4 Months Pregnant: Symptoms, Baby Development And Diet Tips

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Your second trimester, which occurs between weeks 13 and 16, begins when you’re 4 months pregnant. At this stage, you may go through many emotional and physical changes. You may also feel more energetic, and your risk of having a miscarriage will decrease by this month.

This post explains the symptoms you may experience in this month, how big your belly may become, your baby’s development, diet tips, what you can expect when you visit your doctor, and some measures to keep yourself healthy. It also addresses some common concerns you should look out for in the fourth month of gestation.

What Symptoms Do You Experience In The Fourth Month Of Pregnancy?

As you enter the fourth month, most side effects of the first trimester reduce and new 4th-month pregnancy symptoms and changes occur (1) (2):

• Constipation: The increasing progesterone levelsⁱA hormone produced by a woman's ovaries that help in conception and regulation of menstrual cycles alter the digestion process, causing delayed bowel movements and constipation. Drinking lots of water and including a high fiber diet could alleviate this discomfort and ease digestion. Adding olive oil and prunes to your 4th month of pregnancy diet can be helpful. If it is a normal, uncomplicated pregnancy, walking 30 minutes a day is a good way for constipation relief.

• Frequent urination: Your expanding uterus applies additional pressure on the bladder. You might, therefore, have a frequent urge to urinate. If there is a fever or pain during urination or lower abdominal pain,consult with your doctor.

• Shortness of breath: Your growing belly may also apply pressure on the lungs, making it difficult to breathe properly. It is, therefore, common to experience shortness of breath or rapid breathing. If this condition limits your activities, you need to visit a cardiologist.

• Heartburn: With the growing bump, there is additional pressure on the digestive system. This could also push the stomach acids upward, causing heartburn. Dietary changes can help reduce the stress on the digestive tract according to specialists in obstetrics. For instance, Dr. Kimberly Langdon, a US-based obstetrician/gynecologist, says, “Nausea subsides in the fourth month of pregnancy, causing expecting mothers to eat more than they should. However, heartburn and other digestive issues such as constipation occur during this time. To avoid discomfort, it is best to eat small, frequent meals rather than indulging all at once.”

• Bleeding gums: Pregnancy hormones soften the gums and increase their sensitivity. This would cause bruising and bleeding while brushing the teeth. Always check with your doctor.

• Nosebleeds: Increased blood supply in the nose puts more pressure on the tiny blood vessels inside the nose. This may make them more susceptible to rupture, resulting in a nosebleed.

• Morning sickness: Although common in the first trimester, nausea and vomiting can be experienced in the later months of pregnancy too.
• Vaginal discharge: Hormonal changes in the body may also lead to increased white vaginal discharge.

Body Changes During Fourth Month Of Pregnancy

The most evident change you notice is a bigger belly or a visible baby bump. Here are the other physical changes you may notice in the 4th month.

• Skin changes: Your skin is also likely to undergo some changes during pregnancy. The increasing pregnancy hormones could cause blotchy skin in some. Take care of the skin using mild cleansers, moisturizers, and lotions.

• Breast changes: From the beginning of the fourth month, the nipples and areola are likely to become darker. Also, the veins will become more prominent as the blood circulation increases.

• Edema: Swelling in the feet and ankles is likely to develop from the fourth month of pregnancy that may last until your due date. Taking frequent breaks in between and avoiding standing or sitting for extended periods can help alleviate the swelling. If there is significant edema of face and hands, you should visit your doctor.

Image: IStock

• Varicose veins: Increased blood volume in the body can enlarge the veins in the legs, thus causing varicose veins.

There is no need to worry about these mild changes, as they are common during this time of pregnancy.

How Big Is Your Belly In The Fourth Month?

By the end of the fourth month of pregnancy, your uterus is about the size of a head of cabbage. The top of the uterus lies below the belly button. Your 4-month pregnant belly may show a little bit.

Baby’s Development In The Fourth Month Of Pregnancy

While you experience the above changes, your developing baby also undergoes many changes that are listed below (3) (4).

How Does A Fourth Month Baby Look Like In The Womb?

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The fetus has transparent skin, well-formed fingers, and toes at this stage. The fetus’s eyes are still developing since it can react to light while the eyelids are closed and other organs are still developing. At this point, the fetus is the size of an orange weighing about six ounces and measuring six to seven inches.

