Welcome to the so-called “quiet” months of pregnancy! Welcome to the so-called “quiet” months of pregnancy! Hormone levels in your body have stabilized, and you may feel more like yourself – or even better than usual.

Join a prenatal program

• These programs educate you about diet, exercise and breastfeeding.
• They prepare you for childbirth and parenting.
• They help you overcome fears.
• You learn from others’ experience.

Baby Development 4^th month of pregnancy

• Your baby’s tiny features are making different expressions.
• Beginning of this month, your baby now has exquisite fingerprints and is   almost 3 inches long.
• Hair, eyelids, eyelashes, and nails become well developed.
• The heartbeat is now clearly audible through a Doppler instrument.
• The teeth become denser.
• Baby begins to stretch, yawn and make other movements.
• The reproductive organs are now visible on an ultrasound.
• Baby can suck thumb, yawn, and make super cute faces.
• This is the month when nervous system develops.
• Baby can sense light and is forming taste buds.
• Baby’s skeleton is changing from soft cartilage to bone.
• Baby’s umbilical cord is growing stronger and thicker
• Get ready for a growth spurt. In the next few weeks, your baby will double his weight and add inches to his length.

Mother at 4^th month of pregnancy

Your energy is back, make the most of it by doing exercise regularly, shopping  for maternity clothes, planning your baby’s needs & making room for baby in your home & life. You can enjoy telling people about pregnancy, family members become more involved, because pregnancy feels more “real” now.

• Your nausea, will diminish. Your symptoms may be similar to last month symptoms.
• Your heart is now pumping 20% more blood to supply baby with the oxygen.
• You may be able to feel the baby move for the first time during the fourth month of pregnancy. It will start as a feeling of butterflies in your tummy. These movements are called “quickening”.
• You will feel happy, excited & on top of the world to feel these movements.
• The 4th can bring on new symptoms, like an increased appetite, heartburn, and beginning of some back pain.
• Your uterus will start to rise up into the abdomen, and therefore your urinary frequency should decrease.
• You may have heartburn is that burning feeling caused by acids in your stomach coming up through the esophagus.
• This month, you will feel your clothes getting tighter. By week 16, your waistline will start disappearing.
• Mood swings and depression occur much less frequently during the second trimester.

You’ll see your doctor once a month, unless you have a complaint or complications that call for more frequent check-ups.

 If you notice any vaginal bleeding, tell your provider right away. They may want to examine you and run tests to find the cause.

Heartburn – What happens & What you can do?

Heartburn is usually worse when you are lying down. You can try to avoid heartburn by staying away from spicy or fatty foods, eating small but frequent meals, sleeping propped up in bed at night, and drinking a glass of milk before you go to bed. Your doctor may be able to recommend a suitable antacid for use in pregnancy.

Back pain

You can expect to have back pain as uterus expands to accommodate growing baby. Carrying baby, can affect your posture and strain your back. The relaxation of ligaments in in pelvis, hips & back doesn’t help. Learning about & practicing good posture & some postural exercise will be very helpful in managing back pain.

Vaginal discharge

Throughout pregnancy, you may notice vaginal discharge that varies in color and consistency. Most often this is normal. If there is any change in color, smell or consistency in discharge, consult your doctor.

Weight gain

It’s healthy to gain 350-400 grams weight / week, so about 1 ½ kilos every month. Your doctor will monitor your weight to make sure you’re in a healthy range.

Sex during 4^th & 5^th Month

You may have increased desire, because of increased blood flow and lubrication, but if you’re not up for it, that’s perfectly normal, too.

Plan your work day & work at home

Think of your baby as you are planning to complete some tasks. Remember you  still need more rest now than when you were not pregnant, & the baby inside you needs rest too.
Talking to your partner & family & taking support is useful, believe me they all are concerned & would like to help.

Sleeping position during pregnancy 4^th month:

The best way is always recommended is sleeping by the side. Especially the left side is recommended as it helps blood flow to the fetus. Take a quick nap if you feel tired and schedule naps whenever you can. Set bedtimes and stick to them. You can place a pillow under your belly & knees for an additional comfort

Working mama to be

Remember, office furniture is not made for pregnant women. If you have a desk job, get a pillow for your chair that gives you great back support and helps keep your spine straight.

Take your prenatal vitamins

They contain higher levels of certain nutrients that you require in higher doses, such as:

• Folic acid
• Calcium
• Iron

These vitamins assist with proper development of the fetus and help prevent birth defects. Your doctor prenatal vitamins that are best for you.

Call your doctor if you have:

Bleeding or Spotting

• Vaginal spotting or bleeding –like the start of period – can also be the first sign of miscarriage or be a signal an ectopic pregnancy.
• A little cramp in abdomen pain but if you have cramping along with other symptoms, such as bleeding, or the cramping is severe, it may signal a complication.
• Mild, intermittent pain in your abdomen or pelvis can signal an ectopic pregnancy.

Shortness of breath

During pregnancy, you need more oxygen – and you may feel out of breath.

• Gentle deep breath in through the nose.
• Breathing out slowly & consciously from mouth will help reduce breathlessness.

Your body changes so rapidly during pregnancy that it’s hard to know whether a  new ache or pain or other symptom is normal, or whether you should call your doctor or even head to the emergency room.

Additional tips and suggestions for four months pregnant women:

• Your baby will start kicking at this stage, so keep water around to control the hiccups.
• Use sunscreen when going out in sunny weather, as it might harm your baby.
• Take food well ahead of sleeping time; or it can cause nausea or bloating.
• Take care of your posture when you sleep sit and walk as it will affect comfort while sleeping & may give you back pain.
• Rest for a minimum of 8-9 hours a day. This will keep you relaxed & baby  develops better.

