Women's Healthcare Topics
James Brann, MD. Ob/Gyn

12 Weeks Pregnant

In This Article


Pregnant Belly Changes

For weeks, you've probably been asking, "When will I start to show in pregnancy?" You don't have to ask this question anymore. For most women, they are finally showing. You might not have a prominent bump yet, but you should be noticing a difference in your abdomen.

But if you're 12 weeks pregnant with twins, you probably have a nice sized bump by now. Pregnant women carrying twins or multiples often look further along, compared to expectant mothers with a single baby. You may also have a larger bump if you're been pregnant before.






Mom's Belly at 12 Weeks

Your morning sickness and fatigue should be decreasing now. You’ll soon start to feel much better in the second trimester, because your hormone levels tend to level off. Now as your uterus shifts upward and out of your pelvis, it may take pressure off your bladder so you won’t have as many bathroom runs. This may be a relief for you, but keep in mind that this is only a temporary break. In the third trimester, as your baby gets larger, your uterus will start pressing on your bladder again.

Your miscarriage risk is also lower now. A majority of miscarriages occur before week 12. This is a wonderful week to announce the big news to your family and friends. Enjoy this wonderful week and your diminished first trimester pregnancy symptoms!

At 12 weeks pregnant many of your uncomfortable first trimester symptoms – such as morning sickness (nausea and vomiting) and fatigue – are almost gone, or at least not as severe. You might also notice that you don't have to go to the bathroom as often.
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Pregnancy Symptoms

As first trimester symptoms are starting to disappear, new symptoms will start to crop up, such as the common skin changes associated with pregnancy.

Have you ever heard the saying that pregnant women have a special “glow” about them? In some women, the increased blood flow and the increased levels of estrogen give them a beautiful, rosy complexion, or a pregnancy glow.”

Unfortunately, your skin can also change for the worse during pregnancy. You may have already noticed that freckles, moles, and other dark spots on your face have become more pronounced and even darker. Some of this skin darkening will gradually fade after you deliver your baby, however these spots may remain darker than they were before your pregnancy.

You may have noticed discolored, brownish marks or patches on your forehead, temples, cheeks, and chin. This is called the mask of pregnancy or chloasma,and it is very common during pregnancy. In fact, around 70 percent of all pregnant women experience these marks on their face.

Exposure to sunlight will make these patches darker. Chloasma is caused by the increased production of melanin (a skin pigment which protects your skin from ultraviolet light) in your body.

The “mask of pregnancy” is more common in the second trimester, but at pregnancy week 12, some women can also develop these brownish patches. There is nothing you can do to prevent chloasma, but limiting your exposure to the sun can help.

Have you started breaking out now? Acne is another common skin change that pregnant women experience, due to the high levels of progesterone in their body. If you experience breakouts during your regular menstrual period, you may be more prone to acne during pregnancy. However, some women’s acne may improve.

If your acne bothers you, you should cleanse your face regularly with a gentle cleanser. Don’t use acne medications without speaking to your doctor first. Certain acne medications, such as Accutane, can cause very serious birth defects in your baby.

You also may have noticed that the area surrounding your areola and nipple has become darker. Urban legend suggests that this happens so that your baby has a better chance of finding your nipple when nursing. In reality, these breast changes are due to your pregnancy hormones.

Other breast changes you may notice during pregnancy are the little bumps on your nipple or areola becoming more pronounced. These bumps are called “Montgomery’s tubercles.” Almost all women have them, but they become more noticeable during pregnancy due to your increased levels of pregnancy hormones. At pregnancy week 12, as your breasts are enlarging, you may have already noticed these bumps.

Later in your pregnancy, you may also develop a dark line that runs from the top of your belly down to the bottom of your pelvis. This dark line is called the “linea nigra.” It is very common in the latter part of the second trimester, however women with darker skin may notice the linea nigra as early as 12 weeks pregnant.

The linea nigra will fade within a few weeks of delivery, but it may never go away completely.

The most troublesome skin change during pregnancy has to be the development of stretch marks. They are reddish or brownish lines that develop on your skin, as your skin expands during pregnancy. They often appear on your abdomen, breasts, and thighs.

