Pregnancy Week 19

What does my baby look like?

You're in your fifth month, and your baby is now about the size of a mango.

The permanent teeth are starting to form, lining up right behind the first teeth.

Your baby keeps gaining weight and getting ready for birth, which is about 21 weeks away. As thin layers of fat begin to build up, your baby starts to look a little plumper and less wrinkled. Your baby is also covered in a fine layer of hair called lanugo, which helps keep them warm. Most of this hair sheds during the final weeks of pregnancy.

Around this time, your baby begins to be coated in a waxy layer called vernix. This layer helps protect the skin from the amniotic fluid.

Feeling your baby's kicks

Around now, you may start to feel your baby's first movements. Sometimes it feels like a gas bubble, sometimes like the flutter of butterfly wings, and sometimes like something swimming inside your belly. If you haven't felt anything yet, don't panic; that can change before long.

First movements are most often felt between weeks 18 and 22. If this is your first pregnancy, it's perfectly normal to notice them a little later. As your baby grows, these movements become easier to recognize, and you're less likely to mistake them for something else.

Your baby is very active this week. They move their arms and legs, kick, wriggle, and push against the wall of the uterus to shift position. Now and then, you may even notice these movements from the outside on your belly.

You and your baby may not be on the same schedule, so you might feel your baby's movements more clearly at night. Right now, your baby spends most of the day sleeping.

Do I have a big baby?

Some expectant mothers worry that their belly looks too big or too small. But just as everyone's body is different, every pregnant belly looks different too. Many factors can affect how your belly looks, such as this not being your first pregnancy, being short or tall, the baby's position in the uterus, strong abdominal muscles, a multiple pregnancy, or how much weight you've gained during pregnancy.

The size of your belly alone doesn't mean your baby is too big or too small. If your doctor says your baby's development is on track, there's no reason to worry based on the look of your belly alone. If you have any concerns about your baby's growth, talk them over with your doctor.

What's happening in my body?

Around this time, your belly may start to make you feel more noticeably pregnant. Staying active is good for you and your baby, but some exercises, like running, may become more uncomfortable during these weeks. One reason is that the hormone relaxin loosens your ligaments. This can mean your back, knees, and ankles aren't supported quite as well as they normally would be.

As the ligaments supporting the uterus stretch, you may feel short, sharp pains. This is called round ligament pain. The pain usually starts deep in the groin and spreads out to both sides. It should be brief and ease with rest.

However, if abdominal cramps don't go away with rest, are severe, or come with other symptoms such as fever, dizziness, upper abdominal pain, or noticeable tenderness in the belly, call your doctor.

You may notice redness on your palms. This is usually linked to rising estrogen. You may also see darkened patches of skin on your upper lip, cheeks, and forehead. This is called melasma, or the mask of pregnancy. Pregnancy hormones can affect the cells that contain melanin, which is why you may notice darkening on your nipples, freckles, scars, underarms, inner thighs, and vulva. The dark line running from your belly button down to your pubic bone is called the linea nigra. These changes usually fade after birth.

Nosebleeds can also be more common in pregnancy. The increased blood volume can cause the blood vessels in your nose to widen. Colds, allergies, and dry air can make this worse. When your nose bleeds, sit down, tip your head slightly forward, pinch the soft part of your nose for 10 to 15 minutes, and breathe through your mouth. Applying something cold to the bridge of your nose can also help.

You may notice you're getting short of breath. During pregnancy, your body needs more oxygen and adapts to meet that need. As the weeks go on and your growing uterus presses on the diaphragm, breathing can feel more effortful. But if your shortness of breath is sudden or severe, or comes with other symptoms like a fast, irregular heartbeat, seek medical care.

You may feel warmer during pregnancy. This is due to hormonal changes and increased blood flow to the skin. Choosing loose clothing, staying hydrated, and avoiding overly hot environments can help.

Pelvic floor changes

You're carrying more weight, and your pelvic floor muscles can also loosen under the influence of hormones. Because of this, you may leak a little urine when you cough, laugh, or sneeze.

That's why pelvic floor exercises can be helpful. They also matter for pelvic floor support during and after birth. To do them, sit in a comfortable position, try squeezing and releasing the pelvic floor muscles, don't hold your breath, and try not to unnecessarily tense your abdominal, buttock, or thigh muscles. You can start with short sets and gradually increase the duration.

