Pregnancy Calendar: 33 Weeks Pregnant

How big is baby? Baby has grown to weigh about 4.25 pounds (1.9 kg) and 17.25 inches (44cm). He or she is about the size of a pineapple!

What’s new this week? Many women start experiencing heartburn toward the end of pregnancy. Read on for a few tips on keeping heartburn under wraps.

What’s next? It’s time to start thinking about your preferences during delivery. Episiotomies are not routinely performed anymore, but you may still require one. Learn more about the procedure below.

While you can certainly feel your baby moving and growing in your belly, this week, you will want to learn the signs of a premature rupture of membranes. You will also want to make sure you know how to identify whooping cough and seek appropriate medical attention.

What’s happening with my baby?

Baby’s skin continues to plump as fat is added to his or her frame. The skin is becoming smoother each week and appears less red than it did previously. Baby’s skull is malleable. The plates of bone are not yet fused, allowing shifting as baby moves through the birth canal. These gaps, referred to as fontanelles, will not close entirely until baby is about 18 months old.

If your little one is a boy, his testicles are continuing to descend from the abdomen to his scrotum. It is not uncommon for a testicle (or both) to not fully descend until after birth. Most little boys will have both testicles in place by about 6 months after birth.

How big is my belly?

Your uterus has likely expanded another quarter inch (1 cm) above your bellybutton from last week. You should have gained between 22 and 28 pounds (9.9 to 12.6 kg) thus far during your pregnancy.

PPROM

Not all women’s water break before labor begins. In fact, only 10 to 15 percent of pregnant women will experience her water breaking before feeling the onset of labor. This is referred to as premature rupture of membranes (PROM) and refers to the breaking of the amniotic sac. If this rupture occurs before the 37 week of pregnancy, it is referred to as preterm-premature rupture of membranes (PPROM). This only occurs in about 1 percent of pregnancies.

It is important the rupture is identified and treated within 24 hours. Otherwise, there is a heightened risk of infection and other serious complications. If you suspect this has occurred, your doctor can perform a painless test to diagnose PPROM. A sterile swab is inserted into the vagina to test for a protein not present unless amniotic fluid has passed through.

While the medical field is not entirely sure what causes PPROM, there are several contributing factors that may increase risk, including smoking, vitamin and mineral deficiencies and infection. African-American women may also have a higher risk.

Water may break in many ways: with a sudden gush, an ongoing flow or a slow trickle. If you experience any fluid leaking from your vagina and you are not sure if it is urine or water, put on clean underwear and lie down for 30 minutes. Amniotic fluid will pool in the vagina.

Heartburn

As pregnancy progresses, heartburn may become more intolerable. The pain is caused by progesterone, which is responsible for relaxing muscles during pregnancy. The trouble is, it also relaxes the stomach valve that keeps acid below the esophagus. Not to mention a growing baby (or two! or three!) who is putting pressure on the stomach, forcing that problematic acid into the esophagus.

You can help ward off heartburn during late pregnancy by eating five or six small meals a day, ingesting food slowly, sipping liquids and going for a quick walk after a meal rather than lying down. If heartburn keeps you up at night, prop your head and shoulders up using several pillows. And definitely keep TUMS handy at all times!

Whooping Cough

Whooping cough, a lingering cough, can especially affect pregnant women, as their immunity has been compromised. The condition starts as a cold and mild cough, then progresses into a more intense cough, which causes you to cough until there is no air left in the lungs. The inevitable deep breath then creates a heaving cough. Phlegm is often brought up and can even be followed by vomit.

If you believe you have these symptoms, call your doctor immediately. The sooner whooping cough is diagnosed, the more chance antibiotics can help cure it. If it has been more than two years since your DPT immunization booster (diphtheria, pertussis and tetanus) talk to your medical care team about getting another one.

Episiotomy

Here’s a fun topic: episiotomies! The good news? You likely will not need one. Here’s the lowdown on down there:

An episiotomy is a surgical cut in the perineum (the area between the vagina and anus) to enlarge the vaginal opening for delivery. While they were common practice—doctors felt a clean cut would heal faster than a tear—studies over the past two decades have proved this theory wrong. The American Congress of Obstetricians and Gynecologists has recommended they are no longer performed unless there is a real need.

These studies have shown spontaneous tears allow women to heal faster and with fewer complications than an episiotomy. When an episiotomy is performed, the mother often loses more blood during delivery, experiences more pain during recovery and experiences pain and discomfort during sexual intercourse for a longer period of time. An episiotomy may even lead to a tear through to the anal sphincter or rectum. These are obviously difficult to recover from and may lead to trouble with anal incontinence.

An episiotomy is still used in some cases if the health of the mother and baby depend on it. For example, if your physician needs room to utilize forceps during delivery, he may choose to create a cut. Or, if your baby is not tolerating labor well and his or her heart rate spikes, your doctor may create a cut to get baby out faster.

It is important to communicate with your medical team to ensure you are on the same page. Ask your physician when and under what circumstances she may perform an episiotomy and other methods for helping you avoid tearing.

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