Week to Week Pregnancy

Week 1 Your period begins. Officially, this is the first week of your pregnancy, but there's no talk of a baby yet. In only a few weeks, you'll find out whether or not you're pregnant. For now, you have your period as usual and don't know that it's going to be your last one for quite a while. Your uterus must rid itself of the endometrial lining along with some blood, so that it can wait for a possibly fertilized egg with a fresh interior. Week 2 At the end of this week, it's going to happen. A ripe egg cell will jump out of your ovary and will be caught by grabby tentacles and sucked into your Fallopian tube. There, it will float downstream towards your uterus, waiting for visitors. That could be a flood of sperm cells; each milliliter of ejaculate contains about 2,500,000 of them. On average, some 500 million sperm cells will leave the body with each ejaculation. These sperm cells will fanatically start looking for your egg cell. They'll swim as hard as they can to cover the 6 ¾ inches (17 centimeters) that separates the entrance of the vagina from the egg cell. One of the sperm cells will be the winner of the race and this chosen one will stick his head into the egg cell. The gates will be closed immediately and all the other sperm cells will miss the boat. The winning sperm cell will lose his tail and the historical moment is complete: the egg is fertilized! Week 3 For a short while after the impregnation, nothing happens. But after 24 hours the egg starts to divide, divide, divide and while doing so that small ball of cells finds itself a suitable spot in the wall of the uterus. Normally, the uterus expels everything foreign that comes in. But this time something extraordinary happens: instead of resisting, the uterus relaxes, allowing the small egg to dig itself into its wall. This digging in usually takes place at the upper side of the uterus, but it can also happen in the endometrium at the front or side wall. Wherever the embryo nestles, the placenta will later develop. Week 4 The dot in your belly now measures 1 millimeter. It's dividing very rapidly and beginning to show some structure already. The young embryo is busy creating the placenta and umbilical cord, followed by the spinal cord and then the brain. In a week, work on the gastrointestinal organs will start. week 5 If the little embryo grows well, it will measure some 2 millimeters by now.It's as big as a grain of rice and resembles a small bean. Lots of things are going on in that bean-like structure. The first foundations are being laid for the heart and the central nervous system. At the moment, that's not much more than a tube that runs from head to tail. The thickenings at the top end of the tube (the little heart tube) will form the heart. Although it doesn't have the shape of a heart yet, amazingly, it's already contracting. week 6

By now, your little bean measures 5 millimeters and has a small tail. Although small stumps - protolimbs -- have appeared on the sides, it doesn't look like a human-baby-to-be at all yet. It could be any kind of vertebrate,but it most resembles a tadpole with bulging eyes on the sides. Holes for the ears will soon develop and the mouth and jaws develop shortly after that . Two openings in the front indicate the spot where later the nose will evolve. week 7 Your little tadpole is no baby yet, but the little knobs on its sides are now growing into real arms. A few more weeks and then they'll have hands and fingers with tiny nails. Little legs with feet and toes appear, and then the face starts to develop. The eyes are open but haven't got irises yet. Compared to the rest of the body, the head is really big and it will stay like that for a while. Your baby is now growing at a rate of 1 millimeter a day and is about 0.4 inches (1 centimeter) long. The nervous system is continuing to develop and work on creating the brain and spine is almost finished. The skull is translucent, so the brain is visible. In the abdomen, the liver and stomach are growing. At the end of this week, the bones will start to ossify. And in the jaws, the beginnings of 20 milk teeth are being created. Week 8 By now your baby is approximately three-quarters of an inch (2 centimeters) long and weighs about a gram. He keeps on developing at a rapid speed: the beginnings of a skeleton are being created, with cartilage prior to the actual formation of bones. The little heart has started beating at about 60 times a minute, the stomach produces gastric juices, the liver makes blood cells and the brain starts working. Now the resemblance to a tadpole is quite clear, because webbed fingers and toes appear on the hands and feet! In the meantime, your little bean is growing pretty fast: less than two weeks ago he was the size of a grain of rice, now he's as big as your thumbnail. Week 9 Lots of things are going on now with your baby-to-be. A human being has many double body parts and organs that originate at the same time and develop into a right and left counterpart. A beautiful symmetry. Every cell knows exactly where it has to be and what it has to develop into, without anyone telling it what to do. A 'little person' is almost complete, measuring about an inch in length and weighing some 2 grams, happily splashing around in its membrane filled with fluids. Week 10 Your baby is now almost two inches (4.5 centimeters) tall and weighs 5 grams. It's not much, but he is complete! In your belly sits a miniature person who in no way resembles the tadpole of a few weeks ago. You can recognize his little face and the eyelids are clearly visible. The vocal cords are forming and the inner ear and auricle have been formed, too. The first downy hairs are becoming visible. The process of ossification is in full progress; the fingertips are hardening and soon they will get miniscule nails. A bit later the toes will follow, because the development of an embryo (and of a baby as well) takes place from top to bottom. Although the gender already has been determined, you can't see whether it will be a boy or girl yet. At this stage, the umbilical cord between the embryo and the

