Pregnancy in 19th week

This week, your baby should be about 15.3 cm from head to bottom, and weigh approximately 240g. Your baby is now about the size of a beefsteak tomato, which is the largest type of tomato grown in the world. Yes, that’s quite a good size, but remember, your baby has a lot more growing to do. 

Your baby’s development at this stage should be progressing without any glitches: the teeth are forming, the kidneys are making urine, the scalp is producing hair follicles and a few strands, and the brain as well as the nervous system are developing quickly too. Your baby’s reproductive system too should be reaching complete preparedness by now, which means that if you’re having a baby girl, her ovaries have already formed about six million eggs.

Read more: Foetal development week by week

Your abdomen and breasts are likely to be still growing bigger to prepare for the baby. The milk ducts in the breast are activated and producing milk for breastfeeding, and they will probably not grow larger still. This might be a good time to get fitted for a maternity bra if you haven’t done so already. 

Read more: After delivery care for the mother

Your baby bump, however, is growing and will continue to grow. This might put you off balance and lead to back ache, sciatic nerve pain and even hinder regular functions like bending down to wear socks. This might be a bit of a challenge, but you will have to take it in your stride until your little bundle of joy is delivered (at least).

If you didn’t go in for an ultrasound during the 18th week of pregnancy, you might want to consult your doctor about getting it done this week. Your obstetrician may ask you for a couple of blood tests to figure out if your alpha-fetoprotein levels are within the range of safety and to check if you have any infections.

The ultrasound, also known as an anatomy ultrasound, checks the baby for proper foetal development and is a good way to detect congenital defects and anomalies like spina bifida. This ultrasound also checks the baby’s complete anatomy and gender. But simply because the ultrasound checks the baby’s gender does not mean that the gender will be revealed to you.

Prenatal sex determination is not allowed in India since 1994 as per the Pre-Conception and Prenatal Diagnostic Techniques (Prohibition of Sex Selection) Act. So, while you may be going in for an ultrasound this week, you will not be told the gender of your baby. However, you will get a complete update about how your baby is doing inside your womb, which should come as a relief to all parents, unless there are any complications or congenital defects detected.

There are a number of symptoms of pregnancy that you might not even notice much any more because you’ve learnt to live with them over the first 18 weeks of pregnancy. However, other symptoms might show up and affect your general wellbeing. The following are some symptoms that are likely to show up in the 19th week of pregnancy.

• Round ligament pain: Round ligament pain is a type of pain that pregnant women experience in the lower belly or groin area, either on one side of these areas or across them. This is one of the most common complaints in the second trimester, so it’s quite normal. However, if you cannot bear the pain or it appears to be too much, do consult the doctor immediately.
• Sciatic nerve pain: This periodic type of pain might be occurring in your legs. The sciatic nerve is the biggest in the body, and runs under the uterus and all the way down your legs. With the added weight and pressure of the womb on this nerve, sciatic nerve pain is quite normal during pregnancy - especially the second and third trimesters. The best thing to do about it is to rest as much as possible.
• Sleep problems: Whether it’s because of all the aches and pains, the leg cramps, indigestion, trips to the bathroom, heartburn or any other symptoms of pregnancy, getting a good night’s sleep might seem like an elusive goal during pregnancy. Not getting enough sleep can lead to stress and other serious issues, so make sure you consult your doctor about it.
• Melasma: Melasma, also known as chloasma or the mask of pregnancy, basically refers to the dark patches of skin that might appear on your forehead, cheeks, and other parts of the face during pregnancy. This usually occurs due to hormonal changes during pregnancy, and these dark and symmetrical patches are likely to disappear a month or two after delivery as your hormone levels go back to normal.
• Fatigue: Your body is pumping more blood, your weight has increased, there’s a life growing inside you and you still have to remain active and make sure your daily functions are performed. Fatigue is quite natural under these circumstances, and don’t beat yourself up about it. Instead, make sure you get enough rest, get undisturbed sleep and eat well.
• Other symptoms: While the above are some symptoms that might show up in the second trimester, some symptoms from the first trimester are likely to persist and even get worse. This includes bleeding gums, swollen gums, heartburn, indigestion, bloating, constipation, sore breasts as your body prepares for breastfeeding, headaches, nosebleed and mood swings.

