Your Pregnancy - Week 33

You are now 33 weeks pregnant, which is the beginning of week 34. Your baby weighs about 2.1kg (2,100 grams or 4 lbs 10 oz) and measures about 45 cm in length (17.75 inches).
Your baby is now fully formed physically and has a firm grasp reflex. They can also determine the difference between sweet and sour tastes. Premature babies born as early as 33 weeks have been observed to suck harder on a teat dipped in glucose. However, even unborn babies can detect subtle changes in the flavour of the amniotic fluid they float in. It is believed this fluid acts as a 'flavour bridge' to their mother's breast milk. Breast milk changes flavour depending on what the mother eats (such as sugar, garlic or curry) and so does the amniotic fluid. Observations of unborn babies have demonstrated that they swallow more frequently when surrounded by sweet tastes and swallow less fluid if it tastes bitter or sour.

What is my body doing at 33 weeks?
Ready to hear about some more super-exciting pregnancy side-effects? As well as varicose veins on your legs, some women get them on their lady bits in pregnancy – they’re called vulval varicosities. Quite the tongue-twister, no? And, if you’re a sufferer, this makes sitting down a torturous experience. So to alleviate your discomfort try sitting on an icepack (wrap it in a tea towel or cloth). Pelvic floor exercises can also ease things along, as they help the blood to circulate better in the area and strengthen the supporting tissues around the veins.

Try putting a small pillow under your bottom when lying down, or elevating the bottom of your bed. Avoid straining when you’re doing a number two – and if it still hurts, place some folded toilet paper or a sanitary pad in your hand and hold gently against the vulva whilst your bowels are moving. Thankfully, these painful veins should clear up around a month after the birth.

Common symptoms to look out for:
  • Sore stomach: Also known as round ligament pain, this symptom affects many women, and feels like achy, sharp or cramp-like sensations in the lower abdomen, either on one or both sides. You may feel it when you suddenly change positions, get up from lying or sitting down, or make a sudden movement like laughing, coughing or sneezing. If the pain is frequent or accompanied by any other symptoms, like vaginal discharge or bleeding, make sure you call your doctor. If not, keep your feet up or try to wear a belly band under your bump to ease the pain. 
  • Brittle nails: Yup, blame those ever-present pregnancy hormones, which can cause your nails to become brittle. Eat lots of avocados, nuts and bananas to make sure you’re getting enough biotin in your diet.
  • Insomnia: Third trimester insomnia strikes most pregnant women, whether it’s because of leg cramps, heartburn, hormones, needing the toilet, or indeed feeling anxious about the impending birth. Try a warm bath before bed, and try to persuade your partner to give you a massage: you’ll need all the relaxation you can get before the baby arrives!

Physical changes
Frequent urination

As your growing baby increases in weight, your uterus starts to put more pressure on your bladder, making you pass urine more frequently. This may worsen or improve once your baby's head engages or be made worse if your pelvic floor muscle is weakened .

Carpal tunnel
Some women experience feelings of numbness, 'pins and needles' or stiff painful hands - a condition known Carpal Tunnel Syndrome. This is caused by fluid accumulating in the wrists, placing pressure on the median nerve, which moves the muscles in the wrist and hand. Carpal tunnel also makes it difficult to grasp objects.

Emotional reactions
As your pregnancy advances, anxieties and fears may occupy your mind. You may look at women with babies and think "How am I physically going to get from being pregnant to being a mother?" Or you may wonder how you will deal with labour pain or with parenting a child (or another child, if this is not your first). Perhaps you have a mother or sister who has experienced difficult births and find it hard to imagine yours could be different. Or you could be concerned about feeling out of control once you go to hospital.

It is important to recognise and share your concerns. Suppressing your true feelings could mean unresolved issues materialising at an inconvenient time (like when you are trying to push your baby out!) If you find talking with family and friends and/or your caregiver is not enough, perhaps seek professional counselling to help you work with your concerns.

Other considerations
Your baby's position
Most babies assume a head down position by this time (if not already there). A few babies remain in a breech position. Women having twins often find that one baby is head down, while their sibling is breech. Your caregiver feels for your baby's head during your pregnancy visits and should now be able to detect which side of your belly their back is laying on (right or left). Your baby can still move frequently from one side of your belly to the other. At this stage, it does not really matter if your baby's back is anterior (towards your front) or posterior (towards your back).

You may start to notice that your baby's movements are changing to be more stretches and squirms, as they grow larger and there is comparatively less room to move. If you feel concerned about how often your baby is moving, it is important to tell your caregiver. They may suggest using a kick chart.
Birth preparations
Large babies
Being told your unborn baby looks big can immediately undermine your confidence to give birth. Such suggestions often come from caregivers, friends or relatives making judgements about the size of your belly. In some cases this could lead to considerations about being induced early (so that the baby won't be as large), or having a caesarean operation. Most women produce babies that their bodies are able to give birth to. The predicted weight of unborn babies can be frequently overestimated.

Caesarean births
For women having a caesarean, there are many procedures, interventions, monitoring and care that are unique to their experience.

1st stage of labour

Overview


The 1st stage of labour is when the cervix is thinning and dilating and can be divided into three different phases - early, active and transition.

Emotions
The woman and her partner (or support person) can experience a wide range of emotions during the various phases of 1st stage.

Support strategies

The labouring woman needs her environment and the people around her to be supportive on both physical and emotional levels. Her labour experience can be made more positive if she has people close by to help her feel safe, supported and loved. The degree to which a woman supports herself, or relies on others to support her, will vary depending on her individual needs.

First stage variations

For up to 85% of women, their labour will be uncomplicated. However there are no guarantees in life, including the way you give birth. No matter how much preparation is done, you cannot be assured that your labour will actually unfold the way you envisage. A woman's labour can deviate from the 'norm' at any time, and we have no advance knowledge as to what degree these variations will play in the outcome of the birth, and how a woman will ultimately feel about her labour.

What to expect from your caregiver
When labour moves from prelabour and the early phase into the active phase of 1st stage, the contractions usually intensify. With this often comes the need to be in the environment you are giving birth in (if not already there).

What to do this week:
It might not be as appealing as a girls’ weekend in the spa, but a simple daily massage of the area between your vagina and anus (AKA the perineum) can really help prevent tearing, protect you from needing an episiotomy and promote speedier healing of the area after the birth. Make sure your hands are clean and don’t do this if you have anything like thrush or herpes. Here’s a how-to guide for how to do this safely and effectively.
  • Sit in a semi-reclined position with your knees bent and your legs apart. Lubricate your fingers, thumbs, and perineal area with vitamin E oil (from punctured vitamin E capsules), pure vegetable oil, or personal lubricant. Don't use baby oil, mineral oil, or petroleum jelly.
  • Place one or both thumbs (about half their length) inside your vagina. Press down toward the rectum and toward the sides at the same time. Gently and firmly continue stretching until you feel a slight burn or tingling. Hold this stretch for about two minutes.
  • Slowly and softly massage the lower part of the vagina back and forth in a U shape, and apply pressure downwards and sideways.
  • Finally, massage the tissue between the thumb and forefinger back and forth for about a minute.
  • Be gentle – you don’t want to bruise or hurt yourself (the area is definitely delicate!). During the massage, avoid pressure on the urethra (urinary opening) as this can lead to irritation or infection.

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