The 37-week prenatal appointment marks a significant milestone, as the baby is officially considered full-term. This visit represents a shift in focus from long-term monitoring to immediate preparations for labor and delivery. These final appointments are designed to confirm the well-being of both the expectant mother and the baby, address any last-minute concerns, and solidify the birth plan. The transition to a more frequent check-up schedule reflects the body’s imminent changes.
Routine Checks and the Shift to Weekly Visits
The 37-week visit initiates the final phase of prenatal care, moving to a weekly schedule until delivery. This increased frequency allows the healthcare provider to closely monitor the rapidly changing dynamics of late pregnancy. Standard checks continue, including measuring maternal blood pressure and weight, which serve as ongoing screens for potential complications like preeclampsia.
A urine sample is typically collected to check for protein, an indicator of preeclampsia, and glucose, to monitor for late-stage gestational diabetes. The provider also measures the fundal height, the distance from the pubic bone to the top of the uterus, to ensure the baby’s growth remains on track. At 37 weeks, this measurement should approximate 37 centimeters.
Mandatory Screening: The Group B Strep Test
A mandatory procedure performed at or around 37 weeks is the screening for Group B Streptococcus (GBS) bacteria. GBS is a common bacterium that lives naturally in the gastrointestinal tract and the lower genital tract of many healthy adults, with an estimated 15 to 40 percent of pregnant people carrying it at any given time. While generally harmless to the mother, there is a small risk that the bacteria could be passed to the newborn during a vaginal birth, potentially causing serious infections like sepsis or pneumonia.
The screening involves a simple, painless swab of the lower vagina and the rectum, which is then sent to a lab for culture. This test is performed late in pregnancy because GBS colonization can fluctuate, and a result close to the delivery date is the most accurate predictor of the baby’s exposure risk. A positive result means the individual is a carrier, not that they are sick.
If the GBS culture is positive, the standard protocol is to administer intravenous antibiotics, typically penicillin, at the start of labor or when the water breaks. Receiving these antibiotics during labor significantly reduces the risk of the newborn developing an early-onset GBS infection. Treatment is not recommended before labor begins because the bacteria can quickly recolonize.
Assessing Labor Readiness and Fetal Position
A significant focus of the 37-week appointment is assessing the baby’s position, or presentation, to ensure optimal conditions for a vaginal delivery. The provider uses a physical examination, called palpation, to determine if the baby is head-down, known as cephalic presentation. If the presentation is uncertain, or if the baby appears to be in a breech (bottom or feet first) position, an ultrasound may be used to confirm the baby’s orientation.
If the baby is found to be breech, the provider will discuss options, which may include an attempt to manually turn the baby from the outside, a procedure called an external cephalic version (ECV). The provider may also offer a cervical check, which involves an internal examination to assess the cervix for dilation (opening) and effacement (thinning). This check is often optional at 37 weeks and is performed only with patient consent.
Cervical changes like early dilation and effacement indicate the body is preparing for labor, but these findings do not reliably predict when labor will begin. It is possible to be dilated for weeks without going into active labor. The primary purpose of this assessment is to understand the baseline condition of the cervix as the due date approaches.
Final Planning and When to Call
This final-stage appointment is an opportunity for a detailed discussion about the logistics of labor and delivery. The provider will review the signs of true labor, differentiating between Braxton Hicks contractions and regular, progressive contractions that signal the need to go to the hospital. Other signs, such as the water breaking or any significant vaginal bleeding, are also reviewed.
Fetal movement monitoring is also discussed, reinforcing the importance of daily kick counts, even though the baby has less space to move. The provider will give specific instructions on what constitutes a concerning decrease in movement and when to call the office or hospital immediately. This ensures the expectant parent knows the protocol for any sudden changes.
The provider will review the hospital’s admission process and any necessary final paperwork, answering questions about the birth plan. Establishing clear communication guidelines is paramount, so the patient is instructed on the exact circumstances and phone numbers to use when contacting the medical team once labor is underway. This preparation provides practical information and helps alleviate anxiety for the final weeks of pregnancy.