40th week of pregnancy is the last step towards a miracle! Although the entire path to the birth of a child has already been completed, the most important event ahead is childbirth. Expectant mothers are in a state of trembling fear of the unknown, first of all this, of course, applies to those mothers to whom this is the first pregnancy. Now is the final stage: the woman’s body is preparing for childbirth, and the child is preparing for this event.
Fetus at 40 weeks gestation: movement
He is already getting ready. There is nothing to say about appearance: everything has long been formed and took its places, the excess has disappeared, the missing has appeared - the baby is impeccable. The growth of the baby at 40 weeks is an average of 51.2 cm, weight reaches 3.5 kg. The cheeks are chubby, the skin is smooth, the ears, eyes, nose are pretty. You are about to meet him!
The baby can no longer actively move, but you should still feel the movements. Moreover, his movements are very obvious: there is practically no space left in the uterus, therefore, you feel any push of the crumbs very well.
Be sure to listen to the motor activity of the baby: any change in the nature and intensity of movements in the direction of attenuation, or, conversely, excessive activity, become a signal of the tested baby crumb dysfunction.
In general, the norm for a period of 40 weeks is considered to be about 10 perceptible movements within 12 hours. In the case when the baby flounders much more actively, there is every reason to suspect his suffering from a lack of oxygen. A bad sign will be the calming of the baby, the lack of movement. If they are absent - inform your doctor about this.
Is this normal?
Estimated date of birth (DA) exists in obstetric practice in order to approximate the timing of completion of gestation. It is a calculus based on the date of the last menstruation. According to the established practice, obstetricians take three months from her and add a week - this gives an approximate date when the baby should be born.
Therefore, it is also assumed that it is not 100% accurate. Ovulation in a woman could be delayed, come later, and then the baby may well be born for a week, or even two later. In addition, too many maternal and child factors must coincide for the onset of labor.
Regular labor begins when the organisms of the future mother and baby are completely ready for this process. The hormonal background should be favorable, the uterus should be prepared, the neck should soften, the child should be sufficiently mature to safely be born. This is such a complex, multi-stage and individual process that it is impossible to evaluate and calculate it with any obstetric formulas and mathematical calculations.
According to existing medical statistics regarding the period of onset of spontaneous reflex labor, exactly only 5% of women give birth on DA. This means that only about every twenty pregnant women can give birth at exactly 40 weeks of pregnancy, and this is not so much. Most physiological births occur in the week preceding it - 39-40 weeks. About 35% of children are born at 40-41 weeks, about 10% - after 41 weeks.
Therefore, childbirth in the week following the DA is not considered unusual or abnormal. Pregnancy at 40-41 weeks is not considered to be postponed - doctors do not see anything disturbing in the fact that 40 weeks have passed, and childbirth has not yet begun. It's just that the time has not come yet. They begin to talk about overriding if the pregnancy lasts more than 42 weeks.
It should be noted that delivering a baby up to 40-42 weeks is more likely if the first birth is coming. In a second pregnancy and subsequent babies, they are usually born earlier than DA. Also, women with multiple pregnancy, polyhydramnios are unlikely to reach 41 weeks.
If the time has come to give birth, and childbirth does not begin in any way, the main thing is not to worry and not to panic, so as not to harm the baby and yourself. What is happening is a variant of the norm; there are no deviations in this phenomenon.
Harbingers and their absence
Most of all women who are at 41 weeks of gestation are frightened by the situation when there are no harbingers of childbirth. From the point of view of physiology, such a situation is completely impossible. The pregnant woman’s body is actively preparing for this period, just sometimes this preparation goes unnoticed, especially if the woman is not very sensitive.
Pregnant women are not always attentive to the body's signals, and sometimes they simply don’t imagine what they should be, therefore they conclude that signs and symptoms of early delivery simply do not occur.
Indeed, some women have such a low sensitivity of the nervous system that specific markers of health before childbirth can be perceived by them somewhat smoothed out, almost imperceptibly. In addition, it is possible that there really are reasons for the lack of external manifestations of a large internal preparation of the body for childbirth.
The main precursors and reasons why they may not be observed are described below.
Delivery at 40 weeks of gestation: harbingers
Therefore, do not worry if childbirth has not yet begun - it will certainly happen in the coming days. And you will learn about the approach of childbirth thanks to the presence of their clear precursors. What will tell you about the approach of the treasured “Hour X”?
One of the ambiguous precursors of childbirth is lowering the abdomen: the baby in the uterus goes down, pressing its head to its bottom and preparing for an entertaining journey into the new world. You observe this as a certain lowering of the abdomen, due to which your breathing is noticeably easier, heartburn disappears. But, at the same time, sinking in the uterus, the baby begins to put pressure on the bladder - hence the increased need for urination.
Along with frequent visits to the toilet for “peeing”, shortly before birth you can find an eating disorder, which is also considered one of the harbingers of childbirth. Loss of stool, nausea, vomiting - all these unpleasant phenomena can well precede the onset of childbirth, and appear about 24-48 hours before they start.
Shortly before the start of labor, you may find a slight decrease in appetite, sometimes you don’t want to eat at all. Against the background of lack of appetite, weight changes are also possible: it either remains fixed on one designation, or even decreases by 1-2 kg.
The last weeks of pregnancy are also the time of awakening in a woman of the so-called “nesting instinct”. The pregnant woman suddenly begins to equip the apartment, to clean and tidy everything up, to prepare the baby's room. Have you felt the need for even greater improvement of the "family nest"? Wait for the soon birth.
And yet, the most obvious, most distinct precursors of childbirth are the loss of mucous plugs, the discharge of amniotic fluid and the appearance of regular painful contractions. You will recognize the mucous plug by the presence on the panties of a dense lump of thick mucus, possibly with streaks, streaks of blood. The entire period of pregnancy, the mucous plug closed the cervix, preventing infections and viruses from getting to the baby. Now the cork comes out, freeing the baby's birth canal.
Amniotic fluid outflow is also difficult to miss: immediately before the birth, the waters literally pour out in a stream, creeping along the legs in trickles. At the same time they have the appearance of a watery liquid, often transparent, but if the baby’s original feces of meconium get into the amniotic fluid, the water may acquire a yellowish or greenish tint.