wall of the uterus starts to function and a lot of work is done on creating the placenta. That's because from now on your baby-to-be will grow rapidly and that's only possible when he's provided with a sufficient amount of nutrients via the placenta and the umbilical cord. Week 11 In a week's time, your baby's weight has doubled from 5 to 10 grams. He has grown 0.4 inches (a full centimeter) and that growth continues. Your little one now has a neck as well, enabling him to raise his head. He's been moving for a while now, but the future mom can't feel that yet. At this stage, the ovaries and testicles are being formed and all internal organs slowly continue to grow. The heart has been finished now, for example, so that the blood circulation can function and the muscles can strengthen. From this moment on the risk of fetal birth defect will decrease, because once they have been formed organs are less sensitive to external influences. The head is still disproportionately large - it's about the same size as the body. The eyes are finished, including the whites of the eye, iris and pupil. Up until the sixth month they'll stay closed; only then will the lids open and close. There's no need to see anyway, since it's dark inside the uterus; the only thing he does is grow and happily swim around. Week 12 Basically your little child has been fully formed except for his fat and brain, but he'll have to grow and develop during the coming months to be able to live on his own outside of your body. All kinds of details have to be finished and form their definitive shape. At this stage, he'll open his mouth and swallow amniotic fluid. He practices sucking and will let the amniotic fluid flow in and out of his little lungs, which helps with the expanding and developing of his respiratory system. Maybe you'll wonder why babies don't drown in the amniotic fluid. The answer is simple: unborn babies aren't relying on their lungs for their oxygen supply, they get oxygen through the blood from the placenta. Maybe this week you'll hear his heart beat for the first time... a great moment! Now you have the definitive proof that a baby is growing in your belly. His little heart beats really fast, about 160 beats per minute. Later during the pregnancy the rate will drop a bit, to somewhere between 120 and 160 beats per minute. In the meantime, your baby is swimming around peacefully, playing a bit with his umbilical cord and sucking his little thumb; he can already yawn and sleep a bit, too. If only you could have a peek inside to say hello... Week 13 The Baby The baby is getting so big now he's starting to push up your uterus. He weighs just over an ounce (30 grams) and measures almost 3 inches (about 7 centimeters). When not pregnant, a normal uterus is about the size of a small pear. Twelve weeks into the pregnancy, the uterus has grown to the size of a big pear, after 16 weeks it's as big as a grapefruit and when you're 20 weeks pregnant it's the size of a small melon. After 24 weeks of pregnancy it has become as big as a baby watermelon and after 28 weeks it is similiar in size to a balloon that's not fully inflated. By the time you're about to give birth, your uterus is as big as a fully inflated balloon. Your cervix represents the tightly closed mouth of the balloon. A uterus can be positioned leaning towards the front or the back. If yours is positioned towards the front, you can feel your uterus with your hands above the

pubic bone from now on. You can also have your partner or your children feel it if they want. If it doesn't really work out yet, try it again in one or two weeks. Throughout the entire pregnancy you can have normal 'pulling and stretching' pain. Sometimes during the little one's growth spurts, your organs - such as your stomach, liver, pancreas and gall bladder - literally have to make way for your rising uterus. Your uterus is a hollow, muscular organ that always has a certain amount of tension and responds to its surroundings, such as during an orgasm. Now that there's a baby growing inside you, your uterus can harden or tighten briefly during such a growth spurt or when you're doing familiar activities or having an orgasm. That's all normal. You may feel it more often when you're stressed or have a full bladder. These mild uterine contractions are good for the baby -- it feels like a kind of hug, a sign that his mother is there for him. They even have an official name: Braxton-Hicks contractions. First time moms may not even notice them until week 20 or so, where experienced moms may notice them much earlier. Week 14 Swimming, tumbling around in that nice warm amniotic fluid, waving his little arms and playing with his tiny fists, kicking and stretching, yawning and sucking on his thumb, your baby is keeping busy. As long as he's not asleep, that is, because he sleeps most of the time. Did you know that he can move his fingers independently of each other already, because his webbing has disappeared? Too bad you can't feel that at all, because he's only about 3 inches (8,5 centimeters) long and weighs a mere 2 ounces (60 grams). Another thing your baby is capable of by now is urinating. He's continuously swallowing amniotic fluid and that has to come out, too. Now don't think that your amniotic fluid is dirty; it just flushes through and is being refreshed continuously. That's also how waste products are being disposed of. Besides fetal ‘urine,' amniotic fluid also contains dead skin cells, downy hairs and vernix, or fatty coating, from the baby. Amniotic fluid is, at the end of your pregnancy, clear with white flecks of vernix swirling around in it. Amniotic fluid protects against infections that can reach your baby through the vagina and the cervix. There are no nerves running through the membranes and the umbilical cord as a result of which it will not hurt if the membranes break or are broken. If the membranes should break, you would experience either a trickle or gush of fluid from your vagina and the sensation that you are wetting your pants. This is a serious danger sign at this point in the pregnancy and you should call your health care provider immediately. It is extraordinarily rare for the membranes to rupture this early in the pregnancy, however. Week 15 Your baby's skin is still in fine downy hair called the end of the pregnancy. naturally swallow some of very thin and his little body is now completely covered lanugo. Almost all babies will shed their lanugo near It will float in the amniotic fluid - he will even it!

The liver, kidneys, stomach and gall bladder glands are all functioning well. The intestines are filled with meconium, a greenish-black substance that consists of intestinal mucus, intestinal cells, swallowed amniotic fluid and skin oils. The dark colour arises from the release of gall dyes during this period. The fat and sweat glands begin to function. Downy hairs will grow on his head during these weeks. His head is approximately 1/3 of his total body length, measured from the crown of the head to the tail bone. He can bend his spine, neck and head, so that he can lie comfortably or stand straight up if he wants to. Your baby is now approximately as big as a

