Pregnancy Calendar at Week 21

What's Happening with the Baby

At 21 weeks of pregnancy, a white-cream coating appears on the tiny body of the baby. This coating is formed from shed lanugo hair, skin cells, and secretions from the sebaceous glands. It primarily fills the skin folds, protecting against the irritating effects of the amniotic fluid in which the baby will remain until birth.

Antibodies are transferred from the mother to the baby, which will protect the baby from infections the mother has had. This forms what is known as passive immunity.

The baby is growing very actively and already reaches 10.2 inches in length and weighs 14.7 ounces (right now, the baby can be compared to the size of a grapefruit).

The baby's endocrine system is fully operational – the pituitary gland, pineal gland, adrenal glands, pancreas, thyroid, and parathyroid glands. They produce the hormones necessary for normal growth and development.

This week, the baby develops the vestibular apparatus. Its function is to determine the body's position in space.

What's Happening with Mom

At 21 weeks pregnant, most women feel great: full of strength and energy, and the baby bump isn't yet big enough to cause serious discomfort.

Some expectant moms might experience heartburn. This happens because the growing uterus pushes against the stomach, shifting it upwards from its usual position. This leads to the stomach's acidic contents being pushed into the esophagus, causing those unpleasant sensations.

Other women notice that the skin on their sides has become very itchy. The reason is the same – the growing belly stretches the skin.

Belly

You've reached the halfway point of your pregnancy, and it's hard to hide your belly from those around you, as it gets bigger every week. You enjoy feeling your baby move, usually more active in the evening when you lie down to sleep, but also throughout the day, sometimes quite actively. After consulting with your gynecologist, you can start wearing a prenatal support belt, which you can buy at a pharmacy. It will support your growing belly and reduce the strain on your lower back. If you haven't yet bought maternity clothes, it's time – your everyday wardrobe will start to squeeze your belly, which is not ideal.

Uterus

At 21 weeks, the uterus rises about 1 centimeter above the navel, and the height of its fundus is 21 centimeters from the pubic bone. As it grows, the uterus continues to press against all your internal organs, making it harder for them to function normally and causing new discomfort. You might experience shortness of breath, find it harder to breathe, and feel discomfort in your stomach after eating. Now is the perfect time to start practicing breathing exercises, which will teach you proper breathing techniques and help you during labor when it's crucial to control your breathing to assist both yourself and your baby.

Pain

The growth of the uterus is accompanied by the stretching of ligaments, which can cause pulling pains on the sides that are not constant and not intense. The appearance of pronounced abdominal pain, cramping in nature with lower back pain, is a symptom of uterine hypertonicity. If you are troubled by such pains, consult your healthcare provider; they will prescribe treatment for you, usually recommending a course of magnesium supplements. As you progress toward childbirth, you will constantly be plagued by various pains: back pain due to the growing belly, pelvic pain due to the stretching of joint ligaments and the preparation of the pelvic bones for childbirth, leg pain due to venous congestion, and occasional cramps. You will have to cope with all of this by maintaining adequate physical activity, swimming, and getting plenty of rest.

Discharge

Liquid, clear, and odorless, the amount may increase, but if it literally pours out, you should be cautious, as it could be amniotic fluid leaking. So, if something worries you, take a test for amniotic fluid leakage (test pads are sold at the pharmacy) or go to the maternity hospital, where they will examine you and also conduct a rapid test for amniotic fluid leakage. Itching and heavy white discharge may be a sign of a yeast infection – see a doctor to get treated before giving birth and to avoid infecting the baby. The appearance of bloody discharge from the genital tract, especially if accompanied by pulling or sharp pains in the lower abdomen, is a reason for urgent hospitalization.

Heartburn

One of the unpleasant side effects of pregnancy, usually associated with the uterus growing upwards, which pushes other internal organs to the sides. Avoid fried, heavily spiced, pickled, and smoked foods. Also, stay away from acidic fruits and drinks, and don't drink carbonated water. Try not to bend forward right after eating. If heartburn occurs before bedtime, place an extra pillow under your head. If you don't feel relief, consult a doctor.

Some pregnant women occasionally experience cramps in their calf muscles. It's important to mention this to the healthcare provider managing the pregnancy. To quickly stop the cramps, it's recommended to lie down on a flat surface, stretch out your legs, and pull your toes towards you.

