Sixth month of pregnancy: the joys and fears of the “golden” time

It is not without reason that the course of a woman’s pregnancy is divided into three periods - trimesters - they differ significantly from each other in sensations, external changes, development of the unborn baby and even the level of anxiety. The second trimester is called the “golden” time - at this time a woman feels the least discomfort, is already accustomed to her position and can enjoy it. The end of the second trimester—the sixth obstetric month—fully confirms the indicated positive characteristics of the trimester.

• 2 Woman’s feelings and external changes
• 3 What's inside: how the baby looks and develops

  3.1 Medical examination

Fetal development

The second trimester is notable for the fact that the belly begins to actively grow. At the 6th month of pregnancy, for some it becomes more rounded, for others it protrudes forward like a ball. Everything happens very individually for each woman. It becomes quite obvious to others that the woman is pregnant. True, there is one exception: women who are overweight or are accustomed to wearing loose clothing. They will still be able to keep their pregnancy secret for some time. However, for the woman herself, who is seen by a doctor and controls her well-being, external changes in the body become pronounced.

At the 6th month of pregnancy, the belly will grow as actively as the baby grows, because it needs more space, and the amount of amniotic fluid increases accordingly. To ease the increased strain on your back and legs, it is recommended to support your abdomen with a prenatal band. It will allow you to extend your walks and significantly improve the general well-being of the pregnant woman.

At the end of the second trimester, the fetus's growth is about 30 cm and its weight is about a kilogram. These parameters are monitored during the next screening and at an appointment with a gynecologist. He takes abdominal circumference measurements weekly to determine the risk of developing a possible pathology at an early stage.

Nutrition

A woman in an interesting position at 24 weeks of gestation needs more natural microelements and vitamins.

Her diet should contain the following products:

• low-fat varieties of fish for the development of the baby’s central nervous system;
• dairy products, especially cottage cheese, to replenish calcium loss;
• fruits with vitamin C and ascorbic acid to support immunity;
• beef – baked or boiled.

Prohibited foods: flour, chocolate, coffee, smoked products. Restrictions remain on salt and liquid.

The daily calorie requirement increases to 4000.

Polyhydramnios

If a woman notices that she has a large belly at 6 months of pregnancy, then this may be polyhydramnios. This can be determined during an ultrasound examination. At the next examination in the antenatal clinic, polyhydramnios is diagnosed by measuring the circumference of the abdomen and the height of the uterine fundus. Since it is believed that the latter corresponds to the gestational age of the fetus, significant upward deviations indicate the development of polyhydramnios.

Normally, the girth of the abdomen at the 24th week of pregnancy is about 80 cm, and the height of the fundus of the uterus is approximately 22-27 cm. It is worth taking into account the individual characteristics of each woman. So, if you are overweight, these numbers may be slightly higher and vice versa. Many women pay attention to the shape of their belly at 6 months of pregnancy, compare it with their previous pregnancies and agree that no two shapes are the same. You should not look for signs of pathology, and if you have certain suspicions, it is better to consult a doctor.

In addition to the increased size of the abdomen, a pregnant woman may be accompanied by other unpleasant symptoms: gurgling in the abdomen, shortness of breath, fatigue, swelling of the legs, abdominal girth more than 100 cm, pulling in the lower abdomen. At 6 months of pregnancy, these signs should alert not only the expectant mother, but also the observing gynecologist. Self-treatment and taking medications are strictly prohibited. The main tests that need to be taken in this situation should determine or exclude the risk of developing: infection, kidney disease, diabetes, birth defects, heart disease.

Analyzes and research

Mandatory research parameters remain unchanged:

• measuring the weight of the expectant mother;
• size and volume of the abdomen;
• detection of edema in the lower extremities;
• blood pressure measurement.

The patient is not examined on a gynecological chair, but if there are grounds, a smear is taken without the use of vaginal speculum.

The heartbeat is determined with a stethoscope. CTG is performed rarely, and only from 24 weeks.

A routine ultrasound is performed to identify malformations and determine external parameters (height, weight, size of limbs).

In addition to general diagnostics, uteroplacental blood flow is assessed using Dopplerography, and measurement of the uterine isthmus.

