Pregnancy Week 38: Baby, Body & Early Signs of Labour (India)

• Your baby measures about 49 cm crown-to-heel and weighs around 3.2 kg (roughly the size of a leek) and is fully ready for life outside the womb.
• Your cervix is ripening — softening, thinning (effacement) and possibly starting to open (dilation) — which your doctor may assess using the Bishop score.
• Only 10-15% of labours start with your water breaking; most begin with regular, strengthening contractions.
• Antenatal visits are now weekly; expect a blood-pressure check, urine test, fundal height, fetal heart rate and a kick-count review.
• Go to hospital urgently for any bleeding, leaking fluid, reduced baby movements, a severe headache with vision changes, or regular painful contractions.
• Most spontaneous labours happen between 37 and 41 weeks — first babies often arrive closer to 41 weeks, so a quiet week 38 is completely normal.

Week 38 sits in the early-term window (37+0 to 38+6 weeks). Your baby now measures around 49 cm from crown to heel and weighs about 3.2-3.3 kg — roughly the size of a leek. There is far less room to somersault, so movements feel more like strong squirms, stretches and jabs than big rolls. Your baby is fully ready for life outside the uterus.

Fetal development this week: the lungs are mature; vernix (the waxy coating) now sits mostly in skin folds; lanugo (fine body hair) has largely shed; the bones are hardening, except the skull, which stays soft and slightly mobile so the head can mould during birth; the brain is still developing and will keep doing so for years; meconium (the first stool) is building up in the bowel; the immune system is mature; and iron stores are well stocked for the early months of life. Subcutaneous fat is well laid down, giving those plump cheeks.

Heart rate sits in the normal 120-160 beats per minute range. Sensory systems are fully developed — your baby can hear your voice and respond to light and touch.

The placenta is starting to age (a Grannum grade 3 appearance on scan can be normal from around week 38 at term), and there is roughly 800-1000 ml of amniotic fluid cushioning your baby.

Your body at week 38: blood volume and cardiac output are near their peak, and your cervix is ripening — softening, thinning and sometimes beginning to open. Your doctor assesses this on a vaginal exam using the Bishop score. Braxton-Hicks (practice) contractions are frequent now and can feel strong, and the bag of waters (amniotic membrane) can rupture at any time. Sleep is often broken, impatience is common, and this is the week to make sure your birth partner is genuinely ready.

Most week-38 symptoms reflect your body getting ready for labour. None of the following are usually a cause for worry, but always flag anything that feels sudden or severe.

Increased pelvic pressure and a sense that the baby has 'dropped' lower (engagement) — this often eases breathlessness but increases the urge to pass urine.

Frequent Braxton-Hicks contractions that can feel firm but are irregular and ease with rest — learning to tell practice contractions from real labour is genuinely useful now.

Mild period-like cramping and lower-back ache that comes and goes.

More vaginal discharge, sometimes including the mucus plug coming away or a pink-tinged 'bloody show'.

Ongoing heartburn, constipation, leg cramps, swollen feet and ankles, and disturbed sleep from discomfort and frequent night-time urination.

Mood swings, restlessness and a burst of 'nesting' energy to clean and organise, often alternating with deep fatigue.

Colostrum (the first milk) leaking from the breasts.

Loose stools or mild diarrhoea, which can be an early effect of labour-priming prostaglandins.

Your bump is large and obvious to everyone now. Your doctor measures fundal height (the distance from the pubic bone to the top of the uterus) at each visit; up to about week 36 it roughly matches the number of weeks in centimetres, after which it may plateau or dip slightly as the baby engages. A reading more than 2-3 cm off the expected value may prompt a growth scan to check the baby's size and fluid level.

Comfortable, loose clothing matters more than ever — drawstring kurtas, stretchy-waist leggings, loose salwar-kameez, maternity palazzos or kaftans, and supportive low-heeled or slip-on footwear (bending to tie laces is hard, and your centre of gravity has shifted well forward). A full-body or wedge pregnancy pillow (around Rs 800-4000) makes side-sleeping far more comfortable; many women tuck one pillow between the knees and another under the bump. Sleeping on your left side improves blood flow back to the heart, and propping your head and shoulders up eases heartburn and breathlessness.

Skin changes often peak now: the linea nigra (dark midline on the abdomen) is prominent, melasma (darker facial patches) may deepen, and nipples and areolae darken further. Stretch marks (striae) on the bump, breasts, hips and thighs are pink-red at first and fade to silvery over months after birth — genetics largely decides how prominent they become. Moisturising with coconut, almond or vitamin E oil, or creams such as Bio-Oil or cocoa butter (around Rs 200-1500), keeps skin comfortable, though evidence that any product prevents stretch marks is limited.