And, of course, contractions - regular, more and more frequent, accompanied by painful sensations, will report the onset of labor. Many women, especially primiparous, are afraid to confuse false contractions with true ones, especially since false contractions by the end of pregnancy also already have a painful character and are repeated much more often than before. To determine what contractions you are dealing with, simply change your body position during the contractions. Get up, walk around the room, sit on a stool. If the contractions at the same time stopped, then the birth will still have to wait.
The abdomen changes shape and location somewhat, the height of the uterine fundus decreases due to the fact that the baby, at a certain moment of its development, anticipating the imminent birth, moves to the lower part of the uterus, supports the internal pharynx with the head. This pressure also has a stimulating effect on the cervix - it begins to shorten and smooth faster, to open slightly.
After lowering the abdomen, a woman may feel some relief - there is no more pressure on the diaphragm, some internal organs are released, as a result of which it becomes much simpler and easier to breathe, heartburn is reduced. However, this increases the pressure on the bladder - there is a frequent need to empty it. A woman begins to visit the toilet for "little need" very often.
In most cases, in primiparas, the abdomen falls 3-4 weeks before birth, in those who give birth again, in a week, or even several days. It is possible that the baby during repeated birth will take the position of "low start" only with the onset of labor pains.
At 40-41 weeks, most women have this symptom, but there are exceptions. For instance, with the pelvic position of the fetus or its oblique location in the uterine cavity, omission does not occuras the present part is not the head. The abdomen does not change the shape and height of standing in women with twins, in women with polyhydramnios, as well as with certain structural features of the pelvis.
Belly: pulls, hurts
By the 40th week, the abdomen has usually lowered, the baby has taken a position from which he will begin to advance towards a meeting with his mom and dad. However, if no changes have happened to your stomach, do not worry: in some cases, the stomach does not go down until the onset of labor.
Do not be alarmed by abdominal pains - pulling pains in the lower abdomen, passing to the lower back, indicate the imminent onset of labor. The baby is now “at a low start” before the exit, his head presses on the pelvic bones, the woman has a colossal load due to the tremendously increased weight. Hence the feeling of a drawing, painful abdomen.
Two weeks before giving birth, women usually notice that they began to weigh 2-3 kg less. Many associate this with excitement, anxiety in anticipation of the birth process, and some are convinced that the problem is in impaired appetite and less food intake.
In fact, this weight loss is a real harbinger, which suggests that the body is getting less intercellular fluid. Its reserves go away as progesterone levels decrease. The lower the level of this hormone, the faster the birth will begin. Also, the weight goes away due to a decrease in the amount of amniotic fluid.
Body weight may not decrease in women with obesity, with a small fetal weight, according to ultrasound, with endocrine disorders.
The exit from the cervical canal of the cervix of the mucous clot of milk or yellowish color (sometimes with streaks of blood) is a sure sign of an early birth. The neck expands, softens. The mucus, which served as a barrier against microbes and viruses, cannot be held inside and leaves the thin cervical canal. Normally, the discharge occurs either in full or in parts two weeks before the birth during the first pregnancy and a few days before the second birth (jelly-like clots will be present in the discharge).
It should be borne in mind that the cork can go unnoticed, for example, when bathing in the bathroom or during sex. Also, the cork may continue to be held in case of insufficient maturation of the cervix.
It is possible that it will not come out until the very moment of active labor and then it will go outside with the amniotic fluid. For this reason the absence of characteristic discharge should not be considered the absence of a sign of approaching childbirth as such.
Frequently Asked Questions in the Forums
V .: Gone 40 weeks of pregnancy, today in the morning the pain is like with menstruation. Can I give birth?
A .: Such pains may be a symptom preceding the onset of labor. Observe your condition, if there are cramping sensations that will be regular and will become more frequent over time, then urgently go to the hospital. With the same symptoms, training fights can also occur.
V .: Week 40 began and there are still no harbingers of childbirth (second birth). When do I give birth?
A: Harbingers of childbirth in the second pregnancy may appear several days before the birth, or even several hours (all very individually). The second birth takes place more rapidly, therefore, the precursors appear much later.
V .: Water has returned, but there are no contractions (40 weeks). What to do?
A .: Water often leaves several hours before the start of labor, if we talk about the full outflow of water. If after several hours the contractions do not start, go to the hospital, you may have to stimulate labor. Also, at a period of 38-40 weeks, there is leakage of amniotic fluid when they leave in a small amount. This happens often and is not something scary, but the doctor must be consulted for examination.
Doctors will pay special attention to this symptom at 40-41 weeks. A neck is considered mature, the length of which at this time is about one or less than one centimeter. It should be soft along the entire length, its location should be central.
If a deviation of the neck is detected to the right, left, back, or to the front, or it will soften unevenly or remain stiff, as well as if its length exceeds 1.5 centimeters, then drug preparation of the neck will be shown at this time uterus to childbirth.
Harbingers, which consist in a decrease in the baby’s activity, in insomnia, diarrhea and other rather subjective signs, cannot directly indicate the approach of childbirth, so their absence should not worry the pregnant woman.
Sensations like belt pulling, tingling inside, back pains that women mention on thematic forums on the Internet also cannot be considered direct signs of an early birth. They are more associated with fatigue, heaviness, because 41 weeks is a very impressive period for which a pregnant woman is very difficult to walk.
It should be noted that the not always distinguishable presence of precursors means an early birth. It also happens that without any clear precursors a woman begins to give birth, and everything goes quite well.
Weight, height and condition of the fetus at 40 weeks of gestation
At 40 weeks of pregnancy, the baby's weight ranges from 3500-3700 gr. In length, the baby at this time has grown to 55 cm. The baby weighing with big cabbage!
The child fills the entire space of the uterus, and as a result of a lack of space, its activity is noticeably reduced. The baby accumulates strength for childbirth, therefore, the frequency of his heart contractions increases, and the metabolic processes in the brain, on the contrary, slow down.
The fetus is completely ready for birth, it is located in the position most suitable for childbirth: the head is at the bottom - it is firmly pressed to the bones of the small pelvis, the chin is touching the chest, the legs bent at the knees are pressed to the body, the baby is facing the back of the uterus: it is in In this area, the size of the head circumference is minimal, which ensures easy movement along the birth canal.
The skull is still not solid due to the fact that the five main bony plates are separated by fontanelles, so that they can move when passing through the birth canal and prevent damage and trauma to the central nervous system during childbirth. After the baby is born, the bony plates of the skull will open again, and the head will again become round.
