The 38-week prenatal appointment confirms the transition into full-term status and signals the start of weekly visits until delivery. This consultation focuses on ensuring maternal and fetal well-being while preparing for the imminent onset of labor. Your healthcare provider will monitor the baby’s status and engage in detailed discussions to ensure you are ready for birth. This visit is a chance to solidify plans and address any last-minute questions.
Routine Checks and Measurements
The appointment begins with standard physical assessments to track your health and the baby’s continued growth. Your blood pressure is measured to screen for conditions like preeclampsia, and a urine sample is analyzed for protein or sugar. Monitoring protein in the urine is important at this stage as a marker for potential blood pressure issues.
The provider will measure your fundal height, the distance from your pubic bone to the top of your uterus, to estimate the baby’s size and growth trajectory. They will use a handheld Doppler to confirm the baby’s heart rate. Discussions will cover fetal movement, including kick counts and any change in the baby’s activity level, which indicates well-being. Sometimes, a quick bedside ultrasound may be used to confirm the baby’s position or assess the volume of amniotic fluid.
Assessing Labor Readiness
A primary component of this appointment involves assessing your body’s progression toward labor. Your provider will perform an abdominal palpation to determine the baby’s presentation, checking if the baby is head-down (cephalic presentation) and if the head has begun to descend into the pelvis (engagement). If the baby is not head-down, options for external cephalic version (ECV) or planning for a cesarean delivery may be discussed.
A cervical or pelvic exam may be offered to check for signs of effacement (thinning of the cervix) and dilation (opening of the cervix). This internal check also determines the station, or how far the baby’s head has moved down into the pelvis. This exam is optional, and the results do not accurately predict the exact timing of labor.
Group B Streptococcus (GBS) Review
The results of the GBS test, performed between 35 and 37 weeks, will be reviewed. If the culture was positive, your provider will confirm that intravenous antibiotics will be administered during labor to prevent transmission of the bacteria to the newborn.
Finalizing Birth Planning
The 38-week visit is the time to finalize the logistical and medical aspects of your birth plan. This includes reviewing the signs of true labor, differentiating them from late-pregnancy discomforts like Braxton Hicks contractions. You will receive specific instructions on when to call the clinic or head to the hospital, typically based on the frequency of contractions or if your water breaks.
You and your provider will discuss pain management options, reviewing the details of an epidural or strategies for unmedicated labor, ensuring your preferences are documented. This is also the time to confirm preferences regarding interventions, such as continuous fetal monitoring or the timing of pushing. Logistics like the hospital’s admission process and who is allowed in the delivery room will be confirmed to avoid confusion during active labor.
Managing Prolonged Pregnancy
The provider will outline the timeline and procedures for a potential induction if you go past 40 or 41 weeks. Setting expectations for a prolonged pregnancy is an important discussion point to manage post-term care.