Weeks 23 - 25

Week 23

Overview

At week 23 your baby is measuring in at 28.9 centimetres and weighs 501g (17.672oz). The little lungs are continuing their development and getting ready to breathe as your baby is inhaling amniotic fluid and are also creating a substance known as surfactant. This allows for the lungs to inflate for breathing. Your baby’s brain is also making vital connections needed for thinking.

 

Your baby’s development at this stage

With the baby’s movement being well-developed at this stage, he or she is about the size of a mango, quite a large mango in fact. You may also be able to see your baby moving about under your clothing now. Little blood vessels inside of the lungs are also developing to help prepare him or her for breathing. Your baby is getting better at detecting sounds, so remember to talk or sing to your little one when you can. You may also be able to get a response from your baby if you play a specific song or kind of music.

Changes in your life as your baby grows

As you may have noticed already, your ankles and feet are starting to swell at this point, this swelling is often worse during hot summer months or at the end of a long day. Water retention may also be present in your legs due to poor circulation and changes in your blood chemistry, this swelling is known as oedema. Your body will rid itself of this water retention once you have given birth, this often results in a need to urinate frequently and an increase in perspiration for the first few days after giving birth.

It may help if you put your feet up to rest when you can and also stretch your legs out when sitting. Try not to sit or stand in one position for long periods of time. The rule of thumb is to get up and walk around after every hour. You can also wear support stockings and exercise regularly to help improve the circulation in your legs.

A certain amount of swelling (oedema) is to be expected, if you notice excessive swelling, this could be a sign of preeclampsia (also known as toxaemia/toxemia), which is a serious condition. Ensure your doctor is monitoring the changes in your body in order to prevent and/or identify any potential issues that may arise).

What to do at this stage

This is a great time to start thinking about whether or not you want to bank your baby’s cord blood. This is the blood that is left in the baby’s umbilical cord, as well as the placenta after your baby is born. Through collecting, freezing and storing this for future use, you will be keeping a rich source of your baby’s stem cells which are vital building blocks of the body.

Stem cells have the remarkable ability to transform into a variety of other cells. This can help to repair organs, blood vessels and tissues and can be used for the treatment of several diseases.

The collection process to obtain the cord blood is quick and painless for both your baby and you.

If you decide to bank your baby’s cord blood, you have one of two options:

• You are able to donate this cord blood to a public cord blood bank for anyone in need of it. You are likely to have to agree to and sign a document in order to donate this blood at about week 28 or your pregnancy.
• You can pay for your baby’s cord blood and stem cells to be stored at a private cord blood bank for your own personal use. This does carry a significant cost in some countries, so it is best to research various facilities, their storage term options and pricing for this service before making a decision.

Speak to your doctor about whether or not you want to bank the cord blood, the options available to you and what he or she advises.

Week 24

Overview

Weighing in at 600g (21.164oz) and being 30 centimetres in length from tip to toe, your little one is certainly starting to thrive. He or she has now reached the point of viability. This means that your baby would be able to survive without the use of a ventilator if the delivery had to take place. Your baby’s wrinkles are also filling out now as the fat is starting to build up under the skin.

Your baby’s development at this stage

Your baby, now growing at a steady pace, is about the size of an ear of corn, or a large hot dog. He or she is starting to plump up nicely too and the brain is also continuing in its development. The taste buds are starting to form and the little lungs are creating ‘branches’ for the respiratory ‘tree’ needed for breathing. Your baby’s translucent skin will soon start to change. 

Changes in your life as your baby grows

During the past couple of weeks, the top portion of your uterus has started to rise just above the belly button and is now roughly the size of a soccer ball.

You will also need to start learning about the signs and symptoms of preterm labour. This will be discussed below.

Tests and what to do at this stage

Your doctor may suggest that you have a GCT, which is a glucose screening test between this week and week 28. This is a test that will check for gestational diabetes, which is a condition in pregnancy that relates to issues with high-blood sugar.

If diabetes is left untreated, it can increase your risk of having a vaginal delivery that is difficult or requires an emergency caesarean section as your baby will grow too large, particularly in his/her upper body to deliver naturally. It will also raise the baby’s chances of developing other conditions and complications such as suffering from low blood sugar after he or she is born.

If you receive a positive result on your GCT, this does not necessarily mean that you have gestational diabetes, but rather than you should take a GTT, which is a glucose tolerance test, to know for sure.

Preterm labour

A number of women have had preterm labour, many of these have been induced, meaning that the medical team managing the pregnancy decided that labour should be induced earlier or have performed a C-section due to a severe medical condition such as progressive preeclampsia (a pregnancy complication that is characterised by suffering from high-blood pressure) or if the baby has stopped developing and growing or is under stress due for some reason. If labour was not medically induced, then this is known as spontaneous preterm birth. This can occur before week 37 if you go into labour before reaching full-term, having your water break or if your cervix dilates without contractions.

