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A guide through normal pregnancy

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A week-by-week guide through normal pregnancy

An average pregnancy is counted as 40 weeks, as it is counted from the first day of the mother's last period.

Pregnancy is divided into three trimesters:

The development of the unborn baby can be followed week by week, but pregnancy is different for every woman and their baby. The following week-by-week summary is a guide only and women may experience different feelings and/or symptoms at other times than those suggested.

Your doctor will advise you about the progress of your pregnancy. 

First trimester

The first day of pregnancy is counted as the first day of a woman's last period. This is how the expected due date is calculated, i.e., 40 weeks from the first day of the last period.

Weeks 1-2

Ovulation

Ovulation is the time when an egg is released from an ovary. It usually occurs around 14 days after the start of the last period. In this time, multiple events are occurring: the levels of estrogen hormones increase as the egg matures, the uterus and cervix start to produce a special mucus in preparation for arrival of sperm and the lining of the uterus grows and engorges with blood vessels to receive a fertilized egg, should conception occur. If fertilization doesn't happen, this lining is shed as tissue and blood in the next period.

There are some physical changes that some women may be aware of at the time of their ovulation and these may include:

From sexual intercourse to fertilization of the egg

After sexual intercourse, the uterine and cervical mucus will help to transport the sperm up into the fallopian tubes and help the sperm to survive for up to five days, in anticipation of the egg being released.

In order to fall pregnant, the timing of sexual intercourse needs to coincide with, or occur just before, ovulation and:

From fertilization of the egg to implanting into the uterine wall

Within a few hours of its formation, the fertilized egg begins to divide into a series of identical cells. By the fourth day after fertilization, it has grown into 20 cells. After this point, the cells rearrange to form a group of cells surrounded by a sac of fluid, known as a blastocyst. It continues to develop as it travels down the fallopian tube into the uterus, where it implants into the thick uterine lining.

Week 3

By this stage, the blastocyst has fully embedded into the lining of the uterus and is now connected to the mother's blood supply. This produces a hormone that prevents the mother from having her next period. This hormone is called human chorionic gonadotrophin (hCG) and detection of this hormone is what pregnancy tests are based on.

The cells within the blastocyst keep dividing and differentiating to form three distinct layers:

At the same time, the outside cells of the blastocyst form two layers that are involved in the developing baby's life support system. These layers are:

Week 4

The blastocyst is now called an embryo and measures around 1.5mm.

The embryo at this stage has started to form the neural tube, which will become the spinal cord and the brain. It also forms a yolk sac and body stalk from the embryo's waistline. The stalk will become the umbilical cord once the placenta has fully formed (by 12 weeks). Until the placenta is ready, the yolk sac provides nourishment for the embryo - thereafter, it becomes the liver, lungs, bowel and bladder.

Some women may notice some physical changes at this stage that may include:

From this stage onwards, a home pregnancy test can be used to confirm the pregnancy. Upon finding out they are pregnant, many women may choose to consult their doctor. During the first visit, the doctor may carry out routine tests and a physical examination. Routine tests include hepatitis B, HIV, rubella, syphilis, urine sample, full blood count, blood group and antibodies. The doctor may also provide information regarding nutrition, folate and vitamin D dietary supplements, as well as diet and lifestyle factors that may need to be avoided.

Week 5

The embryo is around 2-4mm in length. The embryo at this stage has an umbilical cord that will supply oxygen and nutrients and remove waste. It has a primitive heart, which has already started to beat and circulate blood. This heartbeat may be detectable on ultrasound. It has also started to form feet and hands.

Some women may notice some physical changes at this stage that may include:

Week 6

The embryo measures around 5-6mm by this stage. Some of the developments that commonly occur during this stage may include early development of facial features and internal organs including the esophagus, stomach, liver, kidneys and lungs.

Some women may notice some physical changes at this stage that may include:

The embryo may be detectable on ultrasound from this stage onwards.

Week 7

By the end of this week, the embryo will have doubled in size and may be around 1cm in length. Development at this stage comprises brain cells, more developed facial features, kidneys that are not yet functional, the pancreas, the beginnings of reproductive organs but no physical genitalia, and web-like fingers.

Some women may notice some physical changes at this stage that may include:

Week 8

The embryo is now called a fetus and has grown to about 1.5cm in length. The fetus may have more defined fingers and toes, longer limbs, a more developed heart, a round head and developed ears, although they cannot hear sounds until around the 19th to 24th week.

