Mom and Baby at 36 Weeks Pregnant

BABY DEVELOPMENT

Your baby is packing on the pounds. With only one week to go until he/she is full-term, your baby is gaining about an ounce a day. At week 36 of pregnancy, your baby might be 5.9 pounds from head to heel, and he/she may be 18.6 inches long (or longer).

• Your baby is shedding lanugo and vernix this week. (Lanugo is the downy covering of hair that has covered his/her body since the second trimester, and vernix is the waxy substance that has protected your little one's skin from the amniotic fluid surrounding him/her.)
• Space is limited in your womb, so your baby is spending most of his/her time curled up with the legs and arms folded against his/her body.
• Your baby's lungs are structurally complete at 36 weeks pregnant, and they are producing surfactant (a substance that keeps the air sacs open when your baby takes his/her first breath). If your baby were born this week, he/she would probably help breathing because he/she may not have enough surfactant in his/her lungs yet.
• At pregnancy week 36, most babies are in the head-down position - the best position for a vaginal birth. If your baby is in a breech position, your caregiver may suggest scheduling an "external cephalic version," a procedure in which your doctor tries to coax your baby into the head down position.

Fun Fact:

Did you know that some researchers believe that your baby actually releases a signal to triggers labor? Some scientists theorize that when a baby's brain is fully mature, it sends a signal to the fetal adrenal glands, which start to excrete the hormone cortisol, which then alter the metabolism of estrogen and progesterone and results in labor. Other researchers argue that the baby's lungs secrete signals indicating that they are mature, as well as enzymes, which release prostaglandins - hormones that help ripen the cervix and help the uterus contract.

MOM'S CHANGES

At 36 weeks pregnant, you may think that you can't get any bigger. But hang in there - you only have four more weeks of growing left. Maybe even less than that! Your baby is full term next week, so he/she can arrive anytime after 37 weeks and be considered fully developed and ready for life outside the womb.

You may have gained up to 32 pounds by now (though some women will gain more and others less). Remember to try to aim for the recommended weight gain for your body size. If you are an average sized woman, aim to gain between 25 and 35 pounds during pregnancy. Overweight women should only gain between 15 and 20 pounds, and underweight women can gain anywhere between 28 and 40 pounds.

Isn't it remarkable how fast your uterus and abdomen have stretched in less than nine months? When your pregnancy started, your uterus was only the size of a small pear and now it can hold a seven-pound baby!

Since your baby's due date is only four weeks away, you may notice that you are experiencing more Braxton Hicks contractions than ever. In the next few weeks, these false contractions may occur intermittently and become rhythmic and they may even get closer together. It might become more difficult to tell Braxton Hicks contractions apart from true labor pains.

Be sure to review the signs of labor with your doctor this week. You will want to know when he/she wants to hear from you. As a rule of thumb, your caregiver will probably want you to come to the hospital when you've been having contractions that come every five minutes (and last for a minute) for more than one hour. Of course, you should call your doctor right away if you notice a decrease in your baby's activity level, or if you are leaking amniotic fluid.

At pregnancy week 36, your baby may start to "drop" into your pelvis. This process is called lightning, and it typically occurs a few weeks before labor starts (for first-time moms). You may feel increased pressure in your lower abdomen, which makes waddling a necessity. If your baby is very low, you may feel lots of vaginal pressure and discomfort. You will notice that you have to go to the bathroom even more frequent once your baby drops.

If you have been feeling very uncomfortable these days, you may want to go for a light swim. Not only does swimming render you practically weightless, but it may also relieve a lot of the pain and stiffness that are common in the third trimester. You may also enjoy a warm bath. (But remember to avoid the hot tub - hot tubs are not recommended during pregnancy because they can raise your body temperature to 102 F and higher.)

Helpful Tip:

Stay away from air travel after pregnancy week 36 if possible. You never know when you will go into labor, and you won't want to give birth on a flight, since complications can occur when you least expect them.

PREGNANCY 411

Self Induction Methods

At 36 weeks pregnant, it is still early for you to attempt any methods of self-induction. Your baby is still not mature and ready for life on the outside until next week, though you will want to wait until pregnancy week 40 before you try anything, due to the risk that your due date was miscalculated.

Remember that you should talk to your doctor before attempting any natural induction methods. You will not want to do any of these methods if you are having a high-risk pregnancy.

Natural methods of inducing labor include:

• Nipple stimulation - The gentle rubbing or rolling of your nipples to encourage the start of contractions. The theory is that oxytocin (the hormone that causes contractions) is released when your breasts are stimulated.
• Castor Oil - This is a strong laxative that may stimulate your bowels and cause contractions. Because this method probably doesn't work in many cases and the fact that castor oil can also cause nausea, diarrhea, and dehydration, we do not recommend this method of labor induction.
• Sexual Intercourse - Making love may be the last thing on your mind these days, but sex can trigger oxytocin, which helps start contractions. In addition, semen contains a high concentration of prostaglandins (substances that help soften your cervix to get it ready to dilate). Sex is safe as long as your water was not broken. (You will want to avoid having sex if you have placenta previa, or if you are experiencing vaginal bleeding.
• Walking - This is the easiest method of natural labor induction. Sometimes walking around and being upright gets the forces of gravity working with you and encourages your baby to move down into the cervix. There are no downsides of walking around. It's good exercise - just make sure you don't overdo it and exhaust yourself.

There is very little scientific evidence that will tell you how effective, or how safe, any of these methods are. If you are nearing 40 weeks of pregnancy, just try to be patient. Your baby will come when he/she is ready to.

Dr. James W. Brann, M.D., is a retired obstetrician and gynecologist and editor of Women's Healthcare Topics. When you read "Mom and Baby at 36 Weeks Pregnant ", you know it is accurate and has been approved by an experienced obstetrician/gynecologist. Dr. Brann has written many articles about 36 weeks pregnant that are great references.

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