40 weeks of pregnancy - how much?
40 obstetric weeks is 10 lunar months, 38 weeks from conception - such a pregnancy is considered normal, full-term. If the terms are shifted by two weeks in one direction or the other, this is a completely natural phenomenon, since it is far from always possible to predict the exact date of the birth. It is only possible to talk about overriding when the expectation period of a child is delayed to 42 or more weeks, so that there is still time, and even if there are no signs of childbirth at 40 weeks of gestation, there is no need to be afraid.
On a note! The gestation period may last if the woman lay on hold for 36 weeks with a high uterine tone, and she was prescribed the use of magnesia, which relaxes smooth muscles.
In many women, during pregnancy at 40 weeks, the lower back pulls, the same sensations can be observed in the lower abdomen, which is very similar to the pain before the onset of menstruation. When the baby’s head falls into the pelvis, the birth canal gradually opens and soon the long-awaited baby is born.
The ratio of weeks to months of pregnancy
Now baby in size
All its systems and organs are completely ready for independent functioning outside the mother’s body. The child’s head is usually located in the very lower abdomen. The skin has a light pink tint, but may look a little yellowish or cyanotic.
The fetal movements are not too active, because there is too little free space left around. Nevertheless, the baby moves quite regularly, this is an indicator of his normal condition.
Immediately after the birth of some newborns, the head may have a slightly deformed appearance, but subsequently it takes on a normal shape.
How late are we?
If the duration of pregnancy increases by 10-14 days or more, the doctor will see two main factors in this. At first, he will ask: is the date determined for childbirth appropriate. If during the entire pregnancy the indicated period corresponded to the size of the uterus and the height of the bottom of the uterus, the date of feeling the first movements of the pregnant fetus, the date the doctor listened to the first beats of the fetal heart, then you can be sure of the correct gestational age. Studies show that in 70% of cases, the statement of pregnancy pregnancy is incorrect. Usually this is due precisely to an error in the calculations.
Secondly, the specialist must establish whether the child will continue to develop correctly - as, incidentally, happens with many children in the tenth month. However, sometimes the environment inside the uterus, previously ideal, begins to deteriorate: there is no corresponding amount of nutrients and oxygen, and there is less and less amyotic fluid. And then further successful development of the fetus is compromised.
In addition, it is very important to distinguish between true and false pregnancy. False, or prolongation of pregnancy, is characterized only by its extension by 10-14 days. There are no signs of immaturity in the fetus and changes in the placenta. Prolonged pregnancy is a normal option! It’s just that your baby has not yet “matured”.
With true overriding, the fetus reaches a higher degree of development than during normal pregnancy, and is born with signs of overriding. Ultrasound can detect a decrease in the thickness of the placenta, relative oligohydramnios, large sizes of the fetus, sharper contours and thickening of the bones of his skull. In this case, the pregnant woman loses weight, the circumference of her abdomen decreases by 5 - 10 cm.
Reasons for delayed birth
Of course, a woman who has been carrying her baby for more than 40 weeks is most concerned about why this is happening. Indeed, before my eyes are many examples - women give birth before 40 weeks, and here even the precursors are not observed.
There can be quite a few reasons.
- Own biorhythm of the female body. As a rule, later childbirth begins in women who have a longer menstrual cycle (its duration is more than 30 days).
- Physical inactivity. Women who move little in the later stages, try to lie more or sit at rest, are more likely to experience a delay in starting labor. The fact is that adequate movement helps not only prepare the muscles for childbirth, but also positively affects the preparation of the cervix for the beginning of the reflex birth process.
- Large or giant fruit. Large is called a child whose weight, according to preliminary estimates of ultrasound, for 40 weeks exceeds 4 kg. Giants are considered to be children who weigh about 5 kg at the same gestational age.
- Psychological factor. It is he who should be given special importance. Sometimes it happens that a woman herself, not realizing this clearly, puts off the moment of childbirth with her own fear of childbirth, unwillingness to experience pain, and sometimes even unwillingness to give birth.
Childbirth may be delayed if the pregnancy is unwanted, the woman is in a difficult psychological situation, for example, experiencing significant financial problems or divorcing her husband.
At the physical level, with the described experiences, a muscle “blockade” occurs - the woman is clamped, tense. The cervix, as a result, is in no hurry to open. Stress hormones partially block sex hormones and the production of oxytocin.
What happens to a pregnant woman at 40 weeks gestation?
At this time, the expectant mother ceases to increase in size, gaining an additional 12-16 kg, she will maintain that weight until delivery. The uterus reaches its peak at 40 weeks of gestation, it is 36–40 cm from the pubic symphysis, and 16–20 cm from the navel. A woman may occasionally experience a sensation of itching, as the skin on her stomach is very tight, in the fortieth week of pregnancy the mucous plug departs and contractions occur.
For 40 weeks, mothers have two questions for concern: why is the baby not yet born and what if he decides to be born? But there is no need to worry, the child will be born when psychologically and physiologically ready for this.
If a woman is already having a second birth, then they will definitely differ from the first at the 40th week of pregnancy. Nobody will predict their duration exactly and during the second birth, the opening of the cervix occurs much faster, since the body has already "passed through" it. Also in this regard, the period of fights is much shorter than it was the first time.
In anticipation of the onset of childbirth, it is necessary to try to remain calm and not to be annoyed by the little things, it is important to maintain a good mood in the fortieth week of pregnancy.
When the contractions begin, it is required to work out the methods of proper breathing and relaxation, the body of the expectant mother has been preparing for this moment for a long time, and now its onset has occurred.
The mammary glands of a pregnant woman become fully prepared for the upcoming breastfeeding. Colostrum is produced - a thick, viscous, yellowish, highly nutritious fluid that will provide the newborn in the first hours of his life with all the necessary nutrients. Already on 2 - 4 days breast milk will come to replace colostrum.
Now is the time to prepare for the care of the newborn, when the baby appears, you will be a prepared mom. A detailed description of the care of the newborn we presented in this article.
At 40 weeks of pregnancy, the baby is already fully ready for the birth. The mass of the fetus is 3-3.5 kg, growth reaches 51-55 cm. The child is in a bent position, head down, knees pressed to the body. Now he becomes very crowded in the uterus, so he activates much less often. For 12 hours, you can feel 10 movements. If tremors are felt less often, it is necessary to tell the doctor about this - a similar sign can be a signal of oxygen starvation in the fetus.
