9 Months Pregnant: Symptoms, Preparing for Labor, and Fetal Health
This article provides an overview of what to expect at 9 months of pregnancy, including symptoms and how to prepare for the delivery.
Now is a good time to take a childbirth education class to prepare yourself for labor and birth. You can learn some techniques to help keep you comfortable throughout your labor.
Once you enter your ninth month of pregnancy, visits to your doctor will increase to every week. During these appointments, they will check your blood pressure and weight and perform internal pelvic exams to see if your cervix has started to dilate.
Your doctor will also check you for group B streptococcus bacteria by performing a swab of your vagina and rectum. Group B streptococcus bacteria are normal flora present in the vagina that, when positive in pregnancy, need to be treated with antibiotics in labor so that they do not affect the baby.
At 9 months, you may also want to start thinking about whether you are going to breastfeed or bottle-feed the baby. If you decide to breastfeed, taking a prenatal breastfeeding class can help you better prepare and know what you can expect in the early weeks of breastfeeding. Be sure to let your doctor know what feeding method you prefer.
It is common at this stage of pregnancy to start feeling anxious about giving birth. You may have fears about what labor will feel like and what will happen to the baby after birth. Talking with your doctor can help alleviate some of these common fears so that you know what to expect.
If you have any specific requests about how you want your labor and birth managed, be sure to inform your doctor of these as well.
At this stage, you may start to feel physically uncomfortable as your belly grows more in size. You may feel tired all the time and notice swelling in your feet and ankles. Keeping your legs propped up can help alleviate swelling and give your legs a break.
Some other common symptoms during the ninth month of pregnancy include:
- difficulty sleeping
- difficulty holding urine
- shortness of breath
- varicose veins
- stretch marks
- Braxton-Hicks contractions, or false labor
- leaking colostrum, or the first milk, from the nipples
- lower sex drive
- leg cramps
- increased skin pigmentation
- increased body hair
- white vaginal discharge
During the ninth month, the fetus may start to drop down lower into your pelvis. If this occurs, you may notice your belly hanging lower than usual. This is normal, and it may help relieve constipation and heartburn that are common earlier in pregnancy.
At 9 months, the fetus is now fully developed, and it can survive outside of your body. Its lungs, heart, and other major organs are formed, and its sex is determined. Its average length is 19–20 inches, and it has an average weight of 7 to 7.5 pounds. Its skin is pink and smooth, with little to no hair on the body.
At this point, the fetus can see and hear, and its brain is fully developed. The irises of its eyes are likely slate blue, and these will not take on their permanent color until a few days to weeks after birth. Also, the fetus can now suck its thumb and cry, and its body is covered in a layer of fat to help keep it warm after birth.
The fetus is covered in a creamy, protective coating called vernix caseosa. Its head will be turned down into the pelvis, and the bones of the skull will stay soft to allow the fetus to pass easily through the birth canal.
If you are expecting twins or triplets, you should start discussing with your doctor what kind of delivery you will have.
If you are expecting twins and both of their heads are facing down toward the pelvis, you can opt to have a vaginal delivery. If one of the twins is in the breech position (buttocks facing down) or transverse (lying across the uterus), you will most likely need to have a cesarean delivery. Triplets are almost always delivered via cesarean delivery.
You will also want to start thinking about how you are going to feed the babies and who is going to help you at home. It is possible to breastfeed twins and triplets, but you will likely need some help.
For example, you could consider getting a double electric breast pump so that while you are nursing one baby, someone else can feed your pumped breast milk to one of the other babies. If you are nursing two babies at once, it can help to have a nursing pillow to help you prop them up beside you.
People who carry multiple fetuses are at higher risk of having a preterm delivery. For twins, the average is about 36 weeks.
Sometimes, one or both fetuses may weigh less than expected for their gestational age. This is known as intrauterine growth restriction. It occurs due to crowding inside the uterus and insufficient space for multiple placentas to grow.
When you are in labor, contractions happen that cause your cervix to dilate and make room for the fetus to pass through. Contractions are a tightening and relaxing of the uterine muscles. They help you push the fetus out of the birth canal.
