Fetal development begins soon after conception. Find out how your baby grows and develops during the first trimester. You're pregnant. You'll undoubtedly spend the months ahead wondering how your baby is growing and developing. What does your baby look like?
Your baby can now bend his or her elbows. During fertilization, the sperm and egg unite in one of the fallopian tubes to form a zygote. Embryonic Age 6 weeks. Cocaine use also results in low birthweight, damage to the central nervous system, and motor dysfunction. The heart beat can usually be heard with and electronic monitor at this time. Brent Sstage.
Pussy play pictures. First trimester (weeks 1-12) changes in the mother's body
Overview of Pregnancy Week 5. Because the precursors of the organs are now formed, the fetus is not as sensitive to damage from environmental exposure as the embryo was. Instead, each division produces successively smaller cells. When you talk to people who study genetics and fetal development, they look at pregnancy in a very different way. Alcoholism: Clinical and Experimental Research. JSTORwww. Once the eight-cell point has been reached, the Devolopement fetal pregnancy stage begin to differentiate and take on certain characteristics that will determine the type of cells they will eventually become. Mothers who are deficient in iron are at risk for having a preterm or low birth weight infant. The organ Amateur boy pics require a lot of nuanced changes. The term "conception" refers variably to either fertilization or to formation of the conceptus after its implantation in the uterus, and this terminology is controversial. Tobacco smoking during pregnancy exposes the fetus to nicotine, tar, and carbon monoxide. Devolopement fetal pregnancy stage diet and wellness tips to help your kids stay healthy Stocking style happy.
The menstrual age is also known as the gestational age.
- Fetal development is the term used when talking about the procession of events that starts when sperm and egg meet and unfolds in an orderly progression to form a baby.
- The three stages of prenatal development are the germinal stage, the embryonic stage and the fetal stage.
- While you might think of child development as something that begins during infancy, the prenatal period is also considered an important part of the developmental process.
The menstrual age is also known as the gestational age. Gestational age is conventionally expressed as completed weeks. Therefore, a 36 week, 6 day fetus is considered to be a 36 week fetus.
The pink bars show the gestational age when different organ systems are sensitive to functional defects and minor malformations. Weeks 1 and 2 of Pregnancy During the first two weeks after the last menstrual period egg follicles mature in the ovaries under the stimulus of follicle-stimulating hormone FSH a hormone secreted by the pituitary gland in the brain.
LH causes release of the egg from its follicle ovulation For women with day cycles, ovulation usually occurs on days 13 to Gestational Age 3 weeks. Embryonic Age 1 week. Embryonic Age 4 weeks The embryo is now about the size of a pea. The heart is beating at about beats per minute and sometimes may be seen using a transvaginal ultrasound at this time.
Embryonic Age 5 weeks The embryo is now about 0. This week the hands and feet are forming as well as the mouth and face. The heart is beating at about beats per minute. Movement of the embryo can be detected by ultrasound. The embryo is about the size of a bean.
The fingers and toes are developing. In a process is called physiological gut herniation , the intestine elongates and moves outside of the abdomen herniating into the base of the umbilical cord and rotate counter-clockwise at about 8 weeks.
The intestine returns into the fetal abdomen by about 12 weeks . Embryonic Age 7 weeks. Second Trimester of Pregnancy 14 weeks and 0 days through 27 weeks and 6 days. Hearing is beginning to form . If the fetus is a boy, his testicles are descending. Outcomes are based on specific characteristics in a specific setting: level III NICUs, specialized facilities offering medical care for newborn infant.
Hadlock FP et. The ultrasound femur length as a predictor of fetal length. PMID: 3. Hadlock FP, et al. Radiology ; PMID: 4. Definition of term pregnancy. Committee Opinion No. American College of Obstetricians and Gynecologists.
Age terminology during the perinatal period. Hay DL, Lopata A. Chorionic gonadotropin secretion by human embryos in vitro. J Clin Endocrinol Metab. PMID: 8.
Lohstroh P, et al. Daily immunoactive and bioactive human chorionic gonadotropin profiles in periimplantation urine samples. Biol Reprod. Epub Mar 8 9. Brent RL.
The effect of embryonic and fetal exposure to x-ray, microwaves, and ultrasound: counseling the pregnant and nonpregnant patient about these risks. Fingerprint formation. J Theor Biol.