At the 40th week of pregnancy, the internal organs and systems of the baby are well developed:
- A surfactant has already formed in the pulmonary alveoli, which will help the lungs open at birth and take the first breath.
- The bones of the skull in the fetus remain soft and flexible - when moving through a narrow birth canal, they can go into each other, due to which it will be easier for the child to be born.
- The genitals are already formed. At this time, the testicles in the boys descend into the scrotum.
- The placenta is aging and thinning, its thickness is about 34.4 mm. The embryonic organ becomes unable to fulfill its assigned functions, and the child may experience oxygen starvation. Sometimes babies are born with wrinkled bluish skin, but do not worry much - in a couple of days everything will return to normal.
- The hematopoietic system of the fetus is fully formed and works independently.
- Digestive system organs perfectly perform their work when the baby swallows amniotic fluid. In the intestine, meconium (primordial feces) accumulates, which will go out on the first day after the birth of the baby.
- Most often, the children have already taken the correct position (head), with the head pointing down. If this does not happen, the doctor must decide how the birth will occur - by natural means or using cesarean section.
- The cheese-like lubricant practically disappeared, a small amount remained only in the most tender areas: in the armpits and in the groin area.
On a note! The baby’s immune protection has not yet matured - now the baby receives antibodies through the placenta, and after birth, the necessary substances will pass through breast milk during breastfeeding.
Changes in a woman’s body
Forty weeks of pregnancy in most cases is the final period of gestation, so the body of the expectant mother is almost ready for the upcoming birth. Now the condition of a woman can be described as follows:
- Edema can become more noticeable, with the legs swelling to the greatest extent.
- Often, a pregnant woman complains of pulling back pain in the lumbar region.
- Lives increasingly stony, that is, it becomes hard for a while.
- On the eve of childbirth, some women may experience insomnia caused by anxious thoughts about future childbirth.
- The pubic bone pulls and hurts periodically, which is associated with an increase in uterine pressure on the pelvic area.
- White discharge is normal at any time, and blood discharge may indicate that childbirth will take place very soon. The appearance of blood traces is due to the exit of the mucous plug and the onset of labor.
- The belly has long gone down, so such sensations as heartburn or shortness of breath, worry the expectant mother much less.
- A lot of troubles and discomfort on the eve of childbirth can cause a woman hemorrhoids, causing severe itching around the anus and accompanied by the appearance of nodules.
Mom and baby condition
Future mothers who did not start delivery at the planned time, also worry about the condition of the child, because everyone has heard about the dangers of overshooting. But, as we have already found out, 40 and 41 weeks of gestation are not considered to be an outgrowth, therefore, the risks for the baby are not as great as it might seem, unless, of course, the pregnancy proceeded without complications, and the baby's condition is stable.
While the mother peers anxiously at the calendar and listens to herself in search of symptoms of an early birth, the baby in the womb continues to gain weight. At 40-41 weeks, it weighs more than 3.5 kg, and some more than 4 kg. The growth of children at this time usually exceeds 52 cm.
All organs and systems are developed and work. A sufficient amount of surfactant has accumulated in the lungs - a special substance that alveoli produce. After the baby takes its first breath, it is the surfactant that will not allow the alveolar vesicles to stick together on the exhale. This will allow the baby to breathe freely independently from the first minutes after birth.
If this calms mom, then some pediatric data are listed below.
- Children born as a result of prolonged pregnancy until 41 weeks of pregnancy have stronger immunity and are less likely to get sick. The placenta is old and does not fully perform its barrier functions, so the baby in the last days in the womb receives more maternal antibodies than children who are born before 40 weeks.
- After birth, in children who have gained a good mass and a sufficient amount of subcutaneous fat, adaptive processes proceed better and pathological situations of the early neonatal period develop less often.
The child became cramped. At 41 weeks, the movements are minimal - they are limited only by necessity. For this reason, you should not be afraid that the baby has become less active. If there are no signs of hypoxia (which doctors will definitely check on such a solid gestation period), then the baby is quite comfortable and wonderful, which cannot be said about his mother.
Women by the 41st week are exhausted: it hurts, aches, pulls almost constantly and in almost any part of the body. The pain in the pubic joint is most often disturbed. And it is at this time that hemorrhoids very often worsen.
There is less water, so any movement of the baby is perceived and felt almost painful. Sleeping on one side becomes nauseous and unpleasant, and you cannot sleep in another position - hence the disturbance of sleep.
Adding trouble and training fights - they intensify in those who have experienced them throughout the third trimester, and may first appear in people who have not felt them before.
The transferred fetus is often born by caesarean section. This is done for several reasons. Firstly, children who have been in the womb for more than 40 weeks have a large head circumference. Secondly, during childbirth, they can draw in the original feces. Third, they may have less oxygen and nutrients.
If it was precisely established that 41 weeks of pregnancy have already been completed, and during the examination it was noted that the cervix is ripe (soft), many doctors prefer to stimulate the birth. Some doctors will wait even up to 42 weeks. Note that none of the pregnancies lasted forever. True, some women have been nursing for 44 weeks, but today, in most cases, childbirth is called after 42 weeks.
“Overripe” children are born thin, with dry, wrinkled, peeling skin, without a layer of fruit ointment, usually covering the skin of a full-term newborn. Compared with other children, they have longer nails and hair, their eyes are open and there is a lot of activity.
After childbirth, in 20 - 50% of cases in postponed children, deviations from normal development are observed. Almost half of newborns have asphyxiation. In addition, jaundice, hormonal crises, neurological disorders, decreased adaptive abilities, infectious skin lesions are common.A study of long-term results suggests that children after a late delivery are delayed in their development. They later begin to stand and walk, their first teeth erupt later, later they begin to speak.
At 40 weeks of gestation, the stomach stops growing and mom loses a little weight. The child sinks to the pelvic floor, as a result of which the pressure on the stomach and lungs ceases - it becomes easier for the woman to breathe and eat. But now the head presses on the intestines and bladder, so do not worry if visits to the toilet have become more frequent.
Allocations remain transparent. Also, a pregnant woman can detect the appearance of mucus with blood streaks - this is how the birth cork leaves, protecting the fetus from infections and microorganisms. Therefore, hygiene requirements should be carefully observed at this time. Many mothers are interested in: when the birth begins at 40 weeks, if the cork is removed. In fact, the mucous lump can go away 10 days before the “main event” and before the birth itself. In general, the period from cork discharge to labor begins from 3 to 15 days.
