Your body during weeks 17 to

This month you'll reach the midway point of pregnancy — 20 weeks. Your uterus will expand to your navel.

Sometime during this month, you'll have a very special experience. You'll feel your baby's first fluttering movements, what doctors and other health care professionals call quickening.

These movements may feel like butterflies in your stomach or a growling stomach. These early movements may be somewhat erratic. They'll become more regular later in your pregnancy. The most active time for many babies is the second half of the seventh month and the entire eighth month.

The many changes that began in your first weeks of pregnancy are continuing to increase and accelerate. Your pregnancy is now probably obvious to everyone.

Your hormones

Your hormone levels are continuing to increase this month, influencing the growth of your baby and affecting all of your organ systems.

Your heart and circulatory system

Your circulatory system is continuing to expand rapidly. As a result, your blood pressure will probably stay lower than normal this month and next. After that, it will likely return to where it was before you were pregnant. You may feel lightheaded, dizzy, nauseated or faint when you stand up after lying down or after a hot shower.

Your body is also continuing to make more blood. Through this month, the extra blood you're producing is mostly plasma, the fluid portion of blood. After that, your body will increase production of red blood cells — if you're getting enough iron.

Iron deficiency anemia, a condition marked by a decline in red blood cells, may result if you're not getting the 30 milligrams of iron you need each day to fuel increased production of red blood cells. This condition develops most often after 20 weeks of pregnancy. It can make you tired and more susceptible to illness. But unless it's severe, it's unlikely to hurt your baby.

You may be continuing to experience some annoying side effects of pregnancy this month, such as nasal congestion, nosebleeds and bleeding gums when you brush your teeth. These changes are the result of increased blood flow to your nasal passages and gums.

Your respiratory system

Stimulated by the hormone progesterone, your lung capacity is continuing to increase this month. With each breath, your lungs are continuing to inhale and exhale up to 40 percent more air than they did before. You also may be continuing to breathe slightly faster. Many women become aware of some shortness of breath.

Your digestive system

Under the influence of pregnancy hormones, your digestive system remains sluggish. Owing to this and your expanding uterus, you may continue to experience heartburn and constipation. You're not alone, if that helps. Half of all women experience heartburn or constipation during pregnancy.

Your breasts

Changes in your breasts may be especially noticeable this month. With more blood flowing to them and the milk-producing glands inside growing in size, they now may be almost two cup sizes larger than before you were pregnant. Veins in your breasts may be more visible now, too.

Your uterus

It goes without saying — your uterus is continuing to expand. By your 20th week, it will reach your navel. When it reaches its full size, it will extend from your pubic area to the bottom of your rib cage.

As your baby is growing within your uterus, so, too, is your placenta. By 17 weeks into your pregnancy, your placenta is more than an inch thick, containing thousands of blood vessels to carry oxygen and nutrients to your baby.

Your larger uterus is now almost certainly affecting your center of gravity and, therefore, how you stand, move and walk. As you adjust to this new reality, you may feel especially clumsy. You may also experience continued aches and pains, especially in your back and lower abdomen.

Around the 20th week of pregnancy, you may feel a pulling or stabbing pain in your groin or a sharp cramp down your side, especially after making a sudden move or reaching for something. This pain results from stretching your round ligament, one of several ligaments that hold your uterus. The pain associated with stretching your round ligament usually lasts several minutes and then goes away. Although it can be painful, it isn't harmful.

However, it's a good idea to discuss any continuous abdominal pain with your health care provider. Abdominal pain can be a symptom of preterm labor or other problems.

Your urinary tract

Slowed urine flow is continuing this month, the result of your expanding uterus and relaxed muscles in the tubes carrying urine from your kidneys to your bladder. As a result, you're at continued risk for developing a urinary tract infection.

Signs and symptoms of a urinary tract infection include urinating more often than normal, burning on urination, fever, abdominal pain and backache. If you have any of these problems, contact your health care provider. Even if you don't have a urinary tract infection, it's better to be safe than sorry. These infections are a common cause of preterm labor.

Your bones, muscles and joints

The ligaments supporting your abdomen are continuing to become more elastic, and the joints between your pelvic bones are continuing to soften and loosen. In addition, your lower spine is probably now curving backward to help keep you from falling forward. Together, these changes in your bones, joints and ligaments may now be causing you some back pain.

Back pain affects half of all pregnant women. It can begin at any time during pregnancy, but it most commonly starts between the fifth and seventh months. You may find back pain to be merely an annoyance. If it was a problem for you before you were pregnant, you may find that back pain significantly interferes with your daily activities.

If you have back pain that doesn't go away or occurs along with lower abdominal cramping, contact your health care provider immediately.

Your vagina

You may be continuing to notice more vaginal discharge this month. Thin, white discharge with a mild odor is caused by the effects of pregnancy hormones on the glands in your cervix and the skin of your vagina. It's normal in pregnancy and it isn't cause for concern.

Do call your health care provider, though, if you have vaginal discharge that's greenish or yellowish, strong-smelling or accompanied by redness, itching and irritation of the vulva. These are signs and symptoms of a vaginal infection, which are common in pregnancy and can be treated successfully.

Your skin

If changes in your skin appeared last month, they are likely still apparent this month and may be for the rest of your pregnancy. In addition to the skin changes that are typical during month four, this month you may have mild skin darkening on your face. You may also have darkening around your nipples, navel, armpits, inner thighs and perineum — the area between the anus and the vulva.

Most of these changes are nothing to worry about. They usually fade after your baby is born. Changes in moles or new moles are the exception. If you have a new mole or a mole that has changed a lot in size or appearance, contact your health care provider.

Weight gain

You'll probably gain about a pound a week this month, for a total of about 4 pounds. By the time you reach your 20th week, you'll probably have gained about 10 pounds.

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