Pregnancy Week 18

What does my baby look like?

Your baby has now grown to about the size of a bell pepper.

This week, your baby's:

• sense of hearing is developing
• sense of touch is developing
• swallowing and sucking reflexes are maturing
• arms and legs are moving more often

The hands are becoming more nimble, tiny nails are taking shape, and fingerprints are forming. As the muscles grow stronger, the movements may start to feel more powerful too. The heart has now grown large enough to be heard with a stethoscope.

Your baby's nervous system is maturing quickly

Your baby's nervous system is maturing quickly. The connections between nerve cells are multiplying, and a protective substance called myelin is beginning to support nerve signaling. At this stage there are roughly 12,000 to 14,000 nerve cell endings.

The brain regions involved in touch, taste, smell, sight, and hearing continue to develop as well. The sense of hearing is sharpening, and by the end of this week your baby can hear you more clearly.

Feeling your baby move

You may feel a faint flutter as your baby practices kicking and flexing its limbs. At this stage, though, don't expect very noticeable movement. Especially in a first pregnancy, many people don't notice movement until a few weeks later.

What you feel at first may be similar to:

• a light flutter
• a bubbling sensation
• gentle nudges that could be mistaken for gas

Many people feel those first movements between weeks 18 and 22. In a first pregnancy, this can sometimes take until week 23 or 24.

How many months pregnant am I?

This week you're in your fifth month of pregnancy, with about four months to go.

If my partner smokes, is my baby at risk?

Secondhand smoke can affect both you and your baby, both during pregnancy and after the baby is born.

If someone you live with smokes, you and your baby can be exposed to harmful substances even if they think they're being careful. Opening windows or smoking in another room doesn't make it safe.

What's happening in my body?

As your belly grows, you may feel a little more clumsy. Your breasts may also have gone up a cup size, especially if this is your first pregnancy.

Your blood pressure may be a bit lower. So try not to stand up suddenly after lying down or sitting—it can make you dizzy.

You may also notice a dark line running down your belly called the "linea nigra." This is a normal pigment change and usually fades a few months after birth.

Your belly this week

Your belly may have become noticeable this week. But every woman's body and every pregnancy is different. Some moms-to-be carry smaller, others carry more prominently.

Food cravings and hunger may increase

An increased appetite and cravings for certain foods are common at this stage. Since your body is working hard to support your baby, you may need more energy.

To manage your hunger:

• eat a small meal or snack every three hours
• choose foods with protein, fiber, and healthy fats

Dizziness and feeling faint

Changes in your circulation and nervous system can cause dizziness. It may be more noticeable when you have:

• anemia
• not eaten or drunk enough
• overdone it with exercise
• gotten overheated
• stood up too quickly

If you have frequent dizziness, let your doctor know.

Swelling, discharge, and leg cramps

During pregnancy you may notice mild swelling in your feet, ankles, hands, and fingers. However, sudden or pronounced swelling can be a sign of a more serious problem.

Vaginal discharge may increase throughout pregnancy. Healthy discharge is usually milky white or clear, with a mild odor or none at all.

You may also get leg cramps. When a cramp strikes, straightening the leg and pulling your toes toward your shin, massaging it, and applying warmth can help ease it.

Ligament and joint aches

Ligament and joint aches may increase during these weeks. A warm bath can be soothing.

Your pregnancy signs may include:

• stretch marks
• fatigue and trouble sleeping
• swollen and bleeding gums
• aches along the sides of your belly
• nosebleeds
• bloating and constipation
• indigestion and heartburn
• tender breasts
• leg cramps
• dizziness
• swollen hands and feet
• urinary tract infections
• vaginal infections
• darkening skin or brown patches on your face
• oilier, more breakout-prone skin
• thicker, shinier hair

These symptoms from earlier weeks may also still be present:

• morning sickness
• cravings
• a heightened sense of smell
• mood swings
• milky white vaginal discharge and light spotting

Nutrition this week

Constipation is a common complaint, especially in the second and third trimesters. Eating plenty of fiber can help.

Foods you might choose:

• whole-grain and whole-wheat bread
• whole-grain pasta and cereals
• broccoli, cauliflower, celery, and leafy greens
• fruits like plums, peaches, nectarines, apples, and pears

Try to drink at least two liters of water a day. Regular exercise can also ease constipation. Talk to your doctor before using any over-the-counter laxative.

Calcium and vitamin D in pregnancy

Cheese and milk are usually good sources of calcium. If you're lactose intolerant, these options can help:

• calcium-fortified orange juice
• soy milk
• almond milk
• calcium-fortified breakfast cereals

Vitamin D is also needed for calcium to be absorbed. During pregnancy, a daily supplement of 10 micrograms of vitamin D is recommended, and it can be continued after birth.

Be cautious with supplements

Even though herbal supplements may seem "natural," they may not be safe during pregnancy. Products that haven't been adequately studied in clinical settings can be harmful at different stages.

Always check with your doctor before using any herbal supplement, capsule, or herbal tea.

Move slowly

In the second trimester, the hormone relaxin loosens your ligaments. This can make you feel a little more off-balance when you walk.

To stay safe:

• be careful in the shower
• clear away anything you could trip over and fall
• don't climb onto a chair or up high
• if you need support or compression stockings, put them on early in the morning
• choose comfortable shoes

Stay active

Exercising isn't always easy. Fatigue, stomach issues, and shortness of breath can make it harder. Still, if you're able to, setting aside a little time during the day for a walk or light exercise can be beneficial.

Check your hands

If your palms look redder than usual, this may be palmar erythema. It can occur during pregnancy and often goes away after birth. Even so, check with your doctor.

Your anomaly scan

You'll be offered an anomaly scan at around 18 to 20 weeks. This scan is done to assess your baby's development and appearance in detail.

The scan won't harm you or your baby. However, some pressure on your belly to get a clear image may feel uncomfortable.

Second-trimester symptoms

You might expect to feel more energetic during these weeks. But if you have symptoms that make daily life difficult, talk to your doctor.

Back pain and pregnancy

Your growing uterus shifts your center of gravity, and because the hormone relaxin loosens your ligaments, back pain and aches may become more noticeable. This affects your posture and puts extra strain on your joints.

These may help:

• doing low-impact exercise like swimming
• raising your feet slightly
• resting one foot on a low support while standing
• taking a warm bath

Easing heartburn

Heartburn is a common symptom that can last throughout pregnancy. Things that may help:

• eating slowly and chewing well
• having smaller meals and snacks
• sitting upright for a while after eating
• sleeping with your head raised
• cutting back on very spicy foods

Edema (swelling in the feet and ankles)

When body tissues hold on to extra fluid, your ankles and feet can swell. Not standing for long periods, not sitting for long stretches, and raising your legs whenever you get the chance can help.

Noticing a rumble in your belly?

This feeling could be a hunger pang, or it could be your baby's first movements. Around week 18, it's possible to notice those first movements.

If you have any concerns

Tell your doctor about anything you're worried about. Even if you've discussed the same thing before, this is your pregnancy, and it's important to reach out again about anything that doesn't sit right with you.