Another urinalysis and urine culture may be performed at 28 weeks to rule out a silent urinary tract infection. Such infections put mothers at risk for early birth. Be sure to inform your care provider if you develop any burning with urination, excess pressure or odor, fever or unusual back discomfort.
Some care providers perform a cervical check at this point of the pregnancy. They feel that if they detect any premature cervical changes, they may be able to intervene before preterm labor might occur. This opinion is not shared by all, but you should be asked at each visit if you're experiencing any "tightenings" or contractions that may become regular. Any pattern of four to six contractions in an hour should be brought to the attention of your midwife or doctor. In addition, call your clinic or help line if you develop any spotting (even pink or watery or mucusy) or leaking of any water. Signs and symptoms of preeclampsia, such as headache, vision changes, pain under the right rib cage, excess swelling (especially of the face) or morning water retention should be reported.
Prepare a Birth Plan
If you've not done so already, consider writing a birth plan. As you investigate comfort measures, anesthesia, hospital protocols, etc., jot down your feelings and wishes. Your partner and your midwife or doctor can give you some ideas too. Other things to consider include:
Preference for water birth
Preference for no pain medications or desire for epidural/analgesics
Breastfeeding as soon as possible
Rooming in (no mother/baby separation)
Father and support-person role
Early discharge or extended stay if available
At 36 weeks, you'll be tested for group B strep (also called GBS or beta strep). This is a genital tract infection that occurs in about 30 percent of the population. It is an infection that has no known effects except upon the baby during birth. Due to the immature immune system, newborns who contract the infection may become very ill, and some die if untreated. If your test for GBS is positive, you will be treated with IV antibiotics when you come to the hospital or maternity center in labor. Two doses are necessary, so if a mother comes in and delivers quickly, the baby will be treated right after birth. The test for GBS must be done without a speculum. Your doctor or midwife will swab the vaginal tissue near the entrance to the vagina and then down the perineum into the rectal sphincter. This is the procedure recommended by the CDC (Centers for Disease Control).
The iris of the baby's eye takes on more and more color as the weeks progress, and at birth the eyes are a slate blue. As the process requires exposure to light, it will take an additional month or two after birth to change to the permanent color. While baby is losing much of the downy coat of hair (lanugo) on the body, the hair on the head becomes thicker and more prominent. In preparation for birth and transition to extrauterine life, the immune system is maturing as baby prepares to protect himself from the viruses and bacteria awaiting him. Body fat is appearing now, which will help maintain his temperature and glucose levels after birth.