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Welcome to the 40th week of your pregnancy. You are in your 9th month. No baby yet? Do not worry, many newborns arrive late, usually because their due date was inaccurate. Only 7% of all pregnancies are actually post-term pregnancies. Your back might be hurting a lot right now; you can take a warm bath or use a heating pad for some relief. You can also opt for a prenatal massage or ask your partner or friend to gently massage your back. Your anxiety levels might be extremely high as well, but don’t worry about this. Being nervous before your delivery is absolutely normal. If your anxiety is becoming too problematic for you then it might be a good idea to speak to your family and friends regarding this. The best form of treatment for this anxiety is reassurance and your partner may be the ideal person to help calm you. Do not forget to pay your doctor a visit this week, especially if you have any other illnesses like high blood pressure or diabetes mellitus. Also, you should discuss your options in case you don’t go into labour naturally soon - just to be informed.

(Read more: Gestational Diabetes)

It’s possible for pregnant women to develop complications at the end of pregnancy even if the rest of the gestational period was uneventful. It’s best to know what these complications could be and how to look out for them. Do not overexert yourself this week with any work and try to rest for most of the day. You need to be well-rested and full of energy for the delivery of your baby safely and successfully. Ensure that you are consuming plenty of food and liquids as advised by your dietician.

(Read more: Pregnancy diet chart)

The main aim of this article is to make you aware of the various changes that might occur in your body this week along with how your delivery will take place. This article will also inform you about some of the complications that could occur during the 40th week.

  1. Baby growth in the 40th week of pregnancy
  2. Changes that can occur in the 40th week of your pregnancy
  3. Issues that you might face this week
  4. Complications in the 40th week of pregnancy
  5. Things you should do in the 40th week of pregnancy
Doctors for Pregnancy in 40th week

By the end of 36 weeks, all babies are considered to be full-term. By the 40th week, your baby is expected to be about the size of a small pumpkin. Your baby may weigh around 3.5 kilograms whereas, the tip to toe length would be around 20-21 inches. This would, most probably, be the size of your baby at birth.

The following changes in the baby’s body can be observed in the 40th week of pregnancy:

  • Your baby will acquire antibodies that travel through the placenta. These antibodies protect the newborn from numerous infections. These antibody levels will rise higher after breastfeeding begins.
  • Babies, regardless of their ethnicity, have reddish-purple skin that may change to pinkish-red after 24 hours. The pink colour comes from the red blood vessels, which are visible through the baby’s extremely thin skin. As the baby’s circulation is still not completely developed, the hands and feet may appear bluish for a few days.
  • Further development of the functional capacities of the organ systems in the body continues to take place in the 40th week of pregnancy.
  • By now, your baby would have an almost completely developed nervous system, which allows them to control their own breathing, heart functions and digestion.
  • More fat is added to your baby’s body to completely fill up the loose skin. This additional layer of fat acts as an insulating layer to maintain their body temperature after delivery.
  • Your baby’s skull will remain soft even till the day of your delivery. The head is the largest part of the baby’s body and this flexible nature of the skull makes delivery through the birth canal much easier.
  • Fetal distress could occur in case of post-term deliveries. Meconium indicates fetal distress. Meconium forms the contents of your baby’s fecal matter and is composed of the lanugo (insulating hair coating) along with the vernix (protective layer on the skin). If your water breaks or leaks and If it is greenish in colour, this means that this leakage contains meconium.

The 40th week of your pregnancy may come with some changes in your body as well. These may include the following:

  • The size of your breasts would be at peak so close to giving birth and they might further increase in size post-delivery once the production of breastmilk occurs.
  • Leakage of some amount of breast milk is considered to be absolutely normal at this stage of the pregnancy. The nature of milk is usually thick and yellowish. This is called colostrum, which is packed with huge amounts of nutrients and antibodies for the baby. 
  • The uterus usually extends from the pelvic area to the ribs at this point.
  • Engagement is a phenomenon that involves the descent of your baby into your pelvic region. This process might occur at any point in time after the 34th week of pregnancy. It is suggestive of the fact that your body is preparing for delivery. Your tummy might appear to have shifted downwards and forwards. This helps in the resolution of some late pregnancy symptoms, for example, heartburn and acid reflux.
  • Due to your baby’s descent in the pelvis, there may be an extra amount of pressure applied to your urinary bladder. This causes excessive urination and leakage of urine. It is temporary and should resolve soon after birth. If you continue to experience this, then consult with your doctor.
  • Common symptoms that are associated with the start of labour include dilatation of the cervix, water breaking, diarrhea, nausea and pregnancy contractions that are severe, persistent and spaced at regular intervals.
  • Your body will experience softening of the tissues and joints to help in the delivery process.
  • The considerable increase in body mass makes it difficult for pregnant women to balance their body. Therefore, if you are not already practising it, try wearing shoes with flat soles and get support bars installed in your bathroom.

You’re very close to the finish line but you might still experience some problems in the 40th week of pregnancy. It is a crucial week and therefore, you should have some knowledge about the major issues that you could suffer from. Your doctor may have already recommended some quick solutions for most of these symptoms.