teaspoon, about 4 ¼ inches (11 centimeters) and he weighs 3 ounces (90 grams). He's continuously practicing all of his movements and his muscles are becoming stronger and stronger. His vocal chords are also ready now, but he can't make a sound yet, because he needs oxygen for that. Have patience, little one, pretty soon you can cry and use your vocal chords as much as you want. Week 16 Your baby is now a real teddy bear with downy hair all over! He is really limber and can stick his feet in his mouth. He wriggles his little fingers and sucks on his thumb, because he can already make a little fist. He plays with his umbilical cord and he can swim in his own safe little swimming pool. That warm swimming pool is the amniotic fluid safe inside its amniotic sac in your uterus, which is still hanging slightly loose in your abdomen, attached to four ligaments. You won't really feel it now, but later on when you're gaining weight and your baby is growing and growing, your uterus and baby exert pressure on the ligaments and which pull on the peritoneum. The result is ligament pain. You won't feel it that much right now as your baby is barely 6 inches (15 cm) and he weighs about 4 ounces (120 grams). During the coming months, he will keep growing until he is around 20 inches (50 cm) and weighs - on average - between 5 1/2 and 11 pounds (2500 and 5000 grams). The amount of weight you will eventually gain is totally unimportant. Again, on average, pregnant women gain between 22 and 44 pounds (10 and 20 kilos). How much you gain has little to do with the size of the baby and more to do with the combination of all the extra blood, the weight of the placenta, extra fluids, the increased size of your uterus, growth in your breast tissue, and additional and very important fat stores. Most mothers lose all of their gained baby weight during the first nine months of breastfeeding and beyond. Some women who are overweight at conception find they actually lose weight during the pregnancy due to nausea, while others may gain 70 lbs (31 kilos) or more and still have an average size baby and lose all their baby weight. It all depends. Week 17 The little one in your abdomen is now 7 inches (18 cm) and he weighs approximately 5 ounces (150 grams). Although his eyes remain closed, through his eyelids he can distinguish between light and dark. If you lie in the sun with your naked belly your child will swim, so to speak, in a pink slightly translucent bath. If you lie under the blankets, his little house is dark. Perhaps that's why your baby will move a bit more often at night, just as if he wants to say: "turn on the light". That stomping and movement you still can't feel yourself, but rest assured, it's not much longer now until you will notice that there is something flapping around in your tummy. If this is your second pregnancy, you may feel little flutters by now. Every day your baby develops further. He is growing almost an inch (two centimeters) a week now. Tiny nails and unique fingerprints are developing on the fingers and toes. His teeny tiny eyelashes and eyebrows are also really cute and ensure that your little one's face gets more beautiful by the day. What color eyes will he have? Who will he look like? Like his Dad or Grandpa or maybe a bit like you? Week 18 Your little heir is becoming stronger and stronger -- you might even feel him moving this week-- a wondrous moment! Then again, it may take a couple more weeks before you feel movement, or if you are pregnant for the second or third time, then you may have felt it a few weeks ago. After all, you know what to look for. You can also let the other children feel your growing belly now and tell them

about their new little brother or sister. Then they can rub him and talk to him. The waiting lasts a really long time for children but if they hear the heart at the obstetrician's and perhaps have a look at the ultrasound then the new baby can become more tangible for them. He is now about 8 inches (20 centimeters) long already and he weighs 7 ounces (200 grams), just like a small babydoll. The sense of touch has already developed so that you can make contact with your child. You do that by rubbing all over your tummy and from time to time pushing firmly on your abdomen (obviously not hard enough to hurt yourself. You can't hurt the baby). Your baby feels this and he will start responding to it, perhaps even kicking or punching that spot. Week 19 Your baby is now in his fifth month. His skin is wrinkled and he still has no subcutaneous fat but he is slowly losing his reddish skin color. He is getting more hair on his head. He can also observe sounds now such as the heartbeat and bowel movements of his mother. But he reacts to sounds from outside also; loud or sudden noises may startle him. Some studies have shown that babies in the uterus are calmed by listening to music such as Mozart or Vivaldi. From now on he will also recognize his mother's voice. If your partner or children speak directly to your stomach, the baby will hear and recognize their voices too! What you eat even has an influence on the taste preference of your baby. In a recent study, older babies appeared to eat much more of their mashed carrots if the mother drank carrot juice each day during the pregnancy. From five months on the baby can recognize fragrances and taste substances that wind up in the amniotic fluid via the mother. As the pregnancy progresses, the baby occasionally has a growth spurt when your belly grows extra fast. By now, your waistline has probably disappeared. After twenty weeks of pregnancy your uterus will be above your navel. Your baby doesn't notice anything, he happily continues to give you kicks left and right that you can feel more and more. Week 20 Your baby is now half of his birth length, 10 inches (25 centimeters) that is. He is nowhere near halfway when it comes to his weight, though: he just weighs 11 ounces (320 grams) compared to the average full term birth weight of 7 1/2 pounds His growth will speed up from this point on, especially if you take it easy. It's normal that you don't feel movement every day. Sometimes you feel him a few times a day and sometimes you feel nothing for several days. You can also feel him in different places in your abdomen. He still has enough room to swim to all of the different sides. And, your baby has to sleep, also... He often stays quiet when you're busy and when you come home tired from work and plop down on the couch at night, your little one wakes up. Healthy, normal, everyday stress can't hurt the baby. However, some studies have shown than chronic and serious stress may lead to lower than average birthweight. When the mother is experiencing long term stress - whether from conflicts at work or home, job loss, death in the family, etc, the mother is constantly flooded with the stress hormone cortisol. It appears that the placenta can't metabolize this abundant cortisol and the result is slightly reduced birth weight for the fetus. If you are facing serious stress, seek out ways to reduce it. If you can find counseling, share the work load, cut back your expenses, or exercise more, it may help to reduce your stress. Your health care provider may be able to help you by writing you actual orders to reduce the activity that causes you stress, (if that

is applicable). Week 21 This week your baby is just over 10 inches (27 centimeters) long and he weighs 13 ½ ounces (380 grams). He is not really huge yet but he is gaining a few more ounces every week. He is doing his best to get stronger and to give all the good substances that he receives from you a place in his body. Every once in a while, the health care provider (HCP) may feel and check to see if the little one is growing sufficiently. Your uterus has grown up beyond the height of your navel now and gradually it's getting time for maternity clothing. It's nice to show the world that you are pregnant, isn't it? Your baby moves an average of 200 times per day. In two months that will be up to 500 times per day. Towards the end of the pregnancy, movements will be slower and more intense as there is less room for him to move around. That doesn't bother him at all because thanks to your swaying movements he sleeps most of the day anyway. He will always be able to move his hands and feet and you will feel his kicks up until the last moment. You now may notice a regular, rhythmic, rapid thumping in your belly - your baby is hiccupping! Hiccups are a normal reflex of the diaphragm. One baby has it more often than another. Week 22 You are probably so used to your belly by now and the life that you feel that you notice when there is a radio silence and there's nothing to feel for a while. There are still all kinds of things happening, however, in the factory that is called your uterus. Your baby has lots of fun, reacts to everything that comes from outside and sleeps a lot. He is getting more and more fat on his body and his skin becomes less and less translucent. Now he weighs approximately one pound (440 grams) and he is 11 inches (28.5 centimeters). If you are expectating twins it looks like you are already much further along than five months. Your uterus is much higher and your babies take up a much larger space than if you are only expecting one child. Your children can still tumble over each other and they will also kick and push at all kinds of places in your tummy. Expectant mothers of twins say their abdomen feels like it's full of snakes or even a complete football team. A few more weeks and the little ones will assume their ideal position from which to grow further. The strongest child of the two or the one who pushes the hardest in either case will end up lying on the bottom and be the first born. It's funny that babies at this stage of growth are also already starting to develop reflexes: the grabbing reflex is clearly in place, your little one catches his umbilical cord or his other hand and plays with it. In that way, twins already get used to each other long before they are born. Week 23 This week your baby has reached a nice milestone: he is a foot long (30.5 cm). A complete human being who weighs over a pound (500 grams), happily does somersaults and plays in his safe, warm, cozy nest. You two can make contact with him. If you press on your abdomen and push it slightly to the side, he will definitely respond. Also, if he kicks and you react he will certainly continue, he will let you feel that he's there. You can talk to him and sing for him because you know that he can recognize your voices already.

