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

13 Weeks Pregnant

Pregnant Belly Changes

Many of the discomforts of the first trimester of pregnancy should be easing up, including your morning sickness, mood swings, and fatigue. This is because your pregnancy hormones tend to level off in the second trimester.

You are definitely showing now. As your uterus expands and grows larger, your internal organs are forced to shift their position upward to accommodate your baby's rapid growth.

Although your bump isn't that large yet and you probably don't need maternity clothes, you may find that your favorite pair of jeans no longer fit. Try to wear loose-fitting clothes, if it's possible. This will help you feel better, and it may reduce the abdominal discomfort that you may feel this week. Some women find that baggy clothes and sweat pants are more comfortable now than their regular clothes.

Your risk of miscarriage is now significantly lower. In fact, 80 percent of all miscarriages occur within the first 12 weeks of pregnancy.

To improve your chances of a healthy baby, remember to keep eating healthy foods and to avoid certain lifestyle habits, such as smoking, drinking, and drug use. Smoking and alcohol use has been linked to increasing your chance of miscarriage.

At 13 weeks pregnant, you are probably feeling remarkably better than you have in the previous weeks. Your nausea and fatigue should be greatly reduced by now, and you may even find that you have a renewed sense of health and vigor.

You may notice that you have more energy than before. For a majority of women, fatigue is decreasing with each passing week. Enjoy your higher energy levels in the up and coming weeks. They won't last long. You are going to start feeling tired again in the latter part of your pregnancy.

Breast changes - are common now and throughout your pregnancy. You may have noticed that your areolas are darker, and the blue veins in your breasts are more prominent. Some women also notice that there are tiny "bumps" surrounding the areola. These are called Montgomery's tubercles, and they are a normal pregnancy change.

Shortness of Breath - You may start to experience shortness of breath now. While this can be worrisome, it is a very common pregnancy symptom and it should be mild in nature. An estimated 60 to 70 percent of women experience this symptom at some point during their pregnancy.

Some pregnant women experience shortness of breath this early in pregnancy. However, it is more common later in your pregnancy, as your growing uterus and shifted organs puts pressure on your diaphragm (the main muscle involved in helping us breathe). As you grow larger, you might feel that your breathing is becoming more labored. Luckily, this shortness of breath will disappear after you deliver your baby.

Shortness of breath is often worse when you are sitting down. To help you breathe easier, you may want to stand up straight. This may give your lungs more room to expand. You can also lift your arms over your head to take pressure off your rib cage.

Round ligament pain - You may start to experience abdominal discomfort or pain when you change positions too quickly. Called "round ligament pain," this is a normal pregnancy symptom that is more common in the second trimester, but some women do experience it sooner.

Round ligament pain can feel like cramps or sharp pain, or sometimes a dull ache, often on the right side of your abdomen (though some women do experience this pain on both sides). The pain or jab shouldn't last for more than a few seconds or a few minutes.

Though uncomfortable, round ligament pain is a physical reminder of your growing uterus. As you continue your pregnancy, your uterus will continue to expand and the ligaments that support it will also stretch, pulling and tugging nearby nerve fibers giving you a sharp pain and/or discomfort.

To avoid round ligament pain, you should avoid changing positions too quickly. Just by sitting still and resting is all that is needed to decrease your discomfort. If your pain seems to get worse, be sure to call your doctor.

Pregnancy Gingivitis - Swollen, tender gums are a common pregnancy experience. Your body has double the amount of normal blood circulation in pregnancy, and this can soften your gums and cause minor irritation when you're brushing or flossing your teeth. Your gums may also bleed when you're brushing or flossing. This is called pregnancy gingivitis, and you'll want to maintain good oral hygiene to prevent it from developing into gum disease.

Weight Gain

On average, your pregnancy weight gain at 13 weeks pregnant may be between four and five pounds. You will start to really pack on the pounds in your second and third trimester. In fact, you should expect to gain between one or two pounds a week as your pregnancy continues.

