Tommy's PregnancyHub

My premature baby's development in the womb-week 31

If you have been told you are at risk of a premature birth, you may be feeling anxious. Here’s some information about your baby’s development this week.

This information is for women who have been told that they are at risk of a premature birth

If you are not at risk of having a premature baby, we have information for you in our pregnancy calendar - our week-by-week guide to the stages of pregnancy.

Your baby's development this week

Your baby’s eyes start opening and closing around time, blinking and learning to focus. There is also a real difference in baby’s weight. From 28 to 32 weeks the weekly weight gain is as much as 500g. 

Your pregnancy symptoms

Antenatal appointments

You'll have an appointment at 31 weeks if this is your first baby. Your midwife or doctor will use a tape measure to measure the size of your uterus, measuring your blood pressure and testing your urine for protein. 

Itching

As your stomach grows, the skin on your stomach stretches, which may feel mildly itchy. Itching can also be caused by hormone changes. If you have mild itching, you may find it helpful to:

  • wear loose clothes
  • wear cotton clothes and avoid ones that are made of synthetic or wool materials
  • have cool baths
  • avoid using strong perfume and use unperfumed soap
  • use lotion or moisturiser on your stomach
  • avoid spicy food, alcohol or caffeine.

Contact your midwife or doctor if you are itchy, especially on the soles of your feet and palms of your hand, with or without a rash. Itching can also be a symptom of a pregnancy condition called intrahepatic cholestasis of pregnancy (ICP, also known as obstetric cholestasis). This is a liver condition that needs medical attention. 

Less common symptoms of ICP include:

  • dark wee
  • pale poo
  • jaundice (yellowing of the skin and eyes) 
  • a tenderness or pain on the right-hand side, just underneath your rib cage. 

Symptoms of ICP typically start from around 30 weeks of pregnancy. But it is possible to develop the condition as early as 8 weeks.  

Find out more about intrahepatic cholestasis of pregnancy.

Other symptoms

If you are at risk of giving birth early, it’s important to take care of yourself. There are also some things you can do to try and reduce the risk of giving birth early.

Tell your midwife or doctor if you have any symptoms that you are worried about. Do not worry if you've talked about it before and don't be concerned about whether you're wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Symptoms of early labour

Call your midwife or hospital maternity unit straight away if you think you are in early labour. It may be a false alarm, but it’s best to get checked out. Find out more about the symptoms of early labour

Your mental health

If you have been told that you are at increased risk of giving birth early, it’s important to try and reduce stress and take care of your emotional health. Find out more about coping with the idea of a premature birth.

What may happen if your baby is born this week

If you have any questions about your pregnancy or risk of premature birth please talk to your doctor or midwife.

You can also call the Tommy’s midwives on on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

If your baby was born this week they would be classed as very preterm (rather than extremely preterm).

If your baby is born now, the medical conditions associated with severe prematurity become less serious. But they will still need specialist care in the neonatal baby unit. 

It’s unlikely that babies born now will have severe breathing problems requiring intubation in the delivery room. They will still need help with their breathing. Instead, they will have small prongs into their nostrils or a mask over their nose connected to a machine (called ‘CPAP’) that provides air or oxygen with pressure to make the effort of breathing easier for them.

Your baby may be given some medicine into their lungs, called surfactant, to help with their breathing.

The healthcare team may recommend caffeine treatment to help reduce or treat apnoea.   Apnoea is a common condition where a baby may pause their breathing for a variable amount of time. 

It’s still important to prevent hypothermia, at birth they will be placed into a plastic bag up to their neck to help keep them warm and protect their fragile skin, on the neonatal unit they will be placed in an incubator.

They will need a thin tube passed through their nose or mouth into their tummy that milk can be given through. They will also need fluids (a ‘drip’) through a thin tube into a vein (intravenous or IV line). 

Your baby will also be tested and may be treated for infection. 

Your healthcare team will monitor your premature baby closely to make sure they receive the best possible care. 

Regan, Lesley (2019) Your pregnancy week by week, Penguin Random House, London

NHS. Your antenatal appointments. https://www.nhs.uk/pregnancy/your-pregnancy-care/your-antenatal-appointments/ (Page last reviewed: 2 September 2019 Next review: 2 September 2022)

Royal College of Obstetricians & Gynaecologists (2012) Obstetric cholestasis https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-obstetric-cholestasis.pdf

ICP Support www.icpsupport.org/symptoms

NHS. Itching intrahepatic cholestasis of pregnancy. https://www.nhs.uk/conditions/pregnancy-and-baby/itching-obstetric-cholestasis-pregnant/ (Page last reviewed: 02/08/2019 Next review due: 02/08/2022)

Bamat N et al. (2019) Positive end‐expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia. Cochrane Database of Systematic Reviews 2019; Issue 2. Art. No.: CD004500. DOI: 10.1002/14651858.CD004500.pub3.

NICE (2019) Specialist neonatal respiratory care for babies born preterm. NICE guideline 124. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng124

Moschino L et al. (2020) Caffeine in preterm infants: where are we in 2020? ERJ Open Res. 2020; 6(1): 00330-2019.

Ballout RA et al. (2017) Body positioning for spontaneously breathing preterm infants with apnoea. Cochrane Database of Systematic Reviews 2017; Issue 1. Art. No.: CD004951. DOI: 10.1002/14651858.CD004951.pub3.

BMJ Best Practice (2021) Premature newborn care. https://bestpractice.bmj.com/topics/en-gb/671/pdf/671/Premature%20newborn%20care.pdf