40th – 40th week of pregnancy

You’ve reached the end of your pregnancy, and the day of delivery is fast approaching.

While you are preparing for the onset of labor – which can happen at any moment – ​​you must take into account that only about 5% of babies are born on the exact date of the expected term .

It is quite common, especially in the case of new mothers, to carry the baby a couple of weeks longer also because an induction of labor is often not considered until the 42nd week.

The baby at the 40th week of pregnancy

The sensory organs

All five of your baby’s senses have developed sufficiently, as he is already ready to come into the world.

His eyesight is still quite weak, in fact he is not yet able to distinguish objects more than a few centimeters away.

However , his hearing will allow him to recognize your voice and that of your partner when you talk to him after birth .

The outward appearance

The baby continues to lose the waxy layer of vernix and lanugo, traces of which can often be found on its body, together with the amniotic fluid and blood with which it is covered after delivery .

Babies born after 41 weeks are likely to have drier skin at birth .

Newborns usually have long nails which, after birth, will need to be shortened to prevent scratching .

The fetal position

The baby lies curled up in the limited space inside the uterus, with its arms and legs folded across its chest.

It is quite common for newborns to remain in this fetal position even after birth .

This is thought to be because, after being in this position for a long time, they need some time to realize that they have plenty of room to stretch out .

The fetus during the fortieth week of pregnancy

The reflexes of the child

The baby has already developed basic skills and reflexes such as the sucking reflex which will help him feed and survive after birth . Among the other reflexes that he has at the time of birth, we remember,

• the reflex of the automatic march (or stepping) for which when it is supported under the armpits and with the feet resting on a flat surface, it starts walking,
• the palmar grip reflex or grasping reflex, or the innate instinct to squeeze something in the palm of the hand,
• the startle reflex (startle) which includes a whole series of single movements  .

The internal organs

All of her internal organs are fully matured. They are ready to take over their respective duties once the baby is out of the womb.

The brain and lungs are the only organs that continue to develop after the baby is born .

His liver has already stored enough starch that he can start producing glucose after birth, while the fluid stored in his body helps him get through the first day after birth, until breast milk is available .

The bones and the skull

The bones of her skull have yet to fuse together (this is to allow them to overlap to pass the baby’s head easily through the birth canal) .

For this reason, it is quite common for babies to be born with a vaguely conical head, which gradually becomes round during the first few weeks of life.

On its head there are also two soft points, called “fountains”, which facilitate childbirth.

The posterior fontanelle hardens during the first 3-4 months of a child’s life, while the anterior fontanelle takes 8 to 15 months to solidify .

How large is it

The baby is about the size of a small pumpkin. It is about 51 centimeters long and weighs almost 3.5 kilos .

At birth, boys often tend to be slightly heavier than girls.

The position of the fetus

The fetus is ready for its journey through the birth canal, with its head already in your pelvis.

However, it’s still completely normal for your baby to position itself like this just before labor sets in, especially if this isn’t your first pregnancy .

In the case of a breech position (position in which the baby remains with the feet down), the doctor may consider scheduling a C-section.

However, there is still time to try to turn the baby into the correct position by doing pelvic angulation exercises and kneeling: this implies that the mother has to be in an inverted position for some time, in order to let the baby turn .

The woman in her fortieth week

As the baby descends into your belly, your bump sags slightly, indicating that the day of delivery is fast approaching.

By leaving more room for the stomach and lungs to expand, this descent may reduce symptoms such as heartburn , gas, loss of appetite, rib pain and shortness of breath.

Conversely, the increased pressure on the bladder could worsen the symptom of frequent urination.

Tests and exams at the fortieth week

Your doctor may need a cardiotocography (CTG) to assess your baby’s health, and to check for any complications.

CTG involves monitoring the fetus’s muscle activity, as well as its heart rate, to ensure that it is well .

Another routine procedure done this week is the pelvic exam, which is meant to check if your cervix has started to dilate, efface, and soften.

This helps the doctor estimate the time until labor begins .

The cervical exam also helps decide whether it is necessary to induce labor.

Your doctor will closely monitor your health and that of your baby, in case you are past your terminal date.

An ultrasound may be done to check the baby and the placenta, as the placenta may begin to deteriorate if it is well past 40 weeks .

