Your Guide to the Second Trimester of Pregnancy
The next three months bring lots of changes for your growing fetus and, most likely, welcome relief from early pregnancy symptoms for you. Here’s more on what to expect.
Your baby’s senses during pregnancy
Welcome to your second trimester — for many women, the most comfortable of all three. With the arrival of this milestone, you’ll experience some welcome changes. Most early pregnancy symptoms will ease up or even disappear. You’ll likely feel less queasy (which means food may finally smell and taste good for the first time in a long while), your energy levels should be picking up, and your breasts will still be bigger but feel a whole lot less tender. Most amazing of all: By the end of this trimester, the bulge in your lower abdomen may be looking less like the remains of a large lunch and more like the beginnings of a pregnant belly.
WHEN DOES THE SECOND TRIMESTER START AND END?
The second trimester starts in week 14 of pregnancy and lasts through the end of week 27.
BABY’S GROWTH IN THE SECOND TRIMESTER
Your baby is very, very busy in the second trimester. By week 18 of pregnancy, he weighs about as much as a chicken breast, he can yawn and hiccup, and he’s got fingerprints on those tiny digits. By week 21 you should be able to feel his newly coordinated arms and legs give you little jabs and kicks. By about week 23, your baby takes a cue from you and starts to pack on the pounds; in fact, he’ll likely double his weight in the next four weeks. By the end of your second trimester, you’ll have a 2-pound human in your belly!
A few more exciting things going on this trimester:
- Hair, skin and nails: By around week 15, baby’s first tiny hairs are starting to sprout, and by week 22, he’s got eyelashes and eyebrows, too. Baby’s skin is now covered in lanugo (a downy “fur coat” that keeps him warm until builds up more fat in the third trimester) and, by week 19, vernix caseosa (a greasy layer of oil and dead skin cells that shield his skin from acidic amniotic fluid) — both of which will shed before birth.
- Digestive system: Baby’s digestive system was fully formed by the end of the first trimester. So now baby is starting to suck and swallow in preparation for life outside of the womb. What’s more, he can even taste the foods you eat via your amniotic fluid — which research has shown can influence his preferences outside of the womb (all the more reason to chow down on a healthy pregnancy diet filled with a variety of fresh fruits and veggies). Baby’s waste systems are working hard too: Although he still gets his nutrition via your placenta, all of that swallowing means he’s also peeing about every 40 minutes.
- Senses: Baby’s ears and eyes are moving into their correct positions. By week 22 of pregnancy , his developing senses mean he’s starting to smell, see and hear, and those little eyes are beginning to open.
- Heart: By 17 weeks, baby’s heart is no longer beating spontaneously, as his brain is now regulating his heartbeat — which you should be able to hear with a stethoscope by week 20. In week 25, capillaries begin forming to carry oxygenated blood through his body.
- Brain: In addition to controlling your baby’s heartbeat and inducing kicks, by 24 weeks your baby’s brain will start blinking those little eyelids.
CHANGES IN YOUR BODY
This trimester certain pregnancy symptoms may persist (like heartburn and constipation). At the same time, others may pop up for the first time as your belly continues to grow and levels of pregnancy hormones rise, including:
- Congestion as blood flow is increased to your body’s mucous membranes (including your nose). You may even find yourself snoring for the first time! Fortunately there are some OTC medications that are safe to use during pregnancy.
- Mild swelling of the ankles and feet is experienced by about three in four pregnant women, starting at about week 22 of pregnancy and lasting until delivery. To reduce puffiness, try to keep active, kick up your feet when you’re not moving, avoid long periods of standing or sitting and sleep on your side.
- Sensitive gums and even some bleeding is normal — but be sure to see your dentist if your gums are bright red and bleed easily, as it could be a sign of gingivitis (which is relatively harmless but can develop into a bigger problem if not properly treated).
- Leg cramps, which usually start in the second trimester and last through the third. It’s due not only to hormones and weight but also possibly a shortage of calcium or magnesium — so be sure to keep eating a healthy, well-balanced pregnancy diet.
- Dizziness caused by lower blood pressure due in part to all the extra blood your body is pumping. Take it easy, eat plenty of small meals and fill up on fluids to reduce symptoms.
- Achiness in the lower abdomen — otherwise known as round ligament pain — as the ligaments that support your belly stretch to support your belly’s increasing size.
- Varicose veins and/or hemorrhoids (a type of varicose vein) — which, fortunately, should shrink or go away after pregnancy if you didn’t have them before you conceived.
All of the above are perfectly normal and temporary — as are feelings of apprehension, irritability, forgetfulness and even frustration at looking positively plump but not definitively pregnant.
There may be some big changes in the bedroom as well during the second trimester. Pregnancy can wreak havoc on your sex life as you and your partner cope with your changing body and mood-killing symptoms like fatigue and nausea. Some (lucky) ladies find themselves hotter than ever, with extra blood flowing to all the right spots. A few things to keep in mind: Communication is key to avoiding resentment, so keep talking through the dry spells. And remember — sex will neither hurt your fetus nor scar him emotionally. (In fact, he’ll probably enjoy a little rocking and rolling.)
These next few months are when you’ll really start to gain pregnancy weight, as your appetite likely increases (or appears, if you were suffering from nausea and appetite loss in the first trimester) to support your growing baby. If you started out your pregnancy at a normal weight, expect to gain around one pound per week for a total of about 14 pounds over this trimester.
