Week 33
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At 33 weeks your baby’s eyes are quite remarkable and now focusing. Your baby can detect light as it enters his or her eyes. Your baby’s pupils are dilating and constricting as yours do. Over the next four weeks an amazing amount of growth will take place. Tiny lungs are working hard on maturing.
Your amniotic fluid is now at its greatest capacity within the uterus. As little kicks continue to be counted and felt, they may be a little more noticeable and forceful. Due to your baby’s rapid growth from now to delivery day and his or her greater size in your uterus, your level of amniotic fluid is not as cushioning.
Your baby may have added an inch in length this week and weighs approximately 4½ pounds. Your baby is the size of a small watermelon.
Now is the time to inform your Insurance Company of your expected baby’s arrival.
Your Postpartum Plan
Pregnancy is a time of great anticipation, weekly changes and a new mindset. A savvy birth plan enables you to share your intended choices and wishes leading up to and during delivery with your health care team. But did you realize that delivery day is not the finish line? Or that your baby’s birthday is really the starting point? Enter the Postpartum Plan.
According to Elly Taylor, a parenthood researcher and author of the book Becoming Us: 8 Steps To Grow A Family That Thrives, “Most couples find it hard to think beyond the birth, but there’s so much they can do to plan for a positive postpartum experience. I call it nest-building: plan to take as much time off work as possible, gather your support system (it takes a village!) and have your partner actively involved from the get-go.”
The postpartum period lasts about six weeks beginning immediately after the birth of your baby as your uterus, body, and hormone levels begin returning to a non-pregnant state. The World Health Organization (WHO) describes the postpartum period “is a critical time for women, newborns, partners, parents, caregivers and families. Yet, during this period, the burden of maternal and neonatal mortality and morbidity remains unacceptably high…”
Did you know the United States differs from many countries that savor built-in birth and postpartum traditions that pass from generation to generation? With this in mind, it’s important that you take the time to think, plan and strategize about your postpartum period.
Begin to envision what your new nest will look like following delivery day. Carrie Murphy of Parents. suggests seven steps that will enable you to zero in on how to make your postpartum experience the best. She realizes that taking your baby (or babies) home is when life gets real. Murphy knows that with a simple plan, your postpartum experience will be upbeat and fruitful.
- Write it down: Make a written postpartum plan. This can be as simple as a list of important numbers (doctor/midwife, pediatrician, doula, lactation consultant), or something more detailed and comprehensive. While it may seem a little Type A to actually put pen to paper about post-pregnancy life, the exercise of thinking about it and discussing it with the people in your life will be almost as valuable to you as the actual plan. (There are many ways to make a written plan, of course, but this postpartum plan template from the doula organization DONA International can help you get started.)
- Prioritize your own needs: There’s absolutely nothing wrong with being a little selfish during pregnancy and postpartum—you can only provide good care to your baby if you’re feeling safe, happy, and supported. That means staying rested, hydrated, well-nourished, and calm—so don’t be afraid to ask for or get what you want, physically, mentally, and emotionally. The words “I need” can go far during the postpartum period, so learn to use them. A happy mom and baby are more valuable than a clean kitchen or a freshly-vacuumed rug.
- Get meals taken care of: Having at least one meal a day already planned, prepped, and/or prepared is a lifesaver when you have a needy newborn; bonus if the meal is healthy and nutritious! Thinking ahead about meals for after baby can cut down on instances when your partner is desperately ordering pizza at 8 pm with a screaming baby in the background. It’s great if you’ve been cooking extra food and freezing it, but don’t hesitate to ask your community for help, too. MealTrain is a great service you can use to organize a group of people to bring you meals, and it’s totally free!
- Set boundaries: Your family and friends are so excited about the baby! You don’t want to diminish that excitement, but you need to make sure you’re not getting overwhelmed with well-meaning visitors just after you’ve birthed a small human. Some people want company soon after birth; others prefer to wait a few days or weeks before showing off the babe. So set clear boundaries with family and friends. Say, “We’re only having immediate family visit in the hospital,” or “We’re hoping to limit visits to 30 minutes so we can rest” or whatever works for you. Boundaries can also include conversation topics or advice, i.e., “If we need breastfeeding help, we will ask you for it,” or “I know you think cloth diapering is too difficult, but it’s what we plan to try.” Setting up expectations for the kind of company and support you want can help to avoid hurt feelings and conflict during the often raw, tender postpartum period. The conversations may be awkward now, but clear communication will be worth it in the end.
