5.0 – Month Five (Week 17-20th)

Sources:

1.     The Everything Pregnancy Organizer by Paula Ford-Martin

2.     http://www.babycenter.com/

3.     familyeducation.com

5.1            Checklist

1.     Plan a special night out with your partner.

2.     Choose a method of childbirth instruction.

3.     Tour childbirth centre.

5.2            Baby Development

Week 17th - Around 13 cm long from head to bottom - Weighs 140 gram, about as much as a turnip - His skeleton is changing from soft cartilage to bone - He can move all his joints, and his sweat glands are starting to develop - The umbilical cord is your baby’s lifeline to your placenta and it’s growing stronger and thicker every day

Week 18th - More than 14cm long, about the length of a bell pepper - Weighs around 190 gram - She is busy flexing her arms and legs - Baby’s blood vessels are still visible through thin skin - Her ears are now in their final position, although they are still standing out from her head a bit - A protective covering of myelin is beginning to form around her nerves, a process that will continue for a year after she’s born - If you are having a girl, her uterus and fallopian tubes are formed and in place. - If you’re having a boy, his genitals are noticeable now

Week 19th - Measures about 14cm, about the size of a large tomato - Weighs about 240 gram - Baby’s sensory development is exploding - His brain is creating specialized areas for smell, taste, hearing, vision and touch - Baby may be able to hear your voice now - His arms and legs are in the right proportions to each other and the rest of his body - Baby’s kidneys continue to make urine - The hair on his scalp is sprouting - A waxy protective coating called the vernix caseosa is forming on his skin to protect it during the long stay in your amniotic fluid

Week 20th - More than 16cm long from head to bottom - About 26cm long from head to heel, about the length of a banana - Weighs about 300 gram - Baby’s legs were curled up against her torso and hard to measure for first 20 weeks. So measurements were taken from crown to rump - Now baby is measured from head to toe - Baby is swallowing more these days, which is good practice for her digestive system - She is also producing meconium, a black, sticky by-product of digestion - This gooey substance will accumulate in your baby’s bowels, and you’ll see it in that first dirty nappy

5.3            My Body

Estimated Due Date (EDD):

	Week 17th	Week 18th	Week 19th	Week 20th
Date
Time
My weight

As your baby grows, your muscles and ligaments stretch to support this new weight. The result may be a new set of aches and pains as your body adjusts to the load.

The skin of your belly is stretching, tightening, and itching like crazy. A good moisturizing cream can relieve the itching and keep your skin hydrated, although it won't prevent or eliminate striae gravidarum, or stretch marks.

The band of ligaments supporting your uterus is carrying an increasingly heavy load. You may start to feel occasional discomfort in your lower abdomen, inner thighs, and hips called round ligament pain. Pelvic tilt exercises are useful for keeping pelvic muscles toned and relieving pain. To perform the pelvic tilt:

1. Kneel on all fours on the floor.
2. Keeping your head aligned with your spine, pull in your abdomen, tighten your buttocks, and tilt your pelvis forward. Your back will naturally arch up.

3. Hold the position for three seconds, then relax. (Remember to keep your back straight in this neutral position.)

4. Repeat the tilt three to five times, eventually working up to ten repetitions.

The root of all things uncomfortable—pregnancy hormones—are also contributing to lower back pain you may be experiencing. Progesterone and relaxin—the hormone responsible for softening your pelvic ligaments for delivery—are also loosening up your lower back ligaments and disks, and combined with the weight of your growing belly your back is feeling the strain.

If your abdominal and/or back pains are severe or accompanied by any of the following, call your healthcare provider immediately:

•       Fever

•       Vomiting

•       Vaginal bleeding

•       Leg numbness

Most minor back pain of pregnancy is completely normal, but in severe cases it can be a sign of preterm labor, kidney infection, or other medical problems.

To help you ease your aches and pains:

Stand tall. Try to keep your center of gravity in your spine and pelvis rather than out in your belly, which can give you a swayback.

Sit up straight. Use good posture when you're sitting as well and choose a chair with good lower back support. You can purchase a special ergonomic support pad for your chair back, but a small pillow may do the trick just as easily.

Avoid twists and turns. With everything so loose, a sudden move as simple as quickly turning at the waist to get out of bed may strain your back. Use your arms as support for a slow takeoff when rising from a chair.

