Pregnancy in 18th week

This week, your baby is likely to grow upto 14.2 cm long from head to bottom and weigh around 190g. This is roughly the size of a red bell pepper. The most interesting development is that your baby’s genitals and reproductive system are finally in place, and they now have a gender! 

Of course, simply because they do have a gender does not mean you can find out. 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.

Apart from this, your baby is developing rapidly and now has his or her reflexes developing rapidly. This also means that you’ll feel your baby kick and move in your womb - which is called “quickening” as well.

Your breasts have increased a size or two, your belly has become bigger, more protruded and heavier - obviously, these changes and the spike in hormones as well as the amount of blood being pumped in your body will probably make you feel a little clumsy or off-balance. It might take some getting used to, but know that your uterus and the placenta are going to continue growing as your baby grows in your womb.

There might be a new thing to deal with from this week onwards, and that’s low blood pressure. Like most parts of your body, your cardiovascular system is also affected by pregnancy, leading to hypotension. Make sure you do not make sudden movements, like standing up quickly, because those can end up making you feel dizzy.

Read more: After delivery care for the mother

As your pregnancy reaches the halfway mark, it’s time for another ultrasound appointment along with a fresh set of tests. 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. Both of these are as important as the ultrasound that needs to be done this week.

This ultrasound is known as an anatomy ultrasound, and it is usually done to ensure that your baby is developing and will continue to develop properly. This ultrasound will basically attempt to detect any congenital defects and anomalies, like spina bifida, that might have occurred to the baby. So, this ultrasound does a complete surveillance of your baby’s anatomy and gender to determine if everything is developing properly.

If everything is fine, you should have nothing to worry about. If any anomalies or complications are found, your obstetrician will let you know about the future options for you and your baby. It’s very important to remember that although this ultrasound will check your baby’s gender, you will not be told what this gender is since this is illegal in India.

Getting used to the symptoms of pregnancy - whether they’re new ones or ones you’ve been dealing with since the sixth week of pregnancy - is something you’re probably a pro at by now. You should remember that no matter what the symptom, you should never be in excessive pain or feel like you’re unable to cope. If you do, it’s likely because of a complication, and you should consult your obstetrician sooner rather than later. The following are some of the symptoms you might experience this week.

• 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: The sciatic nerve is the biggest one in your body and runs from your lower spine, under the uterus and all the way down both legs. This nerve can be put under pressure as your baby grows in the womb, leading to pain in either or both legs as well as the back. This type of pain is known as sciatic nerve pain, and can be alleviated by taking rest and a hot or cold compress.
• 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.
• Melasma: Don’t let that pregnancy glow or its expectation make you believe that your skin is or will remain perfect. A lot of women get dark patches of skin on their faces, especially the forehead, during pregnancy. Known as melasma or chloasma, this “mask of pregnancy” 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.
• 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 heartburn, indigestion, bloating, constipation, sore breasts as your body prepares for breastfeeding, bleeding gums, swollen gums, headaches, nosebleed and mood swings.

Complications cannot be avoided in life, and they definitely cannot be completely avoided during pregnancy - no matter how hard you try. This is partially because your medical and genetic history has a role to play in your pregnancy, and especially its outcomes, and these are factors beyond your control.

It’s therefore very important to be aware of complications of pregnancy, take precautions against them and call your doctor or emergency health services if you suspect an issue is emerging or getting worse rapidly.

• Obstetric cholestasis: Obstetric cholestasis is a type of liver disease that usually shows up during the second or third trimesters of pregnancy. Though rare, Indian women are more at risk of suffering from obstetric cholestasis, and it can have some severe repercussions for your baby as well, including premature labour, low birthweight, etc. The main symptom is itching on the hands and feet, especially during the night, so if you observe this symptom get yourself checked immediately.
• Infections: Unless you’re living in a bubble, you might not be able to completely avoid vaginal infections, viral infections, bacterial infections, fungal infections, urinary tract infections and sexually transmitted infections (STIs) while you’re pregnant. These infections can affect your health as well as the well-being of your baby. This is the reason why taking care of your hygiene is of the utmost importance during your pregnancy. You should also take precautions against disease outbreaks, epidemic and pandemics in your region, especially the highly contagious ones like COVID-19.
• Subchorionic hemorrhage: Bleeding during pregnancy can be a cause of worry because there isn’t supposed to be any vaginal bleeding during pregnancy especially during the second trimester. However, if the placenta detaches from the area where it was implanted for any reason, it can cause a subchorionic hemorrhage or hematoma due to placental abruption. Depending on the size of the hemorrhage, the bleeding can be light or heavy. It’s best to consult your obstetrician if this problem shows up at all.
• Hypertensive diseases: Hypertensive diseases are a group of health issues related to high blood pressure which are likely to show up in the second trimester. These issues include preeclampsia, eclampsia, gestational hypertension and chronic hypertension. Most of these disorders can have serious implications for both the mother and child, so consulting your doctor, going in for regular checkups, and getting the treatment recommended by the doctor is very important.
• Miscarriage: Although getting to the 18th week might indicate that your baby is growing well and the risk of a miscarriage has lowered, there’s still a chance that a miscarriage can happen upto the 20th week. A miscarriage, once started, cannot be stopped - and can be a huge trauma for women. This is the reason why psychological counselling is a must for couples who have lost a baby to miscarriage.

You have an ultrasound scheduled this week, so this might be a hectic week for you. However, you should take a few breaths and try to relax as well. It’s of vital importance that you continue with your obstetrician’s recommendations during this week, like you have been through the previous weeks. You might also want to keep the following things in mind.

• Follow a healthy diet and maintain a good exercise routine during this week. These will help you stay fit and active and also ensure that your baby gets all the nutrition he or she needs.
• Maintain contact with your obstetrician and follow the general rules and recommendations given by them. If you see any sign of an infection or any other complication, call your doctor immediately instead of delaying unnecessarily.
• Your doctor might ask you to come in for more check ups or an ultrasound if you are carrying twins, have any genetic predisposition towards certain pregnancy complications, or are above 35 years of age. You might also have to get an alpha-fetoprotein test, amniocentesis, etc done to detect genetic defects in your baby like spina bifida.
• Make sure you have your maternity bra and clothes sorted by week 15, because as your baby bump grows, you’ll need more comfortable clothes. 
• Do not consume raw fish or meat and skip processed foods. These might cause salmonella and listeriosis.
• Make sure you keep stress at bay, because this can add to your burden and harm your baby too. Meditate, practice yoga and engage in activities you enjoy to stay content.

The 18th week of pregnancy is a time when you should be comfortably settled in your role of mom-to-be. Take things easy while maintaining all the recommendations made by your doctor, and make sure that you’re not unnecessarily worried about the ultrasound scheduled for 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.

If you’re a working woman, discuss maternity leave with your employer and get things at work sorted for the remainder of your gestational period. Communicate with your partner or spouse about your feelings, emotions and wellbeing and ask them about theirs as well. This is the best way to ensure that you both get the attention you need and are able to keep depression during pregnancy as well as postpartum depression at bay.

Staying active during pregnancy is very important, but strenuous activities and hectic travel or work schedules should be avoided as your pregnancy progresses. Keep your home and work life in order and maintain simplicity in all its aspects to ensure that your pregnancy goes ahead smoothly.