40 Weeks Pregnancy: Baby Development, Symptoms and Tips

Short Answer: At 40 weeks pregnancy, you have reached your due date. Your baby is about 51 cm from head to heel, roughly the size of a small pumpkin, and weighs around 3.4 kg. Every organ is ready for life outside the womb. Only about 1 in 20 babies arrives on the due date, and most first babies come a few days late, so being pregnant at 40 weeks is normal. Labour can start at any time, and your doctor will watch you closely if it does not start soon. Go to hospital for regular contractions, waters breaking, bleeding, a drop in your baby’s movements, a severe headache with blurred vision or any sign that something is wrong. If you pass 41 weeks, induction is usually offered.

Pregnancy weeks are counted from the first day of your last period, not from conception. Forty weeks pregnant means about thirty-eight weeks since conception. You are at the end of your ninth month. For earlier weeks, start with our guide to 8 weeks pregnant, or read last week’s guide to 39 weeks pregnant.

Week 40 at a glance

Sizes differ between guides and between babies. Healthy babies at term range from about 2.5 kg to 4 kg, and many Bangladeshi babies are born around 2.8 to 3.2 kg and are perfectly healthy. Your own scan results and your doctor’s measurements matter more than a chart.

Your baby at 40 weeks

Growth. Your baby is about as big as a baby will be before birth, and weight gain has slowed to around 100 grams a week or less. The body is plump, with a layer of fat that will keep your baby warm after birth. Babies differ a great deal in size, and a smaller or bigger baby than average is usually normal.

Lungs. The lungs are ready. They make surfactant, the slippery substance that keeps the air sacs open, and they will keep maturing for weeks after birth. Signals from the baby’s lungs and adrenal glands help trigger labour.

Brain and senses. The brain is about a quarter of its adult size and is ready to learn. Your baby hears your voice and the sounds of your home, and prefers your voice to others. Newborns see best at about 20 to 30 cm, which is the distance to your face during feeding, and they are drawn to faces. Taste and smell are working, and your baby will recognise the smell of your milk and skin.

Skin and hair. The skin is smooth and soft. The white waxy vernix remains mostly in the skin creases, and the downy lanugo hair is mostly gone. Hair on the head may be thick, thin or almost absent, and the colour often changes in the first months. The nails reach or pass the fingertips, and may need trimming.

Skull and bones. The bones are hard except the skull, whose plates stay soft and loosely joined so the head can mould through the birth canal. The soft spots, called fontanelles, stay open for months. A newborn’s head may look long or lopsided after a vaginal birth and usually rounds out within days.

Immune system. Your antibodies have crossed the placenta in large amounts, and they protect your baby against infections in the first months. Breastfeeding adds more.

Position and movement. Most babies are head down, and the head is often engaged in your pelvis. With very little room, movements feel more like rolls, stretches and pushes than sharp kicks. The total amount should stay about the same until labour, and a clear drop is never normal.

Born ready. Your baby comes with reflexes that help feeding and bonding. The rooting reflex makes your baby turn toward a touch on the cheek, the sucking reflex starts feeding, the grasp reflex makes a little hand close around your finger and the startle reflex makes the arms fling out at a sudden noise.

Your body at 40 weeks

Womb. The top of your womb is about 38 to 40 cm above your pubic bone. If your baby has dropped, the measurement can fall a little, and that is normal.

Weight. Weight gain has slowed or stopped, and some people lose a little in the last days. By now most people have gained about 11 to 16 kg in total. Sudden rapid weight gain, especially with swelling, needs a check for pre-eclampsia.

Cervix. The cervix has probably softened, thinned and may have started to open, which you cannot feel. A vaginal examination does not predict when labour will start, and you can decline it.

Braxton Hicks. Practice tightenings can be strong and frequent. They are irregular and usually ease with rest, water or a change of position. If they become regular, painful and closer together, labour may be starting.

Pelvic pressure. If your baby has dropped, you may have pressure on your bladder, rectum and pelvis, a waddle and sharp, electric-like twinges in the vagina. Breathing and heartburn often improve.

