Weeks 31-40 (fig16)

The baby is growing plumper, so the skin, which was quite wrinkled before, is now smoother. Both the vernix and the lanugo begin to disappear.

At thirty-two weeks the baby is usually lying head downwards ready for birth. Sometime before birth, the head may move down into the pelvis and is said to be 'engaged' But sometimes the baby's head does not engage until labour has started.

05. Deciding on the place of birth

Deciding where to have your baby

Where and how you have your baby will depend not just on what you want and on your health and circumstances but also on what's available where you live. Facilities and policies vary a great deal around the country and some people have more choices than others. It may be possible to choose between births.

In a government hospital

In a private hospital

At home (now very rare and not recommended)

In a hospital (Government and Private)

Present day most babies are born in hospital. The advantage of a hospital birth is that both expertise and equipment are at hand in case they are needed. If something goes wrong during labour, (and no-one can be 100% sure it won't) then you don't have to be moved. Even if you have to be moved it can be done safely. A Caesarean delivery, for example, can be done on the spot if needed from the level of Base Hospital onwards. In the same way, if there is anything wrong with the baby when it is born, hospital facilities can be life-saving. The baby can be cared for immediately without vital time being lost in a journey to hospital. This applies mainly to Base Hospitals onwards. Therefore, it is better to discuss this matter with your doctor and the family health worker. Wherever it is, safety of the mother, the unborn and the new born should be the number one priority.

It is worth finding out in advance about your local hospital's practice, may it be private or government, so that you know what to expect and you can talk about any problems or worries. And if there is more than one hospital in your district and you can choose which one you go to, try to find out about the practice at each so that you can decide which will suit you best. By talking to your doctor, community family health worker or talk to other mothers who have recently had babies and ask them about heir experiences at local hospitals. But please don't get carried away or biased by them. If you have a doubt please ask your doctor or the family health worker.

How to find a hospital delivery?

Your family health worker will register you when she knows you are pregnant. Or you can inform your family health worker that you are pregnant. Even if you go to a specialist for your entire pregnancy care, please register yourself with your family health worker in order to get our national statistics correct. This is best done as early as possible in your pregnancy.

At home

Some women want to have their babies at home. Although it is rare, still happening in our society. They feel they will be happier and better able to cope in a place they know and with their family around them. If you are planning to do so please discuss with your family health worker. Please remember we do not advocate home deliveries. It is far better to deliver in a set up with emergency facilities.

Finding out what your options are

To find out what's available for you in your area, talk to your family health worker first of all. If your doctor has a special interest in Obstetrics, then he or she will certainly be able to give you a lot of helpful information. Your community family health worker will also be able to help.

06. Natural reactions of being pregnant.

Feelings and relationships

From the time you know you're pregnant, things begin to change. Your feelings change, feelings about yourself, about the baby, about your future. Your relationships change with you and your husband and also with parents and friends.

But you're still having to get on with your life, whether pregnant or not. For this reason adjusting to the changes that pregnancy brings isn't always easy.

The following is about some of the worries that often crop up in pregnancy. There are some suggestions about how to cope and some factual information that you may find helpful. But just because a problem is common doesn't mean that it will be a problem for you. And what is a helpful advice for one person is unhelpful for another. So take from what you find useful, and just discard the rest.

Feelings

Sriyani says:

"I'm fine. I feel really happy. But I do get so tired."

"It's just that everybody asks you how you are all the time. Most of the time I just say "Fine", but sometimes I really feel like telling them off."

Chandra says:

"I get up more quickly. The slightest little mishap and I'm upset."

"I feel contented, happy within myself, happy with the world at large."

Nirmala says:

"I think you have more extremes of emotion than me. You get more easily upset about things, and you can more easily get very happy about things."

Mrs Perera says

"I got so depressed being in the house all the time on my own. I felt lifeless. That's why I want to go to work and I was much better for going out and meeting people."

Mrs Fernando says

"I am scared that my husband will not look after me and my baby. He has not come home for 2 days. I cannot enjoy being pregnant. I am depressed. I do not know what happened to me?"

When you are pregnant it can sometimes seem as though you are not allowed to be anything but happy. People expect you to be looking forward to the baby, to be excited, to 'bloom'	– and they expect you to be like this all the time. You yourself may feel that this is the way you ought to be.

In fact, just like any other time of your life, you're quite likely to have times when you feel low. And pregnancy does bring with it some extra reasons for worry or depression just as it also brings a lot of reasons for happiness.

To begin with, nausea and tiredness can make you feel low in the early months. You may find you cry more, lose your temper more, and so on. It is thought that the hormonal changes going on in your body contribute to this as well, and there are certainly other changes – in your feelings and thinking, for example – which means that life may not seem all that easy.

It's important to keep on top of your feelings as much as you can. But recognize that you probably won't be able to keep on top all the time. Talking, either with your husband or with anyone who is close to you, can help. And it certainly helps if you can avoid getting overtired and keep yourself well. Anyone who is tired and run down is likely to feel emotional and a bit depressed, whether they are pregnant or not.

There are hundred and one other reasons for feeling low, and all of them are very understandable. You may worry about whether the baby will be alright. There may be financial worries, or other practical problems. You may worry about the birth and whether you'll be able to cope. You may worry about whether you'll be able to cope as a parent or about whether you really want to be a parent in the first place. It's also important to do and think about things other than being pregnant, and to do things for you, or you, as well as for the baby.

Although it is natural to have some worries in pregnancy and to feel a bit down from time to time, its a real cause for concern if you're feeling depressed for much of the time. Whatever the reason for the unhappiness, or even if they don't seem to be any reason at all, explain how you are feeling to your doctor or family health worker. Make sure they understand that you're talking about something a bit more than just feeling low.
