Welcome to Week 40

Your Baby: Ready to Roll

The average size of a full-term baby is 6 to 9 pounds (2.7 to 4 kg) and 20 to 22 inches (51 to 56 cm) long at birth. The placenta weighs about one-eighth of the baby's size, and the umbilical cord is almost as long as the baby.

Your Body: What to Expect After Childbirth

Your life as you knew it is about to go topsy-turvy once your baby arrives. Taking care of a baby is a full-time job, and you're going to feel it -- physically and emotionally. Some first-time moms find it difficult to adjust to their new role, but if you know what to expect, it may make the adjustment easier.

Episiotomy aftermath. The healing process may take 2 to 3 weeks. Your stitches will dissolve and you will be able to sit on a normal surface again. Meanwhile, sit on an inflatable cushion or rubber inner tube and keep a squirt bottle on hand to rinse the area after you go to the bathroom. Sitz baths -- sitting in a tub of warm water -- will help the healing process, and give you a much-needed break from your new responsibilities.

Hemorrhoid care. One of the most common after effects of pushing during labor is a hemorrhoid. There are swollen blood vessels around the anus that may bleed and be painful. Depending on the severity of the swelling, you may want to soak your bottom in a few inches of warm water in the bath, or wear a cotton pad soaked with cold witch hazel cream in the anal area.

Uterine contractions. During the first week after birth while your uterus returns to its prebirth state (over a 6-week period), you may feel afterpains or contractions. This may occur in particular during nursing and after multiple pregnancies.

Bleeding. It is normal to bleed after birth for anywhere up to 2 to 3 weeks (and sometimes spotting for longer). You should call your doctor right away if the bleeding:

• Remains heavy after the first week
• Resumes after slowing down
• Turns bright red after the fourth postpartum day
• Has large clots
• Has a foul odor (with fever and chills)

Breast changes. Whether or not you are breastfeeding, you'll know when your milk comes in because your breasts may be so full of milk that they get hard and engorged. Wearing a well-fitted, supportive bra at all times may help relieve any breast pain. If you do get engorged (which may be accompanied by a slight fever and flu-like feelings for a day), apply cold washcloths or ice packs to reduce the swelling. Call your provider if you have any persistent fevers, abnormal nipple discharge, or any areas of tenderness which may be a sign of infection.

Incontinence issues. For the first few days (and sometimes weeks) after birth, your urine and bowel movements may be out of control. The culprit:

• Stretching of the base of the bladder
• Stretching and weakening of the pelvic floor muscles
• Tearing of the perineum
• Nerve injury to the sphincter muscles around the anus

The treatment:

• Kegel exercises to improve the bladder
• Special doctor-prescribed exercises to control your bowels
• Time

Most incontinence resolves in the first few months after delivery. Be sure to tell your health care provider about your symptoms. They can suggest other treatment options. Occasionally, women need surgery to get their bladder and bowels under control.

Intense fatigue. Every new mom suffers from sleep deprivation. To help manage your fatigue:

• Ask for -- and accept -- offers of help from friends or family.
• Unplug your phone and let your answering machine take messages.
• Take naps while your partner watches the little one.
• Leave the housework for later and live with clutter.
• Simplify your daily tasks. Order take-out food, eat frozen food, and use paper plates.

Your baby will only be a newborn for a few weeks. Savor it, and worry about thank you notes and dust bunnies later.

A rollercoaster of emotions. You may feel overwhelmed, stressed out, teary, elated, or even depressed. Some of those feelings are normal and to be expected. But if you're unable to function or can't shake the blues you should consult a professional.

On That Note: If You're Down and Troubled

You may have heard or read about the baby blues, which lasts for about the first two weeks after childbirth. Postpartum depression is a more serious condition a mother experiences after the first few weeks of birth. If baby blues doesn't ease within a couple weeks, or you think you may have postpartum depression, call your provider right away.

Weekly Tip

Feeling like this baby is never going to come out? Put your fears to rest. It will happen: It's just a matter of time. But if your due date is fast approaching and there are no signs of labor, make it special anyhow: Go out to a romantic, candlelit dinner with your spouse to mark the day. Who knows? It may just be your last day as a twosome.

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