Diet for the 4^th month of pregnancy

Food and exercise are important at all stages of pregnancy. You need to have good and proper 4 months pregnancy weight gain should include:

Fruits and Vegetables:

• Including fresh and leafy vegetables in your meals will be beneficial to your health.
• Eating balanced food having all nutrients proteins, complex carbohydrates, healthy fats, vitamins, mineral, fiber & water is important now.

Nuts & Dry Fruits

Take nuts & dry fruits between the meals so that the stomach does not remain   empty.

Have one fist full every day

Whole Grain Products

Have 10-12 servings daily, preferably whole grain products only. Divide in 3-4 meals.

Protein-rich foods

• Proteins are building blocks of life, important to take sufficient protein for mother & growing baby in the
• Have 2-3 glasses daily low-fat milk or equivalent quantity of milk products daily.
• For vegetarians having 3 servings of dal-pulses is
• For non-vegetarians having 2-3 servings of eggs, lean meat is

Fruits & Vegetables – Having Minerals, Vitamins & Fiber

Orange, banana, apples, coconut, mangoes, multi-colored vegetables all seasonal & local fruits & vegetables are preferred.

Have 25-30 % of veggies raw in form of salads / juice. Have 7-9 servings of fruits & veggies daily

Water & healthy fluids

Important to stay well hydrated during pregnancy, especially in our hot weather.  Drink 8-10 glasses of water, and also have healthy fluids like coconut water, buttermilk, fruit juice, soups etc.

Do get a flu shot

Pregnant women can and should get a flu vaccine as long as you don’t have a contraindication. Ask your doctor about flu shot.

Visit your dentist

It is recommended that you have a routine oral health assessment while pregnant, along with regular dental cleanings. Be sure to tell your dentist that you’re pregnant.

Care while sitting

Your legs should not be crossed and your feet should be flat on the floor. Try to avoid sitting in the same position for more than 30 minutes.

Exercise during 4^th month

Regular exercise may help you combat many of the issues that arise during pregnancy, including:

• Insomnia
• Muscle pain
• Excessive weight gain
• Mood problems

Many activities are safe in moderation, as long as you and your baby are healthy:

• Walking is a primal human activity and perfect for pregnancy
• Yoga – Gentle, strengthening yoga could be your best friend if you’re pregnant
• Swimming
• Bicycling

Listen to your body

• If you only have 10 minutes to do a bit of exercise, just pick a few exercises to complete. Choose 2-3 for upper body & 4-5 for lower body & also include your pelvic floor exercises.
• You don’t need to make exercise complicated, move your body to celebrate what it can
• If you’re bursting with energy, add a few more exercises to your

Sitting down body stretches

 Neck Exercises -1

• Move neck upwards hold & move neck downwards & hold
• Repeat 5 times

Neck Exercises-2

• Move neck towards right shoulder hold & move neck towards left shoulder & hold
• Repeat 5 times

Neck Exercises-3

• Rotate neck backwards over right shoulder hold & rotate backwards over left shoulder & hold
• Repeat 5 times

Shoulder Exercise

• Rotate shoulders clockwise 5 times
• Rotate them anticlockwise 5 times

Exercise for back

• Sit with bottom against wall & soles of feet together
• Place hands on ankles and lengthen the spine upwards
• Push thighs downwards maintaining length in spine
• Hold to count of 5
• Repeat these 4 times

Sitting down full body stretch

• Sit cross legged with back straight
• Raise arms on sides at shoulder level, palms facing upwards
• Raise arms above head with arms touching ears
• Stretch body & arms upwards
• Count 1 -5
• Bring arms down
• Repeat 5 times

Backstretch -1

• Sit cross-legged
• Hold left leg with left hand & stretch right hand straight & upwards
• Hold right leg with right hand, stretch left hand straight & upwards
• Alternate both movements 8 times

Backstretch -2

• Sit cross-legged
• Place left hand on floor near left knee, stretch right hand upwards towards left side
• Place right hand on floor near right knee, stretch left hand upwards towards right side
• Alternate both movements 8 times

Backstretch -3

• Sit cross-legged
• Place right elbow & right palm touching floor near right knee
• Raise left hand straight up & bend sideways to right side to your comfort level
• Hold to count of 5
• Repeat exercise on other side

Backstretch -4

• Sit cross-legged
• Place left hand behind, fingers facing backwards
• Place right hand on left knee
• Twist to left side, looking over left shoulder
• Hold to count of five
• Reverse direction
• Repeat five times each side
• Very useful for relaxing back muscles & preventing back problems

Make your pregnancy a holistic occasion to appreciate your self – Body, Mind & Soul

Medical Checkup

Blood pressure and weight are checked. Abdominal examination is done to check growth of baby. You can listen to baby’s heartbeat during prenatal visit (amazing moment for mother to be).

Medications

To continue Iron and Calcium supplements.

Iron & folic acid help to make hemoglobin, which carry oxygen around the      body & baby.

Ultrasound scan

• To check baby’s growth
• To check the fetal movement
• To know of baby’s internal organs
• To detect birth defects
• To check placenta, umbilical cord & amniotic fluid

If problem is detected, necessary precautions can be discussed and taken.

Pregnancy Myth & Fact

1. Myth: Exercise during pregnancy can harm the baby.

1. Fact: Exercises that involves jumping & give a jolt like tennis/badminton and jogging should be avoided.

A planned Prenatal Exercise Program is very important to relieve many discomforts of pregnancy and also helps in having easier & shorter delivery process

2. Myth:  A pregnant woman has a fulfill all her food cravings.

2. Fact: All pregnant women have likes and dislikes to certain foods. Craving for a particular food is called “Pica”.

One should indulge with moderation, as desire for wrong foods is not healthy.