Symptoms of the fortieth week

Symptoms that you may have during this week may consist of,

• pain in the round ligament of the uterus;
• Braxton Hicks contractions 
• pelvic pain;
• coccyx pain;
• sharp pain and leg cramps 
• occasional stiffness and sharp pain in the stomach, with a feeling of pressure in the pelvis
• itchy skin, especially around the belly, thighs and breasts;
• changes in the breast, from which colostrum keeps coming out (thick and yellowish, in preparation for breastfeeding);
• stretch marks;
• edema or swelling of hands, feet and ankles 
• headache and fatigue;
• sore throat and hot flushes;
• constipation;
• joint, groin and back pain;
• restless legs syndrome and insomnia 
• depression and mood swings;
• “nesting”: you feel full of energy enough to clean every corner of the house to prepare it for the arrival of the baby.

Signs of labor in the 40th week

Look out for the following signs as you approach your due date:

• contractions that don’t go away when you change position, and become more frequent over time (5 or more contractions in an hour) 
• copious watery secretions (leakage of amniotic fluid), indicating water breakage 
• vaginal bleeding;
• increased vaginal secretions;
• tan, pinkish, or bloody mucous discharge (loss of mucus plug);
• menstrual-like abdominal cramps;
• dull or throbbing pain in lower back 
• nausea and diarrhea.

The induction of labor at the fortieth week

Unless there is danger to the mother or baby, doctors generally do not induce labor in the 40th week, as it is believed that the longer the baby remains in the uterus, the fewer postpartum complications there will be .

However, an induction of labor may be necessary if it does not start on its own at about 42 weeks  .

Labor induction may also be necessary in cases of,

• water break, or a low level of amniotic fluid due to other reasons 
• development of infectious conditions potentially harmful to the child;
• risk of maternal complications such as gestational diabetes or preeclampsia 
• placental insufficiency;
• suspicion of problems in the development of the child.

Natural ways to induce labor

There are many natural methods, such as castor oil, evening primrose oil and balsamic vinegar that are commonly believed to induce labor, and which are used by many women between 39 and 40 weeks ^( 34 ) .

It is often believed that eating pineapple, chocolate and spicy foods is also beneficial, along with sexual intercourse.

While most of these methods are quite safe, there is no scientific evidence that they are effective.

For example, spicy foods haven’t been scientifically proven to induce labor (though often, given their longer digestion times, they lead to extreme heartburn and swollen ankles)  .

Some herbal teas, such as raspberry leaf tea, are thought to help shorten the length of labor by making contractions more effective .

However, it is always advisable to consult your doctor before using them in order to know any risks for the child.

When to call the doctor

Contact your doctor in the following cases:

• a decrease in fetal movements during kick count;
• one or more signs of labor described above;
• an excessive thirst, light-headedness and dry mouth accompanied by urgency to urinate, passing little urine, tiredness and nausea (may indicate gestational diabetes)
• extreme fatigue, persistent headaches, and sudden vision changes along with upper abdominal pain, sudden swelling of the face and hands, dizziness, shortness of breath, nausea, and vomiting (could indicate hypertension or preeclampsia)
• a burning sensation when urinating and dark/cloudy urine (with or without a foul smell) together with pain in the lower back (around the kidneys), thick white or gelatinous and greenish/yellowish discharge, fever, nausea, vomiting and diarrhea (could indicate a kidney or urinary tract infection  , or thrush
• excessive itching of the palms of the hands and soles of the feet, which does not go away with any treatment (may indicate cholestasis of pregnancy, a liver disease)
• one-sided swelling, i.e. one hand or foot more swollen than the other (could indicate a disorder in blood clotting).

Some useful advice for childbirth, and for a healthy baby

Some tips, also useful for the pregnancy that is about to end,

• wash new clothes, blankets and products bought for your baby (including those that you will put in the bag for the birth ), as they are often treated with chemical products because they maintain their color and texture: if you don’t wash them first, these products could be harmful to baby’s delicate skin .
• follow a daily diet and intake of supplements as recommended by your doctor, with foods rich in vitamin D, which helps maintain your bone health and promotes bone growth in your child by improving the absorption of calcium by his body .
• continue to do prenatal yoga or light exercise (such as walking or swimming) as advised by your doctor, as these help manage third trimester pain and boost your energy levels;
• Keep calm if you think you’re going into labor or your water has broken, as it doesn’t necessarily mean your baby will be born right away. in fact, doctors often ask pregnant women to stay home until regular contractions begin.