The sex organs are developing quickly now. If you have a son his little penis can be seen easily now. If you are having a daughter then there are millions of egg cells stored in her ovaries. Not all of these will stay -- after her birth she has about three hundred thousand left. Your baby can also ‘breathe.' He inhales amniotic fluid that flows through his lungs and this is a beautiful exercise for 'real' breathing. The alveoli expand a bit and contract a bit the same way they will do with oxygen after the birth. Week 24 Whatever happens around you with regard to changes, a move, busy job or vacation, your baby isn't bothered by any of it and just continues to grow. He gradually becomes a plump baby with more and more subcutaneous fat. His muscles are becoming stronger and his head is steadier on the rest of his body. His kicking becomes more powerful. He weighs more than one pound and by now his length is a little over a foot (32 centimeters). Some pregnant women wonder how it is possible that their baby continues to sit and simply waits to be born until nine months have passed (with a few exceptions, of course). That happens through the functioning of the placenta. One of the most important tasks of the placenta is producing progesterone and estrogen. Progesterone in particular ensures that the uterus doesn't contract prematurely so that your child can continue to grow quietly. Estrogen stimulates the growth of the uterus and the production of new blood vessels. Only towards the end of the pregnancy does the quantity of progesterone decrease as a result of which labor can start. Besides fulfilling this important growth task the placenta does much more: the placenta is a transit station for nutrients and oxygen from you to the baby. the placenta eliminates waste products and carbon dioxide from the baby. the placenta delivers antibodies from you to the baby so that the first months after birth he has some defenses in place. the placenta stops pathogens and other detrimental substances from getting to your baby. (Unfortunately not all of them, because for example German measles, certain medicines, nicotine, and addictive substances can reach your baby). Rarely, there are problems with the placenta. If the placenta imbeds in the uterine wall over the cervix, this can lead to excessive bleeding. Obviously a baby can not be born through the placenta, so this condition known as "placenta previa" is one of the rare medically valid reasons for cesearean section. A "partial previa" refers to a placenta covering part of the cervix. A partial previa will normally move during the pregnancy so that vaginal birth is safe and normal. If your health care provider is concerned about a previa, she will monitor it throughout the pregnancy with ultrasound. If the previa is sufficiently close to the cervix as to be risky for vaginal birth, she may want to discuss the option of scheduling a cesearean birth a few weeks prior to your "due date" to try to prevent you from starting labor. Obviously, this is your choice and something you should research thoroughly. Week 25 Your baby is now so large that he no longer floats freely in the amniotic fluid. He can move in all directions, however, and he is still a long way away from reaching his final position for delivery. At one moment, he is entirely to the right at the bottom and the next instant he is entirely in the upper part of your tummy. But you can really feel it when he turns and changes positions. Your health care provider (HCP) can tell you exactly how you can best feel your child yourself

and what you have to pay attention to. You may see also that your baby comes to your hand if you lay it on your abdomen. For the next month or so, your baby's brain will be growing at its fastest rate. Some pregnant women like to eat "brain food," which includes foods high in essential fatty acids like flax seeds, walnuts, fish, grass-fed beef, and eggs. Check to see which fish are safest to eat in your area. It is possible for your partner or child to hear baby's heartbeat from approximately 28 weeks on using a toilet paper roll. The best spot to hear the little one's heartbeat is approximately four inches (ten centimeters) under the navel. Don't be disappointed if it doesn't work immediately. Simply try again a week later. Or take your partner with you on your check-up. Then you both can hear how his little heart beats twice as fast as your heart. From now on you'll have check-ups more often anyway, because your ever-growing abdomen will ask more of you physically. Your HCP will keep an eye on your blood pressure and monitor you to make sure you are not retaining fluid. Low blood pressure makes you feel dizzy when you stand up too fast. Blood pressure consists of two figures: the systolic (the tension in your blood vessels at the moment that your heart contracts) and the diastolic (a base tension in your blood vessels). The systolic pressure can change considerably; so more attention is paid to the diastolic. High blood pressure is bad not only for your heart and blood vessels but also for your baby. If your blood pressure is way too high, it can be very dangerous for you and your baby and your HCP will jump to attention. Week 26 Your baby is growing and growing: he is now 13 inches long (33 centimeters) and weighs 25 ounces (720 grams). For some time now he has been able to distinguish between light and dark but it's not much use to him in his cozy little nest. He keeps kicking harder and harder and he makes a habit of doing it right when you want to relax or sleep. On the other hand, it's great that he often makes you aware of his presence because that means that everything is OK in there. You can also compare bellies now if you have the opportunity, for example at the pool or childbirth classes. Of course, the size of one's pregnancy belly says nothing about the size of the baby inside. A baby who sits forward can be smaller than a baby who sits more to the back or who lies across the uterus. Very tall women may have a very small "basketball belly" with a very large baby. Even your increased weight says nothing about the size of your baby. It really doesn't matter how much weight you gain. On average, during the pregnancy you will gain 35 pounds (15 kilos)-including those women who lose weight and those who gain 100 lbs (45 kilos)! Those extra pounds are not all in your belly. They are divided up approximately as follows: baby 7 ½ pounds (3400 grams) placenta and membranes 1 ½ pounds (650 grams) amniotic fluid 1 ¾ pounds (800 grams) uterus 2 ¼ pounds (1000 grams) extra blood 2 ¾ pounds (1250 grams) breasts 1 ¼ pounds (500 grams) extra fat supply 5 ¼ pounds (2400 grams) extra fluid 4 ½ pounds (2000 grams) Week 27 Most babies are, at 27 weeks old, far enough along in their development that they

