Week 22

22 weeks pregnant: Getting the sleep setup right

Eyebrows and the first wisps of head hair are visible now, and baby's started laying down brown fat — the kind that'll help regulate body temperature once they're born (in male fetuses, this is also roughly when the testes begin descending). At about spaghetti-squash size, baby's finally big enough that your usual sleep positions have stopped cooperating. This is the week to get the pillow setup right, before exhaustion makes you too tired to bother fixing it:

The pillow arrangement

Three pillows does more than any single fancy one: one between your knees, one under the bump, one behind your back so you don't roll flat.
If your hips ache on your side, a soft mattress topper helps more than you'd expect for the money.
A full-body/U-shaped pillow rolls all three into one if you'd rather (a couple of vetted picks below).
If you're already a side sleeper, that habit is doing double duty — it also cuts down on the airway collapse that causes snoring, so it's not just a fetal-position rule.
Before you spend on the full-body pillow, try a simple wedge under just the bump for a few nights — it's a fraction of the price and solves more of the discomfort than people expect.

There are 2 more sections on this week.

Tell us where to send them and we'll email you the rest of week 22 — then one note a week, timed to your own dates — not to the week you happened to land on. Sourced the same way: every claim linked to ACOG, AAP or CDC.

Setting the room up right

Drop the thermostat a couple degrees before bed — pregnancy runs your internal temperature hotter than usual, and a too-warm room is often the real reason you can't get comfortable, not the pillow setup.
Skip the heavy weighted blanket for now — it traps heat right when your body's already running warm, and lightweight layers you can kick off partway through the night work better.
A white noise machine covers more than outside noise — it also masks your own tossing and turning, which is often what wakes you back up in the first place.
Blackout curtains pay off twice: better sleep now, and they'll matter again for naps once the baby's here — worth installing before you're too tired to deal with a step stool.
If you're still awake after twenty minutes or so, get up and do something boring in dim light instead of lying there fuming — the frustration is usually what's keeping you up, not a lack of sleepiness.

Vaccines in pregnancy: what's on the table and why the timing matters

There are four vaccines in the conversation during a typical pregnancy: flu, Tdap (tetanus-diphtheria-pertussis), COVID-19, and the maternal RSV vaccine. Two of them are about you — pregnancy changes your immune response and your lung and heart capacity, which is why a case of flu or COVID that would have been a rough week before pregnancy can land you in the hospital now. The other two are almost entirely about the baby, who will be born with no immune history of their own and can't be vaccinated for months. One framing note before the specifics: as of 2026 there is no longer a single US answer. ACOG withdrew from CDC's vaccine advisory committee in February 2026 and now publishes its own maternal immunization schedule; federal recommendations have been changed, challenged, and partly reinstated by a court order that is still under appeal. Your OB will almost certainly be following ACOG. Where the two differ, we say so below rather than picking one.
Here's the mechanism worth understanding, because it explains every timing rule that follows: your antibodies cross the placenta, and the transfer accelerates sharply in the third trimester. It also takes roughly two weeks after a shot for your body to make antibodies and start moving them across. So a vaccine given at the right point in the third trimester doesn't just protect you — it hands your newborn a borrowed immune system for their first few months, right through the window when they're most vulnerable and least protectable.
Flu is the one where it matters who's telling you. ACOG recommends an inactivated flu shot for anyone pregnant during flu season, in any trimester — ideally by the end of October, but any time flu is circulating. CDC's flu pages currently say the same thing, though federal guidance here has been genuinely unstable over the past year and is still working its way through the courts; your OB will be following ACOG. It's the inactivated shot, not the nasal spray (the nasal version is a live vaccine and isn't used in pregnancy). On timing: September and October are the target. CDC's standing advice is that if you're in the first or second trimester you should not go early in July or August unless there's a real chance you won't be able to get it later — the July/August option is specifically for the third trimester, where an early shot buys the baby more protection. Your antibodies also cover the baby, who can't get their own flu vaccine until 6 months. One live disagreement worth knowing about: CDC's advisory committee has recommended that pregnant people get only single-dose, thimerosal-free flu formulations, while ACOG's position is that thimerosal-containing vaccines are safe in pregnancy and it doesn't prefer one over the other. In practice most US flu vaccine is already single-dose and preservative-free, so this rarely changes anything — but if you'd rather have the single-dose version, you can ask for it.
COVID-19 is the one where the two bodies openly disagree, so be skeptical of anything you read that isn't dated. CDC removed COVID vaccination from its pregnancy recommendations in 2025 and now frames the 2025-2026 vaccine as an individual decision-making call rather than a blanket recommendation, while still listing pregnancy and recent pregnancy among the conditions that raise the risk of severe illness. ACOG, by contrast, still recommends it routinely in pregnancy, at any gestational age and any time of year. Some of the federal changes are currently the subject of litigation and may shift again. This one is a conversation with your provider rather than a box to tick — and if you get different answers from a pharmacy and your OB, that's why.
Tdap is the one to know is coming. It's recommended in every pregnancy, in the 27-to-36-week window, regardless of when you last had a Tdap — including if you had one in a pregnancy a year ago. You don't have to do anything about it yet at 20-something weeks, but put it on your radar now so it doesn't land as a surprise at a busy third-trimester appointment.
The maternal RSV vaccine is the one worth raising at your next visit, because it has the narrowest window of the four: a gestational window (32 weeks 0 days through 36 weeks 6 days) that has to overlap a seasonal one (September through January in most of the continental US). If your dates don't line up, there's an alternative — an antibody shot given to the baby after birth — and it's generally an either/or, not both. Two things to ask now: whether your dates fall inside the window, and whether your practice gives it or sends you elsewhere. If you had the RSV vaccine in a previous pregnancy, current guidance is that you don't repeat it; the baby gets the antibody instead.

Where this comes from

Every medical claim above traces to one of these. We link out rather than paraphrase, and nothing here replaces your own provider.

The body changes behind the aches, heartburn, and restless nights · ACOG
Restless legs syndrome: symptoms and causes · Mayo Clinic
Vaccine recommendations before, during, and after pregnancy · CDC
Flu vaccine safety and pregnancy · CDC
COVID-19 vaccination for women who are pregnant or breastfeeding · CDC
Maternal immunization schedule · ACOG
Vaccines during pregnancy: keeping you and your baby healthy · AAP