Women's Healthcare Topics
James Brann, MD. Ob/Gyn

38 Weeks Pregnant

In This Article

Pregnant Belly Changes

At 38 weeks pregnant and until you give birth; your belly size is going to stay pretty constant. If your baby has already dropped into your pelvis - which is a sign that labor might be on its way in a few days - you may notice that your belly is lower than it was before.

38 week pregnant belly

Pregnancy Symptoms at 38 Weeks

Now the waiting game begins. You must try to be patient and watch out for the signs of labor. Contractions may start; your water may break; you might lose your mucus plug. Pay attention to anything unusual, and make sure that you have your hospital bags packed.

You will feel more frequent bouts of Braxton Hicks contractions now. Unlike earlier in the third trimester, these false labor pains are more intense and might even be painful. They may occur closer together, which can confuse you into thinking you're in early labor.

However, if your contractions go away when you rest or change positions, then they are Braxton Hicks contractions. True labor pains will continue to plague you despite changes in position, and they will become more painful and more intense as time passes.

The Braxton Hicks contractions work to prepare your body for labor. They soften, thin, and even open your cervix a little bit.

For second-time moms, your cervix will probably dilate a centimeter or two before labor actually begins with the Braxton Hicks contractions. (Remember that you are not in active labor, until you are at least 4 centimeters dilated.)

With cervical changes, you may notice that you have vaginal discharge that is tinged with blood. This is called the "bloody show," and it's often a sign that you're on your way towards labor. However, it may be hours, or even days before you'll go into true labor.

Swollen feet and ankles is a normal symptom in the final weeks of pregnancy. This symptom is called "edema," and it occurs when extra fluid collects in the tissues. You can blame physical changes (such as you’re a huge uterus adding pressure to your veins), changes in your blood chemistry (you have more blood pumping in your pregnant body), and poor blood circulation for your swollen feet, ankles, and hands.

Although mild swelling is normal, you'll want to contact your doctor right away if your symptoms are severe. If your swelling comes with persistent headaches, blurred vision or other strange vision changes, extreme upper abdominal pain or discomfort, or nausea, this may be a sign of preeclampsia - a serious complication that needs to be treated.

Your breasts may leak . What they're leaking is colostrum – pre-milk that will nourish your newborn baby in the first days of life if you are breastfeeding.

Pregnancy Health Section

At your 38 week prenatal visit, your doctor or healthcare provider will probably do an exam to see if there are any changes in your cervix. Your doctor may use the following terms:

  • Effacement: The thinning of your cervix. This is calculated in percentages, such as 50 percent effaced or 100 percent effaced (completely effaced). A thin cervix dilates more easily. First time mothers start effacing in the last month of pregnancy with the help of Braxton Hicks contractions. Your cervix will efface before you start to dilate.

  • Dilation: Your cervix starts to open to prepare for childbirth. When you are "fully dilated," your cervix has opened 10 centimeters and you're ready to push and give birth.

  • Station: This term refers to the location of your baby's head as he or she moves through your pelvis (a process called "descent"). The station of your baby gives your doctor an idea of how far the baby's head has descended into the pelvis.

Learning what these terms mean will help you understand how close you may be to starting labor.

"How will I know when I am really in labor?"

when does labor start?

This is the number one question that pregnant women ask their doctors. "How can you tell when labor is really beginning?" There is no definitive answer to this question. Labor is a complicated process, and every woman will experience it differently.

Some women feel excruciatingly painful contractions before labor actually begins, while others experience a relatively comfortable tightening of their uterus. Your water may break before you feel any contractions at all.

When labor does begin you will have regular contractions that will become more frequent and stronger. Each contraction starts at the top of the uterus and moves in a wave-like motion down to the bottom. Contractions push your baby downward into your pelvis, and they place pressure on your cervix. As a result, your cervix effaces (thins out) and dilates (opens up) to allow the baby to pass through the birth canal during delivery.

