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This is your Pea in the Podcast for week 22 of your pregnancy. I’m Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women’s Care Associates in Houston, Texas.
Whenever you see your doctor of midwife now you may notice the first thing they do is whip out an old fashioned tape measure and measure your belly, what’s that all about? “What it’s all about is that the height of the fundus, the size of the uterus, matches the gestational age in centimeters plus or minus three centimeters between 20 and 37 weeks. So it’s not an exact science, I mean after all it is a tape measure, it’s not like the most intricate, delicate, scientific instrument ever made. We use it to make sure mostly that there’s some delta, that it’s different from one visit to the next and by the amount that we’d expect it to be, so to me that’s more important than the absolute number. If you’re 22 weeks but your uterus sort of measures 24 weeks that’s still within normal but I would expect when I saw you four weeks later that it would still measure two centimeters greater than I would expect. So you’re staying along the same growth curve kind of thing.” It’s called measuring fundal height and if your doctor or midwife is concerned about the measurements, they may order an ultrasound. After about 36 weeks or so the measurement of fundal height becomes less accurate because your baby is getting settled into your pelvis as it prepares to make its exit.
As you’re in the rapid weight gain portion of your pregnancy, you’re likely to start experiencing some of those less joyful aspects of creating a new life, “This thing called round ligament pain, it’ is common around this time, it sort of seems like with first babies it’s around this time, with second and subsequent ones it’s earlier around 16 to18 weeks. Nevertheless, anytime second trimester women can have some discomfort that occurs actually under the uterus, it’s often described as they can feel their cervix or their pubic bone hurts or it hurts under their stomach and it’s typically worse when they get up, walk around, move, get up off a couch, that kind of stuff. It feels better if they’re sitting or if they support their abdomen. These are the ligaments that essentially hold the uterus up and they attach into the labia and so we think they sort of stretch and pull. It’s commonly only unilateral, but it can be both sides. And it does hurt a lot but there’s nothing you can do about it.” Round ligament pain is not the only pain that maybe in your future, “Hip pain, sciatica, all those kinds of aches and pains are very common, there are physical therapists who are wonderful in helping women with this. Certainly sometimes if it’s really severe the patient may need an evaluation by an orthopedist to look at her back or spine, not that there can be a whole bunch of manipulation gone on, but if there is any numbness, that kind of stuff, that’s something that needs to be reported. Numbness of a limb is not necessarily a normal pregnancy phenomenon. Women sort of stand funny when they’re pregnant and this is sort of the bain of our existence, we hear this all day, ‘my back hurts, my head hurts’.”
Some pregnant women struggle with wrestless leg syndrome, “basically women describe it as their legs sort of feel like they’re awake. The patient is trying to rest but their legs want to move and the only relief they get is getting up and walking around, there are some medicines for it but they’re not approved for pregnancy. The bigger problem than restless legs are calf cramps and it’s still a small percentage of women have them but they hurt like crazy. The interesting thing about them is they seem to go away, they sort of show up bother the woman for a few weeks and then not really be much of a problem anymore and it may be that she knows how to sort of prevent them by then by the position of her feet and legs but it’s typically at night and it kills, it’s horrible. I tell my patients if they want they can try to increase their calcium, potassium, magnesium but no one actually knows why it’s going on and there’s probably no real actual remedy for it. It’s just nasty.” So yeah there is some discomfort coming your way, much of it is normal but Dr. Swaim says if you feel any real abdominal pain call your doctor.
Now we’ve talked about exercise being a good thing during pregnancy but as your body changes there are a couple of things you need to keep in mind. First, your growing belly means your center of gravity is changing so be aware of that as you exercise. Second, your joints and ligaments are loosening and become more flexible, “We think that there might be some large joint laxity that occurs. We start to tell women who play cutting sports to make sure they have support in their large joints and if they have any pain to knock it off. But a lot of women don’t play cutting sports later in pregnancy anyway. There are a few tennis players out there but there aren’t that many who start lumbering around after awhile.” And why does this joint laxity occur? Well it appears the point is to loosen the pelvis to make room for the enlarging uterus and ultimately the baby to fit through during delivery.
So how is your bean doing in there? Well at more than 7 inches long your baby weighs about a pound. Its brain and nerve endings are formed just enough so that baby is experiencing the sense of touch so they may experiment with this new experience by stroking their face, and that kind of thing. Those itty bitty ears can hear sounds from the outside and react to them which may make you feel tempted to start having daily English literature or music classes for your little prodigy to be. Should you? “Well I think it’s harmless, first of all, and if it makes people happy then fine. Babies I think do respond to their parents’ voices. I always convince myself they respond to mine too because they hear me all the time, they hear my voice every two weeks. But are babies smarter because they hear poetry in utero? I don’t think anyone has ever shown that.”
Now if you’re having a boy, testes have begun to descend from somewhere around their kidneys to their scrotum. If you’re having a girl she now has about 7 million eggs in her ovaries that will drop to about 2 million potential grandchildren when she’s born which will happen by the way in about 4 months. You’re 22 weeks pregnant and we’re now only 18 weeks away from week 40.
That’s your Pea in the Podcast for week 22 of your pregnancy. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week. For a transcript of any of our Pea in the Podcasts go to our website peainthepodcast.com. For Pea in the Podcast, I’m Bonnie Petrie, thanks for listening.