At pregnancy week 12, it is probably too early for you to have stretch marks. They are more common in the second and third trimesters. Between 70 and 90 percent of all pregnant women develop these marks.

Researchers don’t know why some women develop stretch marks and others don’t. However, genetics may play a role.

At 12 weeks pregnant, you may have noticed that your skin is more sensitive and irritated than it was before your pregnancy. This is another very common pregnancy change. You may find that your favorite soaps or detergents cause irritation. To prevent irritation, you may want to use mild, unscented soaps.
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Pregnancy Weight Gain at 12 Weeks

Your pregnancy weight gain at 12 weeks pregnant may be as high as four or five pounds. (Keep in mind that if you’ve gained more than this, that’s perfectly fine too! There is a lot of variability for different women.) If you’re carrying twins, you may have gained up to 10 pounds. Don’t be too alarmed by this early weight gain. Doctors recommend that pregnant women carrying twins gain between 35 to 45 pounds during pregnancy. For triplets, you should gain between 50 to 60 pounds.

Your uterus will also start to pack on some weight as your pregnancy progresses. The uterus will grow by roughly 2 pounds throughout your pregnancy, compared with the tiny 2.5 ounces it weighed prior to becoming pregnant.

Since you are probably starting to feel better, you may be starting to get hungry for food. For most women, their morning sickness (nausea and vomiting in pregnancy) has significantly improved. They can now hold down liquids and food. If you're craving foods, feel free and indulge. Just make sure that you indulge in moderation.

Remember that you should never take the phrase "eating for two" literally. You actually only need 300 extra calories during singleton pregnancy. This is easy to accomplish with an extra glass of milk and half a sandwich.
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Baby Section

Baby at 12 Weeks Pregnant

Your Baby at 12 Weeks of Pregnancy

Your baby is 2.2 inches long from crown to rump, or 55 mm in length. This is comparable in size to a kiwifruit! Your baby is big enough at this point to be weighed and weighs over half an ounce!

Though you won’t be able to feel your baby’s movements until the second trimester, he or she is happily swimming around in your uterus.

Your baby’s arms and legs are now fully formed, so your little boy or girl is probably trying all sorts of positions this week.

An exciting development now – your baby may be making a sucking movement with his or her mouth as early as this week. Your little one's mouth can open and close at this point in gestation, so your baby's time might be filled with sucking, yawning, and swallowing amniotic fluid.

Your baby’s head has a more rounded shape now and there are little buds inside his or her mouth that will eventually form into teeth!

Your baby's kidneys may be developed enough to start producing urine. (Believe it or not, but babies do urinate in the womb.)

Your baby's heartbeat is going strong. The average fetal heartbeat is around 167 beats per minute; this is double the speed of an adult's heart. Your little one's heart rate will slow down once you hit the second trimester.

Your little one's brain is starting to produce hormones now, and nerve cells are multiplying at a rapid rate. Brain synapses are also forming this week (synapses connect nerve cells together to pass information from nerve to nerve).

The umbilical cord is fully formed, but it will continue to get longer and longer as your pregnancy continues. The umbilical cord has an essential role in pregnancy – it supplies the baby with oxygen and nutrients.

YSou have reached a milestone in your pregnancy! This is probably the week of your second prenatal visit (the first doctor’s visit should have taken place around 8 weeks pregnant) and your first ultrasound scan. Are you excited to see your baby for the first time?

During this ultrasound scan, your baby will be measured from crown to rump (the top of your little one’s head to his or her bottom), so that the doctor can accurately date your pregnancy. You may also get to hear your baby’s heartbeat for the first time!

Many new parents describe their baby’s heartbeat like the sound of galloping horses or fast beating drums. By now, your baby’s heart is beating 167 beats per minute – that’s twice as fast as your own heart rate!

