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Month 4

You are hitting your stride at this pregnancy thing, mama! As your fourth month of pregnancy begins, nausea and fatigue should be on the decline, or will have completely ended. The risk of miscarriage has also dropped, and you might feel more confident sharing your big news with friends and family. You may even notice that a little "baby bump" has appeared.

Your Baby

Ready for the best case of the butterflies you've ever experienced? At some point over the next few weeks, you should begin to feel your baby's first fetal movements, a moment called "quickening," often described by moms-to-be as the feeling of tiny flutters, tapping or bubbles. At first, it's can be difficult to tell whether what you're feeling is gas or your baby's movements, but as time passes, you will soon begin to notice a pattern.

Other big changes taking place this month?

  • Your baby's mouth begins making sucking motions, probably to prepare for breastfeeding.
  • Amniotic fluid is routinely swallowed and passed as urine by your baby, the main supplier of its amniotic fluid.
  • Your baby measures about 4¾ inches long from crown to rump, and weighs approximately 3 1/2 ounces.

Your Body

Is your appetite finally back? "If you had to alter your diet or decrease your activity level earlier in pregnancy because of nausea or fatigue, now is a good time to focus on healthy meals and snacks and keeping active," recommends Kelly Kasper, M.D., Obstetrics & Gynecology at Indiana University Health. Staying active throughout pregnancy will also make labor, delivery and recovery easier, she adds. Ask your doctor or midwife if exercising during your pregnancy is safe.

Other changes you might notice this month:

  • Your nipples and areolae (the darker skin around the nipple) become even darker.
  • Though less tender than in the first trimester, your breasts continue to grow in size.
  • Your uterus stretches to about 1½ inches below your belly button and is the size of a cantaloupe.

One pregnancy-related change you want to avoid? Varicose veins. As your uterus expands and your baby grows, the added weight presses down on your leg veins. If your leg veins bulge, put your feet up when you can, go for walks to improve blood flow and ask your provider about wearing support stockings. Eating vitamin C-rich foods can also help, as vitamin C assists with healthy circulation.

Things to Start Thinking About

Prenatal Testing: Sometime in the next five weeks, you'll be offered a blood test to help screen for Down syndrome. You might also be offered amniocentesis, which tests a small sample of amniotic fluid withdrawn by an ultrasound guided needle. Should you have these tests performed? To get answers, this is a great conversation to have with your prenatal care provider at your next appointment.

Boost Your Iron Intake: As your body steps up blood production during pregnancy, you need more of the ingredients that make up blood, including iron! To boost iron content in your prenatal diet, "Eat lean red meats, leafy green vegetables, whole grain breads, dried fruits and beans," recommends Lizellen La Follette, M.D., OB-GYN at Marin General Hospital in Greenbrae, Calif. Pregnant women are at higher risk for anemia. Your OB or midwife may suggest having your iron levels tested to see if you need an additional iron supplement.


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