Move Baby Move

Week 21

Estimated reading time: 4 min reads

Your baby’s is staying awake longer and you will most likely notice increased activity. All of your baby’s main systems have matured and are working in preparation for sustaining a healthy baby on delivery day.

Swallowing, the beginning of taste buds forming, and your baby actually being able to taste may start this week. Now your baby’s digestive system is taking shape and the digestive organs will begin doing their jobs as sugars begin to pass through them. Your baby will swallow the watery amniotic solution and absorb tiny quantities of sugar present in the fluid which makes up a small portion of baby’s needed sustenance. The amniotic fluid surrounding your baby is in a daily state of flux depending on what you are consuming. As your baby ingests this fluid, the flavor of your diet will be experienced by your baby!  Although lots of exciting developments are taking place in your baby’s digestive system, it’s important to remember that your baby’s main nourishment and nutrition is transported via the placenta and umbilical cord.

The function of making your baby’s blood cells is now the duty of the bone marrow. Neurons attaching to your baby’s brain are building so muscles are becoming stronger. The movements of your baby are now further synchronized. As your baby’s gets closer to delivery day, little arms and legs are more and more balanced.

Although only about 7 inches in length, the length of a vivid orange carrot, your baby is all set to gain more weight in the weeks ahead, weighing approximately 11 ounces at the end of this week.

Fundal Height

As the end of your second trimester approaches, keep a check on your baby’s growth measurements. Fundal height measurements, EPV, or estimated weight with ultrasound performed monthly will let you and your team know if the placenta is supplying adequate nourishment for your baby.

Mayo Clinic Obstetrician and Medical Editor-in-Chief, Dr. Roger W. Harms, explains that fundal height is measured from the top of the uterus down to the pubic bone. Once you have entered the second trimester, your fundal height measurement will usually equal your gestational week. So, if you are in your 28th week, your health care team will anticipate your fundal height to measure approximately 28 centimeters. 

Keep in mind, although fundal height is a means for estimating your baby’s fetal development, as well as gestational age, it is not a precise measurement and it is not uncommon to gauge your baby’s fundal height smaller or larger than anticipated. Depending on your height, stature or frame, if your bladder is empty or full, or if you are pregnant with twins or multiples, you may see differences in your fundal height. However, also keep in mind that a faster or slower rate may also be due to growth restriction which is rapid or slow, his or her amniotic fluid, fibroids of the uterus, baby’s descent into the pelvis before time, or baby’s unusual positioning such as a breech presentation.

Usually, fundal height measurements reassure your health care team of your baby’s growth. If you’re concerned about your fundal height measurements, ask your health care provider for specific details. Your health care team may recommend an ultrasound or other tests to determine the cause of an atypical measurement.

Professor Jason Gardosi, MD, FRCSED, FRCOG, Director of the Perinatal Institute, Birmingham, England, has developed the Growth Assisted Protocol (GAP) program based on the motivating principle that many instances of adverse perinatal outcomes of pregnancy are potentially avoidable.

Every mom using this program has a Gestation Related Optimal Weight (GROW) chart for her baby calculated by combining mom’s height, weight, ethnic origin and previous pregnancies at the beginning of her pregnancy.

This chart will predict the growth of mom’s expected baby week by week. By measuring the fundal height, if the baby’s growth falls outside the anticipated “norm” for mom’s predicted growth chart, additional ultrasounds will be ordered to insure that the baby is thriving. Professor Gardosi’s protocol includes 4-5 ultrasounds from Week 28 onwards.

If the ultrasound results indicate the baby needs help, he or she can be treated in the womb. However when careful monitoring shows the baby is still stressed, an early delivery will be performed. To learn more about Professor Gardosi’s GAP program and the importance of fundal height, visit the Perinatal Institute.

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