Month 4 of Pregnancy: What’s REALLY Happening to You and Your Baby

You have made it to month four of pregnancy, so welcome to the second trimester. This is the start of what many people call the honeymoon phase of pregnancy. For many, morning sickness is starting to improve and the fatigue isn't as bad. Today we are on month four of our pregnancy month-by-month series and if you're just joining me for the first time, I will be walking you through pregnancy month-by-month, but if you want even more detailed videos about pregnancy, I've also done a week-by-week pregnancy series which I will link to at the end of this video. My name is Diana. I'm a physician assistant. I specialize in women's health and gynecology. Thank you for watching In The Pink and on this channel, we talk about pregnancy, women's health, babies, and just being a mom. So if you are new here, put in the comment section if you're pregnant and if so, how far along you are. As a women's health PA who's helped so many pregnant women through their first trimester, I know exactly what questions and concerns you have right now. That's why I've created my first trimester survival guide and I'm giving it away for free. Just use the link in the video description to download it and now let's get back to the video. So let's start off by talking about the baby because they are growing so fast. By the end of the fourth month, they are about the size of a large orange. So about four to six inches long and they weigh about three to five ounces which is about a quarter of a pound. Not only is your baby getting bigger, developmentally so much is happening. So their face is starting to look like a baby face. Their eyes are on the front of their face and their eyebrows are forming and they might start to get some hairs on top of their head. Now at this point, their facial muscles are developing and they can start to make facial expressions. They can frown, they can grimace and they can even squint. Now their eyelids are still fused closed and they're going to stay that way for a few more months. Now up until now, your baby's skeleton was mostly made of cartilage but by month four, that cartilage is starting to harden into real bones. They can actually see those bones on ultrasound and the thigh bone is one of the things that they measure to estimate the baby's height and weight. The baby's skin is so thin you can see through it and see the little blood vessels underneath. For now, that delicate skin is protected by a fine layer of soft hair called lanugo which acts as a kind of temporary insulation. Their digestive system is starting to make something called meconium which is that blackish charry poop that babies make the first few days after they're born. Their ears have also started to move into the right place on the side of their head and while their hearing isn't fully developed yet, the inner ear is maturing and they're starting to respond to loud noises outside of the uterus. Noises like your voice or your partner's voice and also music. So start to talk to your baby, start to sing to your baby because they are starting to listen. Now the baby's arms and legs are moving and kicking but for most mamas, it's still too early to feel the baby. First movements which is also called quickening are usually felt around the middle of the fifth month to the middle of the sixth month. Those little kicking feet have little toes and those punching hands have little fingers and something that I think is cool is that those fingers are starting to develop their own unique fingerprints. Nobody in the world will ever have the same ones as your baby, not even identical twins. A lot of people want to know when they get to know the gender of the baby by ultrasound and this month is the soonest that you can. At the beginning of the fourth month, the sex organs are difficult to tell apart but by the end of the fourth month, if the baby is cooperative and willing to give you a nice good view, you can definitely tell. Now sometimes the legs are crossing in the way or the umbilical cord is in the way or your baby is just being modest and when that happens then the 20-week ultrasound should give you a better view so that you'll know if you are having a boy or a girl. I love talking about brain development because the amount of wiring and neural development that is happening right now blows my mind. A baby's brain is adding 250,000 neurons every minute. That's 4,000 neurons a second and over a single day that adds up to 360 million neurons while us adults might only add up around 700. That's half a billion times faster but for that four-month fetus, those neurons will eventually control senses and motor function so even now your baby is starting to soak up sensory experiences like your voice or the motion when you walk. So even though that baby is still small, they are growing rapidly and becoming more and more like a tiny newborn. Now let's go into what is happening with you because month four marks a huge shift for your pregnancy journey. For many of you, you're going to be starting to feel a little bit more like yourself again which is great. If you aren't feeling great yet, be patient. It's not like morning sickness gets flipped off the first day of your second trimester. I