When you're pregnant, you might look forward to having the baby "drop" as an indication that the end of pregnancy is in sight. This process, medically termed "lightening," generally occurs two to three weeks before labor starts in first pregnancies. In subsequent pregnancies, the baby may not drop at all until labor starts. Many factors could contribute to the baby still being high up in the pelvis at 39 weeks. Having a baby that's still floating at the end of pregnancy can increase some pregnancy discomforts and could result in extra testing to determine the cause.
Shortness of Breath
If the baby doesn't drop by the 39th week of pregnancy, you may experience increased shortness of breath, which usually improves after lightening occurs. As the baby grows, he pushes the diaphragm, the muscle that separates the lungs from the abdominal cavity, up around 1 1/2 inches, which decreases your lung capacity, according to the university-run NetWellness website. The crowding of your diaphragm makes it hard to lie flat at night; try sleeping on your left side or sleep with several pillows under your head and shoulders.
If your baby hasn't dropped by week 39, when she weighs between 6 and 9 pounds, she may crowd your intestines and stomach. You may not feel hungry or may not be able to much before feeling full. Heartburn, a common pregnancy complaint, may persist if your baby doesn't drop. The pressure on your stomach may increase the chance that stomach acid will enter the esophagus, causing burning pain and discomfort. Eating small amounts rather than larger meals and avoiding carbonated beverages that increase gas and bloating and may help.
If your baby hasn't dropped by 39 weeks in a first pregnancy, your doctor may schedule you for an ultrasound to assess the baby's size or check the baby's position in the uterus. A baby who may be too big for the pelvis may not be able to descend past the ischial spines, the narrowest part of the pelvis. While 97 percent of babies come head first, according to the University of Maryland Medical Center, around 3 percent present in different positions that don't fit as well, if at all. A breech baby, whose head is up rather than down or a baby lying cross-wise in the uterus may need to be delivered by Caesarean section. If your doctor feels that the baby is too large or is in a position that makes vaginal delivery difficult, she may schedule you for a Caesarean section.
If your water breaks and the baby's presenting part is still high, call your doctor immediately. When the baby's head is not in the pelvis, you have a higher risk of having a cord prolapse, where the umbilical cord drops below the baby's head. Cord prolapse occurs in around 1 in 300 deliveries, according to the Cleveland Clinic. Your doctor may want you to go right to the hospital if your water breaks. When your water breaks, you may experience a much larger gush of fluid than you would if the baby's head was low in the pelvis, blocking the flow of fluid.