Medical Examination

Doctors

A consultation with an obstetrician-gynecologist is necessary if a pregnant woman has any complaints.

Tests

General urine analysis
You should get the results of the first screening – it includes confusing graphs and numbers, so review the results with your doctor. Normal indicators are considered to be a low risk of 1:350, and high risk is considered at 1:250. However, these numbers are relative, and everything should be considered in context: the presence of congenital diseases in the parents, existing children, ultrasound data, and screening results.
If the results are questionable, a consultation with a geneticist and additional diagnostic methods (amniocentesis or cordocentesis – collection of umbilical cord blood) are recommended.

Examinations

At 18-21 weeks, you'll have your second scheduled ultrasound with Doppler imaging of the uterine and placental vessels. This is known as the second screening, but if the woman has no pathologies and the results of the first screening are satisfactory, they usually just do the ultrasound diagnostics.
During this ultrasound, you can find out the baby's gender. The doctor will check the condition of the placenta, cervix, and umbilical cord, assess the baby's internal organs, and estimate their weight and size.
Doppler imaging helps detect blood flow issues in the uterine and placental vessels. If these issues are present, the baby may experience oxygen deprivation, which can negatively impact their development and cause problems after birth.

Pregnancy Challenges

Leg Cramps

These often occur in the evening and at night. The cause is a lack of potassium and calcium in the body. To address this deficiency, special vitamin and mineral complexes are prescribed. Complaints of leg pain may also be due to the development of varicose veins. Risk factors include the increasing size of the uterus and its pressure on the vena cava, weakness of the blood vessel walls, developmental abnormalities, and congestion.

Placental Abruption

Timely medical intervention significantly increases the chances of preserving the pregnancy, even with a large area of detachment. SOS symptoms include abdominal and back pain, and bleeding. These symptoms signal the need for an immediate call to emergency services.

TORCH Infections

The term is derived from the first letters of diseases such as TOxoplasma (toxoplasmosis), Rubella (rubella), Cytomegalovirus (cytomegalovirus), and Herpes (herpes). These infections are dangerous when first contracted during pregnancy, as they can lead to fetal developmental defects and miscarriage. They are an indication for pregnancy termination. Reducing the risk of infection involves following hygiene and preventive measures, including planned vaccination six months before conceiving a child.

Possible deviations from the norm:

Uterine hypertonus;
Gestational diabetes;
Varicose veins.

What You Can and Can't Do

As you enter the 21st week of pregnancy, you're stepping into one of the most peaceful periods. Your baby is already formed, but still small enough to move freely in the womb. The baby is growing rapidly, gaining weight, becoming more active, and strengthening bones and muscles. The digestive system is still developing. This is also the time when the first interactions with the mother become possible.

What Expecting Moms CAN Do:

Boost your immune system with fresh air walks, and by taking vitamins and minerals;
Engage in pregnancy-safe sports with moderate exercise;
Sleep as needed, preferably with access to fresh air;
Maintain your intimate life, avoiding rough physical activities;
Visit exhibitions, concerts, and hobby clubs that promote positive emotions;
Stay on the beach in the shade, getting a moderate amount of soft UV rays;
Manage household chores, but avoid lifting heavy objects and prolonged exposure to gas appliances;
Get professional prenatal massages;
Take relaxing, soothing baths;
Wear shoes that don't squeeze your feet and avoid high, intricate heels;
Socialize with friends, go on nature trips, and swim in clean bodies of water.

What Expecting Moms CAN'T Do:

making sudden movements in daily life and during sports;
unevenly loading your spine when carrying bags;
lifting heavy objects and holding them up for a long time;
wearing uncomfortable, tight clothing and shoes that squeeze your body and legs;
dressing inappropriately for the weather;
trying to control weight gain;
standing for long periods without rest;
crossing your legs while sitting;
sitting on chairs without back support;
sleeping on your stomach;
spending time in saunas or steam rooms;
being under bright ultraviolet rays for extended periods, including in tanning beds;
engaging in sports with high functional loads;
taking medications, including supplements, without consulting a doctor;
using harsh household chemicals;
smoking, drinking alcohol, or using drugs;
working in hazardous conditions;
being in smoky, stuffy rooms;
riding bicycles or horses;
coming into contact with infectious patients, including those with colds.