In order to tell whether or not your labor has started, you need to understand the difference between Braxton-Hicks contractions ("false labor") and true labor contractions. In the early stages of labor, it can be difficult to tell the two apart. Sometimes, early labor contractions start out feeling like Braxton-Hicks contractions.

Braxton-Hicks contractions prepare your body for delivery. These false labor contractions are usually not painful, but some women find them uncomfortable. They occur at irregular intervals, and the intensity level of each contraction varies.

In contrast, true labor contractions occur at regular intervals, getting stronger and more painful as time passes. With each contraction, your cervix undergoes changes to prepare for delivery.

An easy way to tell apart true labor versus false labor is to record the interval between each contraction. If you notice the time gap between each contraction is shortening - i.e. your contractions are getting closer together - you are probably having true labor. If the interval between contractions gets longer, or is irregular in frequency, you may be in false labor.

When you are having false labor contractions, you may get relief by changing positions or walking. When you're in true labor, nothing you do will give you relief from your discomfort.

The only surefire way to tell if you're in active labor is to have your doctor do a pelvic exam. Your doctor will examine your cervix to see if it's effacing or dilating.

If you are a first-time mom, you will probably have several false alarms. To avoid multiple trips to the hospital or your doctor's office, wait until your contractions are strong, regular, and increasing in frequency.

As a rule of thumb, you will want to wait to go to the hospital until you're in active labor. Once you are in active labor your contractions will last between 45 and 60 seconds, and they will be between 3 and 4 minutes apart.

Keep in mind that not every woman will have a textbook labor start. You should always contact your doctor, or go to the hospital when you instinctively feel that it's time. Trust your instinct!

What Causes Labor to Start?

How does Labor Start?

We really don't exactly understand what triggers the initiation of labor. Several theories have suggested that the mother, baby, and placenta all play a role in triggering labor contractions.

What experts do know is that prostaglandins (hormone-like substances) cause the cervix to soften and ripen near the end of pregnancy, as your body prepares itself for labor and delivery.

Once your labor starts, another hormone called oxytocin stimulates the strength of your contractions. In some cases, when labor isn't progressing, your doctor may augment labor with synthetic oxytocin (a medication called Pitocin).

Pack Your Hospital Bag

38 week pregnant make sure you have your hospital bag packed

Have you packed your hospital bag? If you haven't, you better sit down and do it today. You could go into spontaneous labor at any point now.

Not sure what to pack? There are many schools of thought regarding the hospital bag, but here are some of the more common items that moms-to-be pack:

  • Robe or other cover up if you plan on walking during labor.

  • Slippers or warm socks.

  • Lotion or massage oil.

  • Lip balm (your lips will get very chapped during the pushing phase).

  • Snacks or drinks (in case you deliver at 3 am and find yourself ravenous).

  • Watch with a second hand (to time your contractions).

  • Camera and video recorder.

  • Magazine or book to read.

  • Personal toiletries such as a hair brush and toothbrush.

  • Nursing bras.

  • Breast pads.

  • Change of clothes to go home in.

You might also consider packing a change of clothes for your partner. When packing the clothes you plan to go home in, be sure you pack something that is the right size. You will need to bring clothes that fit you when you were about five months pregnant, as you will not magically lose all the weight you gained simply by giving birth. Your belly will still be a bit round for a while after delivery.

Baby Section

Your Baby at 38 Weeks of Pregnancy

Your baby delivered at 38 weeks pregnant

By 38 weeks pregnant, you are probably feeling exhausted, heavy, and bloated. You are most likely impatient for your baby to come. Although you are early term, your baby may not be ready to come out for another week or two (full term). So you'll be playing the waiting game for the next two weeks.

At 38 weeks pregnant, your baby may weigh anywhere between 6 and 7 pounds. The amount of amniotic fluid surrounding your baby continues to steadily decrease as your pregnancy continues. However, your baby still has plenty of amniotic fluid to protect him or her.

