Pregnancy in the 22nd week

By the time the 22nd week of pregnancy arrives, your baby should be approximately 27.8cm from head to toe, and that’s about as big as a papaya. Your baby is clearly developing rapidly now, with all his or her senses becoming more active. 

Not only can your baby respond to stimuli like noise by moving about in the womb, but because his or her taste buds are developing, you should be even more aware of what you’re eating. For example, if you consume too much sugar, this is the time when this secondhand sugar will start affecting your baby’s taste buds. 

Your baby’s lungs are developing quickly now, and he or she is also passing a whitish poo into the amniotic fluid. The eyes are fully formed by now, but the irises don’t have any pigmentation yet and the eyes will remain closed. The baby’s skin might still be quite wrinkly, but as the pregnancy progresses he or she will gain more weight and this skin will fill out properly.

Most women enjoy having a bigger baby bump around the 22nd week of pregnancy. If you find yourself naturally cradling your womb or stroking it, don’t be surprised - those are just your maternal instincts to protect and caress your baby at play here. Stretch marks on both the belly and the breasts are quite normal during pregnancy, and there’s not much you can do about them now.

Read more: How to remove stretch marks

If coping with breasts that have grown larger in size and feel fuller wasn’t enough, you might even start noticing them leak a bit occasionally. This indicates that your breasts are preparing for the arrival of your baby. Braxton Hicks contractions, which might also appear during this week if they’re early, also indicate something similar - that your uterus is preparing for delivery slowly but surely. These contractions are nothing to worry about, but if they increase in intensity or frequency, you should call your doctor immediately.

The second trimester is known as the most comfortable of all three trimesters of pregnancy. While this may be largely true, the 22nd week of pregnancy will still have a number of symptoms that may show up and cause some discomfort. The following are some of the most common symptoms that may show up this week.

• Sciatic nerve pain: The sciatic nerve is the largest in the body, and runs under the uterus and right down both the legs. With the added weight and pressure of the growing baby on this nerve, the sciatic nerve can swell up and get inflamed. As a result, it’s normal to experience sciatic pain during pregnancy.
• Varicose veins: The inferior vena cava and other veins in the lower half of the human body accomplish the gravity-defying act of carrying deoxygenated blood back to the heart all the way from your toes and legs. Due to weight gain and pressure on these veins during pregnancy, these veins swell up, twist and hurt a lot, leading to varicose veins during pregnancy. These varicose veins are mostly located in the legs, vulva and the rectum - which is also known as haemorrhoids - and these can be unsightly as well as painful symptoms of pregnancy.
• Round ligament pain: As your belly stretches to accommodate your growing baby, the muscles and ligaments of the abdomen will be put to work, even strain, during the second and third trimesters. This can cause round ligament pain, which is the most common complaint during pregnancy. This pain usually occurs on one side or all around the belly, and can be managed easily.
• Braxton Hicks contractions: Although most commonly experienced during the third trimester of pregnancy, Braxton Hicks contractions can start early and show up in the second trimester as well. When these contractions occur, your uterus muscles can tighten for 30 or 60 seconds - the contractions might even last for up to two minutes. Although harmless, you should definitely consult your doctor if these contractions show up, intensify in pain and in frequency.
• Sleep issues: With so many symptoms of pregnancy showing up - and especially with your baby’s movements increasing by the day - sleep problems are bound to come up. Backache, leg or limb pain, leg cramps, indigestion, heartburn, constipation during pregnancy, frequent urination, etc., can make getting a good night’s sleep very difficult, which in turn can cause exhaustion, fatigue and lack of concentration. 
• Fatigue: Fatigue is one of the most common symptoms of pregnancy and tends to intensify as the delivery date approaches. This is because the weight of the baby and the size of the belly continue to increase throughout the pregnancy, and might become exhausting to manage from the second half of the second trimester. Add to this the exhaustion from the other symptoms you have to deal with, and fatigue is quite normal.
• Melasma: Also known as chloasma or the mask of pregnancy, melasmas refer to the symmetrical dark patches that appear on the faces of many women during pregnancy. These patches usually appear due to hormonal changes in your body during pregnancy, but melasmas are nothing to worry about. As your hormonal levels go back to normal after delivery, the melasmas will also gradually disappear. 
• Other symptoms: Heartburn, indigestion, bloating, constipation, sore breasts as your body prepares for breastfeeding, bleeding gums, swollen gums, headaches, nosebleed and mood swings are all symptoms of pregnancy that you would’ve gotten used to by the 22nd week of pregnancy, because these are basically continuing since the first trimester. However, if any of these symptoms get worse, you should consult with your doctor about the next steps.