Practice your pickups. If you have small children who still need to be lifted occasionally, it's essential to use good form. To avoid injury, bend and use your leg muscles to lift things rather than bending from the waist and lifting with your back.

Warm up. A warm pad on your back, hips, or other sore spots may help relieve pain.

Wear sensible shoes. Avoid high heels! They will place further stress on your spine.

Rest your feet. Use a low stool or step to rest your feet when sitting. If you must stand for long periods, alternate resting each foot on a step.

Massage. You now have a medical excuse to indulge in a regular back rub from your significant other. A licensed massage therapist who is experienced in prenatal massage may also be helpful.

Fluff and stuff. Sleep on your side with a pillow placed between your legs. This will align your spine and improve your sleeping posture. A full-sized body pillow or beanbag may help support your back and belly as well.

Exercise. Stretching and flexibility exercises may help.

Symptoms you may start or continue to experience this month include the following. Check off any that you are experiencing so that you may ask your doctor about relief and to track the progress of your pregnancy:

	Hot flashes
	Nausea
	Fatigue
	Frequent urination
	Tender and/or swollen breasts
	Bleeding gums
	Excess mucus and saliva
	Increase in vaginal discharge
	Mild shortness of breath
	Lightheadedness or dizziness
	Headaches
	Gas
	Heartburn
	Constipation
	Skin and hair changes

5.4            Activities Recommended

Week 17th
	Do your pelvic floor exercises
	Take a bumpie
	Admire the pregnant, beautiful you
	Start a baby name list
	Do some stretching
	Pack healthy snacks

Week 18th
	Try yoga
	Join a pregnancy exercise class
	Try a relaxation technique
	Look into childbirth classes
	Moisturize your belly
	Track your weight gain

Week 19th
	Take a bumpie
	Look after your nails
	Eat an iron-rich food
	Plan your paternity leave
	Start your childcare search

Week 20th
	Visit the dentist
	Celebrate your halfway point - pedicure, prenatal massage, new outfits, hang out with your partner, friends and family and generally live it up before your baby arrives
	Drink water
	Talk to your baby, sing, or play music
	Jot down a few questions for your caregiver

5.5            Concerns and To Read

Week 17th -       Is it safe to have an X-ray during pregnancy? -       Health: Your anomaly scan -       Eating Well: Why do I keep waking up feeling hungry? -       Your Life: Must-have maternity clothes

Week 18th -       Is it safe to wear underwired bras during pregnancy? -       Health: Exercising safely -       Eating Well: Recipe Salmon with pine nuts and lime -       Your Life:  Should you find out the sex of your baby?

Week 19th -       Is it safe to take Prozac during pregnancy? -       Health: Finger pain and numbness (carpal tunnel syndrome) -       Eating Well: Iron -       Your Life: Paternity leave

Week 20th -       Is it safe to sunbathe or use a sun bed during pregnancy? -       Health: Constipation during pregnancy -       Eating Well: Three great snacks -       Your Life:

5.6            At the Doctor’s Office

Beyond the usual weigh and measure routine, your doctor or midwife may administer an oral glucose tolerance test (OGTT) at the end of the month (between weeks twenty-four and twenty-eight). If your doctor or midwife hasn't discussed counting fetal movements before, he or she may mention it now.

Prenatal Visit Notes

My Weight
Week of pregnancy
Fundal height
Blood pressure
Baby’s heart rate
Tests	Results
Additional Notes:

5.7            Childbirth Classes

Now’s a good time to start gathering information on childbirth classes from your local hospital. There are several different methods of childbirth education, such as Lamaze, the Bradley Method, Leboyer, and HypnoBirthing; researching them now will give you and your partner time to learn more about which one is right for you. Pick a class date that falls in your third trimester so the information will still be fresh in your mind once the big day arrives. While hospital policy will dictate a lot what’s covered in prepared childbirth classes, here’s a general idea of what you will experience:

-       Commiseration: You’ll interact with other pregnant couples and demonstrate that misery (and joy) truly does love company.

-       Reality: Through lecture and (in many cases) actual video footage, you’ll get the full scoop on what really goes on in labor and delivery.

-       Guided tour: If your class is at the birthing centre or hospital, you will probably get a tour of the facilities and some basic instructions on when and where to show up when labor hits.

