Women's Healthcare Topics

38 Weeks Pregnant

Reviewed by James Brann, M.D.

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.

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.

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.

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

"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.

Video: 38 Weeks
Video: Your Pregnancy Week 38

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

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

Growth and Development of Baby

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. (next week)