Show and discharge. A pink, brown or blood-streaked jelly-like mucus, called a show, is the plug that sealed your cervix. Labour may start within hours to days, or not for a week or more. Bright red bleeding that soaks a pad is not a show and needs urgent care.

Loose stools. Hormones that prepare the body for labour can loosen your stools. Drink more water, and call if it is severe or comes with fever.

Skin, breasts, hands and feet. A glow is common, but so are acne, dry skin and a dark line down the belly. Colostrum, the thick yellow first milk, may leak. Mild swelling of the feet and tingling in the hands are common. Intense itching on the palms and soles needs a doctor the same day, because it can be a liver condition called cholestasis.

Tiredness and mood. Tiredness, impatience, vivid dreams and mood swings are common. Many people feel excited, nervous and fed up all at once. These feelings are normal.

How your due date is worked out

Your estimated due date is a guide, not a deadline. It is calculated as 40 weeks from the first day of your last period, which assumes a 28-day cycle with ovulation on day 14. If your cycle is longer, shorter or irregular, or you were unsure of your dates, the date may be adjusted using an early ultrasound, which measures the baby’s size and gives a more accurate estimate.

What the numbers show:

• Only about 1 in 20 babies is born on the due date
• About 7 in 10 babies are born within a week either side
• About 9 in 10 babies are born between 38 and 42 weeks
• First-time mothers often go past 40 weeks, and many deliver at around 41 weeks
• Babies of people who have had a baby before often come a little earlier

Why dates can be off. Ovulation may happen earlier or later than day 14, the baby may need a little more or less time and some mistakes occur in remembering the last period. A scan in the first 12 to 14 weeks is the most accurate. A scan later in pregnancy is less accurate for dating, and should not be used to change your due date.

What it means for you. Do not treat your due date as a fixed day. Plan for a window of about two weeks either side, and try not to tell too many people the exact date, so you are not fielding daily messages.

Signs that labour is close

Signs that labour has started:

• Regular contractions that get stronger, longer and closer together, and do not stop with rest, water or a change of position
• Your waters breaking
• A show together with regular tightenings
• A steady backache with tightenings

When to go to hospital. Use the guide your doctor gave you. A common rule for a first baby is contractions about every 5 minutes, lasting about a minute, for an hour. If you have had a baby before, live far away or roads may be slow or flooded, go earlier. Go at once, whatever the timing, if your waters break, you have bleeding more than a show, your baby moves less, you see or feel the cord, you have a severe headache or blurred vision or you feel something is wrong.

Labour at a glance

Our earlier guides explain labour in detail. Here is a short summary for the day.

Tips for the day:

• Stay at home in early labour if you are well, rest, eat light snacks, drink water and move around
• Go to hospital when you meet your doctor’s guide, or sooner if anything worries you
• Keep your companion close, and ask them to speak up for you
• Move and change position often, and avoid lying flat on your back
• Breathe slowly in through your nose and out through your mouth
• Ask for pain relief when you want it, and know you can change your mind
• Ask what is happening, and ask for your consent before any procedure
• Ask for skin-to-skin contact, delayed cord clamping and breastfeeding in the first hour
• If your baby comes faster than expected, see the emergency birth steps in our guide to 35 weeks pregnant

What to do if you pass your due date

Going past your due date is common, and most babies are fine. Still, the risk of problems rises slowly after 41 weeks, so doctors watch more closely and offer induction before the pregnancy goes much further.

What usually happens:

Checks at each visit when you are overdue:

• Your blood pressure and urine
• The height of your womb, and your baby’s position
• Your baby’s heartbeat, and your record of movements
• Sometimes a scan to check the fluid around your baby and the placenta
• Sometimes a heart tracing, called cardiotocography, to look at your baby’s heart rate

Why the risks rise. After 41 weeks, the placenta may work less well, the fluid around the baby may fall and the baby may grow very large, which raises the risk of a difficult birth. Babies may also pass meconium before birth, and inhale it. The absolute risk of stillbirth is still low, but it rises slowly each week.

