Your second trimester, which occurs between weeks 13 and 16, begins when you’re 4 months pregnant. At this stage, you may go through many emotional and physical changes. You may also feel more energetic, and your risk of having a miscarriage will decrease by this month. This post explains the symptoms you may experience in this month, how big your belly may become, your baby’s development, diet tips, what you can expect when you visit your doctor, and some measures to keep yourself healthy. It also addresses some common concerns you should look out for in the fourth month of gestation.

What Symptoms Do You Experience In The Fourth Month Of Pregnancy?

As you enter the fourth month, most side effects of the first trimester reduce and new symptoms and changes occur (1) (2):

Constipation: The increasing progesterone levels alter the digestion process, causing delayed bowel movements and constipation. Drinking lots of water and including a high fiber diet could alleviate this discomfort and ease digestion. Adding olive oil to your salad and prune to your diet can be helpful. If it is a normal, uncomplicated pregnancy, walking 30 minutes a day is a good way for constipation relief.

Frequent urination: Your expanding uterus applies additional pressure on the bladder. You might, therefore, have a frequent urge to urinate. If there is a fever or pain during urination or lower abdominal pain,consult with your doctor.

Shortness of breath: Your growing belly may also apply pressure on the lungs, making it difficult to breathe properly. It is, therefore, common to experience shortness of breath or rapid breathing. If this condition limits your activities, you need to visit a cardiologist.

Heartburn: With the growing bump, there is additional pressure on the digestive system. This could also push the stomach acids upward, causing heartburn. Dietary changes can help reduce the stress on the digestive tract.  Dr. Kimberly Langdon, a US-based obstetrician/gynecologist, says, “Nausea subsides in the fourth month of pregnancy, causing expecting mothers to eat more than they should. However, heartburn and other digestive issues such as constipation occur during this time. To avoid discomfort, it is best to eat small, frequent meals rather than indulging all at once.”

Bleeding gums: Pregnancy hormones soften the gums and increase their sensitivity. This would cause bruising and bleeding while brushing the teeth. Always check with your doctor.

Nosebleeds: Increased blood supply in the nose puts more pressure on the tiny blood vessels inside the nose. This may make them more susceptible to rupture, resulting in a nosebleed.

Morning sickness: Although common in the first trimester, nausea and vomiting can be experienced in the later months of pregnancy too. Vaginal discharge: Hormonal changes in the body may also lead to increased white vaginal discharge.

Body Changes During Fourth Month Of Pregnancy

The most evident change you notice is a bigger belly or a visible baby bump. Here are the other physical changes you may notice in the 4th month.

Skin changes: Your skin is also likely to undergo some changes during pregnancy. The increasing pregnancy hormones could cause blotchy skin in some. Take care of the skin using mild cleansers, moisturizers, and lotions.

Breast changes: From the beginning of the fourth month, the nipples and areola are likely to become darker. Also, the veins will become more prominent as the blood circulation increases.

Edema: Swelling in the feet and ankles is likely to develop from the fourth month of pregnancy that may last until your due date. Taking frequent breaks in between and avoiding standing or sitting for extended periods can help alleviate the swelling. If there is significant edema of face and hands, you should visit your doctor.

Varicose veins: Increased blood volume in the body can enlarge the veins in the legs, thus causing varicose veins.

There is no need to worry about these mild changes, as they are common during this time of pregnancy.

How Big Is Your Belly In The Fourth Month?

By the end of the fourth month of pregnancy, your uterus is about the size of a head of cabbage. The top of the uterus lies below the belly button.

Baby’s Development In The Fourth Month Of Pregnancy

While you experience the above changes, your developing baby also undergoes many changes that are listed below (3) (4).

How Does A Fourth Month Baby Look Like In The Womb?

By the fourth month, your baby is the size of a large orange that weighs about six ounces and measures 6 to 7 inches in length (5).

Baby’s Movement In The Fourth Month

The baby tends to move four or more times in an hour at this stage. You may feel the movements as light sensations along your lower abdomen. They are called quickening movements and are similar to a fluttering or bubbling in the abdomen (5). Women feel these movements later when they are in their first pregnancies than women with second or subsequent pregnancy.

What Do You Need To Know In Your Fourth Month Of Pregnancy?

Here are a few things to remember as you enter into your second trimester (6).

Dos During The 4th Month Of Pregnancy

Continue to perform regular exercises after the doctor’s approval. Go for regular walks, yoga, swimming, or any other workout of your choice to promote safe and easy delivery.

Sleep on your left side, using cushions around your side and between your legs for comfort. It could also improve blood circulation to the developing fetus.

Nosebleeds, stuffy nose, and blocked ears are common during the 4th month. Carry enough tissues and keep the needed medication with you at all times.