- Ask for help: You don’t have go it alone—if you need help, ask for it! Women in our culture are often scared or embarrassed to admit they need assistance, but there’s seriously no shame in reaching out to your network, even if they’re not close family or friends. Experienced moms know just how hard it is to have a newborn and they’re often eager to help, even if that help involves just coming over to sit on your couch and listen to you cry. So put out that SOS status on Facebook; you can repay the favor once you’re feeling more confident.
- Hire a postpartum doula: Don’t have family nearby? Don’t want family nearby? Are you a single parent or does your partner have limited leave? A postpartum doula can be just the thing to help ease you into new parenthood. Postpartum doulas are trained in infant care, breastfeeding, and general support of postpartum families. They also do light cooking and cleaning, errands—basically whatever you need to make your life more calm and manageable. They generally charge by the hour, but you can buy a package or just a few hours of help, on a regular schedule or only when you feel you need it. Many postpartum doulas will also do overnights, which lets you get the precious rest you need to recharge and take care of your baby. Check out DONA International or CAPPA to find a list of postpartum doulas in your area.
- Aim low: This may sound harsh, but lower your expectations for what life as a new parent is going to be like. Whatever you’re picturing, it’s likely not going to look anything like that—and that’s okay. Some days, just getting out of the house to buy a nipple shield at Target or taking a shower is all you’re going to be able to do. Give yourself the emotional and mental space for your postpartum experience to be whatever it will be—both positive and negative. Don’t expect life to be anything like it was before you gave birth; You’ll find your new normal in time.
There are many ways to fashion the postpartum plan that’s right for you. In realizing the importance of creating an innovative and complete pregnancy experience, Phoenix, Arizona’s leading team of doulas, Phoenix Family Birth (PFB) introduced their tangible postpartum birth plan. As Carrie Murphy mentions above, PFB also advocates using the services of a Postpartum Doula. PFB encourages you to explore the tough questions and varied opinions that will make your plan feasible and realistic. Close your eyes for a moment…
- Who will be in charge of the household chores?
- What do you expect your partner to do?
- Where will your baby sleep?
- When should visitors plan to come?
- Why should you or shouldn’t you use cloth diapers?
- How will you feed your baby?
Did you know that you might avert mood disorders and possible postpartum depression by using a postpartum plan? Remember that like your birth plan, your postpartum plan is also flexible. Share your plan with everyone ahead of time so there will be no surprises or hurt feelings. Keep in mind that the plan you drafted on your iPhone may not work best for you in reality at times and that’s perfectly okay!
With a little planning prior to your baby’s arrival, you will make your hospital stay, arrival home and the weeks and months following delivery enjoyable and practicable.
Stripping Membranes
Dr. McGregor advises that pregnant women avoid unnecessary, frequent or forceful cervical exams that may push bacteria closer to your baby; both vaginal or perineal ultrasounds in place of cervical exams are less invasive.
It is important that you discuss the benefits and risks of possible methods of induction with your health care team well before your due date. You may not be asked before “stripping” or “sweeping” of your membranes is performed.
Stripping or sweeping of your amniotic membranes is a technique performed by your health care team to try to jump start labor. During a regular office pelvic exam, the practitioner inserts a finger into the cervix (the mouth of the uterus) separating the amniotic fluid sac from the side of the uterus near the cervix. Hormones are then released which may soften the cervix preparing the uterus to contract. This approach will not put you into labor right away and may not put you into labor at all but it may start contractions and help the cervix open.
If you have tested positive for GBS tell your health care team not to strip your membranes. Be aware that although you may have tested negative for GBS initially in your pregnancy, you may test positive before your due date. GBS can cross membranes that are intact so stripping membranes or using cervical ripening gel to induce labor may push bacteria closer to your baby.