The Second Trimester Of Pregnancy: Guide And What To Expect

The Second Trimester Of Pregnancy: Guide And What To Expect

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The second trimester is from 13 weeks to 27 weeks (four to six months) of pregnancy. You may begin to notice the “baby bump” and feel the baby’s movements from this trimester. Many women also begin to feel better from morning sickness.

Although body changes in the second trimester can cause some trouble for expecting moms, it is one of the easiest trimesters of pregnancy. Mothers need to stay more positive and healthy since the baby’s brain development begins at this time.

Read this post to know about body changes, emergency symptoms, baby growth, and tips to stay healthy in the second trimester.

What Are The Body Changes In The Second Trimester?

Hormonal changes and the increasing size of the baby can cause certain body changes and symptoms in pregnant moms (1).

1. Lower abdomen aches: Many pregnant women may experience cramps and aches in the lower belly during the second trimester. This can be due to the expansion of the uterus and its pressure on the nearby ligaments and muscles. Stretched ligaments can also cause sharp pain. A warm bath, changing position, placing a hot pack or hot water bottle wrapped in a cloth on the lower belly, and certain relaxation exercises may help reduce the cramps.

2. Backache: Growing babies can put pressure on the back, causing soreness and aches. Sitting straight, avoiding constant weight lifting, wearing low-heel shoes, and using a pregnancy pillow during sleep may help relieve backaches in pregnancy.

3. Gum bleeding: Hormonal changes can make the gums more sensitive, swollen, and tender during pregnancy. Increased circulation in the gums can cause bleeding more easily. You may avoid harsh brushing, use brushes with soft bristles, and floss gently.

4. Braxton-Hicks contractions: Irregular, mild contractions can be felt during the second trimester. This may feel like slight tightness in the abdomen and often occurs in the afternoons or evenings. Intense physical activity, dehydration, full bladder, and sexual intercourse could trigger these contractions. Relaxing and drinking water may help to relieve these contractions. You may seek medical care if the contractions are steadily increasing since this can be a sign of preterm labor.

5. Breast enlargement: Pregnancy hormones also increase the size of the breasts by increasing the fat deposits and the size of milk glands. This is a natural process, preparing your body to nurture your baby. Using a supportive bra with an appropriate cup size can make you feel more comfortable.

6. Nosebleeds and congestion: Hormones can cause mucus membrane swelling in the nose. This may result in a stuffy nose and snoring. These changes may also increase the likelihood of nose-bleeding. Nasal saline sprays and keeping air moist with humidifiers may help reduce these issues.

7. Vaginal discharge: Milky white, thin vaginal discharge can be normal in pregnancy. You may seek medical care if the discharge has a foul smell, yellow or green color, or contains blood.

8. Dizziness: Growing uterus may exert pressure on blood vessels, and mothers may feel dizzy at times. Standing for long, dehydration, hypoglycemia, and hormonal changes can also cause dizziness in the second trimester. Avoiding lying on your back and standing for long periods and adequate food and water intake may help prevent dizziness in pregnancy.

9. Frequent urination: Pressure of the uterus on the bladder can increase the urinary frequency in pregnancy. Clear urine is an indicator of hydration in pregnancy rather than frequency.

10. Hair growth: Hair can become thicker and grow more due to pregnancy hormones. Some women may have hair on their back, arm, or faces during pregnancy.

11. Headache: Many women can experience headaches during pregnancy. This can be manageable with Tylenol. However, if it persists, you may seek a doctor’s prescription.

12. Leg cramps: Muscle contraction on legs is common in the second trimester, especially during night hours. Stretching legs before bedtime, regular exercise, comfortable shoes, and adequate nutrition may help reduce leg cramps in pregnancy. You may eat more magnesium and calcium-rich foods.

13. Heartburn (indigestion): Hormonal changes and pressure of growing babies on the digestive system can make pregnant mothers more vulnerable to heartburn. Avoiding spicy, acidic, and greasy foods and eating frequent smaller meals may help relieve indigestion.

14. Constipation: Hormones can cause constipation during pregnancy. Adequate physical activity and consuming fiber-rich foods can prevent this condition.

15. Hemorrhoids: Rectal and anal veins can be swollen due to pressure from the uterus. Avoiding constipation and over-the-counter medications, such as topical H and hydrocortisone, and sits baths may help manage hemorrhoids in pregnancy.

16. Quickening: Fluttering movements felt in the abdomen around the middle of pregnancy (20 weeks) is called quickening. Some women may experience it by the end of the second trimester or in the third trimester.

17. Skin changes: Skin may appear flushed on the face due to hormonal changes. Melanin pigment can also cause brown marks on the skin. Stretch marks may also appear as the belly expands. All these skin changes gradually disappear during the postpartum period.

18. Urinary tract infections: Pregnant women are more vulnerable to UTIs. Bacterial infection can cause the increased urge to urinate cloudy or smelly urine and pain or burning sensation while urinating. You may seek medical care if you develop symptoms of UTI during pregnancy.

19. Weight gain: During the second trimester, appetite can be better as the morning sickness reduces in most women. Weight gain is often seen in this trimester.

20. Spider and varicose veins: Increased blood flow can cause tiny red veins in the skin called spider veins. The pressure of growing babies on blood vessels may reduce blood flow from the legs and lead to varicose veins in some women. Moving legs, elevating legs, and using a support hose may reduce these issues.

What Are The Emergency Symptoms In The Second Trimester?

