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Weeks 18 to 22 of Your Pregnancy: Care Instructions

Fetal development at the 20th week

Your Care Instructions

Your baby is continuing to develop quickly. At this stage, babies can now suck their thumbs, grip firmly with their hands, and open and close their eyelids.

Sometime between 18 and 22 weeks, you will start to feel your baby move. At first, these small fetal movements feel like fluttering or "butterflies." Some women say that they feel like gas bubbles. As the baby grows, these movements will become stronger. You may also notice that your baby kicks and hiccups.

During this time, you may find that your nausea and fatigue are gone. Overall, you may feel better and have more energy than you did in your first trimester. But you may also have new discomforts now, such as sleep problems or leg cramps. This care sheet can help you ease these discomforts.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

Ease sleep problems

  • Avoid caffeine in drinks or chocolate late in the day.
  • Get some exercise every day.
  • Take a warm shower or bath before bed.
  • Have a light snack or glass of milk at bedtime.
  • Do relaxation exercises in bed to calm your mind and body.
  • Support your legs and back with extra pillows. Try a pillow between your legs if you sleep on your side.
  • Do not use sleeping pills or alcohol. They could harm your baby.

Ease leg cramps

  • Do not massage your calf during the cramp.
  • Sit on a firm bed or chair. Straighten your leg, and bend your foot (flex your ankle) slowly upward, toward your knee. Bend your toes up and down.
  • Stand on a cool, flat surface. Stretch your toes upward, and take small steps walking on your heels.
  • Use a heating pad or hot water bottle to help with muscle ache.

Prevent leg cramps

  • Be sure to get enough calcium. If you are worried that you are not getting enough, talk to your doctor or midwife.
  • Exercise every day, and stretch your legs before bed.
  • Take a warm bath before bed, and try leg warmers at night.

Where can you learn more?

Go to

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.