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

19 Weeks Pregnant

Pregnant Belly Changes

At 19 weeks pregnant, your uterus should be just below your belly button. As your uterus continues to grow, you will notice that you don't have the grace or balance that you once had. Your center of gravity has shifted upward with the expanding uterus and this change is affecting your balance. If you aren't careful, you may have a hard time keeping upright. You may even trip or fall a few times.

This change in your center of gravity will also change your posture. You may notice that you are leaning backwards more often. This puts more strain on your back muscles, and can lead to pregnancy backaches and back pain.

You can reduce your back pain by being more aware of your posture, bending and lifting properly, and by performing exercises to strengthen your back muscles.

To prevent or ease back pain, you should also:

  • Wear low-heeled (not flat) shoes that have good arch support.

  • Avoid lifting heavy objects. Ask for help. Most people are more than willing to help a pregnant lady!

  • If you have to stand for long periods of time, due to work commitments, place one foot on a box or stool. Alternate when you need to.

  • Sleep on your side with a pregnancy pillow between your legs for support.

  • Apply heat or cold to the area that hurts, or massage it. You may also want to ask your partner to give you a back massage.

Your energy level has returned now. The fatigue you had in the earlier weeks is gone.

Should you exercise in pregnancy? The answer is yes. While you may not have the energy to run a marathon, exercise during pregnancy is important. Exercise in pregnancy will help you feel better; prepare your body for labor and delivery, and it may even alleviate many of your pregnancy aches and pains.

Starting in the second trimester, you might glow with pride at the sight of a healthy, full head of hair. When you're pregnant, your hormones lengthen the growing phase and delay the resting phase of the cycle, so more hair is growing and fewer hairs are shed every day.

Unfortunately, hormonal changes don't just affect the hair on your head. They can make the hair on the other parts of your body grow faster than before, including the hair on your face, arms and legs, and even the hair on your stomach, back and breasts.

A common pregnancy symptom at 19 weeks pregnant is dizziness or light-headedness. Though you may have experienced this in the first trimester, some women continue to feel dizzy in their second and third trimesters. You might get dizzy when rising too quickly, or when you are lying on your back.

In the second trimester, lying on your back can cause you to feel dizzy, because your growing uterus compresses the inferior vena cava (a large vein that receives blood from your legs, pelvis, and abdomen and carries it to the heart), slowing down circulation from the legs.

In some cases, you may feel dizzy or light-headed because of the normal lowering of blood pressure in pregnancy (also called pregnancy related hypotension). Your doctor will check your blood pressure at your prenatal visits, so be sure to discuss any dizziness that you may have experienced at these prenatal visits.

To avoid any crashes, falls, or stumbles due to dizziness or your shifting center of gravity, remember to take your time when sitting or standing up.

If you get dizzy to the point where you feel faint, talk to your doctor or healthcare provider.

Believe it or not a stuffy nose is quite common during pregnancy. It actually has a name… Rhinitis of pregnancy.

Most women will experience a stuffy nose during pregnancy any time after the first trimester. Some will find their nose frequently seems congested at night while others may experience congestion on and off throughout the day.

Some doctors recommend using saline nasal drops during pregnancy. You can try using a few drops in each nostril until you experience relief. There is also a natural remedy referred to as a 'neti' pot. While unusual looking, a neti pot can help dramatically improve nasal congestion.

Leg cramps may start to plague you during the nighttime hours.

Leg cramps are one of the major reasons that pregnant women experience sleep disturbances at night. Leg cramps are a normal pregnancy symptom that often strike in the second and third trimesters.

Doctors aren't sure what causes leg cramps in pregnancy, but one theory is that it's caused by the muscles in your leg being exhausted from having to support your pregnancy weight. They use to think that a calcium deficiency caused most leg cramps. Doctors no longer believe this.

Leg cramps can be uncomfortable and even painful, and they might even wake you up in the middle of the night. To minimize your discomfort, try stretch the affected muscle or walking through the cramp. A relaxing leg massage before bed can also give you some comfort.

