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Fetal growth and maternal changes

At the end of the second trimester, your weight will have increased by approximately 6 kg, even though the fetus weighs only 1 kg. This is due to the placenta, uterus, breasts, and increased production of blood. Regular prenatal examinations are necessary not only to check the growth and development of the fetus, but also to check your health. If you had a difficult time in the first trimester due to morning sickness, it will lessen and you should feel better. Make sure you continuously take care of your nutrition and eating habits, exercise, and rest.

(Source : Ministry of Gender Equality and Family, New Dad's Handbook, 2018)

Week 14

• 1. Fetal growth

  The genitalia begin to appear externally. The placenta is almost complete and has firmly attached to your uterus. During this period, the fetus' skin thickens and is not translucent anymore, protecting the internal organs. The back gradually straightens from its forward hunched position, and the first bone tissues and ribs form. The neck becomes thicker, and the head grows larger, gradually developing. Joints develop in the arms and legs, and the fetal body becomes more rigid.

• 2. Maternal changes

  During this time, the uterus grows larger and amniotic fluid increases, so you will gain weight, with your belly appearing larger. As the breasts grow, you may notice a small amount of milk coming out. The ligaments that support the uterus are pulled, causing pain in the groin and lower back(round ligament pain) and frequent fatigue.

Week 15

• 1. Fetal growth

  The height of the fetus doubles from 4 weeks prior and weight increases sixfold, reaching 16-18 cm and 120 g. The kidneys form and begin to secrete urine into the amniotic fluid. The fetus sometimes drinks amniotic fluid through the mouth and spits it out. The internal organs, such as the lungs and heart, which were near the neck, move down into the chest, and they are settled where they should be. The head is the size of a ping-pong ball, and the skull is filled with the brain. Although imperfect, the brain develops and the fetus feels basic emotions such as pleasure, displeasure, anxiety, and nervousness in response to external stimuli.

• 2. Maternal changes

  The uterus becomes as large as a baby's head and the fundus of the uterus rises to the brim of the pelvis, causing a noticeable bulge in the lower abdomen. As the uterus grows upward, the pressure on the bladder is reduced, which reduces the need to urinate frequently.

Week 16

• 1. Fetal growth

  The skin of the fetus during this period is not transparent due to increased fat but still has a reddish tint. The fetus becomes more active in the amniotic fluid, shaking its head and moving its hands and feet independently. The inner ear is fully developed so that the fetus can hear sounds directly from outside the womb. The kidneys and bladder are also almost complete.

• 2. Maternal changes

  This is a more stable time of pregnancy. As the mammary glands develop, the breasts become larger, and as subcutaneous fat accumulates, the body becomes rounder and takes on the appearance of a fully pregnant woman. As the fetus grows rapidly, you will feel your belly getting bigger. The growing uterus pushes the internal organs, such as the stomach and small intestine, upward, causing a feeling of fullness after eating and sometimes pain in the back or waist.

Week 17

• 1. Fetal growth

  During this time, the fetus begins to make facial expressions, moving its eyes, frowning, or even making long faces. Although the eyelids remain fused, the retina begins to respond to light stimulation. Changes begin to occur, with the skin becoming firmer and old cells shedding. Eyebrows, eyelashes, and hair grow, fingernails and toenails appear, and fingerprints form.

• 2. Maternal changes

  Skin pigmentation increases. As the uterus grows to the size of a melon and pigmentation increases in the skin, the nipples and areola darken considerably. During this period, your nipples become sore and tingly, the mammary glands for milk secretion are developed significantly, and the breasts become much larger, preparing for milk production. Veins on the surface of the skin may also become more visible. Some pregnant women may develop so-called pregnancy marks on their face. Pregnancy marks on the face typically disappear after childbirth.

Week 18

• 1. Fetal growth

  Although primitive, the nervous system is well developed, and the senses of touch, taste, and hearing become distinct. The legs are longer than the arms, and the legs are developed in appropriate proportions for each part. The fetus's movements in the amniotic fluid become more active, and it can bend and straighten its arms and kicks. To practice sucking on the mother’s nipple as soon as it is born, the fetus reflexively sucks anything that touches its mouth.