Nutrient fluid is released from the nipples - colostrum, after 4 days, mother’s milk will be replaced. Softening of bones and ligaments occurs, training contractions become even more painful and intense - in this way the body prepares for the upcoming birth.
At 40 weeks, everything should be ready for childbirth.
Possible hazards at 40 weeks of gestation
On the eve of childbirth, a woman and her baby can be at risk from the following dangers:
- Hypoxia of the fetus, which can be acute, arising from squeezing the baby’s neck with an umbilical cord or chronic, which can be caused by oligohydramnios, placental insufficiency, leakage of amniotic fluid and other factors. In the first case, doctors perform an emergency cesarean section to save the baby, or cause childbirth. When signs of chronic hypoxia are detected, specialists also have a question about actively stimulating labor, because oxygen deficiency negatively affects the fetus.
- Gestosis is a condition leading to complications from the endocrine, cardiovascular and urinary systems. If there are symptoms of gestosis (high blood pressure, protein in the urine, etc.), the doctor may decide to stimulate the birth. For treatment, magnesia and other drugs are used.
Since pregnancy at 41 weeks is not considered to be postponed, active actions on the part of doctors should not be expected. They wait, observe, monitor the condition of the mother and fetus.
If at this time they offer drug stimulation and do not explain why it is so urgently needed, then there is a reason to think about changing your doctor or maternity hospital.
Induction of labor only on the basis that the DA was passed a few days ago is not considered reasonable and appropriate - this is reflected in the clinical recommendations of the Russian Ministry of Health and the World Health Organization. Induction must be required.
Childbirth will be called in the maternity hospital at this time in the event that the child is found to be at the initial stage of a disorder according to CTG. Stimulation is also likely with the discharge or gradual leakage of amniotic fluid.
Many indications, according to which a pregnant woman cannot be left alone, to wait for an independent birth, require operative delivery - cesarean section (large or giant fetus with small pelvis sizes, pronounced polyhydramnios and other factors).
The decision about whether to stimulate the birth, how the birth will take place - independently or in the operating room with the help of surgeons, if there are no complications - is made closer to 42 weeks of pregnancy. Only women who have pathologies complicating the onset of labor should go to the hospital at 40-41 weeks. This is usually warned by an obstetrician-gynecologist in a antenatal clinic.
If a decision is made to stimulate labor at 41 weeks, then they usually use the classic scheme:
- amniotomy (puncture of the fetal bladder),
- the introduction of "Oxytocin" and antispasmodics to relax the cervix after 3 hours, if independent contractions after a puncture of the fetal bladder did not occur.
To stimulate childbirth in a hospital, kelp sticks can be used that are inserted into the cervical canal for its mechanical expansion. To prepare the cervix, hormonal gels are used. It is strictly forbidden to stimulate contractions with Oxytocin, Mifepristone and other drugs with an immature neck.
In the vast majority of cases, there is no need for stimulation this week.
Several decades ago, there was a harmful practice in maternity hospitals in Russia - to stimulate childbirth in almost all cases when the date of birth indicated on the map is left behind. When we calculated and analyzed the indicators of child and female injuries during childbirth, as well as the increased number of emergency caesarean sections, at the state level, we decided to abandon this practice.
When is there a reason to think? Experts say that most often a woman is pregnant overtime:
- with endocrine disorders (thyroid function, diabetes mellitus),
- having had abortions and inflammatory diseases of the pelvic organs,
- with an irregular menstrual cycle,
- suffering from diseases of the liver, stomach and intestines (while the processes of estrogen metabolism are disrupted),
- observing bed rest or leading a sedentary lifestyle (the fetal head does not sink into the small pelvis and does not irritate the cervical receptors),
- experiencing strong emotional stress.
Risk factors also include late gestosis, pelvic presentation of the fetus, preterm pregnancy, the age of the primiparous woman is more than 30 years.
Two methods are sometimes recommended to reduce the likelihood of pregnancy being delayed, but both have certain disadvantages. The first is the daily twitching of the breast nipples. However, there is a risk of causing very severe spasms. The second is the manual separation of the fetal membrane from the lower section of the uterus. This must be done by a doctor. But many experts do not recommend taking such actions, since the membrane of the fetus may crack or infection may occur.
How does childbirth begin and flow?
The most common signal of the onset of labor is birth pains, which indicate the beginning of the opening of the uterine neck. True contractions are different from false ones, they proceed differently.
- First, true labor pains are regular, that is, they are repeated after a certain period, which gradually decreases in time.
- Secondly, the duration of each true fight increases over time, and the pain itself intensifies each time. At the very beginning of fights, their frequency can reach 20-30 minutes, and the duration is only a few seconds. Gradually, the interval decreases to 3 minutes, and the fight can last 1 minute or longer. A stopwatch will help in recognizing labor pains, especially if in doubt.
- Thirdly, gripping sensations do not pass when changing the position of the body.
- Fourth, acute girdle lumbar pain and chills may appear.
- Water discharge caused by rupture of the fetal bladder. Amniotic fluid throughout the entire period of pregnancy are designed to protect the baby from the effects of the external environment. After the bubble bursts, water can gush or leak in parts.
While weak fights last at long intervals, you can take a shower, perform a crotch depilation, check the availability of all necessary documents and things in a previously prepared bag (or collect it now, if it has not been done before). During contractions, it is recommended to breathe calmly, it is useful to use certain breathing techniques.
If the water has departed, then it is not worth doubting that your baby will soon be born. Immediately go to the hospital - the sooner you arrive there, the better, at this time you need to be under the supervision of doctors!
At the 40th week of pregnancy, doctors rarely require patients to undergo additional examinations in the absence of complaints and suspicions. Commonly assigned:
- General analysis of urine and blood.
- Daily urine collection.
- CTG - to assess the condition of the fetus by fixing its heart rate. Normally, the heart rate ranges from 140-160 beats per minute.
- Examination of a gynecologist to determine the maturity of the uterus.
- Ultrasound examination - is performed to exclude intrauterine growth retardation, umbilical cord entanglement, fetal oxygen starvation. The method also allows you to determine the amount of amniotic fluid, which is from 63 to 240 ml. A shift in either direction can determine the diagnosis of oligohydramnios or polyhydramnios.
