How do I Know My Pregnancy is Progressing Well?

By Myrah M.

Nothing is as satisfying as a prenatal visit where you hear your baby’s heartbeat and the healthcare provider says, “All is well. Come back in a month.” It’s a good feeling for perhaps the first week, until that memory fades and you wonder if the same can be said now or in a few weeks. It is then that worries often creep in and we stress about whether the baby is still okay.

How can you take a more active role in your pregnancy and keep closer track of the baby snuggled (hopefully) safe inside your uterus between visits? Short of installing a magic window to peek in whenever you’d like, there are some ways to check that your baby is okay as often as you need to. Simply feeling like you are doing something helps many expectant moms feel less distressed about how the pregnancy is progressing.

How to Know the Baby is Okay in the First Trimester

The first trimester (weeks 1 through 12) is the hardest to assess, even for your provider. The fetal heart tones are very hard to hear, even with a Doppler fetal monitor, before 10-12 weeks. Still, there are some ways to know if things are okay.

Nausea and vomiting are uncomfortable parts of the first trimester, yet these awful experiences might be more welcomed if you knew they indicated that the baby is probably fine. This is because many experts believe that nausea is triggered by high levels of the pregnancy hormone hCG. Lots of hCG mean the pregnancy is likely to be progressing well. Only a few rare pregnancy complications have high hCG levels for unwanted reasons. For the rest, nausea is a sign of health in the pregnancy.

Do not panic if you don’t feel this symptom, however, because the absence of nausea and vomiting does not mean much, especially if all else seems fine. Instead, focus on your weight gain. The total weight gain averages 2-4 pounds in the first trimester or about 0.5 pounds per week after the sixth week.

Pay attention to the weight you were before you got pregnant. This is because underweight women should try to gain more weight, while overweight women do not have to try so hard to “eat for two.”

While you may feel bloated in the first trimester, you will not feel the uterus itself until about the 12th week. The uterus does not pop out in the middle of your abdomen. Instead, it rises from the pelvic floor. At 12 weeks, you should feel the uterus as a firm bump just above your pubic bone.

By the end of the 12th week, you can purchase a fetal doppler monitor to use at home. Listen very low in the abdomen, just above the pubic bone. There is a trick to being successful at doing this fairly consistently, as you’ll see next.

How to Know the Baby is Okay in the Second Trimester

The second trimester (from 13 to 29 weeks) offers you a better chance to use more tools to assess your baby’s health. You can use the fetal doppler monitor regularly to listen to the heartbeat.

As you do this, lie down and plan to be patient. Listen low in the abdomen early on and continue listening while focusing more over the lower abdomen than the upper part. Make sure the doppler is charged. The fetal heart tones are faster in the early part of pregnancy and slower later on. The average fetal heart rate in the second trimester is about 140 beats per minute, but an active baby will have a heart rate of up to 180. This is about twice as high as your own.

Dopplers may pick up the sounds of blood flow in your pelvic vessels. Ignore those; the heart rate is slower than a baby’s so they can be identified easily. Once you find a spot where the tapping or whooshing sound is going double time compared to your own, this is your baby’s heart rate. Write down the number of beats per minute to compare over time.

You can also feel the baby move at about 18 to 20 weeks’ gestation. It feels like a flutter at first, like butterflies in your stomach. After the baby gains weight, expect to feel actual kicks or even see your abdomen morph during significant movements. If you cannot feel anything on any day when you normally consistently feel these movements, drink something sugary (like juice) and lie down for about 30 minutes. Your baby loves sugar and will often awaken and begin moving. Be patient with this, too.

Measure your belly. Get a measuring tape and measure from the pubic bone up to the very top of the uterus. This is your fundal height. Most obstetricians say your fundal height should measure about 1 centimeter for every week you are into the pregnancy (28 weeks = 28 centimeters), but the goal for you should be about 1 centimeter per week rather than a specific number.

As for your weight, if you are gaining a pound or so per week, the baby is likely to be happy with that.

How to Know the Baby is Okay in the Third Trimester

Continue what you had been doing in the second trimester in your third trimester (29 to 40 weeks). Listen, measure, and weigh. Your weight gain should be about 1 pound per week. Sudden weight gain in the third trimester can occur with extra heat exposure, walking or standing too long, or eating too much salt. On the other hand, although rare, it could mean you are developing preeclampsia which is a dangerous rise in your blood pressure. You can check for this by getting a home blood pressure monitor and talking with your doctor.

A home blood pressure monitor is inexpensive; you can check your pressure yourself; and results are easy to read.

Check your blood pressure in the morning and evening. Consistent blood pressure readings of less than 120/80 are reassuring. If you have readings higher than this, see your provider.

What You Should Know About your pregnancy

  • Each pregnancy is unique, so pay attention to trends rather than comparing your values to others.
  • Your fundal height may drop at the end to signal that the baby’s head has settled into the birth canal.
  • The baby’s heart rate will drop as she grows. A bigger baby has a lower heart rate than a smaller one.
  • Expect the baby’s heart rate to accelerate with movement. She’s just exercising. If you do not notice this, talk to your doctor.
  • If something doesn’t seem right, bring your concerns to your provider.

latest news

Product Launch! - The "hi! Baby Sounder" - Your at Home Fetal Doppler

Learn more about how our handheld Doppler can make your pregnancy feel safe.

Announcing the Dr.@home brand of home wellness products

Take charge of your wellbeing from the comfort of your home with our all-new Dr.@home product line.

How V6CO helped frontline health staff during COVID19

From the front line to your bedroom, learn how V6CO used its expertise to help the world get through the pandemic.