Guidelines for the last four weeks of pregnancy
The final four weeks of any pregnancy are critical to a successful birth. So here are some guidelines to help ensure that you know exactly what to expect.
- Bleeding must be reported immediately! Please call us DAY or NIGHT as soon as you notice it. Bleeding is described as dripping or pouring of blood. There may also be a mucous-type discharge (pinkish-brown with or without some streaks of blood, which is not significant). Such mucous may occur for a period of hours or even days before the onset of labor. Any actual bleeding must be reported as soon as you notice it regardless of the presence or absence of cramps, pain or other discomforts.
- The “bag of water” will break in a certain percentage of women prior to the onset of actual labor. This is the involuntary loss of clear liquid that may either gush or drip out. This liquid cannot be controlled and does not smell like urine. In most cases, the breaking of water is followed shortly (minutes to hours) by labor. In some cases, labor may not follow for a week or more. PLEASE REPORT THE BREAKING OF WATER IMMEDIATELY!
- “Labor” is the onset of alternate contractions and relaxation of the uterus, in which the baby is contained. The uterus is also known as the womb. The womb is the lump you feel in your abdomen. It may feel firm to you now, but it is the firmness of a relaxed muscle. When it contracts, the muscle will feel harder and much firmer. It is the same phenomenon as “making a muscle,” however it makes the muscle even harder. These contractions are called labor pains. Some women say they feel it only in their back, others feel it as a drawing in their legs. Some describe it as feeling colicky, menstrual cramp-like or a belly-ache type of pain. If you place your hand over your womb, on the top of your abdomen, you will feel the tightening and relaxing of the muscle.
Some women feel very mild, irregular contractions for weeks or even months prior to labor. Such irregular contractions, even though they may be quite painful at times, are usually not significant. Such contractions are referred to as “Braxton-Hicks.” When labor begins, the interval between contractions may be long, the duration of the contractions short and the intensity of each contraction continuing. It is at that point you should begin to note the time of each one. If you feel that you are in labor, DO NOT EAT ANYTHING unless instructed to do so by one of our doctors or nurses. Drinking clear fluids is okay.
If this is your first baby, please call the office when the contractions are five minutes apart for at least one hour continuously. If the contractions should start coming closer than five minutes apart CALL THE OFFICE IMMEDIATELY, DAY OR NIGHT, REGARDLESS OF TIME.
First trimester 0-12 weeks
- Expected weight gain three to five lbs.
- Office visit every four weeks
- 12 weeks: nuchal translucency ultrasound
Second trimester 12-28 weeks
- You start to feel better, have more energy and reduced nausea and vomitting.
- Expected weight gain 10 to15 lbs.
- Office visits every four weeks
- 16 weeks: NIPT – cell free DNA blood testing (instead of amniocentesis) We also offer the noninvasive Harmony™ Prenatal Test for genetic testing for Down syndrome.
- 20 weeks: ultrasound for fetal anatomy check; can detect gender if requested
- 28 weeks: diabetes screen, anemia screen
Third trimester 28-41 weeks
- You should feel regular fetal movement and Brachs and Hicks contractions.
- Office visits every two weeks up to 36 weeks, then every week
- After 36 weeks, travel is restricted.
To learn more about our prenatal classes, contact ObGyn of East Brunswick at 732.254.1500 in East Brunswick or in Manalapan at 732.780.6970. For your convenience, you can also use our online form to schedule your appointment. We welcome mothers-to-be from Old Bridge, Monroe, East Brunswick and New Brunswick in Middlesex County and Manalapan in Monmouth County, NJ.