PMID: Development of fetal hearing. Arch Dis Child. Ultrasonographic assessment of gestational age with the distal femoral and proximal tibial ossification centers in the third trimester. Determination of gestational age by ultrasound.
J Obstet Gynaecol Can. Proximal humeral ossification center of the fetus: time of appearance and the sensitivity and specificity of this finding. J Ultrasound Med. Warburton D, et. Curr Top Dev Biol. Abdominal ultrasound examination of the first-trimester fetus.
Diagnostic criteria for nonviable pregnancy early in the first trimester. Stoll BJ, et. Bromley B, et. Closure of the cerebellar vermis: evaluation with second trimester US. Bennett GL Agenesis of the corpus callosum: prenatal detection usually is not possible before 22 weeks of gestation. PMID: 24 Brumfield CG, The significance of non-visualization of the fetal bladder during an ultrasound examination to evaluate second-trimester oligohydramnios.
Ultrasound Obstet Gynecol. PMC Neonatal mortality and morbidity rates in late preterm births compared with births at term. Obstet Gynecol. Fatigue and swollen or tender breasts are sometimes the first signs of pregnancy.
Embryonic Age 2 weeks The embryo is the size of a pinhead. Most pregnancy tests will be positive at this time. By the end of the week the heart will be pumping blood. Week 5 is the beginning of the embryonic period which lasts from the the 5th to the 10th week.
It is during this critical period that many birth defects occur in the developing embryo. Most of these birth defects will have no known cause or be due to a combination of factors multifactorial. First Trimester. Second Trimester. Third Trimester. Developmental stage. Embryonic Stage. Fetal Stage. Developing Organ s. Central Nervous System. External genitals. Weeks 1 and 2 of Pregnancy.
During the first two weeks after the last menstrual period egg follicles mature in the ovaries under the stimulus of follicle-stimulating hormone FSH a hormone secreted by the pituitary gland in the brain. Embryonic Age 2 weeks.
The embryo is the size of a pinhead. Embryonic Age 3 weeks. Embryonic Age 4 weeks. The embryo is now about the size of a pea. Embryonic Age 5 weeks. The embryo is now about 0. Embryonic Age 6 weeks.
The average embryo at 9 weeks is 0. Fetal Age 8 weeks. Fingerprints are being formed , and bone cells are replacing cartilage.
The average fetus at 10 weeks is 1. Fetal Age 9 weeks. The fetus is starting to have breathing movements. It can open its mouth and swallow.
Wonder how big your baby is now? There is nothing you can do to ameliorate the risks of your DES exposure. Untreated HIV infected expectant mothers pass the virus to their developing offspring between 10 and 20 percent of the time. The two most common ones are chorionic villus sampling CVS and amniocentesis. Cochlear microphones recorded from fetal and newborn sheep. Lymphocytes derived from the thymus are called T lymphocytes T cells , whereas those derived from bone marrow are called B lymphocytes B cells.
Devolopement fetal pregnancy stage. Navigation menu
The early body systems and structures established in the embryonic stage continue to develop. It is at this point in prenatal development that the neural tube develops into the brain and spinal cord and neurons continue to form.
Once these neurons have formed, they begin to migrate to their correct locations. Synapses, or the connections between neurons, also begin to develop. It is during the period between the 9th and 12th week at the earliest reflexes begin to emerge and the fetus begins to make reflexive motions with his arms and legs. This stage of prenatal development lasts the longest and is marked by amazing change and growth.
During the third month of gestation, the sex organs begin to differentiate and by the end of the month, all parts of the body will be formed.
At this point, the fetus weight around three ounces. The fetus continues to grow in both weight and length, although the majority of the physical growth occurs in the later stages of pregnancy.
The end of the third month also marks the end of the first trimester of pregnancy. During the second trimester or months four through six, the heartbeat grows stronger and other body systems become further developed.
Perhaps most noticeably, the fetus increases quite dramatically in size, increasing about six times in size. So what's going on inside the brain during this important period of prenatal development? Around 28 weeks, the brain starts to mature faster with an activity that greatly resembles that of a sleeping newborn. During the period from seven months until birth, the fetus continues to develop, put on weight, and prepare for life outside the womb.
