Your Baby’s Development at 40 Weeks

At 40 weeks, a baby is about 14 1/4 inches (36.3 centimeters) from the top of their head to the bottom of their buttocks (known as the crown-rump length), and baby’s height may stretch over 20 inches (51.7 centimeters) from the top of their head to their heel (crown-heel length). This week, baby might weigh close to 8 pounds (3617 grams). Which Trimester? Third trimester How Many Weeks to Go? 0 weeks

Birth Weight and Length

Your newborn may measure in close to the averages above. However, its normal for a healthy newborn to be smaller or larger than those numbers. A healthy full-term baby can have a measure between 17 3/4 inches (45 centimeters) to nearly 22 inches (55 centimeters) long. It is also normal for a healthy newborn to weigh anywhere between 5 1/2 pounds (2,500 grams) to 10 pounds (4,500 grams).

Full Term

This week, your baby is right on target at 40 weeks, which is considered “full term.” Babies born at full term encounter fewer risks and generally have better health outcomes. Explore a few of your baby’s week 40 milestones in this interactive experience.

Your Newborn at Birth

After months of nothing more than occasional peeks at your little one via ultrasound, it’s time to get ready to meet your baby face-to-face.

Appearance

Your newborn might not look how you expect. Those perfect, plump babies in magazines are usually a few weeks old. Right after birth, newborns are wet and often show the signs of the birth they just experienced.

Baby’s skull will be soft and pliable, which allows for a smoother transition through the birth canal, but it can also leave them with a temporarily cone-shaped head if you deliver vaginally. Your new baby may sport some lingering vernix (the waxy, white substance that covers their skin in utero) and lanugo (the thin, soft hair that covers their skin in utero). Baby’s eyes may be quite swollen. Their hands and feet may be tinged blue. There may be white dots, acne, or a red rash on baby’s face or skin. Baby’s breasts and genitals may be swollen.

While the look of your baby may be a little strange at first, these variations in appearance are normal expectations in healthy newborns. As the hours and days go on, your baby will look more and more ready for their magazine cover shoot.

Baby’s Post-Birth Tests and Procedures

After baby is born, there are a few procedures and tests that will take place right away, and a few more that will take place during the first few days:

Skin-to-skin: Right after delivery, your healthcare provider may suction mucus and amniotic fluid out of your baby’s mouth and nose, dry the baby, and place them on your stomach or chest for skin-to-skin contact—and your first hug. If you don’t get to hold your baby right away, it is likely because they are showing signs of distress or you had a C-section, in which case they may need to be evaluated by a pediatrician first. Umbilical cord: Your partner or your healthcare provider will cut the umbilical cord officially separating baby from the placenta that’s nourished them throughout pregnancy. Weight and length: These initial measurements may be taken almost immediately after birth, or they may be delayed to facilitate skin-to-skin time for baby. These measurements will be repeated at every pediatrician visit going forward. APGAR score: Hospital or birth center staff will assess baby’s skin color, heart rate, respiratory effort, muscle tone, and reflexes; these assessments make up baby’s APGAR score. The APGAR score is measured at one to five minutes after your baby is born and can usually be done while baby is on your chest. Eye drops or ointment: Unless you decline, healthcare providers will apply erythromycin antibiotic eye drops or ointment to baby’s eyes to help prevent infection. 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. Hepatitis B vaccine: The American Academy of Pediatrics (AAP) recommends that all newborn babies receive the first dose of the hep B vaccine within 24 hours of birth. You will be asked to sign a parental consent form for this routine procedure. Hearing test: To test their hearing, baby’s ears are exposed to sounds through headphones while nodes placed on their 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. For these tests, your healthcare provider pricks baby’s heel to collect several drops of blood to test for up to roughly 50 different illnesses, including phenylketonuria (PKU), galactosemia, and congenital hypothyroidism. (What exactly is tested for varies by state.) Circumcision: If you decide to circumcise your child, the procedure will be offered in hospital within a day or two after birth. Is it possible, however, to delay or decline the procedure entirely. For example, many Jewish families delay circumcision until eight days after birth in a religious ceremony known as a bris milah. Many other families chose not to circumcise at all.

Your Common Symptoms This Week

At 40 weeks pregnant, you are full term, but if you do not have your baby this week, you aren’t alone. With babies coming on their own schedule more often than not, you might still find yourself still waiting on your little one’s arrival this week. Patience is definitely key. —Allison Hill, MD, OB/GYN When you do go into labor, you can expect to experience several stages:

The first stage includes early labor, active labor, and transition.The second stage is pushing and birth.The third stage is after baby’s birth with the delivery of the placenta.

Here’s a look at the parts of labor.