Symptoms you might notice this week include:

• fatigue and trouble sleeping
• stretch marks
• swollen, bleeding gums
• side pain or round ligament pain from your expanding uterus
• 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 or more acne-prone skin
• thicker, shinier hair

Symptoms carried over from earlier weeks may continue too. These can include morning sickness, cravings, sensitivity to smells, mood swings, vaginal discharge, and light spotting. Any bleeding needs to be evaluated by a medical professional.

Leg cramps

Leg cramps can be common in the second and third trimesters. They may be more noticeable at night and can wake you from sleep. The exact cause isn't fully known, but your leg muscles carrying extra weight, changes in circulation, or other factors may play a role. When a cramp strikes, straightening your leg and gently pulling your ankle and toes toward your shin can bring relief.

Swelling in the hands and feet

Around this time, you may notice swelling in your feet and ankles. This is often linked to edema, meaning water retention. Sometimes your hands and fingers can be affected too. Drinking plenty of water, keeping your feet elevated during the day, and doing gentle exercise can help. But sudden swelling should always be evaluated, since it can be a sign of preeclampsia.

Nutrition this week

Eating a balanced diet during pregnancy matters for both you and your baby. Healthy eating can help ease some symptoms, such as constipation, morning sickness, and fatigue.

Try to eat a balanced mix from all the food groups. Fruits and vegetables should make up a big part of your diet. Instead of sugary snacks, options like low-fat yogurt, milk, and fruit may be a better choice. You may be eating small amounts more often, so having healthy snack choices on hand can make things easier.

Give in to healthy cravings

Your cravings may be intense. If every craving leads you toward unhealthy foods, try to limit them and choose healthier alternatives. If you're craving a food you should avoid, it may be better to find a safe but similar alternative.

If you feel the urge to eat non-food items like clay, ash, or laundry starch, this may be related to pica and can point to a nutritional deficiency. If this happens, see your doctor.

To ease constipation

Getting enough fluids during the day can help soften stools and make bowel movements easier. Prune juice may help some people. Warm liquids can also help stimulate bowel movements.

How much water should I drink during pregnancy?

Drinking water regularly is important during pregnancy. Especially when it's hot out, try to spread your fluid intake throughout the day to stay well hydrated.

Tips for better sleep

Not being able to sleep well during pregnancy can be really tough. For better sleep, you can try:

• meditation or gentle stretches
• sleeping on your side
• supporting your belly and any achy areas with pillows
• placing a pillow between your knees

Snoring and sleep

Snoring can start or get worse during pregnancy. This is usually due to increased nasal congestion. It's generally not serious, but it can sometimes be linked to obstructive sleep apnea. If you're unsure, check with your doctor.

Carpal tunnel syndrome

Carpal tunnel syndrome can also show up during this time. You may feel burning or numbness in your wrist, hand, and fingers. Supporting your wrist and cutting back on strenuous movements can help.

Yeast infections

Yeast infections can be more common during pregnancy. One reason is higher estrogen levels. If you suspect you have one, talk with your doctor about the most appropriate treatment.

Prenatal yoga

Prenatal yoga can help you feel more comfortable and prepare for birth. It may also help lower the risk of anxiety and depression. But it's important to join a class that's suitable for pregnancy and to make sure the instructor is experienced in this area.

Nails and personal care

During pregnancy, your nails may grow faster and become stronger, or the opposite, more brittle. If you're getting a manicure or pedicure, make sure the space is well ventilated.

Are you having pelvic pain?

Pelvic pain, or pelvic girdle pain, can occur during pregnancy. This pain won't harm your baby, but it can be uncomfortable for you.

Low-lying placenta

In some expectant mothers, the placenta may appear low-lying during an ultrasound. In most cases, it moves upward as the uterus grows. But if it stays low, it can affect your birth plan.

Pregnancy and mental well-being

No matter what week of pregnancy you're in, it's important to focus on your own well-being too. If you're struggling emotionally, it can help to think about the support you may need before and after birth. If anything is worrying you, trust your instincts and share it with your doctor.