Understanding Last-Minute Details About Childbirth, At 39 weeks

It is possible that you have been trying all sorts of home remedies to bring on labor but nothing has worked out yet. You probably detest pineapples by now because you have been stuffing yourself with them since this remedy had worked for a distant aunt. From raspberry leaf tea to having sex and stuffing yourself with papayas; you seem to have tried every possible thing and it is slightly annoying that your baby is not ready to come out yet. More than being annoyed, you are tired and exhausted because your back and your pelvis simply can’t take it anymore. All you want is to deliver your baby and take up parenting for a change. Psychologists advise expecting women to spend more time with their partners towards the end of pregnancy because that is what they basically need. This is a significant time for parents-to-be to bond because once the baby is here, there will be a number of reasons to fall apart since parenting is nothing short of a challenge.

Your Baby

Your baby is at peace inside your womb and is continuing to add layers of fat to her body. Unlike you, she is not worrying herself day in and day out when the waters would break and she will be able to wriggle out of your body. The layers of fat that she is adding to her frame will help her stay warm and comfortable after she is born.

Your baby already measures around 20 inches in length and weighs a little more than 7 pounds. She is a full-grown baby and will do perfectly well if she were to be born now. She is almost the size of a small watermelon now and also feels like one in your pelvis. You are waddling more than ever before. Your baby’s outer layers of skin are being shed only to be replaced by a new layer of skin underneath.

Your baby will probably not grow much after this week but her brain is continuing to develop even more. The first three years of a baby’s life witnesses rapid development of a baby’s brain. You will be cringing one moment and smiling the very next because of how a tiny being can have never-ending questions and a tote bag full of skills to show off.

No Tears Yet

You might be amazed to know that even though your baby will cry quite a lot in the initial days, she will not have tears when she cries. This is because the tear ducts of babies are not developed enough to produce tears. It will take at least a month or so for babies to produce tears. Till then you will need to console your little ones while they cry out in sleep or otherwise without tears to justify their cry.

How Is Your Baby’s Skin?

Your baby’s skin inside the womb has turned a stark white by now. It used to be pink in color earlier but that has changed because of the deposition of a thick layer of fat over the blood vessels under his skin. Even if your baby will eventually have dark-colored skin, she will still have a whitish skin color for the time being till her actual color emerges in a couple of months.

Your Body This Week

“Will I ever be in labor?” is what most women feel like asking by this week and if your baby is still tucked inside your womb, it is likely that even you might ask so. Your pelvis is aching more than ever before and you are sure to feel extremely uncomfortable because of the fact that your baby is bearing down all its weight along with the uterus on you.

If your contractions have intensified and are more frequent, that is a sign of your body preparing for delivery. Your doctor is likely to do an abdominal check to locate the position and growth of your baby. Apart from an external check, your doctor will also want to perform an internal examination to see if you are dilating and whether your cervix is ripe enough for delivery. These figures might still be mere assumptions and there is no way to find out when you will really go into labor.

You may or may not go beyond 40 weeks of pregnancy. A lot of babies are born at 41 or 42 weeks. However, your doctor will carry out a thorough examination to find out if it is safe to keep the baby intact for more than 40 weeks. A fetal examination in the form of an ultrasound helps to find out if it is safe to wait it out.

If your doctor finds out that it is riskier to keep the baby intact, he would suggest induction of labor. If your contractions are not strong enough for real labor to set in, this is the commonest way out.

Paying Close Attention             

It is very important to pay close attention to your baby’s movements this week. If you seem to notice that her moves have slowed down, you will need to report that to your doctor or midwife immediately. It could either mean that your baby is napping or could be indicative of trouble. Your baby should ideally be active till you deliver.

Your waters may break by this week. It could start off as a small trickle and could also be a gush of water down your legs. Whenever you feel that the leakage is more than just a discharge or you see that you have lost your mucus plug let your doctor know about it so that he can make the proper diagnosis. If your amniotic sac ruptures but you don’t get contractions, you will be induced for labor.

Are You Prepared For A C-section?

You could be a woman who has always imagined pushing out your baby vaginally. It is a dream that most of us cherish but not all of us get to live it. An emergency C-section is likely to disappoint you in a big way if you have always planned for a natural birth. A C-section is likely to need more recovery time than a vaginal delivery needs. Along with that, it also needs more care because stitches are involved. There is a sense of incompleteness associated with a C-section. However, you should be aware of the fact that in the United States, around 32 percent of women deliver via C-section.