Proper Nutrition

At 21 weeks of pregnancy, it is recommended:

To prevent constipation – consume fermented dairy products, whole grain flour products, vegetables high in fiber, and prunes. It is also recommended to take oatmeal infusion on an empty stomach in the morning.
Whole grain cereals are beneficial, especially buckwheat, oatmeal, barley, millet, and corn. These are sources of vitamins, trace elements, and natural energy reserves. Breakfast cereals and instant products contain limited nutrients and are not recommended for pregnant women.

Due to the increased demand for calcium, potassium, magnesium, phosphorus, and vitamins in a pregnant woman's body, it is recommended to consume cottage cheese. It is also rich in essential amino acids and protein.
As a source of protein and digestible fats, lean boiled or baked meat is necessary, and it can be replaced with fish twice a week. It is preferable to consume meat and fish products with vegetables for better digestion.

To alleviate and prevent heartburn, it is recommended to consume jelly and purees. They have a coating effect on the mucous membranes of the intestines and stomach, preventing the impact of excess stomach acid.
To avoid fetal allergies, it is prohibited to consume flavorings, canned foods, carbonated drinks, food colorings, and processed foods.

It's important to eat on a schedule and in small portions. This will reduce the strain on your digestive tract.

Need for Vitamins and Minerals

At the 21st week, the formation of the baby's organs and systems is almost complete. The future baby is "gaining" mass, testing out the digestive system, forming white blood cells, and developing taste buds. The baby already has developed hearing, and the eyes are starting to open, and the spleen is beginning to function. All these processes require resources of vitamins and minerals, which by this time are quite depleted in the mother's body. Replenishing these nutrients is the number one task for the 21st week.

Vitamin B1 (Thiamine)

Essential for the normal transmission of nerve impulses in the brain, as well as maintaining proper muscle and uterine tone. Sources include spinach, dried apricots, nuts, cabbage, carrots, grains, sprouted seeds, and potatoes.

Vitamin B2 (Riboflavin)

Involved in the formation of red blood cells, regulates adrenal function, and supports a healthy pregnancy. The main sources are animal products.

Vitamin B3 (Niacin)

Regulates cholesterol and carbohydrate metabolism, ensures proper vascular function, and maintains levels of sex hormones. Sources include fish, eggs, meat, and organ meats.

Vitamin B5 (Pantothenic Acid)

Supports regenerative processes, aids in the formation of antibodies, and influences the immune response. Sources include eggs, nuts, meat, poultry, cauliflower, and green vegetables.

Vitamin B6 (Pyridoxine)

Participates in the body's metabolic processes, establishes innate immunity for the baby, and regulates the placenta's function. Sources include citrus fruits, grains, tomatoes, carrots, nuts, and potatoes.

Vitamin B7 (Biotin)

Helps prevent diabetes in newborns and strengthens hair and nails. Sources include bananas, liver, peas, oranges, apples, milk, and seafood.

Vitamin B9 (Folic Acid)

An essential vitamin for pregnant women. It is involved in the development of the spinal cord and brain and regulates cell division. Sources include tomatoes, greens, vegetables, nuts, legumes, beets, bananas, and egg yolks.

Vitamin B12 (Cyanocobalamin)

Ensures the proper formation of the nerve endings' sheath in the fetus and is involved in the blood formation system. Sources include seafood, shellfish, organ meats, poultry, and eggs.

Vitamin C (Ascorbic Acid)

This vitamin not only aids in the proper absorption of calcium but also strengthens the immune functions of both the expectant mother and the baby at 21 weeks of pregnancy. It actively participates in metabolic processes and influences the future metabolism of the baby. Major sources of ascorbic acid include green vegetables and citrus fruits.

Vitamin A (Retinol)

Vitamin A plays a crucial role in the development of the baby's hearing and vision organs at 21 weeks of pregnancy. The increase in blood volume in the mother's body during this period can lead to a deficiency of this vitamin. Daily intake of vitamin A helps reduce the risk of stillbirth. Sources include chicken and quail eggs, hard cheeses, butter, fish oil, and fresh carrots.

Vitamin D (Cholecalciferol)

Vitamin D is a unique vitamin that can be synthesized in the body under the influence of ultraviolet rays. A deficiency in vitamin D can lead to improper development of the baby's musculoskeletal system and the onset of rickets. Therefore, from 21 weeks of pregnancy, it is important to include it in your diet, especially if you have limited access to sunlight. Sources include sea fish, butter, lean cheese, animal and fish offal, and chicken eggs.