Some women may notice some physical changes at this stage that may include:

Week 9

The fetus has grown up to 2cm in length. The heart is nearly fully developed, fingers and toes are no longer webbed, head and limbs can move and the eyelids are formed but will remain closed until the 24th week of pregnancy

Some women may notice some physical changes at this stage that may include:

Week 10

The fetus is around 3cm in length. It has a fully formed and functional liver, kidneys, intestines and brain. The fetus will also begin to show early external genitalia, a fine growth of hair over the body and have fully developed ears and eyes.

Some women may notice some physical changes at this stage that may include:

It is usually around 10-16 weeks that most women will start their antenatal care, which may be in a hospital, clinic, doctor's surgery, or at home. Healthcare professionals involved in antenatal care may include a general practitioner, an obstetrician and/or a midwife.

During the first appointment, the healthcare professional will take a detailed medical history, which will enable them to set up an appropriate level of support throughout the woman's pregnancy. Also, they will take into consideration any underlying medical conditions that may affect the woman's pregnancy. A routine physical examination and blood tests will also be conducted as references for subsequent visits. The woman will be provided information about maternal serum screening (MSS) to screen for Down syndrome and related conditions and referred for these tests if requested. Information may also be provided about childbirth preparation classes, exercises, physiotherapy and dietitian services, if available and relevant to the individual's needs.

During subsequent visits, assessments will commonly be done of the woman's weight, blood pressure, abdomen and urine (for levels of sugars and proteins).

Any concerns the mother may have about her pregnancy can be addressed during these visits.

The frequency of future visits may vary depending on the health of the mother and baby. It is typical to have the next antenatal visit at around 18-20 weeks and then every 4-6 weeks for the first 28 weeks. After 28 weeks, the visits become more frequent and may take place every second week until the end of the 36th week. From the 36th week onwards, visits are usually weekly until the baby is born.

Week 11

The fetus is around 4-5cm in length. Most of the changes from this point onwards involve growth and maturity of the fetus's structures and organs. All the organs have been formed by this stage and the process of priming begins so that they can be ready for birth. By this stage, the genitals will have physically taken on the male or female form.

Some women may notice some physical changes at this stage that may include:

Week 12

The fetus is around 5-6cm in length. At this stage, the fetus will begin to look more human, have functional kidneys, secrete digestive stomach juices and be able to close its hand or curl its toes.

Some women may notice some physical changes at this stage that may include:

Second trimester

Week 13

The fetus is around 6-7cm in length. There is a rapid growth of the body, a fully developed nose and the fetus can suckle, which will be important once born.

If the fetus is female, she will have about two million eggs in her ovaries by now. This number will drop to one million by the time she is born.

Some women may notice some physical changes at this stage that may include:

Week 14

The fetus is around 8cm in length. It may have hair starting to grow on the head, the heart may be beating in excess of 150 beats per minute, they may practice breathing the amniotic fluid in and out of their lungs and the kidneys are filtering the swallowed fluid and passing it back out as amniotic fluid.

The placenta starts producing most of the pregnancy hormones that are responsible for many of the changes the mother may be experiencing.

Some women may notice some physical changes at this stage that may include:

Week 15

The fetus is around 9cm in length. Some of the fetal developments include well-defined external genitalia, thumb-sucking or hiccups and legs becoming longer than arms.

Some women may notice some physical changes at this stage that may include:

Week 16

The fetus is around 10cm in length. At this stage, the fetus may move freely and/or start playing with the umbilical cord.

Some women may notice some physical changes at this stage that may include:

Week 17

The fetus is around 13cm in length. The gender of the fetus may be detectable by ultrasound. The fetus forms fat under the skin that will provide warmth and energy once born.

Some women may notice some physical changes at this stage that may include:

Week 18

The fetus is around 14cm in length. Key developments include movement of the chest as the fetus mimics breathing, increased thumb-sucking and hardening of bones.

Some women may notice some physical changes at this stage that may include:

Week 19

The fetus is around 15cm in length. There is formation of permanent teeth behind the already-formed milk teeth, the brain forms complex nerve connections and more hair grows on the head.

Some women may notice some physical changes at this stage that may include:

Week 20

The fetus is around 16cm. Eyebrows and eyelashes form, the eyes can move (although they remain shut) and the mouth can open and close.

Some women may notice some physical changes at this stage that may include:

Week 21

The fetus is around 26cm. The fetal brain has more developed nerve connections that allow intentional movements and reactions. There is ongoing formation of waste products in the bowel, which will eventually be passed as their first bowel motion.

