Week 36: Fetal Movement

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Transcription:

This is your Pea in the Podcast for week 36 of your pregnancy. I'm Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women's Care Associates in Houston, Texas.

This week your baby weighs about six pounds and are packed in there quite tightly. The lack of room in there has led to a dangerous myth that later in pregnancy babies become too cramped to move very much. Dr. Swaim says that's just not true, "Term babies should be moving and their movements, while maybe I suppose they may be a little more sluggish, I don't think that they should really decrease in number. So if there is a perception of decreased movement, I want to hear from my patients." Because decreased movement may be a sign that your baby isn't doing well. Now one way your doctor keeps track of your baby's activity is by asking you to count their kicks. "A kick count is mostly just the instruction to the patient to pay attention to fetal movements. It turns out that her perception of fetal movement is really important. In a term baby, I don't usually have my patients do kick counts until after 36, 37 weeks unless there is some question about fetal movement earlier. But a term baby should move 10 times in an hour and so typically we'll have our patients pay attention a couple times a day. But most women don't have to lie down and count and they know their babies are maniacs and are moving constantly." Now if your baby doesn't move 10 times in an hour call your doctor. Dr. Swaim says they may have you come in, "and then we'll usually put them on the monitor, do something called the nonstress test and look at the fetal heart rate pattern. We give the mom a little button that she can press when she feels the baby move and by and large usually what happens is the baby starts moving everywhere and she feels stupid for calling. But still it's important because every once in a while it could mean that the baby is not doing well in which case we'll pick that up on the monitor."

Some people may suggest you drink something sugary before you call the doc and see if that spurs your baby to get busy. Dr. Swaim says in most cases skip the drink and call. I only say that if you haven't eaten all day but other than that I just have them come in, why another hour if the baby might not be doing well." In most cases they will be fine but the alternative is serious. So Dr. Swaim says if your baby's movements slow down or stop, take it very seriously, do call. Now if your baby was born this week, they'd still be considered premature. "Premature or preterm are essentially the same term and they describe the gestation that ends before 37 completed weeks. But the fact is that 36 is pretty much considered term; most 36 weekers will go to the low risk nursery. Very few 36 weekers would need respiratory support, that kind of stuff." And that's great news if you, for some reason, find yourself delivering this week.

Aside from that your baby is adding fat and acquiring kissable dimples, their brain continues its rapid development and some of that movement we talked about may be your baby finally moving into that head down birthing position. This week your baby may even drop, what does that mean? "It is a term used to describe when the baby's head becomes engaged which doesn't usually happen at 36 weeks but it can. Women who are pregnant the first time, it usually happens a couple of weeks prior to delivery, or it can happen up to a couple weeks before delivery. Women with second or subsequent babies, their babies don't really engage until labor. But what engagement means is the leading edge of the baby's skull has reached a certain anatomic position in the pelvis called the ischial spine. That means that the place on their head called the biparietal diameter has negotiated the pelvis inlet. So basically the baby is stuck in the pelvis is what happens. In doing so it moves down a few centimeters so mom typically can breathe a little easier. But it's really not that noticeable in many women." But if your baby drops and frees up a little lung space that's great news if you've been having trouble catching your breath. Your stomach may also be less cramped giving you a little appetite boost. Of course it may be bad news for your bladder as the change in position could add even more pressure there. Don't let this cause you to drink less, you need to remain hydrated. You may want to adjust your position while urinating so that it may help you completely empty your bladder. Also the move, if your baby drops, may cause you to start feeling some tingling or numbness in your pelvis as your baby gets settled in. You might even experience sciatic pain if you haven't already. If you avoided the glamour of hemorrhoids until now well the pressure from your dropping baby may mean you get a few, sorry, if you do there are creams and anointments and that kind of thing that can ease your discomfort. Do tell your doctor if you get hemorrhoids, you'll get plenty of opportunities to talk to your doctor or midwife, you're seeing them every week these days.

Right now your uterus is huge and it's going to get even bigger before all is said and done. While it takes nine months for the uterus to stretch to several times its normal size to accommodate your baby, by your six week check up after your baby it will be back to its normal pre-pregnancy size, that's pretty quick.

Now I know you're uncomfortable now but the next time you feel your baby move, stop and enjoy the gentle rolls and the restrained kicks of the child you are about to deliver, soon you will be separated and they will grow into toddlers and teens and adults with their own babies before you know it. This right now is a special time, savor it. You are 36 weeks pregnant; there are just 4 weeks to go until week 40.

That's your Pea in the Podcast for week 36 of your pregnancy. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week. For a transcript of any of our Pea in the Podcasts go to our website peainthepodcast.com. For Pea in the Podcast, I'm Bonnie Petrie, thanks for listening.