Your 13th Week

For most women, any discomforts of early pregnancy start to disappear this trimester. The high levels of pregnancy hormones, which are thought to contribute to sickness, are subsiding, and fatigue should begin to diminish. Meanwhile, your baby floats peacefully in the amniotic sac. As he goes on growing, so the sac will expand to give him plenty of room to kick and stretch. His brain is developing at a rapid rate.


As you enter this second trimester, your body will settle down to pregnancy

You are 12 Weeks and 1 Day 195 days to go…

This is a good time to start telling the important people in your life your exciting news—before they guess for themselves.

Your baby today

This 3D ultrasound scan clearly demonstrates that the baby’s arms and legs are now fully formed and much more in proportion with the trunk. All of the baby’s joints are now formed, enabling a full range of movement.

Now that you’re in your second trimester and have had your dating scan , you may want to start telling a wider circle of people that you’re pregnant. You can feel confident doing this, knowing that the risk of miscarriage is reduced to no more than 1 percent after the 12th week. Besides this, your belly will begin to show in a few weeks, if it hasn’t already, so hiding the pregnancy will become difficult.

If you and your partner have been keeping the pregnancy a secret for the past three months, announcing it will be a huge release and it can be a positive experience to share the news with others. However, be prepared for an onslaught of advice and people’s tales of their pregnancy and birth experiences!

Sometimes letting others know that you’re pregnant can be difficult. Be sensitive to other people’s feelings: friends who also want to be parents, but are having difficulty conceiving, may find it difficult to share your happiness right away. It’s preferable to tell these people face to face rather than them hearing it through the grapevine. Even if they don’t react positively, and don’t want to talk about your pregnancy all the time, give them time to come to terms with it at their own pace. Remember they can be sad for themselves while being happy for you.

Second trimester tests

If you haven’t had a nuchal translucency scan, blood tests will be offered this trimester to screen for Down .

  • The triple test is done at 16–18 weeks. It measures levels of the hormones hCG, AFP, and estriol.

  • The quadruple test is done at 15–22 weeks. It measures levels of inhibin A in addition to the hormones measured in the triple test.

… Your body
Become a clothes cheat!

Although your clothes may be feeling a little tight by this stage, you probably aren’t ready to wear voluminous maternity clothing just yet, so it’s time to get creative! Simply bridge the gap between your button and button-hole with an rubber band (see image) or by sewing in an elastic panel. Assuming he’s bigger than you, try raiding your partner’s wardrobe—his T-shirts, shirts, and sweaters can be ruched in with a low-slung belt.

Check what’s in your wardrobe already: empire-cut dresses will see you through most of your pregnancy; looser smock tops can be layered over tight-fitting T-shirts; low-slung pants can sit neatly under your belly, topped with an oversized shirt. The one item you might want to purchase is a pair of maternity pants—something stretchy with an adjustable waist.

Diagnostic Tests

If you’ve had a positive screening test for Down syndrome or another genetic abnormality, you will be offered a diagnostic test, which gives a definitive answer as to whether or not your baby has an abnormality.

What are diagnostic tests?

Diagnostic tests are tests that involve taking a sample of either the placenta, the amniotic fluid, or fetal blood. The samples are then sent away and examined in a laboratory for chromosomal or genetic abnormalities. The two main diagnostic tests are amniocentesis and chorionic villus sampling, or CVS. Since both of these tests carry a small risk of miscarriage (see Chorionic villus sampling), you will need to carefully consider the advantages and disadvantages of the tests before going ahead with either of them.

Chorionic villus sampling (CVS)

Chorionic villi are fragments of placental tissue. Because the placenta originates from the fertilized egg, the chromosomes in the cells that make up the placenta are representative of your baby’s chromosomes. During CVS, a small amount of tissue from your placenta is removed and tested in a laboratory to reveal if your baby has a chromosomal disorder such as Down syndrome or another trisomy disorder, such as trisomy 18. CVS is done between 10 and 121/2 weeks’ gestation and the results are usually available within 7 to 10 days. The procedure can also definitely identify your baby’s sex, if you want to know. If you don’t want to have this information, make your wishes clear before the test. In rare cases, the doctor will be unable to perform CVS due to the placenta’s position. In this case, you may be asked to return for an amniocentesis at 15 weeks.