Early Labor

With early labor, you’ll experience telltale uterine contractions. With each contraction, your cervix continues to open (dilate) and thin (efface). Unlike Braxton Hicks, labor contractions don’t stop when you shift positions. They start in the back and move to the front of your abdomen, and they feel stronger than the “practice contractions” you’ve experienced until now. This early stage of labor can last a day or two, so call your doctor or clinic to let them know and get instructions. —Allison Hill, MD, OB/GYN

Active Labor

Active labor can start when the cervix is dilated anywhere from 3 to 6 centimeters. Once you enter the active stage of early labor, your cervix may dilate roughly 1 centimeter an hour. During active labor:

Contractions become more regular and occur closer together.Contractions are stronger, longer, and more painful.The baby is moving down toward the birth canal.

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 are strong and have consistently been three to five minutes apart for at least a few hours:

You can ask your partner to help you keep track of your contractions. You can do this with a notepad and timer or you may consider using a mobile app designed to make this task easier. Keep in contact with your healthcare provider to determine the best time for you to head to your chosen birth location. Keep anticipated travel time in mind when determining departure time, as traffic at certain times of day may make your trip a bit slower than you’d like.

Transition

Transition is the last part of the first stage of labor. It is commonly considered the hardest part, but its also often the shortest. During transition, contractions are long and intense. The time between contractions is short, so it’s difficult to rest or relax. This is a time when the cervix is opening to its widest point. During transition you may start uncomfortable shivering or develop nausea and start to vomit. Although unpleasant, this is usually entirely normal.

Full Dilation

When you reach full dilation or 10 centimeters, you enter the second stage of labor. The second stage can last anywhere from 20 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. If you have an epidural, however, the sensation may be dampened.

Pushing and Delivery

When it’s time to push, it may feel like you have to move your bowels. Your provider will help you know when it’s time to push. Each push helps to move the baby down the birth canal. During the pushing stage, your baby’s head will begin to emerge from your vagina with each contraction. When the baby’s head remains visible without slipping back inside, baby is crowning. Once your baby’s head is visible, you will continue to push as you or your provider helps guide your baby into the world. The second stage of labor ends with the birth of your baby. The second stage can take a little longer with an epidural than without one. However, it shouldn’t greatly impact your ability to push when it’s time.

Delivering the Placenta

After your baby is born, you’ll enter the final stage of labor: delivering the afterbirth or placenta. During this stage, you begin to have contractions again and you may have to push again. The placenta is usually delivered within 30 minutes, and your labor is over once it is out of your body.

Self-Care Tips

Self-care becomes even more important—and yes, often more complicated—as you prepare for labor and the birth of your baby as well as the transition from pregnancy to postpartum.

If You’re Still Waiting

If you’ve reached 40 weeks and you’re still waiting to meet your baby, the best advice is just to do your best to be patient. It may not be what you want to hear, but it’s important to remember that babies come when they’re ready. In the meantime, you can continue to try to encourage your baby to get into position and help get labor on its way by:

Going for walks Stimulating your nipples Having intercourse

Once Your Baby Arrives

Once your baby is here, it can become very easy to neglect your own needs. But remember, whether you had a Cesarean or vaginal birth, you’ll be recovering from one of the most physically and mentally demanding experiences a person can have. It will be important to honor that and ensure that you and your loved ones do what you can to support the recovery process. —Allison Hill, MD, OB/GYN

Supporting Your Physical Health

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 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 vulva and perineum 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 as constipation after giving birth is common. Drink plenty of fluid and eat high-fiber foods to prevent or ease constipation as well.

To soothe sore breasts:

Consider wearing nursing pads between feedings to shield sore nipples from rubbing against clothing. To reduce painful engorgement swelling, apply cold compresses on your breasts. Wear a comfortable, supportive bra. Talk to your doctor about using a safe pain medication, if needed.

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

Supporting Your Mental Health

Many new parents do not feel prepared for the postpartum period. Dealing with the physical recovery of childbirth and the change in healthcare support during this period can be overwhelming and can impact your mental health. Despite what you might see in commercials, you’d be hard-pressed to find a new parent who doesn’t experience bouts of crying following the birth of their baby. Postpartum blues (also known as the “baby blues”) are common in the first two weeks after delivery. However, symptoms that continue beyond those initial weeks or become more severe may be a sign of postpartum depression. While temporarily feeling blue postpartum is to be expected, experiencing postpartum depression or anxiety requires special attention. —Shara Marrero Brofman, PsyD Postpartum depression affects as many as 1 in 5 parents following birth. 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 weeksContinuously cryingFeeling unable to enjoy your baby; not wanting to spend time with babyExperiencing intense rageExperiencing anxious thoughts about your baby being hurtBeing unable to sleep when exhausted; wanting to sleep all the time; or sleeping more than usualPondering harming yourself, your baby, or othersExperiencing a dramatic shift in appetiteAssuming your family would be better off without you

Advice for Partners

Even though your pregnant 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.

