Pregnancy: Second Trimester

What is the second trimester of pregnancy?

Your second trimester begins around week 13 of pregnancy and lasts through the end of week 27. When you’re in your second trimester, you’re in the middle of your pregnancy.

The second trimester often feels like the best trimester. For many people, the morning sickness and fatigue of their first trimester fade into the past. Often, any anxiety that went with your first trimester goes away. During your second trimester, you’ll start looking and feeling more pregnant and may even find yourself feeling a burst of energy. You’ll start to feel the fetus move by 18 to 20 weeks, and you might begin to settle into your pregnancy and enjoy it more than you did in the first trimester.

Of course, it’s important to remember that pregnancy is different for everyone. If you don’t feel your best, that’s OK. Some people continue to feel sick well into their second trimester, or they begin to have new and different pregnancy symptoms.

Getting prenatal care in your second trimester (and throughout your pregnancy) is very important. Your pregnancy care provider will need to monitor you and the fetus to make sure you’re both healthy. Prenatal appointments usually occur every four weeks in the second trimester unless your pregnancy is high risk or your provider tells you otherwise.

How does my baby develop during the second trimester of pregnancy?

The fetus goes through many changes during your second trimester of pregnancy. During this time, the fetus starts to look more like a child — with its facial features aligning, and its fingers and toes becoming well-defined. By month four, it’ll have eyelids, eyebrows, eyelashes, nails and hair. The fetus will also be able to stretch, make faces and even suck its thumb. Your pregnancy care provider will soon be able to determine the sex of the fetus on an ultrasound — often around 20 weeks.

At this point, you might also start feeling the fetus move. People often describe the movement as a flutter or like having butterflies in your stomach. The fetus will move and even do flips throughout your second trimester. This first movement is called quickening. Initially, the feeling of movements may not be regular. Usually around 28 weeks, they become more consistent and predictable.

In the last few weeks of the second trimester, the fetus can also hear you. If you talk to your growing belly, you might notice movement in response. If your baby is born toward the end of your second trimester (premature birth), they may survive with intensive care in a NICU.

What happens to my body during the second trimester of pregnancy?

The fetus isn’t the only one growing and changing during your second trimester. You’ll notice several changes in your own body during this time. Your uterus — the place where the fetus grows — continues to stretch. This organ expands throughout your pregnancy and grows to the size of a watermelon. After pregnancy, your uterus returns to its pre-pregnancy size (picture an upside-down pear).

You’ll start gaining weight and might start developing the telltale enlarged belly. Don’t worry if you don’t have a bump right away. It takes time to develop. Everyone is different, and no two bodies look the same during pregnancy.

What are common discomforts in the second trimester?

Although people generally feel better than they did in the first trimester, you might also feel or develop new symptoms or discomforts of pregnancy during your second trimester. If you experienced morning sickness during your first trimester, it’s likely fading away now.

Some of the common symptoms in the second trimester are:

• An increased appetite.
• Bleeding gums (due to hormones).
• Nosebleeds or nasal congestion (also due to hormones).
• Hemorrhoids.
• Skin changes like noticing a line (linea nigra) down the middle of your belly.
• Darkening of your areolas (the skin around your nipple).
• Round ligament pain.
• Some swelling in your hands, feet and ankles.
• Varicose veins.
• Some stretch marks, especially around your belly, breasts, butt and thighs.

You may also be at an increased risk of infections like UTIs (urinary tract infections) and yeast infections during pregnancy. Watch for signs of infection like itching, changes in vaginal discharge and a burning feeling when you pee.

What tests will I have during the second trimester of pregnancy?

Throughout your pregnancy, your pregnancy care provider will order various tests to check on your health and the health of your developing fetus. You’ll also have an ultrasound during your second trimester. This ultrasound is probably best known for telling new parents the sex of their baby (if you haven’t already found out by earlier, cell-free DNA blood testing), but it’s mainly for providers to look at fetal anatomy. This ultrasound looks at the fetus’s limbs, brain, heart, and other organs and structures.

During your second trimester, you’ll typically be screened for a few different things, including:

• Gestational diabetes.
• Rh factor.
• Complete blood count (CBC) to check for anemia.
• Rescreening of syphilis.

What do I need to prepare for during the second trimester of pregnancy?

There are many things you can start thinking about during your second trimester of pregnancy to prepare for your new family member. Many of these things center around conversations that you should start having at this point in your pregnancy. It’s good to discuss the type of birth you hope to have and learn about the different ways your child might be born.

A few ways your baby could be born can include:

• Vaginal birth (this could be medicated or unmedicated).
• Assisted vaginal delivery (you might need tools like forceps or a vacuum to help with your delivery).
• C-section delivery.

You can learn more about these types of birth through your own research or in a birth class. This is the time for you to look into educational classes about labor, breastfeeding and parenting of your newborn. These classes can help prepare you for your new role as a parent. Ask your healthcare provider for more information on classes and groups you can join at this point in your pregnancy.

You may want to start looking into choosing a pediatrician. Your provider can give you information on choosing a pediatric provider. Many providers are open to doing a “meet-the-provider” in person or through a virtual visit.

This might also be a good time to take a tour of the hospital where you’ll give birth. A hospital tour is a great way to get familiar with the place where your baby will be born. During the tour, you’ll learn where you should go when you first get to the hospital during labor and what will happen afterward.

What should I be doing during the second trimester of pregnancy to stay healthy?

Throughout your second trimester, you should continue maintaining a healthy lifestyle. Try to exercise for about 20 minutes a day. Regular exercise is good for pregnancy. Some of the safest types of exercise include walking and swimming. But there are many other options you can try. Talk to your healthcare provider about the type of exercise you’d like to do beforehand just to be safe. You’ll want to avoid contact sports and activities where you could fall, as these could endanger your pregnancy.

Apart from exercise, you should eat nutritious foods, take your prenatal vitamins and attend every prenatal appointment.

What things shouldn’t you do in the second trimester?

For the most part, the rules of things to avoid in the first trimester apply to the second trimester.

Some of the things to avoid during pregnancy include things like:

• Raw or undercooked meat.
• Unpasteurized dairy.
• Deli meats.
• Fish high in mercury.
• Hot tubs and saunas.
• Smoking, beverages containing alcohol and recreational drugs.

There are other things you shouldn’t do during pregnancy that may catch you off guard. For example, you shouldn’t clean a litter box due to the risk of toxoplasmosis. You should also avoid lying on your back for extended periods of time. At nighttime, sleep on your side instead of your back, as this is best for your circulation. Don’t stress if you wake up and find yourself on your back. Often, your body is going to tell you something isn’t right and that will make you move around.

When should I call my provider during the second trimester of pregnancy?

You’re the person who knows your body best. If you ever feel like something’s wrong, it’s completely OK to reach out to your healthcare provider. It’s also a good idea to call your healthcare provider right away if you have:

• Unusual or severe cramping or abdominal pain.
• Vaginal bleeding.
• Difficulty breathing or shortness of breath that seems to be getting worse over time.

You should also reach out to your provider right away if you start having any signs of premature labor like your water breaking. These include:

• Regular tightening or pain in your lower abdomen or back that occurs more than four times in an hour (contractions).
• Any fluid leakage. Vaginal discharge often increases as part of the hormonal changes in pregnancy. But leaking amniotic fluid may mean you’re going into labor.