Most complications of pregnancy have their own risk factors, which is why knowing about them well in advance and avoiding all risky habits and behaviours is very important. The unfortunate thing is, while you can reduce the risk of most complications, some might still occur, especially if you have a history or genetic predisposition for it. The following are some of the complications that might show up during the 19th week of pregnancy.

• Miscarriage: The 19th week of pregnancy is a time when you should be particularly careful about miscarriage because you’re crossing the stage when this condition poses a risk. A loss of pregnancy after 20 weeks is known as stillbirth, and with the advancement of technology and healthcare, this can be better taken care of than a miscarriage. This is also because miscarriages occur spontaneously and cannot be stopped once they start. This can be a huge source of trauma for a mother-to-be, which is why psychological counselling is a must for couples who have lost a baby to miscarriage.
• Infections: Vaginal infections and urinary tract infections are quite likely to happen during the second and third trimesters of pregnancy because your immunity is compromised and your are therefore more susceptible to infectious diseases. You should contact a doctor if you see any symptoms of any infections at all, and you should especially take precautions against bacterial infections, fungal infections and also viral infections like COVID-19.
• Hypertensive diseases: High blood pressure is never a good thing to have, but it can pose quite a number of difficulties during pregnancy. The list of hypertensive diseases which might plague you includes preeclampsia, eclampsia, gestational hypertension and chronic hypertension. You should take any and all of these very seriously and follow the treatment protocol recommended by your doctor.
• Subchorionic hemorrhage: Since you aren’t supposed to experience any vaginal bleeding during the pregnancy, bleeding due to a subchorionic hemorrhage can be quite alarming. Depending on the size of the hemorrhage, the bleeding can be light or heavy. This type of hemorrhage can happen due to placental abruption, and you should consult your doctor immediately if any signs show up.
• Obstetric cholestasis: This condition affects the liver and is very rare during pregnancy. But since Indian and Asian women are more at risk of obstetric cholestasis than Caucasian women, it’s important that you take note of any symptoms showing up during this week - especially if the skin on your hands and feet itch, particularly during the night. If you see any symptom of this condition, contact your doctor immediately.

If you got your ultrasound done in the prior week, this week should be less hectic for you. If you didn’t then focus on relaxing before and after the ultrasound instead of worrying unnecessarily about it. The following are some other things you must get done this week.

• If you suspect you have an infection, depression or any symptoms of any complications, call the doctor and ask if you can come in for a check up. This is important because delaying treatment can make the symptoms of most diseases worse, and timely treatment can protect your health as well as that of your baby.
• Follow the best prenatal routine you can manage, including a good diet, a healthy (but not strenuous or exhausting) exercise schedule, sleep, rest, etc. This will ensure that you are healthy and so is your baby.
• Keep a check on your mental health and don’t brush symptoms of depression under the rug. Find ways to destress or relax through the day or week, and make sure you have people to talk to about your feelings, emotions and fears.
• Stay well away from any foods that are deemed risky during pregnancy. This includes raw foods like fish, seafood and eggs, as well as soft cheeses. These can increase the risks of infections like salmonella and listeriosis. (Read more: Is it safe to eat fish during pregnancy?)
• Don’t assume that continuing in the same bra or fitting clothes will do you any good during pregnancy. You’re growing and need all the support you need, and this includes the perfect bra, maternity clothes, comfortable shoes, etc.

Read more: Is it safe to eat cheese during pregnancy?

Getting a fetal ultrasound and any other tests recommended by your doctor done should be your priority during the 19th week of pregnancy. At the same time, it’s important to remember to relax and de-stress this week to ensure that you feel rested and ready to deal with the rest of your pregnancy. The following are some things you should keep in mind this week:

• Don’t take any medications unless prescribed to you by the doctor. Sticking to the doses of recommended medications is also very important. 
• Staying active is very important, but strenuous activities and hectic travel or work schedules should be avoided as your pregnancy progresses.
• Talk to your spouse and unwind with your friends and family. Communicate your feelings, fears and expectations, especially if you feel you’re slipping into depression during pregnancy.
• Do not get the baby’s nursery or any part of the house painted during the second trimester. Paint fumes can be toxic, and high levels of exposure to it can also be harmful.
• Avoid wearing heels and opt for comfortable shoes. As your pregnancy progresses, your belly weight will increase and you need proper support on your feet for it.