There are some known risk factors and complications associated with preterm labour, these include:

• Placental issues
• Cervical insufficiency
• Genital tract infections

However, in many cases of preterm labour, doctors do not know what the cause is. Therefore, it is vital that as an expecting mother you know the signs of preterm labour, these are:

• An increase in your vaginal discharge
• Changes in discharge, if the discharge becomes water, bloody or mucus-like
• Any vaginal spotting or bleeding
• Suffering from abdominal pain similar to that of menstrual cramping, or having more than four contractions in an hour
• Feeling increased pressure in your pelvic area
• Suffering from lower back pain, particularly if you haven’t suffered from this before

Sometimes the above symptoms can be confusing, especially when it comes to lower back pain or abdominal pain, as these often occur with normal pregnancies. Having early contractions can often be harmless and these are known as Braxton Hicks contractions.

However, it is best to always be safe and check any unusual symptoms with your doctor.

The closer your baby gets to full-term, the more likely his or her chances of survival are and the less likely he or she is to develop further health issues. Often babies who are born between week 34 and week 37, do not have any additional health problems, yet they may still have a higher risk of developing issues as opposed to babies who have made it to 40 weeks.

Thanks to medical advances, babies born as early as 24 weeks are often able to survive due to neonatal care in NICUs, which are neonatal intensive care units.

To lower your chances or preterm labour, it is advised that you stick to a healthy and nutritious diet, stay away from any harmful substances and keep up your regular check-ups and doctors’ visits.

Now is also a great time to paint the nursery as this will give the paint fumes time to dissipate once the paint is dry and not be a hazard for your newborn.

Week 25

Overview

Your little one is about 34.6 centimetres and weighs 660g (23.281oz). The little window you once had to see into the insides of your baby is now closing as their skin is developing and changing from translucent to cloudy. The heartbeat is also becoming a lot clearer.

 

Your baby’s development at this stage

Your baby is about the size of half a head of broccoli, and his or her long and lean body is starting to build-up a healthy fat layer, smoothing out the wrinkles and making him or her look like a newborn baby. There is also more hair present at this stage.

Changes in your life as your baby grows

You may start to notice that your ability to move around is not as graceful as it once was. Unless your doctor has told you not to, you should continue with your normal prenatal exercise routine. However, try to stick to the below safety rules:

• Stop if you feel dizzy and sit down
• Stop if you feel any pain
• Do not lie flat on your back (this compresses the vein that transports blood from your lower body back to your heart)
• Avoid exercises where you could lose your balance
• Make sure you continuously drink enough water

If you have the glucose-screening test between 24 and 28 weeks, then sometimes a second sample tube of blood is also taken to check for anaemia. If these test results show that you have iron-deficiency anaemia, then your doctor is likely to tell you to take an iron supplement.

Tests and what to do at this stage

Between week 28 and week 36, you are likely to visit your doctor about every second week, this will then be increased to once a week closer to your delivery date.

Depending on how your pregnancy is going, you may be offered one or more of the below tests:

• Haemoglobin / haematocrit – This is a blood test that is done to test for anaemia, and is normally repeated at your third trimester. However, if your glucose-screening results were normal, then this may not be necessary, or as stated above, a second blood sample may have already been tested for this.
• Gestational diabetes testing – In the case that a glucose-screening test has already been conducted, then you will not need this test. However, if you haven’t had a gestational-screening test or your results were abnormal, then this test will be conducted.
• Rh antibody screening test – If your blood type is Rh-negative, then an antibody-screening test will be repeated, which is normally done at the same time as your glucose-screening test, you will also get an injection at 28 weeks of Rh immune globulin. It is rare, but if your baby’s blood fuses with yours through getting into your bloodstream, then the Rh immune globin will offer you protection from antibodies developing that may create a high-risk environment for you and your baby. If the father of your baby is Rh-negative, then your baby will also be Rh-negative, therefore you will not need the Rh immune globin.
• STI testing – If you have a substantial risk of having a sexually transmitted infection (STI), then your doctor will check your cervical cultures for gonorrhoea and chlamydia, as well as this, your blood will also be tested for syphilis. It may also be wise that you retest for HIV if you feel you may have been in a situation where you could have contracted it. If your test is positive for HIV, then there are treatment options available to drastically reduce your baby’s risk of getting it from you during the birthing process.
• Group B strep testing – This is done between week 35 and week 37, where you will be tested for GBS (group B streptococci), present in your rectum and your vagina. If these cultures have positive results, then you can only be treated with IV antibiotics when you are in labour. If you have previously been tested and given birth to a baby with GBS, then this test can be skipped as you would have already been given IV antibiotics during birth.
• Non-stress and biophysical profile tests – When you have specific complications during your pregnancy or you have gone passed your initial due date, then these tests will be conducted to check on the health of your baby. These are simple, non-invasive tests. They check on your baby’s movements, heartbeat and other health factors.

You may want to also start planning your paid or unpaid maternity leave. You should have spoken to human resources at your company by this stage, as you will need to know if your leave is unpaid or paid. Some companies are generous and will give up to four months of paid maternity leave. Regardless, you will need to know where you stand with your current work situation. If you work from home, then think about how you will restructure your day with the new baby.

Tip: It may help if you eat smaller meals more frequently to aid in preventing heartburn throughout your pregnancy.