Induction or waiting. Many people choose induction, to lower the risk and to avoid a long wait. Some prefer to wait, with close monitoring, hoping for labour to start by itself. Both are reasonable. Ask your doctor:

• What are the risks in my case if I wait, and what are the risks if I am induced?
• What does monitoring involve, and how often?
• What happens if my baby moves less, or my waters break?
• How and where would induction be done, and how long might it take?
• What are the options if induction does not work?

You can ask for time to think, unless there is an emergency.

While you wait:

• Keep tracking your baby’s movements, and call the same day for any change
• Keep your visits, and your bag, transport and emergency plan ready
• Rest, eat well and walk each day
• Avoid unsafe methods to start labour, such as castor oil or herbal tonics
• Plan a calm activity each day, and keep in touch with people who support you
• Remember that you are not failing, and that your baby will come

Tracking your baby’s movements this week

Your baby’s movements are one of the best signs of wellbeing, right up to labour. Movements do not slow down at the end of pregnancy, though they may feel different, with fewer big kicks and more rolls and pushes.

What to do:

• Know your baby’s usual pattern, such as more movement after meals or in the evening
• If you want a method, sit or lie on your left side, and count distinct movements, not hiccups, until you reach ten. This usually takes under two hours, and often much less
• Have a cold drink or a light snack first if your baby is quiet
• If your baby moves much less than usual, you do not feel ten movements in two hours or you notice any change in pattern, call your doctor or go to hospital the same day

Do not wait until the next day. Do not rely on a home Doppler or phone app to reassure you. A reduction in movement can be a warning sign, and checking early protects your baby. You will not be wasting anyone’s time, and you can call again if you are still worried.

Natural ways to start labour: what the evidence says

Many families try to bring on labour. Some methods are safe and harmless, some have little proof and some are unsafe. Do not try to start labour before 39 weeks unless your doctor advises it.

The best “method” is patience, rest and a calm mind. Your baby will come when ready.

Birth-day checklist

Keep this list handy for the day.

At home, in early labour:

• Time the contractions, and note when your waters break and what the fluid looks like
• Eat light snacks and drink water
• Rest, shower and move around
• Call your doctor or hospital, and tell them how things are going
• Call your driver, or arrange transport
• Check your bag, documents and cash

When you leave:

• Take your prenatal card, test results, ID, bag and phone charger
• Tell your family where you are going
• Have your companion with you
• Sit upright or on your side in the vehicle, with a seat belt on

On arrival:

• Tell the staff how many weeks you are, when contractions started and their pattern, whether your waters have broken and the colour of the fluid, whether you have bleeding and when your baby last moved
• Tell them your blood group, whether you carry group B strep, any allergies or medical conditions and any past C-section
• Show your birth plan, and ask for your companion to stay
• Ask who is looking after you, and who to call for help

During labour:

• Ask what is being done, and why, before each procedure, and give or decline your consent
• Ask for pain relief when you want it
• Move and change position
• Ask for skin-to-skin contact, delayed cord clamping and breastfeeding in the first hour

After the birth:

• Ask for your baby to be placed on your chest, dried and covered
• Start breastfeeding within the first hour, with help
• Ask for rooming-in, so your baby stays with you
• Ask for your baby’s checks, vaccines and your own checks to be explained
• Ask about danger signs, and who to call
• Rest, drink, eat and let your family help

The first 24 hours after birth

The hours after birth matter for both of you. Knowing what to expect, and what to ask, helps.

For your baby:

• Skin-to-skin contact for at least an hour, with your baby dried, covered and on your bare chest, helps warmth, breathing and feeding.
• First feed. Your baby is likely to be alert in the first hour, and ready to feed. Ask for help with the latch.
• Delayed bath. The first bath should wait at least 24 hours, to keep your baby warm.
• Checks. Staff check breathing, heart rate, temperature, colour and activity. A doctor examines your baby within 24 hours, and your baby is weighed.
• Vitamin K and BCG. Many hospitals give vitamin K, and BCG is given at birth in Bangladesh. Ask what your baby will be given.
• First stool and urine. Your baby should pass urine and the first dark, sticky stool, called meconium, within the first 24 hours. Tell the staff if not.
• Keep your baby with you. Rooming-in lets you feed on demand and learn your baby’s cues.

