9th – 9th week of pregnancy

At the ninth week of pregnancy the fetus has already learned to suck its thumb, to swallow the amniotic fluid, to move its head back and forth; as well as moving the tongue, closing the jaw, sighing and stretching.

As a result of these enormous changes taking place in the fetus and those that are taking place in your body it is possible that in the 9th week you feel quite tired and that nausea, vomiting and morning sickness increase. But it’s the moment when you have to hold on. Depending on the intensity of the above ailments, you may not feel like eating anything. The scent of lemon can be effective in reducing nausea and vomiting. 

Your uterus has grown further, and is now about the size of a grapefruit, inside the fetus measures about 38 mm (this is the so-called CRL -crown rump length, the crown-sacrum length). As a result of this, your waistline is also increasing and, most likely, your face will have become rounder and sweeter.

The fetus at the ninth week

the development of its sensory organs

The eyes of the unborn child already have their own pigmentation, while the small earlobes are visible on ultrasound. Your baby has also developed a tongue with tiny taste buds. 

facial development

Her eyes are now covered with well-formed but closed lids, lids that will not open until the third trimester begins . The other characteristic features of her face, such as the mouth, lips, nose and forehead, continue to grow and stand out; even her teeth continue to grow.

the development of the limbs

The tiny arms and legs into which the wrists and ankles grow fast already make your baby look like a miniature human being. An ultrasound at this time clearly shows ripples at the ends of the hands and feet marking the spaces where the fingers will form. Your baby will now begin to grow in size and gain weight as he continues to rapidly develop his entire body.

the development of the nervous system

During the ninth week of pregnancy, the baby’s brain, nerves, and spinal cord continue to form.

the development of internal organs

All major internal organs, including the heart, lungs, kidneys, and intestines, are already in place and developing, as are the muscles. The heart is already divided into four chambers, and its valves begin to develop. The heart rate in these weeks is around 170-180 beats per minute. Although it is still too early to determine the sex of the child with an ultrasound scan, the development of his genital organs has already begun. The placenta is already sufficiently developed to take care of the production of most hormones and nutrients and then to get rid of waste products. The placenta also produces estrogen and progesterone , which regulate most of the changes that occur during pregnancy.

What happens in the woman’s body

The increased blood volume continues to put more strain on your body’s organs, which leads to various symptoms . Compared to the previous weeks, the body changes: in the ninth week you have fuller breasts, and an increase in weight. This is because your body continues to prepare for the birth and subsequent breastfeeding of the baby. However it is also possible that there may not be weight gain, especially you often suffer from nausea. As you can also see from the gradual increase in swelling in your belly, your uterus continues to grow: it’s almost the size of a small melon. In relation to a series of factors related to the position of the baby in the womb, and to your height, during this week you may already begin to notice a belly bulge . If you don’t have it yet, we advise you to equip yourself with a pregnancy pillow . There are some for all tastes and for all needs: from the mini pillow to the total body pillow.

Ultrasound at 9 weeks of pregnancy

In addition to the small beating heart, an ultrasound can show the baby already making small movements. But the fetus is still too small for you to feel it. You may be able to hear your baby’s heartbeat on a Doppler ultrasound.

However, remember that sometimes an ultrasound done in week 9 may show an empty gestational sac. In rare cases this could be due to an ectopic pregnancy or miscarriage . In most cases, however, this occurs when the woman thinks that her pregnancy is more advanced than it actually is. In these cases an ultrasound performed in a few weeks will (successfully) show the baby.

Symptoms in this stage of pregnancy

As in the previous weeks, responsible for most of the symptoms you feel is the increase in hormone levels, associated with the increase in blood volume. During this week most women continue to experience morning discomfort (nausea and vomiting) associated with headache , dizziness, flatulence, heartburn, bloating , abdominal pain or cramps, and to lumbar pain.

Other common symptoms that arise during this week consist of:

  • Swelling in the veins, especially those of the hands and feet (due to the increase in blood volume which in a healthy woman can increase by almost 50% compared to before and after pregnancy) .
  • Epistaxis .
  • Mood swings, often accompanied by sudden crying . Pregnancy is a transitional period for women, but it is also a very stressful period accompanied by major hormonal changes. This can understandably lead to mood swings
  • Diarrhea and constipation .
  • Frequent urination .
  • Vaginal bleeding or light spotting . According to a 2010 American study, light spotting, especially if painless and lasting only a day or two, does not increase the risk of miscarriage above the baseline risk (i.e. the risk for women who do not have this symptom) .
  • Tiredness and fatigue .
  • Food cravings and aversions .
  • Perversion of the sense of taste .
  • Swelling in the breasts .
  • Excessive salivation .
  • Increased sensitivity to smell .
  • Acne and significant skin changes . Pregnancy is associated with complex endocrinological, immunological, metabolic and vascular changes that can affect the skin and other organs in various ways. Over 90% of women experience significant and complex skin changes during pregnancy. Talk to your doctor about the safety and effectiveness of acne treatments during pregnancy.  .
  • Joint pains .
  • Itching especially on the belly and breasts. Itching affects 20% of pregnant women. Generally, itching in pregnancy is associated with dry skin, but there are other conditions typical of this period that can cause itching. 
  • Stuffy nose . Rhinitis in pregnancy is due to the direct cholinergic effect of estrogen, as it inhibits acetylcholinesterase, causing vascular congestion and increased mucosal gland activity. 
  • Heartburn
  • Insomnia , caused by one or more of the physical changes listed above, but mostly by a bloated belly.

