Week 19

Up to 30–50% of pregnant women and birthing people experience leg cramping. This can cause significant pain and discomfort and may impact daily activities, physical activity, sleep, and quality of life.¹

There is no single, effective treatment for leg cramps in pregnancy. However, there are different interventions that you can try, with the approval of your healthcare provider. These may include:¹

• Electrolytes (magnesium, calcium or sodium)
• Muscle stretching
• Vitamins E and D

• Bloating and gas
• Leg cramps
• Bleeding gums
• Round ligament pain and stretch marks
• Pelvic girdle pain and back ache
• Foetal movement
• Skin changes (such as stretch marks and redness of the vulva caused by yeast infection)
• Heartburn and indigestion

Your baby should now measure around 15 cm, roughly the size of a mango, and weigh 230 g.¹

This week is a key stage for brain development. Cells responsible for receiving, processing and transmitting signals throughout the body, called neurons, have now moved into their final position within the brain. Specific cells responsible for the brain structure, called radial glia, are no longer needed, so they turn into a new type of support cell called astrocytes.³ Astrocytes are crucial for supporting neurons, maintaining the brain environment, and forming the blood–brain barrier.⁴

• Consistently taking folic acid is recommended,⁵ or if you haven’t already, consider taking a prenatal supplement that has the recommended amounts of vitamin A and D, iron and calcium,⁶ which will also help support your oral health⁷
• Book your routine dental check up to help support your oral health during pregnancy⁷
• Staying active and keeping a healthy weight can help support overall health⁸
• Try to avoid alcohol consumption and smoking – both are known as risk factors for miscarriage^9,10
• Nourish your body with pregnancy-safe foods. Try to avoid foods high in mercury, such as mackerel and tuna, raw seafood, undercooked meat, poultry and eggs, unpasteurised foods and cheese with a mould rind such as brie, unwashed fruits and vegetables, and any type of herbal tea¹¹
• Limit caffeine consumption to no more than 200 mg per day¹²  
  As a guide:  
  1 mug of coffee contains 100 mg of caffeine  
  1 mug of tea contains 75 mg of caffeine  
  1 can of cola contains up to 40 mg of caffeine  
  1 bar of chocolate contains up to 50 mg of caffeine
• Confirm your 20-week appointment with your healthcare provider¹³

Around 20 weeks, you should have another ultrasound scan. This appointment is to assess foetal growth, heart function, and movement. They may also be able to distinguish the gender, if you want to know.

During this period, you may also be offered genetic testing to look for genetic conditions, such as spina bifida and Down’s syndrome. You can discuss this testing with your healthcare provider.

Your antenatal appointment around 20 weeks should also include blood tests. These tests are important to check iron levels and check for gestational diabetes. They will also confirm your rhesus status, which is whether you carry rhesus antibodies on your blood cells. If you are rhesus negative, your healthcare provider will need to confirm whether any rhesus antibodies are present as these could attack the red blood cells of the baby if their blood type is rhesus positive.