Laboratory tests are mandatory:

• detailed blood test;
• general urine analysis, and in case of increased urination, analysis according to Zimnitsky;
• blood biochemistry: urea, creatinine, glucose, total protein;
• transaminases and blood diastase;
• serum iron and ferritin;
• blood test for hemolysins and Rh antibodies (if indicated);
• hemostasiogram with determination of D-dimer.

If necessary, hormonal studies and determination of thyroid hormone levels are added.

When primary signs of a threatened miscarriage appear, the patient is admitted to a hospital for prolongation of gestation.

Low water

The opposite of polyhydramnios is another pathology - a small amount of amniotic fluid, which also affects the size of the abdomen at 6 months of pregnancy. It can be moderate or pronounced, vulnerable, late or prolonged. With oligohydramnios, on the contrary, the stomach looks smaller than it should be at this time. This phenomenon is much less common, but despite this it causes some concern in pregnant women. A woman may notice that she has a very small belly when she is 6 months pregnant. For a baby, oligohydramnios means that the space for movement is reduced and he becomes less active. As a result, a lack of amniotic fluid leads to fetal hypoxia, which is why it is so necessary to promptly diagnose oligohydramnios and undergo treatment.

When determining deviations, doctors are guided by the standards adopted by WHO. For example, if the water content is less than 500 ml, then this indicates oligohydramnios. You should also be careful about the nature of the discharge. It may happen that water leaks and this becomes the cause of low water. In this case, only a qualified specialist can provide a competent assessment of the condition of the mother and fetus. If a woman begins to feel pain in the lower abdomen when the baby moves, in addition, the lower abdomen is pulled: at 6 months of pregnancy, it is important to exclude self-medication, it is better to consult a doctor unscheduled.

In addition to ultrasound examination, it is recommended to undergo Doppler ultrasound, which will allow you to monitor the functioning of the blood vessels of the placenta and eliminate insufficient oxygen supply to the baby. It is also worth getting tested to rule out the development of an inflammatory or infectious process. Among the reasons may be hypertension, obesity, multiple pregnancies, abuse of bad habits, and deviations in the development of the baby.

Multiple pregnancy

If in the case of a singleton pregnancy the belly grows from week to week, then when carrying several babies its size can change before our eyes, from day to day. Therefore, you should not be surprised that at the 6th month of pregnancy, the stomach is covered with stretch marks and no amount of oils and creams will save you from this. The increased load on the entire body cannot ignore the appearance of a woman. The waist is smoothed out, and the belly can no longer be hidden and it noticeably reminds others that in front of them is a pregnant woman.

For an expectant mother expecting twins or triplets, this period becomes a real test. She gets tired faster, and the sensations from walking may become less pleasant. It is worth using a prenatal bandage to lighten your burden, do not overwork, and, if possible, rest at the first signs of fatigue. As babies move, the shape of the abdomen may change, for example, if they take a transverse position. What does the belly look like at 6 months pregnant in this case? Most likely, it will look like an oval, however, this phenomenon is temporary. Since there is still some time ahead, it is likely that they will take the correct position before the onset of labor and the stomach will have a more familiar rounded shape.

What weeks are included in the sixth month

The issue of calculating the gestational age in months is quite controversial. The thing is that while ordinary people count the prescribed “9 months” according to the calendar (a calendar month, as a rule, is more than 28 days, 4 weeks), obstetricians count 10 obstetric months, exactly 4 weeks each. The confusion that arises becomes incredibly worse towards the end of the term, which is why you are unlikely to hear from your doctor your term in monthly terms - they prefer to use calculations in weeks, which is more accurate.

There is another controversial issue in obstetrics regarding timing - the presence of two “reference points” - from conception and from the date of the last menstruation - embryonic and obstetric weeks are considered respectively. Obstetricians use the method of the same name - obstetric.

So, next we will talk about the 6th obstetric month, which includes the period from the 21st to the 24th obstetric weeks. The place of the sixth obstetric month in the calendar of pregnancy trimesters is towards the end of the second trimester (it ends with the 26th obstetric week).

