38 Weeks Pregnant: Baby Development, Symptoms and Tips

Short Answer: At 38 week pregnancy, your baby is about 49 cm from head to heel, roughly the size of a leek or a small pumpkin, and weighs around 3 kg. Almost every organ is ready for life outside the womb, and the lungs and brain are putting on their final touches. Your baby is still early term until 38 weeks and 6 days, and full term starts next week. The top of your womb is about 37 to 38 cm above your pubic bone, and many people feel pelvic pressure, a mucus show, loose stools and stronger Braxton Hicks tightenings. Labour can start any day, or not for another two to three weeks. This week, learn the stages of labour from early contractions to pushing, how to spot and respond to heavy bleeding after birth, how to care for a tear, what happens during your hospital stay and which breastfeeding positions work best. Go to hospital for regular contractions, waters breaking, bleeding, a change in your baby’s movements, a severe headache with blurred vision or any sign that something is wrong.

Pregnancy weeks are counted from the first day of your last period, not from conception. Thirty-eight weeks pregnant means about thirty-six weeks since conception. You are in your ninth month, with about 2 weeks to go. For earlier weeks, start with our guide to 8 weeks pregnant, or read last week’s guide to 37 weeks pregnant.

Week 38 at a glance

Sizes differ between guides and between babies. Healthy babies at this stage range from about 2.5 kg to 3.7 kg, and your own scan results and your doctor’s measurements matter more than a chart.

Your baby at 38 weeks

Growth. Your baby is gaining about 100 to 200 grams a week now, and almost no more length. Fat is about 15 percent of body weight, and the cheeks, arms and legs are plump. This fat will keep your baby warm after birth.

Lungs. The lungs make surfactant, the substance that keeps the air sacs open, and they keep maturing until birth and into the first weeks. Most babies born now breathe without help. The lungs release a signal that helps start labour, which is one reason labour often begins when the baby is ready.

Brain and nerves. The brain is still growing quickly, and nerve cells are being coated with a fatty insulation called myelin, which speeds up signals. This continues for years after birth. Your baby sleeps most of the day, in cycles of deep sleep, dream-like sleep with rapid eye movements and short wake periods.

Organs. The kidneys work, and your baby passes urine into the amniotic fluid. The liver is processing waste, though not as well as it will in a few weeks, which is why many newborns get mild jaundice. The gut is full of meconium, the first dark, sticky stool, which is usually passed within a day of birth. The heart beats about twice as fast as yours.

Senses. Your baby hears your voice, your partner’s voice and the sounds of your home, and may calm to them after birth. The eyes open and close, and the pupils react to light. A newborn sees blurry shapes best at about 20 to 30 cm, the distance to your face during feeding. Eye colour is not final.

Skin and hair. The skin is smooth and pink or tan, depending on your family. Most of the lanugo, the fine body hair, is gone, and the vernix, the white waxy coating, remains in the creases of the skin and is thinner overall. Hair on the head can be thick, thin or almost absent, and all are normal. The nails reach or pass the fingertips, and may need trimming.

Bones and skull. The bones are hard, except the skull, whose plates stay soft and loosely joined so the head can mould as it moves 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 keep crossing the placenta in these last weeks, protecting your baby against infections in the first months. Breastfeeding adds more.

Position and movement. Most babies are head down, and the head may already be in your pelvis. About 3 to 4 in 100 are breech at term. With little room, movements feel like rolls, stretches and pushes more than sharp kicks. The total amount should stay about the same until labour. Hiccups are common and normal.

Boys and girls. Newborn genitals can look swollen because of your hormones. A little white or blood-tinged vaginal discharge in a newborn girl, and swollen breasts in either sex, are usually normal in the first days.

Chances at birth. A baby born at 38 weeks is early term and almost always does well. Compared with babies born at 39 to 40 weeks, a few more have trouble with breathing, feeding, warmth or jaundice in the first week, so watch feeding and yellow skin closely.

Your body at 38 weeks

Womb. The top of your womb is about 37 to 38 cm above your pubic bone. If your baby has dropped, the measurement can fall a little, and that is normal.

Weight. Weight gain slows near the end, and some people stop gaining or lose a little. 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 is softening and may start to shorten and open a little. You cannot feel it, and a vaginal examination cannot predict when labour will start, so you can decline it.

Braxton Hicks. Practice tightenings can be stronger and more 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 more pressure on your bladder, rectum and pelvis, and sharp, electric-like twinges in the vagina or pelvis. You may breathe more easily and have less heartburn.

Discharge and show. Discharge may increase. 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 another week or more. Bright red bleeding that soaks a pad is not a show.

