37 Weeks Pregnant: Inducing Labor

37 Weeks Pregnant

In this article

• Pregnancy Week 37: All About You
• Pregnancy Week 37: All About Baby
• How Big Is Baby?
• Most Common Pregnancy Questions
• Multiple Madness
• For Your Partner
• Fun Fact
• Follow The Chronicles of a Real-Life Pregnancy
• Tell Your Due Date Club

At 37 weeks pregnant, this baby is just about done growing inside you. That means it could be any day now!

Have you discussed hospital procedures, including birthing facilities, IVs, shaves, monitors, pain relief, and enemas, with your caregiver? Do you know you have choices about many of these things? Look for answers to your questions (or ask one of your own!) in our Ask the Expert section, and if you haven't done so already, take the time to fill out our Interactive Birth Plan. This is the best action you can take to insure you and your family will be in control of your birth experience.

If you'll be using a diaper service, arrange for predelivery. They'll help you determine how many diapers you'll actually need (it's probably quite a bit more than you think!) What about help after the baby is born? You don't have to be supermom. Ask a family member or friend to help out the days following your delivery or if you can afford it hire a domestic service. Childbirth is overwhelming and exhausting—take the time you need to recuperate (especially if you've had a C-sectionand enjoy this special time in your life.

Pregnancy Week 37: All About You

You're one week shy of full-term status. Your once small baby bump is now the size of a basketball—or bigger. Your internal organs are cramped as they make room for your nearly full-sized baby. Heartburn, indigestion, and flatulence may be constant problems as your stomach has less room to hold in, and digest, your food. You're probably finding it difficult to move, walk, and sleep now that your baby is almost ready to be born.

Inducing Labor
Doctors still aren't sure exactly what causes labor to begin. The prevailing theory is pregnancy hormones, which are active throughout pregnancy, increase around the time your baby is due. Most often, the brain releases the hormone oxytocin, which signals the body to start contractions and the cervix to begin dilating. Yet for some women, labor needs to be jumpstarted.

Reasons for Inducing Labor

The baby's health: Your healthcare provider will carefully monitor your baby-to-be's health throughout pregnancy. If your provider suspects something threatens your baby's progress—for instance, the placenta doesn't seem to be providing enough nourishment—he or she may recommend an induced labor.

The mother's health: Several high-risk conditions—such as gestational diabetes—may make it necessary to induce. Again, your doctor will monitor your pregnancy for potential problems.

One condition which sometimes necessitates an early delivery is preeclampsia (also called toxemia or pregnancy-induced hypertension [PIH]). This complication occurs in 10 percent of pregnancies according to the Preeclampsia Foundation. "The specific risk in preeclampsia is that the hypertension can progress to cause seizures and other severe neurologic complications, including stroke," explains Dr. William Camann, MD, director of obstetric anesthesia at the Brigham and Women's Hospital in Boston, Massachusetts, and coauthor of Easy Labor.

Dr. Camann goes on to explain, "For baby, as the mother's blood pressure goes up [with PIH], the blood flow to the uterus and baby can go down. Thus, the baby can have consequences from too little blood flow and decreased oxygenation."

Past due date: If it appears your baby-to-be is labor-shy, your doctor may suggest inducing.

Labor doesn't progress: When you are already in labor, but it appears your labor isn't progressing, your doctor or midwife may choose to give you certain medications to spur your body into more active labor. For example, if your water has already broken, but your cervix isn't dilating, you may be induced.

How Healthcare Providers Induce Labor
There are two main ways doctors try to help labor along. If you're near your due date, your doctor may "strip the membranes" of the cervix to help the lining thin and move you closer toward labor. This can be done during an office visit or at the hospital. Stripping membranes can be painful and is not a surefire route toward labor.

When doctors need to medically induce labor in the hospital, the drug of choice is oxytocin (also called Pitocin). This medication mimics the naturally occurring oxytocin the brain releases to stimulate labor.

At-Home Inductions
Beyond medical induction, there are several homeopathic methods to spur labor. Dr. Camann cautions expectant women against trying any of these methods without first consulting with their healthcare providers. Popular do-it-yourself induction choices such as cohosh and castor oil can have potentially harmful side effects like severe diarrhea, says Dr. Camann.

Pregnancy Week 37: All About Baby

At 37 weeks, your baby's body is developed enough to survive outside of the womb. Her lungs, now filled with amniotic fluid, are ready to take her first breaths of air. Her eyelids flutter open and shut preparing for her first view of you.

This baby is just about done growing inside you. That means it could be anytime now!

How Big Is Baby?

At around 6 pounds and 19 inches in length (crown to heel) your baby can come any day now!

Most Common Pregnancy Questions

My doctor gave me some reading materials on cord blood banking, but I'm still confused. What is it and should I do it?
Cord blood banking is a system of storing blood obtained from your baby's umbilical cord after she's been delivered. So why would you want to do this? Exciting research in the use of stem cells to treat various diseases encourages many doctors and parents to explore banking or saving cord blood. If your child develops a serious health condition warranting stem cell treatment (such as leukemia, sickle cell anemia, or other disorders), having saved cord blood ensures you'll have a perfect match ready for use. (However, if the condition is genetic, the stem cells might contain the very thing that caused your child to become ill.) According to the American Academy of Pediatrics, the likelihood that you will need to use the blood, ranges anywhere from one in 1,000 to one in 200,000.

There are currently two methods of saving, banking, or donating your child's cord blood. The first way is through a public blood bank. This really is like giving blood to the Red Cross. You know you won't get your own blood, but you give with the idea that it will help others and know that if you needed blood, you have access to this supply. The second way is through private cord blood banking. This is a for-profit business, and costs vary widely. So if you decide to do privately bank cord blood, you should do your homework. There is usually an initial storage and processing fee and then yearly fees. The blood is cryogenically stored and will be available should you need it.

