The First Nine Months

By Vicki Dihle
Physician Assistant- Certified

20 weeks after fertilization

For centuries, humans have marveled at the miracle of life.

Until recently, the process that propels two microscopic
cells to unite and develop into a human being was a
mystery known only to the Creator Himself. Now, thanks
to recent advancements in medical science and imaging
technology, we have the privilege to directly observe the
developing life within the mother's womb. This technology
allows us to witness the miraculous process that follows
the uniting of two cells. Barring the unexpected, this
union will culminate in a fully formed human life with
inherent value and worth in a mere 266 days.1 Witness
the miracle in the making as we journey through the "First
Nine Months" of human life.

The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003, pg
104

The First Nine Months

The time frames referenced below indicate gestational age. See page 9 for further explanation on the
difference between fertilization age and gestation age.
Fertilization
The oocyte (also known as ovum) and sperm most often unite in the fallopian tube (uterine
tube) to form a single cell called a zygote. The zygote contains 46 chromosomes, 23
chromosomes from each the oocyte and the sperm cell. This tiny new cell, smaller than a grain
of salt, contains all the genetic information for every detail of the new created life - the color of
the hair and eyes, the intricate fine lines of the fingerprint, the physical appearance, the gender,
the height, and the skin tone. This new life is now known as an embryo.
~ 2.5 Weeks
The embryonic cells are continuously dividing while traveling down the fallopian tube before
arriving to their final destination the uterus around 3 to 4 days after fertilization.
Meanwhile, the lining of the uterus (endometrium) is preparing for implantation.
~ 3 Weeks
The embryo begins to implant in the lining of the uterus. Once this occurs, a series of
hormonal signals are triggered which prepares the uterus and the body to sustain the pregnancy,
and prevent a monthly period (shedding of the lining of the uterus). The embryo is about 0.1
mm (about the size of the period used in this sentence) and the embryonic cells are beginning to
differentiate into specific tissues and organs systems.2
~ 4 Weeks
Implantation is typically completed around the 14th day after fertilization and is visible by
ultrasound.3 There is enough of the pregnancy specific hormone (called human chorionic
gonadotrophin - hCG) circulating in the mothers blood to give a positive pregnancy test.4
~ 5 Weeks
The foundation for every organ system is already established and beginning to develop. The
first signs of brain development are evident. During this week, the foundation for the ribs,
vertebra, and muscles are present, and the developing lungs are evident.5 The heart, about the
size of a poppy seed6, is the first organ to function and begin beating; this can be seen by
ultrasound.7
~ 6 Weeks
At this stage the origin of the entire central nervous system (brain and spinal cord) is in place.8
Eye formation, jaws, and upper limb buds are evident. By the end of the 6th week, the lower
limb buds are apparent.9
2

ibid, pg 2, 3, 29. 45
ibid, pg 47, 51
4
ibid, pg 44
5
Essentials of Human Embryology, Larsen, William, Churchill Livingston 1998, pg 90
6
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 15
7
Essentials of Human Embryology, Larsen, William, Churchill Livingston 1998, pg 67, 70, 73
8
Understanding How the Brain Develops, Maureen Mulligan LaRossa, R.N., Sheena L. Carter, Ph.D.,
www.pediatrics.emory.edu/NEONATOLOGY/DPC/brain.htm
3

~ 7 Weeks
The embryo makes its own blood in the liver, bone marrow, and spleen. The upper limbs are
paddle shaped and the lower limbs are flipper like.10
~ 8 Weeks
The elbows and fingers become evident. Some reports show that the developing baby has
spontaneous movement of the trunk and limbs. The vertebrae in the neck are able to bend, and
the trunk is able to straighten. Further, some reports demonstrate that the embryo can respond
by reflex to touch.11 The embryo is about long.12
~ 9 Weeks
There is rapid development of the limbs and fingers, and the soft boney tissues of the upper
limbs begin to calcify and harden. Development of the intestines is quite prominent as well.
The developing ears and nose are visible and there is pigment in the retina.13

9 weeks
~ 10 Weeks
The upper and lower portions of the arms and legs are clearly distinguishable. The bony tissues
of the lower limbs begin to calcify. The fingers and toes are lengthening and are separate
digits. For the first time in development, the limbs purposefully move. By the end of the 10th
week, the embryo has very distinct features and weighs about 1/3 of one ounce.14 There are 20
tiny tooth buds present in the gums.15 The eyelids are developing and begin to close. This
marks the end of the embryonic stage of development.16

The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003, pg
84
10
ibid, pg 70, 84, 85
11
ibid, pg 85-86
12
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 18
13
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003 pg
88
14
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 22
15
ibid, pg 23
16
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003 pg
90-94

