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What’s Happening with You

Physical Changes

  • A decrease or end to nausea and vomiting - In a few women, this “morning sickness” may continue and in even fewer it is just beginning.
  • Nasal congestion and occasional nosebleeds, often accompanied by ear stuffiness.
  • “Pink toothbrush” from gums that may bleed.
  • Mild swelling of ankles and feet, as well as hands and face.
  • Hemorrhoids
  • Slight, whitish vaginal discharge, called leukorrhea.
  • Fetal movement - Between weeks 16 and 20, you will begin to feel the fetus moving.

 Call your health care provider if you do not feel the baby move in a 12-hour period.

  • Fatigue - You may experience disrupted sleep due to frequent need to urinate at night. Try to go to bed earlier at night and/or take an afternoon nap to minimize your exhaustion.
  • Increased appetite - As your nausea subsides, your appetite will return. Keep in mind a healthy, balanced diet for you and your growing baby.
  • Expanding abdomen - By the end of the second trimester, the top of your uterus will be near your rib cage.
  • Itchiness and stretching - Many women experience itchiness as their abdomen and breasts stretch and grow. Use a good skin cream to help alleviate the itchy symptoms.
  • Abdominal aches - As the ligaments that support your uterus are stretched, you may feel aching on one side or the other.
  • Linea nigra - Many women experience a dark line, called the linea nigra, that appears down the middle of the stomach from your navel to your pubic line. This will disappear after delivery.
  • “Mask of pregnancy” - You may get brown patches, also called the “mask of pregnancy,” on your face. This, too, will disappear after delivery.
  • Darkened areolas - The areolas, or the darker skin around your nipples, may darken even further.
  • Leg cramps – Many women say that these are particularly problematic first thing in the morning, when you stretch before getting out of bed. To help avoid leg cramps, stretch with your ankles flexed, not with toes pointed.
  • Feet and ankle swelling.
  • Shinier, fuller hair.

Emotional Changes

  • Frustration at not really looking or feeling pregnant, but are too big for your normal wardrobe and too small for maternity clothes. This feeling tends to turn to excitement as the second trimester progresses and you begin to “show” the world that you are pregnant.
  • A feeling of being “scatterbrained” - You may feel forgetful, drop things, and even have trouble concentrating.
  • Many women experience dreams about baby animals, such as kittens or puppies with their mothers.
  • Fewer mood swings.

What’s Happening with the Baby

Your baby is growing and developing rapidly. By the end of the fourth month (13-16 weeks), he/she will weigh ½ ounce and measure 2 ½ to 3 inches, or the size of a large goldfish. At this point, the fetus’ head is typically disproportionately large. At 13 weeks, the eyes are developed, although the lids will remain closed for several months still. At 15 weeks, the ears are fully developed. Most major organs, the circulatory system and urinary tract are operating. Although genitalia are developing, it may not be possible yet to determine the gender with ultrasound.

By the end of the fifth month (17-20 weeks), your fetus is approximately 4 inches long, the size of a small avocado. By now, the body is beginning to catch up with the head in size. Fingers and toes are well-defined and tooth buds are now appearing. You are probably experiencing the first joyful feelings of fetal movement. During the second trimester, the fetus kicks, moves, sleeps, and wakes. He/she can swallow, hear, pass urine, and even suck his/her own thumb!

By the end of the sixth month (21-24 weeks), your fetus is about 8 to 10 inches long. At this point, the fetus is covered by a protective, soft down called “lanugo.” Hair will now begin to grow on the head and white eyelashes will appear. Your baby is now beginning to develop fat, which helps to keep it warm. The fetus’ chances of surviving outside the womb are still risky, but it is possible at 23 to 34 weeks in a hospital with a good neonatal intensive care unit (NICU).

Your baby is nearly 13 inches long and weighs approximately 1 3/4 pounds by the end of the seventh month (25-28 weeks).

Eyebrows, eyelashes, and fingernails are now formed. The baby continues to move consistently, with more pronounced periods of activity and rest.

Special Concerns

Sleeping positions – All pregnant women want a good night’s sleep, especially since they know that sleep will be elusive once the baby arrives! However, the two most common sleeping positions are on the belly and on the back, neither of which are recommended during pregnancy. The belly position may feel like sleeping on a watermelon! The back position may rest the entire weight of your pregnant uterus on your back, your intestines and the inferior vena cava, the vein responsible for returning blood from the lower body to the heart.

