Week 19: Vernix Protection
A waxy, cheese-like coating called vernix caseosa now covers your baby's skin, protecting it from the amniotic fluid. Baby's sensory development is rapid.
Medically reviewed by Samantha L. Fox, RN, BSN, MSN
Nursing Informaticist · United States Navy Nurse Corps · Last reviewed
Your baby is the size of a...
🥭 Mango!
👶 Baby Development
- ✓Vernix caseosa covers and protects baby's skin
- ✓Sensory brain areas for taste, smell, hearing, sight, and touch developing
- ✓Arms and legs are in proportion to each other
- ✓Hair is growing on the scalp
- ✓Baby may develop a regular sleep/wake cycle
- ✓Permanent teeth buds forming behind baby teeth buds
💊 Common Symptoms
- •Hip pain as ligaments loosen
- •Round ligament pain with quick movements
- •Skin darkening (melasma, linea nigra)
- •Stuffy nose continues
- •Increased hunger — strong cravings
- •Feeling baby's patterns of activity
🩺Clinical Context — From a Nurse's View
Hip pain, pubic pain, and low-grade pelvic discomfort all step up around now. This is partly relaxin loosening the symphysis pubis (the front joint of the pelvis) and the sacroiliac joints in the back, getting your body ready for delivery. Symphysis pubis dysfunction (SPD) is the more severe end of the spectrum — sharp groin pain with walking, climbing stairs, or rolling over in bed — and a maternity support belt plus pelvic floor physical therapy help most people. It is not dangerous but can be miserable. Skin changes are accelerating: linea nigra darkens, melasma (patches on the face) may appear, and existing moles may darken from melanocyte stimulation. New, irregular, asymmetric, or rapidly-growing pigmented lesions still warrant a dermatology visit — pregnancy doesn't get a free pass on melanoma surveillance.
Written by Samantha L. Fox, RN, BSN, MSN — Emergency Department nurse, US Navy Nurse Corps officer.
🚨 When to Call (or Go to the ER)
- !Vaginal bleeding — call
- !Severe headache, visual changes, RUQ pain, swelling — call (preeclampsia)
- !Sharp escalating pelvic pain that prevents walking — call
- !New pigmented lesion that's changing — book dermatology
✅ Normal — Even If It Feels Worrying
- ✓Pubic and hip pain
- ✓Skin pigmentation changes (linea nigra, melasma)
- ✓Stronger and more predictable fetal movement
- ✓Cravings, including non-food items (pica) — flag pica to your provider as it can indicate iron deficiency
✅ To-Do This Week
- The anatomy ultrasound is coming up — get excited!
- Research natural childbirth options if interested
- Set up or continue adding to baby registry
- Plan your baby shower guest list
- Consider hiring a doula
- Start doing hip-opening stretches for labor prep
🩺 Questions for Your Doctor
- ?What will the anatomy scan check for?
- ?Is hip pain normal and how can I manage it?
- ?Should I be worried about skin changes?
- ?Is the baby's growth on schedule?
- ?What are the signs I should call you about?
- ?Do you recommend a doula?
📚 References
- [1]ACOG Committee Opinion No. 762: Prepregnancy Counseling. Obstet Gynecol. 2019;133(1):e78-e89.
- [2]ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260.
Editorial review: Samantha L. Fox, RN, BSN, MSN. Last reviewed: see footer.
Your baby is the size of a...