What Are The Reasons For A Scheduled C-section?

You might need to be scheduled for a C-section because of a number of reasons. Most of the reasons behind a C-section are generally predetermined. Emergency C-sections are performed when the risks outweigh the benefits. Listed below are some of the reasons for a planned C-section:

  • The Baby’s Health

Your baby’s health is of utmost importance to you as well as to your doctor. He would always prioritize it over and above your want for a normal delivery. If there is a medical condition in which passing through the birth canal could affect your baby’s chances of survival, you will be scheduled for a C-section.

  • Your Own Health

If you suffer from any medical condition like diabetes, preeclampsia, high blood pressure, heart problems etc that could strain you even further in a vaginal delivery, a C-section would definitely make more sense.

  • Maternal Infections

If you are HIV positive or have a genital infection that could pass onto your baby during a vaginal birth, a C-section is the only way out.

  • A Bigger Baby

You could have a bigger baby who would be put at risk while passing through the birth canal. It can not only place immense amount of pressure on your baby’s brain but could also affect her body parts if too much strain is involved in the process.

  • Obesity

If you are obese to begin with and stay on the other side of safer limits, your doctor will probably schedule a C-section beforehand. This is because obese women tend to have longer labor hours and could also end up with unnecessary complications, putting both mother and baby at risk.

  • Baby’s Position

The ideal position in which a baby should be placed in the womb is the cephalic presentation. If you baby is heads up and legs down in the womb, he is in the breech position that will require a C-section. If your baby can be turned before delivery, he might as well be delivered vaginally.

  • Placenta Previa

If you have had a low-lying placenta that covers your cervix partially or fully, the doctor will schedule a C-section. Most placentas make their way upwards after the first trimester but if yours doesn’t, you will need a C-section.

  • A History Of C-Section

If you have had a C-section earlier, there is every possibility that you will have another C-section. This is because VBAC’s are not always successful and could involve a number of complications.

Emergency C-Sections

There are a number of circumstances under which your C-section will be performed as an emergency. Listed below are a few of them:

1. Baby Is In Distress

If the baby is in distress or has passed meconium already, your doctor will opt for an emergency C-section.

2. Labor Does Not Start

Even after your membranes rupturing or induction of labor, if contractions don’t start, your doctor will decide on a C-section.

3. Labor Stops Midway

This often happens when the mother is too tired or exhausted to push. This could also happen baby’s head does not fit into the birth canal. Under both the circumstances, you will need a C-section.

4. Umbilical Cord Issues

If your umbilical cord comes into the birth canal before your baby can pass through it, you will need a C-section to avoid the cord from cutting off your baby’s oxygen supply.

5. Uterine Tears

If your uterus ruptures, your doctor will immediately opt for a C-section to prevent any complication arising from it.

The Procedure

A typical C-section will begin with a routine IV and an epidural or spinal block to keep the lower half of your body numb while you are operated upon. Your pubic hair will be shaved or trimmed at least 4-5 hours before the surgery is slated to take place. The next step is to clean your abdominal area with an antiseptic solution.

A catheter will then will inserted into your urethra and sterile drapes will be placed on your abdomen by the attending nurses or hospital staff. A screen will be put up between you and the site of the procedure so that you don’t need to witness being cut open. You can request your doctor to hold up the baby once she is born so that you get the first glimpse of your little one.

If you or your baby are in any kind of distress and you need an emergency C-section, your doctor will not have the time to give you an anesthesia. He would rather use general anesthesia for your surgery. However, general anesthesia has its own disadvantages. When you wake up you will feel slightly disoriented, your throat will feel sore from the insertion of the tube and you could also feel nauseous. All these symptoms will fade away in a couple of days.

The Incision And Delivery Of Baby

Once the doctor is sure that you are either fully asleep or totally numb waist down, he will make the first incision on your skin just above the pubic hairline. The second incision will be done on the lower half of the uterus. There are two types of incisions that doctor generally do. They are:

  • The commonest incision these days, a low-transverse incision is usually preferred because the lower part of the uterus has thinner muscles and will not be prone to impact during the next deliveries.
  • The vertical cut is rarely opted for and is done in circumstances where the baby is positioned in an unusual manner.

