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

39 Weeks Pregnant

In This Article

Pregnant Belly Changes

At 39 weeks pregnant, you might delivery your baby at any time. It is very possible that he or she may arrive this week. Be on high alert for any signs of labor.

If you are having Braxton Hicks contractions, you may notice that they're occurring more often and becoming stronger. It's common for Braxton Hicks contractions to transform into real contractions at this time. Make sure you start timing your contraction's frequency and duration.

If your contractions are coming at irregular intervals and do not increase in strength, then you are probably having false labor pains. During true labor, your contractions have regular intervals, get closer together, last longer and will increase in strength.

Pelvic pressure and discomfort is a common pregnancy symptom at 39 weeks pregnant, and it's a sign that your body is preparing for labor. As your baby's head moves deep into your pelvis, you may feel increasingly uncomfortable. Just take heart in knowing your baby will soon arrive.

In the days before your labor starts, you may have diarrhea, indigestion, nausea and vomiting, and the need to constantly go to the bathroom. These are all common "early labor" signs.

Increased vaginal discharge is also a common early labor sign. If you notice an increase in vaginal discharge that's tinged with pink, red, or brown blood, this may be a sign that your cervix is dilating and/or thinning.

Pregnancy belly at 39 weeks.

Knowing When Labor Starts

Do you know the early signs of labor at 39 weeks.

The signs that labor has begun include:

  • Increasing vaginal fluid (discharge) that is mucus-like and thick, or maybe slightly bloody. This is also sometimes referred to as bloody show or mucus plug.

  • Baby drops, or rather moves lower inside your belly

  • Belly cramps or low back pain

  • Your water breaks. Your baby is inside of your womb in an amniotic fluid-filled sack. Before your child is born, the amniotic sac breaks open. When this happens, the fluid in it comes out of a woman’s body through her vagina. You may feel just a trickle of the fluid, or more of a gush of fluid.

  • Contractions begin. During these, your uterus will tighten. Your belly feels hard, and there may be some pain. When a contraction eases, the pain goes away and your uterus relaxes. Some women experience false labor contractions, also called Braxton Hicks contractions, While these may feel like contractions, they are not and don’t signify labor.

Sometimes it’s difficult to tell whether you’re having Braxton Hicks contractions or true contractions.

  • With Braxton Hicks, they may come every few minutes, but over time, they won’t increase in frequency.

  • Usually with rest, Braxton Hicks contractions go away but true contractions do not.

  • Braxton Hicks normally don’t strengthen and become more painful but true contractions will over time.

If you’re uncertain, you need to call your midwife or doctor.

If you’re feeling contractions, you want to time them to determine how far apart they’re coming. This gives you a good idea if they’re getting more frequent.

Write down the time each of your contractions begins. Use a watch with a second hand to time how long the contraction is. Your doctor or midwife will need this information.

When to call your midwife or physician

You should call your midwife or doctor if you believe you’re in labor. You also want to call for these things:

  • Leaking vaginal fluid, mucus or blood

  • More painful and stronger contractions

  • 6 or more contractions over 1 hour (your contractions are no more than 10 minutes apart)

Your midwife or doctor will likely want to do an exam to check you out. They’ll need to check your cervix to see if it’s dilated (opening) and thinning out. Your doctor will also want to know the frequency of your contractions. There may also be other tests.

Fetal Heart Rate Monitoring

Learn about Fetal Heart Rate Monitoring.

During labor and delivery, your baby's heart rate will be monitored. Fetal heart rate monitoring helps your doctor evaluate your baby during labor to make sure that everything is going as planned.

Typically, when your uterus contracts, the oxygenated blood flow to your placenta is restricted. Because this is a natural process it will not be a problem for most babies. However, in some cases, this can result in fetal distress. A fetal monitor will be able to assess whether or not your baby is stressed.

Your doctor can monitor your baby's heartbeat either through external fetal monitoring or internal fetal monitoring. External fetal monitoring can be used any time during labor. A belt with a receiver can be strapped onto your abdomen. It works much like ultrasound does in detecting a fetal heart rate, providing a little feedback strip that tracks your baby's heart rate during and in between contractions.

An internal fetal monitor may be used to assess your baby's heart rate as well. To do this, an electrode would be placed directly on your baby's scalp via your vagina and cervix. You need to be dilated at least 1 cm and your membranes must have ruptured in order to use this type of monitoring.

Baby Section

Apgar score" or "Apgar test

Apgar Evaluations for Babies
Since you are now 39 weeks pregnant, you will want to try to learn everything you can about what happens during labor and delivery and the care afterwards for your newborn baby. One term you should become familiar with is "Apgar score" or "Apgar test."

Developed in the early 1950s by Dr. Virginia Apgar, the Apgar test is used to quickly appraise your baby's health immediately following birth, and it determines whether your baby will need extra medical or emergency care. Your baby will undergo the Apgar test at one-minute and five-minutes after birth. APGAR stands for "Activity, Pulse, Grimace, Appearance, and Respiration."

How Apgar Scores are Calculated
The Apgar test looks at the strength and regularity of your baby's heart rate, lung maturity, muscle tone and movement, skin color, and response to stimulation. Depending on how well your baby does in each of these categories, his Apgar score can range from zero (a deceased baby) to ten (a baby that is in perfect health).