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

Skin and hair. A glow is common, but so are acne, dry skin, dark patches on the face and a dark line down the belly. Stretch marks can appear. Itchy red bumps on stretch marks, called PUPPP, are harmless but very itchy. Intense itching on the palms and soles needs a doctor the same day, because it can be a liver condition called cholestasis.

Breasts. They are larger and heavier. Colostrum, the thick yellow first milk, may leak. A supportive nursing bra and breast pads help.

Hands, feet and legs. Mild swelling is common, especially in hot weather. Tingling in the hands from carpal tunnel syndrome is common too. Varicose veins and piles can appear or get worse.

Tiredness and mood. Tiredness, impatience, vivid dreams, forgetfulness and mood swings are common, as is nesting, the urge to clean and organise. Avoid climbing, heavy lifting and strong cleaning fumes. Many people feel excited and anxious at the same time.

The stages of labour, step by step

Labour does not run on a clock. Every labour is different, and a first labour is usually longer than later ones. This guide shows what to expect, so that the process feels less frightening.

Early labour. This is the longest and least intense stage. Stay at home if you can, rest, eat light snacks, drink water and move around. Early labour often stops and starts, and that is normal.

Active labour. The pain becomes stronger and you need your full attention. This is usually when to go to hospital, if you are not already there. Many people want a calm, dim room, a companion close by and a change of position. WHO guidance recognises that the cervix may open more slowly than one centimetre an hour and still be normal, and does not treat this as a reason to intervene unless there is another concern.

Transition. This is the hardest part, and the shortest. It is common to feel panic, to say you cannot do it and to want to give up. This is a sign that the baby is close. Your companion’s job is to stay calm, remind you to breathe and tell you that you are doing it.

Resting phase. In some labours, the contractions pause for a few minutes before the urge to push begins. Rest if you can, and breathe.

What helps in each stage:

• Keep moving and change position often, and avoid lying flat on your back
• Sip water and take light snacks in early labour, unless your doctor advises otherwise
• Pass urine regularly, because a full bladder can slow labour
• Breathe slowly in through your nose and out through your mouth, letting your shoulders and jaw go loose
• Use warmth, such as a shower or a warm cloth on your back, and firm pressure on your lower back
• Keep the room calm, quiet and private
• Ask for pain relief at any point, and know that you can change your mind

Pain relief. The options depend on your hospital. Support, breathing, warm water, massage and movement are widely available. Injections and epidurals may need an anaesthetist, so ask in advance what is offered, what it costs and whether someone is on call at night.

Pushing and the birth of your baby

When the cervix is fully open, your baby moves down the birth canal. You will usually feel an urge to push, a strong pressure like needing to open your bowels. Many people also feel a burning or stretching sensation as the head crowns.

How to push:

• Wait for the urge. WHO advises against telling you to push before you feel the urge, unless there is a reason
• Push when you feel the urge, in short bursts of about five to six seconds, three or four times with each contraction, and breathe between pushes
• Let your body lead. Some people make low sounds, and that is fine
• Keep your jaw and pelvic floor relaxed
• Do not hold your breath for a long time, which can reduce oxygen to your baby

Positions that help:

Lying flat on your back is the least helpful position, because it narrows the pelvis and can lower your blood pressure.

Crowning. When the head is about to come out, your doctor or midwife may ask you to stop pushing and pant or breathe slowly, so the skin stretches gently and tearing is less likely. A warm cloth against the perineum helps.

Episiotomy. This is a small cut near the vagina made to widen the opening. WHO advises against doing it routinely. It is used only when there is a medical reason, such as signs that the baby is distressed and needs to be born quickly. Ask your doctor when they do one.

After the head is born. The shoulders and body usually follow with the next contraction. Your baby is placed on your chest, dried and covered, and you hold your baby skin-to-skin.

Assisted birth. If pushing is not working or the baby is in distress, a doctor may use a vacuum cup or forceps to help. It is done only with your consent, in a hospital, and usually with pain relief and a small cut. Most babies are fine, and you may have some bruising.

When a C-section is needed. Common reasons include a baby in distress, labour that stops progressing, a breech or sideways baby, a placenta covering the cervix, severe pre-eclampsia, bleeding and a cord that comes out before the baby. If a C-section is advised in labour, ask why and what the alternatives are, unless it is an emergency, and ask for your companion to stay if possible.

How your baby is monitored in labour

Your baby’s heartbeat tells staff how your baby is coping. In a healthy pregnancy with no complications, WHO recommends listening to the heartbeat at regular intervals, using a handheld Doppler or a Pinard horn, usually every 15 to 30 minutes in the first stage and more often when pushing. Continuous monitoring with a belt, called cardiotocography or CTG, is used when there are risk factors, such as high blood pressure, diabetes, a small baby, an induction, bleeding or a heartbeat that is not normal.

