Week 40 of Your Pregnancy

A look at your body, your baby, and more

Welcome to week 40 of your pregnancy. Congratulations! Hopefully, you’ll be welcoming your brand-new baby this week. Whether that happens or you find yourself overdue, the road ahead is a short one. Though pregnant women are all obviously aware that labor and delivery are eventual, the feelings that come with the reality of "the big day" can take many by surprise.

week 40 pregnancy highlights
Illustration by Verywell

Your Trimester: Third trimester

Weeks to Go: 0

You This Week

At 40 weeks pregnant, you are definitely full term. However, know that if you do not have your baby this week, you are not alone. In fact, “only 19 percent of women actually go into labor during week 40, with 14 percent going into labor at 41 weeks or more,” says Allison Hill, M.D., author of Your Pregnancy, Your Way and co-author of The Mommy Docs’ Ultimate Guide to Pregnancy and Birth.

If you go into labor this week, you’ll experience telltale uterine contractions. However, in early labor, many women are unsure if they are experiencing true contractions or Braxton Hicks. “The early (latent) phase of labor can consist of irregular, not-very-painful contractions that last 30 to 45 seconds,” says Dr. Hill. “But it can also consist of painful contractions from the get-go.”

Either way, with each contraction, your cervix continues to open (dilate) and thin (efface). Unlike Braxton Hicks, labor contractions don’t stop once you shift positions. They start in the back and move to the front of your abdomen, and they feel stronger than practice contractions.

Since this early stage of labor can last a day or two, it’s best to go about your day as best you can.

Active Labor

Once you enter the active stage of early labor, your cervix dilates roughly 1 centimeter an hour. In order to accomplish that, your contractions become more regular; move closer together (every two to three minutes); last longer (60 to 90 seconds); and become significantly more intense.

You’ll want to make your way to the hospital or birthing center at some point during this stage of labor. Dr. Hill recommends going when contractions have been three to five minutes apart for at least a few hours. (You can ask your partner to help you keep track with a notepad and timer, or you may consider using a mobile app designed to make this task much simpler.)

But, of course, keep in contact with your healthcare provider to make the best decision for yourself. Keep anticipated travel time in mind when making your decision, as traffic at certain times of day may make your trip a bit slower than you’d like.

The active stage of labor is capped with what’s dubbed transition. While this is the shortest part of labor, lasting 30 to 90 minutes, it’s also the hardest. Now, intense contractions occur every one to two minutes. They’re working to get you to the second stage of labor, marked by full cervical dilation (10 centimeters), slowed contractions, and pushing. The second stage can last anywhere from a few minutes to a few hours.

You'll feel the pressure of your baby’s head between your legs along with a strong urge to push; be sure to wait for your healthcare practitioner’s direction to start doing so. If you have an epidural, however, the sensation will be dampened. While this may extend the birthing process, it likely won’t greatly impact your ability to push when it’s time.

Pushing

During the pushing stage, your baby’s head will begin to emerge from your vagina with each contraction. Once baby’s head remains visible without slipping back inside, he or she is crowning. This phase, full of hard work, ends with a sweet reward: In most cases, you'll see your son or daughter within the hour.

Delivering the Placenta

After your baby is born, you’ll enter the third and final stage of labor: delivering your placenta. To help with the process, you may want to nurse your baby. This helps your uterus contract and expel your placenta.

It’s important to remember that no two birthing experiences are the same. While your curiosity may be satisfied by hearing others’ stories, your experience (how you deliver, how long it takes, and more) will be your own.

Your Baby This Week

Your newborn very likely measures between 19 and 21 inches long and weighs about 6¾ to 10 pounds, but he or she might not look like you expect.

First, baby’s skull is soft and pliable. This allows for a smoother transition through the birth canal, but it can also leave him or her with a cone-shaped head if you deliver vaginally. This will generally revert to round after a few days, but the soft spots called fontanelles will remain for three to 15 months.

Your new baby may also sport some lingering vernix and lanugo; his or her eyes may be quite swollen; baby’s hands and feet may be tinged blue; and/or there may be bits of red discoloration (called nevus simplex) on baby’s forehead, eyelids, and/or on the back of baby’s neck. All are perfectly normal.

Right after delivery, your healthcare provider may suction mucus and amniotic fluid out of your baby’s mouth and nose and place him or her on your stomach or chest for skin-to-skin contact—and your first hug. If that latter doesn’t happen right away, it is likely because the baby shows signs of distress or you had a C-section; babies born in this manner need to be evaluated by a pediatrician first.

