What to Expect at 38 Weeks of Pregnancy: Preparing for Labor and Self-Care

Highlights

• Pregnancy enters the final stage, with the baby fully developed.
• Common maternal changes: abdomen drops, improved breathing, reduced heartburn, frequent Braxton Hicks contractions.
• Baby size: ~50 cm, ~3.1 kg, head-down position typical.
• Key labor signs: regular contractions, mucus plug discharge, amniotic fluid leakage, breast colostrum.
• Monitoring: fetal movements, maternal health, weekly prenatal visits, ultrasound/CTG as needed.

In This Article

1. Signs of Impending Labor
2. Maternal Changes and Sensations
3. Fetal Development
4. Common Discomforts
5. Vaginal Discharge and Warning Signs
6. Fetal Movements Monitoring
7. Potential Complications
8. Fetal Position in the Womb
9. Recommended Examinations and Tests
10. Ultrasound and Cardiotocography
11. Birth Plan Preparation
12. Nutrition Guidelines
13. Physical Activity
14. Intimacy and Emotional Well-being
15. Psychological Preparation for Labor
16. Tools and Assistance

Signs of Impending Labor

• Dropped abdomen (lightening): Uterus shifts lower into the pelvis, reducing pressure on stomach and diaphragm, easing breathing and heartburn.
• Pelvic discomfort: Ligaments soften in preparation for labor; pain may occur if the baby presses heavily. Consult a doctor if pain is severe.
• Braxton Hicks contractions: Initially mild, they may intensify. Regular contractions with intervals <5 minutes indicate labor onset.
• Breast colostrum: A natural pre-labor sign, providing the first nutrition for the newborn.
• Digestive changes: Nausea may persist, especially after overeating. Eat small, frequent meals.

Maternal Changes and Sensations

• Weight gain slows or stops; minor reduction (~1–1.5 kg) is normal due to reduced edema.
• Hormonal preparation: Stress hormones provide energy; blood clotting increases.
• Labor dominant in the brain: Reduces fear, coordinates breathing, provides mild pain modulation.
• Fatigue is common; light movement, socializing, and relaxation help maintain balance.
• Abdominal circumference: ~92–95 cm.
• Increased urinary frequency due to uterine pressure on the bladder.

Fetal Development

• Size: ~50 cm, 3.1 kg, head-down.
• Respiratory system: Cortisol prepares lungs for first breath.
• Digestive system: Amniotic fluid swallowed → converted to meconium.
• Neuromuscular system: Coordinated movements; reflexes like thumb-sucking, grasping, and umbilical cord holding.
• Skin: Pink, smooth, coated in vernix; some wrinkling on hands/feet.
• Cranial bones: Soft, allowing passage through birth canal.
• Heart rate: 120–160 bpm.

Common Discomforts

• Pain: Pelvis, pubic joint, sacrum, lower back, calf muscles, headaches.
• Sleep disturbances: Difficulty finding a comfortable position, frequent urination.
• Digestive discomfort: Nausea, bloating, mild heartburn.

Vaginal Discharge and Warning Signs

• Normal: Whitish, odorless, slightly increased.
• Watery discharge may indicate amniotic fluid leakage.
• Blood-streaked mucus may signal mucus plug discharge.
• Seek immediate care for heavy bleeding, strong odor, or abnormal fluid.

Fetal Movements Monitoring

• Activity reduced due to limited space; baby mostly sleeps and practices reflexes.
• Mothers should monitor daily.
• Abnormal frequency (too low/high) requires obstetric consultation.

Potential Complications

• Pre-eclampsia: Nausea, edema, high BP.
• Placental abruption, fetal hypoxia, large fetus, immature birth canal.
• History of miscarriage may require hospital monitoring.

Fetal Position in the Womb

• By 38 weeks, vertex (head-down) position typical.
• Malposition may require Cesarean section.

Recommended Examinations and Tests

• Weekly prenatal visits to monitor:
  • Fetal heart rate
  • Uterine height & abdominal circumference
  • Maternal BP & weight
  • Urine & blood tests
  • Cervical assessment if necessary
• Carry medical record card for hospital admission.

Ultrasound and Cardiotocography

• Ultrasound: Assess placenta, amniotic fluid, cord position, fetal well-being.
• Cardiotocography: Monitors heart rate and uterine tone, detects fetal hypoxia, guides labor management.

11. Birth Plan Preparation

• Choose hospital & doctor.
• Pack two sets of clothes for mother and newborn.
• Discuss birth preferences: natural vs. assisted delivery, pain management options.
• Ensure mental preparation and relaxation strategies.

Nutrition Guidelines

• Easily digestible foods: dairy, vegetables, fruits.
• Iron: buckwheat, liver, leafy greens, legumes.
• Vitamins: vitamin A-rich foods for tissue elasticity.
• Hydration: 2 liters water, herbal drinks, weak tea.
• Avoid: fried, fatty, sugary foods, caffeine, alcohol.

Physical Activity

• Limit strenuous exercise; focus on:
  • Breathing exercises
  • Kegel exercises
  • Daily walks (~1 hour)
• Helps labor efficiency, pelvic muscle tone, and recovery.

Intimacy and Emotional Well-being

• Safe if no contraindications.
• Gentle positions recommended; sexual activity may stimulate labor.
• Maintain communication and comfort for both partners.

Psychological Preparation for Labor

• Practice relaxation, breathing, and visualization techniques.
• Prepare mentally for pain management and labor stages.
• Discuss expectations and support systems with partner and healthcare provider.

Tools and Assistance

• Fetal movement tracker apps: Track daily baby activity.
• Maternity support belts and pillows: Reduce back, hip, and pelvic pain.
• Comfortable clothing: Stretchable and breathable.
• Breathing and Kegel exercises: Prepare for labor and recovery.
• Hospital bag checklist: Mother and newborn essentials.
• Telehealth or on-call obstetric support: For urgent consultations.
• Educational resources: Prenatal courses, peer support groups, books.