Pregnancy Week 16

What does my baby look like?

This week your baby is about the size of an avocado.

Around now, your baby may start making little facial expressions, though these aren't intentional yet since muscle control is still developing. The nervous system keeps maturing, which brings more arm and leg movement. Your baby can even curl those tiny hands into fists.

As the spine and small muscles grow stronger, your baby begins to hold their head and neck a little more upright.

Your baby's see-through skin

At this stage your baby's skin is still very thin and can look almost translucent. The blood vessels underneath are visible through it.

The sense of hearing continues to develop and becomes more noticeable around week 18. There's even research suggesting that sounds heard in the womb may be recognized after birth.

Your baby's first movements

Some people start to feel their baby's gentle movements around this week. At first these feel less like kicks and more like a flutter, a bubbling sensation, or a light nudge.

With a first pregnancy, it's completely normal to notice these movements a bit later. Some people don't feel clear movement until week 20, or sometimes even later. If the placenta is positioned at the front, it can take longer to feel movement. That said, if you haven't felt any movement at all by week 24, you should talk to your doctor.

What's happening in my body?

You may have a prenatal checkup around these weeks. Your weight, your overall wellbeing, and the results of some blood tests may be reviewed. You might also have the chance to hear your baby's heartbeat for the first time.

As part of your prenatal care, you may have been tested for certain infectious diseases. If an infection is found, your care team will walk you through the plan to protect your health and reduce the risk of passing it to your baby.

Your blood pressure and a urine test may also be done. Checking whether there's protein in your urine is important for assessing your risk of preeclampsia.

Constipation

Constipation is common in pregnancy. It can cause bloating, discomfort, and belly pain.

These things may help:

• eating fiber-rich foods like whole-grain bread, vegetables, fruit, beans, and lentils
• getting regular exercise
• drinking plenty of water

Iron supplements can make constipation worse, but you should talk to your doctor before stopping any medication.

A note on carbon monoxide

Carbon monoxide can't be seen, smelled, or tasted, yet it's a harmful gas. Cigarette smoke and faulty or poorly ventilated cooking and heating appliances can all lead to exposure.

If you have a carbon monoxide detector at home, it's important to check that it's working.

The ligaments supporting your uterus are thickening

As your uterus grows, the round ligaments that support it stretch and thicken. This can cause a sharp pain on either side of your belly, known as round ligament pain. Resting usually eases it, but if the pain persists you should see your doctor.

The hormone progesterone also relaxes the muscles in your digestive system. This can lead to gas, bloating, and general tummy discomfort. Eating smaller, more frequent meals, taking your time when you eat, and staying active can all help.

Back pain is also common at this stage. As your uterus grows, your abdominal muscles can weaken and put more strain on your lower back. Hormonal changes can loosen your joints too. Exercises like walking, swimming, prenatal yoga, and pelvic tilts can bring relief.

You may notice breast tenderness, prominent veins, changes in pigmentation, and darkening of the areolas. Some harmless breast lumps can also develop during pregnancy, but you should tell your doctor about any lump that feels hard or worries you.

You might find yourself feeling forgetful or having trouble concentrating during pregnancy. The exact cause isn't known, but fatigue, stress, anxiety, and hormones may all play a part.

Headaches are common too. Dehydration, lack of sleep, cutting back on caffeine, and hormonal changes can all contribute. That said, a severe headache in the second or third trimester can be a sign of preeclampsia, so it should be taken seriously.

Your bump may be more noticeable around these weeks, though it looks different in every pregnancy. With a first pregnancy the belly tends to show later, and in later pregnancies it can show earlier.

Symptoms you might have this week

You might experience the following symptoms this week:

• round ligament pain
• gas and bloating
• constipation
• back pain
• breast changes
• forgetfulness and trouble concentrating
• headaches
• a stuffy nose
• nosebleeds
• varicose veins

A stuffy nose and nosebleeds can be linked to pregnancy hormones and increased blood flow swelling the lining of your nose. A saline spray, nasal strips, a humidifier, and drinking enough fluids can bring relief. Check with your doctor before taking any medication.

Nutrition this week

Vitamin A is important during pregnancy. It's essential for your baby's heart, lungs, kidneys, eyes, bones, and nervous system. It also plays a role in tissue repair after birth.

