WEEKS 17 – 20

This is the time to enjoy your pregnancy, as you are feeling much better. You are also in a much better position to enjoy all the pampering you get.

Common Complaints

Though the changes of 2^nd half of pregnancy has started, they have not reached their peak so as to prove troublesome. Hence you can take your mind away from the pains and pay more attention to the pleasures of pregnancy.       .Except they are marginally more severe.The linea nigra may become prominent and stretch marks also may start appearing on the abdomen.These stretch marks depend on the elasticity and tone of your skin as well as the hereditary factors. Some of you may go through pregnancy without any stretch marks at all.Those who have stretch marks need not despair, these usually fade after deliver. There are a lot of anti stretch mark creams available in the market. None of them can guarantee to prevent stretch mark completely. Massaging with plain oil or cream is as effective as massaging with these creams. Your spouse can do the art of massaging the cream. It is both fun and helps in bonding of the spouse to be father to the pregnancy.

Movements

You may start feeling some movement in your lower abdomen. These are the foetal movements and kicks usually perceived at around 18 – 20 weeks of pregnancy and thence till term / delivery.

PICTURE OF FOETUS:

The baby’s limbs are completely formed. So also the skin and the muscles.The length of the baby is between 7 – 10" (18 – 25 cms) the teeth buds have begun forming in the gums by 18 – 19 weeks.Vernix, which is a cheesy white substance covering the baby’s skin, has also made its appearance.

Your Body and You
The uterus is easily palpable and at 18 weeks it is half way between your pubic bone and navel.You can also appreciate feotal movements another event, which can be appreciated, is painless contractions or hardening of your uterus intermittently. These are a normal finding during pregnancy and are called "BRAXTON – HICKS" Contraction and are nothing to worry about (as long as they are not accompanied by pain and bleeding)Your spouse can appreciate the foetal movements and uterine contraction by placing the hand gently but firmly over the uterus in the lower abdomen.This is an event, which needs celebration, or this is the first feel of your baby.You must have started putting on weight and inches around your waist and hubs. Your breast has also significantly increased in size and may need a bra one size larger for support.One should be careful to avoid putting an excessive weight. The usual weight gain in around 11b/week. The weight gain between 13 – 28 weeks is around 5 – 6 kgs over the pre-pregnant state.    .
Emotionally you are much more stable than before.Your mood swings have reduced, but irritability still occasionally occurs. There is also an acceptance of the reality of pregnancy.

Visit ToYour Doctor     .
Your usual visits to your doctor at monthly intervals will continue. Some of the additional things done during this period will be:

1. Giving you your 1^st tetanus toxoid injection (vaccine). The 2^nd one will be given 4 – 6 weeks later.
2. An ultrasound scan may be done especially to rule out any birth malformation or defects (though all of them cannot be diagnosed on an ultrasound scan).
3. Certain selected individuals may undergo special tests like amniocentensis, Triple tests etc….     .
4. Weight gain is approximately 1.5 – 2 Kg per month between 14 – 28 weeks (1 pound / week approximately 12 – 14 pounds in total during this period). Excessive weight gain is not good and weight gain more than 2 pounds /after 20 weeks should raise the suspicion of pregnancy induced Hypertension.

Possible Problems      

Important Instruction       

 Apart from the previously mentioned facts, some points worth noting are:

• 20 weeks is legally a very important land mark. Medical termination of pregnancy (MTP or abortions) can be now done up to this week now that the abortion laws are much more relaxed.
  The method of performing this of abortion though is slightly different from that followed during an early less than or equal to 3 months old pregnancy.
  
• Now is also the time to have a look at your wardrobe if you are not the "sari" wearing kinds. Women who wear saris exclusively don’t have too much of a problem as "one size fits all".As your body is undergoing a fast and obvious change, it would be a sound idea to go in far loose apparel; keeping your future body image in mind.You may also have to change the size of your bra. Buying one that fits well is important to prevent your breasts from sagging later on.Dresses that are front opening are comfortable and may be found useful later on during breast-feeding.

• If you wear contacts, you may experience some discomfort due to changes in the eye. These revert back after pregnancy it is advisable to consult your ophthalmologist or change over to conventional spectacles for this period.

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