• 2. Maternal changes

  Pregnant women who are sensitive to their bodies feel fetal movements during this period. You may first feel the fetus moving inside your womb, which is called fetal movement. Fetal movement usually occurs around 18 to 22 weeks of pregnancy for first-time mothers. Statistically, second-time mothers(or more) will feel fetal movements faster than first-time mothers. The moment you feel the baby move for the first time may be strange, but it is also the time you will really feel pregnant, giving both joy and worry.

Week 19

• 1. Fetal growth

  The fetus is about 25 cm long and weighs about 300 g. The head circumference grows to 4.5 cm, making the head about one-third of the body. The baby’s heartbeat becomes stronger, enough to hear the fetal heartbeat with a stethoscope. The number of nerve cells develops to almost the same level as that of an adult. The brain stem develops, and the fetus reacts to the mother's emotional changes, which are transmitted through the umbilical cord. As the part of the brain responsible for memory develops, the baby can remember the voices of its mother and father that are frequently heard.

• 2. Maternal changes

  At first, you may feel a "bubbling" sensation in your belly, and day by day, you will feel more powerful fetal movements. However, there are individual differences. Some first-time mothers may feel fetal movement after 20 weeks. A pregnancy line(called a linea nigra) appears in the middle of the lower abdomen. As the fetus grows, the height of the fundus of the uterus reaches approximately 14 to 18 cm. The fundus refers to the uppermost end of the enlarged uterus, which has risen to the level near the navel, high enough for a medical professional(nurse, doctor, or midwife) to examine it by feeling it with their hands. The fundus, which is the uppermost end of the enlarged uterus, rises to the belly button enough for a doctor to examine by palpation. A dark line called pregnancy line appears vertically down the middle of the lower abdomen and sometimes on the calves.

Week 20

• 1. Fetal growth

  As the amount of amniotic fluid increases and moves freely, the location where fetal heart sounds can be heard frequently changes. As the fetus' movements become more active, you may feel a stabbing belly pain. Vernix caseosa begins to appear on the surface of the skin, and it acts as a natural lubricant to help the baby pass through the birth canal smoothly during childbirth.

• 2. Maternal changes

  This is the most stable period of pregnancy, where you’ll feel fetal movement more easily. As you become fully pregnant, your weight gain and belly will become noticeable, making it clear that you are pregnant. As the uterine muscles contract to accommodate a growing fetus, you may feel your stomach tightening 4 to 6 times a day. In pregnant women with rapidly developing breasts, colostrum may come out when the nipples are pressed.

Week 21

• 1. Fetal growth

  The fetus begins to develop the balance organs in its ears. Its hair noticeably gets darker, and its eyebrows and eyelashes grow as well. The skin is still red and wrinkled, and the skin layer is thin, so the blood vessels are clearly visible. Meanwhile, the fetus has more taste buds in its mouth than an adult, so it begins to react to tastes and may even hiccup, which you may feel through regular fetal movement.

• 2. Maternal changes

  An increased metabolism means you will sweat more. The lower abdomen is very swollen and the abdominal ligaments that support the uterus are stretched, so you may sometimes feel abdominal pain. As the burden on the heart increases, symptoms of indigestion and bloating may occur. Hyperthyroidism can cause you to sweat a lot and feel short of breath even with the slightest movement. Additionally, as blood vessels dilate, the face, arms, and shoulders may easily turn red, and in severe cases, moles or engorgement may appear. If you have not felt fetal movement yet, this is when most first-time mothers will feel it for the first time. This is a time when most of first-time mothers can feel fetal movements.

Week 22

• 1. Fetal growth

  As the amniotic fluid increases, the fetus can move its hands and feet freely and frequently changes direction. It is common for fetuses to be breech during this time., the fetus’ head gradually turns downwards from 29 weeks of pregnancy, so don’t worry too much at this stage. Brain cells become more differentiated and the fetus' ability to process information increases significantly. A fetus that has consumed amniotic fluid excretes urine through the kidneys.

• 2. Maternal changes

  Weight gain and a larger uterus can put pressure on the blood vessels in the pelvis, which can interfere with blood circulation in the lower body and cause engorgement. However, it will disappear soon after giving birth, so if it is not severe, you do not need to worry too much. Pregnant women who suffer from severe constipation may suffer from hemorrhoids, so be careful to have regular bowel habits.

Week 23

• 1. Fetal growth

  The fetus is about 28 to 30 cm long and weighs about 650 g. The overall appearance gradually becomes more balanced, and the skeleton and joints develop so that the skull, spine, ribs, arms, and legs can be clearly identified through an X-ray. The baby’s eyelids begin to move and it can open its eyes. Its hearing is so developed that it can hear everything that happens outside the womb, including your heartbeat, the sounds of food being digested in your stomach, and the sound of blood flowing through your blood vessels.