Though space is becoming very limited in your womb, your baby may still be trying to move and stay active. (Always call your doctor if you notice a change in your baby's movements.)

By now, the long bones in your baby's arms and legs have hardened. This process is called ossification and it has been occurring throughout your pregnancy.

Your baby's grasp reflex is very strong now. He or she is often grasping the umbilical cord or curling his or her hands into little balls.

Doctor's Corner

Pregnancy Week by Week - Women's Healthcare Topics

What does a Newborn Baby Look Like?

A healthy newborn may look a little strange in the beginning. Before a child is born, it is in the uterus, surrounded by liquid. Your baby is also curled-up because there’s not too much space left to move around anymore. In addition, babies born during vaginal births have to squeeze through a small passage. All of these types of things contribute to a newborn baby’s appearance.

A newborn may look a little strange right after birth.


Newborns are born with a thick white substance all over them, as well as blood and fluid from their mother. This washes away during your child’s first bath.

A healthy newborn also normally has pink skin. Occasionally, a baby’s skin may look kind of blue, most commonly around the lips, as well as the feet and hands. All of this is perfectly normal.

Your child may also have some scratches, red spots or bruises after delivery. The scratches and bruises may have been caused by what’s called a fetal probe. This is what doctors use to help monitor your baby during delivery. Some newborn babies also have small bumps or spots similar to acne. These will eventually go away. You may even notice a birthmark, which may fade with time but usually is permanent.


A newborn's face sometimes has a squished or swollen look right after delivery. However, your child’s face should be even, or rather symmetrical, when you look at both sides. Your baby’s nose and mouth are full of mucus, which the doctor or nurse needs to suction out immediately after birth.


A newborn baby’s head normally looks kind of big in comparison with the rest of its body. The head may also appear cone-shaped or pointy if you had a vaginal delivery. Your baby’s head should look normal after a few days. Newborn babies also normally have a number of soft spots on their heads where their bones still need to grow together fully.

While some babies don’t have any hair, others have a lot. Many times, a baby’s hair will fall out over the first month and new hair will replace it.


Your newborn’s neck should be lump-free and smooth. Some newborns have their neck twisted to one side because of the position they were in inside the womb. Doctors call this torticollis or wry neck. There are certain treatments to help straighten out a child’s neck when this happens.


A baby’s genitals are often swollen or puffy right after delivery. Sometimes, girl babies have vaginal discharge that is white or even bloody. This is caused by the mother’s hormones. It’s normal and goes away.

As for boys, the skin that covers the tip of the penis, or the foreskin, shouldn’t be pulled back, and is normally tight. If you want to have your baby circumcised, surgery will remove this skin.

Belly and Chest

You may see some swelling in your baby’s breasts. You may even notice some milky fluid. This is due to hormones from the mother. The leaking or swelling normally goes away over the next few days or even weeks.

A newborn baby’s belly usually sticks out some, and is usually round. Once the umbilical cord is cut, you’ll notice the small stump where your child’s belly button is. Your nurse will tell you how to take care of this. The stump normally falls off over the next week or two.

Legs and Arms

Your newborn may want to keep its legs and arms close to his or her body, and bent as if they were back in your womb. You want to make sure their legs and arms move the same amount on both sides.

Is my baby OK?

Right after your baby is born, your nurse or doctor will check these things:

  • Check genitals to see whether baby is a boy or girl

  • Check body’s movement and position

  • Check skin color

  • Measure baby’s length, weight and head

  • Check baby’s body to make sure everything is normal

  • Check baby’s organs to make sure everything is working correctly

Can the Nurse or Doctor tell if my Baby is Healthy?

It’s difficult to know just by looking at a newborn baby whether the child is healthy. However, your nurse or doctor will check for certain things. These include the size, appearance and position of certain body parts. These things can be signs of other health issues. This makes it extremely important that a nurse or doctor sees your baby after delivery.

(next week)