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Fetal growth and maternal changes

During the third trimester(the last 3 months of pregnancy), you may feel anxious about giving birth and want time to pass quickly. During this time, you’ll gain approximately 5 kg in weight. Most of this weight will come from the fetus, but additional weight will be gained from amniotic fluid, the placenta, breasts, blood, and uterus. You will have more frequent prenatal examinations. Periodic checks are needed to ensure that everything is progressing smoothly, including checking for your and your fetus’ health. You may experience discomfort such as back pain, discomfort while sleeping, and pressure on your lungs from the fetus. They are not a sign of labor.

(Source : Ministry of Gender Equality and Family, New Dad's Handbook, 2018)

Week 28

• 1. Fetal growth

  Thanks to the almost complete senses of sight and hearing, the fetus responds actively to stimuli. The fetus's hearing, which has been steadily developing, is almost complete by this time. It may tense up or be startled by strange sounds coming from outside the womb. The fetus hates angry or loud noises, but it likes relaxing music or its mother's voice. Its vision is also developed, and it startles when exposed to strong light from outside.

• 2. Maternal changes

  Your belly is getting bigger and your belly button is starting to stick out. The uterus rises to about halfway between the navel and the pubic bone, pressing on the heart and stomach, causing bloating. Your heart is pumping harder, and you may feel sick to your stomach more often. In the evening, your feet and legs may swell, and your movements may become increasingly clumsy. As your belly grows, your abdomen often itches and your belly button will bulge out. The eyelids are fully formed, and the pupils begin to form, allowing the eyes to open. As the fetus's pupils develop and it begins to practice focusing, it also notices changes in emotions, such as when its mother is happy or sad. The fetus frequently responds to sounds, and it moves actively, sometimes hitting the uterine wall hard. The brain becomes much larger and folds into a walnut-like shape to fit within the skull.

Week 29

• 1. Fetal growth

  Subcutaneous fat accumulates on the body, making it plump. As more fat accumulates in its body, the fetus becomes chubbier. The eyelids are fully formed, and the pupils begin to form, allowing the eyes to open. As the fetus's pupils develop and it begins to practice focusing, it also notices changes in emotions, such as when its mother is happy or sad. The fetus frequently responds to sounds, and it moves actively, sometimes hitting the uterine wall hard. The brain becomes much larger and folds into a walnut-like shape to fit within the skull.

• 2. Maternal changes

  The uterus grows toward the lungs and pushes on them, causing shortness of breath. You may often experience pain in your lower back or back area or get tired easily. Your arms, legs, and even her face may swell. A little swelling in the evening is not a big problem, but if swelling starts in the morning and worsens throughout the day, the symptoms may indicate pre-eclampsia, so please heed caution. Sudden weight gain, high blood pressure, or proteinuria(high levels of protein in the urine) may be symptoms of worsening gestational hypertension. In this case, visit the hospital as soon as possible and receive medical treatment from a healthcare professional.

Week 30

• 1. Fetal growth

  As birth approaches, the head of the fetus, which was once moving freely and changing position, will settle lower into your pelvis. A fetus may have its bottom down and its head up towards the top of the uterus. However, you do not need to worry about its position just yet, as there is plenty of time for it to flip. Lanugo gradually decreases except a little on the shoulders and back, and the hair also grows longer. The fetus receives oxygen from the placenta through the umbilical cord. However, at this time, the fetus begins to practice breathing in earnest, such as by starting to move its diaphragm.

• 2. Maternal changes

  Pigmentation of the breasts becomes more severe. Colostrum begins to form, and some pregnant women may even leak breast milk. Pigmentation in the lower abdomen, nipples, and vulva may become severe, but it will fade after childbirth, so don't worry too much. You may continue to feel uneasy and have back pain, varicose veins, hemorrhoids, etc., so make sure to take care of these. During this period, the amount of amniotic fluid does not increase much.

Week 31

• 1. Fetal growth

  The fetus is about 40 cm long and weighs about 1.5 kg. The fetus, now with a plumper body, has less subcutaneous fat and a lot of wrinkles, but its face also has a distinct shape. The skeleton is almost complete, and the brain cells and nervous system are connected and begin to function. The fetus's memory and sensory abilities develop to be even better. The amount of amniotic fluid increases to its maximum, but the fetus also grows and has less room to move, so movements become slower. The fetus can regulate its body temperature and breathe independently, so it has a high chance of survival even if it is born at this gestational age. However, it still lacks subcutaneous fat, and its organs are not fully developed, so if born early, it will need the help of an incubator.