Some women may notice some physical changes at this stage that may include:

Week 22

The fetus is around 28cm. There are more fat deposits under the skin so that the fetus looks less translucent. If the fetus is female, her uterus and vagina are in place and if male, his testes descend from the abdomen down to his scrotum.

Some women may notice some physical changes at this stage that may include:

Week 23

The fetus is around 29cm in length. At this stage, the fetal heart is clearly visible on an ultrasound. The fetus has more coordinated movements and is able to hear and respond to loud noises. The lungs produce surfactant to help with breathing once the baby is born.

Some women may notice some physical changes at this stage that may include:

Week 24

The fetus is around 30cm in length. There is a rapid growth in brain size, taste and touch senses are fully developed and breathing increases.

Some women may notice some physical changes at this stage that may include:

Week 25

The fetus is around 35cm in length. There is further lung development and the fetus will physically respond to touch through the abdomen.

Some women may notice some physical changes at this stage that may include:

Week 26

The fetus is around 36cm in length. Some of the developments include eyes that can open and look around, awareness of noises and more frequent movements.

Some women may notice some physical changes at this stage that may include:

Week 27

The fetus is around 37cm in length. There is development of the immune system, coordination of the suck-and-swallow action and ability to distinguish light from dark.

Some women may notice some physical changes at this stage that may include:

Third trimester

Week 28

The fetus is around 38cm in length. The bone marrow matures enough to produce a blood supply, the liver starts to store iron and rapid eye movement sleep occurs.

Some women may notice some physical changes at this stage that may include:

Week 29

The fetus is around 39cm in length. At this stage, there is increased urine output, smaller movements as the fetus becomes more cramped and further maturation of airways.

Some women may notice some physical changes at this stage that may include:

Week 30

The fetus is around 40cm in length. The lungs and digestive tract are nearly fully developed, more body fat is produced and there are definite sleep and wake patterns.

Some women may notice some physical changes at this stage that may include:

Week 31

The fetus is around 41cm in length. There is ongoing fetal weight gain, fine hair disappears from the fetus's face but remains on the body and longer periods are spent in deep sleep.

Some women may notice some physical changes at this stage that may include:

Week 32

The fetus is around 42cm in length. If the fetus is male, his testes will usually have fully descended into his scrotum. There is increased maturation of lungs and bones become stronger.

Some women may notice some physical changes at this stage that may include:

Week 33

The fetus is around 44cm in length. Most organs are fully functional and the lungs are approaching full function.

Some women may notice physical changes at this stage that may include:

Week 34

The fetus is around 45cm in length. There is further weight gain and development of the immune system. It is around this stage that the fetus is nearing full development of all functions, systems and structures. There is a high chance of their survival if preterm labor occurs from this stage onwards.

Some women may notice physical changes at this stage that may include:

Week 35

The fetus is around 46cm in length. The head may engage lower into the mother's pelvis in preparation for birth. Increased hiccupping of the fetus may be noticed.

Some women may notice physical changes at this stage that may include:

Week 36

The fetus is around 47cm in length. At this stage the lungs are fully mature and further engagement lower into the pelvis may occur.

Some women may notice physical changes at this stage that may include:

Weeks 37- 42

The fetus is around 49-52cm. The fetal head continues to engage lower in the pelvis in anticipation of labor. Their growth slows down and the amount of amniotic fluid decreases. There is less room in their sac and so their movement may slow down.

By the end of week 37, the pregnancy is considered full-term and labor could start any day. A baby born between 37-42 weeks is considered full-term.

Some of the symptoms that some women may experience in the days leading up to their labor may include:

What actually triggers the start of labor is yet to be clearly understood. Some theories suggest it is caused by hormones that are released by the mother or baby. Another idea is that it is actually the result of chemical messages that are sent to the mother's body from the baby's brain. However none of these ideas have been proven.