Sex in the third trimester is safe for most women without specific reasons to avoid it (such as placenta previa, threatened preterm labour or ruptured membranes). Libido varies — fatigue, body image and discomfort can lower it. Side-lying, spooning or woman-on-top positions reduce pressure on the bump. Semen contains prostaglandins and orgasm releases oxytocin, both of which may modestly help ripen the cervix after 37 weeks, though neither reliably starts labour. Stop and get checked if there is bleeding or significant pain afterwards. The common belief that intercourse must be avoided throughout pregnancy is not medically necessary in an uncomplicated pregnancy.

Skincare safety: avoid retinoid products (tretinoin, isotretinoin) as they are unsafe in pregnancy; daily broad-spectrum SPF 30+ helps limit melasma; gentle moisturisers ease the itch of stretching skin. Important caution — intense itching, especially on the palms and soles and worse at night, can signal obstetric cholestasis, a liver condition linked to a higher stillbirth risk that needs blood tests (liver function and bile acids) and may mean planned early delivery. Tell your doctor promptly.

India's antenatal schedule, in line with WHO and Ministry of Health and Family Welfare guidance, recommends visits at booking and around weeks 14-20, 24, 28, 32 and 34-36, then weekly until delivery — about 8-12 visits in all, with more for higher-risk pregnancies. By week 38 your visits are weekly. Women with conditions such as gestational diabetes, high blood pressure, anaemia, a previous preterm birth, twins, a prior caesarean or restricted fetal growth need closer monitoring; see who counts as high-risk and what extra care means.

A typical week-38 visit covers your weight; blood pressure (watched closely, as preeclampsia can appear or worsen late in pregnancy — see the warning signs of preeclampsia and eclampsia); a urine dipstick for protein, sugar and infection; fundal height; the baby's heart rate by handheld Doppler; a review of your symptoms, supplements and daily kick count; and your test results. If indicated, your doctor may do a vaginal exam to score the cervix (Bishop score) — finding that you are 1-2 cm dilated or partly effaced before labour starts is common and not a reason to rush to hospital.

Some centres discuss or offer a membrane sweep from around 38-39 weeks (others wait until past your due date). The doctor gently separates the membranes from the lower uterus to release prostaglandins, which may bring on labour within 24-48 hours; it can be briefly uncomfortable and the benefit is modest.

Group B Strep (GBS) screening: GBS is a bacterium that 10-30% of women carry harmlessly in the vagina or rectum, but it can occasionally cause serious infection in a newborn. A vaginal-rectal swab at 35-37 weeks identifies carriers, who are then given antibiotics in labour to protect the baby. ACOG, RCOG and FOGSI support screening, but practice in India varies — many private labs offer it (around Rs 500-1500), while many government facilities use a risk-based approach instead of universal screening. Ask your doctor which approach they follow; read more about GBS in pregnancy.

This is also the week to finalise your birth plan using an India-specific template — who will be present, your pain-relief and position preferences, immediate skin-to-skin, delayed cord clamping and early breastfeeding. Confirm your hospital, your transport plan for labour (the free 102 Janani Express maternity ambulance, 108 for general emergencies, or a pre-booked cab), your paediatrician and your postpartum support. Your hospital bag should already be packed and within easy reach.

Fetal monitoring such as a non-stress test (NST/CTG) is often done weekly from around week 36-37, especially for higher-risk pregnancies, with a biophysical profile (BPP) added if the NST is not fully reassuring. From week 41, twice-weekly monitoring is standard until birth. Learn how NST and BPP monitoring work in India.

In the government system, antenatal care is free under JSSK at PHCs, CHCs, district hospitals and medical colleges, and PMSMA on the 9th of each month provides free specialist obstetric review — useful for high-risk pregnancies. Your Mother and Child Protection (MCP) card tracks the whole pregnancy. Private antenatal visits typically cost Rs 500-2500 each, often bundled into a package that includes scans and NSTs.

In the third trimester you need only about 450 extra calories a day above your pre-pregnancy intake — not 'eating for two'. Quality matters more than quantity. Because the uterus presses on your stomach, smaller, more frequent meals (three mains plus two or three snacks) usually feel more comfortable and reduce heartburn.

