Home Stretch
A guide to the last month of pregnancy
By Janice Pearson

Finally! You're in the home stretch. Only a month to go and your baby will be in your arms. You already know that when that happens, things are going to change. In fact, things are already changing. This phase of your pregnancy feels different.

What's going on in your body?

Your baby is well developed, but gains weight rapidly during this last month. The extra weight of the baby in front might cause your back to ache and you may notice that you get tired more easily. Some gentle exercise like walking or swimming, or some easy stretches can relieve tired muscles. Some women, on the other hand, experience aching in the pelvic joints when ligaments loosen in preparation for labour, and may find even walking uncomfortable. Do what you can. In warmer months, your feet may swell. Wear comfortable shoes to give your feet plenty of room.

Your baby will be born soon, so you need to take every opportunity to rest in preparation for the work of labour. Sleeping may be more difficult these days, but see if you can build in some daytime naps, or at least some time to relax and put your feet up.

Julie O'Brien lives in Cornwall, Ontario. She says she has more indigestion and heartburn now, at 38 weeks, and her feet are swelling. As for sleeping, she has found her own solution. She sleeps with eight pillows!

Arrin Alford lives in Selby, Ontario and is having her baby in three weeks. "This is our first child," she says, "and Dave and I are both very excited but nervous about what to expect." Her pregnancy has been uneventful, and even this far along, she reports that she has lots of energy. "Dave can attest to this," she explains, "since he's witnessed me cleaning at 10:30 in the evening. I'm sure this can be blamed on 'nesting.'"

Your baby "drops"

Up until now your baby's head has been higher than the brim of your pelvis. In the last weeks, your baby will "drop" down into your pelvis, usually head down. Once your baby has dropped, there's less pressure upwards. That means less heartburn and breathlessness. At the same time, the increased pressure downwards might mean aching in the thighs, even more bathroom trips and sometimes vaginal discharge, hemorrhoids and varicose veins. Take it easy. Enjoy warm baths and naps.

Since the baby has less room in the uterus and is in a more fixed position, you may notice less fetal movement. A dramatic change, however, should be reported to your doctor.

What about work?

When do you want to stop work? At one time, women didn't work at all during pregnancy. Your mother might have taken a month to six weeks off work before you were born. These days, women often work up until "the last minute," or quit when they've arranged for a break in their schedule. Do be flexible. Make sure you're not overdoing it and have a contingency plan in place. This will help you to relax a little should you have your baby earlier than planned or just not feel able to keep working as you approach your due date.

Looking forward to labour

Now's the time to pack your bags for the hospital. Find out what's appropriate to bring in by speaking with your prenatal teacher or asking your caregiver. You may also want to prepare a separate "labour kit," with supplies to help you through labour - anything from music to lip balm. Finally, get your phone book organized. There'll be lots of people to call with your exciting news!

As the big day approaches, you may be wondering what to expect. How will labour start and how will you deal with it?

Even before you are in active labour, your body is preparing. Your cervix, for example, has become soft and will get shorter and start to open just a bit. This activity might cause the plug of mucous to come away from your cervix, sometimes with a little bit of blood. Those stronger Braxton Hicks contractions you're experiencing also mean that things are starting to heat up!

Everyone is worried that they might show up at the hospital and be sent home again in "false labour." Don't worry! The staff is quite used to it. They realize that with a first baby, you really don't know what to expect and, with a subsequent baby, your body can have a few false starts. Once your labour is established:

  • contractions will get stronger and longer, and usually have a regular pattern
  • contractions don't go away when you walk around or change position
  • you may lose your mucous plug (have a "show")

Your bag of waters may break at any time during labour. TV comedies are fond of scenes where the water breaks out of the blue - the woman's first clue that she is in labour. In fact, only 20 percent of the time does this happen before labour is really underway. Most caregivers will want to know about it if it does.

Most women are excited and nervous all at the same time when they consider labour. Will it hurt? Will the baby be okay? Will I get enough support? Alford is hoping for a natural birth at a birthing centre, with midwives. She's learning about massage, showers and baths during labour, acupressure and breathing techniques while she waits for her baby to arrive. On the other hand, she knows she would put these dreams aside if her baby needed extra help.

Overdue: the LONGEST month

Most women think of their due date as something magical. We are used to living in a world where our appointment books dictate our lives, after all. If your due date comes and goes, it can be puzzling. What's going on in there? Remember that the date you've circled on the calendar is simply an estimate: 40 weeks from the first day of your last period. There's plenty of individual variation - but you certainly won't be pregnant forever!

Most babies are born in the week before or after their due date, so that gives you a 50 percent chance of being overdue. After 41 weeks, many caregivers will suggest inducing labour. If you are overdue and your caregiver advises induction of labour, discuss the risks and benefits and make sure you understand your options.

Alford doesn't know how she will feel if her baby is late. "I would feel some disappointment," she admits. "If I had my way, the baby would be here tomorrow!"

