Week 18 of pregnancy sees a fetus start to yawn and hiccup. It is the stage of pregnancy at which your pregnancy belly will become more obvious.

The womb is moving further out of the pelvic area during this week, and your waist will shrink as the uterus continues to move into the abdomen.

Although this is the 18th week of pregnancy, it may not be exactly 18 weeks since you conceived. Most people do not exactly know when conception took place, so they count from “day 1,” which is the first day of your final period before pregnancy.

This feature is part of a series of articles on pregnancy. It provides a summary of each stage of pregnancy, what to expect, and insights into how your baby is developing.

Take a look at the other articles in the series:

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Your pregnancy may be starting to show at 18 weeks.

One of the most noticeable symptoms at this stage of pregnancy is a feeling of dizziness and lightheadedness on standing up too quickly.

The uterus can push against an artery and slow the flow of blood. This means that when a woman who is around 18 weeks pregnant sits upright or stands up quickly, the rush of blood can cause a dizzy sensation.

The womb also demands a large volume of blood to support the fetus, which can cause occasional feelings of lightheadedness.

However, the body produces extra blood during pregnancy to compensate for this. To help support the increased blood volume, make sure you consume foods rich in iron and drink lots of fluids.

You may also feel aches or pains in the back, as the growing fetus and uterus might have caused you to shift your center of gravity forward and place stress on the spine.

You may not notice much weight gain yet, as people put most weight on after 20 weeks of pregnancy. The amount a person gains is usually between 22 and 28 pounds (lb) during pregnancy, but this depends on an individual’s body mass index (BMI) at the beginning of a pregnancy.

Hormones will be preparing your hips for delivery by making them looser.

This can affect other joints, and the combination of this and the extra body weight can have an impact on the comfort of your back.

The fetus now weighs around 8 to 9 ounces (oz) and measures roughly 9 inches from crown to rump. They are about the size of a dollar bill.

Around this time, you will be starting to feel the baby move. It will feel like a fluttering or bubbling sensation at first. However, this is not a fixed starting week for fetal movement, and you may not feel any movements for another 2 weeks.

The fetus will now have learned to yawn and hiccup, and you may even be able to feel the hiccupping motion.

Female fetuses will be developing their own uterus and fallopian tubes, and male fetuses may have visible external genitalia at this stage of pregnancy, although this can be difficult to see.

As the fetus’ nervous system develops, myelin, the protective sheath that covers nerve cells, is now forming.

Between 18 and 20 weeks of pregnancy, the birth doctor will call you in for your third prenatal visit.

At this doctor’s visit, you will get to hear your baby’s heartbeat with a special Doppler ultrasound machine. Your doctor will also review your blood pressure and weight.

The doctor may carry out screening blood tests to check for chromosomal or anatomic abnormalities. If a screening blood test shows positive results, you will likely have further testing to confirm whether your baby has genetic anomalies that could affect development.

A maternal serum alpha-fetoprotein screening (MSAFP) is a screening blood test that helps evaluate a fetus’ risk of neural tube defects, such as spina bifida and abnormalities in the abdominal wall.

This tests the levels of alpha-fetoprotein (AFP) and helps the physician estimate the likelihood of an abnormality.

If you are feeling anxious about the screening tests, remember that these are not diagnostic tests and are only meant to be an indication that diagnostic tests are necessary. Some people decline a screening after discussing all of the options with their doctor.

A fetal anatomy scan may also take place between weeks 18 and 21 of pregnancy. This is a detailed ultrasound scan of the fetal brain, heart, bones, face, spinal cord, and abdomen.

It provides imaging of physical abnormalities, although it will not find every problem.

The scan will look for:

  • open spina bifida
  • cleft lip
  • a diaphragmatic hernia
  • exomphalos
  • anencephaly
  • gastroschisis
  • serious abnormalities of the heart
  • lethal skeletal dysplasia
  • trisomy 13, 18 and 21
  • bilateral renal agenesis
  • the sex of the fetus

The technician carrying out the ultrasound, or sonographer, will apply gel to your abdomen to create good contact between the probe of the ultrasound device and the fetus. The image of your fetus will appear on a screen.

You are welcome to bring a partner or friend along for emotional support.

The developing child causes many lifestyle modifications which are necessary during pregnancy and after delivery.

General health

During pregnancy, look after yourself and the baby. Avoid alcohol, smoking, and all other toxic or illicit substances during this time. Discuss any prescribed medications with your healthcare provider to make sure that they are safe for use while pregnant.

Make sure you eat a healthy diet and take vitamin supplements if necessary.

Exercise

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Light exercise is vital for maintaining health during pregnancy.

Staying physically active throughout pregnancy is vital for both your own health and that of the fetus.

However, by the 18th week, the shape of your body will be changing. You may find that maintaining an exercise routine is becoming difficult.

A woman who is pregnant can stay active while keeping discomfort to a minimum. The key factor is avoiding overexertion or exhaustion.

You should be able to hold a conversation while exercising during pregnancy. If you find yourself becoming out of breath, it is likely that the exercise is too strenuous. Light exercise can still have benefits for both mother and infant.

Avoid intense exercise during pregnancy. Limit any aerobic exercise program, such as swimming, cycling, or even walking, to 15 minutes for three sessions per week.

You can then gradually increase your weekly exercise regimen to four 30-minute weekly sessions.

Here are some tips to help you get as much benefit from exercise during pregnancy as possible:

  • Warm up before every session and cool down when finished.
  • Avoid working out in hot weather.
  • Try to engage in physical activity every day, even if that only means going on a half-hour walk.
  • Make sure you stay hydrated by drinking plenty of water and fluids.
  • If taking an exercise class, confirm that the instructor has full qualification to teach women who are pregnant and is aware of the stage of your pregnancy.
  • Swimming can provide great benefits during pregnancy, as the water can support your weight. Aquanatal classes may be on offer at your local swimming facility.
  • Take extreme caution with exercises that pose a risk of falling, such as skiing, horseriding, or gymnastics, or avoid them completely. Falling can damage the fetus.

Avoid exercises that involve lying flat on your back for long periods of time, contact sports, or long periods diving in deep water or exercising at high altitudes.

Refer any questions about your pregnancy to your healthcare provider.

Call your doctor if you are experiencing symptoms of vaginal bleeding or passage of tissue, leaking vaginal fluid, feeling faint or dizzy, low blood pressure, rectal pressure, shoulder pain, and severe pelvic pain or cramping.