Third trimester · Pregnancy week by week
Week 40 of pregnancy
Baby is the size of a small pumpkin. About 20.50 inches, 3500g.
Week 40 is your due date. The CDC documents that Black women die from pregnancy-related causes at 3 to 4 times the rate of white women — the postpartum period (the next 6 weeks) is the highest-risk window. Postpartum vigilance is the final advocacy. Source
What's happening with the baby
The fetus is fully developed and ready for delivery. Average fetal weight is around 3.5 kg (7.7 lbs). The fetus continues to gain weight while in the womb.
What's happening for you
Most women are in early labor or close to it. Some women go past 40 weeks; induction is typically discussed at 41–42 weeks. Many women have intense pelvic pressure, frequent prodromal labor, and exhaustion.
Common (normal) symptoms this week
Active labor signs may begin: regular contractions (5-1-1 rule), water breaking, increased bloody show. Pelvic pressure, mild diarrhea, nesting urge.
Call your OB or 911 if
- Severe headache that won't go away with acetaminophen — preeclampsia.
- Vision changes — blurred vision, light flashes, vision loss.
- Severe right-upper-quadrant pain — HELLP syndrome.
- Sudden swelling of face, hands, or feet.
- Reduced fetal movement — fewer than 10 kicks in 2 hours.
- Vaginal bleeding, fluid leakage, or persistent contractions.
- Severe shortness of breath at rest or chest pain.
- Fever over 100.4°F.
- Seizure — eclampsia, life-threatening.
Note: Postpartum preeclampsia and postpartum hemorrhage can develop up to 6 weeks after delivery. Black women die from postpartum hemorrhage at 3 to 4 times the rate of white women and from postpartum preeclampsia at higher rates. If any of these warning signs appear after delivery, go to the obstetric ED.
Why this week matters for Black families
The final weeks and the immediate postpartum period are where Black-maternal-mortality cases cluster. Postpartum hemorrhage rates are 3 to 4 times higher in Black women per ACOG Practice Bulletin 183, and recognition is documented to be slower. If after delivery you soak a pad in under an hour, pass golf-ball-sized clots, feel lightheaded standing up, or your heart races at rest — go to the ED, not to your OB's office for an appointment. Postpartum preeclampsia can develop up to 6 weeks after birth and is repeatedly missed. The Serena Williams near-miss in 2017 wasn't an outlier — it was the median pattern.
What to do this week
If labor hasn't started, discuss induction timing with OB. Postpartum recovery is the final advocacy: every Black woman should have a 1–3 week postpartum visit (not just 6 weeks). Watch for hemorrhage, preeclampsia, mood disorders. Postpartum depression screening is critical — Black women have similar rates of perinatal mood disorders but lower rates of treatment per the AMA.
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References
- CDC Pregnancy Mortality Surveillance System.
- ACOG Committee Opinion 757 — Screening for Perinatal Depression.
- AMA Journal of Ethics — Disparities in Perinatal Mental Health Care.
Last medically reviewed: .
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