Vitamin E (Tocopherol)

Vitamin E is considered one of the most beneficial vitamins for women in early pregnancy and at 21 weeks. It acts as an antioxidant, protecting the body's cells, and also supports the level of progesterone necessary for the normal development of pregnancy at 21 weeks and beyond. Vitamin E also supports the functioning of the placenta. Sources include eggs, oils, liver, milk, and cottage cheese.

Vitamin K

Vitamin K includes various subgroups such as K1, K2, and the artificially synthesized K3. These vitamins play a crucial role in the formation of the circulatory system and ensure its function, which is necessary for the fetus after 21 weeks of pregnancy. They support normal blood clotting and can thin the blood when needed. Sources of vitamin K include vegetables, fruits, juices, milk, kefir, veal, chicken, and other foods.

Calcium

Calcium is essential for women after 21 weeks of pregnancy, as this is when the baby's active growth begins, and its systems and organs are already formed. Calcium is necessary for the proper development of bones and the formation of a healthy musculoskeletal system. A lack of calcium can manifest as brittle nails, split ends, and dental health issues. Sources of calcium include sesame seeds, almonds, garlic, cheeses, cottage cheese, meat, poultry, fish, milk, and eggshells.

Magnesium

Magnesium plays a role in the development of the child's nervous system after 21 weeks. It also supports the function of the placenta and helps relieve muscle spasms, preventing premature labor. Magnesium contributes to stabilizing the pregnant woman's sleep, which is important for the proper development of the fetus. Major sources of magnesium include leafy greens, legumes, nuts, cereals, seeds, and whole-grain bread.

Phosphorus

Phosphorus at 21 weeks of pregnancy ensures the proper formation of the future child's brain, heart, kidneys, and liver. It also participates in the development of future teeth and helps absorb B vitamins, without which pathologies are possible. Sources of phosphorus include seafood, fish, nuts, seeds, cheese, meat, soy, eggs, and cottage cheese.

Potassium

Potassium is as important as magnesium for pregnant women. It supports the normal functioning of the cardiovascular system, regulates blood pressure, and controls the function of the placenta and uteroplacental blood flow. For the child, this is critical as nutrients and oxygen are delivered through the blood. Sources of potassium include bananas, potatoes, cantaloupe, prunes, oranges, spinach, and raisins.

Sodium

Sodium actively participates in both intercellular and intracellular metabolism. It is crucial for both the future baby and the mother. A sodium deficiency can lead to muscle atrophy and impaired cardiovascular function. Daily consumption of table salt provides the body with the necessary amount of sodium.

Chromium

Chromium plays an important role in regulating carbohydrate and energy metabolism in the body. It's essential for the baby to receive enough chromium starting from the 21st week, as this is when the thyroid gland begins to form. Chromium controls this process and regulates the body's response to increased insulin levels. Sources of chromium include eggs, tomatoes, mushrooms, oatmeal, and salads.

Cobalt

Cobalt is closely linked with vitamin B12 and is necessary for regulating metabolic processes in the body of the expectant mother and the baby after 21 weeks. It is involved in the breakdown of proteins, fats, and carbohydrates, as well as in the absorption of beneficial nutrients. Cobalt supports the normal function of the thyroid and adrenal glands. Sources of cobalt include fish, squid, eggs, sprats, soy, tomatoes, and quail.

Copper

Starting from the 21st week of pregnancy, the body's need for copper significantly increases. A lack of copper can raise the risk of developing cancer, diabetes, heart and vascular diseases, as well as obesity. Sources of copper include veal, lamb, horse meat, seafood, nuts, buckwheat, oats, and parsley.

Iron

At the 21st week of pregnancy, iron deficiency becomes a common issue among women. This condition is accompanied by weakness, apathy, pale skin, and headaches, which can lead to hypoxia and slowed embryo development. You can get iron from the following foods:

meat;
organ meats;
caviar;
pomegranates;
buckwheat.

Selenium

Selenium is an important antioxidant that helps a woman's body eliminate harmful substances and prevents them from reaching the baby. It supports the functioning of the placenta and protects the fetus. Additionally, selenium promotes normal bone tissue growth and prevents developmental delays in the embryo. Sources of selenium include:

bran;
seeds;
fish;
cottage cheese;
eggs;
beans;
oats;
lentils;
garlic;
cheese.