• 2. Maternal changes

  You’ll start to take deeper breaths and have frequent trouble eating. The height of the fundus is 25-28 cm. As such, the abdomen gradually grows, and the uterus rises to 7-8 cm below the breastbone, pressing on the stomach and making eating difficult. Fetal movement becomes stronger, making you short of breath. Even when you breathe, you may not feel like you are breathing properly, so you will take deep breaths frequently. In many cases, a pregnant woman cannot lie flat due to the shortness of breath. Painless uterine contractions called Braxton Hicks may occur four to five times a day, and the pregnant woman may describe it as a feeling of abdominal tightness. As labor gets closer, vaginal discharge also increases.

Week 32

• 1. Fetal growth

  The fetus' powerful movements are visible in the mother's belly. The fetus can wiggle its fingers and toes. With its arms and legs now stronger, it can bend and straighten its arms with energy. Its lively movements are seen even on the surface of the pregnant woman's abdomen. The iris of the eye begins to contract and relax, and when exposed to bright light, the iris contracts. It can open its eyes to focus and blink to see objects.

• 2. Maternal changes

  Pregnancy hormones relax and weaken the joints in the bones near the pelvis, especially the hips and in front of the bladder, making the ligaments and muscles around the spine more susceptible to injury. Your joints may become misaligned when you move, making a clicking sound or causing pain. Additionally, the fundus rises to just below the ribs, pressing upwards on the stomach and causing chest tightness. You may feel sick to your stomach, as if you have morning sickness.

Week 33

• 1. Fetal growth

  Subcutaneous fat increases and wrinkles disappear. As the subcutaneous fat increases, the redness of the skin fades and it becomes plump and beautiful. The white fat that accumulates under the fetus's skin provides energy and helps control its weight after birth. The internal organs are almost fully developed and the vellus hair on the skin is almost gone. The fingernails grow long enough to reach the tips of the fingers. However, the toenails are not fully grown yet. Its hair has also grown quite thick. All the hormone-secreting glands in the fetus grow to almost the same size as an adult.

• 2. Maternal changes

  You may not get enough to eat because the uterus is close to the pubic bone and presses upward on the chest. Some pregnant women may need to use their entire upper body to breathe due to a rapid heartbeat and shortness of breath caused by pressure on the heart. The weight of the enlarged uterus can cause pain in the pubic bone or the connecting part of the pelvic bones and can lead to constipation and hemorrhoids. The abdomen bulges to the point where the navel protrudes, and as the abdomen becomes firmer, the frequency of urination also increases. As labor gets closer, irregular uterine contractions become more common.

Week 34

• 1. Fetal growth

  The fetus' position is almost fixed. Most fetuses at this stage are in a head-down position to prepare for delivery. However, some fetuses remain head-up until delivery. The fetus has less room to move, so its movements become more sluggish, such as wiggling more and kicking less. However, its body reacts to external stimuli. The fetus's sensory organs are quite developed, and it has the ability to react actively to stimuli. In some cases, the mother may notice a change in facial expression, such as when the baby smiles or gets angry. When the fetus is examined with an ultrasound, the mother may see it smiling.

• 2. Maternal changes

  As the fundus grows to about 30 cm, movement becomes slower and more languid due to the severe lower back pain, making daily life difficult. Your buttocks and pelvis may be uncomfortable and sore. The uterus presses on the bladder, causing increased frequency of urination, and a feeling of residual urine after urinating. Vaginal discharge becomes thicker and contains more mucus. Your ankles and feet will swell more, along with your hands and face. You may experience cramps or pain in your feet and may even experience cramps in your calves while you sleep. As pigmentation worsens, dark lines become noticeably darker.

Week 35

• 1. Fetal growth

  The fetus’ body shape is similar to that of a newborn. It reaches a size of 45 to 46 cm and a weight of 2.3 to 2.6 kg, which is almost the same as that of a newborn baby. Vernix caseosa, a substance that protects the skin, also becomes very thick. The external genitalia are fully developed and the distinction between male and female is clearly defined. The toenails also grow all the way to the end. Most of the functions of the internal organs, except the lungs, are fully mature. Fetuses at this stage may have some breathing problems at birth, but most survive and can live healthily.

