38 Weeks Pregnant: Let’s Talk About Labor
Just like you, your baby is ready for her grand entry! She weighs between 6 and 9 pounds and is a bit more than 1½ feet tall. Her brain is now ready for the next big job, life outside the womb. It is perfectly set to help her handle the impending flood of new sensations: bright lights, smiling faces, new smells, sounds and touch.
And, her lungs are gearing up for the big debut, too! That first breath is a huge life transition. Her lungs are filled with collapsed air sacs, but each tiny sac is coated with a special chemical that will keep them popped open after those first few lung expanding breaths.
The drama of entering a new world—the cool air on her wet body and the light on her face —triggers her brain to jump-start her breathing. Even at week 38, she’s set to do it all. Nevertheless, waiting 60-90 seconds to clamp the umbilical cord will give her a boost of extra blood, oxygen, iron and stem cells.
Because of their skinny legs and arms and big heads, babies have much more exposed skin than adults, so they lose heat quickly. To help warm her little body, your baby has stored up some special brown fat that generates extra heat and will be used up over the first day or two. Another great way to keep your little one toasty—and to begin bonding and start the breastfeeding process—is to have skin-to-skin contact right away.
38 Weeks Pregnant: S’up with Your Bod?
Let’s talk about one of the biggest things on your mind these days: labor.
Stage 1: Early Labor, Active Labor and Transition
Labor is divided into 3 stages. The first stage is the longest and consists of contractions, contractions and…yep, more contractions!
Note: Your uterus is a muscular sack. During labor, it alternates between tensing up (contraction) and relaxing. When it squeezes, the muscle pushes your baby downwards…pressing her head against your cervix. That thins the cervix (effacement) and starts to push the cervix open (dilatation).
Stage 1 usually gets off to a slow, creeping start. (The breaking of the bag of waters may be dramatic, but even that is usually more of a dribble than a flood.) Some women describe the start of stage 1 as period-like pain or a lower-back ache, but soon, the contractions strengthen, lengthen and become more frequent. If you’re a first-time mom, this stage will likely last 6-12 hrs., but might drag on for a day or longer. (For second-time moms, things can go a whole lot faster!)
If it’s your first pregnancy —and you are low-risk —your care providers may have you stay home during most of this stage. Try to relax, stay hydrated and eat light, carb-rich meals to keep your energy up. If you can sleep…do! Giving birth is a marathon, not a sprint, and you don’t want to tire yourself out early on.
Your doctor/midwife will have told you to time your contractions (from the beginning of one to the beginning of the next—not to the end) and advised when to call her / head to the hospital.
When you arrive, your cervix will be checked to see how far you’ve dilated. It’s possible you’ll be sent home or told to go out for a walk or a meal, if you need to dilate more.
Once you begin active labor, you’ll have strong contractions around a minute long and 3-5 minutes apart. It may be hard to talk or move easily. At this point, your cervix will be dilated 3-10 centimeters. (Dilating 1 cm/hr is textbook, but like in early labor, it’s different for every woman.) If you’re opting for an epidural, the time is…now!
Transition is the most intense stage. Luckily, it’s also the shortest! You'll be dilating those last few centimeters and your contractions will be coming quicker. Stage 1 ends when your cervix has stretched to 10 centimeters (fully dilated).
Note: Epidurals may weaken your contractions and prolong labor 40-90 minutes (and may even lead to more drugs—like Pitocin, which is given to amp up contractions.)
Stage 2: Delivering Your Baby
When you’re fully dilated, you’ll move on to pushing…which is an overwhelming muscular impulse, much like throwing up (but down there). Some women can control the pushing process, but if you’re numb from an epidural, your doctor/midwife will likely coach you on when to push hard and when to slow down to allow your body to relax and open.
At some point, your baby’s head will emerge (some women ask for a mirror…to be able to see the baby’s head coming out). Next, they’ll ask you to push hard—again—to deliver her shoulders. Then, the rest of her body will slide out like a slippery, wet little fish. Unless there’s a need for immediate medical care, your baby will be placed on your chest and covered with a warm blanket.
YOU. DID. IT! Congrats…you’re a mom!!
Stage 3: Delivering the Placenta
But, Wait. There’s More…
You’re not 100% done yet…you need to deliver the placenta. Don’t worry, it’s the easiest stage and usually just slips right out after a few minutes.
If you want to breastfeed, start right away. (Bonus: Breastfeeding will cause your uterus to contract, help to expel the placenta and shrink in size.) You’ll also lose a lot of blood, about a pint. Your caregiver will massage your belly to get this blood out and to help your uterus go down. If you aren’t catheterized, you may be asked to pee because a full bladder can block the uterus from emptying all the way.
Your doctor or midwife will stitch up any tears or episiotomy cuts. If you’ve had an epidural, you won’t feel this, but if you haven’t, you’ll be given a shot or two of local anesthesia. (That rarely hurts because the whole process usually makes the labia a bit numb.)
Note: After all this labor, you may find yourself shaking uncontrollably for minutes…or for over an hour. It may feel strange, but trust us: You’re not dying! It’s believed the shaking is caused by rapid hormonal shifts or the adrenaline of birth.
A To-Do List for Your 38th Week of Pregnancy
Get food for labor: Labor is an athletic event. You’ll be thirsty and sweaty during…tired and sore afterward. The proper fuel can help: Eat a real meal or two in the early stages of labor (especially if your hospital has a policy against eating during active labor); sip on a drink with electrolytes, like coconut water; chomp on snacks that will boost your energy and keep your blood sugar up. And, after delivery, you might want hydrating fruits like watermelon, or fuel like a banana.
Stock up on household basics: Toilet paper, laundry detergent, etc. Buy ‘em now, so you don’t have to run for more in the busy first week with baby.
Don’t forget the nipple cream. A lanolin- or shea-butter-based nipple cream can be soothing in the early days of breastfeeding. Bring it along to the hospital.
This Week’s Fun Fact: Why Your Water Breaks
Your bag of waters is held by 2 membranes, and both must break to release your waters. Like much of pregnancy and childbirth, the exact reason why the water breaks is a mystery. However, we do know that the hormones that help the uterus to contract—prostaglandins—are partially responsible. The contractions also work to thin these membranes.
In the movies and on TV, just about every pregnant woman’s water breaks dramatically in a public place. In real life, for most women, it doesn’t happen until you are in active labor. Some women’s water breaks early (this is called PROM, or premature rupture of membranes) and very rarely a baby is born en-caul or within an intact amniotic fluid sack. It’s a sight to see!
Quote of the Week
There is a secret in our culture, and it’s not that birth is painful. It’s that women are strong. — Laura Stavoe Harm