Harbingers of Childbirth
It is possible that by the beginning of the 40th week of pregnancy, a woman already had such signs of an approaching childbirth, as a prolapse of the abdomen, the disappearance of shortness of breath and heartburn, increased urge to the toilet, a tendency to diarrhea, increased pain in the lower back. In addition, the stomach hardens more and more, pain in the uterus appears. If the above symptoms are absent, this should alert the expectant mother, because in such a case, the fetus can be overloaded.
A day or two or several hours before the onset of labor, signs may appear such as a mucous plug, discharge of amniotic fluid, loose stools (diarrhea), frequent urination, the appearance of the first real contractions in the form of sharp painful sensations in the lower abdomen. If they occur, you should hurry to the hospital, because childbirth can begin very soon, especially in multiparous.
Second births in women usually occur somewhat faster from the time of the appearance of their precursors than in primiparas, because the body already knows how to act in such a situation in order to give birth to a baby with the least amount of energy.
Is your baby in a hurry? Do not panic and fuss! First of all, pay attention to general health. Are there swelling, fluid stagnation in the body. In the event that there are significant deviations from the norm, be sure to consult a doctor - perhaps you should go to the hospital in advance. Well, if you feel good, the tests are normal, then it is better for mom and child to stay at home for a day or another week, in the usual atmosphere. Do not rush to go to the hospital in advance with a normal pregnancy. Otherwise, the doctor will begin to “rush” the baby with various stimulants, which is also not always good.
It is worth checking how the placenta functions. After all, this is the most important organ through which respiration, nutrition and excretion of metabolic products of the fetus occur. Throughout pregnancy, the placenta goes through several stages of evolution: formation, growth, maturity, aging, each of which performs certain functions. Moreover, the quality of her “work” will determine how well the child’s needs are met.
Follow the power - It is better if now it will be separate. It is not recommended during this period in large quantities meat, sour cream, fatty cottage cheese, ripe cheeses, yeast flour and sweet products. It’s better to switch to a non-strict vegetarian menu. The joints and muscles involved in childbirth will become flexible, plastic. From the products, choose fruits, dried fruits, honey, vegetables, cereals on the water, sprouted cereals, seafood, nuts, greens.
Keep doing stretching exercises specially recommended in preparation for childbirth, do joint exercises, learn to relax. During pregnancy, two types of exercises are very important: general developmental, which helps muscles and other tissues to prepare for childbirth, and aerobic (respiratory), which strengthen the respiratory system and cardiac activity.
Help yourself using breathing exercises. These are daily walks in the fresh air, and swimming or just water procedures, and actually breathing exercises. They will help to calm down, relax and improve the supply of all tissues and organs with atmospheric oxygen and nutrients.
Do not forget to communicate with your baby - now it is very important. He feels and understands you, senses your mood and mood for childbirth, hears and "evaluates" the rhythm of your heart, picks up the vibrations of your voice. Call the baby, invite, but do not rush. Let him choose the time for his birth.
When the baby is ready for birth, special substances begin to be produced in the mother’s body, which “start” the process. Childbirth occurs at a certain moment, regardless of the desire of the mother or the doctor’s instructions. Remember that the child must be not only physiologically mature, but also psychologically ready for birth!
Fact 1: Studies show that in 70% of cases, the statement of pregnancy pregnancy is incorrect.
Fact 2: With true overriding, ultrasound can detect a decrease in the thickness of the placenta, relative water shortage, large sizes of the fetus, sharper contours and thickening of the bones of his skull.
Fact 3: After childbirth, in 20 - 50% of cases in postponed children, deviations from normal development are observed.
Fact 4: Do not rush to go to the hospital in advance with a normal pregnancy. Most likely, the doctor will begin to “rush” the baby with various stimulants, which is also not always good.
Consultant: Tamara Panasevich, obstetrician-gynecologist
Is it necessary to specifically cause childbirth?
As a rule, if the 40th week of pregnancy is still ongoing, the need for special stimulation of labor does not arise, because the child is not yet considered to be transferred. But in some cases, doctors try to bring the delivery closer, as the baby may be in danger.
The need for drug stimulation of labor arises in the following cases:
- Polyhydramnios in a woman, due to which premature amniotic fluid flow is possible, weak labor, development of fetal hypoxia, as well as the risk of bleeding immediately after childbirth.
- Increased symptoms of gestosis. In this case, it is necessary to save not only the baby, but also the woman herself, because the risk of adverse effects becomes very high.
- Amniotic fluid outflow, after which subsequent labor is absent or very weak.
Stimulation of labor through the use of drugs (Oxytocin, Papaverine (No-shpa), Pencrofton, Mifepristone, etc.) will avoid the development of acute fetal hypoxia. To prepare the cervix for childbirth, Ginipral is used, as well as Buscopan suppositories.
The need to provoke childbirth in a drug-free manner in the absence of labor pains may also arise in other cases, but in any case, the doctor must first establish why such a situation arose in order to make an informed decision.
The decision to stimulate labor is made by doctors, taking into account the condition of the woman and the fetus. Often, women themselves look for the answer to the question of how to cause childbirth, and turn to videos dedicated to this topic.
The manifestation of the precursors of childbirth at 40 weeks of gestation can occur both weakly and pronouncedly and cause the future mother to feel discomfort. Primitive women can confuse the onset of labor with the usual malaise, since the first signs are often smooth and inconspicuous.
Harbingers of childbirth, which the primipara can notice at 40 weeks:
- Abdominal prolapse - when the baby rests in the small pelvis and begins to pull the uterus down. Due to this, pressure on the lungs and stomach decreases, a change in gait, the disappearance of heartburn is noted.
- Pain in the lower back. Also, patients at 40 weeks of pregnancy often complain that they have a stomach pull and tingles in the pubic symphysis.
- Training fights that can be recognized by irregularities and varying lengths. In addition, they pass completely painlessly. Doctors recommend in this case to sit or lie down for a bit, if the discomfort disappeared, then the contractions were false.
- Isolation of a cork, which is a mucous lump with bloody spots. Its volume is about 2-3 cm. Pink discharge before delivery at 40 weeks can also indicate the cork is moving away - when a small amount of blood is separated, the mucus turns pinkish and does not have blood streaks.
On a note! If the discharge turned pink or red after a visit to a doctor or sexual intercourse, this may indicate tissue damage.