What the heartbeat should be. A normal baby’s heart rate is about 110 to 160 beats per minute, and it rises and falls with movement and contractions.

If there are concerns. Staff may ask you to change position, usually onto your left side, drink water or breathe oxygen. They may check your cervix, give fluids, stop an oxytocin drip or move to a faster birth. Ask what is happening, and do not hesitate to say if you are worried.

Your own checks. Staff also check your blood pressure, pulse, temperature, urine and how your labour is progressing. A vaginal examination is usually done every four hours in a low-risk labour, unless there is a reason to do it sooner. You can ask what the examination is for and decline it.

Heavy bleeding after birth: what to know

Heavy bleeding after birth, called postpartum haemorrhage or PPH, is one of the leading causes of maternal death in the world, including in Bangladesh. Most cases can be prevented or treated if they are recognised quickly and the right care is given. Knowing what to expect can save a life.

What counts as PPH. Blood loss of 500 mL or more after a vaginal birth, or 1,000 mL or more after a C-section, or any bleeding that makes you unwell. It usually happens in the first 24 hours, but it can occur up to 12 weeks later.

Why it happens. The most common cause is a womb that does not contract firmly after birth, which is called uterine atony. Other causes are tears in the birth canal, a retained piece of placenta or membrane, and clotting problems.

Who is more at risk:

• Anaemia in pregnancy
• A long labour, or very fast labour
• A big baby, twins or too much fluid
• Having had many births before
• A previous PPH
• A labour that was induced or sped up
• Placenta problems, such as praevia or abruption
• Pre-eclampsia, an infection or a C-section
• Some medical conditions or blood thinners

Many women who bleed heavily had no risk factors, so every birth should be attended by a skilled person who is ready to act.

How it is prevented. WHO recommends that every woman receives an injection of oxytocin, usually 10 units into the thigh, within one minute of the baby being born. Staff then deliver the placenta carefully, with gentle controlled pulling on the cord, and check that the womb is firm. This is called active management of the third stage, and it lowers the risk of PPH a great deal. Ask your hospital if it does this routinely. Also have your hemoglobin checked, take your iron and treat anaemia, because an anaemic mother can tolerate blood loss much less.

How it is treated. Doctors and midwives act quickly:

1. Massage the womb through the belly until it is firm
2. Give oxytocin and other medicines that make the womb contract
3. Give tranexamic acid, which helps blood clot. WHO recommends it as early as possible, within three hours of birth
4. Give fluids and, if needed, a blood transfusion
5. Check for and repair tears, and remove any piece of placenta left behind
6. If bleeding continues, use a balloon inside the womb, a compression procedure or surgery

Time matters. Do not delay going to hospital, and do not leave the hospital early.

Signs that bleeding is too heavy. Call for help at once or go to hospital if you have:

• Bleeding that soaks a pad in an hour, or a steady gush or trickle that does not slow down
• Large clots, bigger than an egg or a plum
• Dizziness, feeling faint, a fast heartbeat, pale or cold skin, blurred vision or sweating
• A soft, boggy womb that does not feel firm
• Severe pain in the belly or pelvis
• Bleeding that comes back or gets heavier after it had slowed, even days or weeks later
• A foul-smelling discharge, fever or chills

What you or your companion can do while waiting for help:

1. Lie down, and raise your legs on pillows
2. Place a hand on your lower belly, below the navel, and massage firmly in circles until the womb feels hard like a ball
3. Put your baby to the breast, because suckling makes the womb contract
4. Empty your bladder, because a full bladder stops the womb contracting
5. Keep warm, and sip water
6. Call 999 or go to hospital at once, and tell the staff that you are bleeding heavily after birth
7. Keep a record of how many pads you use

Plan ahead. Know your blood group, and arrange two or three healthy adults with the same group as donors. Ask your hospital how it gets blood in an emergency. Agree with your family that if there is heavy bleeding, you go to hospital immediately. Choose a hospital with a doctor who can manage emergencies and a blood supply.

After PPH. Recovery takes time. You may need iron, extra rest and help with your baby. Tell your doctor if you feel weak, dizzy or very tired for weeks, because anaemia and low blood pressure can last.

Tears, stitches and healing

Many people who give birth vaginally have a tear in the skin and muscle between the vagina and the anus, called the perineum. Most tears are small and heal well.