wish but it does improve gradually for most women. Not always but for a lot of people, this is when food starts to sound good again and the cravings kick in. My cravings were different in every single pregnancy. My first, it was chocolate cake. My third, it was jalapenos weirdly enough. Let me know in the comments section what your cravings are but besides cravings and feeling more energy, here are a few other things that you might be noticing. First, your growing belly. By month four, your uterus is about the size of a grapefruit and it's growing up out of your pelvis and into your abdomen. This is where some people start to notice that they are popping out or starting to show or that they are just thicker around the middle but if this is your first pregnancy, you might not be showing at all and that is totally normal too. You're also going to be feeling more energy. Most women feel like they are exhausted all the time during the first trimester and that starts to improve finally by month four and in some people might feel like they are getting a burst of energy and motivation to start cleaning and organizing and getting ready for baby. This is when I did a lot of stuff. So take it from me, ride that wave while you can because in a few months, your belly is going to start getting bigger and you might not feel as motivated. Next, I want to talk about something called round ligament pain and I want to give you this heads up because this one catches a lot of moms off guard. Round ligament pain is a sudden sharp or pulling pain or stitch in the lower belly, usually on one side or the other and it happens when you stand up too fast or change positions. You might not feel this for another couple of months but it's totally normal and it can be pretty uncomfortable. The round ligament is a large cord-like structure that supports your growing uterus and as it stretches, it can cause a sudden sharp pain. However, if the pain feels like it's severe or constant, it's definitely worth getting checked out by your medical provider but brief little zings are super common. You might start to notice feeling a little forgetful or spacey and that's always been chalked up to something called pregnancy brain but it's actually a real thing. Studies using MRIs have shown that pregnancy causes measurable changes in a woman's brain including reduced gray matter in areas linked to social and emotional processing. Researchers think this is an adaptive rewiring to support motherhood but also hormones, sleep, and stress all play a role in pregnancy brain so offer yourself some grace if you forget an appointment or space off texting someone back. It's normal. You're not alone. It's fine. Some women might notice a dark line that runs from your belly button down. This is called the linea nigra and again this is caused by pregnancy hormones and it is totally normal. It's going to go away after the baby is born and if you want to know more about skin changes during pregnancy, I have made a whole video talking all about that which I will link to right here. Click on that after you've watched this video but there are definitely some things that you can get to help you with some of the harder parts of pregnancy. So let's jump into the must-haves or maybe wants of the fourth month of pregnancy. Now I didn't purchase all of these suggestions. What you decide to get will really depend on what is bothering you but here are some of the tried and true pregnancy must-haves that can make this month way more manageable. So first off, belly butter or stretch mark oil. Now is there really a magical potion to prevent stretch marks? Not really. Genetics is mostly what determines if you are likely to get stretch marks or not. Now there's no product clinically proven to prevent stretch marks 100% but hyaluronic acid or centella asiatica may help reduce their appearance and are considered safe during pregnancy. Also, hydrating your skin can help reduce itchiness and keep things feeling softer as your belly grows so look for options with cocoa butter, shea butter or vitamin e. If you love drinking water, this may not apply to you but if you are struggling with the flavor of water or are just bored with it, the key is to make it more enjoyable and not to drink less of it. So however that is, whether it is a cute water bottle with markings on it to help you pace your water intake throughout the day but I personally love these fruit infusion water bottles. It gives your water a hint of fruit or mint or ginger or whatever to help you enjoy staying hydrated. Staying hydrated helps with headaches, constipation, swelling, you name it. It's really important. Next is high fiber snacks. Let's just say it constipation sucks and your prenatals can cause constipation and it's all because of the iron supplement that's almost always in your prenatal vitamin. So the best way to manage constipation is anticipate that you could have it and then prevent it and the best way to do that is regular exercise, hydration and fiber. So stack up on high fiber snacks, things like dried apricots, chia pudding, whole grain crackers or even a little kiwi. Having these options on hand can help keep things moving. If you're craving carbs, go for the ones that give you fiber too and