Mom and Baby at 31 Weeks Pregnant

BABY DEVELOPMENT

Your baby keeps packing on the weight and fat this week. At week 31 of pregnancy, your little bundle of joy weighs almost 3.3 pounds, and he/she might be as long as 16 inches from the top of the head to the bottom of the toes. (But there's a lot of variability between babies now.)

As more layers of fat accumulate underneath your baby's skin, he/she won't look as wrinkly as he/she did weeks ago. The skin is smoothing out, while the arms and legs start to fill out.
Space in your womb is getting more limited by pregnancy week 31. Your baby has less room to move around, but when he/she moves, the movements are strong. You may even gasp unexpectedly with your baby's sudden movement changes.
Around this week, many babies will have already turned into the head-down position for birth (the best position for a vaginal delivery). Only about one-fourth (25 percent) of babies remain in the breech position (head up and legs or buttocks near the bottom of the cervix). Fortunately, a majority of babies will turn before it is time for delivery.
By 31 weeks pregnant, your baby has an established cycle of sleeping and waking. He/she alternates between periods of quiet rest, REM sleep, being awake with activity but no eye movement, and being awake with lots of activity and eye movement.
Now that you're in the third trimester of pregnancy, with less than nine weeks left to go before your due date, your baby's movements and actions are more coordinated than before.

Fun Fact:

Your baby's skin is still covered by fine lanugo hair and vernix at pregnancy week 31, but most of this will be shed before he/she is born.

MOM'S CHANGES

What an exciting journey it's been! You only have nine weeks left to go before your due date, and only six more weeks until your baby is full-term. From this point onward, you should expect to feel Braxton Hicks contractions more frequently. These false labor pains, which are essentially the muscles in your uterus tightening, will occur more frequently in the third trimester. They often only last about 30 seconds and they should be irregular.

Call your doctor right away if you start to feel contractions that come at regular intervals, get closer and more intense as time passes. This could be a sign of preterm labor. Other signs of preterm labor that you may want to be aware of include an increase in vaginal discharge (including discharge that becomes watery, mucous-like or is tinged with blood), abdominal pain or menstrual-like cramps, pressure in your pelvic area (or sensation that something is pressing down), and low back pain. Discuss anything unusual with your doctor right away.

Now that you've reached 31 weeks pregnant, your uterus is 4.5 inches above your belly button. You are bigger than you've ever been. Your pregnancy weight gain may be as high as 20 or 25 pounds, and if you're carrying twins, you might have gained upwards of 30 pounds already. You don't stop growing anytime soon - you should expect to gain at least five more pounds before your baby is born.

Your belly button may have already "popped" by pregnancy week 31. A protruding belly button is absolutely normal, and even cute. It's caused by the pressure of your growing uterus against your belly. Celebrate this pregnancy change while you can. Your belly button will go back to its pre-pregnancy appearance after your baby is born.

With your baby's due date approaching, you may notice that your breasts are leaking colostrum, or "pre-milk." This is nothing to worry about. Colostrum will nourish your newborn within the first few days of life. It may look clear in color, or slightly yellow or even orange. If the leaking bothers you, tuck some nursing pads in your bra to soak it up.

Other breast changes that you may notice in the third trimester include fuller, heavier breasts than before. You may want to also consider switching to a nursing bra to give you more comfort.

Helpful Tip:

If you're pregnant with a little boy, this may be a great week to research the pros and cons of circumcising your baby.

PREGNANCY 411

Overview of Your Delivery Options

Even though your baby won't be full-term for six more weeks, this is a good time to start thinking about what kind of labor and delivery you want to have. In the United States, there are only two methods of childbirth: a vaginal birth or a cesarean section. In most cases, you can choose how to give birth. It's only in emergency situations that you don't get to decide.

A majority of babies in the United States are born vaginally. Around 32 percent are born via c-section (both planned and emergency), and this rate increases every year. If you choose a vaginal birth, your labor starts with a dilated cervix (10 centimeters is considered fully dilated) and it ends with your baby passing through the birth canal into the world. With a vaginal delivery, you can choose to go all natural without any pain medications, or you can have a medicated labor and delivery.

Not all women decide to have a vaginal birth. Perhaps they are worried about the fear of childbirth, or they want more control of when the baby arrives. In these cases, they can choose to have a planned cesarean section - which is basically surgical removal of the baby. Sometimes, a planned cesarean may be a better option due to medical problems (such as placenta previa, an STD, a large sized baby, etc).

When you have a c-section, you will be given an epidural or spinal block to numb the lower half of your body. You will be conscious the entire time. A screen will be placed above your waist so that you don't have to see the incision being made. You'll be able to see your baby after he/she is born.

There are pros and cons for each method.

For a vaginal delivery, the pros include a shorter hospital stay, a quicker postpartum recovery time, and your baby is at decreased for persistent pulmonary hypertension, and he/she is less likely to face newborn respiratory problems, such as fluid in the lungs.

On the other side, delivering vaginally puts you at risk for perineum tearing, and your baby faces a small risk of physical trauma (such as mild bruising and swelling) from the birth canal.

With a planned cesarean, which is typically performed at 39 weeks of pregnancy, your baby faces the risk of being delivered premature if your due date was miscalculated. He/she also faces more newborn respiratory problems, and he may also be nicked or cut by the doctor's scalpel. After a c-section, you may be at risk for health complications, such as blood clots, hemorrhage, numbness or pain in the area of the incision, and potential heart attacks.

On the plus side, a planned cesarean section gives you more control over your baby's birthday, and you're at decreased risk of a pelvic floor injury and urinary incontinence.

In some cases, you may not be able to choose how you deliver. You may need to have an emergency c-section if your baby does into fetal distress, your cervix stops dilating or your baby has stopped progressing down the birth canal, if the umbilical cord slips through the cervix into the vagina, and if you experience placental abruption.

Fortunately in most cases, your labor will be uncomplicated and you will get to choose your method of delivery.

Dr. James W. Brann, M.D., is a retired obstetrician and gynecologist and editor of Women's Healthcare Topics. When you read "Mom and Baby at 31 Weeks Pregnant," you know it is accurate and has been approved by an experienced obstetrician/gynecologist. Dr. Brann has written many articles about 31 weeks pregnant that are great references.

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