This is the most common diagnostic test, done at around 15 to 19 weeks of pregnancy. The amniotic fluid around your baby mainly consists of your baby’s urine and contains cells from your baby’s skin and urinary tract. During amniocentesis, a number of cells are collected from the amniotic fluid. They are then sent to a laboratory and grown in a cell culture, until there is a sufficient number of cells to examine your baby’s chromosomes and identify whether your baby has a chromosomal abnormality such as Down syndrome. Amniotic fluid can also be tested for high levels of the substance alpha-fetoprotein (AFP), which could mean that your baby has a neural tube defect such as spina bifida or anencephaly. Other DNA testing can also be done during amniocentesis to check for congenital conditions that may run in either parent’s family. .

How you might feel

You may be concerned about the idea of a needle going through your abdomen, or a catheter into your cervix; however, the majority of women find that these procedures are not particularly painful. If you are having a transabdominal procedure, the needle usually doesn’t hurt any more than it does when you are having a blood test. Some doctors use a small amount of local anesthetic before the transabdominal procedure to numb the area, although the anesthetic itself can occasionally sting. Although afterward it’s common to experience uterine cramps, similar to the cramps you feel during menstruation, rest assured that these cramps alone do not mean that you have an increased risk of miscarriage.

If your blood type is Rh negative you should receive an injection of anti-Rh after the procedure to prevent complications from occurring during this and future pregnancies.

After the procedure

It’s generally thought that being active after CVS or amniocentesis does not increase your risk of miscarriage. However, you may feel better if you don’t exercise heavily right away; it’s not necessary to remain in bed. In most cases, you should be physically able to return to work within a day or so after a diagnostic procedure, although some women may feel emotionally fragile and may not feel up to returning to work right away.

Getting the results

Usually, chromosomal results from diagnostic tests take around 1–2 weeks to return, and sometimes may take as long as three weeks. If you have had your AFP level tested with amniocentesis (see Amniocentesis), the results for this are usually available fairly quickly, after around 1–3 days. If you are considering terminating your pregnancy based on the results of a diagnostic test, opt for testing earlier in the time frame during which it is offered, rather than later, to reduce risks of complications.

Chorionic villus sampling

There are two ways of doing chorionic villus sampling. In the transabdominal method, a fine needle is placed through the abdomen to collect placental fragments. In the transcervical procedure, a thin tube (catheter) is inserted into the cervix. The method used depends on the position of the placenta and the doctor’s training and expertise. During the procedure, ultrasound guidance is used so that the doctor can see the placenta’s position.

CVS can also be done in a multiple pregnancy; in this case both the transabdominal and transcervical methods of collection may be used.

Transabdominal procedure

Transcervical procedure

When to worry

If, following the procedure, you experience severe abdominal pain, fever greater than 100.5° F (38° C), vaginal bleeding, or a large gush of clear fluid from your vagina you should call your doctor immediately.


During amniocentesis, the doctor uses ultrasound to locate an open pocket of amniotic fluid. Under continued ultrasound guidance, a thin needle is placed through the skin of the abdomen and then through the uterus and into the amniotic fluid. A small amount of the fluid is drawn up into the needle and an attached syringe. A local anesthetic may be applied to your abdomen before the procedure to ease any discomfort.

Comparison of CVS and amniocentesis

Before deciding on a diagnostic test, you may want to weigh their pros and cons. Consider too that the risks may be reduced with a doctor who has expertise in a particular test.

CVS: the pros

  • CVS can be done up to five weeks earlier than amniocentesis, so if an abnormality is found and you decide to terminate, this can be done in a safer, less traumatic way.

  • Since more genetic material is collected, the results may arrive sooner, decreasing the anxious wait.

  • If you’re nervous about a needle going into the abdomen, transcervical CVS means that you can avoid this but still have a prenatal diagnosis.

CVS: the cons

  • The risk of miscarriage after CVS is similar to amniocentesis, at around 1 in 400. The miscarriage rate is the same whether it’s done transabdominally or transvaginally.

  • In the past, some women had CVS then had babies with limb abnormalities. It’s now thought that most of these cases occurred when CVS was done before 10 weeks when the limbs were starting to form.

Amniocentesis: the pros

  • Amniocentesis is highly accurate and has the lowest risk of miscarriage at around 1 in 400.

Amniocentesis: the cons

  • Since this is done later than CVS and the results take longer, if you terminate you may be offered an induction for vaginal delivery, but most doctors can perform D&E until 20 to 24 weeks depending on the state.

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