Week 9 of pregnancy: baby changes and visit to the midwife

In our journey through the weeks of pregnancy, we have now reached week 9, which as you know corresponds to a gestation of 7 embryonic weeks.It may seem like a short time, and yet so many changes take place inside you: a wonderful development of the new life, and a series of modifications in the mother that can sometimes cause some discomfort, but which, in any case, Their purpose lies in contributing to the baby's development. and in preparing the body for childbirth and breastfeeding, which are still a long way off.

Your daughter or son is still an embryo, but This phase is about to endAnd in a few days we'll be referring to him as a fetus (although of course, you'll still call him "my baby"). He's still very small and is estimated to measure about 2,5 centimeters, with a weight similar to that of a cherry. It is important to remember that intrauterine growth is not the same for all embryos. (as occurs after birth), therefore variations between pregnancies will be normal even if they are all in the same week of gestation. However, with this information and advice we intend to support and guide you on the most fascinating journey that you are going to make in your entire life.

In week 8 of pregnancy, Valeria told us that what we know as cell specialization occurswhich translates, among other things, into a very important maturation of the heart and lungs, and a clear development of the intestines. The basic structure of the body is already formed, even though it's no bigger than a large grape.The heart chambers are divided and the valves are forming relentlessly, while the placenta gradually assumes the main role in the baby's nutrition.

Week 9 of pregnancy: more changes in the embryo

Week 9 of pregnancy practically marks the end of the embryonic stageThese days your baby is almost double in size compared to previous weeks, and their appearance is starting to look more and more like that of a mini-baby. Although still very small, their body already shows a complex organization, and many organs have completed their basic structure.

Among the most important changes that occur in the embryo/future fetus this week are:

Movement: Although the embryo is constantly moving, its muscles don't yet have a mature connection to the brain. Therefore, rather than coordinated movements, these are more like spasms or spontaneous jerks. You won't be able to feel them yet; that perception will come later, in the second trimester.
Hands and feet: The hands appear with clearly differentiated fingers, and the feet also begin to show their toes. The wrists form first, then the ankles, so that The limbs lengthen and become articulated. better every time.
Face and head: The upper lip, ears, and overall shape of the face become more clearly defined. The facial bones form, and the head, which was initially disproportionately large, it begins to balance with respect to the body, which is lengthening and straightening.
Eyes and eyelids: The eyes migrate to the front of the face and the eyelids are already formed, although they will remain closed for several weeks (around 17 more weeks) to protect eye development.
External and internal ears: The ears have also just formed internally and externally, which will allow the baby to perceive sounds from inside and outside the womb later on.
Skeletal system: If the facial bones form, so do the ribs and vertebrae. Specialization in the limbs is a given. elbows, knees, shoulders, ankles and toes They are already recognizable. Although ossification is taking place, the skeleton is very fragile because the bones have not yet accumulated enough calcium and have the consistency of cartilage.
Digestive system: The organs of the digestive system, such as the stomach and intestines, continue to develop. They begin to move into their final position within the abdomen and prepare to function once the baby is born.
Reproductive system: The external sex organs are not yet developed, although sex is determined at conception. By week 9, the embryo has a genital tubercle which will later differentiate into a penis or clitoris/vulva, depending on chromosomal sex. This difference is not yet visible on ultrasound, so It will take a while to find out if it's a girl or a boy.We imagine this doesn't bother you because what all mothers want is to give birth to healthy babies.
Mouth and swallowing: The baby begins to use its mouth, it can open it, ingest small amounts of amniotic fluid and, very early on, even put their thumb in their mouth, thus training their sucking reflexes.
Placenta and umbilical cord: The placenta increasingly assumes the primary role in nourishing and oxygenating the baby. The gestational sac gradually loses its importance, and the umbilical cord, composed of one vein and two arteries surrounded by Wharton's jelly, it becomes the interchange highway between your blood and your baby.
Disappearance of the embryonic tail: The trunk begins to straighten and the characteristic embryonic tail, typical of earlier stages, disappears almost completelygiving a more defined and human appearance to the small body.

Here is a video that explains very well the changes in an embryo of 7 weeks / 9 weeks of gestation; What caught my attention most was the explanation about limb development.It's in English, but you can activate the subtitles function and then (in settings) open the translation and select "Spanish"; in any case, it's quite easy to understand.