For you:

• Checks. Staff check your bleeding, womb firmness, blood pressure, pulse, temperature, pain and how you feel.
• Bleeding. A heavy, period-like flow, with some clots, is normal in the first days. Soaking a pad in an hour, large clots or feeling faint needs help at once.
• Afterpains. Cramps as the womb shrinks, especially while breastfeeding, are normal. Ask for pain relief.
• Passing urine. Try to pass urine within a few hours. Tell staff if you cannot, or if it stings.
• Stitches. If you had stitches, ask how to care for them.
• Getting up. Walk a little, with help, when you are told it is safe, to prevent clots and help recovery.
• Food and drink. Eat and drink as soon as you can. You may be very hungry.
• Rest. Sleep when your baby sleeps.
• Feelings. You may feel joy, exhaustion, shock, sadness or nothing at all. All are normal.

Questions to ask before you go home:

• What are the danger signs for my baby and me, and who should I call?
• When and where are the next checks, for both of us?
• How do I care for my stitches or wound?
• Which medicines should I take, such as iron, calcium and pain relief?
• Is my baby feeding well? Can someone watch a feed?
• Where do I get my baby’s vaccines, and what is the schedule?
• Where do I register the birth?
• What contraception can I start, and when?

The first 40 days: recovery and rest

Many families in Bangladesh follow a period of about 40 days of rest after birth. It is a good tradition when it means rest, help and good food, and a harmful one when it means isolation, restricted food or delayed care. Here is a guide to a safe, healthy recovery.

What your body goes through.

• Bleeding. Lochia, the bleeding and discharge after birth, is red in the first few days, then pink or brown, and yellow-white by two to three weeks. It can last four to six weeks and may increase when you are more active.
• Womb. It shrinks back to its normal size over about six weeks. Afterpains ease after the first week.
• Perineum or wound. A tear or stitches heal over two to four weeks, and a C-section wound over six weeks or more.
• Breasts. Milk comes in on days 2 to 5, and the breasts may feel full, heavy and tender. Frequent feeding eases it.
• Hormones. Sweating, hair loss in the following months, mood swings and tearfulness are common.
• Tiredness. It lasts for weeks. Broken sleep is a part of life with a newborn.

Postnatal checks. WHO recommends checks for you and your baby within 24 hours, at about day 3, between days 7 and 14, and at about six weeks. Keep your appointments, even if you feel well.

Rest and help.

• Sleep when your baby sleeps, and let others cook, clean and care for older children
• Limit visitors, especially in the first week, and ask them to wash their hands and not to visit if they are unwell
• Share night feeds and baby care with your partner as far as you can
• Accept help, and ask for it. You do not have to do everything

Food.

• There is no need to avoid fish, vegetables, fruit or other nutritious food after birth. A new mother needs a balanced diet, with extra protein, iron and calcium. Breastfeeding mothers need about 500 extra calories a day.
• Drink plenty of water, and eat small, frequent meals.
• Take iron-folic acid and calcium as your doctor advises for at least three months after birth, or longer if you are anaemic.
• Ask your doctor before following any food restriction, because many can leave a new mother short of nutrients.

Perineal and wound care.

• Keep the area clean and dry. Rinse with warm water after urinating and passing stools, pat dry from front to back and change pads often
• A cold pack for 10 to 20 minutes eases swelling in the first days, and sitting in a few inches of warm water helps
• Eat fibre, drink water and ask for a stool softener, so you do not strain
• Hold a clean pad against the stitches when you pass stools
• After a C-section, hold a pillow against the wound when you cough or laugh, walk a little each day and avoid lifting anything heavier than your baby for about six weeks

Pelvic floor. Start gentle pelvic floor squeezes in the first days, when you feel ready, and build up. If you leak urine or stool, or feel a bulge, tell your doctor.

Bathing. You can bathe from the first day. Showering is safe and does not harm you or your milk.

Exercise. Short walks from the first days, and slowly more. Wait for your doctor’s advice before strenuous exercise, usually after about six weeks.

Sex and contraception. You can have sex when you feel ready and bleeding has eased, often after four to six weeks. You can become pregnant again before your first period, even while breastfeeding. Waiting at least 24 months between births is safest. Our guide to 39 weeks pregnant lists the options.