Protein needs are around 71 g a day (about 1.1 g per kg of pre-pregnancy weight) per ICMR guidance. Good vegetarian sources include dal (15-18 g per cooked cup), sprouts, paneer, curd, milk, soya chunks (very protein-dense), and nuts and seeds. Pairings such as dal-chawal, rajma-rice, idli-sambar, dhokla, khichdi and paneer-paratha give complete protein. Non-vegetarians can add well-cooked eggs, chicken and small fish such as sardines and mackerel (good omega-3 sources) — but avoid large predatory fish like shark, swordfish and king mackerel because of mercury.

Iron stays important to build your baby's stores and support your own blood volume. With anaemia affecting about half of pregnant women in India (NFHS-5), most need supplements — usually 60 mg elemental iron daily, more if anaemic. Take it with a vitamin C source (lemon or orange) for better absorption, and away from calcium, tea and coffee. Requesting delayed cord clamping (1-3 minutes after birth) in your birth plan also gives your baby a useful extra dose of iron-rich blood.

Calcium needs are 1000 mg a day — from milk, curd, paneer, ragi, til (sesame), almonds and drumstick (moringa) leaves, with a supplement if your diet falls short. Vitamin D deficiency is very common in India even in sunny areas, so supplementation is usually advised.

Dates (khajoor) in late pregnancy: there is reasonable randomised-trial evidence (mainly from Iran, with some Indian studies) that eating about 5-6 dates a day from week 36 onwards is linked to a more favourable cervix at admission, shorter labour and less need for induction. Dates contain compounds with mild prostaglandin- and oxytocin-like activity plus quick energy for labour. The risk is minimal for women with normal blood sugar, but because dates are concentrated sugar (around 60-70 kcal each), women with gestational diabetes should check with their doctor or dietitian first and, if cleared, keep portions small and pair them with protein. Budget Iranian or Iraqi dates cost around Rs 200-400/kg; premium Ajwa or Medjool more.

Indian foods that suit this stage well: khichdi, idli-dosa with sambar, rajma-chawal, dal-chawal-sabzi, vegetable pulao with raita, sprouted moong salad, ragi porridge, jowar or bajra rotis, curd with most meals, buttermilk (chaas), coconut water, and 2-3 servings of fresh fruit daily (ripe papaya in moderation is safe and beneficial, along with banana, orange, pomegranate and seasonal melons).

Foods to be careful with: raw or undercooked meat, fish and eggs; unpasteurised dairy and soft cheeses; high-mercury fish; large amounts of unripe papaya; more than about 200 mg caffeine a day (roughly one coffee or 2-3 teas); street-vendor cut fruit and food with hygiene concerns; and any alcohol, which should be avoided completely.

Hydration: aim for about 2.5-3.5 litres of fluid a day, more in summer or if you have diarrhoea or vomiting. Water is best, with coconut water, lemon water and buttermilk as good options; keep ORS sachets handy in the heat. Good hydration supports amniotic fluid volume, and dehydration can increase Braxton-Hicks contractions.

Unless your doctor has advised otherwise, gentle activity is still recommended at week 38. WHO, FOGSI, ACOG and RCOG all support moderate exercise in pregnancy because it helps with weight, blood-sugar and blood-pressure control, back and pelvic pain, mood, sleep, an easier labour and faster recovery. This late, the goal shifts from fitness to comfort, labour preparation and pelvic-floor work.

A realistic pattern now is around 150 minutes of moderate activity a week if you feel up to it, though many women drop to 20-30 minutes on 3-4 days, which is perfectly fine. Use the 'talk test' — moderate intensity lets you hold a conversation but not sing. Add daily pelvic-floor exercises and some time on a birth ball.

Suitable options at week 38:

Walking — the most accessible exercise here; 20-45 minutes most days is excellent (indoors during peak summer heat or high-pollution winter days).

Swimming or aqua-aerobics, if available — buoyancy supports the bump and eases swelling.

Stationary or recumbent cycling.

Prenatal yoga (Iyengar with props suits this stage; avoid hot/Bikram yoga).

Birth-ball sitting and gentle hip rocking (a 65 cm ball if you are under about 165 cm, 75 cm if taller; around Rs 500-2500) to ease back and pelvic ache and encourage a good baby position.

Pelvic-floor exercises (Kegels): squeeze for 5-10 seconds, release, and repeat 10-15 times, three sets a day. In late pregnancy also practise fully relaxing these muscles, which helps in the pushing stage. Daily perineal massage from around 34-36 weeks has good evidence for reducing tearing at birth.

What to avoid: contact sports and anything with a fall risk; scuba diving; high altitude without acclimatisation; saunas, hot tubs and very hot baths; lying flat on your back for long; full sit-ups or planks; and high-impact activities like running or jumping — switch to walking.