You may be given a printout of your baby after the ultrasound scan. Don’t be surprised if you find yourself staring at the printout over and over again. You will be filled with love and joy at the sight of your little baby. After this prenatal visit, you may want to share the wonderful news with your family and friends (if you haven’t already!).
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Pregnancy Health Section

Heartburn during Pregnancy

Heartburn is a common pregnancy symptom to expect. You may find that you are experiencing more heartburn than normal now. Heartburn is a burning sensation in the throat, chest and upper abdomen. This is a very common complaint during pregnancy at 12 weeks. It is caused by an increase in the hormone progesterone during pregnancy. Progesterone relaxes the valve between your stomach and esophagus. This relaxation allows stomach acids to enter the esophagus and cause severe irritation, which gives you that burning sensation.

Some great suggestions to relieve and prevent heartburn are as follows:
  • Eat less at each meal and have six meals a day instead of three.

  • Chew your food adequately and eat slowly.

  • Drink liquids before and after your meals and not with them.

  • For heavens sake stay away from fatty and greasy foods which will only make the problem worse.

  • Stay away from fizzy drinks, citrus juices and spicy meals.

  • Do not eat before going to bed.

  • Raise the head of your bed or prop yourself up with pillows which will help minimize heartburn.

  • Consider liquid antacids… they work much better than the tablet forms.
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Spotlight on Twin Pregnancy

Spotlight on Twin Pregnancy.

Many women wonder early in their pregnancy if they might be carrying twins. Your physician might start suspecting a twin pregnancy early in your pregnancy if your uterus is larger than expected. Most of the time, a uterus that is larger than normal is the result of a miscalculated due date rather than twins. However, your healthcare provider might opt to perform an ultrasound now at 12 weeks pregnant (though some perform one many weeks sooner) to determine if your date is correct or if you are carrying twins.

Some telltale signs that you might be carrying twins include: larger than average uterus for your due date, larger weight gain early in pregnancy, more than one heartbeat, worse than normal morning sickness, and increased levels of AFP.

A twin pregnancy is usually considered a higher risk pregnancy, but that doesn't necessarily mean you will have complications. One of the more common risks associated with carrying twins is pre-term labor, but many people will go on to carry their twins to term.

There is a slightly elevated chance of miscarriage in multiple pregnancies. Sometimes a mother will lose one baby but go on to carry the other to term. Most of the time however, the risk of fetal loss is reduced after the 12th week of pregnancy. Typically women who lose one twin will go on to deliver the other baby without complication. If a twin is lost in the first 12 weeks of pregnancy it will actually be reabsorbed and not cause any harm for the health of the infant that is continuing its development in your body.

If you are carrying twins or multiples, you are also at an increased risk for developing preeclampsia, a condition that results in high blood pressure during pregnancy. Preeclampsia is more common in up to 20 percent of women carrying multiples.

You may realize worse than normal pregnancy symptoms if you are carrying twins, but this isn't always the case. Horrible morning sickness can strike a mom carrying a singleton just as much as one carrying multiples. Symptoms of fatigue and general discomfort are sometimes greater in moms carrying multiples, particularly later in pregnancy or during the third trimester.

Almost half of all mothers with multiples will go into labor before 37 weeks pregnant. Many women assume that they will undergo a cesarean section if they are carrying twins, but this is not always the case. There is a good chance you will be able to deliver both of your babies vaginally, depending on the position they present in at birth, and whether or not you experience any complications such as preeclampsia during your pregnancy.

Some women will have to be put on bed rest during their pregnancy in order to help minimize complications such as pre-term labor. A woman carrying multiples will likely be encouraged to take things easy much earlier than a woman carrying one baby.

If you are carrying multiples, even during pregnancy week 12, it is very important that you remain well hydrated and eat nutrient dense foods to maintain your energy levels and stay healthy during pregnancy. The average weight gain for a twin pregnancy is usually 45 pounds, which is more than the 25-35 pounds recommended for singleton mothers.
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Pregnancy Skin Conditions

For many women, their hair, nails and skin all change during pregnancy. Some of the more common changes include:

  • Melasma- patches of brown on the nose, forehead and around the cheeks

  • Darks spots on the inner things, nipples or breasts

  • Linea nigra- a dark line running from the navel to pubic hair

  • Acne

  • Stretch marks

  • Spider veins

  • Changes in hair and nail growth

  • Varicose veins

While some of these changes are due to changing hormone levels during pregnancy, doctors aren’t sure of the cause of most skin changes.