have a reasonable chance of survival outside the uterus, but still would have to continue growing inside an incubator in a Neonatal Intensive Care Unit (NICU) for a considerable amount of time. Premature babies generally have a hard time at birth. They need artificial air as their little lungs are not completely developed yet. Frequently, children that are born far too early experience dysmaturity -the baby's birth weight is lower than expected on the basis of gestational age. This occurs most often with twins, as they must share blood and oxygen from the placenta(s). Babies born too early are not only thin and light - at 27 weeks they weigh not even 2 pounds (800 grams) and are just over a foot (34 centimeters) long - but they also show other external characteristics of immaturity. Their skin is still translucent and thin; you can see the veins running through it. The soles of the feet are still smooth usually. The skin is sometimes still covered with downy hairs. The eyes are often closed. They cry silently because of the breathing tube inserted between their vocal cords. Breastfeeding is extra challenging for premature infants, whose suck-swallow reflex is not fully developed. Mothers of premature babies benefit from help from lactation specialists in the hospital. By pumping their colostrum and breastmilk and saving it to feed to the baby when he is ready to eat, by avoiding bottles and pacifiers, and by getting the baby to the breast as early as possible, even to just rest against the mother's breast, most premature babies will successfully breastfeed. Premature infants who are offered "kangaroo care" - lots and lots of carrying and snuggling skin to skin against a caregiver's chest - are shown to grow faster and be released from the NICU earlier than peers who do not receive kangaroo care. Similarly, premies who receive their mother's colostrum and breastmilk have greater immunity and better health than those exclusively fed artificial baby milk. Luckily, the vast majority of pregnancies go well and an incubator is rarely needed. You are doing all you can - exercising, eating right, and staying healthy - the rest is up to the baby. Week 28 Your baby has reached the magical mark of 28 weeks. The proportion of head to body is correct and if he were to be born now, he would be completely developed except for the extra fat that keeps him warm outside of the womb. That does not mean that all of his organs are working that well. It is also not very pleasant for him to have to trade in his warm nest for that scary incubator. He is still really small and vulnerable: he's just over a foot long (35 centimeters) and he weighs approximately 2 pounds (900 grams). For this reason, it's better if he stays nicely in your abdomen for now so that he can grow further. The skeleton of your baby is changing. The cartilage is slowly ossifying into firm bones. The ossification continues until his birth. The skull bones remain the softest so that the skull can compress enough to slip gently through the pelvis and birth canal. Typically, boys will be about 2.2 to 2.6 pounds and girls will weigh between 2 and 2.4 pounds at 28 weeks gestational age. Your child will develop more and more of an individuality and personality of his own. If this is your second or third child, perhaps you can already feel a difference from the previous pregnancies. This one might be very busy whereas the previous baby sat quietly in your abdomen. Each pregnancy and each baby is unique.

Week 29 Your baby is now just over 2 pounds (1 kilo) and a little over a foot (36.5 centimeters) long. It's still over ten weeks to wait until he will appear. He will grow for about ten more weeks and you feel him move frequently. His movements are now pretty strong and if he kicks continuously against the same spot, it can get sore. If he is in the top part of your abdomen, he pushes against your stomach and at the bottom it's your bladder that may suffer. Your baby can still move to all sides and he has enough room to do summersaults. If he is positioned with his head at the bottom, you feel the wiggling and scratching of his little hands. If his head is in your upper abdomen, it seems like there's a basketball game going on. There are also days that you feel very little and that's when your child is asleep. If you are very busy during the day especially, he will keep quiet. At night, on the other hand, he comes to life and there is a good chance that he will keep you from sleeping. Either by kicking against an empty stomach which makes you wake up due to the heartburn, or by twisting so much that it wakes you up. Be patient for a few more months and then your child will get stuck with his little head in one place. Did you know that, as a matter of fact, you don't even feel half of all of his movements? Although the pattern of his movements will change from day to day, he is likely to establish some sort of waking and sleeping routine. While he's awake, you'll get used to certain rhythms and patterns. If you notice his movements change dramatically - weaker, or far less frequent - you may want to call your health care provider (HCP) to discuss it. Baby may be having a slow day. But don't worry unnecessarily, follow your instinct and do not hesitate to contact your HCP or doctor. Week 30 The baby is about 15 inches (38 cm) long and weighs almost 3 pounds (1300 grams). Continue to grow rapidly, little one, and stay in your warm nest for now. In most western countries, women have blood tests done early in pregnancy. One of those tests determined your blood type. One thing the test looks for is the socalled "Rh factor," which is a type of protein on the surface of the red blood cell. You can be either Rh-positive or Rh-negative. The fetus can inherit the Rh factor from the father or the mother. If the mother is Rh-negative and the fetus is Rh-positive, problems may arise. If the mother is Rh-negative, she may develop antibodies to the Rh-positive baby. If a small amount of the baby's blood mixes with her blood, for example during a medical procedure like amniocentesis, her body may respond as if it is allergic to the baby, making antibodies to the Rh antigens in the baby's blood. This condition is called being Rh "sensitized." The mother's antibodies may cross the placenta and attack her baby's blood, breaking down its red blood cells and producing anemia. This condition can become quite severe. If the blood type screening reveals the risk of Rh-incompatibility, the health care provider (HCP) may offer an injection of Rh immunoglobulin (RhIg), a blood product that can prevent sensitization of an Rh-negative mother. It is used during pregnancy and after birth. If a woman with Rh-negative blood has not been sensitized, her HCP may suggest that she receive RhIg around the 28th week of pregnancy to prevent sensitization for the rest of pregnancy. If the baby is born with Rh-positive blood, the mother will be offered another dose of RhIg to prevent her from making antibodies to the Rh-positive cells that may have crossed into her blood system before and during the birth, which could lead to Rh-incompatibility with a subsequent pregnancy.

