Week 34 of pregnancy (Days 238-244)

Baby

By the 34th week your baby can be up to 45cm in length – from crown to heel. Body fat continues to develop and build up beneath the skin in preparation to assist in regulating body temperature after birth. Babies born at 34 weeks have an excellent chance of surviving and will usually only require minimal medical intervention.

Babies born at this stage rarely have long-term problems related to prematurity. The lungs are now nearly fully developed although the central nervous system is still maturing. Both the digestive and intestinal systems are now fully developed and functioning and the bowel will probably be holding the first meconium stool (the first bowel movement), which will be passed after birth.

Urine is being passed from the bladder out into the amniotic fluid. Around this time the ability to hear is fully developed and the fetus is able to hear and attend to external noise such as your voice, and the voices of your partner and family. Some research shows that babies prefer higher pitched sounds both in the uterus and after birth. Hair continues to grow on the head and eyebrows and eyelashes are becoming thicker. Fingernails and toenails are also growing and are probably now reaching the tips of the fingers and toes.

You

At this stage of pregnancy, some women experience a tingling sensation or numbness in their pelvic region. This is thought to be the effect of a loosening of pelvic muscles in preparation for giving birth. Although this is perfectly normal, some women also experience pain in the hips and/or pelvis. If you are struggling to deal with pain, you should consult your midwife or Doctor.

Some women experience changes in their vision during pregnancy. There are a number of causes of this. Firstly, pregnancy hormones can cause vision to appear less sharp. The tear ducts may also be producing fewer tears, causing eyes to feel dray and irritated. Finally, an increase in fluid behind the eye can cause increased pressure on the eyeball, altering its shape. This can lead to changes in vision. All of these changes are temporary and should all resolve after giving birth. You may also notice changes in your hair and its growth. Many women report that their hair grows more quickly and is thicker during pregnancy. Some women also find that, due to pregnancy hormones, hair grows on the cheeks, chin and back. If you are concerned about this, you should consult your pharmacist about pregnancy-safe hair removal options.

After giving birth however, your hormone levels will return to normal and hair growth will lessen. An increased level of oestrogen during pregnancy stimulates all mucous membranes in the body. This, combined with an increased blood flow to the pelvic area, can lead to increased vaginal discharge during pregnancy. This is perfectly normal and should return to normal after giving birth.

If you can, you may find taking gentle exercise helpful, e.g. a daily walk. This will not only help to maintain your general level of fitness and stamina, which will help you during labour, but can also help to alleviate pregnancy-related aches and pains and can promote more restful sleep.

Symptoms to watch out for

It is important to ensure that the baby is moving well. This means at least ten episodes of movement per day. The baby may not move much one day but the next it should. If it does not you should see a medical professional. In essence the tummy should be growing and the baby moving.

Pre-eclampsia, vaginal bleeding, premature birth and obstetric cholestasis are important complications in late pregnancy. Pre-eclampsia manifests as headaches, disturbances of vision, swelling particularly of the legs and face and upper abdominal pain. It can result in a small baby and the tummy being smaller than it should be. Vaginal haemorrhage (bleeding) is abnormal in late pregnancy. Painful contractions can result in premature birth. Itching of the palms of the hands and the soles of the feet may be due to obstetric cholestasis which is a threat to the baby. A blood test can check for this. More generalized itching is common and usually harmless.

What is routinely offered on NHS

Visits to the midwife or GP become more frequent in later pregnancy. She will ask about symptoms, take the blood pressure and check the urine. The midwife will measure the tummy with a tape measure. This is a crude, basic method of estimating the size of the baby. Referral will be made to the consultant as necessary. If there is a serious threat of early birth then an injection of steroids is given to the mother which will help to protect the baby from respiratory distress.

What other care is available

In a private self referral clinic additional blood tests and ultrasound scans can be done at short notice with rapid reporting of results. This is important if the baby is smaller than it should be or not moving enough. The woman and her partner can see a consultant for opinion and advice. This is done at a convenient time and with plenty time for discussion.

Pregnancy-safe massage is available to ease muscle ache and stress associated with late pregnancy.