Danger signs for you. Go to hospital or call 999 if you have:

• Heavy bleeding that soaks a pad in an hour, or large clots
• A fever of 38°C or more, or chills
• Foul-smelling discharge
• Severe belly pain
• A severe headache, blurred vision or fits
• A painful, swollen, red leg, or chest pain or breathlessness
• A red, hot, painful breast with fever
• A wound that is red, swollen, leaking or opening
• Trouble passing urine, or burning
• Feeling faint, very weak or a racing heart
• Thoughts of harming yourself or your baby

Feeding your baby

Breastfeeding. WHO recommends starting within the first hour, breastfeeding exclusively for the first six months and continuing, with safe foods added, for up to two years or more. Breastfeeding protects babies from diarrhoea, pneumonia and other infections, and it helps you recover.

• Feed 8 to 12 times in 24 hours, day and night, whenever your baby shows early hunger signs
• Colostrum, the thick yellow first milk, comes in small amounts and is all your baby needs in the first days
• Mature milk usually comes in on days 2 to 5
• A good latch has a wide-open mouth, the chin touching your breast, more of the dark skin above the top lip than below the bottom lip and deep, rhythmic sucks
• Signs of enough milk: from about day 5 or 6, at least 6 wet nappies a day, soft yellow stools and a content baby after most feeds. Most babies regain birth weight by about two weeks
• Try different positions, such as cradle, cross-cradle, football hold, side-lying and laid-back. Our guide to 38 weeks pregnant describes them
• Ask for help early if feeding hurts, your baby will not latch or you worry about milk

What to avoid. Do not give honey, water, sugar water, ghutti, formula or any other food before six months unless a doctor advises. Never give honey under one year. Do not discard your colostrum.

If you cannot breastfeed, or your doctor advises formula for a medical reason, ask for help to feed safely, with clean boiled water, clean bottles and exact measuring. Every drop of breastmilk still helps.

Newborn care basics.

• Warmth. Keep your baby warm with skin-to-skin contact, a cap and a dry wrap. Do not overheat.
• Cord. Keep the stump clean and dry. Do not apply oil, ash, turmeric or other substances. It falls off in one to three weeks. See a doctor for redness, swelling, pus or a bad smell.
• Sleep. Place your baby on the back, on a firm, flat surface, with no pillows, loose blankets or soft toys. Keep smoke away from your baby.
• Jaundice. Mild yellow skin on days 2 to 5 is common. Go to a doctor the same day if yellow appears in the first 24 hours, spreads to the belly, legs or soles, lasts beyond two weeks or comes with sleepiness, poor feeding or pale stools.
• Vaccines. BCG is given at birth in Bangladesh, and the Expanded Programme on Immunization gives free vaccines from about six weeks. Keep your baby’s card safe.
• Danger signs. Go to hospital at once for fever or very low temperature, poor feeding, fast or difficult breathing, grunting, fits, a floppy or very sleepy baby, deep yellow skin, a red or pus-filled cord, a blue or pale colour or not passing urine or stool.

Registering your baby. Register the birth with the local authority. It is free within 45 days, and the certificate is needed for school and many services.

Your mind and your relationship

Waiting. Waiting for labour is hard. You may feel impatient, tired and anxious, and you may be tired of questions from family. Take it one day at a time, and give yourself permission to rest.

Birth feelings. After birth, your emotions can swing. You may feel joy, awe, relief, tiredness, sadness or fear, and sometimes all at once. Some people do not feel an instant bond with their baby, and that is normal. Bonding grows with time, skin-to-skin contact and care.

Baby blues. Many mothers have the baby blues in the first two weeks, with tearfulness, mood swings and anxiety, which fade by themselves.

Postnatal depression. About 1 in 7 mothers develops postnatal depression, and anxiety is common too. It is more likely if you had depression before, have little support or have had a difficult birth or violence. Signs lasting more than two weeks include sadness, hopelessness, losing interest, feeling worthless, constant worry or panic, trouble sleeping beyond the baby’s wakings, no appetite, trouble bonding and thoughts of harming yourself or your baby. Tell your doctor, and do not wait. It is treatable, and it is not your fault. If you have thoughts of harming yourself, go to the nearest hospital or call 999.

