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Welcome To Week 22


3 Week Old Embryo

Your Baby: The Eyes Have It
Your fetus weighs about 12-13 ounces (350 g) and measures 7.5-8 inches (19 cm) in length. Your baby is really starting to look like a baby now! Now the fetus's senses are becoming more defined with taste buds being complete. Additionally, the nerve endings have been developed enough at this point for the fetus to feel things using her hands. If you could watch, you would see more movement and even to the extent of feeling other parts of her body. The baby has complete eyebrows and eyelids now.

Your Body: A Is For Anemia

What is it? Anemia is a condition in which you have too few red blood cells, requiring your body to boost its iron stores to help produce them. In your pre-pregnancy state, you needed a daily dose of about 15 milligrams of iron. Thanks to your growing fetus, you now require about 30.

How is it diagnosed? Your caregiver can spot anemia with a blood test, which she may give at your first prenatal visit. Most women pass this initial check for iron deficiency with flying colors. In fact, the majority of expectant mothers start off pregnancy with enough iron stores to last until week 20. At that point in your pregnancy, your blood volume increases tremendously and with the increased volume often the hemoglobin (part of the cell that carries the iron) in your blood stream drops. This can cause a dramatic drop and some doctors may recommend that you take an iron supplement earlier so that anemia can be prevented rather than diagnosing it and having to treat it afterwards.

Women with severe nausea and vomiting early on in their pregnancy, carrying more than one baby, on an inadequate diet with no iron supplement, or who have had another baby relatively recent to this pregnancy are all at higher risk for anemia.

Since the symptoms related to anemia often occur normally as a result of pregnancy, it is often not easily identified from symptoms alone. However, the symptoms that accompany anemia include: feeling very tired all the time, shortness of breath, dizziness, and exhaustion.

Effective treatment for anemia is generally taking an iron supplement orally. Women that are unable to tolerate oral iron will be given iron through their vein. Increasing the iron in your diet will also be encouraged. If the anemia is severe and was coupled with any kind of blood loss, then you might need a blood transfusion (this is unusual).

If you don't receive treatment for anemia while you are pregnant, there is a risk for premature labor and delivery. It is definitely more dangerous to you due to the normal blood loss that takes place during the delivery. If you are anemic and lose more blood during the delivery, you could have potential problems post delivery from severe anemia.

The bottom line is to avoid anemia during pregnancy by being proactive with your diet and iron supplements. If you are diagnosed with anemia during your pregnancy, often increasing your intake of iron easily treats it. An easy solution is to take care of yourself and go to all of your prenatal visits.

On a Different Note: Looking Into Labor And Delivery

With 22 weeks down and 18 more to go, it's time to start thinking about labor and delivery. Check out the signs of labor to learn the ins and outs (and do's and don'ts) of the birthing process.

The Three Stages Of Labor

Labor is described in three stages, and together these stages complete the delivery and the passage of the placenta.

Stage One
The first stage is the process of reaching full cervical dilatation. This begins with the onset of uterine labor contractions, and it is the longest phase of labor. The first stage is divided into three phases: latent, active, and deceleration.

  • In the latent phase, the contractions become more frequent, stronger, and gain regularity, and most of the change of the cervix involves thinning, or effacement. The latent phase is the most variable from woman to woman, and from labor to labor. It may take a few days, or be as short as a few hours. We typically expect the latent phase to be 10 to 12 hours for a woman who has had children. For first pregnancies, it may last closer to 20 hours. For many women, the latent phase of labor can be confused with Braxton Hicks contractions. Membranes may spontaneously rupture in the early- to mid-portion of the first stage of labor. If they rupture, the labor process usually speeds up.

  • The next portion of the first stage of labor is the active phase, which is the phase of the most rapid cervical dilatation. For most women this is from 3 to 4 centimeters of dilatation until 8 to 9 centimeters of dilatation. The active phase is the most predictable, lasting an average of five hours in first-time mothers and two hours in mothers who have birthed before.

  • Finally, there is the deceleration phase, during which the cervical dilation continues, but at a slower pace, until full dilation. In some women the deceleration phase is not really noticeable, blending into the active phase. This is also a phase of more rapid descent, when the baby is passing lower into the pelvis and deeper into the birth canal. The deceleration phase is also called transition, and, in mothers with no anesthesia, it's often punctuated by vomiting and uncontrollable shaking. These symptoms can be frightening to watch, but they're a part of normal birth, and they signal that the first state is almost completed.

Stage Two
The second stage is the delivery of the infant. During the second stage, mom actively pushes out the baby. For first time mothers, this can take two to three hours, so it's important to save your energy and pace yourself. For second babies and beyond, the second stage often lasts less than an hour – and sometimes, only a few minutes.

Stage Three
The third stage of labor is the passage of the placenta, which can be immediate, or take up to thirty minutes. The process may be sped up naturally by breastfeeding (which releases oxytocin), or medically by administering a drug called pitocin.

Weekly Tip
Iron can be tricky for your system to assimilate. To make sure your body absorbs enough of this important mineral, take your iron pills with your morning OJ or other vitamin C-rich foods. Be sure to steer clear of caffeine, which blocks iron absorption. If your iron supplement makes you constipated, talk to your caregiver about safe ways to loosen things up.

Review Date: July 23, 2001
Reviewed By: Victoria Kennedy, RN, A.D.A.M. editorial.


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