References

  1. 40 Weeks Pregnant. Accessed September 5 2014.
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  3. Average Fetal Length and Weight Chart - BabyCenter. Accessed September 5 2014. link here
  4. Fetal Development - 40 Weeks - BabyCentre. Accessed September 5 2014. link here
  5. Is It Pre-Labour? Accessed September 5 2014.
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  7. Pregnancy | Healthdirect. Accessed September 5 2014.
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  9. Pregnancy - 37 to 40 Weeks | Pregnancy Birth and Baby. Accessed September 5 2014. link here
  10. Pregnancy Week 42: Get Ready to Give Birth. About. Accessed September 5 2014. link here
  11. Pregnancy - Week by Week. Better Health Channel. Accessed September 5 2014. link here
  12. Antenatal Care and Classes | Pregnancy Birth and Baby. Accessed September 5 2014. link here
  13. 6 Weeks Pregnant. Accessed September 5 2014. link here
  14. Your First Antenatal Appointment. Accessed September 5 2014. link here

10 Most frequently asked questions (FAQs)

What is the length of a normal pregnancy?
An average pregnancy is counted as 40 weeks, as it is counted from the first day of the mother's last period.
What are the symptoms of pregnancy?
Women can experience a variety of symptoms that can vary throughout the pregnancy and each woman may have a unique set of symptoms. Some of the more common symptoms that may be associated with pregnancy may include: Morning sickness; Increased urination; Excessive saliva (spit) production; Fatigue; Aches and pains; Headaches; Insomnia; Increased forgetfulness; Breathlessness; Low blood pressure; Varicose veins; Heartburn; Indigestion; Constipation, and; Fluid retention.
How is pregnancy confirmed?
Pregnancy can be confirmed by detection of human chorionic gonadotrophin (hCG), which is secreted by the placenta. This test can either be an over-the-counter urine testing kit, or a blood test performed by a doctor.
Can pregnancy be prevented?
No form of contraception is 100% effective but some are extremely effective at preventing pregnancy if used correctly. Different methods of contraception include: Barrier protection such as: condoms, diaphragms, cervical caps or spermicides; Hormonal methods such as oral contraceptives, injectable birth-control implants, vaginal rings, emergency contraceptive pills; Intrauterine methods - either a copper or hormonal intrauterine device (IUD), and; Sterilization - tubal ligation or vasectomy.
What increases the chances of developing complications during pregnancy?
There are various risk factors that may cause complications during pregnancy: Being over 35 years of age; Being under 20 years of age; Being obese or underweight; Having diabetes; Having a sexually-transmitted infection, and; Having a multiple-birth pregnancy.
What factors can trigger preterm pregnancy?
Preterm pregnancy may be more likely in women who: Are under 20 years of age; Have had a previous preterm birth; Have had cervical surgery; Have certain medical conditions such as kidney disease; Are underweight, or; Are carrying twins or triplets.
What can cause pregnancy?
In order to fall pregnant naturally, you need to have sexual intercourse. Some sex activities can make you pregnant and others cannot. You cannot get pregnant from: kissing, dry humping (with clothes on), oral sex or anal sex.
What are the side effects of taking medications during pregnancy?
The safety of any medication will depend on the type of medication being used, its dose, the stage of pregnancy and the health of the unborn baby and their mother. It is important to consult with your doctor before you start taking any new medication and for advice regarding continuing medication.
Is it safe to have sex while pregnant?
For most pregnant women, with normal pregnancy development, having sex is safe throughout the pregnancy. Sex is not recommended in case of conditions such as placenta praevia (when the placenta inserts into the lower segment of the uterus).
What causes a difficult pregnancy?
A difficult pregnancy may be a result of pregnancy-related symptoms, such as heartburn, fatigue, varicose veins and morning sickness, becoming severe. This is more likely in women who have chronic underlying medical conditions, smoke, or are obese.

Related topics

Diet and pregnancy

During pregnancy, you need to make sure both you and your baby get all the nutrients you need. Not only does your baby need a range of nutrients for their development, there is increasing evidence that what you eat during pregnancy can affect your baby's health throughout their lives.

Pre-pregnancy check-up

Pre-pregnancy check-ups can improve pregnancy outcomes by identifying risk factors that may cause complications and providing options to avoid such occurrences. Consulting with your doctor on lifestyle factors – such as diet, alcohol and smoking – and making some changes may result in better outcomes.

Pregnancy and mental health

Pregnancy can be a time of great change. While it can be joyful and very exciting, it can also place extra stress on both women and men, which can lead to an increased risk of mental health problems. Understanding the signs and symptoms and seeking help early can prevent symptoms from worsening.

Fertility

Fertility is the ability to have a baby. This requires sperm from a man to fertilise an egg from a woman. Follow the numerous stages in this journey of the sperm to reach the egg.

About this article

Title: A guide through normal pregnancy

Author: Dr Nikki Wallis PhD, BSc

First Published: 18 Nov 2014

Last reviewed: 17 Jan 2022

Category: Information on A guide through normal pregnancy

Average rating: 4.5 out of 5 (1399 votes)

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