Week 16 of pregnancy: First Movements Soon

This is the earliest point at which some people, usually those who have been pregnant before, feel their baby move. If you feel nothing yet, that is normal: in a first pregnancy movements are often noticed after 20 weeks. Your baby's arms and legs are moving in a more coordinated way, and the face makes fleeting expressions. Your uterus is now around halfway to your navel, and brief groin twinges are common. This is also a good time to think about omega-3 foods and to talk openly about sex in pregnancy.

The NHS puts average crown–rump length at about 11.6 cm this week; the 100 g weight is an estimate, and some sources quote nearer 110 g. Differences like this between charts are normal. In a few weeks many charts switch to measuring from head to heel, so the length will appear to jump.

Every pregnancy is different - you may have some, all or none of these.

First flutters

Early movements are often described as fluttering, bubbling or light tapping, and are easy to mistake for wind. Many people, especially in a first pregnancy, do not notice them until after 20 weeks. There is no need to count them.

Round ligament pain

A brief, sharp or pulling pain on one or both sides of the lower abdomen or groin, often when you stand up or turn over in bed. Moving slowly helps. Pain that is severe or constant, or comes with bleeding, fever or pain passing urine, needs checking.

Backache

A changing posture and loosening ligaments can strain the lower back. Gentle movement and good posture help. If you need a painkiller, paracetamol is the usual choice; avoid ibuprofen unless your doctor advises.

Constipation

Progesterone keeps the bowel sluggish. Fluids, fibre and a daily walk help. Isabgol is a safe option to try, taken with plenty of water and kept about two hours apart from your iron tablet.

• Routine check-up

  Routine

  UK around 16 weeks; India any time from 14 to 26 weeks

  The UK has a routine 16-week appointment to check blood pressure and urine and go over your screening results. In India, your second government visit falls in the 14–26 week window, with haemoglobin and weight checks as well.

• Whooping cough (pertussis) vaccine

  Varies by provider

  UK from 16 weeks; India and US 27–36 weeks

  In the UK it can be given from 16 weeks and is usually offered around 20 weeks. In India, FOGSI recommends Tdap at 27–36 weeks in each pregnancy, available privately, and the US also advises 27–36 weeks. India's government programme gives Td instead.

• Quadruple test or amniocentesis

  Only if needed

  Around 16 weeks, if needed

  If your first visit is in the second trimester, Indian experts suggest the quadruple blood test at about 16 weeks. If earlier screening showed a higher chance, amniocentesis can be done after 16 weeks in India.

If you have not felt any movements by 24 weeks, tell your doctor or midwife so they can check on your baby. Before then, not feeling movements is not usually a concern.

• 🌿Omega-3 fats such as DHA are important for your baby's developing brain. Oily fish is the richest source: for non-vegetarians, up to two portions a week of low-mercury fish such as sardine (mathi or tarli), mackerel (bangda or ayala), salmon, or freshwater rohu and katla are good choices.
• 🌿Avoid shark, swordfish and marlin because of mercury, and limit tuna. Cook fish thoroughly and avoid raw fish.
• 🌿Vegetarian sources include flax seeds (alsi), chia seeds and walnuts. They provide ALA, a plant omega-3 that the body converts to DHA only in small amounts.
• 🌿If you do not eat fish, ask your doctor whether an algae-based DHA supplement is worth taking. Avoid cod liver oil, which can contain too much vitamin A.

• •Carry on with walking, swimming or prenatal yoga, and increase effort gradually rather than in sudden jumps now that you feel better. Walking in the cooler part of the day is often easiest.
• •To ease round ligament pain, roll onto your side before sitting up from lying down, and avoid sudden twisting movements.
• •Pelvic tilts on hands and knees, or standing against a wall, can ease backache; move slowly and breathe steadily through each one.

• •Sex is safe in a healthy pregnancy and does not harm the baby. Your doctor may advise against it if you have heavy bleeding, a low-lying placenta, cervical problems or a risk of preterm labour, or after your waters have broken.
• •An anterior placenta, one that lies at the front of the uterus, can cushion movements so you notice them later. The anomaly scan at 18–22 weeks will show where your placenta is.
• •You do not need to count movements yet. Once they are established, getting to know your baby's usual pattern matters more than any number.

• ?When might I expect to feel movements, and where is my placenta?
• ?Is this groin pain normal round ligament pain?
• ?Is sex safe for me in this pregnancy?
• ?Should I take a DHA supplement?
• ?Do I need the whooping cough vaccine, and when?

• Note the date if you feel a first flutter
• Roll to your side before getting up
• Add omega-3 foods twice this week
• Book or attend your second antenatal visit
• Talk with your partner about intimacy and any worries