Feelings from the growth of the abdomen

By the end of the second trimester, the woman gets used to her new position and changes in the body. Therefore, most of thematic photo shoots occur during this period. The most popular belly photos during the 6th month of pregnancy are taken at home in amateur shooting mode. This is a simple and quick way to record in memory the growth of a baby who is actively developing inside the womb. In addition to the pleasant sensations from fetal movements, a woman may experience discomfort associated with pressure on internal organs. The longer the period, the heavier the stomach becomes and, consequently, the load on the back. Pain in the lumbar region may indicate internal tone and overstrain. In this case, it is recommended to reduce the load and wear a bandage, allow yourself to lie down during the day or, best of all, sleep.

It is believed that during the normal course of pregnancy, a woman should not experience any negative symptoms or pain throughout the entire period. The appearance of fatigue, various skin rashes on the body, and a feeling of tone more often indicate the presence of a deficiency of vitamins in the body, excessive physical activity, lack of a proper daily routine, nutrition, sleep disturbance and rest.

Sex

Sexual intimacy is possible only if there are no contraindications to it. For example, the threat of miscarriage, uterine tone and fetal presentation are contraindications to intimacy.

If there are no restrictions, it is important to choose a comfortable position for both partners and reduce the intensity.

Sex does not harm the health and development of the fetus, but if unpleasant symptoms and painful sensations appear during sexual intercourse, it is a reason to stop intimacy.

The appearance of striae

Active growth of the abdomen while a woman is carrying a baby is accompanied by damage or stretching of the skin; in a word, stretch marks appear. A pregnant woman may feel itching in the area where the stretching occurs: the sides, lower abdomen, area around the navel, and even the chest. In some women, especially when carrying several babies, stretch marks can cover the entire surface of the abdomen. You can find many stories on the Internet about how to prevent their occurrence. The most popular recommendations involve the use of special cosmetics for body care during pregnancy with various vitamin complexes. A photo of the belly at 6 months of pregnancy, no matter how neat it is in shape, with red stripes can significantly ruin the mood of any woman. Therefore, special attention is paid to skin care.

The color of stretch marks can range from pale pink to purple. If a woman sunbathes in the summer, then due to the uneven surface of the skin of the abdomen, its color will almost certainly be uneven. Therefore, it is a mistake to believe that tanning will help hide them. Moreover, you should not abuse open sunlight to avoid burns. Because the skin on your belly is already thin, UV exposure can cause even more damage than usual.

Prevention of stretch marks

Needless to say, there are those who have never experienced stretch marks at all and have no idea what it means to use special skin care creams on the stomach during pregnancy. If by the end of the second trimester a woman has not found a single red stripe on her body, this does not mean that they will bypass her in the third trimester. It is advisable to use oils containing vitamin E or A (for example, olive) for the purpose of prevention. The sensations from gently stroking the abdomen can provoke response movements of the fetus or tone of the uterus, so hand movements should be careful, not putting strong pressure on the abdomen.

It has been noted that in women who engage in active sports, they maintain a toned figure, and the abdominal muscles are more resistant to stress during pregnancy. As a rule, they are less likely to experience the appearance of stretch marks not only on the stomach, but also on the hips and chest. This is also facilitated by proper nutrition, abstinence from alcohol and smoking abuse, and a stable weight. If metabolic processes in the body proceed without any deviations, then skin restoration occurs faster.

What to do.

• If you are planning to breastfeed your baby, then at this time it is necessary to take measures to prepare your breasts for feeding; consult your doctor for professional advice.
• To avoid swelling or at least reduce its manifestation, it is recommended to raise your legs higher in a sitting or lying position, for comfort, place a pillow or bolster under your legs.
• To improve your well-being, you need to regularly do gymnastics for pregnant women, breathing exercises, and relaxation, but do not overdo it.

Pigment strip

Changes in hormonal levels can be seen with the naked eye when, in the second trimester, due to the active growth of the fetus, the abdomen increases. If you look at a photo of the belly at 6 months of pregnancy, you will notice that this strip does not spoil the appearance at all. In approximately 90% of pregnant women at this stage it has either already appeared or becomes more noticeable. Although there is a chance that it will not appear at all (this happens in 10% of women). Outwardly, it seems to divide the stomach in half with a vertical line.