Buy some maternity clothes as your abdominal muscles start to stretch rapidly. Your regular clothes could be tight and uncomfortable now.

Indulge in sex as maintaining intimacy with your partner is very important. However, take your doctor’s advice beforehand.

Go for a regular dental check-up to avoid oral complications with bleeding gums.

Don’ts During The 4th Month Of Pregnancy

Stay away from alcohol as the fetus could get fetal alcohol syndrome (FAS).

Avoid cleaning cat litter as it could increase the risk of allergies and toxoplasmosis.

Do not use hot tub baths or saunas as high temperatures might be dangerous for the growing fetus.

Quit smoking as those who smoke are likely to give birth to low weight babies that are at a higher risk of disabilities.

Diet Tips For The 4th Month

Be careful of what you eat and how much you include. Include enough vitamins and supplements in your diet since the growing baby requires proper nourishment (7).

Include iron-rich foods such as fish, meat, liver, tofu, soybeans, nuts and seeds, brown rice, dark green leafy vegetables, eggs, and dried fruits. They help in meeting the increasing iron requirement.

Eat fiber-rich foods such as oatmeal, barley, flaxseeds, chia seeds, almonds, pistachios, pecans, broccoli, green peas, sweet corn, raspberries, strawberries, apples, bananas, figs, and pears.

Calcium foods, including milk, yogurt, cheese, kale, watercress, okra, broccoli, and almonds, are essential for fetal bone development.

Zinc-rich foods include lamb, beef, wheat germ, spinach, mushrooms, squash, and pumpkin seeds. They help in the development of a healthy immune and nervous system.

Vitamin C foods include bell peppers, sweet potatoes, tomatoes, cauliflower, broccoli, leafy greens, and cabbage. It is a key nutrient for iron absorption.

Have foods rich in omega fatty acids, including vegetable oils, soybeans, walnuts, almonds, sardines, chia, and flax seeds.

Have at least five portions of fruits and vegetables every day.

Include protein foods such as nuts, seeds, legumes, meat, chicken, soybeans and quinoa, and carbohydrates, including rice, bread, pasta, and potatoes.

Avoid refined flour (Maida) as it can increase blood sugar levels.

Avoid ocean fish such as king mackerel, white tuna, and swordfish that contain mercury. Include freshwater fish (trout and salmon).

Avoid soft cheeses (Brie) and blue cheese (camembert) as they might cause food listeria poisoning. Include only hard cheeses such as cheddar and parmesan.

Do not include raw or undercooked eggs. Eat only properly cooked or pasteurized eggs.

Avoid having excess tea or coffee as overindulging in caffeine is harmful.

Drink enough water – pregnant women need to have at least two to three liters of water every day. Avoid spicy foods, fried foods, and foods containing excessive salts and sugars.

What To Expect During Your Visit To OB/GYN?

You should visit your doctor more frequently from the fourth month to check up on the health and development of the baby. Your doctor will usually recommend the following tests (4) (8).

Physical examination: Your weight and blood pressure are checked. Also, parts such as the breasts, abdomen, and vagina are examined.

Ultrasound scan: This is conducted to analyze the baby’s development.

Heartbeat: Doppler ultrasound is used to check the fetal heartbeat.

Alpha-fetoprotein screening: This is done around 16 weeks of pregnancy to screen the presence of Down’s syndrome or spina bifida. But there are more accurate tests that can be done as early as eight to nine weeks of pregnancy. Always ask your doctor.

Triple test: Also referred to as Bart’s test, triple test screens for hormones such as estriol and hCG in the blood

Edema test: The measure of swelling is examined as abnormal swelling indicates gestational diabetes, preeclampsia, or blood clotting.

Ultrasound During The Fourth Month

The ultrasound scanning determines the fetal gender as external genitals would have developed by this stage (9). It can also show the facial features the baby had developed, including the forehead, eyes, and nose. It could, therefore, determine the major physical defects in the baby.

What Are The Common Concerns During The Fourth Month Pregnancy?

Certain changes can be worrisome for you and your partner. To better understand them, discuss it with your doctor sooner.

An increase in appetite and weight gain is common, and also your likes and dislikes for foods may change starting from this period.

Constipation and heartburn are common, but you should consult your doctor before using any medicine for it.

You should be careful with sex if you have a history of high-risk pregnancy or a miscarriage.

Tips For Dads-To-Be

The dad-to-be also has to do certain things to understand what the pregnant mom is going through. A few things he can do include:

Help with household chores, as it might get difficult for you to manage home and work.

Understanding the physiological and psychological changes that you go through. Understand how the baby progresses over the period and talk to your doctor for any suggestions.

Communicate with your partner to ensure you are both on the same page about the pregnancy. Discuss with other dads or dads-to-be about his fears and feelings and get some helpful tips.

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