The lungs begin to expand and contract, preparing the muscles for breathing. The prenatal period of development is a time of physical growth, but what's going on inside the brain is critical for future psychological development. The brain development that takes place during the prenatal period helps set the course for what will take place outside the womb.
While prenatal development usually follows this normal pattern, there are times when problems or deviations occur. Disease, malnutrition, and other prenatal influences can have a powerful impact on how the brain develops during this critical period. But brain development does not end at birth. There is a considerable amount of brain development that takes place postnatally including growing in size and volume while changing in structure.
The brain grows by about four times the size between birth and preschool. As children learn and have new experiences, some networks in the brain are strengthened while other connections are pruned. Ever wonder what your personality type means? Sign up to find out more in our Healthy Mind newsletter. Flaxman, Samuel M. JSTOR , www.
Anatomy and Physiology , Anatomy and Physiology , " Office on Women's Health, " Stages of pregnancy. More in Theories. During the fifth week, buds that will form the arms and legs appear. A Word From Verywell. Was this page helpful? Thanks for your feedback! Sign Up. What are your concerns? Article Sources. Levine, L. Shaffer, D. Developmental Psychology: Childhood and Adolescence. Belmont, CA: Wadsworth. Plasma cells are derived from B cells and their life in fetal blood is 0.
The thyroid is the first gland to develop in the embryo at the 4th week of gestation. Insulin secretion in the fetus starts around the 12th week of gestation. Initial knowledge of the effects of prenatal experience on later neuropsychological development originates from the Dutch Famine Study, which researched the cognitive development of individuals born after the Dutch famine of — There is evidence that the acquisition of language begins in the prenatal stage.
After 26 weeks of gestation, the peripheral auditory system is already fully formed. Growth rate of fetus is linear up to 37 weeks of gestation, after which it plateaus. A baby born within the normal range of weight for that gestational age is known as appropriate for gestational age AGA. An abnormally slow growth rate results in the infant being small for gestational age , and, on the other hand, an abnormally large growth rate results in the infant being large for gestational age.
A slow growth rate and preterm birth are the two factors that can cause a low birth weight. The growth rate can be roughly correlated with the fundal height which can be estimated by abdominal palpation. More exact measurements can be performed with obstetric ultrasonography. Intrauterine growth restriction is one of the causes of low birth weight associated with over half of neonatal deaths.
Poverty has been linked to poor prenatal care and has been an influence on prenatal development. Women in poverty are more likely to have children at a younger age, which results in low birth weight. Many of these expecting mothers have little education and are therefore less aware of the risks of smoking , drinking alcohol , and drug use — other factors that influence the growth rate of a fetus.
Women between the ages of 16 and 35 have a healthier environment for a fetus than women under 16 or over Women over 35 are more inclined to have a longer labor period, which could potentially result in death of the mother or fetus. Women under 16 and over 35 have a higher risk of preterm labor premature baby , and this risk increases for women in poverty, women who take drugs, and women who smoke. Young mothers are more likely to engage in high risk behaviors, such as using alcohol, drugs, or smoking, resulting in negative consequences for the fetus.
There is a risk of Down syndrome for infants born to those aged over 40 years. Young teenaged mothers younger than 16 and mothers over 35 are more exposed to the risks of miscarriages, premature births, and birth defects. An estimated 5 percent of fetuses in the United States are exposed to illicit drug use during pregnancy.
When using cannabis , there is a greater risk of birth defects, low birth weight, and a higher rate of death in infants or stillbirths. It can also lead to low birth weight, a shortened gestational period and complications in delivery. Opioids including heroin will cause interrupted fetal development, stillbirths, and can lead to numerous birth defects.
Heroin can also result in premature delivery, creates a higher risk of miscarriages, result in facial abnormalities and head size, and create gastrointestinal abnormalities in the fetus. There is an increased risk for SIDS, dysfunction in the central nervous system, and neurological dysfunctions including tremors, sleep problems, and seizures. The fetus is also put at a great risk for low birth weight and respiratory problems. Cocaine use results in a smaller brain, which results in learning disabilities for the fetus.
Cocaine puts the fetus at a higher risk of being stillborn or premature. Cocaine use also results in low birthweight, damage to the central nervous system, and motor dysfunction. Prenatal methamphetamine exposure has shown to negatively impact brain development and behavioral functioning. A study further investigated neurocognitive and neurodevelopmental effects of prenatal methamphetamine exposure. This study had two groups, one containing children who were prenatally exposed to methamphetamine but no other illicit drugs and one containing children who met diagnosis criteria for ADHD but were not prenatally exposed to any illicit substance.