In some it stretches from the navel down to the pubic bone, in others it continues to the diaphragm. It has been noticed that in dark-skinned women, as well as those who are prone to pigmentation, it is brighter. It is almost impossible to prevent its occurrence. The reason for this is the production of melanin, which turns the white line of the abdomen dark. This is the tendon that connects the symmetrical abdominal muscles in the middle. In the normal state, when a woman is not pregnant, its color is white and invisible to the naked eye. When carrying a baby, the production of hormones in the body changes and it turns light brown. The longer the term and the closer the due date, the darker it becomes.

The length and width of the pigment stripe is purely individual and does not depend on gender or the number of children. You can avoid long periods of exposure to the open sun and wear closed clothing. This will reduce pigmentation and the strip will be lighter. It is also believed that the intensity of its color is influenced by the content of folic acid in the body of a pregnant woman. If there is a shortage of it, the stripe will be brighter.

What happens to the body in the 6th month

The figure of the expectant mother is changing significantly - the tummy has already grown significantly, and the waist has become smoother, the back has bent forward, movements have become leisurely and smooth, and an increase in body weight is already felt, familiar things have become small, and synthetic elements of clothing can cause discomfort and sweating.

This means that you will need to update your usual wardrobe and purchase more spacious and comfortable items and underwear made from natural and breathable materials (cotton, linen, knitwear). In the summer, a woman may have a hard time with heat and stuffy rooms; she should spend more time in the fresh air and in the cool to avoid hypoxia.

You need to set aside time for yourself to rest, avoid standing on your feet for long periods of time and avoid looking in uncomfortable positions, and reduce the time you spend at the computer. Gymnastics for pregnant women and physical activity, breathing exercises and training for the upcoming birth will be useful; this will help maintain emotional and physical tone.

Now the belly and chest are actively growing, weight is gaining and you need to make sure that dryness, itching of the skin and stretch marks do not occur. It is worth treating the skin with special products against stretch marks and moisturizing and nourishing it.

In a month, the fundus of the uterus will rise by four to five centimeters and reach a height of 28-29 cm from the pubis; now the uterus is increasing the thickness of its walls and stretching due to the active growth of the fetus, which has completely occupied its entire cavity.

Now the weight gain has become significant, and it will continue until the end of pregnancy, but the weight will be smoothly and evenly distributed throughout the body. It is important to weigh yourself regularly and monitor your gains; they should not deviate too much from the norm, and this should be done once a week, in the morning, on an empty stomach, wearing only underwear. The average increase should be 500g per month, by the end of the month a total of up to 8 kg of weight will be added, depending on the initial weight and build. If there are excessive increases, tell your doctor - this is a risk factor for pregnancy complications, late toxicosis and edema.

During this period, the level of blood cholesterol increases, from which the synthesis of sex hormones and substances necessary for the fetus occurs, this does not threaten the woman in any way, and there is no need to worry about this, everything is under control.

If your stomach hurts?

Doctors recommend being attentive if you experience any unpleasant symptoms, in particular those accompanied by pain. They are not always associated with the risk of premature birth or deterioration in the health of the expectant mother. It happens that when a child moves, he touches internal organs and this causes pain. Also, one should not exclude cases when a woman has problems with bowel function. Most often this is due to constipation or gas. You can solve the problem by establishing proper nutrition, and you should also drink enough clean drinking water (about 1.5-2 liters per day).

However, you should be wary if at 6 months of pregnancy your stomach feels tight, it becomes tense and stiff. This may indicate uterine tone or even training contractions. Doctors recommend taking a No-shpy tablet or using a Papaverine suppository. If there are no other symptoms (brown or bloody discharge, leakage of water), then these medications should help and the pain will subside. Otherwise, you will need to contact a doctor or call an ambulance.