Partners. Partners can feel anxious, left out, tired or low too, and some develop depression. Look after each other, talk about how you feel and share baby care and chores. Closeness does not need to mean sex in the early weeks.

Family. New babies bring family visits, advice and sometimes tension. Be clear and kind about what you need, such as rest, quiet and help with chores rather than holding the baby. You can say no to visitors.

If you feel unsafe at home, tell your doctor or a trusted person. In Bangladesh you can call the national helpline 109 for support with violence against women and children. It is free.

When to call a doctor

Go to hospital at once, or call 999, if your waters break and the fluid is green, brown or bloody or smells bad, you see or feel the umbilical cord, you have heavy bleeding or bleeding with severe pain, you have a severe headache, blurred vision or fits, you have constant severe pain with no break between contractions, you have a fever of 38°C or more or your baby moves much less than usual or not at all.

Pre-eclampsia. A serious blood pressure condition. Signs include a severe headache that will not go away, blurred vision or flashing lights, sudden swelling of the face and hands, pain under the ribs on the right side, vomiting and rapid weight gain. It needs urgent care.

Fever. In Bangladesh a fever can also mean dengue, so do not treat it at home. See a doctor straight away.

If you feel sad, anxious or hopeless for more than two weeks, tell your doctor. If you ever have thoughts of harming yourself, seek help right away.

Food, exercise and sleep this week

Food. Eat small, frequent meals, with protein, iron-rich foods such as leafy greens, lean meat and lentils (with lemon or guava for vitamin C), calcium-rich foods such as milk, yogurt and small fish eaten with the bones, whole grains, fruit and vegetables and plenty of water. Take iron-folic acid and calcium as prescribed, at different times, and use iodised salt. Limit caffeine to about 200 mg a day, and avoid alcohol, tobacco, raw or undercooked meat, fish and eggs, unpasteurised dairy, unwashed produce, large predatory fish and herbal tonics your doctor has not approved. In early labour, light snacks and water are usually fine unless your doctor says otherwise. If a planned induction or C-section is booked, follow your fasting instructions.

Dates. Some studies suggest eating about six dates a day in the last weeks may help the cervix soften and shorten labour. The evidence is limited. If you have gestational diabetes, ask your doctor first, because dates are high in sugar.

Exercise. Keep walking, about 30 minutes on most days. Gentle yoga, swimming, sitting on a birthing ball and pelvic floor exercises are good. Avoid hot yoga, lying flat on your back during exercise, contact sports and heavy lifting. Stop and call your doctor if you have pain, bleeding, dizziness, trouble breathing, regular tightenings or fluid leaking.

Pelvic floor. Squeeze and lift the muscles you use to stop urine flow, hold for a few seconds and release. Do 10 repetitions a few times a day, and practise relaxing fully after each squeeze.

Sleep. Sleep on your side, with a pillow between your knees and another under your belly. Sleeping on your back in the third trimester is linked to a higher risk of stillbirth. If you wake on your back, turn onto your side. Do the same for naps. Rest as much as you can, because you will need your energy. Keep a fan, loose cotton clothes and water by the bed in hot weather.

Final preparations

Hospital bag. It should be packed and by the door, with your prenatal card, test results, scans, National ID, loose cotton clothes, maternity pads, nursing bras, baby clothes, wraps, nappies, a phone charger, cash and snacks.

Transport. Know the fastest route to the hospital, and a backup. Fill the vehicle with fuel, or agree with a driver who can come at any hour. Save the numbers of the driver, an ambulance service and a neighbour. In heavy traffic, rain or floods, allow more time, and leave earlier if you live far away.

Emergency plan. Know your blood group, arrange two or three healthy adults with a matching blood group as donors and keep money and documents ready. Agree with your family that if there is bleeding, fluid leaking, a drop in movement, severe pain or a severe headache, you go to hospital at once, with no waiting for permission or for morning.

