38 Weeks pregnant: Baby development, symptoms and signs

Your body at week 38

Swollen ankles and feet 

Some swelling in the feet and ankles, which can get worse in the final weeks of pregnancy, is considered normal and doesn’t pose any medical risk to you or your baby [1]. It’s usually caused by your body retaining more water when pregnant and the extra pressure of your uterus, which affects blood flow to your extremities. Because of gravity, swelling tends to be the worst in your ankles and feet.

Resting with your feet and legs elevated, wearing comfortable shoes, and light exercise like walking or foot stretches can all help to relieve swelling and discomfort [1].

However, if you experience sudden swelling in your hands, face, or feet, contact your primary healthcare provider immediately as this might be a sign of preeclampsia [1]. Preeclampsia is a hypertensive disorder (relating to high blood pressure) that is estimated to occur in approximately 2-10% of pregnancies worldwide [2]. Though many cases are mild, it’s important to seek medical attention immediately because unmonitored, untreated preeclampsia can lead to serious complications for you and your baby [3].

Trouble sleeping

The majority of pregnant women suffer sleep disruptions in the third trimester, with over 98% reportedly not being able to sleep through the night [4]. There’s lots going on in your body that can affect your sleep —  discomfort in your legs, not being able to find a comfortable sleep position, needing to go to the bathroom frequently, fetal movements, and general stress and anxiety. Insomnia, which affects up to 80% of pregnant women, is also worse in the third trimester [4]. With a baby on the way, you might feel pressure to get some extra sleep while you can, and not being able to can feel frustrating and stressful!

During the day, insomnia can cause fatigue and mood changes, affecting relationships you have with a partner and close family and friends. Third-trimester sleep disturbances have also been tied to an increased perception of pain in labor, longer labor, and more assisted deliveries and cesarean sections [4]. For these reasons, it’s important to take insomnia and sleep disturbances seriously and contact your healthcare provider for help if needed. Try to prioritize rest when you can — even if it’s just lying down or closing your eyes for a bit during the day.

To ease the physical discomforts associated with pregnancy insomnia, you can try:

• Regular, gentle exercise: walking, prenatal pilates, and yoga can be great options if considered safe during your pregnancy
• Get some fresh air: time outside can relieve both physical and mental strain 
• Cool off: you might have also noticed you tend to get warm or hot, particularly in the evenings, so switching to lighter sleep clothes or bedding can help
• Load up on pillows: using extra pillows, or a pregnancy pillow, to support your belly or legs can make it easier to find a comfortable sleeping position. 
• Talk to someone: if you suspect stress or anxiety about labor, birth, or welcoming a newborn is the culprit of your insomnia, talk to your midwife, nurse, or OB-GYN to see if counseling or a support group is available [5].

Braxton Hicks contractions

In Week 38, you’re likely on alert for any contractions that indicate that labor has begun. Braxton Hicks contractions, commonly referred to as practice contractions, can be easily confused with labor contractions and there are some key differences to remember. Braxton Hicks contractions, which are more common in the third trimester, are irregular and don’t get closer together over time [6]. In contrast, labor contractions will get stronger and come more frequently at regular intervals. Braxton Hicks contractions can also go away completely and come back hours later. Once labor contractions begin, they won’t stop until you give birth. 

Your baby’s development at 38 weeks

At 38 weeks, you are nine months pregnant and your baby is considered term, even though your due date is not for another couple of weeks. Your baby is still growing and gaining weight, but the major organs are all fully functional. 

You might be wondering what your baby will look like — what color will their eyes and hair be? While this is exciting to think about and imagine, you likely won’t know the answer even when your baby is born! Eye color, in particular, tends to settle around six to nine months, while research has shown that hair color and texture can change during the first few years of your baby’s life [7, 8]. It is good to also remember that some newborns are born with lots of hair, and some might be almost bald, or have very fine hair.

At 38 weeks, your baby weighs around 6.25 to 7.5 pounds (2.8 to 3.4 kg) and is likely 17 to 20 inches (43.2 to 50.8 cm) long [9].