Both groups of children completed intelligence measures to compute an IQ. Study results showed that the prenatally exposed children performed lower on the intelligence measures than their non-exposed peers with ADHD. The study results also suggest that prenatal exposure to methamphetamine may negatively impact processing speed as children develop. Maternal alcohol use leads to disruptions of the fetus's brain development, interferes with the fetus's cell development and organization, and affects the maturation of the central nervous system.
Even small amounts of alcohol use can cause lower height, weight and head size at birth and higher aggressiveness and lower intelligence during childhood. Children with FASD have a variety of distinctive facial features, heart problems, and cognitive problems such as developmental disabilities, attention difficulties, and memory deficits.
Tobacco smoking during pregnancy exposes the fetus to nicotine, tar, and carbon monoxide. Nicotine results in less blood flow to the fetus because it constricts the blood vessels. Carbon monoxide reduces the oxygen flow to the fetus. The reduction of blood and oxygen flow may result in miscarriage, stillbirth, low birth weight, and premature births.
If a mother is infected with a disease, the placenta cannot always filter out pathogens. Viruses such as rubella, chicken pox, mumps, herpes, and human immunodeficiency HIV are associated with increased risk of miscarriage, low birth weight, and prematurity, physical malformations, and intellectual disabilities. Untreated HIV infected expectant mothers pass the virus to their developing offspring between 10 and 20 percent of the time.
Examples of diseases include chlamydia, syphilis, tuberculosis, malaria, and toxoplasmosis. A pregnant female may become infected through contact with contaminated soil, such as through gardening, eating raw or undercooked meat or unwashed vegetables or fruits, or contact with the feces of infected cats. If the exposure occurs during the first trimester, eye and brain damage may result.
Exposure later in pregnancy may result in mild visual and cognitive impairments. Adequate nutrition is needed for a healthy fetus.
Mothers who gain less than 20 pounds during pregnancy are at increased risk for having a preterm or low birth weight infant. Mothers who are deficient in iron are at risk for having a preterm or low birth weight infant. Low birth weight increases an infants risk of long-term growth and cognitive and language deficits. Stress during pregnancy can impact the development of the embryo. Reilly states that stress can come from many forms of life events such as community, family, financial issues, and natural causes.
While a woman is pregnant, stress from outside sources can take a toll on the growth in the womb that may affect the child's learning and relationships when born. For instance, they may have behavioral problems and might be antisocial. The stress that the mother experiences affects the fetus and the fetus' growth which can include the fetus' nervous system Reilly, Stress can also lead to low birth weight.
Even after avoiding other factors like alcohol, drugs, and being healthy, stress can have its impacts whether families know it or not. Many women who deal with maternal stress do not seek treatment. Similar to stress, Reilly stated that in recent studies, researchers have found that pregnant women who show depressive symptoms are not as attached and bonded to their child while it is in the womb Exposure to environmental toxins in pregnancy lead to higher rates of miscarriage, sterility, and birth defects.
Prenatal exposure to mercury may lead to physical deformation, difficulty in chewing and swallowing, and poor motoric coordination. From Wikipedia, the free encyclopedia. Main article: Human fertilization. Main article: Human embryonic development.
Main article: Development of the endocrine system. Further information: Fetal origins hypothesis. Further information: Alcohol and pregnancy and Smoking and pregnancy. Main article: Drugs in pregnancy. Main article: Cannabis in pregnancy.
Main article: Prenatal cocaine exposure. Main article: Fetal alcohol spectrum disorder. Main article: Smoking and pregnancy. Main article: Environmental toxicants and fetal development. Care of the Newborn. Edition 7. Psychology Second Edition. United States of America: Worth Publishers. Human anatomy 3rd ed.
Manual of Obstetrics, 3rd Edition. Prenatal determinants of early behavioral and cognitive development: The generation R study. Rotteram: Erasmus Universiteit. Nutrition and mental performance. Science, 62 , Weight in infancy and death from ischaemic heart disease. Lancet, 2 , Schizophrenia and affective disorders after prenatal famine.
