40 Weeks Pregnant

40 Weeks Pregnant: Your Expected Due Date

At 40 weeks pregnant, you are around your expected due date. Labor may start this week, but it may not start immediately, and that alone does not always mean something is wrong. The key now is to monitor fetal movement, recognize labor signs, and follow your clinician's plan if pregnancy continues past the due date.

You may feel excited, anxious, and physically tired. Contractions, pelvic pressure, back pain, frequent urination, and sleep difficulty may increase. But bleeding, water breaking, reduced fetal movement, or severe headache should not be treated as ordinary symptoms.

This content is educational only and does not provide a diagnosis or treatment plan. If you have bleeding, severe pain, dizziness, fainting, severe vomiting, fever, or concerning symptoms, consult a licensed clinician in Saudi Arabia.

How is week 40 calculated?

Pregnancy is medically dated from the first day of the last menstrual period, not from the day of fertilization. When you are described as 40 weeks pregnant, this means the calculated pregnancy age is about 40 weeks.

The due date is an estimate, not a guaranteed birth date. If your last period date is unclear or cycles are irregular, your clinician may use previous measurements or a fetal growth ultrasound to confirm the estimated timing. You can use the pregnancy due date calculator as an initial estimate, then rely on the date documented in your prenatal record.

Symptoms at 40 weeks pregnant

This week, symptoms may be more connected to the baby moving lower and labor approaching. Possible symptoms include:

• Pelvic or lower abdominal pressure, especially if the baby's head has moved lower.
• Lower back, hip, or pelvic discomfort.
• Braxton Hicks contractions or irregular tightening.
• Regular contractions that may be labor if they become stronger and closer together.
• Frequent urination because of pressure on the bladder.
• Marked tiredness and sleep difficulty because of the abdomen and waiting.
• Heartburn, gas, or constipation, though heartburn may improve for some women if the baby moves lower.
• More vaginal discharge, and you may notice the mucus plug.
• Mild swelling in the feet by the end of the day, while sudden or severe swelling needs review.
• An urge to finish home or hospital preparations before birth.

Losing the mucus plug does not always mean birth will happen immediately. Clear water leakage, bleeding, regular contractions, or reduced fetal movement should be discussed according to your clinician's instructions.

What is happening with the baby at 40 weeks?

At 40 weeks, the baby is usually fully grown or nearly fully grown, and may continue gaining small amounts of weight until birth. The lungs, brain, and nervous system continue maturing even around the expected due date.

• The body bones are stronger, while the skull bones remain softer and flexible to help during birth.
• The skull bones may overlap slightly during vaginal birth, so the baby's head can look cone-shaped for a short time after birth.
• The fontanelles, or soft spots on the baby's head, remain open after birth and close gradually later.
• Space for movement is tighter, but movement should still be present in a familiar pattern.
• The amniotic fluid and placenta continue supporting the baby, so your clinician may monitor fluid and fetal well-being if birth is delayed.
• If meconium appears in the amniotic fluid, the care team may monitor the baby closely during and after birth depending on the situation.

Less space does not mean fetal movement should disappear. A clear decrease or change in movement needs contact with your clinician or emergency care.

How big is the baby at 40 weeks pregnant?

At 40 weeks, the baby may be around 48.3 to 53.3 centimeters from head to heel and may weigh about 3 to 4.5 kilograms. These figures are approximate and vary with actual pregnancy age, genetics, maternal health, and measurement technique.

Estimated weight alone is not enough to decide the birth method. Your clinician looks at the full picture: fetal position, clinical pelvic assessment, previous births, diabetes, placenta, amniotic fluid, and maternal and fetal condition.

Fetal movement at 40 weeks

At 40 weeks, movement may feel different: stretching, pressure, rolling, or side-to-side movements instead of wide kicks. Movement should not disappear, and reduced movement should not be dismissed because the due date is close.

Continue fetal movement follow-up by paying attention to your baby's usual pattern. If you notice a clear decrease or disappearance of movement that had become familiar, contact your clinician or emergency care immediately depending on severity. Do not rely on drinking something cold or sweet instead of asking for advice when you are clearly concerned.

True labor signs

Labor may begin with regular contractions, water breaking, or changes in discharge. Not every pain means labor, but the following signs deserve attention:

• Regular contractions that become stronger and closer together over time.
• Lower back pain or pelvic pressure that increases with contractions.
• Watery fluid leaking from the vagina, either as a gush or a persistent trickle.
• Mucus-like discharge mixed with light blood, which may reflect cervical change.
• Contractions that do not improve with rest, hydration, or position change.
• A strong urge to push, especially with intense pelvic pressure.

Ask your clinician in advance: when should I go to the hospital, what contraction pattern should I follow, what should I do if my water breaks, and do instructions change if I had a previous cesarean, positive GBS result, or high-risk pregnancy?

Braxton Hicks or labor?

Braxton Hicks contractions are often irregular, do not keep becoming stronger in the same pattern, and may ease with rest, hydration, or changing position. True labor contractions tend to become regular, stronger, and closer together over time, and usually do not settle easily.

• Track contraction timing, duration, and spacing.
• Notice whether contractions become stronger and closer together or remain uneven.
• Do not use herbs or home remedies to induce labor without your clinician's approval.
• If you had a previous cesarean birth, ask your clinician in advance about instructions when contractions begin.

If contractions are regular or severe, or if they come with bleeding, water breaking, reduced movement, severe pain, or a strong urge to push, contact emergency care or go to the hospital.

Water breaking at 40 weeks

Water breaking means the membranes around the baby have ruptured. It may feel like a clear gush or a persistent trickle that you cannot control. If you think your water has broken, contact the hospital or clinician even if contractions have not started yet.