In January of 2007, the AAP issued a position statement regarding their philosophy on cord blood banking. It states: "Cord blood stem cell banks can provide an invaluable service to those afflicted with leukemia and immune disorders. The American Academy of Pediatrics (AAP) encourages families to donate their newborn's cord blood, which is normally discarded at birth, to cord blood banks (if accessible in their area) for use by other individuals in need. Storing cord blood at private banks for later personal or family use as a general "insurance policy" is discouraged."

If you do decide to pursue private cord blood banking, the AAP recommends you consider the following questions:

• Does the company bank for personal and family use?
• Institutional Review Board-approved protocols should be in place, including annual disclosure of the financial interest and potential conflicts of interest.
• Financial viability and stability of the company should be considered.
• Physician should disclose any potential conflict of interest.
• Company should have an informed consent process in place and require the parent to sign an informed consent.
• Cord blood banks should comply with national accreditation standards developed by the Foundation for the Accreditation of Cellular Therapy (FACT), the US Food and Drug Administration (FDA), the Federal Trade Commission, and similar state agency.

The AAP also states that:

• Cord blood donation should be encouraged with the cord blood is stored in a bank for public use.
• Private cord blood banking should be encouraged when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation.
• If banking for future personal or family use, parents should know that most conditions that might be helped by cord blood stem cells already exist in the infant's cord blood and would not be used (such as premalignant changes in stem cells).
• Storing cord blood as "biological insurance" should be discouraged because there currently is no scientific data to support (self) autologous transplantation.

Making a decision in a confusing time such as this can be difficult … make sure you talk this over with your doctor. She can help you make the best decision for you and your child.

Multiple Madness

Your Recovery

Beyond the obvious, there are many benefits to having your new babies in your arms rather than in utero. One, very soon you'll be able to sleep on your stomach. Two, soft cheeses can go back in your diet (if you're inclined toward such a staple). Three, you can breathe again!

Many new moms of twins jump into parenting with reckless abandon and fail to take appropriate care of themselves after giving birth. Remember, your body is recovering from a spectacular (and exhausting!) event. You'll need to take care of yourself and pay attention to your body to ensure that you don't end up back in bed from overdoing it.

Some good tricks to employ during your recovery include:

• You should receive a peri-bottle from the hospital which is great to continue using to cleanse your perineal area after urinating until you heal to the point where you can again use toilet paper. In addition, even though you'll probably be told to only use an ice pack on your perineum for the first 24 hours after delivery, if it feels good to apply one for 30 minutes here and there throughout the day, there's nothing wrong with doing so. This will feel sensational after you've experienced a did-too-much-today day. An additional product that you will likely receive at the hospital is called Proctofoam. If you don't receive any, you can request a prescription for it. You spray the foam onto your pad so it will cover your perineum. It is cooling and feels great!
• Warm sitz baths work wonders for both a sore perineum and hemorrhoids.
• A 2.5-percent hydrocortisone cream from your doctor (this will require a prescription) can ease discomfort of hemorrhoids. The one-percent version sold over-the-counter often isn't strong enough to combat bad hemorrhoids.
• Cold witch hazel pads placed on top of your sanitary pad help both with hemorrhoids and with perineal discomfort. However, if used too often the witch hazel can overdry the area which causes discomfort. So use them sparingly and opt for Proctofoam when you need extra relief in the perineal area.
• Belly bands are often given for C-sections, both for singleton births and multiple births. They are especially great for women who've had multiples because multiple moms often have more extra skin after delivery (which tends to "pull" at the incision) and the uterus often distends more with a multiple birth. These bands help to support the uterus so that the weight of your extra skin doesn't pull too hard on the incision.

How will you know if you're overdoing it? You'll know! Some women feel their perineum or incision sting when they are working too hard. In the later weeks, vaginal bleeding may subside and then rev up again if you do too much. These are your body's ways of telling you to slow down. Pay attention and listen closely; if you do, chances are your recovery will go much more quickly.

For Your Partner

How Will I Know If She's in Labor?
Determining whether your partner is in labor is a crucial step in the childbirth process. Make sure both you and your partner know the difference between real labor and false labor. Having this knowledge will better serve you when the big day nears.

There can be something quite alarming about watching your partner begin to experience contractions. Not only does it signify the beginning of the most nerve-wracking phase of her pregnancy, but it can be hard for many men to helplessly sit back and watch their loved one struggle in pain.

How can you help if you think your partner is going into labor? Here are some tips:

• Don't hesitate to contact your birthing professional—be it a doctor, midwife, or doula. Treating pregnant patients is their job, they're used to it, and they handle calls from concerned parents-to-be every day.
• Remember to help your partner with her breathing and maintain steady and supportive physical contact with her.
• Distract your partner in any way that you can in between contractions. Is there music or jokes or stories she enjoys hearing?

Because you never really know when labor is going to begin, have everything ready to make the mad dash to the hospital.

And don't forget to bring your own bag of tricks to the hospital, too. Your partner is really going to need you to be there for her. Pack some things to help "get you going" when you feel tired. If you have an MP3 player, put together a "Pump Me Up" playlist you both can listen to if you need it. Pack a few snacks, too. Having an energy bar or some fruit on hand can also be extremely helpful for when your baby decides 3:30 in the morning that it is finally time to enter the world.

Fun Fact

When a baby nurses, the mother's brain reacts by releasing oxytocin. Just as with labor, the oxytocin causes the uterus to contract, helping the uterus regain its pre-pregnancy size.

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