To determine your baby's Apgar score at birth, your healthcare provider will calculate a score of 0, 1, or 2, depending on well your baby does in each category. Some doctors may use an Apgar score calculator similar to the table below:

  • Strength and regularity of heart rate
  • 100 beats/minute or more (2 points)
  • Less than 100 (1 point)
  • None (0 points)
  • Lung maturity
  • Regular breathing (2 points)
  • Irregular breathing (1 point))
  • Absent (0 points)
  • Muscle tone and movement
  • Active (2 points)
  • Moderate (1 point)
  • Limp (0 points)
  • Skin color / oxygenation
  • Pink (2 points)
  • Bluish extremeties (1 point)
  • Totally blue (0 points)
  • Reflex response to irritable stimuli
  • Crying (2 points)
  • Whimpering (1 point)
  • Silence (0 points)

Normal Apgar Scores
In general, most healthy babies will receive an Apgar score of 8 or 9, which indicates to your doctors that your baby is in great condition. (It's rare for a baby to have a 10 Apgar score, due to the fact that almost all newborn infants have blue hands and feet.)

Low Apgar Score and What it Means
An Apgar score that is lower than 8 suggests that your baby needs medical assistance. However, if your baby scores low at one minute after birth, and then scores higher at the 5-minute test, your baby will probably not have any long-term problems.

The Apgar Test is Not a Fortune Teller!
Remember - don't dwell on your baby's Apgar score. The Apgar test is designed to help your healthcare team assess your baby's overall physical condition after delivery, so they can determine whether your baby needs immediate medical care. Your baby's Apgar score does not predict your child's long-term health, intelligence, behavior, or future outcome.

Babies that have slightly lower Apgar scores at the one-minute mark after birth tend to be premature babies, babies from a high-risk pregnancy, infants born via C-section, and newborns of women who've had a complicated labor and delivery.

If your doctor or healthcare team is concerned about your baby's Apgar score, they will let you know. In the meanwhile, don't worry about it. Chances are your baby will be perfectly healthy.

Your Baby at 39 Weeks of Pregnancy

At 39 weeks pregnant, you only have one more week to go until your estimated due date. Now that you're this close to the finish line, have you made the final preparations for your baby's arrival? Is your hospital bag packed and ready to go? Have you made a list of the names and phone numbers to call after your baby is born?

Your baby is fully formed and ready to be delivered, however some babies may want to stay in the womb for one or two additional weeks. (After 42 weeks pregnant, your baby is considered "post-term" and your doctor will induce labor, or perform a c-section, to deliver your baby.)

Since your baby is fully mature, he or she has reached their birth weight and length. Your baby may weigh anywhere between 7 and 7.5 pounds, though some babies may weigh more. Your little one is likely to be between 19 and 21 inches long at this point in your pregnancy.

Newborn Appearance

Spotlight on Newborn Appearance

All newborn babies share several common features and characteristics. Most are born with a misshapen head that resembles a cone or elongated shape, particularly if you were in labor for an extended period of time.

Your baby's head has soft spots called fontanels, which are openings in the skull that allow your baby's bones to move during delivery. The movement of the bones is necessary for your baby's head to fit through the birth canal and this flexibility of the bones gives rise to the elongated shape.

When your baby is born, you may notice that his or her genitals and breasts are swollen. This is due to a higher than normal dose of female hormones transferred from you to the baby right before delivery. Fortunately, these 'irregularities' will disappear in the days following delivery.

You may find that your baby is born with acne or other red spots. This is perfectly normal. Some babies are born with a condition called pustular melanosis, which is little pus filled bumps that look like acne on the skin.

Other babies are born with birthmarks. There are several different types of birthmarks. The more common include angel kisses and stork bites.

Some babies are born with red and blond hair, even when both parents are dark haired. Keep in mind that regardless of your newborn's hair color, there is a relatively good chance your baby's hair will change colors once or twice as they are growing. It isn't uncommon for a baby born blond to turn into a brunette.

Pregnancy Health Section

A Flood of Mixed Emotions

Pregnancy Emotions at 39 Weeks Pregnant

Once all the preparations have been made and you get closer to your due date, you may start to feel a flood of mixed emotions. Part of you may feel elated at the prospect of meeting your new baby - this bundle of joy that you've carried around for nine months. Another part of you may start to feel afraid. You may have fear about labor and delivery, or fear that you'll be a bad mother or that you won't know how to care for your newborn infant.

Lay all your fears to rest. Women have been delivering babies since the beginning of time and raising them without any books or instruction manuals. Most mothers have a natural instinct when it comes to raising their children. Don't worry - your maternal instinct will kick in when you meet your baby for the first time!.

Doctor's Corner

Pregnancy Week by Week - Women's Healthcare Topics

Forceps and Vacuum Delivery

Some women may require the use of forceps or a vacuum extractor to assist the delivery of your baby. While relatively uncommon sometimes a little assistance is needed to help your baby be born.

Forceps and Vacuum Delivery

Forceps are instruments that resemble a pair of tongs. They are sometimes used to help with the delivery of your baby. Forceps are used when first time moms have been pushing for three hours with an epidural or two hours without. If you have had a baby before they can be used if you have been pushing for two hours with an epidural or one hour without. They can be used without regard to the time of pushing if your baby has developed fetal distress.

If you doctor needs to use forceps, he will likely numb your vaginal area and may perform an episiotomy. The forceps are placed on the sides of your baby's head and used to help pull the baby out. The risks of using forceps when used correctly can be relatively low, but may include bruising or swelling on your baby's head and lacerations to the sidewalls of the vagina.

In other cases, your doctor may need to use a vacuum extractor. This is a device that is shaped like a cup. It is placed on top of your baby' head. The vacuum extractor applies a gentle suction to the top of the baby's head to help pull your baby out of the birth canal. Bruising or swelling might also occur when a vacuum extractor is used.

In most instances, neither of these instruments will need to be used, but there is always a small possibility. If you have any concerns be sure to check with your doctor prior to labor and delivery. They can help explain the risks and potential need to you in greater detail.

(next week)