Dark patches and spots

Dark patches and spots are due to an increase in melanin. This is the natural substance, which provides color to your hair and skin. These dark spots and melisma will usually fade away once you have your child. In some women, though, the dark patches may last for several years. Be sure and wear a wide-brimmed hat and sunscreen when you are outside to help keep melisma from getting worse.

Stretch marks

As your belly grows larger, your skin may get some reddish lines on it. These are called stretch marks. By the time you hit your last trimester, many women have stretch marks on their buttocks, thighs, breasts or abdomen. While a heavy moisturizer can help soften your skin, it won’t make stretch marks go away. Usually they fade after delivery, but may never go away.

Acne

Acne is fairly common in pregnant women. While some women notice the acne they already have worsens, sometimes women with clear skin suddenly develop acne.

You can treat acne by shampooing every day if you have oily skin, and trying to keep your hair off your face. You can also try washing your face twice a day with lukewarm water and a mild cleanser. You’ll also want to pick up some oil-free makeup. You don’t want to squeeze or pick acne, for it could cause scarring.

Over-the-counter acne products SAFE during pregnancy include:

  • Azelaic acid

  • Topical benzoyl peroxide

  • Glycolic acid

  • Topical salicylic acid

If you find an over-the-counter product with ingredients not on the list above, make sure you talk to your doctor.

Prescription acne medications NOT to use during pregnancy include:

  • Isotretinoin - A form of vitamin A, this drug may cause birth defects including intellectual disabilities, potentially life-threatening brain and heart defects and other physical deformities.

  • Hormonal therapy - While several medications blocking specific hormones can treat acne, there is a risk of birth defects during pregnancy.

  • Topical retinoids - A form of vitamin A, these medications are similar to isotretinoin. Unlike it, though, you apply topical retinoids to the skin, and the amount your body absorbs is low. Despite this, doctors generally recommend against using these medications during pregnancy. While some retinoids are prescription only, you may also find them in certain over-the-counter products, so read those labels.

  • Oral tetracyclines - If you take this after your fourth month of pregnancy, the antibiotic may discolor your child’s teeth. It can also affect how your baby’s bones are growing while you take it.

Spider veins

These tiny red veins may appear due to higher amounts of blood in your body, and hormonal changes during pregnancy. They often appear on a person’s arms, neck and face. Usually, the redness fades after delivery.

Varicose veins

Your leg veins may become sore, swollen and even blue due to the pressure and weight of your uterus decreasing blood flow from your lower body. They may also appear in your vagina, on your vulva and even your rectum, which is called hemorrhoids. Generally, this a cosmetic problem which will fade away after you deliver.

Although there’s no way to prevent varicose veins, you can do certain things to try and ease the soreness and swelling of varicose veins, and even prevent them from worsening. These include:

  • Not sitting with crossed legs for a long period of time

  • Moving around occasionally if you have to stand or sit for long periods

  • Exercising regularly, meaning riding an exercise bike, swimming or walking

  • Propping your legs up on a footstool, chair or couch when possible

  • Avoiding constipation by eating fiber-rich foods and lots of liquids

  • Wearing support hose.

Changes to hair

Because of the hormonal changes of pregnancy, your body and head hair may become thicker or grow faster. Some women find hair growing in places where it usually doesn’t, like their abdomen, chest, arms or face. This usually goes back to normal within about six months of delivery.

About three months after delivery, many women start noticing hair loss from their head. This is due to the hormones going back to normal levels, meaning your hair also goes back to its normal growth cycle. Expect that your hair grows completely back in about three to six months.

Changes to nails

Some women say their nails grow a lot faster while they’re pregnant. Others, meanwhile, deal with split nails that are easier to break. Just like your hair, the changes in your nails will let up after delivery.

Uncommon skin changes

There are some uncommon skin conditions during pregnancy, too. These may cause you to have itchy skin or bumps.

Pruritic urticarial papules and plaques of pregnancy (PUPPP)

With this condition, you’ll get hives and small red bumps during late pregnancy. These bumps can then turn into large, itchy patches. You’ll usually first notice the bumps on your abdomen before they spread to the breasts, buttocks and thighs. It’s not known exactly what causes PUPPP, but it usually goes away after delivery.

