16 to 20 weeks

16 - 20 week appointment

You are almost at the halfway point of your pregnancy. This is the time when you will feel your best.  Your energy level increases and the nausea and vomiting of pregnancy should be resolving. Twenty weeks is when most will start to "show." However you may "show" sooner with each pregnancy.
 
At this appointment, we will review all your lab work ordered at your first visit. Your ultrasound is ordered if you haven't already scheduled it. The purpose of the ultrasound is to look at the baby's growth, his/her organs are forming correctly, placenta and fluid. Hopefully, you will also find out the sex of your baby, the closer we wait until 20 weeks, the more likely you are to see the baby's sex.

If you declined first trimester and desire to have the second trimester quad screen and/or cystic fibrosis testing, we will order it today. The quad screen can not be done after 21 weeks.

Fetal movement

Between 16 and 24 weeks you may begin to feel fetal movement. It's described as quickening and initially felt as little flutters. If this is your first pregnancy, you may not feel it until closer to 24 weeks. Also, if your placenta is anterior it may take longer for you to feel him or her.

Round ligament pain

During your second trimester you may experience round ligament pain which is caused by enlarging uterus stretching the ligaments that hold it in place. This pain will be sharp, off to the side, and radiate to the top of your leg. While severe, it usually only lasts for a few seconds and is nothing to worry about. Gas pains will be similar, usually occurring on the left side, and will likewise be sharp, short and will come and go. Lastly, a hormone called "relaxin" is released that relaxes the joints in your pelvis. This will lead to some back and hip pain and the feeling that things are "loose." These problems are often improved with Tylenol. You should call for pains that are persistent and that worsen over time, or any pain associated with bleeding. You may find that with each pregnancy your pains are more intense or start earlier and this is generally normal. Let us know if you are concerned about this.

Back pain

Back pain may start to cause your problems during the first trimester. There are several exercises you can do that help. Refer to this website or ask for a copy from our office. The book "Great expectations - a guide to enjoying your pregnancy" provided to you at your first appointment also has some pictures/description of back exercises. 

  • Wear shoes with good arch support
  • Get off your feet and take frequent breaks during the day
  • If you must lift something, do not lift from your waist.  Squat down and bend your knees
  • Warm showers or baths can be very comforting
  • Heating pad for 15-20 minutes at a time (wrap in a towel to avoid burns)
  • Get a massage!
  • Consider purchasing an abdominal support girdle.  These can be found at most maternity stores
  • Or go to amazon.com and search pregnancy support belts

Headaches

It is not uncommon from around 17 to 24 weeks to have an increase in headaches. This is most likely due to the normal drop in blood pressure around this time. If this happens to you, make sure you are drinking lots of water and resting as much as you need to. You can take Tylenol as needed. You may want to add a little caffeine if your headache still persists, such as a Diet Coke. See the section on headaches to learn more.