If you are an average-sized woman, you should aim to gain between 25 and 35 pounds during pregnancy. This is your recommended pregnancy weight gain. You will want to gain more than this (between 25 and 40 pounds) if you were underweight before pregnancy, and you should gain less (only between 15 and 25 pounds during pregnancy) if you are an overweight woman.

Baby Section

Growth and Development of Baby

At 13 weeks pregnant your baby is growing up very fast! He or she is close to 3 inches long from crown to rump and weighs close to an ounce! Though your little one is still pretty small, he or she does look like a miniature human baby now. The baby's head is still huge, but the body is slowly catching up!

His or her muscle control is developing. Your baby is kicking, flipping, and flopping this week, though he or she has little control over his muscles at this point.

Your baby's toes are now separate, and they're about the same length. The ankle joints have matured. Unfortunately, you won't feel any of your baby's acrobatics until the second trimester.

Amniotic Fluid is Increasing
Your baby has lots of room to move around inside the amniotic fluid. This week, you may have up to 25 ml of amniotic fluid. As you continue your pregnancy, this amount will steadily increase until pregnancy week 32. In the last few weeks of pregnancy, this amount will slowly decrease.

Baby's Skin is Still Transparent
If you were to peek inside your uterus right now, you'd see bones underneath your baby's transparent skin. Your baby doesn't have underlying body fat, but this will soon change. In the second trimester, he or she will start packing on the pounds, and his or her skin will become less transparent. Also, your baby's bones continue to harden (called "ossification").

Baby's Brain is Maturing
The right and left cerebral hemispheres of your baby's brain are starting to connect. Each hemisphere controls the opposite of the body, with the left hemisphere controlling your baby's right side and the right hemisphere controlling the left side of the body. As your baby's brain develops, your little one will have more and more control of his or her movements. The motor fibers in the brain will develop first, followed by sensory nerves later. Your baby's brain will be completely developed in about ten weeks!

Pregnancy Health Section

Return of Libido toward the end of the First Trimester

Return of Libido toward the end of the First Trimester.

Many women find that their libido returns to normal at the end of the first trimester. In fact, many women find they are more easily aroused in part due to the increased blood flowing through all parts of their body, including the genitals. Some women find that having relations is particularly arousing, and others find their climax is more intense than normal.

Along with the return of your libido, however sometimes come misgivings, which can occur in either partner. You may find that you or your partner is eager to make love now that the first trimester symptoms are ending, but afraid that intercourse may harm the baby. By and large, making love during pregnancy is safe for most women, provided you do not have a high-risk pregnancy or are at risk for pre-term labor.

To help with the concerns that either of you may have, consider bringing your partner with you to your next OB appointment so the both of you can address your concerns.

Pregnancy Complication: Incompetent Cervix

Although your risk of miscarriage is lower at 13 weeks pregnant, miscarriages can still occur. Some women are still at risk for miscarrying through their 20th week. In certain circumstances, a woman might be diagnosed as having an incompetent cervix.

An incompetent cervix is the result of a cervix that is too weak to hold the pregnancy and stay closed. Typically what happens when a woman has an incompetent cervix is the baby is delivered too early to survive.

This relatively uncommon problem is usually the cause of up to 25 percent of second trimester losses. A diagnosis of an incompetent cervix can be made using an ultrasound or a manual exam. Generally an incompetent cervix is diagnosed when the cervix is open more than 2.5 cm during pregnancy, or when the cervical length is less than 20 mm.

Unfortunately, an incompetent cervix is often only diagnosed after a woman has had one or two previous miscarriages. There are some circumstances that may increase a woman's risk of suffering from this disorder, including: cervical conization or cryptherapy (procedures to treat abnormal pap smears), congenital anomalies and a previous D&C.

Fortunately, there is a surgical procedure called a cervical cerclage that can be performed to help keep the cervix from opening up. This procedure typically allows a woman to carry the baby to term.

Remember that most women will not have problems from an incompetent cervix, and they will have a very high chance of carrying their baby to term after the 13th week of pregnancy. (next week)


Doctor's Corner

Pregnancy Week by Week - Women's Healthcare Topics