Biological Psychiatry, 39 7 , Prenatal exposure to wartime famine and development of antisocial personality disorder in early adulthood. Jama, 5 , Further evidence of relation between prenatal famine and major affective disorder.
Stages Of Pregnancy & Fetal Development | Cleveland Clinic
For a pregnant woman, feeling a new life developing inside her body is an amazing experience, even though she may not always feel her best at some points along the way. Pregnancy can be different from woman to woman, and even for the same mother from one pregnancy to the next. Some symptoms of pregnancy last for several weeks or months, while other discomforts are temporary or don't affect all women. A normal pregnancy usually lasts about 40 weeks, counting from the first day of a woman's last menstrual period, which is about two weeks before conception actually occurs.
Pregnancy is divided into three trimesters. Each of these periods lasts between 12 and 13 weeks. During each trimester, changes take place in a pregnant woman's body as well as in the developing fetus, and a summary of these changes will be described below.
About two weeks after a woman has her period, she ovulates and her ovaries release one mature egg. The egg can be fertilized for 12 to 24 hours after it's released as it travels down the fallopian tube toward the uterus. If an egg meets up with a sperm cell that has made its way into the fallopian tube, it combines into one cell, a process that's known as fertilization or conception.
At fertilization, the sex of the fetus is already determined, depending on whether the egg receives an X or Y chromosome from a sperm cell. If the egg receives an X chromosome, the baby will be a girl; a Y chromosome means the baby will be a boy.
According to the Cleveland Clinic, it takes about three to four days for the fertilized egg or embryo to move to the lining of the uterus, where it attaches or implants to the uterine wall. Once the embryo is implanted, the cells start to grow, eventually becoming the fetus and the placenta, which is tissue that can transport oxygen, nutrients and hormones from the mother's blood to the developing fetus throughout pregnancy.
A woman will experience a lot of symptoms during her first trimeste r as she adjusts to the hormonal changes of pregnancy. In the early weeks, the pregnancy may not be showing much on the outside of her body, but inside many changes are taking place.
For example, human chorionic gonadotrophin hCG is a hormone that will be present in a woman's blood from the time conception occurs. Levels of hCG can be detected in a woman's urine about a week after she has a missed period, and it is why a woman will have a positive result on a home pregnancy test. Other hormonal changes can contribute to pregnancy symptoms: Rising levels of estrogen and hCG may be responsible for the waves of nausea and vomiting known as morning sickness that a woman typically feels during her first few months of pregnancy.
Despite its name, morning sickness can occur any time of day. A woman will also feel more tired than usual during the first trimester, a symptom that's linked with rising levels of the hormone progesterone, which increases sleepiness. She may also need to urinate more frequently as her uterus grows and presses on her bladder. Early in pregnancy, a woman's breasts will feel more tender and swollen, another side effect of rising levels of pregnancy hormones. Her areolas, the skin around each nipple, will darken and enlarge.
A pregnant woman's digestive system may slow down to increase the absorption of beneficial nutrients. But reduced mobility of the digestive system might also trigger such common complaints as heartburn, constipation, bloating and gas, according to the Office on Women's Health OWH. Many parts of the body will work harder during pregnancy, including a woman's heart.
Her heartbeat will increase to pump more blood to the uterus, which will supply it to the fetus. As more blood circulates to a woman's face, it will give her skin a rosier complexion, described as a "pregnancy glow. Besides the physical changes in a woman's body, she may also experience emotional highs and lows in the early months of her pregnancy and throughout it.
These emotions may range from weepiness, mood swings and forgetfulness to fear, anxiety and excitement. A developing baby is called an embryo from the moment conception takes place until the eighth week of pregnancy. During the first month of pregnancy the heart and lungs begin to develop, and the arms, legs, brain, spinal cord and nerves begin to form, according to the American College of Obstetricians and Gynecologists ACOG.
The embryo will be about the size of a pea around one month into a pregnancy, Burch said. Around the second month of pregnancy, the embryo has grown to the size of a kidney bean, he explained. In addition, the ankles, wrists, fingers and eyelids form, bones appear, and the genitals and inner ear begin to develop. By the end of the second month, eight to 10 of the fetus' main organs will have formed, Burch said.
At this stage of pregnancy, he stressed, it's extremely important that pregnant women do not take harmful medications, such as illegal drugs. The first trimester is also the period when most miscarriages and birth defects occur.
