Pregnancy – Month 4

Welcome to the second trimester. For a lot of women, this is the stretch where pregnancy actually starts to feel good. The nausea from Month 3 is easing up for most people, your energy is coming back, and you're not quite big enough yet for the aches that show up later on. Enjoy it while it lasts.

Physical changes you might notice

A lot of what showed up in Month 2 and Month 3 can still be around, just quieter. New this month, your sex drive might shift in either direction, and don't be surprised if you're up at night to pee more often. Your uterus is growing out of your pelvis now, which puts new pressure on your bladder.

Emotional changes you might notice

Some of the anxiety from earlier months starts to loosen its grip, especially once you've had a good ultrasound and started to feel more confident this pregnancy is sticking around. You might also notice a strange new one, oddly specific dreams about baby animals, kittens or puppies with their mothers. Nobody knows exactly why that happens so often, but plenty of pregnant women report it.

Appetite changes

Appetite tends to pick back up as nausea fades, and cravings can get more specific. Some women still deal with morning sickness this month, with or without vomiting, though it's usually milder than it was a few weeks ago. If food still isn't sitting right, our pregnancy nutrition guide has ideas for eating well even when your stomach is picky.

The inside story

By the end of this month, your baby is about four and three quarter inches long and weighs around four ounces, roughly the size of an avocado. The head is still large compared to the body, but the rest is starting to catch up. Eyes can make small movements now, though the eyelids stay fused shut for a few more months yet. Ears are settling close to their final position, and your baby's kidneys have started producing urine and practicing swallowing amniotic fluid, both signs the digestive and urinary systems are coming online. If you're hoping to find out whether you're having a boy or a girl, this isn't the month for it. A useful read at this stage isn't reliable yet, even with a good ultrasound. The anatomy scan around eighteen to twenty weeks, which falls in Month 5, is usually when there's enough to see clearly.

Sleep and energy

Nighttime bathroom trips can chip away at your sleep this month. If grogginess is dragging you down during the day, try going to bed an hour or two earlier, or sneak in an afternoon nap when you can. Most women do find their energy improving overall compared to the first trimester, even with the extra trips to the bathroom.

Easing the stress

This is a good month to get moving again if you weren't up for it earlier. Walking, swimming, prenatal yoga, gentle indoor cycling, light weight training, and low impact aerobics are all solid choices for most healthy pregnancies. If you're an experienced runner, jogging or cross country skiing can be fine too, just steer clear of anything above about ten thousand feet in elevation, since lower oxygen levels at altitude aren't worth the risk. Check with your doctor before starting anything new, especially if you weren't very active before pregnancy.

Special risks worth knowing about

The good news is that miscarriage risk drops quite a bit once you're safely into the second trimester, especially after a healthy heartbeat has shown up on ultrasound. That doesn't mean zero risk, so it's still worth paying attention to warning signs. Coming up next month is the anatomy scan, a detailed ultrasound that checks your baby's organs, growth, and development, so this is a good time to get that appointment on the calendar if your doctor hasn't already scheduled it.

Curious what your baby actually looks like at this stage? Our ultrasound images page has real examples, and our pregnancy weight gain chart can help you track how you're doing so far. The Mayo Clinic has a helpful breakdown of healthy weight gain ranges by starting weight if you want more detail than a chart alone gives you. When you're ready, Month 5 picks up right where this leaves off.