10 weeks
~ 11 Weeks
The developing baby has all major organ systems and is now known as a fetus, which is Latin
for young one or offspring. At this stage of development, the fetus is about two inches
long. During the next stages of development, the babys body will grow rapidly, and the
tissues and organ systems will continue to mature and differentiate. The eyelids are fully
formed and closed to protect the developing eyes, and they will remain closed until later in
gestation. 17 The fetus is able to yawn and suck.18
~ 14 Weeks
The baby is able to urinate and swallow.19 Roughly three inches in length, the fetal body is
rapidly growing while the heads growth has slowed. The foundations for the fingernails and
toenails are clearly distinguishable.20 The baby is coordinated enough to isolate the thumb and
suck it.21

14 weeks

17

ibid, pg 102-103
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 24
19
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003 pg
106
20
ibid, pg 103
21
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 37
18

14 weeks
~ 16 Weeks
At approximately 4 in length and weighing nearly 3 ounces,22 the fetus can coordinate the
movement of the upper and lower limbs which are easily visible with ultrasound though the
mother will not likely feel them. Slow eye movements are noted for the first time. The gender
of the fetus is recognizable on ultrasound.23
~ 18 Weeks
The skeleton of the fetus is hardening and calcifying and is visible by ultrasound. The external
ear can be clearly seen on the outside of the head.24

~16 weeks

~22 weeks

~ 20 Weeks
The babys movement, known as quickening, can usually be felt by the mother, and the fetal
skin has a protective covering known as vernix caseosa. If the fetus is female, her uterus is
formed and her ovaries have eggs.25

22

ibid, pg 40
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003, pg
106
24
ibid, pg 103, 106
25
ibid, pg 103, 107
23

~ 22 Weeks
At this stage, the pregnancy is about half over, and the mother is beginning to show. The
fully formed eyelids remain closed and hair is visible on the head and body. The fetus is about
7.5 inches long. If the fetus is male, his testicles are fully formed and are beginning to descend
from the abdomen to the scrotum.26 The sensation of pain can be experienced by the fetus,
possibly as early as 18 weeks. In fact, from now until about 32 weeks pain is felt more
intensely than any other time in development.27

22 weeks
~ 24 Weeks
The baby now weighs slightly more than one pound. Though survival is not guaranteed, a baby
born at this stage of development has been known to survive outside the uterus. The baby
inhales amniotic fluid in preparation for breathing. Hearing is well established and the baby
can hear its mothers voice and heartbeat.28 The babys skin is pink, translucent, and wrinkled.
Additionally, rapid eye movements are present, and the fetus can have a blink-startle response
resulting from sound applied to the mothers abdomen.29

26

ibid, pg 102, 103, 107

Dr. Kanwaljeet S. Anand, M.B.B.S., D. Phil. Dr. Anand was asked by the U.S. Department of Justice to prepare a
statement as an expert witness on fetal pain and the effects of maternal anesthesia on fetal pain, and to assist the Court in
the assessment of the Partial-Birth Abortion Ban Act of 2003. Dr. Anands expert witness statement is dated January 15,
2004.
28
Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 60, 61
29
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003, pg
103, 107
27

~22 weeks
~ 28 Weeks
The baby is now about 11 inches long and weighs about 2.5 pounds. With the support of
intensive care, a fetus born at this stage is capable of breathing, and the brain is developed
enough to coordinate rhythmic breathing and regulate body temperature. The wrinkled fetal
skin begins to smooth because of increased fat. The spleen is primarily responsible for making
fetal blood. The eyelashes are clearly evident, and the baby begins opening its eyes.30 The
baby is able to respond to touch and sound, and also has fully functioning taste buds on the
tongue.31
~ 34 Weeks
The baby, now about 19 from head to toe and weighing about 5 pounds,32 continues to grow
and mature. By this stage of development, the eyes are wide open and if a light were shined
into them, the pupils would constrict. The head is covered in hair, the fingernails have reached
the tips of the fingers, and the toenails are close behind.33 The baby has active sleep and wake
cycles.
~ 40 Weeks
The baby is now roughly 20 inches long, has a more plump body and a firm grasp. The chest is
more prominent.34 Typically, the baby is head down in the mothers pelvis and is awaiting
birth.

30

ibid, pg 103, 107

Watch Me Grow, Stuart Campbell, M.D., St. Martins Press, 2004, pg 71, 72
32
ibid, pg 92
33
The Developing Human, Clinically Oriented Embryology 7th Edition, Moore, Keith L., Saunders Publishing, 2003 , pg
103, 107
34
ibid, pg 103
31

Newborn at 3 days old

For Further Information

Fertilization age refers to the time elapsed since conception: the fertilization of the egg by the sperm.
Most women ovulate (release a mature egg from the ovary) in the middle of their monthly cycle. For
instance, if a woman has a 28 day cycle, she will typically ovulate on the 14th day after her period
began. If a woman conceives and becomes pregnant at that time, this becomes the first fertilization
day.
Gestation age is slightly different than fertilization age. Gestation age refers to the time elapsed since
the mothers first day of her last period. Typically, this is two or more weeks earlier than the
fertilization age. In other words, if a woman had her period two weeks ago and then conceives, the
gestation age of the developing baby is two weeks; fertilization age is one day. Gestation age is the
one commonly used by medical professionals when referring to the age of the baby.