Baby's Development in Month 5 of

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The fifth month of pregnancy covers weeks 18 to 21. Details of the baby's growth and development during each of these weeks appear below.
Week 18
At 18 weeks of pregnancy, the placenta and umbilical cord are now fully developed [1]. Over the next month, fetal movements will become strong enough that you regularly notice them [2].
As ossification (bone formation) continues, the fetal bones are now visible by ultrasonography [3]. Ears stick outward from the fetus’s head and can now hear sounds [3,4]. Your fetus can hear loud noises and noises from within your body, such as your heartbeat and your stomach [4].
Visually, the fetus’s head is more proportional to its body, and its legs have lengthened [3].
Week 19
At 19 weeks of pregnancy, fetal growth begins to slow [3]. Brain development makes it easier for the fetus to start consciously moving its muscles [4]. The fetus also notices more sounds now that its hearing is better developed, including your voice [4].
The fetus is developing vernix caseosa, a waxy protective substance secreted by the sebaceous glands on the skin [3,4]. Vernix caseosa will cover and protect the fetus’s delicate skin from scratches, chapping, and the effects of exposure to amniotic fluid [3,4].
Week 20
At 20 weeks of pregnancy, the fetus’s skin, hair, and nails continue to develop and grow [4]. The skin contains juvenile sweat glands [5]. The fused eyelids begin separating over the next four weeks [6].
As the fetus grows, its space becomes increasingly restricted. In response, the fetus adopts a “fetal position” with its limbs bent and tucked in [2]. Should you feel rhythmic fetal movements, it is likely fetal hiccups. If you have not yet noticed quickening (the first fetal movements), pay attention to anything that feels like the “tickling of butterflies.”
If you are having a girl, the vaginal canal is developing, and her uterus has formed [3].
Week 21
At 21 weeks of pregnancy, most of the fetus’s organs are nearly or entirely developed [4]. The fetus starts rapidly gaining weight in preparation for regulating its temperature after birth [2]. As the fetus swallows amniotic fluid, the digestive system practices processing sugars in the fluid [4].
The production of blood cells, which primarily occurred in the liver and spleen, now happens in the bone marrow as well [4]. The fetus’s fused eyelids continue separating [6].
Vernix and lanugo continue to cover the fetus’s skin. While vernix protects the skin, it may also serve as lubrication during childbirth [2].
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References:
1. Betts JG, Young KA, Wise JA, Johnson E, Poe B, Kruse DH, et al. 28.2 Embryonic Development. Anatomy & Physiology. Houston: OpenStax; 2013.
2. Betts JG, Young KA, Wise JA, Johnson E, Poe B, Kruse DH, et al. 28.3 Fetal Development. Anatomy & Physiology. Houston: OpenStax; 2013.
3. Moore KL, Persaud TVN, Torchia MG. The Developing Human: Clinically Oriented Embryology. Philadelphia: Elsevier; 2016.
4. Harms R, Wick M, editors. Mayo Clinic Guide to a Healthy Pregnancy. Boston: Da Capo Press; 2011.
5. Fu X, Li J, Sun X, Sun T, Sheng Z. Epidermal stem cells are the source of sweat glands in human fetal skin: evidence of synergetic development of stem cells, sweat glands, growth factors, and matrix metalloproteinases. Wound Repair Regen. 2005;13: 102-108.
6. Tawfik HA, Abdulhafez MH, Fouad YA, Dutton JJ. Embryologic and Fetal Development of the Human Eyelid. Ophthal Plast Reconstr Surg. 2016;32: 407-414.
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Produced and written by: Samantha Lattof, PhD MSc
Medically reviewed by: Ayodeji Olelakan Abere, MD MBA MHA
Animation by: SciePro / Pond5
Music from: Envato Elements
Narration by: Ava / Wellsaid

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