Contact your doctor immediately if you experience any of the following symptoms during the second trimester (2).

  • Vaginal bleeding (more than the usual mucus-mixed spotting)
  • Severe vomiting or nausea
  • Fever
  • Severe abdominal pain
  • Seizures, often due to preeclampsia or hypertension, type 1 diabetes, or hypoglycemia
  • Suspected water break (ruptured membrane)
  • Jaundice
  • Rapid weight gain or weight loss
  • Internal bleeding and certain conditions could cause shock, which is indicated by low blood pressure, cold and clammy extremities, dizziness, sudden weakness, and pale skin

These symptoms may occur due to various reasons. Some of them may threaten pregnancy and risk the life of the mother if left untreated. You may contact the doctor or visit the emergency department if you cannot contact your doctor on time.

How Does The Baby Grow In The Second Trimester?

By the end of the first trimester, all organs and systems are formed in the fetus, and they continue to grow in the second and third trimesters. The weight of the fetus increases over time. A fetus may weigh about two to three pounds and grow 13 to 16 inches long by the end of the second trimester (3).

The following fetal developments are seen during the second trimester (3).

  • Vernix caseosa, a creamy white substance, appears on the skin
  • Fetus movements, such as kicks, are felt
  • Development of sucking and swallowing reflexes
  • Eyes and ears form at their place and baby can hear the voice
  • Response to certain stimuli, such as maternal voice
  • Placenta becomes fully formed
  • Fingers and toes are separated, and nails are grown
  • Fetus may go through cycles of sleep and wakefulness
  • Hair growth occurs on the head, and skin can be red and wrinkly with downy hair (lanugo)
  • Eyelids begin to open, and eyelashes and eyebrows are visible
  • Fat begins to deposit in the fetus
  • Complex brain development begins in the second trimester

A fetus born at the end of 24 weeks of pregnancy can survive in a neonatal intensive care unit if they do not have any life-threatening anomaly.

Are There Tips To Stay Healthy In The Second Trimester?

You must adopt a healthy lifestyle with adequate nutrition throughout the pregnancy. The following tips may help to cope with the second-trimester changes (4).

  • Eat well-balanced meals to meet daily nutrition needs. Additional 340 calories per day are needed from the beginning of the second trimester for mothers with one fetus. The calorie requirement can be more in multiple pregnancies, such as an extra 600 calories per day for twins and 900 extra calories for triplets.
  • It is recommended to drink eight to 12 cups of water a day during pregnancy, not when you feel thirsty. Adequate water intake can help keep the circulation well and eliminate waste products, such as urea, from the body.
  • Exercise regularly to promote good health and relieve body aches. This may also help maintain body weight during pregnancy. You may also talk to your doctor to know the safest and effective physical activities based on individual factors.
  • Take recommended prenatal vitamins and other supplements each day. Iron, folic acid, calcium, magnesium, omega-3 fatty acids, choline, vitamin B, and vitamin C are the most needed nutrients in pregnancy. Folic acid 600 mcg is recommended for the second and third trimesters. More than recommended amounts of vitamins supplements can be harmful such as excess vitamin A can cause birth defects.

Other dos and don’ts to stay healthy during the second trimester include:

  • Moisturize the belly to reduce stretch marks and itching during the second trimester.
  • Avoid excess heat since it may cause heatstroke, harming the mother and reducing the baby’s oxygen supply.
  • Avoid contact with toxins and chemicals since they can be hazardous to the fetus.
  • Avoid X-rays and other harmful diagnostic procedures during pregnancy. You may also avoid dental procedures since dental X-rays and certain medications may also negatively affect the baby.
  • Practice good hand hygiene to reduce the risk of viral and bacterial infections.
  • Always seek prescriptions for any condition after informing that you are pregnant to avoid teratogenic medications. Avoid over-the-counter medications and self-treatments during pregnancy.

What To Expect In Second Trimester Antenatal Visits?

Doctors may focus on the baby’s growth and health during the second-trimester visits. Blood pressure and weight are assessed in all visits. Uterus size is estimated by measuring fundal height, the distance from the top of the fundus to the pubic bone. Fetal heart monitoring and movements can also be assessed in the second trimester.

You may also discuss any symptoms or signs concerning you during this time. Doctors may also suggest nutritional intake and physical activity requirements for the second trimester. In addition, various genetic testing and blood tests might be offered during these visits.

How To Prepare For Birth In The Second Trimester?

Although several weeks are left for childbirth, you may begin preparations from the second trimester to make the third trimester easier. The following measures may help expecting moms prepare for the third trimester and birth.

  • Attend baby care classes online or from an educator. This may reduce worries related to caring for the newborn and breastfeeding after childbirth. They may also teach you first aid for newborns and parenting tips. First-time moms can benefit more from prenatal education.
  • Invest time to do mommy and baby shopping in the second trimester since you may feel less morning sickness and not have difficulties as in the third trimester.
  • Learn more about various delivery methods and maternal hospitals to prepare well for childbirth.
  • You may also begin searching for caretakers for your baby at this time.

Stress and confusion during childbirth can be less if mothers and other family members are prepared for childbirth earlier.

The second trimester of pregnancy is a time when the baby begins to increase in size. You may consume recommended amounts of nutrients and supplements to meet their growing needs. Although you may experience a few symptoms and discomfort due to the increased size of the uterus, most of them are manageable through lifestyle changes.


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Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more