Stop and contact your doctor if you have vaginal bleeding, leaking fluid, regular painful contractions, dizziness or fainting, severe breathlessness, chest pain, a headache, calf pain or swelling (a possible clot), or reduced baby movements.

For Indian conditions: exercise in the cooler early morning or evening and hydrate hard in summer; check the AQI and stay indoors on high-pollution days. Importantly, push back gently against the common 'late pregnancy means complete bed rest' belief — for most women that advice is wrong and is linked to worse outcomes, including a higher clot risk.

Some symptoms at week 38 are emergencies. When in doubt, your maternity team would always rather assess you and send you home than miss something — never feel you are over-reacting. Call 102 (the free maternity ambulance) or 108, or go straight to the nearest hospital with obstetric services, for any of the following.

Go to hospital immediately if you have:

Any vaginal bleeding (a light blood-streaked mucus 'show' is normal, but fresh bleeding is not).

A gush or steady trickle of fluid — your waters may have broken; note the colour, as greenish-brown (meconium-stained) fluid needs urgent attention.

Reduced or absent baby movements — do not wait until morning.

A severe or persistent headache with blurred vision, flashing spots or light sensitivity, severe upper-abdominal pain, sudden swelling of the face and hands, or a sudden weight jump — possible preeclampsia.

Regular, painful, strengthening contractions — true labour.

A fever above 38°C, burning urine or one-sided calf pain and swelling (a possible clot).

Severe, persistent itching of the palms and soles, worse at night — possible obstetric cholestasis needing liver and bile-acid tests.

Reduced baby movements deserve special emphasis: lie on your left side after a meal or sweet drink and count distinct movements. The common reassuring target is 10 movements within 2 hours (some centres use other thresholds). If you do not reach it, have something sweet and recount; if it is still low, go to hospital that day or night for an NST and possibly a BPP. Reduced movements can be the first sign of a baby in trouble, and prompt checks save lives.

Knowing the signs of true labour helps you act at the right time. From 37 weeks, go in when you have regular, painful contractions that get longer, stronger and closer together — the '4-1-1' guide for first babies means contractions every 4 minutes, lasting 1 minute, for 1 hour. Second and later babies often come faster, so go earlier (around every 5-7 minutes). Also go in for ruptured membranes (even without contractions) or a heavy bloody show. Braxton-Hicks, by contrast, are irregular, do not build up and usually settle with rest. Read about how labour progresses through its stages so you know what to expect.

If you ever feel hopeless or have thoughts of harming yourself, reach out now: iCall (9152987821), Vandrevala Foundation (1860-2662-345), AASRA (9820466726) or NIMHANS Telemanas (14416), and tell your partner or family.

Your emotional health this week deserves as much attention as the physical changes. With about two weeks to your due date, it is normal to swing between excitement about meeting your baby and anxiety about labour, alongside impatience, broken sleep, nesting urges and worries about the baby's health, your finances or family dynamics. The cultural expectation that an expectant mother must be calm and joyful throughout simply does not match real life, and your feelings are valid.

Late-pregnancy anxieties often centre on pain and pain relief (you can read about the epidural decision and costs in India), whether labour will start on its own or need induction, and whether you will have a vaginal birth or a caesarean. India's private-hospital caesarean rates are high (often 40-60% in metro chains, well above the WHO-suggested 10-15%), which fuels worry; a caesarean is sometimes genuinely life-saving and never makes you 'less of a mother', so it helps to understand how a caesarean decision should be shared with you.

Antenatal depression and anxiety each affect a meaningful share of pregnancies in India, and untreated, they raise the risk of poorer outcomes and postnatal depression. The instinct to 'tough it out' or stop medication is often the wrong one — talk to your doctor and, where needed, a psychiatrist experienced in perinatal mental health. Effective options include talking therapies (CBT is well supported) and, where indicated, medication such as sertraline, which is generally considered safer than untreated illness. Tele-counselling through platforms like YourDost, Practo and Wysa is widely available (around Rs 500-3000 a session).

Lean on your support network — an emotionally present partner who validates rather than 'fixes' your feelings matters most, alongside family, friends and peer communities. Helplines include iCall (9152987821), Vandrevala Foundation (1860-2662-345), AASRA (9820466726) and NIMHANS Telemanas (14416).

Bonding deepens now as movements become easy for your partner to feel. Talking, singing or simply resting a hand on the bump all count, and there is no single 'right' way to bond — for some women it grows most strongly after birth, which is equally normal.