However, every subsequent pregnancy requires additional treatment with RhIg. Any time an Rh-negative woman has treatment for miscarriage, ectopic pregnancy, or induced abortion, she also needs treatment to prevent any chance of the woman developing antibodies that would attack a future Rh-positive baby. If a woman develops antibodies, RhIg treatment is not effective. A mother who is Rh sensitized will be checked during her pregnancy to see if the fetus is developing the condition. In most cases, the baby is born normally, but shortly after birth receives a blood transfusion for the baby to replace the damaged blood cells with healthy blood. In the most severe cases, the baby may be delivered early or even given a blood transfusion in utero. Rh disease has become quite rare in modern societies where early diagnosis and treatment is available. Research has shown that there may be a link between mothers who receive a RhIg shot that was preserved with a mercury-containing compound, infants who received shots preserved with mercury, and increased risk of autism. It is worth asking your HCP if the RhIg shot (and your child's shots) are mercury-free. Week 31 This week your baby is about 15 inches (almost 40 centimeters) long and he weighs approximately 3.3 pounds (1500 grams). He's quite large already but not yet developed enough to thrive outside the incubator. His temperature regulation system is not fully developed, so he cannot keep himself warm. Moreover, your baby has not yet built up sufficient resistance and, as a result, if he were living outside of you, he would be sensitive to infections. If, during your regular check-up, it appears that your child is very large for 31 weeks then there is a possibility you may have pregnancy, or gestational, diabetes. If your health care provider (HCP) is concerned about the baby's weight gain, she may suggest you test your blood sugar levels. Ask lots of questions if you are concerned about the screening, and make sure you get really good information and directions before you go in to be tested. You want to get the most accurate possible results. If you actually do have pregnancy diabetes - which fortunately strikes only 2 to 3 percent of pregnant women - then for most people, a visit with a dietician will help you come up with a diet that controls the condition. Some pregnant women will be asked to test their blood sugar levels throughout the day to see how their body responds to food. If your diet is not helping regulate your blood sugar, your HCP may prescribe medication for the duration of the pregnancy. If you have a family history of diabetes, your HCP may want to monitor your blood sugar levels after the baby is born. In most cases, though, gestational diabetes resolves after the baby is born. Gestational diabetes is an issue for babies and mothers because the baby gains additional weight from the extra sugars in your blood, and may have broader shoulders than expected. These broad shoulders may have a harder time navigating through your pelvis. A good midwife or a skilled doctor will know techniques for helping you find good positions to open your pelvis during the labor and to help ease the baby out during the birth. These extra chubby babies may, ironically, have low blood sugar (hypoglycemia) at birth. Because it keeps getting more cramped in your abdomen, your baby can no longer move as freely as before. His kicks are pretty powerful now, so that you can sometimes 'catch' his foot. But it can also happen that you must wait a long time for him to stick something out. It is a nice game to make contact with your baby.

In a few weeks your baby will "engage." Then his little head (hopefully) will descend into the pelvis and stay there. The advantage is that the pressure on your stomach will lessen, so that you won't experience as much heartburn as before. But, the pressure on your bladder will increase, so you'll have to pee even more than before, if such a thing is possible! Week 32 He's becoming quite a big baby, your little one! He's about 16 inches long and almost 4 pounds now. Your child is so big now that the space in which he moves is very limited. He can't make any more major movements - a final turn-around before he engages, at the most. But he can still prod, push and kick. However, once he engages, he will no longer change his position. Sometimes you can feel the engagement. At that time, you will get a heavy feeling in your vagina and some women have contractions for a brief while. After the baby engages, you will have more air and space in the upper part of the uterus. The lack of pressure on your ribcage is a huge relief - you can take a deep breath for the first time in weeks! Most babies by far lie in the 'occipital anterior position'. Occiput refers to the back of the baby's head, and the position means whether this heavy part of his head is facing your front (anterior) or your back (posterior). Why can't this be called something simple? In other words, the baby's nose is pointing towards your butt and this is a good thing. Some babies are lying with their noses pointing to one side or another, and that's good too. With his chin on his chest, the baby will have no problem during a vaginal birth. Both of these head-down positions are the most favorable positions for the baby because they enable him to conform his little head to the shape of your pelvis. Occasionally, a baby is sunny side up with his nose facing your pubic bone (the birth team will call this ‘occiput posterior'). This position is a bit more of a challenge, it's harder for him to navigate through your pelvis and the heavy part of his head is banging along your vertebrae. Ouch! But, a vaginal birth is still his way out, although the labor may take longer than expected. At this point in your pregnancy, you still have the power to help your baby find the best position for birth. By spending time on your hands and knees, by sitting leaning forward, and by swimming with your belly hanging down, you can help convince the heaviest part of your baby - the back of his head and his back - to be at your front. Yoga and chiropractic care may also help move a stubborn baby. Still, your baby will decide which position he prefers. This will feel the best for him. Week 33 All of the organs are now developed and some are functioning already just as they will after the birth. More and more subcutaneous fat is forming so your baby's wrinkles disappear slowly but surely. The skin becomes a rosy color and the fine downy hair that was on the skin is replaced with vernix caseosa. This "baby cream cheese" prevents the skin from drying out. The fine downy hair comes off and floats in the amniotic fluid. Because the baby takes small sips of amniotic fluid, he swallows these hairs which then tickle and stimulate his intestines, which helps in their function after birth. Within 24 hours after his birth, your baby will have his first bowel movement. This is called meconium. It is greenish-black in color, odorless, and is very sticky. It looks like greenish tar and is just about that sticky - you may need to wipe him with almond oil or olive oil to get the meconium off of him! But that's something to think about later. For the time being, your child must continue to grow. He is now 16 inches (41 cm) long and