- Amniotic fluid outflow - can occur both before the contractions themselves, and at the initial stage of uterine contractions. Normally, the liquid should have a whitish or transparent color, but with fetal hypoxia, it becomes greenish. If at 40 weeks the water has passed, and there are no contractions, it is necessary to go to the maternity hospital, while the first or second birth does not matter.
- Changes in posture due to a shift in the center of gravity: in order to maintain the area of support, the pregnant woman has to slightly spread her legs to the sides. In the common people they say that a woman’s gait becomes a duck.
- Weight loss of 1-1.5 kg, due to a decrease in tissue edema. Before giving birth, the intestines also need to be cleaned, so at this moment not only urination, but also acts of bowel movement can become more frequent.
- Nausea, vomiting and diarrhea at 40 weeks often occur before the birth itself, because the intestines should be completely released when the woman gives birth. The reproductive organs in this case become elastic and prepared for the passage of the child through the birth canal. On the other hand, such phenomena can be signs of dyspeptic disorders in case of poisoning or overeating.
- Cervical ripening. The question that worries many pregnant women is when to give birth if the cervix is soft at 40 weeks. If it is shortened, smoothed, and placed along the longitudinal axis of the pelvis, childbirth can occur within a week.
On a note! With a vaginal examination, the doctor can determine the cervical distension in the upper part, where the fetus adjoins. The narrow part is from 1 to 2 cm. Such a neck is considered mature and prepared for the birth process.
Is it possible to cause contractions on my own?
If the child is in no hurry to be born, then he has certain reasons for this. The issue of self-stimulation is rather dubious. It is clear that the woman is very tired of bearing a heavy burden, but there is very little left, so it will be more correct to wait until the contractions begin on their own. Up to 42 weeks is still a lot of time.
In matters of independent stimulation of labor, traditional medicine succeeded more than others. She instructs women to drink a decoction of raspberry leaves, rose hips, in order to bring the delivery closer. You can also have sex, unless, of course, the mucous plug is still in place and there are no other contraindications.
Obstetricians recommend moving more, doing light gymnastics, and, as much as you can, do simple homework that is not associated with excessive loads.
The precursors of labor in multiparous births usually occur somewhat faster. At birth, the baby’s head expands the cervix, as a result it becomes supple and elastic, so the second and subsequent births at 40 weeks are faster. If in women giving birth for the first time, the neck opens from 6 to 12 hours, and this is accompanied by severe painful contractions, then in multiparous women this process is much easier and takes 3-7 hours. Mom “with experience” should remember that pain is not an obligatory companion for repeated birth and therefore, when the first precursors are discovered, it is necessary to go to the hospital.
The precursors of labor in multiparous at 40 weeks after the previous planned caesarean section proceed in the same way as in the first-born. Since the baby did not pass through the birth canal, the cervix could not stretch properly. In emergency surgical delivery, much depends on the characteristics of the passage and the period of delivery, when it was decided to have a cesarean section.
If the interval between births is more than 10 years, signs of childbirth at 40 weeks of gestation may occur two weeks before labor. During this time, the female body “managed to forget” the processes experienced and fully recover.
In the second, third and subsequent pregnancy at 40 weeks, childbirth occurs earlier: the muscles and cervix are already stretched and easily tolerate the familiar process. And since women with multiple births are self-confident and self-confident, their emotional outbursts are much less common. Even when opening with one finger, when childbirth cannot be said with accuracy, they can occur both at 40 weeks and after 10-14 days. With an insufficient degree of maturity of the uterus, drug preparation using artificial prostaglandins is used.
On a note! If the 40th week of pregnancy has already passed, and there are no harbingers of childbirth, this is not so scary. Symptoms can occur both a couple of days and a few hours before labor.
According to women, the most effective way to bring about labor at this time is sex. After a “productive” weekend spent with a spouse, many in a day go to the hospital with full-fledged labor pains that have begun.
According to the reviews of those who gave birth at exactly 41 weeks, the children did not show signs of overload, hypoxia, and trouble.
Typically, women perceive a prolonged pregnancy as a postponed pregnancy, therefore in their reviews they are quite emotional.
An even and calm psychological state and a little patience - this is exactly what is needed for such a period.
You can find more tips for pregnant women who have not yet given birth at 41 weeks in the next video.
medical observer, specialist in psychosomatics, mother of 4 children
Why doesn’t the birth begin at week 40?
It happens that pregnancy lasts 40 weeks, and childbirth does not begin. This usually happens for the following reasons:
- Incorrect delivery date. In women with a short menstrual cycle (23-25 days), labor can begin even before the appointed time. If the cycle exceeds 28 days, it is likely that the child will want to stay in her mother’s belly a little more. In this case, the stimulation of labor for a period of 40 weeks will be superfluous.
- Earlier abortions.
- Digestive and endocrine system diseases in the expectant mother.
- Hereditary factor - if the mother of a pregnant woman gave birth at 40-42 weeks.
- Failures in the endocrine system, hormonal imbalance.
- Big fruit weight (from 4 kg).
- Sedentary lifestyle of the mother.
- Low water. If amniotic fluid is scarce, they exert insufficient pressure on the cervix, as a result of which its opening slows down.
- Pelvic presentation (when the baby is in a sitting position on the priest).
- If, after 40 obstetric weeks of pregnancy, childbirth does not occur, the cause may be psychological disorders. Most often they are the pregnant woman’s unwillingness to have a baby, fear of childbirth.
When is it necessary to call an ambulance?
Urgently call an ambulance and go to the hospital is necessary in such cases as:
- An outflow of amniotic fluid.
- Discovery of bleeding.
- Contractions, especially if the interval between them has decreased to 10 minutes.
- A sharp deterioration in the condition of the expectant mother: fainting, dizziness, vomiting, headache.
- Acute abdominal pain.
- The child does not move for a long time or, on the contrary, has become very active.
In general, even if childbirth does not begin at 40 weeks, this is considered not a pathological process, but a completely normal phenomenon. But sometimes an increase in the term can negatively affect not only the health of the woman, but also the fetus. Possible consequences could be:
- Gestosis is a pregnancy complication in which there is a violation of the blood supply to tissues and organs, which leads to malfunctions in their functioning. Most affected are liver, kidney and brain cells. Inadequate blood supply to the placenta can provoke its premature discharge, as well as bleeding, oxygen starvation in the fetus.
