Pregnancy Week By Week (Week 40)

Week 40 Fetus

Must-ask Questions this Week (Week 40)

Is it possible for your doctor to predict ahead of time if your baby is likely to be overdue?

Not really. A common pregnancy myth states that first time mothers are most likely to have postdate pregnancy; studies however indicate otherwise. The only time doctors can make a fair enough prediction is if you were overdue in your previous pregnancy(s). Your baby can still surprise you by arriving early despite your history with postdate pregnancy.


What is the difference between being postdate and being overdue?

Ten percent of all babies don't arrive until at least 2 weeks past their due date; these are described as postdate. Overdue pregnancy is one where baby arrives a little after its due date.


At what point does being postdate become a risk to the developing baby?

If the pregnancy continues for too long, there is reason to be worried. Postdate babies are at increased risk of becoming too large for safe delivery or of experiencing fetal post maturity syndrome which is essentially a situation where the placenta fails to function properly as it used to. As the weeks increase, the risk rises. In some situations the due date is out of whack, causing babies to be classified as postdate wrongly. Most doctors are reluctant to let a pregnancy drag on and usually would recommend induction after week 41 (increase the chances of healthy babies and decrease the chances of C-section). If you decide against this, your doctor would want to monitor baby closely by performing some tests.

• A nonstress test (NST): the baby's heart rate is monitored via external monitoring equipment for up to 40 minutes

• An amniotic fluid index (AFI): ultrasound is used to assess the quantity of amniotic fluid

• A biophysical profile: an NST and a detailed ultrasound that assesses baby's breathing movements, body movements, fetal tone and the quantity of amniotic fluid

• A contraction stress test: the baby's response to uterine contractions is monitored




Based on the findings of these test you and your doctor will decide if you want to continue with the waiting game or proceed with induction. Either way your baby is going to be with you very soon.

Some Basic Pointers (Week 40)

Factors for a Successful Birth

How your baby makes its way into the outside world and how easy the process will be for you depends on these factors:

• The shape and size of your pelvis

• The baby's position: most babies come out head first. Birth is more difficult with the feet first

• The diameter of baby's head; the head is designed to adjust and usually compresses enough to pass through the pelvis

• Contractions and muscles: during labor, involuntary uterine contractions, together with mother's use of her abdominal muscles push the baby out


Having a Cesarean

Complications weeks before your due date or during the birth itself may warrant for delivery by cesarean section. It is a straightforward procedure, taking about 5-10 minutes to deliver the baby and another 30 minutes to complete. It is usually performed under a regional anesthesia such as an epidural, unless it is an emergency c-section where a general anesthesia may be administered as it acts much faster. In a non-emergency situation, the epidural anesthesia is administered into the mother's lower back (she stays conscious throughout). A catheter is inserted to drain the bladder of urine. A small horizontal incision is made at the base of the abdomen and the amniotic fluid is drained off. The baby is lifted out, cleaned up and if all is well, given to the mother or her partner to hold. The placenta and membranes are delivered last and the incision is stitched up. The IV drip and the catheter are left on for several hours, and the stitches are removed few days later.
Common reasons for a C-section

• A forceps delivery fails

• The cervix fails to dilate

• The fetus displays signs of extreme distress

• The baby is in the breech position (feet or bottom first)

• You had a previous c-section delivery

• The baby is very large

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The last few weeks of Pregnancy: week 40

Delivery should be any day now. Prop yourself up and support your knees with pillows when you lie on your back. Do not lie flat on your back as this stage of pregnancy which might restrict oxygen supply to the baby

• Continue to practice positions for labor

• Rest when you can and use the time to practice relaxation techniques

• Drink fennel tea to increase milk flow ready for breastfeeding

Facts in a Gist

• Your baby will weigh about 7.5lb and measure at 21½in by the time you deliver

• If you notice a decrease in the pressure on your diaphragm and an increase in the pressure in your pelvis, chances are your baby has 'dropped'

• If your membranes have ruptured and you notice meconium in the fluids, contact your doctor right away

• Ten percent of babies don't arrive until at least 2 weeks after due date; they are described as postdate or post-term babies

Your Nutrition (Week 40)

How you feel emotionally and physically after a C-section will depend largely on whether you had an elective (planned) or an emergency section (rushed into theatre because of concerns about you or the baby). The latter can leave you feeling shocked and emotional and you are more likely to have had a general anesthetic.

Possible Problems

• Side effects of anesthetic

• Fatigue and tearfulness

• Infection

• Insufficient lactation

Key tips

• Get as much rest as possible to aid healing and recuperation

• Allow yourself time to recover properly and do not attempt to do too much

• Eat a healthy diet, especially zinc-rich foods as this will help you heal faster

A good diet is important following section. Take a daily multivitamin and eat plenty of foods rich in vitamin C, (citrus fruits and broccoli) iron and zinc (fish, poultry and wholegrain) to encourage your body to fight infection and aid iron absorption, to help your wound heal and to prevent anemia (if you lost a lot of blood). In addition Take energy rich drinks and light meals or snacks regularly
Take a DHA supplement if you are breastfeeding.

Note: if you develop fever, chills, extreme fatigue, flu-like symptoms or your wound is inflamed and does not seem to be healing properly you may have an infection. Consult your doctor.