A baby born at 37 weeks is generally considered full term but may still need some extra support to maintain body temperature and glucose. At this point in development, creases on the soles of the feet extend almost to the heel. Dimples and creases appear near joints, and fat is deposited under the nipples. Baby's ears stand away from his head as cartilage becomes more firm. Reflexes are more developed, which is a sign of the maturing neurological system. Baby may "startle" with a loud sound and may have more periods of hiccuping. He may turn toward a bright light, so if he is still in a breech presentation some mothers try shining a bright light near the vagina in the hope that baby will orient into a head-down position. Vernix '- a waxy coating on the baby's body '- is almost totally gone now but may remain in the wrinkles of the skin.
At term, 40 weeks from the first day of the last period, most babies are beginning to respond to the maternal cues that labor may soon ensue. The uterus becomes more sensitive to maternal levels of oxytocin and prostaglandin. The cervix assumes a more anterior position, shortens (effaces) and may open one to two centimeters. If this is your first baby, the fetus will typically engage into the pelvis. Second babies and beyond (and multiples due at one birth) often wait until labor to settle into the pelvis. If you are expecting multiples, the cervix may stay long as well. At this time near the end of your pregnancy, baby may move just as frequently, but, due to the close quarters, he may be confined to punches and kicks instead of full-body somersaults, so prepare to feel the blows! Notify your care provider if your baby changes his pattern of movements. It is also important to call your clinic, birthing center or hospital if you have any suspicion that your membranes have ruptured. Although this can happen with a large gush and loss of fluid, it may happen with a small leak. If you're uncertain, try lying down for an hour and check for an increased flow when arising. If the fluid is not clear, inform your care provider.
If contractions begin, start to time them from the beginning of one to the beginning of the next. If this is your first baby, it is safe to wait until the contractions occur every four to five minutes unless your doctor or midwife has told you otherwise. Keep well hydrated and eat lightly while at home. Call your "baby line," labor and delivery area or "after hours" number for advice along the way.
Two-thirds of all births occur within a week of a mother's due date. A normal pregnancy can safely go to the end of the 42nd week. However, fetal compromise can occur with advancing fetal age, so testing is started at 41 or 41.5 weeks. Most care providers begin with nonstress testing and/or an ultrasound for amniotic fluid volume. A decline in the amount of fluid (oligohydramnios) may indicate a problem with placental perfusion. Some maternity centers require a biophysical profile weekly or biweekly after 41 weeks. This test consists of an ultrasound where the fetus is assessed for fetal breathing (fluid moving in and out of baby's trachea), flexion of the arms and legs, fetal movement and amniotic fluid volume). When a nonstress test is added, a baby can achieve a score of 10/10. A score of 7 or less may indicate that the baby needs to be delivered. Cervical ripening followed by oxytocin infusion or artificial rupture of membranes may be performed to induce labor.