The next step is to suction the amniotic fluid out of the sac. Before you hear your baby cry out, he will need some suctioning so that the extra fluid in his lungs can be squeezed out. In vaginal deliveries, the baby passes through the birth canal which naturally helps in suctioning out the fluid from his lungs.

After pulling out your baby gently, the doctor will severe the umbilical cord and carry out a basic checkup of his vital organs. The next step is to deliver your placenta which hardly takes much time. After all this is done, your doctor will stitch you up with dissolvable sutures.

Stitching up at the end takes more time than cutting up the abdomen because several layers of the abdomen need to be closed. After you are wheeled to the recovery room, you will receive antibiotics to prevent any kind of infection and oxytocin to help speed up the shrinking of the uterus and control bleeding. Your bleeding will be checked periodically to ensure that you are healing well.

If you have always wanted to breastfeed your baby, do let your doctor know about it so that he is aware of your choice. You can breastfeed immediately after your baby is born or at least practice skin-to-skin so that your baby gets to feel you before you are shifted to the recovery room.

Could There Be Complications?

Complications are rare in C-sections these days. At times, the mother might react adversely to some medication or the anesthesia used during the procedure. She could also have excessive blood loss or infections at the site of the operation. Following the doctor’s advice thoroughly is of utmost importance.

There is another issue that could happen in some women. Blood clots in legs or lungs could happen and the only way out is to walk around as soon as possible after your numbness is gone. If you experience breathing difficulties, fever, unusual discharge etc, let your doctor know about it immediately.

Some babies born via C-sections tend to have complications after birth. One of the commonest problems is rapid breathing from leftover fluid in his lungs. While this definitely sounds scary, it generally gets resolved on its own. However, if your baby is born before 39 weeks, he will be under close observation because complications are likely to arise.

Recovering From A C-section

Even though a C-section is considered quite safe, you need to remember that your body has been cut open and it is a major surgery that you have gone through. You need to give your body that amount of time to heal and recover. It will take you around three to four days in the hospital and six to eight weeks at home to completely recover from a C-section.

You will need to lower your expectations as far as activities are concerned. Ignoring rest initially will only lengthen the recovery time. Always be careful about your scar while moving about or nursing your baby. Using a maternity pillow helps a good deal.

Distribute your work as much as you can. You will need added energy to breastfeed your baby so do not spend it elsewhere. Let the housework pile up or let your partner take over the duties for the time being. Spend every free minute to get enough rest for the wakeful nights that will arrive very soon.

Your scar is supposed to itch and pull a little because it is drying up but if you have a fever and chills, you could be harboring an infection. Always keep the area clean and wear loose clothes that do not brush against the wound.

You will need to take all the medicines very seriously. Your doctor will know the best which is why taking the pain medication and antibiotics on time will help you recover faster.

Always avoid constipation as far as possible. Straining your stitches is a bad idea and you can keep that away by taking laxatives as prescribed by the doctor. You will also need to have a diet rich in leafy greens and fibrous food to help regulate your bowel movement.

Eat well and eat healthy. You will need to refuel yourself after this major surgery and the best way to do that is to keep healthy food at hand that will keep up your energy levels. Try and consume whole food as much as possible.

Keep yourself active in some way by moving around a bit. Your doctor will give you the green signal to start working out at around the 6th week. Till then you can keep building your stamina by walking around in the house, to begin with.

A C-section does not necessarily mean that you cannot have vaginal deliveries in the future. If having a VBAC does not affect you negatively, your doctor will be the first person to advise you so.

Helping Your Pregnant Spouse

Your wife is going through an emotional upheaval this week because she is probably tired of waiting for the D-day. You could help her out with reading to her, giving her light massages, making meals for her or taking her out.

Although she might not particularly enjoy going out now, nobody can deny a decent takeaway meal for dinner. Help her shed the load and share as many responsibilities as possible. If the doctor is of the opinion that your wife must undergo a C-section and if she is absolutely unconvinced, you can try to show her the risks that none of you need to take.

If your spouse happens to have a C-section this week, pay close attention to what the doctor advises. You will need to know about the details so that you can take over the entire responsibility. If your wife plans to breastfeed, you will be expected to take over everything and let the two of you spend quality time together.

This week could be yet another disappointment as far as the arrival of the baby is concerned but you never really know about the 40th week that lies ahead.