Silicon

As pregnancy progresses, the strain on the blood vessels and heart increases. Silicon helps cleanse the blood vessels of cholesterol plaques and restores normal uteroplacental blood flow. This element is essential for the proper development of the fetal cardiovascular system and the prevention of congenital vascular diseases. Sources of silicon include:

beans;
mineral water;
oatmeal;
buckwheat;
corn;
peas;
lentils.

Zinc

At 21 weeks, the fetus gains weight daily, and zinc plays a key role in proper weight gain. Zinc deficiency can lead to issues such as low birth weight and intrauterine growth retardation. To ensure adequate zinc intake, it is recommended to include foods such as:

shrimp;
sesame seeds;
garlic;
rice;
almonds.

Important! The choice of multivitamin complexes should be made based on the recommendation of your doctor, obstetrician-gynecologist, and/or therapist.

Helpful Tips

If you experience itching, try not to scratch your skin, as scratches can easily become inflamed. Get a soothing and moisturizing cream or lotion. There are also special products for pregnant women that help prevent stretch marks. You can buy them at the pharmacy. If the itching persists, see a doctor. It might be related to liver function issues and may require additional examination.

It's important for the future dad to remember that his wife should spend as much time as possible outdoors: make it a habit to take an evening walk before bed. This will be your little ritual that will bring you closer during the waiting period for the baby, and it will also help your partner get ready for a good night's sleep (which gets harder each week), relieve anxiety, and relax.

Exercises for Expecting Moms

Physical activity is more essential than ever for pregnant women: it not only helps keep muscles toned but also boosts blood circulation. The perfect exercise for moms-to-be is swimming. It engages all muscle groups, relaxes the body, and doesn't put pressure on internal organs.

Off-limits: high-impact exercises, routines that engage the abdominal muscles, and any workouts done while lying on the back.

Discomforts During Pregnancy

Shortness of breath. This occurs due to the pressure of the growing uterus on the diaphragm. To alleviate breathing difficulties, it is recommended to take walks in the fresh air, get healthy sleep, and do specific physical exercises.
Heartburn. This happens because of stomach acid reflux into the esophagus. Do not drink baking soda. You should adjust your eating habits: eat frequently, in small portions, and chew thoroughly.

Excessive fetal movements. This symptom can be unsafe and may indicate fetal hypoxia. Be sure to inform your doctor about it.
Pain in the lower pelvis, sometimes extending to the lower back. This occurs due to increased uterine tone. Do not ignore this symptom, but initially, you can try to sit down, relax your muscles, and think about something else. If the phenomenon recurs and the pain intensifies, a doctor's consultation is mandatory.

Unusual vaginal discharge, different from what was present in the early stages. If the discharge changes color from white to green, brown, or red, and is accompanied by pain or discomfort, a visit to the doctor is inevitable.
Swelling in the hands and feet. It is necessary to check kidney function. It is important to regulate salt intake and not overdo it with fluid consumption.

Bleeding gums. This can be caused by hormonal issues. Local treatments include rinsing with sage and myrrh extract, as well as massaging the gums with a special toothbrush. Hormonal imbalances are corrected with medication, as prescribed by a doctor.

Checklist

Scheduled visit to the gynecologist. If a vaginal exam wasn't done during the previous visit, have it done at 21 weeks.
Measure blood pressure and temperature, determine abdominal circumference and the height of the uterus, and check the baby's heartbeat.

Have the second scheduled ultrasound to find out the baby's gender, check for any abnormalities, and assess the condition of the placenta.
As per the doctor's orders, determine the baby's blood type and Rh factor.

If genetic tests weren't done at 20 weeks, have them done at 21 weeks.
Conduct a study of the baby's heart function. Based on the doctor's conclusion, additional tests may be needed.

Submit urine and blood for general clinical tests.
Have blood drawn for the "triple test" if there are special indications.

Choose and start attending parenting classes for expectant families.
Purchase and learn how to wear a maternity support belt to relieve lower back strain.

Buy new clothing and shoes that allow for free movement.
Monitor your diet and avoid uncontrolled eating.

Get and use stretch mark cream: your baby is starting to gain weight rapidly.
Start establishing tactile and auditory contact with your baby, as they can now hear and open their eyes.

1. What pains are normal at 21 weeks pregnant?

3. What is the position of my baby at 21 weeks?

20 weeks 22 weeks