-       Teamwork: Your husband, partner, or labor coach will learn more about his or her role in this process, and you may even be given homework to try out techniques at home.

-       After-birth instruction: Many classes offer valuable information on breastfeeding basics and baby care. Don’t be surprised if the instructor brings in a bag full of baby dolls for practice.

-       Seasoned support: Most prepared childbirth classes will be conducted by a trained childbirth educator.

-       Paperwork: A lot of literature, brochures, pamphlets, handouts, forms, photocopies, and leaflets will come your way. Bring a bag.

To find out which method is right for you, explore the details of each in the following sections.

Lamaze While rhythmic breathing exercises are stressed for each stage of labor in Lamaze, helpful laboring and birth positions, relaxation techniques, and pain management are also covered. In addition to massage, water therapy, and hot and cold compresses, you’re taught how to focus on a picture or object to diminish your discomfort. Lamaze also stresses the empowerment of the mother-to-be and her right to the birth experience and environment she wants.
Pros	Cons
Additional Thoughts:

Bradley Method Denver obstetrician Robert Bradley, M.D., was a big advocate of fathers helping their partners through the birth process. Bradley Method classes teach couples how to relax and breathe deeply, but the emphasis is on doing what comes naturally – such as father as coach, proper nutrition during pregnancy, and knowing all the options beforehand. They also emphasize the natural in natural childbirth, suggesting that pain medication be used as a last resort rather than a front-line tool.
Pros	Cons
Additional Thoughts:

Leboyer Frederick Leboyer, M.D., author of Birth without Violence, developed this method of childbirth that attempts to soften the trauma of the transition from the warm, dark womb to the cold, bright world. It advocates dim lights in the delivery room, a warm bath for the new baby, calm voices, and soothing room temperatures.
Pros	Cons
Additional Thoughts:

HypnoBirthing British doctor and natural childbirth pioneer Grantly Dick-Read, who authored the classic Childbirth without Fear, is the inspiration behind HypnoBirthing education. Dr. Dick-Read believed that a woman’s labor pains were magnified by her fear and anxieties. HypnoBirthing emphasizes slow abdominal breathing and other relaxation techniques that teach you how to focus on the feelings and signals your body sends during labor.
Pros	Cons
Additional Thoughts:

Childbirth Class Follow-Up Sheet

If you are still confused about the different types of childbirth classes, call your hospital and ask for printed schedules and descriptions of upcoming classes. Once you get a basic feel for what is offered, you can call with follow-up questions. Use the template below to gain as much information as you can:

1.     What are the instructor’s credentials and training?

2.     What methods are taught in the class?

3.     What is the typical class size?

4.     What does the curriculum consist of?

5.     How much does the enrollment cost?

6.     Are there additional costs beyond the enrollment fee, such as for study materials or leaning aids?

7.     Are there couples that can be contacted as references?

Once you have chosen which class best suits your needs and those of your partner, record any information about the class here:

Class starting date:

Class meeting times:

Class instructor:

Address of class:

Phone number:

Additional notes:

When you begin taking labor classes later in your pregnancy, use this space to record notes from class. As you approach the time of labor, you can check back and review the helpful tips and techniques that you learned in childbirth class.

5.8            Touring the Hospital

Even if you don’t choose a childbirth class sponsored by the facility at which you’ll be giving birth, you should try to arrange a tour. On the tour, you can:

-       Find out where you must park when you and your partner arrive at the center

-       Scope out the labor and birthing rooms

-       Get a feel for the staff’s attitude and level of friendliness and approachability

-       Peek at the nursery and maternity ward

-       Observe newborn care

-       Acquaint yourself with hospital policy and procedures

5.9            Milestones and Memories

Here is a place for you to record the thoughts, feelings, and physical changes you experience during your first month of pregnancy.

Time until due date: Firsts: Concerns: Looking forward: Questions for the doctor next month: Reflections from the Heart: I felt my baby move on It felt like How I felt When I saw my baby on the ultrasound, I felt Dad felt During the ultrasound, we found out that we’re having a When I found out, I felt Dad felt We decided not reveal to others because But I hope our baby has my I hope our baby has Dad’s My message to our baby Dad’s message What I like best about being pregnant Friends and family who are pregnant and when they’re due