Physical changes in the ninth month of pregnancy
We’re down to the wire! You are now considered full-term and could deliver at any time. Sometime this month, your baby’s head will begin to settle downward, deep inside the pelvis, ready for birth. This is called “lightening,” and you will find it easier to breathe when this happens because there will be less pressure on your upper abdomen. However, the increased pressure on your bladder will make you want to urinate more often, if that’s possible!
Your Braxton Hicks contractions will become more frequent this month as the uterus makes its final preparations for birth. Electrical buzzes may run along your legs and vagina, caused by the baby hitting your nerves when she settles into the pelvis. You may feel heavy and weary, or you could get a sudden burst of energy and want to clean and decorate. The urge to get the house ready for your new arrival is called the “nesting instinct.”
You will notice changes in your baby’s activity because there is little room left in the uterus. There will be more squirming, less kicking, and a few hiccoughs! You may feel jabs from her feet and knees. You might feel sharp kicks under your ribs at one side or the other.
It is recommended that you keep track of your unborn baby’s kick counts from about six months of pregnancy, as a way of making sure that she is OK. Each day, record how long it takes for your baby to make 10 kicks, flutters, swishes, or rolls. You should feel at least 10 movements within two hours, but you will probably feel that many movements in a much shorter amount of time. Alternately, time how long it takes your baby to make three movements. You should feel at least three movements in a half hour.
You may start to notice patterns and a general length of time that baby usually takes to make a certain number of movements. If you notice major deviations from the pattern, check with your health care provider.
Medical visits in the ninth month of pregnancy
This month, you will have a medical visit once each week. Your health care provider will check the following:
- blood pressure
- fetal heartbeat
- height of the top of your uterus, called the fundus
- size and position of the baby
- swelling of ankles and feet, especially if accompanied by headaches, visual changes or abdominal pain, which are possible signs of pregnancy-induced hypertension
- cervix: to see if it has started to dilate or open
- frequency of Braxton Hicks contractions
Medical tests in the ninth month of pregnancy
It is recommended that all pregnant women between 35 and 37 weeks’ gestation undergo screening for group B streptococcus infection. This is a simple and painless test, where the doctor will swab your vagina and rectum to check for the presence of the bacteria.
For information about group B strep, see "Bacterial Infections in Pregnancy."
Your due date
Your due date is expected to fall within the 40th week of pregnancy. However, only 4% of women actually give birth on their due date. Most women deliver their babies in the two weeks before or after their due date. Keep aware of the early signs of labour:
- loss of your cervical mucous plug, which is a bloodstained gel-like plug in your uterus that seals off your cervix
- a slow trickle or maybe even a rush of water from your vagina
- strong contractions that become progressively closer and closer to each other and last longer and longer over time
Concerns in the ninth month of pregnancy
Bleeding this month may be a true emergency. Bleeding may be very mild or extremely heavy, and might be accompanied by abdominal pain. Causes of late pregnancy bleeding include problems with the placenta such as placenta previa, where the placenta covers the opening to the cervix, and placenta abruption, where the placenta comes away from the walls of the uterus. Another cause of bleeding in late pregnancy is rupture of the uterus. All of these conditions are very dangerous if not treated immediately. If you notice bleeding, which is more than spotting or blood on the toilet tissue when wiping, or abdominal pain this month, contact your health care provider right away.
If your baby has not arrived by the 40 th week of pregnancy, you may start to worry about overdue pregnancy. Rest assured that, usually, an overdue pregnancy is just the result of a miscalculated due date. You may feel heavy and weary at this point, so make sure to get lots of rest. Remember to do your kick counts as they can help you monitor your baby’s health. If your baby is truly overdue, you may need a nonstress test and/or an ultrasound to make sure the baby is still doing well, and your health care provider may need to induce labour.
Other things to consider in the ninth month of pregnancy
You may be apprehensive about your upcoming labour and delivery. Many times, educating yourself about the unknown can help ease your fears. If you have not already done so, you should take the time to learn about the three phases of labour and the basics about childbirth. Also find out about the possible interventions that may be needed during labour and delivery, such as:
- fetal monitoring
- pain relief
- forceps and vacuum extraction
- caesarean section
Emotional changes and depression in the third trimester of pregnancy
This is a trimester of pride, fulfillment, and anxious anticipation of the unknown. Thoughts about your baby are ever present, and you will probably talk constantly about her. You may ache to hold your baby. You might still worry about losing her.
The reality of pregnancy is inescapable now and your protruding belly will bring lots of attention. You will feel quite special, as strangers will want to give you their chair or help you in other ways. Some women appreciate these gestures, while others may feel annoyed if they are treated as though they are helpless.
You may need to stop working at some point this trimester. If work has been important to your self-esteem, you may find this to be a very difficult adjustment. Add to this the fact that you will have renewed energy this trimester, with an intense urge to bustle around and do things. You may wonder what you will do with your time if you stop working before your due date. There are lots of last-minute preparations to be made, though, and these should keep you occupied.
Body image is a major issue in the third trimester. Your belly may swell larger than you thought it would. You may feel unattractive and sloppy, and will need lots of reassurance from your partner.
If you are a first-time mother, the unknowns of labour and delivery may be frightening and worrisome. You might be concerned about “losing control” during the labour process. You may worry about unexpectedly having to deliver your baby at home. If you have had children before, you might be concerned about reliving the pain of childbirth or any previous complications you may have had.
The physical symptoms of pregnancy can lead to irritability, mood swings, and impatience to get on with the birth. These feelings are perfectly normal. However, if you feel continuously sad, hopeless, and resentful of the pregnancy, you could be depressed and you should seek help from your doctor. Depression symptoms in late pregnancy often carry over into the postpartum period, so it is important to get these feelings checked out.