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One aspect that stands out is precisely the disappearance of the embryonic tail and the progressive definition of the spine and ribs.

How big and heavy is the baby at week 9 of pregnancy?

At this time, Your baby measures approximately between 2,5 and 3 centimeters From head to rump (craniocaudal length), it is about the size of a cherry or a 1 euro coin. Its weight is around 2 to 3 grams, which is equivalent to a thumbtack or a small paperclip.

These measurements are average estimates: Every pregnancy is different. It's possible your baby may be slightly above or below these figures without it being a problem. Growth is always assessed holistically, taking into account ultrasounds and clinical progress.

Prenatal diagnosis and testing schedule in the first trimester

I am aware that pregnancy is not an illness, although it is worth remembering that a pregnant woman should take good care of your diet and your overall health. Like is logic, you will continue to take folic acid And following the advice given to you by your midwife or gynecologist, then any interference with toxins (some medications, alcohol, tobaccoUnjustified X-ray tests would negatively affect your baby and their development. The first quarter is a period of great vulnerability in which the main organs are being formed.

What tests will you have between week 9 and week 12?

You have probably already gone to the midwife and listened to the heartbeat; And you may have even gone through the first ultrasound. The first check-up visit usually takes place between week 9 and week 12 of pregnancy. (if you haven't already done so). In that consultation you can expect that:

They open your pregnancy booklet or history, where all relevant information will be recorded.
They take the blood pressure and write down your starting weight to monitor weight gain throughout your pregnancy.
They prescribe you a complete blood and urine analysis, which is usually done around weeks 10-11.
Explore your breasts and perform a vaginal examination to assess the cervix and rule out abnormalities.

The following parameters are usually requested in the first pregnancy blood test:

Blood group and Rh factor: to find out your blood type and detect possible Rh incompatibilities between mother and baby.
Indirect Coombs test or irregular antibody screening: It allows the identification of other less frequent blood group incompatibilities.
Complete blood count: evaluates the state of the blood, detects possible anemia and rules out other hematological abnormalities.
Urine analysis: Urinary tract infections are common during pregnancy and should always be diagnosed and treated.
Serologies: Immunity against infections such as rubella, syphilis, toxoplasmosis, hepatitis, or HIV, among others, is tested for prevent complications in pregnancy.
Chromosomal abnormality screening test: Biochemical markers are analyzed (such as free beta-hCG and PAPP-A) which, together with ultrasound, allow the calculation of the risk of certain genetic alterations.

Furthermore, it is very important during the first quarter control the thyroid hormones, perform the combined screening and check the result of the anti-toxoplasma IgG test.

First trimester combined screening (Triple Screening)

Combined screening, often known as triple screening or screening for chromosomal abnormalities, It is not a diagnostic testbut a mathematical estimate of the risk that the baby will have chromosomal abnormalities such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18).

To calculate this risk, the healthcare professional takes into account:

Maternal agebecause the risk of some chromosomal abnormalities increases with age.
Blood levels of free beta-hCG y PAPP-Aproteins produced by the placenta.
The data first trimester ultrasound (between weeks 11 and 13+6), especially the nuchal translucency, the baby's size (crown-rump length) and other markers.

With all this information, a risk index is obtained. If the result is high riskMore precise tests may be recommended, such as the non-invasive fetal DNA test using maternal blood, or invasive techniques like amniocentesis or chorionic villus sampling, which allow for a more accurate study of the fetal karyotype. Your healthcare team will always provide you with individualized advice.

Other prenatal diagnostic tests

In selected cases, and always under medical supervision, invasive prenatal diagnostic techniques may be recommended:

Amniocentesis: It is performed from weeks 14-15 onwards to obtain amniotic fluid containing fetal cells. It allows for the study of the baby's karyotype and rule out or confirm specific chromosomal alterations.
Chorionic villus sampling: It is performed between weeks 11 and 14 and consists of taking a small sample of chorionic villi (placental tissue) for genetic analysis.

These are procedures that involve a small risk of pregnancy lossTherefore, these tests are only offered when there is sufficient medical justification (high risk of chromosomal abnormality, family history, ultrasound findings, etc.). Many centers also offer rapid techniques such as QF-PCR, which provide some preliminary results on specific chromosomes.