Possible problems of the sixth month

Despite the fact that in general the second trimester is not characterized by any specific problems, the beginnings of those that will manifest themselves in full force later may already appear now. What do doctors fear at this time? In the second half of pregnancy, the cervix begins to receive increasing loads, so this time is often marked by the organization of its support; the body is completely rebuilt into a pregnant state, so some women, especially those who are prone to this, experience the first signs of specific “pregnant” diseases - preeclampsia and gestational diabetes mellitus, anemia of pregnant women. So, the possible problems of the sixth month are:

• ICI (isthmic-cervical insufficiency) - incompetence of the cervix, is eliminated surgically (suturing) or using special devices (pessaries); ICN is also associated with the threat of premature birth at the period under consideration;
• gestosis is a complex of disorders that initially manifests itself as an increase in edema, blood pressure, protein in the urine and which results towards the end of pregnancy in disruption of the functioning of all systems and organs (it is treated only symptomatically, doctors try to prolong the pregnancy as long as possible, in critical cases they perform an emergency delivery) ;
• problems of the placenta (not very typical for the period under consideration) - fetoplacental insufficiency, premature aging, which entails delayed development of the fetus, its oxygen starvation; pregnancy is supported with medication until the maximum possible time;
• placental abruption is an emergency condition, at this stage most often associated with injuries - depending on the degree of abruption, pregnancy can either persist or be urgently terminated;
• Leakage of amniotic fluid is a violation of the integrity of the amniotic sac under the influence of infection, injury, etc. This is rare at this stage, but the forecasts in this case are much less optimistic than in later stages. Pregnancy can be maintained for some time, but we will still be talking about a very early delivery.

Among the “ordinary” situations of the sixth month that can be corrected on an outpatient basis are:

• anemia (women are prescribed iron supplements);
• genital tract infections characteristic of the entire period of pregnancy (prescribe medications appropriate to the infectious agent);
• viral and bacterial infections not related to the reproductive organs - acute respiratory viral infections, acute respiratory infections, otitis media, tonsillitis, etc. In the sixth month, the choice of medications for a pregnant woman expands significantly, however, only a doctor can prescribe treatment.

What symptoms should you pay attention to?

Pregnant women are extremely suspicious people: any, even the most minor, hitherto uncharacteristic symptoms can cause them to panic. In a sense, this is the right quality. However, it is better to know which “oddities” of the body should be perceived calmly, as natural, and which ones should be brought to the attention of a doctor. So, you should sound the alarm when:

• the appearance of red (brown) vaginal discharge - this may be a sign of placental abruption;
• the appearance of clear liquid discharge in a significant amount - this may be leakage of amniotic fluid;
• detection of regular painful contractions of the uterus (should be distinguished from painless and irregular training, false contractions - they are a variant of the norm) - a sign of the onset of premature labor;
• the absence of the baby’s movements for a long time (days) is a sign of fading pregnancy;
• a sharp deterioration in health (sharp pain anywhere, pre-fainting and fainting, nausea, vomiting, weakness, etc.) - may indicate any dangerous condition, even not related to pregnancy.

If you detect: uncharacteristic (but not red or profuse) discharge from the genitals; not very disturbing, nagging pain in tissues and ligaments when moving; minor changes in condition (weakness, swelling, constipation, etc.); false contractions (if there were none before); changes in the child’s activity - you should bring this to the attention of the attending physician at your next appointment.

What tests should be taken at 6 months?

During your next visit to the gynecologist, he will definitely measure your abdominal circumference. At 5-6 months of pregnancy, they also undergo another ultrasound examination, a urine test, and, if necessary, a general blood test. In order to eliminate the risk of developing placental insufficiency, a Doppler ultrasound examination may be prescribed. Since the baby is actively growing, starting from the 20th week, the gynecologist listens to the fetal heartbeat through the mother’s abdomen using a special obstetric stethoscope. This way the doctor can determine what position the child is in.

Any other tests are prescribed strictly according to indications, as well as in the presence of complaints or chronic diseases of the mother that existed before pregnancy. Of course, if there are complaints, for example, if your stomach hurts during the 6th month of pregnancy, your doctor may recommend a urine test or an ultrasound scan to rule out abnormalities in kidney function.

What does a baby look like in the sixth month of pregnancy?

At the end of the 6th, beginning of the 7th month, the development of the brain section occurs, which is responsible for the consciousness and thinking of the child. This period is a developing period for the baby's personality. The baby may simply suck his thumb, or he may swallow amniotic fluid, and if he swallows a lot of liquid, hiccups may occur. Fluid will be removed from the baby’s body along with urine. Before birth, the child begins to prepare his body, he develops his lungs, this happens with the help of chest breathing exercises. By the 28th week, the baby has taste buds. At this time, the child already feels where is bitter, where is sweet, and where is salty.