Signs of labor at 38 weeks

Because most low-risk, “normal” births happen between weeks 38 and 40, now is a good time to familiarize yourself with the early signs of labor. 

The earliest signs of labor are contractions, when the mucus that has been in your cervix throughout the pregnancy is discharged (sometimes referred to as a “show” or “bloody show”), and your water breaking [10]. You might also experience a backache, or heavy aching feeling in your back, and the need to go to the bathroom. 

• Contractions are tightenings of your uterine muscles that push the baby further into birthing position and dilate, or open, the cervix in preparation for delivery
• A “show” can be primarily mucus of a jelly-like consistency and but can also have some blood mixed in causing it to be pink or reddish in color [10]
• When your water breaks, also called the “rupture of membranes” in medical-speak, the amniotic sack holding the baby opens and amniotic fluid will come out of your vagina. This can happen all at once, like a rush of water, or it can trickle out more slowly. While a common sign of oncoming labor in movies and on TV, it’s important to remember that only about 8-12% of women actually experience water breaking as a first sign of going into labor [11,12].

The first stage of labor, when your cervix begins to dilate to 10 cm, can often take many hours, but it’s important to remember that labor can progress unexpectedly. Be sure to follow the medical advice of your healthcare team and monitor the progress of your contractions by taking note of the duration of the contractions and how frequent they come.

You should contact your midwife or maternity unit urgently if your water breaks, you experience any vaginal bleeding, and if you believe your baby is moving less than normal [10]. Similarly, contact your healthcare provider if you experience any severe pain in your belly, nausea and throwing up, trouble breathing, severe headache, blurred vision or changes to your vision, or dizziness [13].

Your 38-week checkup

At the end of your pregnancy, you’re likely seeing your doctor, midwife, or nurse frequently. If you have an appointment this week, you can expect that your healthcare provider will use a tape measure to measure your belly, take your blood pressure, test your urine for protein, check the baby’s position, and ask about your baby’s movements. If you have a low-risk, “normal” pregnancy with no underlying health conditions, you might not have an ultrasound. 

Your healthcare provider might also discuss birthing options with you. While your baby is fully developed and term at 38 weeks, your medical team will most likely recommend letting your body naturally go into labor [14]. However, if your examination or test results suggest that you or your baby are having a health problem, or if you have certain pre-existing conditions like diabetes or high blood pressure, your healthcare provider might suggest artificially inducing labor rather than waiting for labor to proceed naturally [15]. 

Tips in week 38 

• Getting to the hospital: if you plan to give birth at a maternity center or hospital, make sure you have a plan for getting there! Remember that you can go into labor at any time of day, and it’s not advised to drive yourself to the hospital for safety reasons. Making a transportation plan can help you stay calm when labor begins.
• Research baby feeding: whether you intend to breastfeed your newborn or know you will use formula, it’s good research ahead of time the various options, bottle-feeding basics, and tips for breastfeeding. Like birth plans, it’s important to try and be flexible in your approach and expect the unexpected. Familiarizing yourself with the basics of different feeding methods can help you feel more prepared and comfortable adjusting to your baby’s needs.
• Remember those pelvic floor exercises: gentle exercises to help strengthen the pelvic floor can help you manage pelvic discomfort and urinary incontinence in the final weeks of your pregnancy. The pelvic floor muscles also come under heavy pressure during childbirth, and studies have shown that exercises that strengthen these muscles can help during delivery and postpartum recovery [16].
• Learn about newborn screenings: after your baby is born, they will likely be seen by a nurse or doctor frequently in their first six months to receive important screenings, vaccinations, and well-being checkups. Familiarizing yourself with the recommended timeline and schedule of these appointments will help you know what to expect, and when. 
• Safety and first aid courses: consider taking an in-person or online infant CPR or first aid course. Knowing what to do in case of an emergency can help you feel more comfortable when you bring your newborn baby home from the hospital.

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