Ultrasound scans during pregnancy: how many are necessary?

During pregnancy they are only strictly necessary three main ultrasounds in normal pregnancies (unless otherwise indicated):

First trimester ultrasound (weeks 11-14): It confirms fetal viability, accurately dates gestational age, and is part of the combined screening for chromosomal abnormalities.
Second trimester morphological ultrasound (weeks 19-22): It explores fetal anatomy in detail to detect significant malformations.
Third trimester ultrasounds: Depending on the evolution, one or more procedures may be performed to monitor the baby's growth and blood flow using Doppler ultrasound.

Although many women want a greater number of ultrasounds, there could be risks derived from a very high exposureIt is always advisable to follow the recommendations of the healthcare team.

Fetal DNA test in maternal blood

Starting in these weeks, part of the Your baby's DNA is circulating in your blood.This allows you to have a non-invasive fetal DNA test, if you wish and if indicated. It is a blood test that analyzes fragments of fetal genetic material and can reliably detect some common chromosomal abnormalities, as well as... inform about the baby's sex.

It's an expensive test, and in most public healthcare systems, it's not offered universally except in cases of increased risk, although you can always get it done privately. Its advantage is that It does not carry the risks of invasive testsHowever, in the case of a high-risk result, confirmation by amniocentesis or chorionic villus sampling is usually required.

The midwife: your great ally in week 9 of pregnancy

When a woman receives the news of her pregnancy, one of the first things that worries her is who will be the professional who will attend to her; whether she will be monitored by the public health system, by medical insurance or privately, and whether that doctor will assist her in childbirth.

This is one of the first facts that many women don't know about pregnancy: The health professional best trained and prepared to monitor pregnancy, childbirth and the postpartum period is the midwife or matron.If a pregnancy is normal, the midwife can and should be the woman's primary healthcare provider, not necessarily the gynecologist. Doctors specializing in obstetrics are trained to monitor and manage high-risk pregnancies and deliveries.

When a healthy woman, with a healthy pregnancy, is accompanied in the process by a professional who treats her as if she were ill, the experience of pregnancy can become more distressing and less satisfyingwithout thereby improving perinatal outcomes.

What can a midwife do for you?

If the woman hasn't contacted a midwife before, the beginning of pregnancy is an ideal time to do so. With her, you'll not only have a good clinical control of the pregnancybut it will also provide you with emotional support and help you resolve all kinds of doubts:

You will talk to the midwife about your fears, expectations and emotions.
You will review your diet and lifestyle habitsas well as your sleep and rest patterns.
He will explain it to you in detail. what is the process of pregnancy and childbirth like?and what changes you can expect at each stage.
It will guide you on the postpartum period and breastfeeding, resolving frequently asked questions about newborn care.
She will listen to the fetal heartbeat, measure your blood pressure, monitor your weight and uterine height, but above all will accompany you closely.

In the public healthcare system, there are midwives in almost all health centers. If there isn't one in yours, it would be advisable to request their presence, as it is the professional trained for the control of normal pregnancy.

In the private healthcare sector, there are also midwives who work independently. These professionals often offer support during childbirth (at home or in private clinics) and throughout the postpartum period and breastfeeding.

Recommended visits during pregnancy

The frequency of visits will depend on each healthcare professional and each healthcare system. In general, a possible schedule for monitoring a healthy pregnancy could be:

1th visit: Midwife (week 5-8). Initial contact, background information gathering, request for blood tests and first-trimester ultrasound. Guidance on adapting to pregnancy.
2nd visit: Midwife / doctor / gynecologist (around week 12). Assessment of the results of the analyses, performance or review of the first trimester ultrasound and general evolution of the first stage of pregnancy.
3th visit: Midwife (week 16-18). Beginning of the second trimester, review of bodily sensations and frequent discomforts, first thoughts about the birth plan and request for the second trimester morphology ultrasound.
4th visit: Midwife / gynecologist (week 20-22). Review of the morphological ultrasound and general evolution of the second trimester.
5th visit: Midwife (week 24-28). Request for the second analysis (including gestational diabetes screening), preparation for motherhood, resolution of concerns and more detailed work on the birth plan.
6th visit: Midwife / gynecologist (week 32-34). Third trimester ultrasound, assessment of fetal growth and baby's position. Discussion about the final stage of pregnancy.