SYMPTOMS TO HAVE CHECKED OUT
Odds are that once you make it to your second trimester it should be relatively smooth sailing for the next three months. However there are a few symptoms that do always warrant a call to your doctor, including heavy vaginal bleeding, severe abdominal pain and fever over 101.5 F.
Also keep an eye out for signs of gestational diabetes (which usually starts around week 24 to week 28 of pregnancy), including extreme thirst, frequent and copious urination, extreme fatigue and snoring. Also talk to your doctor if you notice sudden weight gain, severe swelling in the face and hands and vision changes, which can be signs of preeclampsia.
SECOND TRIMESTER TO-DOS
Words to live by now: Eat well, exercise regularly and get plenty of rest. Here are the top to-dos for the second trimester:
- Prepare for routine monitoring: At each checkup this trimester, your practitioner will check your weight, the size of your uterus, height of your fundus (top of your uterus) and the baby’s heartbeat to ensure everything is progressing as expected.
- Schedule a level two ultrasound: Usually between 18 and 22 weeks of pregnancy, your doctor will measure the baby, check developing organs, determine the amount of amniotic fluid, and — if you like — clue you in on your baby’s gender. Keep in mind that while it’s exciting to get a peek at your developing baby, only your doctor should perform ultrasounds, including 3D and 4D ultrasounds (in other words, avoid the keepsake versions from your local mall).
- Get your glucose screening: About one in 10 pregnant women is diagnosed with gestational diabetes, which is why the American Congress of Obstetricians and Gynecologists (ACOG) recommends that all women be screened for the condition around week 24 to week 28 of pregnancy. If your test result comes back positive for extra glucose in your urine, it doesn’t always mean you have gestational diabetes — you’ll need further testing for a diagnosis. If you do, your doctor will probably refer you to a nutritionist who can help create a meal plan, and you’ll have to keep track of your blood sugar levels regularly.
- Talk to your doctor about prenatal genetic screening: If you haven’t already and if you have certain risk factors, your doctor may suggest a genetic screening including NIPT or a quad screening, both of which are blood screens that look for increased risk factors for chromosomal or congenital abnormalities (such as Down syndrome or neural-tube defects).If either of these screenings comes back positive, your doctor may recommend amniocentesis — where amniotic fluid is extracted and analyzed for genetic abnormalities — to get a more definitive diagnosis. It’s up to you ultimately whether you get a genetic screening, so it’s a good idea to learn more about what they can tell you, testing benefits and questions to ask your doctor first. And keep in mind that while all this might seem overwhelming and even a bit frightening, the majority of babies are born healthy.
- Get immunized: If you’re pregnant in cold and flu season, make sure to get the flu shot, and plan to get the Tdap vaccine in the third trimester to protect baby against whooping cough when he’s born. Also make sure to avoid these vaccinations during pregnancy.
- Shop for maternity clothes: Now that your bump is finally starting to show, you’ll need a maternity wardrobe to match. Here are a few essentials you’ll want in your closet.
- Sleep on your side: While pregnancy sleep is usually easier to catch in the second trimester than in the first or third, you will want to start sleeping on your side now, since the weight of your growing uterus puts pressure on the vena cava (the vein bringing blood from your lower extremities back up to your heart), which can interfere with circulation.
- Keep doing your Kegels: Keep your pelvic floor in shape for birth by getting in the habit of doing Kegels regularly— aim for ultimately three sets of 20 every day.
- Decide if you’ll find out baby’s sex: Your second trimester ultrasound, around week 20 of your pregnancy, can tell you — so think about the pros and cons of finding out your baby’s sex before birth.
- Make prenatal workouts a priority: Given all of the benefits of exercise for you and your baby, if you haven’t already it’s never too late to pick up a pregnancy-friendly workout. Just avoid activities that aren’t as safe now that your belly is bigger.
- Bump up your caloric intake: If you were normal weight before getting pregnant, you’ll need about 300 to 350 additional calories during the second trimester (which is less than you might think — only about two glasses of skim milk and a bowl of oatmeal).
- Track your weight gain: Now that you should be steadily gaining weight, your doctor will likely recommend that you keep track of it every week.
- Take bump shots: While you’ll likely want to wait until the third trimester to have your “official” baby bump photo shoot, it’s a smart idea to schedule it now — and in the meantime, take plenty of selfies as souvenirs of your ever-growing bump.
- Think about taking a baby moon: Since first-trimester nausea should be quelled (and some airlines put restrictions on traveling later in pregnancy), now’s a good time to plan one last hurrah before baby’s arrival.
- Envision your baby shower: While you won’t be the one actually planning your baby shower, you can certainly let your host(s) know any theme/food/decor requests you have. If it’s your second or third time, think about having a baby sprinkle.
- Create a baby registry: On that note, you’ll also need to create a baby registry for your shower guests and other well-wishers.
- Keep considering baby names: You still have time, but if you haven’t landed on a baby name yet it’s a good idea to keep reviewing your options.
- Look into childbirth classes. While you likely won’t start taking one until the third trimester, start looking into your childbirth class options and try to find a program that offers your preferred method near you.
- Think about where you want to give birth: In a hospital?Birthing center? At home? Start looking into your options now. You’ll want to take a hospital or birthing center tour in your third trimester, which it’s smart to schedule toward the end of your second trimester.
- Start looking into childcare: If you’re planning to go back to work after your maternity leave, it’s not too early to start looking into your local childcare options — whether daycare, nanny, babysitter or relative.
- Look forward to your third trimester: Once you make it through your second trimester, it’s on to your third — and then baby’s arrival before you know it!