also remember prune juice, it's not glamorous but it does work and if fiber isn't working, talk to your OB or midwife about getting a gentle stool softener that's safe during pregnancy. Colace is commonly recommended but make sure to check to see what your OB would want you to do. And speaking of prenatals and I know I've said it before, I might sound like a broken record but be sure that you are taking a really good prenatal. Double check that your prenatal vitamin includes DHA which is essential for babies developing brain and eyes. Now some prenatals include it and some don't and if you need to take it separately, look for one that's pregnancy safe and doesn't cause those fishy burps. Trust me on that one. Next is a pregnancy journal. This is the perfect time to start documenting your journey whether you are writing letters to your baby, tracking your symptoms, writing down questions for your OB can help you feel more connected to what is happening. You'll love looking back on it later. And then finally the last must-have is a support system. I know that's not really a thing you can buy but it's absolutely essential. Whether it's your partner, a sister, a mom group, maybe your best friend that you can text at 2 a.m., make sure that you have people around you who can support you because month four can feel exciting but it's also really emotional and having somebody that you can talk to really makes all of the difference. Now let's talk about what is hopefully on your calendar this month which is your second trimester prenatal appointment. Now it may not feel like a huge deal on the outside but this visit can be packed with really important updates and it may help you feel even more connected with your pregnancy. So at this appointment your OB or your midwife is going to check your vitals, they're going to check your weight, they'll always check your blood pressure to keep an eye out for signs of elevated blood pressure during your pregnancy and then they're going to check your urine for protein and glucose levels and also to check and screen for any signs of infections. These are all part of keeping tabs on how you're doing and catching early signs of things like gestational diabetes, preeclampsia, even though those typically show up later in your pregnancy. They may use a doppler to check the heartbeat which is a favorite thing to hear for most women in the early second trimester because it might be the first time that you actually get to hear it. The baby's heartbeat sounds like a and it is the best sound ever. You can usually start to hear it on a doppler around 12 weeks but sometimes you can't hear it till 14 to 16 weeks. So don't panic if it takes a few seconds for your provider to find that heartbeat or if they decide to switch to ultrasound to check things. This appointment is also a good time to discuss optional genetic screenings. So month four is often when you'll be offered certain second trimester screening tests depending on your provider, your pregnancy history and whether you opted to do earlier tests. One common option is called the quad screen. It's also called the second trimester serum screening. This is typically done between weeks 15 and 20. This blood test will check for things like down syndrome, trisomy 18 and neural tube defects like spina bifida and sometimes other conditions based upon the lab setup. Now this test isn't diagnostic, it just gives you a risk assessment which can help guide further testing or reassurance. It's optional so your provider should walk you through the pros and cons and what you think you might do with the results. And then depending on your timing, your medical history, your provider might check other labs as well like iron levels, thyroid functions or repeat testing for rh factor especially if you've had spotting, bleeding or prior sensitization. Now a lot of people will ask if they're going to get an ultrasound this month and that answer really depends on your OB. Some providers will do a quick bedside ultrasound every single visit and then some just do it at necessary points. That part is really up to your medical provider. Remember that your OB appointments is also a time for you to be able to ask your medical provider questions. So some topics that you might want to consider bringing up at that visit, you want to ask them about any symptoms that you are experiencing so you can discuss if they are normal or something to worry about. You can talk to them about travel, certain exercises that you want to do, if there are any supplements or foods or medications that you need to start or stop. This is also a good time to talk about mental health. If you are feeling anxious, if you're feeling depressed or overwhelmed, be sure to bring it up to them. Your provider wants to support your whole self, not just your growing belly. Now I hope that you liked this video. If you did, hey, be sure to give it a thumbs up. Make sure to subscribe to Diane in the Pink. And like I mentioned at the beginning of this video, if you want to know more detailed information about every week of pregnancy, I've done a whole pregnancy series walking you through pregnancy week by week. I'm going to link to that series right here. Click on that and I will see you over there.