Week 40

What’s happening this week

You…

• may wake up every morning wondering whether today will be ‘the day’
• may get impatient with people ringing up to see if you’ve gone into labour yet
• may have trouble sleeping, or anxious dreams
• may worry that your waters will break in public (see Week 37)
• may feel huge and uncomfortable.

Your baby…

• is ready to be born – the average baby weighs around 71/2 lbs (3.4 kg) and measures around 51 cm in length – your baby may be lighter or heavier, shorter or longer than this
• has all his senses working – smell, touch, taste, sight and hearing.

Still here then?

You may be feeling quite heavy and slow. Listen to your body and take things easy if you can. Your baby will soon be here! The last few days before your baby is born can drag. The secret is to keep busy. Plan something for every day: visit a friend, go and see your mother, go shopping for last-minute things, have your hair done. No-one will mind if you have to cancel an arrangement because you are in labour! Eight out of ten babies are born within ten days of the due date. It will be your turn soon!

The birth

Once the cervix is fully open, you can begin to push your baby out. This is called the second stage of labour. Being upright helps make this stage easier, try:

• sitting on the bed well propped up with pillows
• kneeling on the bed with your arms and shoulders on pillows over the end of the bedhead
• kneeling on the floor leaning over a chair..

With every contraction, you will feel your baby move down the birth canal, and then, as the contraction fades, the baby slips back a bit. Most women get a strong urge to push with each contraction; try to use little breaths and little pushes so you give three to five pushes with each contraction. If this isn’t working, or if you have an epidural set up and cannot feel to push, you may want to hold your breath for the whole contraction and push all the time. This is very tiring, though.

Your labour partner may need to encourage you if you get tired. He or she can help you sit up, sponge your face and give you a drink. He may be able to see your baby’s head at the peak of each contraction and can tell you about it.

As your baby is about to be born, your LMC will tell you not to push, but to pant. This allows the baby’s head to be born gently. Almost at once your baby will be born, with a rush of waters and a warm slithery feeling. If you wish, the LMC can lift the baby straight onto your abdomen, or the baby can be wrapped first. You can then hold your baby and start to get to know him or her.

Third stage

This is the delivery of the ‘after birth’ – the placenta. You will usually be given an injection in your thigh just as the baby is born to help deliver the placenta. Some mothers prefer to have a natural third stage, which can be much slower and relies on being upright and the baby stimulating your natural hormones. It does increase the risk of heavy bleeding after the birth, so it’s important to discuss this with your LMC before the baby is born. You will be given the choice of whether you want to keep the placenta or not.

Cuts, tears and stitches

Pushing gently, or panting the baby out, can help the baby be born gently and give your muscles and skin time to stretch. Sometimes the perineum stretches enough to allow the baby to be born, but occasionally this area tears slightly or has to be cut to enlarge the birth outlet. You may have:

A cut (episiotomy, see Week 36)

A tear

Stitches

Retained placenta

Usually the placenta is delivered a few minutes after the baby is born. Sometimes it does not come away quickly, or only part of it comes away, and it has to be removed manually. You may be moved to the theatre for this and you may be given an epidural while it is done.

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