Learning about the signs of labor can help you prepare for giving birth. Some of the most common signs of labor include:
- contractions that last for 30–70 seconds and come 5–10 minutes apart
- tightening or pain in your belly and lower back that does not go away when you move or change position
- brownish or reddish vaginal discharge, or bloody show
- breakage of the amniotic sac
- contractions that are regular and that get closer together over time
- contractions that get stronger over time
- contractions that are so strong that you cannot walk or talk
Some contractions happen before true labor starts. These are called Braxton-Hicks contractions. The purpose of Braxton-Hicks contractions is to soften and thin your cervix in preparation for labor and birth. Sometimes, it can be hard to tell if these types of contractions are true labor or not.
If you are unsure, time your contractions and note how strong they are and whether or not they go away when you move or change position. You are typically more likely to have Braxton-Hicks contractions later in the day or after doing physical activity. They are usually irregular and do not get closer together over time.
If you suspect that you are in labor, contact your doctor right away so that they can advise you on when to come to the hospital. If your contractions are still 5–10 minutes apart, they will likely tell you to wait until they are about 2–3 minutes apart to come to the hospital. If your water has broken, you should go to the hospital right away.
Once you arrive at the hospital, you will go to the triage area in labor and delivery, where a nurse will take your vital signs and ask you what brought you in. From there, you will go to a birthing room, and you will remain there until after you give birth.
A nurse will place an IV line in your arm and put a contraction monitor and fetal heart monitor on your abdomen. These devices will monitor how far apart the contractions are and how fast the fetus’s heart rate is, respectively.
If you are still in early labor, your nurse will encourage you to walk around or use a birthing ball to help open up your cervix. If you are a little further along in your labor and start to have very painful contractions, you can elect to have an epidural placed in your back for pain relief.
An epidural is a small catheter placed in the dural space in the spine that gives continuous pain medication. Keep in mind that with an epidural, you will feel numb from the waist down, and you will not be able to get out of bed.
If your labor starts to slow down or your cervix is not dilating well, your doctor may give you an IV medication called Pitocin. Pitocin is the synthetic form of oxytocin, which is the hormone responsible for giving you labor contractions. Pitocin will help make your contractions stronger and more frequent so that your cervix will change in response.
As you start to approach the pushing stage, a nurse will help you into the birthing position. If you have an epidural, you will likely be on your back with your feet in stirrups. If you do not have an epidural, you can be in any position that is comfortable for you. This may include squatting or getting onto your hands and knees.
Your doctor and nurse will coach you through the pushing stage. With every contraction, you should bear down (like you are having a bowel movement) while breathing through the contraction.
A warning sign you should look out for is going into preterm labor. Preterm labor is defined as labor that happens before the 37th week of pregnancy. If your water breaks or you notice other signs of labor before 37 weeks, it is important to call your doctor and get help right away. Babies born before 37 weeks are more likely to need extra care and may need to go to the neonatal intensive care unit for monitoring.
Another condition to look out for is placental abruption. This occurs when the placenta starts to detach from the uterus before birth. This is an uncommon but life threatening condition that needs treatment right away. If you start noticing vaginal bleeding accompanied by severe abdominal pain, go to the hospital as soon as possible. Placental abruption increases the risk of preterm birth and stillbirth.
If you had a vaginal delivery, a nurse will help you to the bathroom to empty your bladder soon after giving birth. If you had a cesarean delivery, you will remain in the recovery room for a few hours for post-surgical monitoring.
After you give birth, you will have a chance to bond with the baby. The baby will be placed on your chest, and if you are breastfeeding, they will be encouraged to latch on within the first hour of life. A lactation consultant, which is a healthcare professional who specializes in breastfeeding, can help you get into a comfortable position for a proper latch.
It is recommended to nurse eight or more times in a 24-hour period.
If you are bottle-feeding, a nurse will show you how to give a bottle and how much milk to give.
It is normal to feel some discomfort after having a baby. If you had a vaginal delivery, you might notice some soreness in your vaginal area. Ice packs and over-the-counter pain relief medications, such as Motrin, can help. If you had a cesarean delivery, stronger pain medications — such as Percocet — can help relieve incisional pain.
At 9 months pregnant, you should start preparing for labor and birth. Ask your doctor how you can best prepare and what you can expect once you arrive at the hospital. If you start having contractions, be sure to time them and note if they are regular and coming on strong.
After you give birth, you will have plenty of time to bond and get to know the baby.