weighs 4 ½ pounds (2 kilos). For the next four weeks on he will gain up to a couple of ounces a day. Depending on the time of his birth he will become a seven-, eight-, nine- or ten-pounder. Little girls are a bit smaller and lighter and the oldest (first) children are generally lighter than the following children. That may be because of the tight abdominal muscles, the stretching of the uterus and the age of the mother. The more children a mother has, the more the abdomen will be able to stretch. Week 34 This week your baby weighs about 5 pounds (2250 grams) and he is 17 inches (42.5 cm) long. With his arms crossed over his chest and his knees pulled up high, in most cases he is positioned neatly folded with his little head down in his mother's pelvis. In the coming weeks his head will go down further behind the pubic bone. The pressure of the growing baby and your loosening pelvis will allow the baby to descend lower and lower in your pelvic region. Even if his head is engaged he can still easily turn on his axis. At one moment, he is lying with his back to the right, the next minute he turns to the left, which will feel like a huge movement - anyone could see this on the outside! You'll hear his heart on the right one minute and left the next. The head-first position is the ideal one for your child. There are also babies who are stubborn and will remain diagonal, lying across your pelvis. If he is still in this "transverse" position at 40 weeks then he cannot be born vaginally and he will come into the world via Caesarean section. A small percentage of the babies lie in the breech position around the 35th week. There are 3 types of breech positions: complete, frank and footling breech position. The complete breech position looks like the baby is squatting. Ideally, first the feet are born, followed by the legs, his buttocks and finally his head, the largest and most difficult part. However, it can happen that his feet descend along with his butt, which would make for a very challenging birth! The birth attendant may reach inside of you to reorganize the baby, moving his feet so they are born first. Or, you may opt for a cesarean birth. When the baby is in the frank breech position, his buttocks are down, while his legs are straight up near his ears. A baby that is born in the frank breech position is thus born bottom first and cannot put his legs down the first couple of days. If they get the chance, the legs will kick up, just like when he was in the uterus. To make it even more complicated, there is the footling breech position: then the baby has one leg up and one leg under itself. Again, his feet will be born first - but this baby needs help to make sure both feet are down at the same time. Vaginal breech birth can be a bit riskier than a head-first birth, so it can be a good idea to try to convince the baby to turn head down. If you determine at around 35 weeks that the baby is breech, there are a number of tricks to try to turn the baby. Always first discuss with your health care provider (HCP) what tricks she would recommend befor trying any. One that is always safe to use is to talk to the baby inside your head, asking it to turn and reminding it that it is loved, or playing music and shining light down near your pubic bone to see if the baby will turn towards it. Some midwives report that when a mother lies on a "tilt board" with her feet higher than her head, the baby may turn on its own. Some say that if you drink extra fluids, encouraging your placenta to make extra amniotic fluid, it may give the baby more room to maneuver. A chiropractor may use different techniques to manipulate the pelvis to change its shape, allowing the baby to turn. Research shows that the ancient Chinese art of "moxibustion," a form of acupuncture in which an heated herb is held close to

different acupuncture points, has a high rate of success in turning breech babies, especially if the mother is undergoing hypnosis or deep meditation at the time! If none of these tricks work, a trained midwife, neonatologist, or gynecologist may perform an "external version." This is another ancient technique, used by midwives throughout history, in which the provider applies pressure on your abdomen, firmly pressing the baby into a new position. If the provider is gentle and the mother is deeply relaxed, this may be a pleasant experience. If the provider is in a big hurry and the mother is worried about it, it may hurt a lot! The rule of thumb is, for a breech baby, turn him early and turn him often babies sometimes flip back into their cozy breech position! If none of these techniques is successful, the birth will be assessed on a case by case basis. One midwife may be perfectly comfortable attending a breech birth at home, where another may prefer to attend you at a hospital instead in case of complications. One doctor may be well trained for attending a vaginal breech birth, where another may never have seen one before and will expect to perform a cesarean birth. However the baby is born, it is still your birth, and you get to work with your HCP to make the decisions. However, different hospitals can have different protocols about breech birth. Week 35 Another milestone for your baby: he weighs over 5 pounds (2.5 kilos) now. With a length of 17 inches (43.5 cm) he is still a bit on the small side but with a weight of over 5 pounds there is a good chance that he will not have to go in the incubator if he is born now. After all, he is completely ready, except for his lungs! If he were born today, the neonatologist - a specialist in newborn care -will check to see if the baby is premature. If his lungs are not fully developed, he may need to spend time in a special care nursery with medication. If he's healthy, though, he can even go home soon, despite his small size. Breastfeeding is very important for premature babies, because their immune system can still be underdeveloped. The chance of infections is greatly reduced through breastfeeding. The first milk, colostrum, is extraordinarily rich in antibodies and is an outstanding precaution against infections. Baby intestines can handle breastmilk better than formula and breast milk contains fatty acids which stimulate the development of the brain and eyes. Even though the baby is so tiny, he may still be able to suckle at your breast. If this is hard work for him, you can pump your colostrum and milk with a special pump most hospitals can provide you. Every single drop of colostrum is precious - you can feed it to him with an eye dropper or a syringe. If you can, avoid using bottles and pacifiers with your baby - it will only confuse him when he goes to suck at the breast. Ask you health care provider for advice, tips and tricks. If you have to place your baby in the incubator, go there as often as you can to be with him and cuddle him often, skin to skin. It is wonderful to hold your baby against your warm breast. In spite of all the tubes he enjoys this time tremendously and relaxes by listening to your heartbeat. Fathers can cuddle just as well and it is very moving to see the two of them together enjoying each other's warmth. Naturally, it is better for your baby to grow inside your uterus for a little bit longer; that is, in the end, the best incubator there is. Week 36 Your baby is completely ready to be born, except for his lungs which will not mature until at least week 38. Even slow growers are now heavy enough to endure the birth without problems. Your little one is now over 6 pounds (2900 grams) and almost a foot and a half long (45 centimeters). There can be differences in length