• 2. Maternal changes

  Varicose veins are prone to developing in the thighs, calves, and vulva. The uterus weighs 1.5 kg and the fundal height is 20 to 24 cm. Because your weight will increase by 5-6 kg compared to before pregnancy, you may experience back or waist pain, swollen feet, or numbness in your legs. Although there is an increase in blood volume and dilation of blood vessels, the enlarged uterus puts pressure on the dilated veins, making it easy for varicose veins to develop in the vulva, thighs, calves, etc., where the veins become twisted and dilated.

Week 24

• 1. Fetal growth

  The fetus floats in the amniotic fluid, moves its hands and feet frequently, and assumes a handstand position with its buttocks and feet raised. The skin loses its transparency and becomes completely opaque, taking on a reddish tint. However, the skin surface is wrinkled because fat has not yet accumulated. The genitals are developed with the testicles in the male located in the abdomen and the labia majora in the female still underdeveloped.

• 2. Maternal changes

  Fetal movement that was previously felt faintly near the lower abdomen is now felt over a much wider area. As your stomach gets bigger, it will become harder to keep your balance, and you may get dizzy easily. Changes in the skin such as skin discoloration may occur, and the abdomen becomes very itchy. The area under the armpit may become swollen due to the development of mammary gland tissue.

Week 25

• 1. Fetal growth

  The upper and lower eyelids that were fused are split into upper and lower portions. Although the baby cannot see yet, it can sense contrast between light and dark in its brain through the increase and decrease of a substance called melatonin, which is received from the mother. Although its body is still slender, the arms and legs become longer, and the proportions of the head and the body become somewhat normal. It often opens its mouth to drink and spit out amniotic fluid and reflexively turns its head away when the umbilical cord or fingers are near its mouth. Sometimes the fetus will suck its fingers.

• 2. Maternal changes

  Purple pregnancy lines appear around the belly and breasts. These pregnancy lines appear when the skin stretches as the abdomen grows due to increased amniotic fluid, causing the capillaries under the skin to become visible. Most of the time, they disappear after you give birth. As your belly swells, you may experience rapid and shallow breathing and have trouble sleeping.

Week 26

• 1. Fetal growth

  The fetus starts to practice breathing. Hair grows, and the spinal cord, heart, and liver develop so that internal organ functions become more defined. The brain develops further. As the parts that control perception and movement develop, it is possible to control the entire body. Alveoli in the lungs begin to develop so the fetus can practice breathing. Its hearing has improved, and it can clearly hear its mother and father's voices coming from outside the womb. As sebum secretion increases, the skin becomes covered with fat.

• 2. Maternal changes

  Rib pain may occur, and your indigestion may get worse. As the fetus grows, it pushes against your ribs. As the fundus rises, the lower ribs bend outward, causing rib pain. As the uterus grows, a stinging pain may be felt in the lower abdomen, and the pressure on the stomach may cause digestion problems. The colon may be pressed, making constipation worse. Sometimes the uterine muscles contract and become hard for a moment before relaxing, causing colostrum to leak from the breasts.

Week 27

• 1. Fetal growth

  The alveoli develop to prepare the fetus for breathing. The fetus is about 35 cm long and weighs about 1 kg. Its face still has many wrinkles like an old person, and the soft, fine lanugo covering its skin like vellus hair grow obliquely along the direction of the hair roots. As the alveoli develop, the number of blood vessels surrounding the alveoli increases dramatically to take in oxygen and release carbon dioxide. With the nostrils open, the fetus takes shallow breaths and makes sounds on its own. Although it is growing enough to function as human, its development is still immature, so if it is born at this age, it will need to receive care in the neonatal intensive care unit(NICU).

• 2. Maternal changes

  The pregnancy line(linea nigra) becomes darker, and you may experience cramps in your calves at night. You should be careful because you may fall over if you are full and have difficulty maintaining your balance. As body weight increases by more than 6-7 kg, excessive force is applied to the legs, resulting in severe fatigue of the leg muscles. Your legs may swell and become tired, and you may experience cramps due to pressure on her femoral veins. This symptom tends to worsen at night when you are sleeping. However, it can be lessened by pressing the calf area firmly.