What you can do to lower the risk:

• Perineal massage from about 34 to 35 weeks, if your doctor agrees
• Giving birth in an upright or side-lying position
• A warm cloth on the perineum during the second stage
• Slow, steady pushing, as guided
• Avoiding an episiotomy unless it is needed

Stitches. The area is numbed, and stitches that dissolve are used. A repair usually takes 20 to 60 minutes. Ask the doctor to explain.

Caring for the area:

• Change pads often, and keep the area clean and dry
• Rinse with warm water after passing urine and stools, and pat dry from front to back
• Use a cold pack wrapped in a cloth for 10 to 20 minutes for the first days to ease swelling, and sit in a few inches of warm water for comfort
• Take pain relief as advised, such as paracetamol
• Eat fibre, drink plenty of water and ask about a stool softener, to avoid straining
• Hold a clean pad against the stitches when you pass stools
• Start gentle pelvic floor squeezes in the first days, when you feel ready
• Avoid sex until you feel comfortable and bleeding has eased, often around four to six weeks

Seek help if you have a fever, severe or worsening pain, a foul smell, pus, the wound opening, swelling that grows, difficulty passing urine, leaking urine or stool, or you cannot control gas. Third and fourth degree tears can cause long-term problems, and early treatment and physiotherapy help.

Your hospital stay and going home

After a vaginal birth. WHO recommends staying in the facility for at least 24 hours, because most serious problems appear early. Many hospitals discharge after one to two days, if you and your baby are well. After a C-section, you usually stay two to four days.

What is checked, for you:

• Your bleeding, womb firmness and temperature
• Your blood pressure and pulse
• Your urine, and whether you can pass it
• Your stitches or wound
• Your pain, and how you are feeling
• Your breasts and feeding

What is checked, for your baby:

• Breathing, colour, temperature and heart rate
• Weight, length and head size
• Feeding, wet nappies and the first stool
• The cord, skin and eyes, and the hips
• Jaundice
• A full examination by a doctor

Vaccines and injections for your baby. Many hospitals give vitamin K to prevent bleeding. BCG is given at birth in Bangladesh as part of the free national immunisation programme, and further doses are given from about six weeks. Keep your baby’s vaccination card safe.

Before you leave, ask:

• What are the danger signs for me and my baby, and who do I call?
• When and where is the next check for each of us?
• How should I care for my wound, stitches and breasts?
• Which medicines should I take, such as iron, calcium and pain relief, and for how long?
• What contraception can I use, and when should I start?
• Is my baby feeding well, and do I need a breastfeeding check?
• Where do I register the birth, and where are the vaccines given?
• Can I have my discharge papers and test results?

Going home. Plan safe transport, and keep your baby warm and secure. Hold your baby in your arms or in a sling against your chest, and avoid rough roads, dust and smoke. If you use a car, use a car seat. Do not carry a baby on a motorbike. Ask relatives to cook, clean and look after other children, so that you can rest.

Danger signs after birth. Go to hospital or call 999 if you have: heavy bleeding, fever of 38°C or more, foul-smelling discharge, severe belly pain, a severe headache or blurred vision, fits, a painful swollen leg, breathlessness or chest pain, a red hot painful breast, a wound that is red or leaking, trouble passing urine, feeling faint or very weak or thoughts of harming yourself or your baby.

Your mood. Many mothers have the baby blues in the first two weeks, with tearfulness and mood swings. Postnatal depression affects about 1 in 7 mothers, and is more likely if you had depression before, have little support or have had a difficult birth or violence. Sadness, hopelessness, constant worry or trouble bonding that lasts more than two weeks needs help. Tell your doctor. It is treatable, and it is not your fault. If you have thoughts of harming yourself, go to the nearest hospital or call 999.

Breastfeeding positions that work

A comfortable position makes a good latch much easier. Try several in the first days, and use pillows to support your baby so that you do not strain.

Latch checks.

• Baby’s mouth wide open, with the chin touching your breast
• More of the dark skin above the top lip than below the bottom lip
• Lips turned outward, like a fish
• Deep, slow sucks, and swallows you can hear or see
• No pain after the first few seconds
• Baby’s head and body in a straight line, tummy to tummy, with the nose level with the nipple

If it hurts, break the suction by slipping a clean finger into the corner of your baby’s mouth, and try again. Ask a nurse or midwife to watch a feed. Sore or cracked nipples are almost always a latch problem, and they heal when the latch improves.

Hand expression. Learning to hand-express colostrum is useful if your baby is sleepy, small or unable to feed. Wash your hands, hold your thumb and fingers about 3 cm behind the nipple, press back toward the chest and squeeze gently, and repeat in a rhythm. Collect the drops in a clean spoon or cup. Ask your nurse to show you.

