What to Expect at 40 Weeks of Pregnancy: Preparing for Labor and Self-Care

Highlights

• 40 weeks marks full-term pregnancy, ready for natural childbirth.
• Common signs of impending labor: intensified Braxton Hicks contractions, dropped abdomen, weight loss, mucus plug release, amniotic fluid leakage.
• Baby size: 48–51 cm in length, ~3.5 kg in weight.
• Maternal sensations: fatigue, pelvic pressure, frequent urination, mood swings.
• Recommended actions: monitor fetal movements, maintain balanced nutrition, stay active, prepare hospital bag, attend prenatal visits.

In This Article

1. Early Signs of Labor
2. Fetal Development at 40 Weeks
3. Maternal Sensations and Emotional Changes
4. Common Discomforts
5. Vaginal Discharge and Warning Signs
6. Fetal Movements
7. Potential Complications
8. Fetal Position in the Womb
9. Abdominal Growth and Stretch Marks
10. Nutrition Guidelines
11. Physical Activity Recommendations
12. Necessary Tests and Examinations
13. Ultrasound Assessment
14. Tips for Expecting Mothers
15. Tools and Assistance

Early Signs of Labor

At 40 weeks, labor can begin at any time. Common signs include:

• Increased Braxton Hicks contractions, which may now become stronger and more frequent.
• Dropped abdomen, shifting downward toward the pelvis.
• Slight weight loss (1–2 kg) due to the elimination of excess fluid.
• Mucus plug release several days before or immediately before labor.
• Amniotic fluid leakage or complete rupture of membranes.

Labor is considered full-term from 38 weeks onward, meaning both mother and baby are ready for birth.

Fetal Development at 40 Weeks

• Size: 48–51 cm, ~3.5 kg.
• Age: 38 weeks from conception (embryonic age).
• Lungs: surfactant is fully formed, enabling first breaths.
• Digestive system: processes swallowed amniotic fluid, forming meconium.
• Reflexes: sucking and grasping are fully functional.
• Senses: vision and hearing developed; the baby can distinguish light, color, contrast, and sound.
• Skin: slight bluish tint and wrinkling may appear at birth due to mild hypoxia.
• Genitourinary system: fully formed; in boys, testicles are almost fully descended.
• Skull bones: flexible for passage through the birth canal.

Maternal Sensations and Emotional Changes

• Fatigue and anticipation dominate; physical strain from the large abdomen is significant.
• Evening weakness, leg heaviness, sleepiness, and back pain are common.
• Mood swings: excitement alternates with anxiety about childbirth and readiness.
• Nesting instinct may prompt organizing the home or preparing baby clothes.
• Dropped abdomen may relieve breathing discomfort and improve appetite.
• Increased urination and possible hemorrhoid discomfort require careful attention.

Psychologists advise focusing on positive activities, hobbies, and light errands to manage stress.

Common Discomforts

• Abdominal pain from Braxton Hicks contractions.
• Back and pelvic pain.
• Leg pain from swelling and circulation issues.
• Hemorrhoid discomfort.
• Sacral pain due to nerve compression.

Intensifying or persistent pain should prompt consultation with a healthcare provider.

Vaginal Discharge and Warning Signs

• Slightly increased discharge is common.
• Blood-streaked mucus may indicate mucus plug release.
• Watery or heavily blood-streaked discharge requires immediate hospital visit.
• These signs help determine whether labor is imminent or if a complication, such as placental pathology, exists.

Fetal Movements

• Movements may be less active due to limited space.
• Most fetal activity occurs in upper abdomen (rib area) and when stretching limbs.
• Rhythmic belly vibrations may indicate fetal hiccups.
• Mothers should track at least 10 movements in 12 hours.

Potential Complications

• Fetal hypoxia (oxygen deprivation).
• Infections, such as candidiasis.
• Placental abruption.
• Late-onset preeclampsia (gestosis): nausea, vomiting, high blood pressure, swelling.

Severe complications require prompt medical attention; labor may be induced for maternal and fetal safety.

Fetal Position in the Womb

• Optimal: head-down, longitudinal.
• Malpositions (breech, transverse, oblique) often necessitate Cesarean delivery.
• Small babies or cases without umbilical cord complications may still allow natural delivery.

Abdominal Growth and Stretch Marks

• Fundal height: ~36–40 cm.
• Abdomen is large, often showing visible fetal movements.
• Braxton Hicks contractions occur daily.
• Dropped abdomen reduces heartburn and improves breathing.
• Skin may itch or feel tender; hydration and moisturizing are recommended.
• Large belly requires caution when walking; prefer company for safety.

Nutrition Guidelines

• Balanced diet rich in proteins, vitamins, minerals.
• Include leafy greens, fruits, vegetables, dairy, poultry, and fish.
• Focus on Vitamin K (spinach, broccoli, green onions, dairy, tea, oils) to support blood clotting.
• Avoid alcohol, caffeine, smoked, overly salty or spicy foods.
• Light, frequent meals are recommended for digestive comfort.

Physical Activity Recommendations

• Avoid strenuous exercise at 40 weeks.
• Recommended activities:
  • Long walks in safe areas
  • Breathing exercises
  • Light home workouts
  • Kegel exercises
• Movement helps oxygenate the baby, prepare for labor, and aid postnatal recovery.

Necessary Tests and Examinations

• Weekly prenatal visit should include:
  • Abdominal palpation to determine fetal position
  • Fetal heartbeat monitoring
  • Fundal height and abdominal measurement
  • Blood pressure and weight
  • Urine analysis
  • Additional tests as needed (e.g., cardiotocography to check fetal oxygenation)

Ultrasound Assessment

• Indicated if prior tests or CTG suggest complications.
• Evaluates fetal condition, placental maturity, amniotic fluid volume, and umbilical cord status.
• Helps plan labor and assess safety for mother and baby.

Tips for Expecting Mothers

• Continue regular prenatal visits; monitor for late-stage complications.
• Engage in enjoyable activities to manage stress.
• Prepare baby clothes and hospital bags: one for postpartum, one for discharge.
• Avoid long trips; ensure support is nearby for hospital transfer.
• Maintain adequate rest: 1–2 hours daytime nap, 8–9 hours nighttime sleep.
• Nesting is normal, but avoid heavy tasks or renovations.

Tools and Assistance

• Fetal movement trackers to monitor daily activity.
• Maternity pillows and belts for comfort and support.
• Hospital bag checklist including essentials for mother and baby.
• Breathing and Kegel exercises for labor preparation.
• Professional support: obstetric guidance and emergency contact plan.
• Educational resources: prenatal courses, apps, and informative guides.