A supportive partner makes a real difference this week. Practical ways to help: ask how she is feeling without pressure to be cheerful; share decisions about the hospital, birth plan and pain relief; attend the weekly antenatal visit; learn the stages of labour and comfort techniques together; take on more of the housework; and act as a buffer against well-meaning but contradictory family advice.

Partners feel the build-up too — joy mixed with anxiety about supporting the labour and about becoming a parent. It helps to know that the partner's job in labour is not medical: it is emotional support, advocacy (relaying her wishes to the team when she is too focused to speak), and comfort measures such as back rubs, sips of water, position help and steady encouragement.

India's joint-family setting brings genuine help — cooking, company and newborn-care wisdom — alongside real friction: advice that conflicts with medical guidance, gender-preference pressure, and strong opinions about the mode of delivery. Two opposite pressures are common: relatives insisting on a 'normal delivery' even when a caesarean is medically needed, and some private settings pushing an over-eager elective caesarean for convenience or timing. A useful approach is to agree that the mother, guided by her doctor, is the decision-maker, with the partner advocating for her, and to use 'my doctor advised this' as a polite shield. A trained birth companion or doula can provide steady, experienced support if a partner cannot be present or if you want an extra layer of help.

By week 38 the partner should be reachable 24/7, know how to recognise true labour and when to leave for hospital, and have their own small bag ready (clothes, snacks, water, phone charger, cash). If they are due to travel for work, it is worth postponing.

On leave and logistics: India's Maternity Benefit Act provides 26 weeks of paid leave for the first two children at establishments with 10 or more employees, usually starting around weeks 34-36. Plan handovers, line up household help if you can (a japa maid or postpartum help often costs Rs 10,000-25,000 a month), and confirm who does what during early labour, the hospital trip and the first few weeks at home.

Costs this week cover your routine visit plus any tests, monitoring and birth preparation. A private antenatal visit runs about Rs 500-2500 (weekly now, so 4-6 in this final month), while care at a government PHC, CHC, district hospital or medical college is free under JSSK — including visits, tests, scans, medicines, delivery and postnatal care.

Typical late-pregnancy test costs in the private sector: GBS swab Rs 500-1500; CBC for anaemia Rs 200-600; urine routine and culture Rs 100-500; growth scan with Doppler Rs 1500-3500; biophysical profile Rs 2000-4500; and an NST Rs 500-1500 per session (often weekly from week 36, and twice-weekly from week 41). The Bishop-score vaginal exam is usually included in the visit.

Delivery package costs vary widely. Private metro chains typically charge Rs 60,000-1,50,000 for a normal vaginal delivery and Rs 1,00,000-4,50,000 for a caesarean; standalone private clinics in smaller cities are lower (around Rs 25,000-80,000 for a vaginal birth). An epidural usually adds Rs 5000-15,000, and NICU care is charged separately if needed. Government facilities provide delivery, surgery, NICU and postnatal care free under JSSK.

If your doctor discusses bringing labour on for a medical reason — being past your due date, preeclampsia, gestational diabetes or restricted growth — it helps to understand how induction works in India and what it costs.

Supplements (iron, calcium, vitamin D, prenatal multivitamin, DHA) cost around Rs 500-2500 a month, and many women add dates from week 36. Birth-preparation extras include hospital-bag supplies (Rs 2000-8000), childbirth classes (Rs 3000-15,000) and optional doula support.

Government schemes worth using: JSSK (free, comprehensive maternity care), PMSMA (free specialist review on the 9th of each month), PMMVY (a Rs 5000 cash benefit for the first live birth, registered via your anganwadi or ANM) and JSY (cash support for institutional delivery in eligible groups), plus state schemes such as Tamil Nadu's Dr Muthulakshmi Reddy Maternity Benefit Scheme. Also check your employer or family health insurance for maternity cover, waiting periods and per-claim sub-limits, and whether you are covered under Ayushman Bharat PM-JAY, CGHS, ESI or a state scheme. Planning early avoids surprises, as total private pregnancy-to-first-year costs can run from Rs 1,50,000 to Rs 8,00,000 or more.

• ACOG — Definition of Term Pregnancy (Early, Full, Late, Post Term)
• ACOG — How to Tell When Labor Begins
• WHO — Recommendations on Antenatal Care for a Positive Pregnancy Experience
• NHS — Signs that labour has begun
• RCOG — Group B Streptococcus (GBS) in pregnancy and newborn babies
• Ministry of Health & Family Welfare (India) — Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
• ICMR-NIN — Nutrient Requirements for Indians (RDA), 2020