Your partner or your healthcare provider will then cut the umbilical cord. Finally, some screening tests and procedures will be performed. Some occur over the next few minutes or hours, others over baby’s first days, such as:

  • Weight and length: These measurements are taken almost immediately after birth.
  • Apgar score, which assesses baby’s skin color, heart rate, respiratory effort, muscle tone, and reflexes. This once-over is performed just one minute after your baby is born.
  • Eye drops or ointment: Most often, healthcare providers use erythromycin antibiotic eye drops or ointment to help prevent infection. (Exactly when it’s given is often dictated by state law.)
  • Vitamin K injection: Usually given within six hours of birth, a vitamin K injection is important to ensure proper blood clotting, which reduces baby’s risk of brain and other bleeding. (Your state may or may not mandate this.)
  • Hepatitis B vaccine: The American Academy of Pediatrics recommends that all new babies receive this shot within 24 hours of birth. You will be asked to sign a parental consent form for this to be administered to your new daughter or son.
  • Hearing test: Baby’s ears are exposed to sounds through headphones; nodes placed on his or her head determine how well the tones are heard.
  • PKU test: This is also called the newborn screening test and it’s most likely performed when your baby is between 24- to 48-hours old. Here, your healthcare provider pricks baby’s heel in order to test several drops of blood for up to roughly 50 different illnesses, including PKU, or phenylketonuria, galactosemia, and congenital hypothyroidism. (What exactly is tested for varies by state.)
  • Circumcision: If you decide to circumcise your son, the procedure will likely occur within a day or two after birth.

At Your Doctor’s Office

If you find yourself still pregnant and at your physician or midwife’s office this week, hang in there. Know that you are not officially considered post-term until you are 42 weeks pregnant. Due dates are not an exact science; things like irregular periods and an inaccurate menstrual history can throw off delivery-day calculations.

Regardless, your healthcare provider may offer to strip your membranes in an effort to kickstart labor at your visit. “One of the most common reasons that your baby has not come out yet is that he or she may not be in the proper position,” says Dr. Hill. “Encourage your baby to drop into the pelvis by staying active, going on walks, and gently stretching your hip and groin.”

If you don’t go into labor within a week, you’ll likely have a non-stress test and/or a biophysical profile (BPP) to check on baby’s heart rate, movement, and overall wellbeing. Your healthcare provider will review the results to determine if an induction is advised.

Special Considerations

About 32 percent of babies born in the United States arrive via Cesarean section (C-section). For some women, the procedure is planned due to circumstances such as:

But for most women, unforeseen complications during labor prompt the decision to deliver by way of C-section.

C-Section: Step-by-Step

Here is what can be expected during and after the surgery:

  • The anesthesiologist will give you an epidural or spinal, if you haven’t already had one. Beware that this anesthesia may affect your ability to sense your muscles moving, leaving you with a sensation that you are not able to take deep breaths. Try not to panic: You are breathing just fine (and being monitored).
  • Your abdomen will be scrubbed with an antibiotic cleaner.
  • Drapes and curtains will be placed over and around you to stave off infection and shield you from witnessing the surgery, if that’s your preference. (Some birthing facilities offer clear drapes, if you desire them.)
  • Your arms will be loosely strapped to armrests placed away from your body. (This is simply to remind you not to touch any part of your belly that has been sterilized.)
  • Once you’re numb, your healthcare provider will make a four-inch incision above your pubic hairline, through your skin, muscle, fat, peritoneum (lining of the abdominal cavity), uterus, and finally the amniotic sac.
  • Your healthcare provider will also cauterize blood vessels to help prevent excessive blood loss, and he or she will take steps to protect your bladder from damage.
  • When it’s time to deliver the baby, you will feel pushing, pulling, pressure, and possible nausea, but not pain.
  • Once your baby is delivered, he or she will be evaluated by a pediatrician. Most practitioners will bring the baby to you so you can see him or her first.
  • All the while, your healthcare provider will manually remove your placenta; inspect and clean your uterus; and close your incision, which is the longest part of the entire procedure. (The incision can be closed with staples, sutures, or glue.)
  • Once your incision is closed, you will spend roughly one hour in the recovery room before being sent to your postpartum room. Unless your baby is being monitored or treated, or your hospital or birthing center has another policy, he or she will join you bedside.
  • Most likely, you will stay in the hospital for about four days.
  • Before you are discharged, any stitches or staples will likely be removed. (If a dissolvable option was used, this won’t apply to you.)

Upcoming Doctor’s Visits

The American College of Obstetricians and Gynecologists recommends that you schedule your postpartum care visit within six weeks of delivery. (For women at high risk of postpartum depression, a one- to two-week follow-up appointment is encouraged.)

During your appointment, you can expect a:

Your practitioner will also advise you on contraception and resuming intercourse; yes, it is physically possible to get pregnant soon after birth.

Take this opportunity to also talk about your labor and delivery, and clear up any questions you may have. Share how you are feeling both physically and emotionally as a new parent. Don’t hesitate to review any lingering pregnancy-related health issues such as hemorrhoids, varicose veins, and skin changes. And bring up any issues that may have recently cropped up, like urinary or anal stress incontinence.

Taking Care

Once your baby is here, it can become very easy to neglect your own needs. But remember, whether you had a Cesarean or a vaginal birth, you’re recovering from what may be the most harrowing event that your body has ever been through. Honor that and help ease the recovery process as best you can.