Timing Contractions

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 start of one contraction and the start 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 once every hour).

Heading to the Hospital

You or partner should speak to the healthcare provider once you believe labor has started. Your doctor or midwife will give you instructions on when to head to the hospital. Don’t hesitate to go straight to the hospital if:

Your partner’s water has broken but they’re not experiencing any contractions.Your partner is experiencing vaginal bleeding.Your partner is in a lot of pain.The baby isn’t moving as much as before.

If you are unsure of what to do, go to the hospital or birthing center. The staff can evaluate the situation and decide if it’s time to be admitted or if you should go home and wait a little longer.

At the Hospital

Take direction from the hospital or birthing center staff, as well as your partner, when they’re in labor—and know that just being there and holding their hand (if that brings them 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).

Returning Home

Once your partner and baby are discharged from the hospital and you head home for the first time as a new family, you may feel uncertain of the best ways to help, especially if your partner is breastfeeding—a unique responsibility, should they choose to. Do what you can to help your partner focus on their own recovery, as well as the care of your newborn. Bring them water when they’re nursing. Change baby’s diaper. Learn how to burp baby after a feeding and how to swaddle them for soothing and sleep. Ask what supplies you can pick up at the store. Most of all, remember that in the days, weeks, and months ahead, you both 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 baby has siblings. Try to be patient with and understanding of each other—and yourself.

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.

Stripping the Membranes

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 this week.

Special Considerations

Chances are good that you just might meet your baby this week, but how you give birth will ultimately depend on a multitude of factors. Even if you plan to give birth vaginally, it can be helpful to be familiar with the alternative in case you’re faced with a change in plans. Postpartum Care The American College of Obstetricians and Gynecologists (ACOG) positions postpartum care as an ongoing process. After your care at birth, you should be in contact with your doctor within 3 weeks and you should see your doctor for a thorough postpartum exam no later than 12 weeks after the birth of your baby. Care should be individualized based on need and those with a high risk of postpartum depression or other health concerns should be in contact with their doctor and see their doctor sooner. During your comprehensive postpartum appointment, you can expect a:

Pelvic exam to make sure that your uterus, ovaries, and cervix have returned to their pre-pregnancy state Pap test to check for abnormal cervical cells Perineum exam to review swelling and/or episiotomy or tear recovery Breast exam to look for abnormal growths and blocked milk ducts Cesarean scar exam (if applicable) Postpartum depression screening

Your provider will also answer your questions about sex and birth control. Yes, it is physically possible to get pregnant very 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.

Chances of Childbirth This Week

Research suggests that you have a good chance of having your baby this week. In a large U.S. study of over 34 million births, 54% to 60% of those expecting had their baby between 39 and 40 weeks.

Cesarean Section

A cesarean section is a surgery to deliver a baby. With this surgical procedure, instead of going through the birth canal, the baby is born through an incision in the abdomen and uterus. About 32% of babies born in the United States arrive via Cesarean section (C-section). For some, the procedure is planned due to circumstances such as:

Prior C-section with no intention of attempting a VBAC (vaginal birth after Cesarean) Carrying multiples (twin pregnancy or more) Breech presentation Placenta previa Certain parental conditions or prior uterine surgery for which labor is not advised Personal preference

But for most people, a C-section is an unplanned change in plans due to unforeseen complications such as labor not moving along as it should or concerns for parent or baby’s health during the labor process. If you have a Cesarean birth, you can expect the following:

An 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 you’re being closely monitored. Your abdomen will be scrubbed with an antibiotic cleanser. 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 may 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 an incision in your abdomen through your skin, muscle, fat, peritoneum (lining of the abdominal cavity), uterus, and finally the amniotic sac. When it’s time to deliver the baby, you will feel pushing, pulling, pressure, and possible nausea, but no pain. Once your baby is delivered, they will be evaluated by a pediatrician. Most providers will bring the baby to you so you can see them first. Your healthcare provider will then deliver your placenta; inspect and clean your uterus; and close your incision, which is the longest part of the entire procedure. 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, your baby will join you bedside in recovery. Most likely, you will stay in the hospital for about four days. Your stitches or staples will likely be removed about 8 to 10 days after the surgery.

A Word From Verywell

As you near the end of your pregnancy journey, it can be tempting for all the focus to be on getting to the finish line, but if you can, take some time to reflect. Whether you basked in your pregnancy glow or struggled through challenges, try to appreciate these final moments with your baby before they are born. Most importantly, be sure to give yourself the credit you deserve for all the hard work your body has done growing and nourishing your baby-to-be, and embrace that strength as you transition to new parenthood.