Baby’s Movement In The Fourth Month

The baby tends to move four or more times in an hour at this stage. You may feel the movements as light sensations along your lower abdomen. They are called quickening movements and are similar to a fluttering or bubbling in the abdomen (5). Marisa, a mom with two kids, talks about how feeling her baby move at 16 weeks of her second pregnancy was one of her happiest moments. She says, “I started feeling the baby move about a week or so ago. It seemed very early. I don’t feel it often but occasionally I can feel the baby and see my stomach move. My husband has even felt the baby (i).”
Women feel these fetal movements later when they are in their first pregnancies than women with second or subsequent pregnancy.

What Do You Need To Know In Your Fourth Month Of Pregnancy?

Here are a few things to remember as you enter into your second trimester (6).

Dos During The 4th Month Of Pregnancy

• Continue to perform regular exercises after the doctor’s approval. Go for regular walks, yoga, swimming, or any other workout of your choice to promote safe and easy delivery.

• Sleep on your left side, using cushions around your side and between your legs for comfort. It could also improve blood circulation to the developing fetus.

• Nosebleeds, stuffy nose, and blocked ears are common during the 4th month. Carry enough tissues and keep the needed medication with you at all times.

• Buy some maternity clothes as your abdominal muscles start to stretch rapidly. Your regular clothes could be tight and uncomfortable now.

• Indulge in sex as maintaining intimacy with your partner is very important. However, take your doctor’s advice beforehand.

Did you know?

Due to the increased blood flow below your waist during the second trimester, you are more likely to experience a quick orgasm (13).

Image: IStock

• Go for a regular dental check-up to avoid oral complications with bleeding gums.

Don’ts During The 4th Month Of Pregnancy

• Stay away from alcohol as the fetus could get fetal alcohol syndromeⁱA disorder caused by the consumption of alcohol during pregnancy. (FAS).

• Avoid cleaning cat litter as it could increase the risk of allergies and toxoplasmosisⁱA parasite infection brought on by ingesting raw or undercooked meat or coming into contact with cat poop. .

• Do not use hot tub baths or saunas as high temperatures might be dangerous for the growing fetus.

• Quit smoking as those who smoke are likely to give birth to low weight babies that are at a higher risk of disabilities.

Diet Tips For The 4th Month

• Be careful of what you eat and how much you include. Include enough vitamins and supplements in your diet since the growing baby requires proper nourishment (7).

• Include iron-rich foods such as fish, meat, liver, tofu, soybeans, nuts and seeds, brown rice, dark green leafy vegetables, eggs, and dried fruits. They help in meeting the increasing iron requirement.

• Eat fiber-rich foods such as oatmeal, barley, flaxseeds, chia seeds, almonds, pistachios, pecans, broccoli, green peas, sweet corn, raspberries, strawberries, apples, bananas, figs, and pears.

• Calcium rich foods, including milk, yogurt, cheese, kale, watercress, okra, broccoli, and almonds, are essential for healthy fetal weight and bone development.

• Zinc-rich foods include lamb, beef, wheat germ, spinach, mushrooms, squash, and pumpkin seeds. They help in the development of a healthy immune and nervous system.

• Vitamin C foods include bell peppers, sweet potatoes, tomatoes, cauliflower, broccoli, leafy greens, and cabbage. It is a key nutrient for iron absorption.

Image: Shutterstock

• Have foods rich in omega fatty acids, including vegetable oils, soybeans, walnuts, almonds, sardines, chia, and flax seeds.

• Select folic acid-fortified foods, such as enriched bread, pasta, flour, rice, grain products, and cereals.

• Have at least five portions of fruits and vegetables every day.

• Include protein foods such as nuts, seeds, legumes, meat, chicken, soybeans and quinoa, and carbohydrates, including rice, bread, pasta, and potatoes.

• Avoid refined flour (Maida) as it can increase blood sugar levels.

• Avoid ocean fish such as king mackerel, white tuna, and swordfish that contain mercury. Include freshwater fish (trout and salmon).

• Avoid soft cheeses (Brie) and blue cheese (camembert) as they might cause food listeria poisoning. Include only hard cheeses such as cheddar and parmesan. According to the World Health Organization (WHO), pregnant women are 20 times more susceptible to listeriosis than other healthy adults.

• Do not include raw or undercooked eggs. Eat only properly cooked or pasteurized eggs.

• Avoid having excess tea or coffee as overindulging in caffeine is harmful.