To ease vaginal and perineum pain:

  • Use an anesthetic spray to numb the area.
  • Soak your bottom in a warm sitz bath to soothe soreness.
  • Wear frozen maxi pads. (Soak a pad with witch hazel and squirt aloe vera gel down the center. Fold and place in a zipped bag inside the freezer.) Use as needed for 10 to 20 minutes at a time.
  • Sit on a doughnut cushion to take pressure off your sensitive perineum area.
  • Ask your healthcare provider about taking ibuprofen to ease pain, cramping, and post-birth bleeding.

To make using the bathroom easier:

  • Use a peri bottle to indirectly squirt lukewarm water on your body as you pee to cool the sting. You can use this in lieu of toilet paper after urinating.
  • Ask your healthcare provider about taking a gentle stool softener; constipation after giving birth is common.
  • Drink plenty of fluid and eat high-fiber foods to ease constipation as well.

To soothe sore breasts:

  • Consider wearing nursing pads to shield sore nipples from rubbing against clothing.
  • Massage a small amount of modified lanolin ointment or expressed breast milk on your nipples after nursing to help heal soreness.
  • To reduce painful engorgement swelling, apply cold compresses on your breasts for 10 minutes after nursing.

In addition, if you experience any worrisome physical symptoms, such fever, excessive bleeding, an inflamed C-section scar, or more, do not wait until your postpartum checkup to seek care and guidance from your physician or midwife.

Your Mental Health

At the same time, don’t neglect your mental health. While feeling blue postpartum is to be expected (and temporary), experiencing postpartum depression or anxiety requires special attention.

Despite what you might see in commercials, you’d be hard-pressed to find a new mom who doesn’t cry. Postpartum blues are common in the first two weeks after delivery. However, symptoms that continue beyond that or that become more severe may be a sign of postpartum depression. “It's not what you’re feeling, exactly. It's how often you feel it, how long you’ve been feeling that way, and how much it interferes with your everyday functioning,” says Shara Marrero Brofman, PsyD, a reproductive and perinatal psychologist at the Seleni Institute, a nonprofit organization that specializes in women’s maternal and reproductive mental health.

If you are experiencing one or more of the following symptoms, seek the help of your healthcare provider as soon as possible:

  • Feeling weepy and overwhelmed for longer than three weeks
  • Continuously crying
  • Feeling unable to enjoy your baby; not wanting to spend time with baby
  • Experiencing intense rage
  • Experiencing anxious thoughts about your baby being hurt
  • Being unable to sleep when exhausted; wanting to sleep all the time; sleeping more than usual
  • Pondering harming yourself, your baby, or others
  • Experiencing a dramatic shift in appetite
  • Assuming your family would be better off without you

For Partners

Even though your partner is doing the heavy lifting of labor and delivery, you’re still a key part of the whole process, especially when it comes to offering encouragement and support; timing contractions; and helping to gauge when it’s time to go to the hospital or birthing center.

Remember to time contractions by the second, using the stopwatch feature on your phone or an app. You’ll time each of your partner’s contractions from start to finish to figure out how long the contractions are. Next, you’ll time the distance between the end of one contraction and the beginning of the next. This is how far apart your partner’s contractions are. Record all of this information and repeat the process a few times to check for regularity.

Do yourself and your pregnant partner a favor and refrain from timing every contraction. Only do it when there appears to have been a change (and/or every hour). It’s a good idea to get your partner to the hospital or birthing center when contractions last for 45 to 60 seconds and are three to five minutes apart for at least a few hours. If this is not your partner’s first baby, head to your destination when contractions occur every five to seven minutes.

Take direction from the hospital or birthing center staff, as well as your partner, when she’s in labor—and know that just being there and holding her hand, if that brings her comfort, may be the best thing you can do in that moment. If you prefer not to see the actual birth, voice that to staff so you can be positioned at the head of the bed (or elsewhere).

Once baby arrives and you return home, you may feel uncertain of the best ways to help, especially if your partner is breastfeeding—something that is uniquely Mom’s responsibility, should she choose to take it on. Do what you can to help your partner focus on her own recovery, as well as the care of your newborn. Bring her water when she’s nursing. Change baby’s diaper. Offer to give your son or daughter a bottle. Ask what supplies you can pick up at the store.

Most of all, remember that in the days, weeks, and months ahead, the pair of you will be working to learn the ins and outs of your newborn, parenthood, and perhaps even life as a family of four, five, or more, if the baby is a sibling. Try to be patient with and understanding of each other—and yourself.

Verywell Checklist

  • Continue taking prenatal vitamins (even after birth if you are breastfeeding).
  • Continue drinking about eight to 12 glasses of water a day.
  • Continue doing your Kegel exercises daily (helpful for birth and your recovery).
  • Continue doing your daily perineal massages (unless you've already delivered).
  • Review how to time contractions.
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