Ninth month is the last part of Pregnancy and is considered full term. In some ways, these final few weeks are a bit like the first three. Aches and discomforts in the belly and back are more common. At 9 months pregnant, the woman feels big, heavy, tired, weary and impatient. Feeling uncomfortable might even make it fidgety sitting or lying down. The woman may be getting tired of pregnancy and eager to move on to the next stage. At times, there may also be an experience of a surge in energy, as the body prepares for birth. Thus, the ninth month could be physically and emotionally challenging. As the end of pregnancy is nearing, here are some facts that may help on what to expect in the meantime.

Physical changes in the ninth month of pregnancy:

• The baby is now fully formed and continues to grow and change getting ready for life outside the womb. The baby is probably around 20 inches long and weighs between 1.918 – 2.622 kg. The baby gains weight until he/she is born, mostly accumulating fat around the elbows, knees and shoulders. Eyes and pupils are more developed. The brain continues to grow and develop until delivery. Bones have hardened but the skull remains soft to make way through the birth canal. Reflexes are coordinated to blink, grasp and muscles are well toned to turn the head. Head is covered with hair and nails grow till finger tips. Less vernix is found on the body now and the downy lanugo has most probably disappeared. Baby’s chest becomes more prominent. For boys, the testes start to descend into the scrotum, and for girls, the labia starts covering the clitoris.

• To prepare for birth, the baby’s head might start descending into the pelvis and settle downward. The pregnant belly looks more protruded and can feel the baby dropped down. If this happens, there will be less pressure on the upper abdomen allowing the mother to breathe easier. This may also relieve constipation and heartburn, which may otherwise be more common earlier in pregnancy. This overall better feeling is called “lightening”. At the same time, the baby’s head down may increase the pressure on the mother’s urinary bladder, urging frequent urination. It is to be noted that some babies don’t drop down until the very end of pregnancy.

• The baby occupies most of the amniotic sac and the crowded conditions inside the uterus might give less activity for the baby. With the little room left, there will still be more squirming, less kicking, few hiccoughs, some rolling, wiggles and stretches. There may be occasional jabs from the baby’s feet and knees under the ribs on one side or the other if the baby is already head down. The mother may observe patterns and a general length of time that baby usually takes to make a certain number of movements. It is recommended to keep track of the baby’s kick counts mainly towards the end of pregnancy to make sure that they are normal. A record of how long it takes for the baby to make 10 kicks, flutters, swishes or rolls each day would help monitor baby’s activity. At least 10 movements within two hours is considered normal but that many movements may be felt in a much shorter amount of time. Alternately, to time how long it takes for the baby to make three movements can be noted. A minimum of three movements in half hour would be a regular pattern. Major deviations require immediate report to the gynaecologist.

• As the uterus makes the final preparation for birth this month, Braxton Hicks contractions will become more frequent. Braxton Hicks contractions are sporadic contractions and relaxation of the uterine muscle. Sometimes, they are referred to as prodromal or “false labour” pains. Electrical buzzes may run along the legs and vagina, caused by the baby hitting the nerves when they settle into the pelvis.

• The breast nipples and areola become darker with little oozing of colostrum, a yellow fluid that becomes the baby’s first food.

• The expanding uterus leads to tearing of the skin tissues, creating visible stretch marks.

• Due to the hormonal changes, the mother may have more beautiful and fuller hair.

• The pregnancy line called the Linea nigra that runs from the belly button to the pubic hairline, becomes darker due to skin pigmentation.

Emotional changes in the ninth month of pregnancy

Physical changes during pregnancy affect sleep and mental state. Day to day activities ranging from getting up out of a chair to trying to get sleep at night, everything may seem like a chore now. It is common to feel uncomfortable a lot of the time and feel very done being pregnant. Some women also report having strange dreams during these last few weeks of pregnancy due to the apprehension of the nearing due date. Some of the common emotional disturbances during the last month of pregnancy are:

• Mood swings, stress and anxiety
• Insomnia
• Absent-mindedness and forgetfulness
• Nesting instincts start to surface as the mother gets ready for the arrival of the baby. The urge to clean and organize is known as nesting. Nesting during pregnancy is the overwhelming desire to get the home ready for the new baby. The nesting instinct is strongest in the later weeks coming upon delivery.

Symptoms of going in to labour

• Period-like cramps
• Constant backache
• Diarrhoea
• The walls of the vagina and the cervix soften, resulting in increased vaginal discharge to prevent any bacteria from reaching the uterus through the birthing canal

• A small bloodstained discharge called a “show”
• A gush or trickle of water as the membranes break
• Contractions
• The expulsion of the mucus plug, which acts as a shield to the vagina, before delivery indicates that labour is very close.

Pregnancy though is usually a time of excitement, towards the end of pregnancy, pregnant women and their partners may feel like they’re expecting a bundle of anxiety along with the joy. They may have a long list of to-dos. They have to cope with the changes and unknowns that come with pregnancy and birth. It is a crucial role in ensuring that the mother gets the support she needs, both physically and emotionally during this life-changing time. Try to remain positive as looking forward to the end of pregnancy. Attend all medical examinations and stay in constant touch with the consultant gynecologist to discuss all the concerns and clarifications regarding labour and birthing.

ours with lots of love

Dr Manu Lakshmi ( Best Gynecologist in Chennai)

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