Week 14: Beginning The 2nd Trimester

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This is your Pea in the Podcast for week 14 of your pregnancy. I'm Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women's Care Associates in Houston, Texas.

So we're sailing on in to the second trimester with the greatest of ease and you may be convinced that those flutters you're feeling in your tummy are your baby. Dr. Swaim says 'no, you're probably not feeling the baby yet', although you're not alone in thinking this. "I remember I was pregnant with my first child and I said 'I feel the baby'. My obstetrician said no you don't. I was so insulted, I was like 'how does he know, he's a guy'. Then a few weeks later I felt her and I was like 'oh'. So with your first baby it's very unlikely that you will feel the baby less than about 18 weeks. It's usually not until 20, 21 weeks that you feel the baby reliably. There are a few reasons I think, first of all you don't know what the heck you're feeling. Second of all, sometimes the placenta is actually in the front, the baby has to be strong enough to actually bend the placenta and bend the uterus to this thin layer which is called the perineum which is the one with all the nerves in it so you can feel it. But there's no way you can feel a baby at 13 or 14 weeks; it's just gas. When women insist that they feel it, I say 'okay'. What am I going to do, argue with them? The truth is that maternal perception of fetal movement is very important in the third trimester but it's not important at all in the second trimester. Now with second and subsequent babies you'll feel it a lot sooner. Most women will feel their second and subsequent baby by 16 or 17 weeks." But just because you can't feel it yet, it doesn't mean your baby isn't moving because they certainly are. Your little lemon length baby's joints and muscles are now developed enough so there is a lot of movement going on in there. Their little hands can grasp at things too and they may now gain the ability to start sucking on that thumb they've been sticking in their mouth for the last week or so. Your baby is also starting to develop the ability to move their eyes this week although the eyelids are still fused shut. If you have a little boy in there, well, the prostate will start to develop. Your little girl's ovaries will move from the abdomen into the pelvis.

Now you should have gained a few pounds by now, not too much but some, "Actually if she hasn't gained any weight then I might be a little concerned and talk to her about her diet. I want to make sure that she's not really dieting or that she's really not too sick to eat. Unfortunately though a lot of women who are nauseous eat more because it makes them feel better. But it turns out that not everyone complains and that's one of the ways that we can make sure that she's not throwing up, make sure that she is gaining some weight."

Now your breasts may already begin to produce that liquid gold, colostrums, with its high concentrations of nutrients and immunities designed to give your newborn that extra protection as it faces its first days outside the womb. You may notice your nipples and areola are getting darker and the blue veins in your breasts dilating and becoming more noticeable. You may also need some looser pants by now, you're not obviously pregnant yet but you're probably getting quite uncomfortable in your old pants. As your baby grows and hormone levels drop in the second trimester, giving you some ease from your first trimester symptoms, you may add increased constipation to the list. Some extra fiber in your diet may help keep things moving, some prunes may do the trick, if not you may want to mention it to the doctor. If you have a history of second trimester loss, or if you have some damage to your cervix, you may this week get what is called a cerclage. That's when your cervix is sewed closed during pregnancy to keep that baby right where it belongs. The cervix is the lowest part of the uterus and extends into the vagina and if you get a cerclage you may have a general, spinal or epidural anesthesia for pain control while a doctor stitches a band of strong thread around the cervix. That thread will be tightened to hold the cervix firmly closed. The thread is generally removed around week 37 or so of your pregnancy.

Okay, at 14 weeks many of you can hear your baby's heartbeat on the Doppler and have been able to for a couple of weeks and some of you will want to run right out and rent a Doppler to have at home. There are a lot of companies that rent them and according to medical news today several thousand of the devices are rented every year for between $20 and $50 a month or some people buy them for between $150 and $600. You're really not supposed to rent them though without a prescription from your doctor indicating medical necessity. The fine for renting a medical device without a prescription can be as high as $16,500 per violation, although the FDA says it's highly unlikely they're going to prosecute a mom or dad trying to listen to their baby's heartbeat at home. So why would you need a prescription for one of these things you can so easily rent online? What's all the fuss about? Well Dopplers are little ultrasound machines, the FDA and some doctors are concerned people are over using those devices without supervision and exposing those fetus' to extraneous ultrasound. Dr. Swaim says even if you did, ultrasound is safe: "There are babies who have bazillions of ultrasounds; babies who need infusions or transfusions, who have non-immune hydrops, bad anomalies, babies who have extra amniotic fluid or not enough amniotic fluid. There are some babies who have ultrasounds up to a couple of times week. They're fine." But she's still not a fan of at home rental Dopplers, "I think it's goofy but if you want to spend the money, go ahead." Now Dr. Swaim is not alone among obstetricians who actually fear patients are a) getting fleeced into a bunch of money for a Doppler that doesn't have the ability to let you hear what you want to hear or b) the unskilled user, you, won't be able to consistently use the Doppler effectively and when you can't hear your baby's heartbeat, "then you get stressed because you can't hear it, so that's the goofy part." Since Doppler rentals have been available, OBs have been fielding calls from frantic moms who can't hear their baby's heartbeats but their babies are just fine, the moms are just using the Dopplers incorrectly. That said, I rented a Doppler and I loved it and I rented it during week 14.

Now you are 14 weeks pregnant and you have 26 weeks to go until week 40.

That's your Pea in the Podcast for week 14. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week, we'll talk to you then. I'm Bonnie Petrie, thanks for listening.