Pregnancy Week by Week: Week 21

SECOND TRIMESTER

WEEK 21

Can you believe that at week 21, you are just over the halfway mark of your pregnancy, with approximately 19 weeks to go?

Hopefully by now your baby is making his or her presence known, and you have felt the first bubble or flutter in your abdomen that signifies foetal movement. You may also be able to figure out when baby is sleeping, as a definite sleep/wake pattern is established, with about 12-14 hours of sleep in every 24 hours. Very soon, your partner will also be able to feel baby kick and punch when he places his hand on your abdomen.

Baby’s development at 21 weeks pregnant

Growth and development continue at an amazing rate as all the systems and organs are in place and maturing and baby is beginning to put on a little weight. Your baby still has plenty of space in the womb and is approximately the size of a carrot, weighing roughly 350g and measuring 27cm.  Measurements will now be taken from head to heel as baby straightens out and legs lengthen. From now on, the weight of your baby will surpass that of the placenta. Even though the placenta will continue growing, baby will be growing faster.

The little limbs are far more in proportion to the body this week, movements are now more controlled and not always spontaneous jerks. The neurons between muscles and brain have hooked up and are working well. Baby can suck fingers and thumbs, open and close fists, stretch out, flip over, punch and kick.

The liver and spleen are developing rapidly and producing blood cells. In addition, spaces in the bone marrow are sufficiently mature to also contribute to the formation of blood cells.  The bone marrow function will continue into the third trimester as well as after birth, while the spleen and liver will stop producing blood cells soon after the second trimester.

Your baby is still fully dependent on nourishment from the placenta but is also starting to take in and swallow little sips of the amniotic fluid.  This is partly for nutrition but mostly for practicing swallowing and digesting skills, which will be needed immediately after birth.

The sense of taste is beginning as the tiny taste buds start to develop and there is a good chance that your baby will taste whatever it is that you are eating.  Hearing is developing and research indicates that baby can recognise your voice.  You may also notice that your baby responds to sounds like music or the TV.

Little sweat glands are starting to develop on your baby’s skin, which is still thin but now has all the layers.  The soft downy lanugo that covers the body continues to keep your baby well protected and insulated.

New symptoms at 21 weeks pregnant:

Braxton Hicks contractions

Braxton Hicks contractions are something that you have not yet come across in this pregnancy, as they are only noticeable from about the middle of the second trimester.

Braxton Hicks contractions are infrequent, irregular, and painless uterine contractions. Even though they possibly begin early in pregnancy you would be unaware of them, and only notice them when you are around 21 weeks pregnant, if at all. Some mums-to-be never experience them.

Braxton Hicks contractions are most common towards the end of the day when you are dehydrated or have not emptied your bladder. They can also occur during or after a bout of physical activity such as sex, yoga, or walking. Although Braxton Hicks are not dangerous, it can be difficult to tell them apart from preterm labour. Call your healthcare practitioner if you start having regular contractions or if you think you are going into premature labour.

Leaking nipples

During pregnancy, your breasts start to prepare to produce milk months before baby is due. Your milk ducts will be fully developed within the next few weeks, so you may experience some leaking from the breast or perhaps even some dried breast milk on your nipples. The leaking milk is called colostrum, which is a form of breast milk that is particularly nutrient-rich. It has a higher content of protein and is lower in carbohydrates and fats than breast milk and it also contains different antibodies that help protect a newborn baby from infection and assists in developing their immune system.

Weight gain

You may notice that your weight suddenly starts to increase now that nausea, food aversions and morning sickness have ceased.

Your healthcare practitioner has probably advised you on ideal weight gain goals for your pregnancy. At each antenatal visit your weight will be measured and recorded so that a check can be made to keep you on track.

Most mums-to-be gain roughly between 10kg and 13kg, and usually start gaining from about 21 weeks pregnant, once nausea and morning sickness have stopped. Weight gain during pregnancy varies from person to person and is an important indicator that all is well as either gaining too much or too little can cause complications.

Gaining too little weight can be problematic in that it can cause a premature birth or a baby weighing less than 2.5kg, which is considered a low birth weight. It can also mean that you are not putting down fat stores which are needed as an energy source for both mum-to-be and baby.

Some women are naturally slender and start off their pregnancy slim. As long as weight gain is slow and steady, you are on the right track.

Too much weight can be detrimental to your health and your unborn baby’s wellbeing, and can cause an increase in blood pressure, known as hypertension.

There are many disadvantages that can be affected by high pregnancy weight gain, but the most serious are:

• Gestational diabetes is the result of too much sugar (glucose) in your blood and can up the risk of having a larger than normal baby, which in turn can mean a difficult delivery.
• Research shows that overweight pregnant women are more likely to develop certain hypertension disorders, including pre-eclampsia, which can be noticed by a rise in blood pressure. In most cases pre-eclampsia is mild and normal, but sometimes it can cause serious complications as it affects the mother’s blood vessels and the baby’s blood supply.

If you are concerned about your weight gain or obesity, discuss a plan of action with your healthcare practitioner. Under no circumstances should you embark on a weight-loss diet during pregnancy as restricting food intake could be dangerous to the development of your baby. You and your baby need a balance of nutrients that are obtained from all food groups, so it is most important to eat healthily.

Eat balanced meals and healthy snacks that include protein, fibre, healthy fats, vitamins and minerals and complex carbohydrates. Stay hydrated by drinking at least 8 glasses of water a day, and exercise on a regular basis.

Eating regular meals, with healthy snacks in between, can keep your blood sugar stable and help to manage your weight throughout your pregnancy.

Healthy snack ideas:

• Greek yoghurt with berries and nuts
• Tortilla with hummus
• Wholemeal toast with mashed avocado
• Apple with nut butter
• Pitta bread with grated cheese
• Trail mix

‘A baby fills a place in our heart that you never knew was empty’

-Author Unknown-