The Development of the Fetus in the Fourth Month of Pregnancy
The fourth month of pregnancy marks a pivotal period in fetal development, occurring during the second trimester. This stage is characterized by significant growth and maturation of the fetus, which undergoes a range of physiological changes. Here is a detailed overview of what to expect regarding the shape and development of the fetus during the fourth month of pregnancy.

Physical Development and Size
By the end of the fourth month, the fetus has grown considerably from its earlier stages. Typically, it measures about 5.5 to 6.5 inches in length, and its weight ranges from 4 to 7 ounces. The fetus’s body is beginning to take on a more proportionate shape, moving away from the previously more curved appearance.
The fetus’s limbs are now more elongated, and the arms and legs are more proportional to the rest of the body. The hands and feet have distinct fingers and toes, with small nails beginning to form. The skeleton, although still largely cartilaginous, is starting to ossify into bone. This process of ossification is crucial for providing the fetus with structural support as it continues to grow.
Facial Features and Body Proportions
During the fourth month, the fetus’s facial features become more defined. The eyes are moving closer together, and the ears are positioned closer to their final locations on the sides of the head. The nose and mouth are becoming more recognizable, and the overall facial structure is taking on a more human-like appearance.
The fetus’s body is becoming more proportionate. The head, which was previously disproportionately large compared to the body, is now more in line with the rest of the body. The fetus’s neck, once a featureless continuation of the head, is now more defined, giving the fetus a more distinct head and torso.
Movement and Sensory Development
At this stage, the fetus is becoming more active. The mother may start to feel these movements, though they might be subtle and described as “flutters.” These movements are a result of the developing muscles and nervous system. The fetus is now capable of some degree of coordinated movement, such as kicking and stretching.
Sensory development is also progressing. The fetus’s ears are developing, and it can start to respond to sounds. Although the fetus is still in a relatively quiet environment, it may react to external noises, which is a precursor to the more noticeable reactions seen in later months.
Organ Development
The organs are continuing to mature during the fourth month. The digestive system is becoming more functional, and the liver is starting to produce bile. The kidneys are also becoming more active, beginning to produce urine, which is excreted into the amniotic fluid. The reproductive organs are developing, and it is possible to determine the sex of the fetus with greater accuracy through ultrasound examination.
The fetal heart is fully formed and beating strongly. It can be heard using a Doppler device or during a routine ultrasound. The lungs are also developing, although they will not be fully functional until closer to birth. The fetus’s respiratory system is preparing for life outside the womb by practicing movements that resemble breathing.
Skin and Hair Development
The fetus’s skin is still quite thin and translucent, but it is gradually becoming more complex. The skin’s outer layer, known as the epidermis, is forming and developing its basic structure. The underlying layers, which will eventually include fat and connective tissue, are also starting to develop.
Hair is beginning to grow on the fetus’s scalp, though it is still fine and sparse. The presence of hair follicles is a sign of the developing hair growth process, which will continue and become more pronounced in the coming months.
Amniotic Fluid and Placental Changes
The amniotic fluid surrounding the fetus continues to increase in volume during the fourth month. This fluid provides a cushioning effect, protecting the fetus from external impacts and allowing it to move freely within the uterus. The placenta, which provides nutrients and oxygen to the fetus, is fully functional and growing to meet the increasing needs of the developing baby.
Summary
In summary, by the end of the fourth month of pregnancy, the fetus undergoes significant growth and development. Its body becomes more proportionate, facial features become more distinct, and movement becomes more noticeable. The development of organs, skin, and hair continues, and the amniotic fluid and placenta provide essential support for the fetus’s ongoing growth. This stage represents a crucial period in fetal development, setting the stage for further growth and maturation in the months to come.