• Drink enough water – pregnant women need to have at least two to three liters of water every day.
• Avoid spicy foods, fried foods, and foods containing excessive salts and sugars.

What To Expect During Your Visit To OB/GYN?

You should visit your doctor more frequently by the time the baby is fourth month old in gestational age to check up on the health and development of the baby. Your doctor will usually recommend the following tests (4) (8).

• Physical examination: Your weight and blood pressure are checked. Also, parts such as the breasts, abdomen, and vagina are examined.

• Ultrasound scan: This is conducted to analyze the baby’s development and fetal position.

• Heartbeat: Doppler ultrasound is used to check the fetal heartbeat.

• Alpha-fetoprotein screening: This is done around 16 weeks of pregnancy to screen the presence of Down’s syndrome or spina bifida. But there are more accurate tests that can be done as early as eight to nine weeks of pregnancy. Always ask your doctor.

• Triple test: Also referred to as Bart’s test, triple test screens for hormones such as estriol and hCG in the blood

• Edema test: The measure of swelling is examined as abnormal swelling indicates gestational diabetes, preeclampsia, or blood clotting.

Quick fact

The ideal period for pregnant women to receive the whooping cough (pertussis) vaccine in the UK is from week 16 onward (14).

Ultrasound During The Fourth Month

The 4-month pregnancy ultrasound scanning determines the fetal gender as external genitals would have developed by this stage   (9). It can also show the facial features the baby had developed, including the forehead, eyes, and nose. It could, therefore, determine the major physical defects in the baby.

What Are The Common Concerns During The Fourth Month Pregnancy?

Certain changes can be worrisome for you and your partner during the 4th-month pregnancy. To better understand them, discuss it with your doctor sooner.

• An increase in appetite and weight gain is common, and also your likes and dislikes for foods may change starting from this period.

• Constipation and heartburn are common, but you should consult your doctor before using any medicine for it.

• You should be careful with sex if you have a history of high-risk pregnancy or a miscarriage.

Tips For Dads-To-Be

The dad-to-be also has to do certain things to understand what the pregnant mom is going through. A few things he can do to enhance prenatal care include:

• Help with household chores, as it might get difficult for you to manage home and work.

• Understanding the physiological and psychological changes that you go through. Understand how the baby progresses over the period and talk to your doctor for any suggestions.

• Communicate with your partner to ensure you are both on the same page about the pregnancy.
• Discuss with other dads or dads-to-be about his fears and feelings and get some helpful tips.

Infographic: Diet Tips For The Fourth Month Of Pregnancy

During the fourth month of pregnancy, expectant mothers must maintain a healthy and balanced diet. The infographic below provides a list of food items that should be included and avoided during this time. Give it a read and share it with others as well. Additionally, prioritize your overall health and well-being with regular exercise and enough rest.

Illustration: Momjunction Design Team

Illustration: 4 Months Pregnant: Symptoms Belly Size & Baby Development

Image: Dall·E/MomJunction Design Team

Observe your baby’s incredible growth and development during the fourth month. Take note of interesting developmental milestones such as their ability to roll over and their first laugh.

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Reviewer Expert Author Editor Fact Checker

Dr. Mozhgan SayyadMD

Dr. Mozhgan Sayyad specializes in obstetric and gynecological cases, and her area of interest includes cosmetic gynecology. An associated member of the Royal College of Obstetrics and Gynecology and a member of the European Society of Aesthetic Gynecology, Dr.

Read full bio of Dr. Mozhgan Sayyad

• 
  Dr. Kimberly LangdonMD Dr. Kimberly Langdon is a gynecologist with 19 years of experience wherein she delivered more than 2,000 babies. She is currently working as vice-president, product development and research at Physician Integrative Laboratories in the US. She did her doctor of medicine from the Ohio State University.
  
  Dr. Kimberly Langdon is a gynecologist with 19 years of experience wherein she delivered more than 2,000 babies. She is currently working as vice-president, product development and research at Physician Integrative Laboratories in the US. She did her doctor of medicine from the Ohio State University.

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

Read full bio of Rebecca Malachi

Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

Read full bio of Swati Patwal

Aneesha AmonzMSc

Aneesha holds a Bachelor's degree in Biotechnology from USTM, Meghalaya and Master’s degree in Applied Microbiology from VIT, Vellore. With two years of experience, she has worked on different research projects in the field of Food Sciences.

Read full bio of Aneesha Amonz