• Notice the fluid color: clear, pink, green, brown, or unusual smelling.
• Avoid putting anything in the vagina after your water breaks, including sex or self-examination.
• If the fluid is green or brown, or if there is fever or reduced fetal movement, seek urgent assessment.
• Follow the hospital's instructions about when to come in, especially if your GBS result is positive or unknown.

Tests and follow-up at the final visit

At 40 weeks, your clinician may discuss or request fetal monitoring if labor has not started or if there is a medical reason. Follow-up may include a nonstress test NST, amniotic fluid index AFI, or biophysical profile BPP.

Your clinician may also review fetal position assessment, placenta and amniotic fluid assessment, and the result of your GBS swab or Group B Strep screening. Not every test is needed for every pregnancy; the decision depends on pregnancy age, fetal movement, blood pressure, diabetes, amniotic fluid, and symptoms.

Your medical file may also require review of a complete blood count CBC, blood group and Rh factor, or urinalysis and urine culture.

Going past the due date and induction

If labor does not start at 40 weeks, your clinician may explain the follow-up plan for the coming days. Some women go into labor naturally after the due date, while others need closer monitoring or induction.

A labor induction consultation can help you understand options such as cervical ripening, oxytocin, artificial rupture of membranes, or other approaches chosen by your clinician. Do not use home induction methods such as herbs, oils, or medicines without your clinician's approval; some are ineffective or unsafe.

• Induction may be discussed if pregnancy continues past the due date, especially with fluid changes, diabetes, high blood pressure, or reduced movement.
• Your clinician may assess the cervix to understand how ready it is for induction.
• If you had a previous cesarean birth, induction options may be different and need careful discussion.
• If the mother or baby needs faster birth, cesarean birth may be discussed depending on the situation.

Pushing, crowning, and the ring of fire

During a vaginal birth, the baby's head may begin to appear with each contraction. When the head remains visible and does not slip back between contractions, this is called crowning. You may feel a strong burning or stinging sensation as the vaginal opening stretches around the head, sometimes called the ring of fire.

Follow the midwife's or clinician's instructions closely. You may be asked to stop pushing or breathe in a specific way to protect the perineum and reduce tearing risk as much as possible. Do not push forcefully if the care team asks you to pause, because controlled pushing at this stage may help the birth happen more gradually.

APGAR score after birth

Soon after birth, the baby receives a quick assessment called the APGAR score. It is used to assess the newborn's general condition at one minute and five minutes after birth, including breathing, heart rate, color, movement, and response.

APGAR is not an intelligence test and does not predict the child's future personality or development. It helps the care team decide whether the baby needs routine care or extra support after birth.

Cesarean birth, VBAC, or vaginal birth

At 40 weeks, your birth plan may be clear, but it can still change depending on what happens during labor. A flexible birth plan consultation can include when to come in, pain relief, support person, and postpartum preferences.

If you had a previous cesarean birth, a VBAC consultation can help clarify instructions when labor begins. If there is a medical reason or the situation changes during labor, a cesarean birth consultation or cesarean birth may be discussed as a safer option.

Breastfeeding and the first hours after birth

If you plan to breastfeed, a breastfeeding consultation before or soon after birth may help. Ask about skin-to-skin contact, the first feed, signs of a good latch, and when to ask for help if there is severe pain or difficulty.

After birth, your health matters too. Heavy bleeding, dizziness, fever, chest pain, shortness of breath, severe leg pain, severe headache, or persistent overwhelming sadness needs assessment.

Practical tips for week 40

• Make sure your hospital bag is ready with ID, insurance if available, key tests, phone charger, and clothes for mother and baby.
• Review your GBS result with your clinician and ask whether antibiotics are needed during labor.
• Keep emergency, hospital, and clinician contact numbers ready, and agree on a transport plan with your support person.
• Continue pregnancy vitamins and do not double doses on your own.
• Discuss iron during pregnancy according to your tests if you have anemia or low stores.
• Side sleeping during pregnancy may remain more comfortable until birth.
• Do not start a new medicine or supplement or stop a long-term medicine before a medication review during pregnancy.

When may closer follow-up be needed?

You may need high-risk pregnancy follow-up or a closer birth decision if risk factors need monitoring.

• Gestational diabetes or pre-existing diabetes, high blood pressure, thyroid disease, kidney disease, heart disease, or autoimmune disease.
• Pregnancy with twins or more, or pregnancy after fertility treatment.
• Previous cesarean birth, difficult birth, previous bleeding, or previous preterm birth.
• A clear decrease in fetal movement after movement has become familiar to you.
• Low amniotic fluid, high blood pressure, or a finding on ultrasound or fetal monitoring.
• Positive GBS result or antibiotic allergy that needs a clear plan.

Warning signs at 40 weeks pregnant

Seek urgent medical assessment or emergency care, depending on severity, if any of the following occur:

• Clear or increasing vaginal bleeding.
• Watery fluid leaking from the vagina or persistent unusual wetness.
• A clear decrease or disappearance of fetal movement after movement had become familiar.
• Strong or close regular contractions according to your clinician's or hospital's instructions.
• Severe or persistent abdominal or pelvic pain.
• Very severe headache, visual changes, upper abdominal pain, chest pain, severe shortness of breath, or sudden swelling.
• Fever, chills, severe pain with urination, or flank pain.
• Persistent vomiting that prevents fluids or causes reduced urination and dizziness.
• Green or brown fluid, or foul smell when your water breaks.
• A strong urge to push or intense pelvic pressure before reaching the hospital.

Next step

After week 40, if labor has not started, follow-up with your clinician becomes important to decide whether to wait with fetal monitoring or discuss induction or another plan. Continue to book pregnancy and childbirth care, or return to the week-by-week pregnancy guide.