The 36-week prenatal appointment marks the beginning of the final phase of pregnancy care, transitioning from bi-weekly visits to a more frequent schedule. This visit occurs when the due date is near, prompting providers to focus on final preparations for delivery. The appointment combines routine physical checks with a time-sensitive screening test and detailed discussions about labor logistics. It sets the stage for the remaining weeks of gestation, ensuring both the parent and the baby are monitored closely.
Routine Physical Assessments
The appointment begins with standard checks to monitor the health of the parent and the progress of the pregnancy. Blood pressure and weight are measured to track changes and screen for conditions like preeclampsia. A urine sample is collected to look for protein, which can indicate blood pressure issues, or sugar, which may signal gestational diabetes concerns.
A provider will listen to the baby’s heart rate using a Doppler and measure the fundal height. This measurement helps gauge the baby’s growth, and at 36 weeks, the measurement in centimeters should generally correspond to the number of weeks of gestation. The baby’s position is also assessed through external palpation of the abdomen to determine if they are head-down for birth. The provider will also ask about fetal movement, reinforcing the practice of monitoring for a consistent level of activity.
The Group B Streptococcus Screening
The screening for Group B Streptococcus (GBS) bacteria is conducted between 36 and 37 weeks. GBS is a common bacterium that lives harmlessly in the gastrointestinal and lower genital tracts of up to 40% of people. The timing of this test is intentional because GBS colonization can be transient, meaning an earlier result may not be accurate near the time of delivery.
The screening procedure is simple and non-invasive, involving a cotton-tipped swab to collect a sample from the lower vagina and the rectum. This sample is sent to a lab for culture to determine if the bacteria grows.
If the result is positive, it means the bacteria is present, but the parent is not sick. A positive result indicates a risk that the baby could be exposed to GBS during a vaginal delivery, potentially leading to serious infection in the newborn.
To prevent this rare but serious complication, the standard protocol is to administer intravenous antibiotics during labor. The antibiotics must be given for at least four hours before the birth to effectively reduce the risk of transmission to the baby.
Essential Discussions on Labor and Delivery
A significant portion of the 36-week appointment is dedicated to finalizing the logistical aspects of labor and delivery. Providers review the signs of true labor, differentiating them from common late-pregnancy sensations like Braxton Hicks contractions. You will receive specific instructions on when to call the provider or go to the hospital, based on the frequency and intensity of contractions and whether the water has broken.
The discussion covers a review of any birth preferences or plans, allowing the provider to offer guidance based on medical history and hospital policies. Pain management options are discussed, including non-pharmacological methods, epidurals, and nitrous oxide. The provider will also confirm hospital logistics, such as pre-registration paperwork, to ensure a smoother admission process when labor begins.
What Happens After 36 Weeks
The 36-week visit marks a transition to a more frequent monitoring schedule for the final month of pregnancy. For most low-risk pregnancies, appointments shift from bi-weekly to weekly until the baby is born. This increase allows the care team to closely monitor for any sudden changes in the parent’s health or the baby’s well-being as the due date approaches.
The provider may begin to check the cervix for signs of dilation and effacement (thinning of the cervix) in preparation for labor. The term “full term” begins at 37 weeks, but the goal is to remain pregnant for at least 39 weeks for the best outcomes. If the pregnancy extends past the due date, additional monitoring, such as non-stress tests or biophysical profiles, may be ordered to assess the baby’s movement and overall health.