Sexual Relations – Sex is a common concern for many pregnant women and their partners. Unless your health care provider has told you otherwise, it is perfectly safe to make love throughout your pregnancy without any risk to you or your developing baby. Many women experience a heightened sexual desire, while others would prefer not to be touched at all - it really does vary from woman-to-woman. As your body changes and your abdomen expands, you may want to experiment with different positions to find one that is comfortable for you and your partner.

Intercourse may be restricted under some of the following circumstances:

  • Any time unexplained bleeding occurs.
  • During the first trimester, if you have a history of miscarriage or threatened miscarriage, of if you are showing signs of a threatened miscarriage.
  • During the last 8 to 12 weeks of pregnancy if you have a history of premature or threatened premature labor, or if you are experiencing signs of early labor.
  • If your membranes (amniotic sac of water) have ruptured.
  • If you have been diagnosed with placenta previa, when the placenta is located near or over the cervix.
  • In the last trimester if you are carrying more than one fetus.

Feeling the baby move – Fetal movement is one of the biggest joys - and one of the biggest sources of stress - during pregnancy. From the moment that you feel that first flutter, you begin to truly understand that there is a living, human being growing inside of you. But just like you, the fetus will have moments of quiet relaxation and other times of restlessness and kicking.

More often than not, the fetus’ activity is related to your level of activity. For instance, if you have had a busy day, running errands or busy at work, you may actually “lull” the baby to sleep. The result? You may not feel much movement. In addition, because you are so busy, you may not be paying real attention to the level of activity. Once you slow down, you will most likely begin to feel more movement. That is why many women feel the most movement when they are laying down in bed at night.

If you are concerned that you have not felt much movement on any given day, you can try to do “kick counts.” In order to do this, sit or lie down in a quiet place. Check the clock when you start counting and count movements of any kind - kicks, flutters, swishes or rolls - until you reach 10. Note the time. Many times, you will feel 10 movements within 10 minutes or so, but sometimes it may take longer.

If you have not counted 10 movements by the end of an hour, have some ice water, milk, juice or a small snack (okay, you can indulge in some sugary candy), then lie down, relax and start counting again. If another hour goes by without movement, call your health care provider immediately. Although limited or no fetal activity is generally not a problem, it may indicate fetal distress.

Premature Labor – Premature labor is not something to be taken lightly. Although your baby has a good chance of survival outside the womb in a neonatal intensive care unit (NICU), there still exists a high chance for complications. If you even suspect that labor may be beginning, call your health care provider immediately. Following are some signs and symptoms of premature labor.

  • Menstrual-like cramps, with or without diarrhea, nausea or indigestion.
  • Lower back pain or pressure, or a change in the nature of any lower back pain that you have been experiencing throughout your pregnancy.
  • An aching or feeling of pressure in the pelvic floor, thighs or groin.
  • A change in your vaginal discharge, particularly if it is watery or tinged/streaked pinkish or brownish with blood. The passage of a thick, gelatinous “mucous plug” may or may not precede this “bloody show.”
  • Rupture of membranes, with either a trickle or rush of fluid from your vagina.

Sometimes, it is difficult to tell the difference between “real” labor and the Braxton Hick contractions that many women experience after the 20th week of pregnancy. Braxton Hicks contractions are a strange sensation for most women, a tightening of the uterus that typically lasts 30 seconds to two minutes. If this is your second pregnancy, you are more likely to experience Braxton Hicks contractions. The following are some ways to determine whether less frequent contractions may be a warning sign of premature labor:

  • In general, contractions coming at regular intervals are a sign of real labor, although some women never have regular contractions.
  • Go for a short walk - false labor contractions usually decrease with movement. If labor strengthens, call your practitioner.
  • In general, true labor contractions become more intense. With false labor, intensity may waver or decrease.
  • If you have not had a leakage of fluids, drink a cup of hot tea while taking a warm, relaxing bath (not hot!). This can often stop or slow down false contractions.
  • You may want to call your health care provider, who can likely tell from your voice whether or not you are in labor. How? If you need to stop talking during a contraction, it could be the real thing!

Call Your Health Care Provider – If you experience any of the following symptoms, call your health care provider immediately:

  • Fever over 100.4 degrees in absence of cold or flu symptoms.
  • Severe headache.
  • Blurred, dim or double vision.
  • Fainting or dizziness.
  • Sudden, unexplained large weight gain.
  • Sudden increase in thirst with infrequent and/or painful urination, bleeding or cramping.
  • No fetal movement in 12 hours.
  • Severe cramping.
  • Bleeding or spotting.
  • Change in vaginal discharge, especially if it is watery or tinged or streaked pinkish or brownish with blood.
  • Rupture of membranes (a trickle or rush of fluid from your vagina).