Medically reviewed by Dr. Hemalatha, MBBS, DGO, Consultant Gynaecologist
The last month of pregnancy is mostly waiting, punctuated by symptoms that make you wonder whether the waiting has ended. Here's how to read them.
What happens in the last four weeks?
Your baby is gaining weight steadily and their lungs are finishing maturing. Around 36 to 38 weeks, the baby often drops lower into your pelvis — "lightening" or engagement. Breathing gets easier and the pressure moves downwards, so you'll need the bathroom more often and may feel a heaviness in the pelvis.
Your antenatal visits become weekly. Go to all of them, even when you feel fine. Blood pressure, urine protein, fundal height and the baby's position and heart rate are all being tracked precisely because problems in late pregnancy can develop without you noticing.
What's normal in the last month?
Most of what makes this month uncomfortable is normal:
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Braxton Hicks contractions — irregular tightenings that come and go
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Pelvic and hip pressure, sometimes a sharp pain when you shift position
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Backache and difficulty finding any comfortable sleeping position
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Swollen feet and ankles, especially at the end of the day and in the heat
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Frequent urination, and sometimes small leaks when you cough or laugh
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Heartburn and breathlessness (though breathlessness often improves after engagement)
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Increased vaginal discharge — clear or white, without itching or smell
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The mucus plug coming away — a jelly-like plug, sometimes tinged with blood
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A burst of energy in the last days, the so-called nesting instinct
Swelling deserves a note. Gradual swelling of the feet and ankles is normal. Sudden swelling of the face and hands, or a rapid increase overall, is not — see the warning list below.
How do I know if I'm in labour?
The distinction is regularity and progression. Braxton Hicks contractions are irregular, don't get closer together, ease when you change position or drink water, and are usually felt at the front. Real labour contractions come at regular intervals, get longer, stronger and closer together over time, don't stop when you move, and are often felt starting in the back and wrapping around.
The other signs of labour starting: waters breaking — a gush or a persistent trickle you can't control, a bloody show, and low back pain that comes and goes in a rhythm.
Go to hospital when: contractions are around five minutes apart, lasting about a minute each, for an hour — the common "5-1-1" guide — or as soon as your waters break, or immediately if any warning sign below appears. If it's your second or later baby, or you live far from the hospital, go sooner. Ask your doctor at your next visit for the threshold they want you to use.
What are the warning signs in late pregnancy?
Go to hospital immediately — not at your next appointment — if you have any of the following:
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Reduced or changed fetal movement. This is the most important item on the list.
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Any vaginal bleeding
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Waters breaking, especially if the fluid is green, brown or foul-smelling
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Severe headache that painkillers don't touch
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Blurred vision, flashing lights or spots
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Sudden severe swelling of the face, hands or feet
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Pain under the ribs on the right side
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Persistent vomiting in late pregnancy
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Fever above 38°C
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Severe constant abdominal pain, as opposed to contractions that come and go
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Fainting, or severe breathlessness at rest
The headache, vision changes, upper abdominal pain and sudden swelling cluster together as possible signs of pre-eclampsia, which can develop quickly and needs assessing the same day.
How do I monitor my baby's movements?
Pay attention to your baby's own pattern rather than a fixed number. You'll know their usual active times by now. If movements feel reduced, changed, or noticeably weaker, contact your hospital immediately.
Three things not to do:
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Don't wait until morning
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Don't drink cold water or eat something sweet and wait to see if the baby responds — this delays assessment and doesn't reliably tell you anything
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Don't assume a baby moves less near term because there's less room. That is a common belief and it is not correct.
Reduced movement is checked easily and quickly. Nobody at the hospital will mind you coming in. Coming in and being reassured is the intended outcome.
What can I do to prepare?
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Pack the hospital bag by 36 weeks and put it in the car
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Keep your antenatal file, scans and ID together in one folder
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Programme the hospital number and your doctor's number into your phone, and give them to your family
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Sort out transport, including a backup plan for the middle of the night
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Ask your doctor at 36 weeks what their specific instruction is on when to come in
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Rest properly, eat regularly, and keep moving gently — short walks help
Quick answers
Is it safe to have sex in the last month? Usually yes, in an uncomplicated pregnancy. Ask your doctor if you've had bleeding, a low-lying placenta, or your waters have broken.
Can walking or spicy food bring on labour? Neither reliably starts labour. Walking is good for you regardless. Don't try castor oil or herbal preparations to induce labour — these can cause harm, and induction should be a medical decision.
Is 37 weeks full term? 37 to 38 weeks is "early term"; 39 to 40 weeks is "full term". Babies born from 37 weeks generally do well, but the last weeks still add real benefit for the lungs and brain.
What if I go past my due date? Common, especially with a first baby. Your doctor will increase monitoring and discuss induction, usually somewhere between 40 and 42 weeks.
Should I be worried about a breech baby at 36 weeks? Most babies turn by then, and some turn later. Your doctor may discuss turning the baby manually, or plan a caesarean. It's a common situation with clear options.
