Pregnancy: The Fifth Month

Pregnant mom reading book outside 
Physical changes in the fifth month of pregnancy

Your baby becomes more and more active this month, often in the evenings. You may be able to see your baby moving and then kicking at the beginning of this month. By the end of the month, your baby will settle into a regular pattern of activity and sleep. You may find that the baby is most active when you are trying to rest.

Your physical symptoms this month may include:

  • fatigue
  • constipation
  • heartburn
  • flatulence (gas)
  • nasal congestion or nose bleeds
  • bleeding gums
  • increased appetite
  • swollen ankles
  • achy feet
  • varicose veins
  • white vaginal discharge
  • stretch marks
  • breathlessness
  • backache
  • skin pigmentation changes
  • absent-mindedness

Early this month, your heart rate will start to increase in order to provide more blood to meet the oxygen requirements of your baby. You will start putting on weight on your buttocks as well as your abdomen. Remember to keep doing mild exercise throughout your pregnancy.

In week 20, you will enter the second half of pregnancy! Your belly button may pop out as the uterus continues to compress upwards. The growing uterus pushes up against your lungs and presses your tummy outward. You may have trouble breathing as your lungs become cramped with your other internal organs.

Your belly may make it uncomfortable to wear a seat belt when driving or riding in a car but you should still buckle up. Fasten the belt below your belly, across your pelvis and upper thighs. If there is a shoulder harness, wear it over your shoulder, not under your arm, and to the side of your tummy. Airbags are a potential problem, so move the front seat back as far as it will go or better yet, sit in the back seat.

Your chest will expand and your breasts will continue to become larger. Your nipples will grow softer and small bumps may appear around the nipples. These bumps are sebaceous glands that secrete a fatty lubricant called sebum. Hormones in your system may cause varicose veins and your legs may ache. To reduce varicose veins, put up your feet whenever you can and try to avoid standing for long periods of time. Take solace in the fact that varicose veins often disappear shortly after birth.

This month, and for the rest of your pregnancy, you may have insomnia because of frequent bathroom visits and difficulty getting comfortable at night. Fatigue will set in again, because of the extra weight. See your doctor if you have excessive fatigue, as this could be a sign of anemia.

Starting around the middle of the month, you may notice itching around your enlarged belly. Try wearing loose clothing made of natural fibres and use calamine lotion.

Your feet and ankles may start to swell because your body is holding more fluid than normal, which tends to gather in your feet by the end of the day. Wear comfortable shoes and make sure to tell your doctor about any swelling if it is accompanied by headaches, visual changes, or abdominal pain, as this could be a sign of pregnancy-induced hypertension.

Toward the end of this month, you may notice a few aches. The growing baby and expanding uterus may start to push the lower ribs outward a bit, causing pain. Relaxation and massage may be helpful in reducing these aches and pains.

Hormones may cause your eyesight to become less sharp and certain contact lenses may no longer be comfortable. Your vision should return to normal after you have delivered your baby. Therefore, it is a good idea to put off buying new glasses or contact lenses while you are pregnant.

Your medical visit in the fifth month of pregnancy

This month’s medical visit will be similar to that of previous months. Your health care provider will check the following:

  • weight
  • blood pressure
  • urine
  • fetal heartbeat
  • size and shape of uterus
  • height of the top of your uterus, called the fundus
  • swelling of ankles or feet, especially if accompanied by headaches, visual changes or abdominal pain, which could be signs of pregnancy-induced hypertension

Medical tests in the fifth month of pregnancy

Some women at high risk may be offered a test called cordocentesis to confirm a diagnosis of chromosomal abnormalities, or to follow fetal well-being if there is a specific prenatal problem. In this test, a hollow needle is inserted through the mother's abdominal wall into the umbilical vein, close to the placenta, and a sample of the baby’s blood is withdrawn. This test is only done after week 18 of pregnancy, to ensure that the blood vessels are large enough to withdraw blood.

For more information about CVS and other tests, see "Prenatal Testing."

Emotional changes and depression in the second trimester of pregnancy

Mood swings occur much less frequently in this trimester than in the first or third trimester. As usual, though, you may be worried about certain things. You may wonder if the pregnancy is proceeding normally and worry about injuring your baby. You may be disappointed that you can no longer control the appearance of your body, and need reassurance from your partner that you are still beautiful and sexy. You might be concerned about the consequences of becoming a mother. You may become hypercritical of your partner’s attitude, manners, and masculinity, and worry about his ability to run the household when you are unable to do so. You might even be concerned that your partner could be jealous of your pregnancy.

Depression is far less frequent in the second trimester than at any other time during pregnancy. Depression during these months is usually related to the reliving of anxieties or events of past pregnancies. For example, a woman may be depressed if she previously had a second trimester pregnancy loss. Ongoing marital problems may contribute to depression. Try to talk out any problems you may be having with your partner. Supportive psychotherapy can help too if you are feeling particularly distressed.

How your baby is developing

Nicolette Caccia, MEd, MD, FRCSC

Rory Windrim, MB, MSc, FRCSC ​