Quite a few of the complications of pregnancy are out of your control, but if you see the early signs of these and report them to a doctor as soon as possible, it can minimize the risks to both your life and that of your baby. The following are some of the complications that might show up in the 22nd week of pregnancy:

• Stillbirth: According to the Indian health ministry, stillbirth is the “complete expulsion or extraction of baby from its mother where the fetus does not breathe or show any evidence of life, such as beating of the heart or a cry or movement of the limbs”. The causes can vary from maternal infections and health disorders like high blood pressure to birth defects.
• Hypertensive diseases: Moms-to-be can get high blood pressure (BP). This needs to be monitored regularly, as it can have a negative health outcome for the mom and baby. For example, high BP in the expecting mom can reduce the availability of oxygen and nutrients to the baby in the womb. It has also been associated with placental abruption, in which the placenta becomes partially or completely detached from the uterus before the due date. Gestational hypertension can also slow down baby development in the womb, and lead to other problems such as going into premature labour and low birth weight (under 2.5 kilograms) of the baby.
• Pre-eclampsia: This is a condition in which high blood pressure after the 20th week of pregnancy threatens organ damage in the mother and reduces the supply of oxygen and nutrients to the baby. Pre-eclampsia is potentially life-threatening. Getting regular health checkups and blood pressure monitoring can help in early detection and treatment. Eclampsia, a complication of preeclampsia, can cause seizures. However, there’s no reason to panic. Going for regular checkups will help to alert your doctor, in case there are any conditions that need to be closely monitored. (Read more: How to use a blood pressure machine)
• Subchorionic haemorrhage: This type of bleeding occurs when the original connection between the placenta and the uterus is affected, though not completely broken (placental abruption). This occurs in over 3% of pregnancies. Usually safe in the early stages of the first trimester, this type of bleeding should not be ignored later in the pregnancy. Your doctor may be able to diagnose this during your routine ultrasound, even if you don’t notice any bleeding. If you are diagnosed with this condition, your doctor may prescribe progesterone and bedrest to improve the outcome for you and your baby.
• Infections: Pregnant women are more prone to some infections, like bacterial vaginosis and urinary tract infection or UTI. It is important to tell your doctor early on about signs like itching or abnormal discharge from the vagina and get treatment as soon as possible.
  Infections typically cause a fever: a normal occurrence as your body fights the pathogen. A rise in body temperature during pregnancy, however, can be harmful to your health as well as your baby’s. (Read more: How to naturally reduce your body temperature during pregnancy)
• Obstetric cholestasis: A rare condition in which some pregnant women experience persistent itching, usually in their palms and the soles of their feet. Though doctors don’t yet know the exact cause of obstetric cholestasis, they have linked the condition to the effects of pregnancy hormones on the liver. There’s no treatment for this condition, and it usually becomes better on its own after delivery. In the meantime, if the itching gets to be too much, ask your doctor for salves to soothe it.

While this might seem like the most comfortable and laidback week of your pregnancy, there are a number of things you should get done or start doing during the 22nd week of your pregnancy. Here’s a list you can use to get these important things done:

• Consult your doctor and start doing pelvic floor exercises. Exercises like Kegels will help you strengthen your pelvic floor and muscles to better carry the weight of your growing baby and aid delivery at the end of your term.
• Do not consume risky foods like raw fish, seafood, undercooked chicken, processed meats, junk food, etc. Some of these can cause infections like salmonellosis and listeriosis, while others can shoot up your sugar and sodium levels.
• Wear comfortable, loose maternity clothes and avoid high heels completely. Do not take it for granted that wearing your old bra is good enough during pregnancy. Try to get fitted for a proper maternity bra.
• If you’re a working woman, discuss maternity benefits and leaves with your managers and the human resources team this week.
• Prioritise your physical and mental well-being above everything else. If you do well, so will your baby.

Following the most appropriate prenatal care routine that you can manage is the best thing to do during pregnancy. Diet, exercise, rest and sleep are integral parts of this system, to ensure your health as well as that of your baby. It’s also important to build a good support system of spouse, family and friends - this can help you manage the pregnancy as well as early childcare phases better. What’s more, the more people you have to socialise with and depend upon, the more your chances of avoiding depression during pregnancy as well as postpartum depression.

This is also partially the reason why you should always keep the communication channels open between you and your doctor. Your gynaecologist clearly wants the best outcomes for you and your baby, so follow their advice and do not take any medications without consulting them. The most important thing you need to remember this week is that while staying active is in your best interest, strenuous activities should be avoided and proper rest should be taken.