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Newsletter - Week 40

Welcome To Week 40

40 Week Old Fetus

Your Baby: Ready To Roll

The average size of a full-term baby is 6 - 9 pounds (3400 g) and 20 - 22 inches long at birth. The placenta weighs about one-eighth of the baby's size, and the umbilical cord is almost as long as the baby.

Your Body: What To Expect After Childbirth

Your life as you knew it is about to go topsy-turvy once your baby arrives. Taking care of a baby is a full-time job, and you're going to feel it -- physically and emotionally. Some first-time moms find it difficult to adjust to their new role, but if you know what to expect, it may make the adjustment easier:

  • Episiotomy aftermath: The healing process may take two to three weeks, but eventually your stitches will dissolve and you will be able to sit on a normal surface again. Meanwhile, sit on an inflatable cushion or rubber inner tube and keep a squirt bottle on hand to rinse the area after you go to the bathroom. Sitz baths – sitting in a tub of warm water – will help the healing process, and give you a much-needed break from your new responsibilities.
  • Hemorrhoid care: One of the most common after effects of pushing during labor is a hemorrhoid, or swollen blood vessels around the anus that may bleed and be painful. Depending on the severity of the swelling, you may want to soak your bottom in a few inches of warm water in the bath or wear a cotton pad soaked with cold witch hazel cream in the anal area.
  • Uterine contractions: During the first week after birth while your uterus returns to its prebirth state (over a six-week period), you may feel afterpains or contractions, especially during nursing and after multiple pregnancies.
  • Bleeding: It is normal to bleed after birth for anywhere up to two to three weeks (and sometimes spotting for longer). But if the bleeding remains heavy after the first week (exceeding the heaviest day of a period or flows freely), resumes after slowing down or turns bright red after the fourth postpartum day, has large clots, or has a foul odor (with fever and/or chills), call your doctor immediately.
  • Breast changes: Whether or not you are breastfeeding, you'll know when your milk comes in because your breasts may be so full of milk that they get hard and engorged. To best protect your breasts from engorgement pain, be sure to wear a well-fitted, supportive bra at all times. If you do get engorged (which may be accompanied by a slight fever and flu-like feelings for a day), apply cold washcloths or ice packs to reduce the swelling.
  • Incontinence issues: For the first few days (and sometimes weeks) after birth, your urine and bowel movements may be out of control. The culprit: stretching of the base of the bladder, the stretching and weakening of the pelvic floor muscles, tearing of the perineum, and nerve injury to the sphincter muscles around the anus. The treatment: Kegel exercises to improve the bladder, special doctor-prescribed exercises to control your bowels, and time. Most incontinence resolves in the first few months after delivery. Be sure to tell your health care provider about your symptoms. He or she will be able to advise you about other treatment options. Occasionally, women need surgery to get their bladder and bowels under control.
  • Intense fatigue: Every new mom suffers from sleep deprivation. To help manage your fatigue, you can line up or accept offers of help from friends or family, unplug your phone and let your answering machine take messages, ask your spouse to help you so you can nap. Leave the housework for later and live with clutter, and simplify your daily tasks: order take-out food, eat frozen food, use paper plates, say no to anyone who needs a volunteer. Your baby will only be a newborn for a few weeks. Savor it, and worry about thank you notes and dust bunnies later.
  • A rollercoaster of emotions: You may feel overwhelmed, stressed out, teary, elated, or even depressed. Some of those feelings are normal and to be expected, but if you're unable to function or shrug off the blues you should consult a professional.

On That Note: If You're Down And Troubled

You may have heard or read about the baby blues, which usually lasts for the first two weeks after childbirth, or a more serious condition a mother experiences after the first few weeks of birth called postpartum depression. Learn more about how to diagnose, treat, and prevent this kind of depression here.

Weekly Tip

Feeling like this baby is never going to come out? Put your fears to rest. It will happen: It's just a matter of time. But if your due date is fast approaching and there are no signs of labor, make it special anyhow: Go out to a romantic, candlelit dinner with your spouse to mark the day. Who knows? It may just be your last day as a twosome.

Updated: 12/9/2012

Irina Burd, MD, PhD, Maternal Fetal Medicine, Johns Hopkins University, Baltimore, MD. Review provided by VeriMed Healthcare Network.

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