During the third month of pregnancy, bones and muscles begin to grow, buds for future teeth appear, and fingers and toes grow. The intestines begin to form and the skin is almost transparent. By the second trimester, some of the unpleasant effects of early pregnancy may lessen or disappear as a woman's body adjusts to its changing hormone levels. Sleeping may get easier and energy levels may increase.
Nausea and vomiting usually get better and go away, Burch told Live Science. But other symptoms may crop up as the fetus continues its growth and development.
Women feel more pelvic pressure, Burch said, adding that the pelvis feels heavy like something is weighing it down. A more visible baby bump appears as the uterus grows beyond a woman's pelvis, and the skin on her expanding belly may itch as its stretches, according to the OWH.
As the fetus is getting bigger and a woman is gaining more pregnancy weight in the front of her body, she may also experience more back pain, Burch said.
Sometime between the 16th and 18th weeks of pregnancy, a first-time mother may feel the first fluttering movements of the fetus, known as quickening, Burch said. If a woman has had a baby before, she is likely to feel the fetus kicking, squirming or turning even sooner because she knows what to expect, he explained.
Burch encourages his patients to take a "baby-moon" — a mini-vacation or weekend getaway — during the second trimester, and he said the best time to get away is around the 28th week of pregnancy. A woman is generally feeling pretty good at this point, there's a lower risk of miscarriage and premature labor, and some health professionals may discourage airplane travel after the 36th week.
In the second trimester , the fetus is growing a lot and will be between 3 and 5 inches long, Burch said. Sometime between 18 and 22 weeks, an ultrasound may reveal the sex of the baby , if parents want to know this information in advance. By the fourth month of pregnancy, eyebrows, eyelashes, fingernails and the neck all form, and the skin has a wrinkled appearance.
In addition, during the fourth month the arms and legs can bend, the kidneys start working and can produce urine, and the fetus can swallow and hear, according to ACOG.
In the fifth month of pregnancy, the fetus is more active and a woman may be able to feel its movements. The fetus also sleeps and wakes on regular cycles. A fine hair called lanugo and a waxy coating called vernix cover and protect the thin fetal skin.
By the sixth month of pregnancy, hair begins to grow, the eyes begin to open and the brain is rapidly developing. Although the lungs are completely formed, they don't yet function. During the third trimester , as a woman's enlarged uterus pushes against her diaphragm, a major muscle involved in breathing, she may feel short of breath because the lungs have less room to expand, according to Johns Hopkins Medicine. Her ankles, hands, feet and face may swell as she retains more fluids and her blood circulation slows.
A mother-to-be will need to pee more frequently because more pressure will be placed on her bladder. She may also have more backaches and more pain in the hips and pelvis, as these joints relax in preparation for delivery. Her face may develop dark patches of skin, and stretch marks may appear on her belly, thighs, breasts and backside. She may also notice varicose veins on her legs. In the third trimester, a woman's breasts may experience some leakage of colostrum , a yellow liquid, as they get ready for breastfeeding, according to the OWH.
The baby will drop lower in her abdomen. False labor, known as Braxton-Hicks contractions, may begin to occur as a woman gets closer to her due date. A "nesting instinct" may kick in as a mother-to-be and her partner baby-proof their home, shop for baby items, prepare the nursery and await their new arrival.
During the final weeks of pregnancy, it will become harder to find a comfortable sleeping position, so women may be extremely tired, Burch said.
As delivery approaches, some women love the experience of being pregnant, while others may feel like they can't wait for it to end, Burch said. By the seventh month of pregnancy , the fetus kicks and stretches, and can even respond to light and sound, like music, Burch said.
Eyes can open and close. During the eighth month of pregnancy, the fetus gains weight very quickly. Bones harden, but the skull remains soft and flexible to make delivery easier. Different regions of the brain are forming, and the fetus is able to hiccup, according to ACOG. The ninth month is the home stretch of pregnancy, and the fetus is getting ready for birth by turning into a head-down position in a woman's pelvis. The lungs are now fully mature to prepare for functioning on their own.
The fetus continues to gain weight rapidly. The new definition of a full-term pregnancy is when a baby is born after 39 to 40 weeks it used to be 37 weeks , Burch said. Live Science. Stages of fetal development over 38 weeks, from embryo to full-term. Image credit: Dragana Gerasimoski Shutterstock.