- Hypoxia - insufficient saturation of the tissues and organs of the child with oxygen. In a hypoxic state in acute form, for example, when a cord is clamped or a cord is dropped, a cesarean section is prescribed. If the fetus has chronic hypoxia, the question arises of how to accelerate the onset of labor at the 40th week of pregnancy, since a lack of oxygen can lead to extremely serious consequences.
- Compaction of the bones of the child’s skull - because of which the baby’s head will not be able to change its shape when moving through the birth canal, which increases the likelihood of a prolonged birth process, the appearance of injuries and hypoxia in the fetus.
- Abdominal pain. During pregnancy at 40 weeks, the abdomen is stony (for example, with false contractions) and a little aching, but there should be no sharp pain.
- Meconium aspiration syndrome - a respiratory disorder in a child, provoked by the penetration of meconium masses into the respiratory tract and obstruction of the lumen of the bronchi.
- Vaginal bleeding.
In order to prevent complications, a woman should measure blood pressure daily, take a urine test and undergo CTG by recording the fetal heart rate and uterine contractions. If there is a suspicion of pathology, the future mother goes to the hospital at 40 weeks of gestation, where the doctor decides whether to stimulate the birth or the process will go naturally.
When do you need to stimulate labor?
If the first or second birth does not begin at the 40th week of pregnancy, there is nothing wrong with that. The baby will be born when it is already completely ready for life outside her mother’s tummy.
But sometimes at 40 weeks it is simply necessary to accelerate the birth process, this happens under circumstances such as:
- Pronounced signs of a postponed pregnancy.
- Multiple pregnancy or polyhydramnios, in which the risks of weak labor and hypoxia of the fetus increase.
- Strengthening the symptoms of gestosis - in such conditions, provoking the onset of labor at week 40 is simply necessary, because if complications arise, doctors will need to save the life of not only the mother, but also the child.
- Severe pathologies in women associated with the work of the heart and kidneys.
- Lack of labor after the passage of amniotic fluid at 40 weeks - in many maternity hospitals a woman is given time up to 12 hours, and only after this is the stimulation of labor or cesarean section.
What is the danger of labor stimulation?
What is the danger of stimulation of labor at 40 weeks? Intervention in the physiological process can have negative consequences:
- More painful contractions - epidural anesthesia may be required.
- Inconvenient position of the woman in childbirth during childbirth. Medicines are administered through a dropper, the woman herself must constantly lie and be limited in movements.
- Hypoxia in the fetus.
Of course, the best option is to give birth naturally, but if the doctor believes that they should be accelerated at week 40, you should not refuse the proposed procedure. The obstetrician will choose the right drugs and decide which stimulation method is best for the woman.
How to cause childbirth at 40 weeks of gestation?
At 40 weeks of pregnancy, stimulation is carried out only with clear indications, so that a woman can give birth faster, the following methods are used:
- Amniotomy. During the procedure, the doctor pierces the fetal bladder with a special tool, as a result of which amniotic fluid flows away and the head begins to move along the birth canal. The manipulation itself is quick and painless.
- The introduction of oxytocin (an analogue of the hormone synthesized by the hypothalamus) is carried out intravenously or by drip. It is prescribed if labor is absent or contractions begin to fade. A side effect may be increased birth pain and a powerful uterine contraction, which increases the risk of fetal hypoxia. Therefore, the introduction of this drug should be carried out in strictly limited quantities.
- The use of prostaglandins. Hormones contribute to the opening and softening of the cervix. Used in the form of a gel or tablets, which are absorbed in the uterine throat. After the use of the agent, the contractions begin after 3-4 hours, in the absence of a positive result, after 6 hours the procedure is repeated. Such stimulation is very mild, practically has no side effects and does not have a detrimental effect on the fetus.
To stimulate childbirth at 40 weeks of gestation using prostaglandins on your own, you need to have sex with your beloved husband more often - in male sperm, these hormones are contained in kind.
On a note! There are other methods of stimulating labor, but they are rarely used.
How to accelerate childbirth at 40 weeks?
No mom wants to use artificial stimulation of labor, so the woman at this time raises the question: what to do to give birth at 40 weeks of gestation? First of all, you need to visit a doctor and make sure that the baby has managed to roll over and take the correct position. If the baby has long been ready to see mom, you can use the following methods:
- Physical activity. It is recommended to walk more, move, walk up and down the stairs, you can also carry out a general cleaning, and at the same time prepare a “nest” for the baby. In this case, you do not need to overwork: this can lead to detachment of the placenta.
- Intimacy without a condom. The composition of male sperm includes prostaglandins, which soften and expand the cervix. Sex at 40 weeks of gestation can lead to a strong contraction of the uterus and provoke labor.
Important! You can’t make love if the water has passed - this can lead to infection.
- Exercises to accelerate childbirth at 40 weeks of gestation. The program includes: squats, smooth swaying of the stomach, walking, squatting. This method allows you to prepare the cervix and move the baby’s head closer to the “exit”.
- Eat foods rich in fiber: apples, beets, parsley, cabbage, prunes.
- Massage nipples. Twist the nipples for 2 minutes with the thumb and forefinger, take a break, go to another gland. Then start over. During the procedure, oxytocin is produced, which helps stimulate uterine contractions. Massage should be carried out for 20 minutes three times a day.
- Intestinal stimulation. Castor oil causes intestinal cramps and tones up the intestines, which in turn leads to contractions. To achieve the effect, you need to drink 1 tbsp. l of oil, which can be diluted with freshly squeezed apple or orange juice.
Important! It is strongly not recommended to take a bath in the later stages - this can lead to infection of the genital tract and the appearance of thrush.
Also, at 40 weeks, you can call childbirth with folk remedies, the most common is taking a decoction of raspberry leaves. It smoothes and softens the cervix, preparing it for childbirth, and stimulates uterine activity.
To prepare the product, pour 1 tsp of plant material 200 ml of water, strain and insist for 30 minutes. At 40 weeks, 4 cups per day are allowed. If a woman is ready for the birth process, the decoction must be taken hot.
If labor activity does not begin at the 40th week of pregnancy or there are no precursors of childbirth, this is quite normal. Only a doctor can determine whether stimulation is necessary at a given time after examination and careful examination of the results of the examinations. To accelerate the onset of childbirth, a future mother can use safe "home" remedies.