From this point on, depending on the circumstances, it may be helpful to meet with the midwife a few more times, until the end of the pregnancy (between weeks 38 and 42), to continue resolving any doubts. adjust the birth plan and accompany you in the final stretch.

How does the mother live this week of pregnancy?

We're talking about a 7-day difference compared to the previous week, but in this first quarter the changes can be very noticeableSome of these we've already mentioned, and others you might discover now. Not all women feel the same: some experience a lot of discomfort while others hardly notice any changes, and both situations can be normal.

Frequent physical changes in week 9

Tiredness and drowsiness: Progesterone and increased blood volume can make you feel exhausted and sleepy at any time of day.
Nausea, dizziness and vomiting: They are very common in these weeks. They can appear in the morning, after strong odors, or unpredictably.
Sensitive and larger breasts: The mammary glands prepare for breastfeeding and blood flow increases, so you may notice tightness or pain.
Possible fluid retention: You might notice some swelling in your feet or hands, although the most obvious signs usually appear later.
Digestive discomfort: Heartburn, gas, a feeling of heavy digestion, or abdominal bloating are very common.
Mild pelvic cramps: The uterus grows and the ligaments that support it stretch, which can cause period-like discomfort if not accompanied by heavy bleeding.
More frequent urination: Hormones and increased blood flow to the kidneys make you need to go to the bathroom more often.
Possible skin changes: They can improve existing blemishes or, in some cases, cause acne due to increased sebaceous gland activity. Hair usually looks shinier and fuller.
Bleeding gums: If your gums bleed or you notice dental discomfort, it's a good time to call your dentist, as tooth enamel also requires extra care during pregnancy.

The uterus has not yet ascended and is located within the pelvis.So, apart from possible fluid retention or bloating from gas, your belly probably hasn't undergone any obvious changes to others, although you might notice your clothes are a bit tighter.

Emotional changes in week 9

It's common to feel more sensitive, irritable, or emotionalHormonal changes can make you go from laughter to tears in a matter of minutes.
You can experiment new concerns related to your health, the baby's health, family organization, work, or the future.
You may also feel joy and fear at the same time, something very common in the early stages of pregnancy.

Feeling this way is completely normal. Talking about it with your partner, friends, or your midwife can help. channel these emotions and feel less alone. If you notice that feelings of sadness or anxiety are very intense or persistent, don't hesitate to seek help; taking care of your mental health is just as important as taking care of your body.

Daily care and organization at home

Although, as we've mentioned, pregnancy isn't an illness, it does require care. And not just physical care, but also emotional and socialLet others take care of you, and take care of yourself. Rest if you need to, and don't give in to social pressure: you're a mother, and that already makes you a superhero, but that doesn't mean you have to be able to do everything.

What I mean is that even if there's dust on the furniture and you can't do your weekly shopping, Absolutely nothing is going to happenThe world should stop for you, not you carrying an excessive burden. Seek support from your partner, demand shared domestic responsibility, and if the father works long hours or you're going to be a single mother:

Performs small purchases in the neighborhood shops to avoid carrying heavy loads.
Organize your home in a more practical way that doesn't require you to spend many consecutive hours.
Accept help from family or friends to specific tasks, such as deep cleaning or running heavy errands.

Regarding food, it continues with a healthy and balanced dietRich in fruits, vegetables, quality protein, and healthy fats. It is especially important to ensure an adequate intake of folic acid, iron, calcium and vitamin DTo avoid or reduce gas and acidity:

Avoid fizzy drinks and foods that cause a lot of gas (chickpeas, beans, raw lettuce, etc., if you find they make you feel unwell).
Chew slowly and take your time eating.
Eat 5 to 6 small meals a day instead of a few large meals.

Finally, it is essential that you maintain a good hydrationDrink water frequently throughout the day. Don't reduce your fluid intake to go to the bathroom less often; your body and your baby need that hydration.

And now, we'll leave this week of pregnancy behind and return in a few days with a new installment of our Pregnancy Week by Week series. Your body and your baby are working intensely, even if it's barely noticeable on the outside, so let your own feelings guide the pace, lean on your midwife and those around you, and remember that every little question you answer helps you experience this process with more calm and confidence.

Images - Pietro zucco, Wiki how.