and weight, because how tall and how heavy he will be eventually also has to do with the functioning of the placenta, the size of your uterus and a bit of heredity. A big mother and father have a greater chance of having a big child. Your child's skin is still covered in vernix: a white, slippery layer that protects him from all of that amniotic fluid. Otherwise he would be completely wrinkled! That layer of vernix may come off during the last weeks before his birth, or he may be born looking like he is covered in cream cheese! Most of the time, though, it flakes off in the amniotic fluid. If you have questions about the upcoming birth or the growth of your baby, if you are worried about something, be sure to discuss it with your health care provider. Don't stew about it. Ask, if need be, if you can come more often for a check-up. Week 37 The baby and his amniotic fluid now fill the uterus to the max. Your child can still be sitting in the upper part of your stomach -- more common in a subsequent pregnancy-- but normally he is already engaged. His head is pushing heavily on your bladder and slowly sinking deeper towards your cervix. Luckily, this gives your stomach a bit more room. During this period you can start to experience prelabor contractions. These are effective contractions that may last up to a minute and make you pay attention. They work on toning your uterus and softening and thinning your cervix. Sometimes, they even start to dilate your cervix! Remember, though, you can walk around with your cervix dilated for three or four weeks without true labor beginning. This just means that you've gotten lots of work out of the way before the labor begins. All of these contractions are doing work! If you are concerned, call your health care provider (HCP). No matter what, he only has a small space in which to move. From time to time you'll feel him, a big stretch, a wriggling hand or a kicking foot, but he will also sleep a lot. When you notice that his movements are less powerful or that he doesn't move at the same times he used to, contact your HCP. This week his nails are longer than his fingers and he may already be scratching his own face, his vernix and downy hair is almost all gone and he may have real baby hair on his head (or still be completely bald). Or, in other words: he is full-term. He continues to gain weight, at a rate of ½ to 1 ounces per day-- up to a pound per week!. The placenta should still be working well but at some point the way it functions slows down and then the birth will start. Normally about 9 quarts of blood per minute flows past and through the placenta at this stage. It's filled with oxygen and food for your little one who weighs approximately 7 pounds (3100 grams) now and is about a foot and a half long (46.5 cm). Of course, babies vary widely in size - some full term babies weigh 5 ½ lbs, where others weigh 11! Week 38 Your big baby weighs around 7 pounds (3200 grams) now (48 cm) long. Once he's born, he will be able to keep because the layer under his skin is now thick enough. pound per week during these last three weeks or so of weight is fat. and he is about 19 inches himself warm with your help, Babies can gain up to half a pregnancy. Much of this

Healthy, unmedicated infants are born with a strong sucking reflex and instinct to nurse. In fact, an unmedicated baby can crawl up his mother's abdomen to her breast and latch himself on with little assistance! If you have questions about breastfeeding, look for a support group in your community such as La Leche League International, which is found in countries around the world. Most newborns nurse within the first hour after birth and as often as every hour or so thereafter. At

the other end, some newborns may be sleepy after all their hard work and not nurse at all for the first day. As long as your nipples don't hurt and your baby is pooping and peeing adequately and doesn't appear dehydrated, don't worry too much about his weight. After one or two weeks, most babies are at their birth weight once again. But if you have serious concerns you should always talk to your health care provider (HCP). It's wonderful to see what your baby is like shortly after his birth. You can see by his position how he was lying in the uterus. He probably crosses his legs in the same manner and places his hands just like he did in the womb: under his chin, thumb in his mouth, his little hand over his ear or against his nose or cheek. If you lift your baby up shortly after the birth while he is in the fetal position, you can see exactly how he was folded up in your womb. Take a picture because in a few days he can no longer do this trick. The due date is not for another three weeks but babies seldom come into the world on the exact date that was calculated. Only five percent of women give birth on that day. There is a five week window of opportunity around your due date, from 37-42 weeks of "due time." Week 39 Your baby is now completely ready to be born. He is 19 inches long (49 cm) and just over 7 pounds (3300 grams). He is lying low within your abdomen and pressing heavily on the cervix. Fortunately his bones are very supple so that they can easily adapt during the birth in the narrow birth canal. His head can also easily fit through because the skull bones are not fused and can compress. Moreover, there are openings between the bones. You can feel these openings, the fontanelles, very easily during the first year of your baby's life. You can see his heart beating under the skin. This area is covered with a thick membrane but it is still not bone - be careful of this "soft spot!" Some babies who have been in the birth canal a bit longer are born with some head "molding," when the skull is lumpy or elongated. Molding will always go away by itself. Babies that come into the world by means of a Caesarean birth usually have a nicely rounded head. Your baby is so used to certain sounds that after the birth he can immediately recognize your voices or the barking of the dog. Your baby will also become quiet right away when he is placed on your abdomen after he is born. Your voice and warmth and the beating of your heart make him think of that safe warm uterus where he was all those months. But it might very well be that your baby shows no sign of leaving his safe, trusted place yet. If the placenta is still working properly and there is sufficient progesterone being produced as a result of which the contractions still - do not get into gear, your baby will happily stay where he is - which is absolutely fine and the best thing for him at this point. Week 40 Congratulations - your due date is this week! But don't worry if there's still no sign of your baby. Only 5% of the babies is born on his or her due date. Your baby continues to grow at about half a pound per week. His lungs are matured, his nails are grown, his vernix may be - almost - gone and he lies patiently waiting in his cramped little house. Only when your little one decides that he's ready will the labor start. Your baby will do that himself through the release of the stress hormone cortisol. This hormone enters your blood by means of the placenta. Under

the influence of this hormone and the hormones oxytocin and prostaglandin, the contractions will ensue. The first four centimeters of dilation can last longest. The cervix must first soften and thin out and then start to open up or dilate. Your baby may sleep through it all quietly and withhold his cooperation until you start pushing. The hormones adrenalin and endorphin play an important role during the labor and birth also. Endorphin is an natural pain-reducing hormone, similar to an opiate, that is produced by the body itself. It helps to moderate the pain from the contractions. The more you can surrender yourself to the discomfort and remain calm in between contractions the more endorphin will be released into your blood. Endorphin helps contractions become stronger which makes the cervix dilate more rapidly. Fear causes adrenaline to be released into your blood, which slows down the contractions and makes them unnecessarily painful. Your body is smart: adrenaline may make the contractions slow down as you drive to the hospital or if labor begins and your partner isn't there yet. The birth of a baby is always complicated teamwork for mother and child, and you never know precisely how it's going to go.