Weight Gain

You continue to steadily gain weight as your second trimester continues. The average weight gain at 19 weeks pregnant is roughly between 11 and 12 pounds. Keep in mind that there's a lot of variability between each woman, so if you've gained more than this, don't fret. That's normal, too.

Pregnancy Health Section

Understanding Tdap Vaccine Given in Pregnancy

The Tdap vaccine helps to prevent three potentially life-threatening bacterial diseases with one shot. This includes tetanus, diphtheria and pertussis.

Each of the three diseases may be serious, or even deadly. Diphtheria may cause a thick covering to develop in the back of the throat, resulting in breathing problems. Tetanus is also serious. It causes muscle spasms and stiffness. Pertussis is also commonly called whooping cough.

If you do become ill, the Tdap vaccine may help you from becoming severely ill. It may also help those close to you from becoming sick.

These people SHOULD get the Tdap vaccine:

  • Children ages 7-18 - The Tdap vaccine is recommended as a booster to children who already received the diphtheria, tetanus and whooping cough vaccines when they were younger than seven. A number of years later, when people are given the vaccine again, it’s called a booster. This helps the body keep away infection. This is important because with certain vaccines, including those given to kids for diphtheria, tetanus and whooping cough, the vaccines no longer work after awhile. If your child didn’t get the vaccine earlier in life, they can get the Tdap vaccine when your doctor says so.

  • Adults ages 19 and older - The Tdap vaccine is recommended for people who never got it. This type of vaccine is vitally important for those ages 65 and older who are also around kids younger than age one. This may include childcare workers, nurses, doctors, other health care workers, and even grandparents.

If you’re not sure if you had the Tdap vaccine, your doctor will likely give it to you. This is important to help protect you, and babies. Whooping cough is extremely serious for babies, and can even lead to death.

Pregnant women SHOULD get the Tdap vaccine. It’s safe during pregnancy, and all women need to get it after week 20. This is the case no matter if they had the Tdap vaccine before, or the pertussis vaccine before.

Traveling During Pregnancy

Learn about Traveling During Pregnancy.

The second trimester is often the best time to travel. You should be feeling better, (no more nausea or vomiting), and you aren't weighed down by a huge, bulging belly. You may want to take a vacation to spend some quality time with your partner or husband.

Traveling during pregnancy often poses no risk for a normal pregnancy. In the second trimester of pregnancy, you can choose any method of travel - air, car, and even sea travel. However, it's recommended that you talk to your healthcare provider before making any plans.

A few tips for travel during pregnancy:

  • Plan your trip carefully. Give yourself extra time to pack. Don't feel rushed or stressed when doing pre-vacation preparations. (Stress can have a negative impact on your baby, too!)

  • When packing your carry-on luggage for a flight, try to pack light. You don't want to have to lug heavy bags with you, especially since your energy level may not be as high as it was pre-pregnancy.

  • If by air, check with the airline before booking. Guidelines for pregnant women may differ with each airline. Although most airlines allow you to travel during pregnancy, you should double-check your air carrier's guidelines to avoid any hassles.

  • If by car, buckle up and take breaks. Car crashes are one of the leading causes of trauma in pregnant women, so you will want to buckle up with a shoulder-lap belt to protect you and your baby.

  • Frequent urination is also a complaint of many pregnant women, so you will want to take lots of breaks to go to the restroom and to stretch your legs.

  • When traveling abroad, keep hydrated. Drink lots of water when you are traveling. Keep bottled water handy. Say "no" to ice in foreign countries. Local ice tends to be made using tap water.

  • If in the sun, don't forget the sunscreen. Your skin is more sensitive to ultraviolet rays during pregnancy, so you should lather your body in a high SPF sunscreen if you are going to be in the sun. You may also want to try to remain in shade, if possible.

  • Sun exposure may cause you to develop chloasma or melasma (more commonly called the mask of pregnancy.") Chloasma is dark, brown blotches that appear on sun-exposed areas of your face. To reduce your risk of these dark spots, you should protect your face from the sun with a sunscreen with SPF 30 or higher.

