Week 32: Practice Breathing
Your baby is practicing breathing, sleeping for 20-40 minutes at a stretch, and growing fingernails that might need trimming at birth!
Medically reviewed by Samantha L. Fox, RN, BSN, MSN
Nursing Informaticist · United States Navy Nurse Corps · Last reviewed
Your baby is the size of a...
🫛 Jicama!
👶 Baby Development
- ✓Baby practices breathing movements 40% of the time
- ✓Sleeps for 20-40 minutes at a time
- ✓Toenails are fully formed
- ✓Skin is becoming less wrinkled and more smooth
- ✓Baby has definite periods of sleep and wakefulness
- ✓Lungs are almost fully developed
💊 Common Symptoms
- •Shortness of breath — uterus pushes up on lungs
- •Heartburn intensifying
- •Contractions (Braxton Hicks) more frequent
- •Difficulty sleeping — can't get comfortable
- •Lower back pain and pelvic pressure
- •Swelling in hands, feet, and face
🩺Clinical Context — From a Nurse's View
Thirty-two weeks brings a growth ultrasound for many, especially if you have any risk factors (gestational diabetes, hypertension, prior small or large baby, or fundal height measuring off by more than 2 cm). It checks fetal weight, growth percentile, amniotic fluid index, and fetal position. Babies born at 32 weeks have survival rates above 95%, though most still spend 2-4 weeks in the NICU. The cervix may begin softening (effacement) and slight dilation can occur this early without indicating labor — your cervical exam findings only matter in the context of the whole picture. Heartburn and reflux peak in the next few weeks. Sleep on a wedge or with the head of the bed elevated 6 inches; avoid eating within 3 hours of lying down. Famotidine (Pepcid) and TUMS are safe; talk to your provider before using PPIs.
Written by Samantha L. Fox, RN, BSN, MSN — Emergency Department nurse, US Navy Nurse Corps officer.
🚨 When to Call (or Go to the ER)
- !Regular contractions, fluid leak, bleeding — call
- !Decreased fetal movement — call
- !Severe headache, vision changes, RUQ pain, swelling — call
- !Severe back pain that comes in waves — call (could be back labor)
✅ Normal — Even If It Feels Worrying
- ✓Strong Braxton Hicks
- ✓Pelvic pressure
- ✓Heartburn
- ✓Swelling that resolves overnight
✅ To-Do This Week
- Pre-register at the hospital if not done
- Finalize birth plan and share with your medical team
- Prepare a 'coming home' outfit for baby
- Set up the bassinet or co-sleeper in your bedroom
- Learn infant CPR — take a class!
- Start weekly kick counts and log them
🩺 Questions for Your Doctor
- ?Is the baby in head-down position?
- ?What is an ECV (external cephalic version) if baby is breech?
- ?Are my Braxton Hicks contractions concerning?
- ?When does the Group B Strep test happen?
- ?Should I be concerned about swelling?
- ?What should I do if I think my water broke?
📚 References
- [1]ACOG Practice Bulletin No. 234: Prediction and Prevention of Spontaneous Preterm Birth. Obstet Gynecol. 2021;138(2):e65-e90.
- [2]ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260.
- [3]ACOG Practice Bulletin No. 229: Antepartum Fetal Surveillance. Obstet Gynecol. 2021;137(6):e116-e127.
Editorial review: Samantha L. Fox, RN, BSN, MSN. Last reviewed: see footer.
Your baby is the size of a...