Second Trimester

Second Trimester Overview

During the second trimester, which are months three through six of your pregnancy, you will experience many changes as your baby continues to grow and develop. The fatigue and nausea you may have felt in the first trimester will likely disappear, leaving you feeling energized. Take advantage of your renewed energy to schedule childbirth classes, a tour of the birthing centers, begin to make preparations at home for the new baby and find a pediatrician.

Helpful Information

Physical Changes

The milk-producing glands in your breasts get larger, and additional fat may accumulate in your breasts. A supportive bra becomes a necessity.
As your uterus expands to make room for the baby, your belly expands. Talk to your Wellstar obstetrician about healthy weight gain.
Braxton Hicks contractions may be felt in your lower abdomen and groin as your uterus starts building strength for labor and delivery. These contractions are usually weak and unpredictable. Painful or regular contractions may be a sign of preterm labor. Call your obstetrician immediately if this happens.
An increase in blood circulation to your skin can cause the skin around your nipples, on parts of your face and the line that runs from your navel to your pubic bone to darken. In addition, your skin may become more sensitive to the sun. Use a sunscreen whenever you go out.
Pink, red or purple lines, known as stretch marks, may appear on your abdomen, breasts, upper arms, buttocks or thighs. While stretch marks can’t be prevented, they will eventually fade. Moisturizers can help with the itching that sometimes accompanies them.
An increase in blood circulation can cause the lining of your nose and airway to swell, which can lead to snoring, congestion and nosebleeds. It can also soften your gums and cause some bleeding when you brush or floss your teeth. A softer toothbrush may help.
Pregnancy hormones cause your blood vessels to dilate. Until your blood expands to fill them, your blood pressure will fall and you may experience some dizziness. If dizziness becomes a problem, drink lots of fluids, stand up slowly after lying or sitting down and lie on your left side to raise your blood pressure.
Leg cramps, especially at night, may be the result of pressure from your uterus on the veins returning blood from your legs. Stretch the muscles or walk to ease the cramps.
Your lungs are processing more air than before your pregnancy as your blood carries oxygen to your placenta and the baby. This may leave you breathing slightly faster and feeling short of breath.
You may have a thin, white vaginal discharge. It is thought to help suppress the growth of bacteria or yeast. If the discharge becomes strong smelling, green or yellowish or is accompanied by redness, itching or irritation, contact your physician. Any of these may be signs of a vaginal infection.
You will be more apt to get bladder and kidney infections. Contact your Wellstar obstetrician if you need to urinate more often than normal, you experience a burning when you urinate, or you have fever, abdominal pain or backache.
Now that you are no longer experiencing morning sickness, your appetite should return, and even increase. Keep an eye on how much you eat. You need an extra 300 to 500 calories a day during the second trimester. You should gain about 1/2 to 1 pound each week.
The extra weight you've likely gained will put pressure on your back, making it ache. To ease the pain, sit up straight and use a chair that provides good support. Sleep on your side with a pillow between your knees.
Avoid picking up or carrying heavy things. Wear low-heeled, comfortable shoes with good arch support. Ask your partner to rub your back, or treat yourself to a pregnancy massage.

Your Baby

At 13-14 weeks your baby will begin to respond to the outside world. If your abdomen is poked, the fetus will try to wriggle away. As this starts, you won’t be able to feel it, but it will be visible on an ultrasound.
You may be able to hear the baby's heartbeat in the doctor's office.
Around week 20 you may start to feel your baby move. Called "quickening,” it usually feels like a gas bubble or fluttering at the beginning, but increases in regularity until you recognize it as your baby.
At week 22 your baby should be moving pretty constantly, and responding to sound, rhythm and melody. Try singing and talking to him or her. After birth, the same sounds will be soothing.
At week 25, the end of the second trimester, your developing baby will be about 8.8 in. from crown to rump and weigh about 1.5 pounds. His or her body is covered with folds of skin, like a shar pei puppy.

Routine Exams and Tests

Between weeks 16 and 18 you will be offered the blood tests maternal serum alpha-fetoprotein (MSAFP) and multiple marker screenings. The MSAFP test measures the level of alpha-fetoprotein, a protein produced by the fetus. Abnormal levels indicate the possibility, but not certainty, of Down syndrome or a neural tube defect such as spina bifida. Amniocentesis would be used to confirm the defects.
Multi-marker screenings check levels of the hormones estriol and hCG and the marker inhibin-A. The quad marker test picks up about 75% of neural tube defects and 75-90% of Down syndrome cases.
Amniocentesis, an optional test, is usually performed at 15-18 weeks for women who are 35 or older, have a high-risk of genetic disorders or whose maternal serum alpha-fetoprotein (MSAFP) or multiple marker test results were suspicious. Amniocentesis involves inserting a needle through the abdomen into the amniotic sac and withdrawing fluid that contains fetal cells. This procedure can detect 99% of neural tube defects and almost 100% of certain genetic disorders.
About week 20 you'll have an ultrasound so your physician can see how your baby is progressing. Depending on how the baby is turned, you may also be able to learn the sex, unless you'd rather be surprised. Ultrasound is a non-invasive procedure, when a device is moved across your abdomen. It transmits sound waves creating an image of the uterus and fetus on a computer monitor.
Glucose screenings are typically done at 24 to 28 weeks to test for pregnancy-induced diabetes. Gestational diabetes can result in overly large babies, harder than usual deliveries and health problems for you and your baby. This test measures your blood-sugar level an hour after you've had a special sugar-laden drink. If the sugar level is high, you'll take an additional glucose-tolerance test, in which you drink a glucose (or sugar) solution on an empty stomach and have your blood drawn every hour for 2-3 hours.
Routine tests and procedures performed at each second trimester doctor visit will likely include:
- Blood pressure check
- Weight
- Measurement of your baby’s growth by measuring your abdomen
- Listening to your baby's heartbeat
- Assessment of fetal movement. Let your WellStar physician know when you begin to feel the baby move.

Don’t Forget!

Sleeping on your left side starting in the fourth or fifth month is a good idea as it increases your circulation to the baby.
To reduce cramping, especially in your legs, increase your intake of calcium and potassium. A glass of milk before bedtime or potassium-rich snacks, such as grapefruit, oranges and bananas, can help reduce leg cramps.
Consider what types of childbirth education classes you would like to take during your third trimester. Purchase infant car seat.
Choose a Pediatrician.