That said, too much vitamin A can be harmful. For this reason, supplements shouldn't be taken casually.

Some foods that contain vitamin A:

• tomatoes
• carrots
• oranges
• apricots
• cantaloupe
• mango
• dairy products
• eggs, especially the yolk

It's important that any vitamins you take are appropriate for pregnancy.

Plant-based and other protein sources

If you're finding it hard to eat meat, chicken, or fish, you can meet your protein needs from these sources:

• cottage cheese
• yogurt
• beans
• tofu
• edamame
• quinoa

If vegetables are getting harder to tolerate, options like carrots, sweet potatoes, cantaloupe, mango, peaches, and apricots are worth considering too.

Greens and fiber

Salads, grilled vegetables, leafy greens, lentils, beans, and vegetable soups are rich in fiber and can help ease constipation.

If your baby's movements decrease

Over time your baby's movements may feel like kicks, glides, rolls, or wriggles. If you think your baby's movements have decreased, weakened, or stopped, contact your doctor.

Your second prenatal visit

Around week 16 you may have a checkup to assess how your baby is growing. Your blood test results may also be shared during this visit.

At future checkups, your blood pressure and urine may be monitored regularly. This helps catch serious conditions like preeclampsia early.

Exercises to avoid in pregnancy

Staying active during pregnancy is usually beneficial. However, after week 16, exercises that involve lying flat on your back for a long time can cause low blood pressure and dizziness in some people. For this reason, it's best to avoid staying on your back for extended periods. It's also important that whoever is leading your workouts knows you're pregnant.

Pelvic floor exercises

Doing pelvic floor exercises during and after pregnancy can ease some symptoms and support your recovery afterward. Briefly tightening and releasing your pelvic floor muscles can help strengthen the muscles that support your bladder and uterus.

Movement for back pain

Gentle prenatal yoga, pregnancy-safe Pilates moves, and appropriate exercises that support your core can help relieve back pain.

Varicose veins in pregnancy

Varicose veins are enlarged veins that can look blue or dark purple, raised, and twisted. Most of the time they don't need treatment, but if they cause pain, discomfort, or irritation, you should tell your doctor. In some cases they can be linked to more serious vein problems.

Steps that may help lower your risk of varicose veins:

• lying on your left side
• avoiding standing for long periods
• raising your feet
• moving your ankles
• doing exercises like walking and swimming
• keeping your weight gain steady

Screening tests and the quad screen

Between weeks 16 and 18, some people may be offered an Alpha-Fetoprotein (AFP) test to help evaluate for neural tube defects. If screening for Down syndrome is desired, the quad screen may also come into play.

The quad screen is a test that measures the levels of four substances produced by the fetus and placenta in the mother's blood. It can be used to assess the risk of certain chromosomal conditions and neural tube defects, and the results can be interpreted alongside other screening methods. Which tests are right for you should be assessed by your doctor.

Vaccines

Around these weeks, the whooping cough vaccine may be recommended. This vaccine can help protect your baby against whooping cough in their first weeks of life. Recommendations about the flu, RSV, and Covid-19 vaccines can also be given by your doctor based on your individual situation.

Can I use cleaning products?

It's common to worry about some of the chemicals used around the house. Avoiding sprays and aerosol products and ventilating the area while you clean can be a safer approach.

Your mood

If you're struggling to cope with your emotions, let your doctor know. Depression can happen during pregnancy too. If you have symptoms like low mood lasting more than two weeks, loss of interest, crying, withdrawing from others, sleep problems, or hopelessness, it's important to get support.

If you're Rhesus negative

If your blood type is Rhesus negative, it usually doesn't cause a problem in a first pregnancy. However, in later pregnancies there can be a risk of Rhesus disease. This can lead the baby to develop anemia or jaundice.

If it's deemed necessary, an anti-D immunoglobulin injection may be recommended. Thanks to this preventive treatment, Rhesus disease is much rarer today.

Preeclampsia risk

Preeclampsia usually appears after week 20 of pregnancy. It's associated with signs like high blood pressure, noticeable swelling in the face and hands, and protein in the urine. Your risk and how to protect against it should be assessed by your doctor.