As your belly grows, you may find it extremely helpful to use a pregnancy pillow for sleep. A twin pregnancy increases the risk of such symptoms due to higher levels of HCG . However, it’s also perfectly normal to have few, if any, symptoms during week 9 . So, there is nothing to worry about if you don’t feel pregnant at this stage.

Some tips for symptom management

    • Excessive Salivation : Brush your teeth a few times a day with mint mouthwash.
    • Heartburn, food aversions and flatulence :
      • eat 5-6 small meals, instead of 3 large meals,
      • avoid lying down after eating fatty foods or spicy foods;
      • Drink some lemon water to get rid of any “unpleasant” taste from your mouth.
    • Gastric reflux during the night: do not sleep prone or completely supine , and use a double pillow.
  • Indigestion and heartburn: Chew sugarless gum or take antacids (consult your doctor before taking antacids).
  • Nasal congestion : Drink decaffeinated tea and chicken broth. You can also try and use a vaporizer or humidifier to help lessen the symptoms.
  • Breast changes : Wear pregnancy support bras.
  • Insomnia : Try to go to bed early so you get enough sleep. Avoid using the computer before going to sleep, as it may interfere with your sleep.

Signals to which particular attention should be paid

  • Heavy vaginal bleeding : may indicate the existence of complications, such as ectopic pregnancy and miscarriage .
  • Whitish, yellowish or brown, foul-smelling discharge : they could indicate the existence of an infection in progress.
  • Severe nausea and vomiting (more than 3-4 times a day) that interfere with your daily “routine”: this could lead to severe dehydration, and weight loss that can harm the fetus. Otherwise, by itself, having nausea and vomiting poses no risk to the fetus.
  • Fever above 39°C, accompanied by severe joint pain and skin rashes : this could indicate the existence of an active infection.
  • Burning sensation or pain while passing urine : This could be due to a urinary tract infection.
  • Severe headache or migraine : This could be caused by high blood pressure or preeclampsia .
  • One-sided swelling in the legs : This could indicate the existence of a blood clot.
  • Persistent abdominal or pelvic pain.
  • Clot or tissue loss : these could be signs of a miscarriage.
  • Fatigue accompanied by muscle weakness, general malaise, tingling of the fingers and respiratory disorders . If so, you may have Guillain-Barré syndrome (GBS). The incidence of this nervous system disorder is 1.2 – 1.9 cases per 100,000 people per year.For the rest, however, remember that – mainly due to hormonal changes – it is normal to feel tired, if not exhausted, during pregnancy, especially in the first 12 weeks. The only answer is to rest as much as possible. 
  • Sudden vision problems

Curiosity and advice for this period

  • During this time, when you feel tired and fatigued, you might be tempted to keep your shoulders hunched and lean forward.
    • On the other hand, it is important that you take care of your posture: keep an upright posture, with your chest out and your gaze up.
    • You are not a “sick” person , but you are about to give birth to a new creature: live the moment with the right pride and let it leak from your body and your posture !
  • In this period the unborn child begins to suck his thumb and may swallow the amniotic fluid.
  • He also begins to bob his head back and forth, open and close his jaw, move his tongue, yawn, sigh and stretch.
  • If you’re pregnant with twins, you may be advised to eat for three. Nothing more false.
  • In that case, rather coordinate with your doctor, and possibly also with a nutritionist, to avoid overeating and gaining too much weight.
  • In this week it is not yet possible to identify the sex of the unborn child: its external genitalia, in fact, will not be distinguishable for a few more weeks.

Other useful tips for a peaceful pregnancy and a healthy baby

  • If you are over 35, it is necessary that you coordinate with your gynecologist to perform prenatal diagnosis screenings which are carried out between the 9th and  16th week of pregnancy .
  • Eat a healthy diet containing calcium-rich foods such as broccoli, cheese and sardines. 
  • Do not wear clothing that is too tight, especially around the waist, which could put prolonged pressure on your belly.
  • Try to be comfortable and, if possible, prefer maternity clothing  and, in any case, comfort.
  • Schedule one or more visits to your dentist: pregnancy has a negative effect on your teeth and, therefore, you need to take better care of them.
  • Consider enrolling in a preparatory course .
  • Drink enough fluids to avoid dehydration. Be careful with sugary drinks (such as fruit juices or sodas): high sugar intake during pregnancy can increase the risk of your offspring developing atopy and asthma
  • When you’re tired, rest: you have to accept the fact that your body is doing a great job, and that it takes away a lot of energy.
  • Watch out for urinary tract infections.
  • In this period, in fact, the risk of urinary tract infections increases. And, if you do experience one, contact your doctor right away: a poorly treated infection can cause serious damage, such as kidney disease or premature birth.
  • In addition to continuing — or starting — a light exercise “routine,” also consider enrolling in a prenatal yoga class.
  • Among the various sports, prefer (if you like) swimming which, to the invigorating action of fresh water, adds the benefits of moving the shoulders and arms which strengthen the muscles of the arms and torso.
  • Don’t forget to take the supplements recommended by your doctor (folic acid, etc.).
  • Even if drinking a glass of wine from time to time does not compromise the fetus, in this and in the coming weeks, alcohol is recommended in great moderation.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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