Prurigo of Pregnancy

With this condition, very small and itchy bumps can appear anywhere on your skin. They look like insect bites, usually starting with just a few that then increase very day. Doctors suggest they may be caused by changes in your immune system during pregnancy. Prurigo may last for several months, or even continue once your child is born.

Pemphigoid gestationis

This rare skin condition usually beings during either the second or the third trimester. It may also start right after delivery. With it, you get blisters on the abdomen. In more severe cases, those blisters may cover a large part of the body. Doctors think this is an autoimmune disorder. Possible pregnancy problems include a slight risk of a smaller-sized baby and preterm birth.

Intrahepatic cholestasis of pregnancy (ICP)

This is pregnancy’s most common liver condition. Severe itching occurs, but not a rash. You’ll usually experience this on the soles of your feet or the palms of your hand, but it can also spread to your trunk. Symptoms normally start during the final trimester, but usually go away just a few days after giving birth. ICP may raise the risk of preterm birth, as well as even fetal death.
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Doctor's Corner

Pregnancy Week by Week - Women's Healthcare Topics

How to Talk to your Older Children about a New Sibling

There is no perfect way to break the news to your toddler or young child about the news of a new pregnancy. Every child handles the news differently, just as the rest of your family will.

Depending on the nature of your child, and your relationship with him or her, you may expect happiness, fear, anxiety, sadness or jealousy. Hoping for the first emotion is ideal, but over time, your child will adjust to the idea of having a new baby brother or sister. A lot depends on how you, as the parent, feel about your pregnancy.

In many cases, a mother is very close to her first child and may have many of these same emotions, especially if the pregnancy was unanticipated. However, if you and your spouse were planning on having more children, you can start to adjust to the thought of having a new baby even before you conceive. Asking the child how he or she feels about it is a great beginning. Subtle questions like, “How would you feel about having a brother or sister?” are a good way to break the ice.

As you already know from having your first child, it does require a lot of work and attention to handle a newborn’s fundamental needs. Including your older child in the participation can make them feel proud of being a big sister or brother, rather than jealous.

Depending on the skill level of the child, you can ask your son or daughter to do small favors. “Honey, can you do mommy a big favor and go get a clean diaper for me?” is one example. This makes the child feel important and like they are needed, which can greatly help them to adjust.

10 Tips to Prepare Your Child for a New Baby during Pregnancy

The best time to prepare your child is during the pregnancy, rather than just showing up one day with a brand new baby in tow. Some children handle the issue with maturity, while others react as if it were the end of the world. It is important that you allow your child to ask as many questions as possible and to be honest. Here are some other ways you can include your child in the process and help them to transition to big brother or sister:

  • Read books about a mommy having a new baby. There are many different levels of books for children, from toddler to preschooler, or even school-aged children. Choose an age-appropriate book or two. It can be fiction or non-fiction as you see fit.

  • Include your child on shopping for the baby supplies, if they are able to help you choose the best things. For example you could say, “Which bassinet do you think your new baby brother or sister would like best, this one or that one?” This helps the child to be part of the process and shows them that their opinion matters to you.

  • Show the child pictures of themselves when they were a baby, in as much chronological order as you have available. This helps to show them that they were a baby once too, as well as improving their memories of the lives you have lived thus far.

  • Take them places where babies are present. If you have friends who have babies, make a play date. While introducing the baby to your child, mention that “soon you will have a new brother or sister who will be a baby just like this!”

  • Have your little one help to decorate the nursery. You can even let them draw special pictures or stick decals with you to welcome the new baby.

  • After you make a list of potential baby names, you can also run them by your child to see how he or she feels about any of these names. Ultimately, you will choose the name, but you can help the child bond with his or her new sibling by picking out a name to call the baby ahead of time. It makes it more real than just a “baby bump” inside of mommy’s belly.

  • If the child is able to and if it is okay with the doctor, you can bring him or her to an ultrasound appointment. You can show them on the monitor what the baby looks like that is growing in your belly. Be prepared to get hit with a slew of questions. The doctor may even allow your child to listen to the baby’s heartbeat.