Birth plan. Keep it to one page, and share it with your doctor and companion. Include who you want with you, movement and positions, pain relief, delayed cord clamping, skin-to-skin contact, breastfeeding in the first hour, rooming-in and your contraception choice. Stay flexible.

Companion. Share the guide for birth companions in our 36 weeks pregnant article with your partner or support person.

Numbers to save: your doctor, the hospital, an ambulance, your driver, a relative, the national emergency number 999, the government health call centre 16263 and the national helpline 109 for violence against women and children.

Home. Set up a firm, flat sleeping space with a mosquito net. Wash newborn clothes and wraps with mild soap, rinse well and dry them in the sun. Stock easy, nutritious food for the first weeks. Remove standing water around your home.

Help. Arrange who will look after other children, the house and visitors when you go to hospital and after you return. Ask relatives to take shifts in the first weeks.

Work and money. Under Bangladesh’s labour law, working mothers in the private sector are entitled to 16 weeks of paid maternity leave, eight weeks before and eight weeks after the birth, and government employees receive six months. If you are still working, confirm your leave and paperwork in writing. Ask the hospital for a written estimate of costs, and what is paid in advance. Government hospitals provide delivery care, including C-sections, at low or no cost, and you should not delay going to hospital because of cost.

Checklist for this week

• Keep your weekly visit, and check your blood pressure, weight, womb size, baby’s position and your baby’s heartbeat
• Ask about a membrane sweep, and the plan if you pass 41 weeks
• Ask what your doctor advises about induction, and what your options are
• Take iron-folic acid and calcium as prescribed, at different times, and use iodised salt
• Keep tracking your baby’s movements, and call the same day if the pattern changes
• Sleep on your side every night, including naps
• Know when to go to hospital, and what to do if your waters break or labour starts at night
• Keep your hospital bag, documents, cash and transport ready, and fill the vehicle
• Confirm your hospital, doctor or midwife and who will be with you
• Arrange blood donors, family help and care for other children
• Plan your first 40 days after birth, including postnatal checks, food and help at home
• Choose a contraception method with your partner
• Tell someone if you feel low or anxious
• Save your doctor’s number and the nearest hospital’s emergency number

FAQ

How big is the baby at 40 weeks?
About 51 cm from head to heel and 3.4 kg, roughly the size of a small pumpkin. Healthy babies at term range from about 2.5 kg to 4 kg.

Is it normal to be pregnant at 40 weeks?
Yes. Only about 1 in 20 babies arrives on the due date, and many first babies come a few days later. Being a little over is common and usually not a problem.

What happens if I go past my due date?
Your doctor sees you more often, checks your baby’s movements and heartbeat, and may offer a membrane sweep. Induction is usually offered between 41 and 42 weeks. Ask about the options.

How can I tell labour has started?
Regular contractions that get stronger, longer and closer together, a show with regular tightenings or your waters breaking. Braxton Hicks tightenings are irregular and ease with rest.

When should I go to hospital?
A common guide for a first baby is contractions every 5 minutes, lasting about a minute, for an hour. Go earlier if you live far away. Go at once if your waters break, you have bleeding, your baby moves less or you feel something is wrong.

Is it safe to try to start labour at home?
Walking, resting and having sex (if your waters have not broken) are safe. Castor oil, strong herbal tonics and nipple stimulation are not advised without a doctor’s guidance.

What should I eat after birth?
A balanced diet with extra protein, iron and calcium, plus plenty of water. There is no need to avoid fish, vegetables or fruit. Ask your doctor about any food restriction.

What is the 40-day rest period?
A traditional time of rest and help after birth. It is healthy when it means rest, good food and support, and harmful if it means isolation, food restriction or delaying medical care. Keep your postnatal checks.

Is it safe to exercise at 40 weeks?
Yes for most healthy pregnancies. Walking, swimming, gentle yoga and pelvic floor exercises are good. Avoid contact sports, heavy lifting, hot yoga and lying flat on your back during exercise.

Note: This article gives general information and does not replace advice from your doctor or midwife. Every pregnancy is different. Call your doctor or go to a hospital if you have bleeding, severe pain, fever, fainting, fluid leaking, a change in your baby’s movements or any symptom that worries you.