The following symptoms might be observed in the 40th week of pregnancy:

  • Round ligament pain: Lower abdominal pain in late stages of the pregnancy may occur due to round ligament pain. This stabbing pain can be characterized as a unilateral or widespread pain. If you notice that this pain is radiating or is very severe then inform your doctor at the soonest.
  • Sciatic nerve pain: Sciatic nerve pain is considered to be a very common complaint during pregnancy. Due to the enlarged uterus, there is an excessive amount of pressure that is exerted on the sciatic nerve; this can result in the groin, lower abdominal and lower limb discomfort or pain. The pain could disappear this week due to the descent of your baby. In case it doesn’t, apply a warm compress to the painful region or take painkillers such as paracetamol after discussing it with your doctor.
  • Varicose veins: While varicose veins usually develop early on in the pregnancy, they can occur even in the 40th week. It’s a result of a large amount of pressure exerted on the inferior vena cava. You may develop large blue clusters of veins in your vulva, anus or lower limbs and these clusters are often painful and hard.
  • Sleep problems: Experiencing sleep problems at any point of time in the pregnancy is common. This may be caused by the discomfort you might be experiencing, including generalised pain, frequent urination or gastrointestinal issues. Talk to your partner or friends if you have any strange dreams that bother you; you can also seek professional help if this doesn’t help. Pregnant women are recommended to get 10-12 hours of sleep in a day.
  • Digestive issues: Bloating, belching, acid reflux, nausea and heartburn are very common problems faced by pregnant women. If these issues become extreme, talk to your doctor about them. They might advise you to take some antacids or proton pump inhibitors.
  • Fatigue: Fatigue is experienced by almost all pregnant women. By the end of pregnancy, you might be feeling exhausted all the time. While the stress of pregnancy on your body results in excessive tiredness, remember that it is only temporary and you might go into labour any day now.

The following complications may be seen during the 40th week of pregnancy:

  • Stillbirth: Fetal death after the 20th week of pregnancy is considered to be a stillbirth. Whereas, if fetal death occurs prior to the 20th week of pregnancy, it is categorized as a miscarriage. In case you experience vaginal bleeding, severe abdominal pain or unbearable contractions then you should contact your doctor. If caught early, stillbirths can be prevented.
  • Subchorionic haemorrhage: The placenta might separate partially from its original site of attachment in late pregnancy. This causes a large amount of bleeding per vaginum. This condition is called a subchorionic haemorrhage.
  • Hypertensive diseases: A persistent blood pressure of 140/90 mm hg after the 20th week of pregnancy is termed as gestational hypertension. Preeclampsia occurs when urine analysis shows the presence of proteins. Preeclampsia along with seizures is called eclampsia. All of these could still occur in the 40th week of pregnancy.
  • Placenta previa: Presence of a low lying placenta that covers the cervix completely or partially is called placenta previa. Usually, it is caught early on in the pregnancy and resolves on its own as the placenta migrates upwards. But, if it persists till late pregnancy, then your doctor might request more frequent ultrasound scans and offer a C-section, as a normal vaginal birth might lead to a disastrous amount of bleeding.
  • Infections: Pregnancy is a state of immunosuppression (low immunity). Therefore, a pregnant female is extremely prone to developing numerous kinds of infections. Bacterial infections such as bacterial vaginosis caused by G.vaginalis or urinary tract infections caused by E.coli are the most common out of all. If exposed, patients might develop viral infections such as genital herpes or hepatitis.

At this point in your pregnancy, most of the things you need to get done would have been taken care off already. Just in case you think you may have forgotten something, here a checklist for things to keep in mind:

  • Do not panic if your due date has passed. It can be a frustrating situation, but it is normal and extremely common. In case you do not go into labour within a week, your doctor might suggest inducing labour.
  • Speak to your doctor, midwife and experienced friends all about labour and maybe even late labour, just to be informed. They will put forward some suggestions such as when to go to the hospital in case contractions start or your water breaks.
  • If you have children, they may already be aware of the new baby that’s about to arrive. You can continue talking to them about becoming an older sibling and answering any questions they have. Also, reconfirm the arrangements you’ve made for someone to take care of your children (as well as any other dependants) while you are delivering your baby at the hospital.
  • Make sure you have gathered all basic goods such as food, pantry staples, toiletries, diapers and medicines that you may need once you return from the hospital.
  • Your delivery kit should be ready for the big day. It can contain a change of clothes, your spare chargers, your medical records of the current pregnancy and any other things you think you may need or bring you comfort.
  • Manage your expectations in terms of how you’ll feel and look after the birth. Remember that even after your uterus shrinks post-pregnancy, you still might look pregnant for a few weeks to months.
Dr. Vrinda Khemani

Dr. Vrinda Khemani

Obstetrics & Gynaecology
6 Years of Experience

Dr Megha Apsingekar

Dr Megha Apsingekar

Obstetrics & Gynaecology
4 Years of Experience

Dr. Dyuti Navadia

Dr. Dyuti Navadia

Obstetrics & Gynaecology
1 Years of Experience

Dr. Sheetal Aggarwal

Dr. Sheetal Aggarwal

Obstetrics & Gynaecology
15 Years of Experience

References

  1. American Pregnancy Association [Internet]. Irving, Texas, USA; 40 Weeks Pregnant
  2. Nemours Children’s Health System [Internet]. Jacksonville (FL): The Nemours Foundation; c2017. Week 40
  3. Start4Life. National Health Service [Internet]. Hertfordshire. UK; You and your baby at 40 weeks pregnant
  4. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; The Third Trimester
  5. National Childbirth Trust [Internet]. London. United Kingdom; Pregnancy week 40
  6. Caughey Aaron B., Stotland Naomi E., Washington A. Eugene, Escobar Gabriel J. Maternal Complications of Pregnancy Increase Beyond 40 Weeks’ Gestation. Am J Obstet Gynecol. 2007 Feb; 196(2): 155.e1–155.e6. PMID: 17306661.
  7. Alexander J M, McIntire D D, Leveno K J. Forty weeks and beyond: pregnancy outcomes by week of gestation. Obstet Gynecol. 2000 Aug;96(2):291-4. PMID: 10908780.
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