  • Look into some birthing classes that you both can take, which will help your child learn how to hold and feed a baby with your assistance.

  • Most of all, don’t force your child to adapt too quickly. It does take time for the adjustment and your child will grow to love his or her brother or sister very much.

  • Always be sensitive to their feelings!

Doing these things might make your child more equipped to handle the new baby, rather than feeling spiteful or sad about not being the center of mommy and daddy’s universe. It can be tough for some children to have to “share the spotlight”, especially kids who are used to being constantly doted upon. No matter what, reassure your child how much you love them and how special they are. One day your little one will realize just how nice it is to be part of a family and to have someone else to love and play with, rather than feeling excluded or isolated.
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Understand How to Avoid Infections during Pregnancy

Avoid infections

There are several reasons why pregnant women need to try to avoid an infection. Some infections are worse in a pregnant woman than in a non-pregnant woman. Other infections can be passed from mom to baby, while still others could lead to problems for baby after delivery.

Just like everyone else, a pregnant woman can pick up an infection from a variety of different things. This may include from certain foods, mosquitoes, other people or animals.

Infections that cause problems

There are a number of different types of infections, which could lead to health problems for mom and her unborn child. These are the most serious:

  • Cytomegalovirus, also called CMV - This is spread through body fluids, urine, saliva or even sex. It may lead to a sore throat, body aches or a fever. If you have any of these symptoms, let your doctor know right away. You may need a blood test to determine if you have CMV.

  • Parvovirus, also called fifth disease - This is spread between people. It leads to a rash on the legs, arms, back, face and chest. It may also lead to body aches and joint pain. If you’ve spent some time close to someone with parvovirus, tell your doctor. You may need a blood test to rule out an infection.

  • Listeria - This causes back pain, chills and fever. You get it from eating food that’s spoiled. Because it’s sometimes difficult to tell whether food is spoiled, though, doctors usually recommend pregnant women stay away from things like deli meats, soft cheeses and raw milk. Your doctor may provide you with a list of all foods they want you to avoid.

  • Toxoplasmosis - You get this from either touching cat waste while changing out a litter box, or eating uncooked meat. It doesn’t usually lead to symptoms for adults.

Vaccines during pregnancy

Vaccines can help prevent deadly or serious infections. Some are safe during pregnancy. These include:

  • Influenza shot (flu shot) - The flu may cause chills, a cough, muscle aches, a sore throat or a fever. Every adult needs a flu shot every year.

  • Tetanus, diphtheria, and pertussis - With tetanus, your muscles begin working abnormally. With diphtheria, it leads to a thick covering over the back of your throat, which may impact breathing. Pertussis, also called whooping cough, leads to a severe cough. Every pregnant woman needs this vaccine between weeks 27-36 of their pregnancy, no matter if they’ve had it before, or not. Babies can get very sick if they come down with pertussis.

How to avoid an infection

You can try to lower the chances of getting an infection by doing these things:

  • Don’t share foods, drinks or silverware with anyone

  • Wash your hands frequently, especially after you prepare food, use the bathroom, garden, touch garbage or animals, or change a diaper

  • Use bug spray to avoid mosquito bites, wear long-sleeved shirts and pants, and stay inside during dusk

  • Follow food safety tips

  • Don’t travel to certain countries where you could be at risk of serious infections

  • If there’s any chance your partner has an infection, use a condom during sex

  • Don’t change a liter box. If you need to do it, wash your hands afterwards and use gloves.

  • Don’t touch mice or rats poops

  • Have all family members fully vaccinated

There’s a right and a wrong way to wash your hands. The best way is to:

  • Place your hands under running water and use some soap

  • Rub your hands for 15-30 seconds. Clean in between your fingers, your fingernails and your wrists

  • Rinse your hands off

  • Dry off with a paper towel, which you can then just throw away

If there’s not a sink around, use hand gel. The best ones out there include alcohol.

Treating infections during pregnancy

The treatment of an infection during pregnancy depends on a number of things. This includes: what type of infection you have, the risk the infection could harm the mother and the risk for the baby.

If you do have an infection, make sure you ask your doctor what the right treatment is for you and your baby.

(next week)
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