• 2. Maternal changes

  The inconveniences of life grow. Although you may feel relieved that it's almost time to give birth, you may also feel anxious and impatient. These feelings mean you may feel irritable and overly sensitive. Your blank feelings may worsen, and symptoms such as nosebleeds, nasal congestion, ear congestion, and anemia may occur. As your gums weaken, they may be bleeding. Appetite frequently increases and decreases, and physical discomfort such as headaches, dizziness, and vertigo increases.

Week 36

• 1. Fetal growth

  Internal organs function more smoothly, weight gain increases, and muscles develop considerably. As the time of birth approaches, its head gradually moves into the pelvis. This causes its body to become immobile and movements to become increasingly slower. Immunity is passed from the mother to the fetus through the placenta, and the fetus awaits birth.

• 2. Maternal changes

  When the fetus descends into the pelvis, the pressure on your lungs is relieved, making it easier to breathe and reducing pressure on your stomach. This also improves appetite. When your belly grows, you may experience back strain and swelling. Since the fetus is not always born on its due date, if your uterine contractions are recurring, you need to check the timing and pattern to see if they are occurring regularly and consult a nurse or midwife.

Week 37

• 1. Fetal growth

  The fetus skin becomes plump and fine wrinkles disappear. All organs, including the heart, liver, respiratory system, digestive system, and urinary system, are complete. The body has grown large enough to fill the uterus, and the back is curled up with the arms and legs in front. Resistance to infection is also strengthened, so there will be no problems with birth after this period. The fetus lanugo almost completely falls out, with only a little remaining on wrinkled areas of the body such as the shoulders, arms, and legs.

• 2. Maternal changes

  The cervix becomes softer to allow the baby to come out easily. The fetus head is gradually descending, causing frequent urination and tightness in the abdomen. Fetal movements are somewhat reduced but still energized. Skin pigmentation, breast engorgement, and the pregnancy line(linea nigra) become the most noticeable during this time. The cervix becomes more flexible and elastic as it moistens to allow the baby to come out more easily. Pregnant women during this stage often experience premature dilation of the cervix.

Week 38

• 1. Fetal growth

  The fetus body is four heads tall and has a face shape almost the same as that of a newborn. It has enough fat to regulate its own body temperature. After birth, the fetus fingernails grow long enough to cover the nails to prevent its face from being scratched and injured, and its hair also grows to about 3 cm. The fetus stores enzymes and hormones in preparation for life outside the uterus. The daily sleeping and waking rhythm is done in a 40-minute cycle.

• 2. Maternal changes

  Most fetuses are head down, with the head retracted into the pregnant woman’s pelvis, slowing fetal movements. This will greatly reduce the pressure or stuffiness above. However, the belly becomes heavier, making it difficult to move or sleep. If the fetus is too quiet or not moving, have someone put their ear to your belly, or gently touch your belly to see if it responds. If there is no response even after stimulation, go to the hospital immediately.

Week 39

• 1. Fetal growth

  The fetus is ready to come into the world! The fetus is about 50 cm tall, weighs about 3 kg, and has a head circumference of about 34 cm, which is equivalent to the weight of five large pears. The skin is shiny and pink, and it has little to no vernix caseosa. It is plump and its skin is shiny. It develops reflexes across the entire spectrum, enough to respond to sounds, smells, light, and touch. Its eyebrows become clearer, its limbs move more actively, and it starts to urinate and defecate.

• 2. Maternal changes

  As the fetus grows, your abdominal muscles will stretch tighter, hiding the umbilical indentation. When labor is approaching, abdominal pulling may become more frequent, but this does not mean that labor pains have begun. This is a prenatal symptom. If the contractions are irregular, it is not a cause for concern.

Week 40

It’s time to have a baby! As childbirth approaches, your body will show the following symptoms : The bloody show may appear, and regular contractions will begin. In some cases, labor occurs 2 to 3 days or up to a week after the bloody show. Usually, labor pains start first, then your water breaks, but the membranes can rupture before labor starts. If you are not sure whether it is urine or amniotic fluid, you need to go to the hospital right away to get examined.