O'Brien's baby has stayed in the breech (feet or bottom down, head up) position and she and her doctor have decided on a Caesarean delivery. She is booked in at 39 weeks, so she knows she won't be overdue. She's feeling fine about her planned Caesarean, but is nervous about taking care of her baby and recovering from her surgery at the same time.

How are you feeling?

For many women, the last weeks of pregnancy are when "reality hits." It's taken this long, says Alford, for it to really sink in that she's actually having a baby.

As you make the journey from pregnancy into motherhood, you're bound to have some mixed feelings. Like O'Brien and Alford, your focus shifts now to the birth and beyond. Excitement? Yes - at the prospect of finally seeing your baby, but perhaps some apprehension too, about how your labour will progress, and how you'll manage all those new responsibilities.

At the same time, it can start to feel like your pregnancy will go on forever, and you may begin to think that perhaps this baby won't really be born at all. Perhaps it's just an enormous joke. Of course, your baby will be born when things are ready, and it is going to happen soon.

Meanwhile, you may be feeling irritable or moody this month. Not only is your body becoming cumbersome, but you've got a lot on your mind. You may feel overwhelmed by how much there is to do and think about. These feelings are completely normal.

If it helps, make a list of the worries you have. Sometimes just seeing them written down brings them down to size and makes them more manageable. It may also suggest some problem-solving steps you can take: Do you have concerns about labour? If so, discuss them with your caregiver, and write a birth plan if you haven't already done so. Are you worried about your recovery? Make sure you have some postpartum support lined up.

Talking to your partner or friends who've been there can also be reassuring.

Building a community

One of the best uses for your time in the final month is to put together a list of people and services that will be useful to you when you get home with your new baby. If you are going to prenatal classes, ask your teacher what's around. You'll be surprised at how much there is, if you just look for it.

Prenatal classes are a great place to network with other parents and take advantage of your instructor's knowledge of community resources. If you haven't been able to fit in a prenatal class yet, you can still contact a childbirth education centre in your last month and ask for some private instruction. If all else fails, at least make sure you have a book or two about labour, baby care and breastfeeding.

Include on your resource list:

  • breastfeeding support: La Leche League, a lactation consultant and/or breastfeeding clinic
  • drop-in centres for new parents
  • the number for your Public Health Unit or a home nursing service
  • the names and numbers of friends or relatives who have had a baby recently
  • favourite places for take-out or delivery of food, and/or a grocery store that delivers
  • your closest 24-hour drug store
  • the number for the doctor who'll take care of your baby

There are many other ideas. Think about your specific situation and make sure that your list includes the resources that will help things go more smoothly. If there's only one item on your list, make it the names of those who can support you when you get home. For O'Brien, this will mainly be her husband. He's taking time off to take care of the house and help Julie with the new baby.

A month isn't very long, but there is usually enough time to prepare. Just take it a day at a time, work through your list of things to do and before you know it, your new baby will have arrived. Being prepared will make these last days of pregnancy much more relaxing. "Everything is in place," says O'Brien. "All we need now is a baby!"

Preparing the Nest

What do you still need to do to get your home ready for a baby? Don't worry too much if everything isn't perfect. Your baby won't notice. But do have the essentials on hand: somewhere for baby to sleep, diapers ordered or bought, and your list of resources and helpers.

Decorating the nursery is great if it will give you pleasure, but getting organized to save yourself work and shopping trips in the postpartum weeks is definitely more useful. Some ideas:

  • Tie up loose ends at work.
  • Buy baby clothes and diapering supplies (or arrange a diaper service).
  • Get any personal care items you may want on hand for you and your baby: sanitary pads, diaper and bath supplies, baby nail clippers or scissors, etc. Your caregiver may have specific suggestions.
  • Organize a convenient change area, with everything you'll need close at hand.
  • Put a few casseroles in the freezer and some easy meal ingredients in the pantry to use after the baby is born.
  • Prepare your resources list.
  • Learn about breastfeeding, especially if you don't know many breastfeeding mothers. Studies show that prenatal instruction in breastfeeding can help get you off to a good start, so if you're worried, see a lactation counsellor now.
  • Install a CSA-approved infant car seat according to the manufacturer's instructions. (Hospitals require that you have an infant restraint when you and the baby are discharged.)
  • Pack your hospital bag (check with your hospital to find out what they supply) or lay in supplies that you'll need if you're having a home birth.
  • Plan your route to the hospital, and if your partner or labour support people aren't easily accessible on the job, arrange for a pager.
  • Review what you learned in your childbirth preparation classes, and think about what you'll need to help you cope during contractions.
  • Update your phone book, and include a list of people you would like to call with the news of your baby's birth.

Finally, resist that "nesting instinct" that keeps you up cleaning until midnight. Do a little each day, and remember that your baby won't notice. Try to go into labour well-rested.

Originally published in Great Expectations, Winter 1998

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