When is the Best Time to Travel? According to the American Congress of Obstetricians and Gynecologists (ACOG), the best time for a pregnant woman to travel is in the second trimester, between 14 weeks pregnant and 28 weeks pregnant. This is because a majority of common pregnancy emergencies occur in the first and third trimester.

If you plan to travel, make an appointment with your doctor for a prenatal check-up before you leave on your trip. Get the OK from your doctor that is safe for you to travel and make sure to get a copy of your prenatal records.

Traveling to a Developing Country

Should you travel to a developing country while pregnant? Probably not. Particularly if you are close to your due date or if your pregnancy is considered high risk. The reason being that some developing countries simply will not have the medical resources necessary to care for you should something unexpected happen.

If you aren't far along in your pregnancy and are relatively healthy, you should see which immunizations might be necessary before traveling. There are some vaccines that are safe during pregnancy and some that are not.

There are also some medications that may be recommended for travel to certain exotic locations that you are not able to take during pregnancy (such as anti-malarial drugs). By and large, it is very important that you weight the risks versus benefits if you plan on traveling to a developing country during your pregnancy.

Remember that the biggest risk would be a lack of access to a medical care facility that could handle an early delivery. While a delivery at 32 weeks is manageable here in the United States, it is not in many other parts of the world.

Hot Tubs and Pregnancy

At 19 weeks pregnant, you may want to soak in a hot tub during pregnancy to relieve your aches and pains, but you should resist the urge. Hot tubs in pregnancy are not recommended, and they can be a dangerous combination, especially for your unborn baby.

Soaking in a hot tub for 10 minutes or more can increase your body temperature to 102 Fahrenheit and cause hyperthermia. There have been a number of research studies that have shown an increase risk of neutral tube defects and miscarriages in the infants of women who experienced high temperatures in the first month or two of pregnancy.

At any point in pregnancy exposure to hot tubs can lower your blood pressure and cause you to overheat. This can impair your baby's oxygen supply, and it may stress out your baby.

Taking a hot bath when you're pregnant is fine, as long as the water stays underneath 100 degrees Fahrenheit. A good rule of thumb is to dip your foot into the tub, and if it's too hot to touch, you'll want to turn on some cold water to cool it down. The water should be a comfortable level for you to soak in.

Baby Section

Growth and Development of Baby

By 19 weeks pregnant, your baby weighs almost 8.5 ounces and is about half a foot long! Did you know that when your little one is born, he or she will have increased in size by 15 times? From this point of your pregnancy your baby will simply grow, grow, and grow!

This week, your baby is starting to produce vernix – a white sticky substance that covers your baby's skin to protect it from its watery environment. The vernix will keep your baby's skin looking soft and supple.

Your little one's brain is in the process of forming pockets that specialize in smell, taste, hearing, vision, and even touch.

If you are having a girl, she already has produced six million eggs in her ovaries, though this number will decrease by 4 million by the time your newborn baby is born.

Your baby's identity is becoming more distinct this week. The pads on his or her fingers now have ridged patterns that will later become your baby's unique fingerprint!

Your baby's eyes are still closed, but the eyes are making random movements underneath the eyelids. Your little one will not open his eyes for a few more weeks, around 26 to 28 weeks of pregnancy.

This week, fat is starting to cover your baby's body, but he or she still looks very skinny. Your baby continues to pack on the fat as your pregnancy continues.

Around 19 weeks, your baby may start to hiccup. These hiccups are short, lasting less than a second, but they often occur in a rapid succession.

Doctors don't know why babies in the womb hiccup, but some theorize that it may be due to your little one's respiratory muscles preparing for breathing after birth. Others believe that it occurs after your baby swallows amniotic fluid and hiccups prevent the fluid from entering the lungs. Whatever the reason, hiccups are a very normal part of pregnancy. (next week)


Doctor's Corner

Pregnancy Week by Week - Women's Healthcare Topics