Symptoms and Baby Growth at 5 Months Pregnant

The fifth month — roughly weeks 18 to 22 — is, for most women, the easiest stretch of pregnancy. Early nausea has usually settled, the bump has become visible, and somewhere in these weeks you are likely to feel your baby move for the first time. It is also the month of the most important scan of the pregnancy.

How your baby is growing

By the end of the fifth month your baby measures around 25 centimetres from head to heel and weighs roughly 300 to 450 grams — about the size and weight of a small coconut. A great deal is happening beneath that:

• A fine downy hair called lanugo, and a waxy protective coating called vernix, now cover the skin
• Eyebrows and scalp hair are appearing
• The baby can hear — muffled sounds, your heartbeat, your voice
• Sleep and wake cycles are establishing, which is why movement often comes in bursts
• In female babies the ovaries already contain their lifetime supply of eggs; in male babies the testes have begun descending
• Fingerprints are forming, and the baby swallows amniotic fluid, practising for digestion

First movements

Quickening — that first flutter — is usually felt between 18 and 22 weeks, and later in a first pregnancy, often closer to 20 to 24 weeks. It is easy to mistake for gas at first: a tapping, bubbling or swishing rather than a kick. If you have not felt anything by 24 weeks, mention it at your next visit; it is usually just placental position, but it is worth confirming.

At this stage movements are not yet regular, so do not start counting kicks or worry about a quiet day. Formal monitoring of movement patterns begins in the third trimester.

What you may feel this month

• More energy than in the first trimester, and usually a returned appetite
• A growing bump, with stretching or pulling sensations low down as the round ligaments take the strain — common, and eased by moving position slowly
• Backache, as your centre of gravity shifts
• Heartburn and constipation, from pregnancy hormones slowing the gut
• Leg cramps, especially at night
• Nasal congestion and occasional nosebleeds, from increased blood flow to the lining of the nose
• Skin changes — a darkened line down the abdomen, darker areolae, and sometimes patches on the face
• Mild swelling of the feet, particularly late in the day and in Chennai's heat
• Occasional dizziness, as blood pressure runs lower in mid-pregnancy

The anomaly scan

Between 18 and 22 weeks you will have the anomaly scan, sometimes called the TIFFA or level II scan. It is the most detailed look at your baby of the whole pregnancy, and it examines the brain, face, spine, heart and its major vessels, abdominal organs, kidneys, and the limbs — along with the position of the placenta, the volume of amniotic fluid, and growth measurements.

Two practical points. A low-lying placenta reported now usually moves upward as the uterus grows and is rarely a problem at delivery; it will simply be rechecked later. And the scan cannot detect everything — it is very good, not perfect. Ask the sonographer to explain anything unclear before you leave; a question answered in the room saves a week of anxious searching afterwards.

Other checks around this time

• Blood pressure and urine protein at every visit — the key screen for pre-eclampsia
• Haemoglobin, since anaemia is common in pregnancy in India and easily treated
• Blood sugar screening, generally between 24 and 28 weeks, earlier if you have risk factors
• Iron, calcium and folic acid supplements as prescribed
• The tetanus or Tdap vaccination, as advised locally

Looking after yourself

• Sleep on your side as the bump grows, ideally the left, with a pillow between the knees. Avoid lying flat on your back for long periods later in pregnancy.
• Drink more than you think you need — dehydration is a frequent cause of dizziness and cramps here
• Keep moving. Walking, swimming and antenatal yoga are all appropriate unless your doctor has advised otherwise
• Eat for nutrition, not for two. Around an extra 300 calories a day is enough in the second trimester; protein, iron and calcium matter more than quantity
• Take no medicine, herbal preparation or supplement without checking with your obstetrician
• Wear supportive footwear and a well-fitting bra; both prevent a lot of avoidable discomfort

When to contact your doctor the same day

• Vaginal bleeding, or a gush or steady leak of fluid
• Severe or persistent abdominal pain, or regular tightening that does not settle
• A severe headache, blurred vision or flashing lights, or sudden swelling of the face and hands — possible signs of pre-eclampsia
• Fever, chills, or burning on passing urine
• Painful, swollen or red calf, or sudden breathlessness
• Persistent vomiting, or a marked reduction in movements once they have become established

The obstetrics team at Iswarya Hospital provides antenatal care through the second trimester including the anomaly scan, and can advise on anything in this list that is worrying you.

This article provides general health information and is not a substitute for personal medical advice. Every pregnancy is different — please discuss your own symptoms and care with your obstetrician.