arrive anytime between 37 and 42 weeks of pregnancy!

However, if you must travel, keep in mind that many airlines have restrictions on air travel. In the last month of pregnancy, a majority of airlines require you to provide a doctor's letter indicating your due date and stating that traveling does not pose a health risk. This letter must be signed within 72 hours of your flight.

The airlines do not want you to give birth in the air. You won't want to go into labor during your travels, either. Complications can occur at the last moment, and you will want to be surrounded with the latest technology in a hospital setting.

Take it easy at 36 weeks pregnant and enjoy preparing for labor and delivery!

Baby Section

Growth and Development of Baby

Your baby may weigh as much as 6 pounds and is as long as 18.6 inches (possibly longer!). Now that your baby is almost early term ( Between 37 weeks 0 days and 38 weeks 6 days ), he or she will continue to pack on the pounds and will grow longer as your pregnancy draws to a close.

Space is running out in your uterus, so your baby is spending his or her time curled up with the legs and arms folded against his or her body.

Your baby has started shedding the lanugo (the downy layer of fine hairs) and vernix (waxy-like substance) that has covered most of his or her body up until now. Lanugo and vernix protects your baby's skin from its immersion in amniotic fluid throughout your pregnancy. Some babies are born still covered with these two substances, but lanugo and vernix will disappear shortly after birth.

Your baby's lungs are structurally developed, however if your baby was born this week, he or she may need help with breathing. The air sacs in the lungs are producing surfactant, a substance that keeps the air sacs open when your baby takes her first breath. Surfactant production may not yet be complete, making it a little difficult for your baby to breath and a small chance of oxygen support for a few hours after delivery.

Your baby's heartbeat still beats very fast, between 110 and 160 beats per minute. Even after he or she is born, your baby's heart will continue to beat faster than yours.

The level of amniotic fluid in your uterus is relatively constant. Next week, when your baby is early-term, it will begin to steadily decrease. Your baby continues to swallow amniotic fluid, and excreting it as urine.

There is a balance between your baby swallowing and excreting the amniotic fluid that is maintained each and every day. If this balance is not maintained, the amount of fluid in your womb will increase or decrease significantly, causing a condition called polyhydramnios (too much fluid) or oligohydramnios (not enough amniotic fluid).

Did you know that some researchers believe your baby actually releases a signal to trigger the onset of labor?

There are several theories on how baby does this. Some researchers believe that your baby's brain sends a signal to the fetal adrenal glands. These glands then start to secrete the hormone cortisol, which may alter the metabolism of estrogen and progesterone, resulting in labor.

Other researchers have postulated that the fetal lungs secrete signals indicating they are mature, as well as enzymes that result in the release of prostaglandins, which help the cervix ripen and help the uterus to contract. This is highly likely as the body does release prostaglandins around the time of birth.

Whatever the reason, some early term babies may arrive earlier than others. Your baby might decide to come into the world next week, and others decide to wait until you're 40 or 42weeks pregnant. (next week)