The fifth month of your pregnancy is almost complete, which means you are halfway through. Your tiny miracle has already started to move about the amniotic sac, kicking and punching, even if you are yet to feel them. From this week onwards, your baby will be growing around a centimeter every week .
Baby development pregnancy week 19
Nervous system development
This week is vital for the fetal nervous system development as the nerve cells responsible for the senses of taste, touch, sight and sound are developing in their respective brain areas . Production of new nerve cells slow down at this stage as the already existing ones start growing larger, creating complex connections within themselves.
The arms and legs are almost in their proper proportion , while the bones in the extremities continue to harden or ossify. Your baby can now control his limbs better as the neurons between the muscles and brain are now connected .
A fat layer has already started to form just beneath the skin, although it is still semi-transparent with visible veins and blood vessels . Another big change occurring this week is the formation of a cheese-like, greasy coating, referred to as vernix caseosa, all over your baby’s body. This waxy layer protects the delicate fetal skin, preventing wrinkles, chapping and abrasions due to exposure to the amniotic fluid .
All the internal organs are in working order, with the kidneys producing urine which constitutes a major portion of amniotic fluid . His heart is still beating twice as fast as your own with the heartbeat getting stronger every week .
A special substance called brown fat starts forming over the internal organs and systems this week. This layer is unique to newborns, meant for protecting your baby’s vital organs from any harm due to the temperature extremes during and after delivery .
How big is your baby this week?
The fetus is approximately 6 inches (15.24 cm)  long, weighing almost 8.5 oz (240.9 gm) , about the size of a mango.
Pregnancy week 19: Your belly and body changes
Your belly is growing larger and rounder every week as the top of the uterus has almost reached your belly button , meaning it has completed half of its journey up your abdomen. The increased blood volume raises your body temperature to some extent, making you feel warmer and perspire oftener than usual . The colostrum (the first fluid secreted by the breasts) production continues with your body preparing for breastfeeding as you may notice a yellowish, thick fluid leaking from the nipples .
Fetal movement this week
Although many first time mothers start to feel their baby move (quickening) at this stage, there is nothing to worry about if you do not feel the flutters. Feeling the fetal movements is related to the positioning of your uterus, as those with the uterus situated toward the front of their abdomen are likely to feel their babies earlier than those with the uterus more toward their back .
19 weeks pregnant ultrasound scan
The routine second trimester transabdominal ultrasound, called a fetal morphology scan , is usually performed between the 18th and 20th weeks. At this stage, an ultrasound image allows your doctor to see both the external and internal body parts of the baby due to his translucent skin . Another exiting thing during this week’s ultrasound is finding out the gender of the baby (if you do not already know). However, the main purpose of this scan is evaluating the fetal growth and heartbeat as well as checking for any congenital anomaly .
It is also known as the fetal anomaly scan as it can detect many neural tube defects and internal organ malformations such as spina bifida, anencephaly, hydrocephaly, major heart, kidney and limb abnormalities, cerebral palsy and Down’s syndrome . Further scans and tests are performed in case an ultrasound detects any of the above problems. In some cases, a transvaginal ultrasound may also be ordered to check for pregnancy complications like a low lying placenta .
Twin pregnancy week 19 ultrasound
The fetal morphology scan helps to ascertain the health and growth of both babies while looking for any twin pregnancy complications such as conjoined twins or twin-to-twin transfusion syndrome . The babies are captured separately in an ultrasound picture as it is often too difficult to evaluate their growth at once .
Week 19 pregnancy signs and symptoms
- Leg cramps, especially at night 
- Linea nigra
- Appearance of dark patches, mainly on your face (the ‘mask of pregnancy’ or chloasma) 
- Feeling out of breath 
- Swollen or bleeding gums 
- Occasional stabbing pain in one or both sides (due to the growing uterus applying pressure on the organs around it) 
- Round ligament pain
- Joint and hip pain 
- Pelvic and tailbone pain
- Constipation and flatulence
- Heartburn, indigestion 
- Weight gain (the average weight gain at this stage is between 8 and 14 pounds) 
- Mood swings and depression
- Feeling hungry more often 
- Itchy skin, especially around the expanding abdomen, chest and nipples
- Feeling out of breath 
When to call the doctor?
- Getting the symptoms of increased pelvic pressure, mild stomach cramps, lower back pain and light bleeding or any change in the vaginal discharge (might indicate an opening cervix and increased risk of miscarriage) 
- Burning pain during urination along with back pain, greenish yellow or whitish jelly-like discharge and stomach pain (might indicate a vaginal or kidney infection such as yeast infection) 
- Watery thin, clear or straw colored discharge (might indicate leaking amniotic fluid)
- Extreme tiredness accompanied by nausea, dry mouth, increased thirst and vision problems (might indicate gestational diabetes) 
- Persistent headaches along with a racing heart, dizziness, vision changes, upper right abdominal pain and swelling, especially of the hands and feet (might indicate high blood pressure or preeclampsia) 
- Severe morning sickness (nausea and vomiting) and diarrhea lasting for over a day 
- Chronic depression or anxiety (as regular anti-anxiety drugs like Xanax are not recommended in pregnancy) 
Tips for a healthy pregnancy and baby
- Maintaining good posture is essential throughout pregnancy to prevent the aches and pains related to the growing uterus putting pressure on your muscles and ligaments. Make sure to keep your body straight, so your shoulders and hips stay lined up with each other when standing or walking .
- Straightening your legs and flexing your ankles and toes toward the shins can help to relieve those late night leg cramps .
- Trying to remain in quiet, peaceful surroundings as your baby is now developed enough to respond to sounds, and sudden loud noises are likely to upset him. You can even play soothing music to keep him calm .
- Going to prenatal yoga classes or following a regular light exercise routine under medical supervision
- Going for a dental checkup in case of extremely swollen or bleeding gums 
- Getting enough calcium, vitamin D (milk products like yoghurt and cheese) and folic acid (vegetables and fruits like spinach, asparagus, beans, avocados and oranges) from your daily diet 
- http://www.mayoclinic.org/healthy-living/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082 [/ref]