How often. Feed 8 to 12 times in 24 hours, day and night, whenever your baby shows early hunger signs. Do not give honey, water, sugar water, formula or other food in the first six months unless a doctor advises it. Never give honey under one year.

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.

Common symptoms and what helps

Do not take any medicine, including painkillers and herbal products, without asking a doctor or pharmacist. Paracetamol at the recommended dose is generally considered safe. Avoid ibuprofen, aspirin and diclofenac unless your doctor prescribes them.

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.

Your baby’s movements. Keep tracking them. Learn the usual pattern, and if you want a method, count distinct movements until you reach ten, which usually takes under two hours. If you notice a clear drop or change, call your doctor the same day, and do not wait until the next day or rely on a home Doppler.

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.

Last-week worries, answered

If your baby is late

Only about 1 in 20 babies are born on their due date, and a first baby often arrives a week or more after it. Your due date is an estimate. Being a little late is common and usually not a problem.

What usually happens:

• Your doctor sees you more often, and checks your blood pressure, urine, womb size and baby’s heartbeat
• You are asked to track your baby’s movements, and to report any change
• A membrane sweep may be offered from 39 weeks, to help labour start
• A scan may check the fluid and the placenta if there are concerns
• Induction is usually offered between 41 and 42 weeks, because the risk of stillbirth and other problems rises slowly after 41 weeks. Your doctor will talk through the benefits and risks, and the options, including waiting with close monitoring
• Induction may be advised sooner if you have pre-eclampsia, diabetes, a small baby or other medical reasons

What you can do while waiting:

• Keep tracking your baby’s movements, and call the same day for any change
• Rest, walk, eat well and sleep when you can
• Keep your hospital bag, transport and emergency plan ready
• Avoid anything unsafe to bring on labour, such as castor oil or herbal tonics
• Plan something calming each day, and keep in touch with friends and family
• Ask your doctor for a clear plan for when to go to hospital

Food, exercise and sleep

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.

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 labour can start at night. 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, skin-to-skin contact, delayed cord clamping, breastfeeding in the first hour and rooming-in. 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.

After the birth. Plan your postnatal checks, contraception and the first 40 days of rest. Ask your doctor about contraception before you leave hospital, because waiting at least 24 months between births is safer for mother and baby.

Birth registration. Register your baby’s birth with the local authority after the birth. It is free within 45 days, and the certificate is needed for school and many services.

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.

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.

Checklist for this week

• Keep your weekly visit, and check your blood pressure, weight, womb size, baby’s position and hemoglobin
• Ask about your group B strep result and the plan if your baby is breech or you need an induction
• Ask about the whooping cough and tetanus-diphtheria vaccines if you have not had them
• 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
• Learn the stages of labour, when to go to hospital and what to do if your waters break
• Learn the signs of heavy bleeding after birth, and what to do
• 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
• Practise a few breastfeeding positions with a pillow, and learn hand expression
• Plan your first 40 days after birth, including postnatal checks and contraception
• 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 38 weeks?
About 49 cm from head to heel and 3 kg, roughly the size of a leek or a small pumpkin. Healthy babies at this stage range from about 2.5 kg to 3.7 kg.

Is 38 weeks full term?
Not quite. A baby is early term from 37 weeks to 38 weeks and 6 days. Full term starts at 39 weeks. Most babies born at 38 weeks do well.

How long does labour last?
It varies a lot. A first labour often takes 12 to 18 hours or more from the start of regular contractions to birth, and later labours are often shorter. Early labour is the longest, and it can stop and start.

What is transition in labour?
The last part of the first stage, when the cervix opens from about 8 to 10 cm. Contractions are strongest and closest together, and you may shake, feel sick and think you cannot go on. It is usually short, and it means the baby is close.

What is postpartum haemorrhage?
Heavy bleeding after birth, usually 500 mL or more after a vaginal birth. It is a leading cause of maternal death, but it is preventable and treatable with an oxytocin injection after birth, womb massage, medicines and blood if needed. Go to hospital at once for heavy bleeding.

What should I do if I bleed heavily after birth?
Lie down, raise your legs, massage your lower belly firmly in circles, put your baby to the breast, empty your bladder and call 999 or get to hospital at once.

What is the best breastfeeding position after a C-section?
The football hold and side-lying keep your baby’s weight off your wound. Use pillows for support.

What if my baby is late?
Most babies arrive within two weeks of the due date, and first babies are often late. Your doctor monitors you, and induction is usually offered between 41 and 42 weeks, or sooner for a medical reason. Track your baby’s movements, and call the same day for any change.

Is it safe to exercise at 38 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.