Your second trimester of pregnancy spans weeks 13 to 27. As a rule, morning sickness goes away, and you start to feel better emotionally and physically. Even by the 27th week, the baby is not big enough to make you uncomfortable. Just two months ago, the baby was a cluster of cells, and now she has muscles, nerves and organs. Now, the baby moves on her own, and may even get hiccups you can feel by the end of the trimester.
Your hormones are still in high gear, but you have probably adjusted over the past three months. It is normal to feel anxious and worry about how your body will respond after the baby is born. You might have dreams about problems with the baby. These are very normal, too. During your second trimester, you will probably feel less tired, as your morning sickness is gone and you can eat a more balanced diet. Now is an excellent time to focus on making good food and lifestyle choices for you and your baby. You should also sign up for childbirth preparation classes and look for a good pediatrician.
Your body will undergo physical changes during your second trimester, as your baby grows from the size of a lima bean to weighing nearly two pounds. You may experience some standard pregnancy aches and pains. Almost all of these changes are temporary and will disappear once the baby is born. Keep up with your prenatal visit schedule and call the obstetrician if any symptom seems to be a significant problem for you.
- Backache: As you gain weight over these next few months, it puts pressure on your back and changes your posture. Sleep on your side with a pillow between your legs to try and ease some of the strain on your pelvis. Use chairs that provide good back support and remember to sit up straight. Now is the time to stop carrying heavy things or picking up heavy items. High-heeled shoes are also going to aggravate a backache.
- Braxton Hicks contractions: Usually, these contractions feel mild, more like menstrual cramps or tightness in your belly. They happen more often after physical activities or sex. They are not harmful to you or your baby. If they become painful or regular (time them from the start of one contraction to the start of another contraction), contact your doctor right away. In these cases, they could signal preterm (premature) labor. There are things the doctor can do to stop early labor.
- Dental problems: Pregnancy can make your gums more sensitive or prone to bleeding because of the increased blood volume in your body. Use a softer toothbrush and rinse your mouth with salt water to help lessen the irritation. If you have had frequent episodes of morning sickness, this may have weakened the enamel on your teeth and made them more prone to cavities. Keep your dental checkups as scheduled while you are pregnant so you can catch any problems before they begin.
- Dizziness: Your circulation changes when you become pregnant because you have more blood volume and you are supporting a baby inside you. These changes can cause you to be dizzy, especially if you stand up or change positions too fast. If this is a problem for you, make sure you are drinking enough fluid. Try to change positions more slowly, and do not stand up quickly. Do not stay on your feet for long periods of time if you are having problems feeling dizzy. If you do start to feel dizzy, lie down on your size until the feeling passes.
- Expanding belly and breasts: Your uterus has to grow to make room for your rapidly growing baby. As it grows, your belly expands, too. Your breasts also continue to grow. You need a bra that gives good support. Wide shoulder straps will feel far more comfortable. You may also feel some discomfort or aches in your abdomen as it grows and the uterus and its supporting ligaments stretch. This is normal.
- Heartburn and intestinal problems: Your body makes more of the hormone progesterone during pregnancy. It relaxes muscles, including a ring of muscle in your esophagus that keeps acids and food in your stomach. It also relaxes the muscles that move food through your intestines, causing constipation. You may find relief by eating smaller, more frequent meals and avoiding foods that are greasy, spicy or acidic, such as citrus fruits. If constipation is a problem, eat more fiber and drink extra fluids plus try some gentle exercise like walking to keep your bowels moving regularly.
- Hemorrhoids: Hemorrhoids are a kind of varicose vein that form around the anus. Thanks to the extra blood in your body and the pressure of your growing uterus during pregnancy, these veins may become swollen, painful and discolored. Sitting in a warm tub or a Sitz bath may help relieve the itching and pain from hemorrhoids. Ask your doctor if it is safe for you to use over-the-counter hemorrhoid creams or ointments.
- Leg cramps: As your pregnancy progresses, leg cramps become more common. They often occur at night. Help prevent them by staying active and drinking plenty of fluid. Do calf stretches before bedtime. If you get a leg cramp, stretch the calf muscle gently. Sometimes warm showers or baths, muscle massage or ice massage on the cramped muscle helps relieve the pain.
- Nasal problems: Your body has made more blood to support your baby and your enlarged uterus. You also have increased hormone levels. This combination may cause you to have nose bleeds or a constant feeling of stuffiness in your nose. A saline rinse or saline drops can help keep the inside of your nose moisturized to prevent nose bleeds. Staying well-hydrated, using a humidifier at night, and keeping the skin around your nostrils moisturized also helps prevent problems.
- Sexuality: You may feel more amorous during your second trimester. In part, this is because you feel better all over now that morning sickness has passed, and partly because you are making estrogen at an incredible rate. A pregnant woman’s ovaries make as much estrogen in one day as they will in three years when she is not pregnant.
- Shortness of breath: You may feel out of breath as you progress through your pregnancy. Your uterus is growing and starting to crowd your lungs. Even mild activity like walking might seem more difficult. If you find this becoming a severe problem, talk to the doctor.
- Skin changes: Your hormone changes during pregnancy can trigger changes in the melanin, or pigment cells, in your skin. Some people may see brown patches on their face, called melisma, or a dark line down their abdomen called linea nigra. These changes are common, and they usually fade after the baby is born. They are aggravated by sun exposure, so use a good sunscreen.
- Spider and varicose veins: The extra blood in your body has caused new blood vessels to grow. Some of these vessels may be the tiny red veins, called spider veins, that appear very close to the surface of your skin. These usually disappear after you have your baby. As your pregnancy progresses, the growing uterus puts more pressure on your legs and can slow the blood flow to your entire lower body. Some people develop swollen blue or purple veins in their legs, called varicose veins. To keep these at a minimum, stay active during the day. If you must sit for a long time prop up your legs. Wear support hose or stockings to help push the blood out of your feet and legs, as well. After your baby is born, most varicose veins should improve within about three months.
- Stretch marks: Sometime during your second trimester of pregnancy, you may start to notice reddish lines forming along your abdomen, buttocks, thighs or breasts as these areas grow larger. Stretch marks cannot be prevented by moisturizing the skin. However, most stretch marks eventually fade after your baby is born. As you lose your pregnancy weight, they should become nearly invisible or show as silver or white streaks.
- Urinary tract infections: Pregnant women are more susceptible to bladder infections. Call your doctor if it hurts when you urinate, or if you have a fever and backache. Without prompt treatment, a urinary tract infection can get worse or even become a kidney infection.
- Vaginal discharge: It is normal for pregnant women to have a clear or white and slightly sticky vaginal discharge. If there is an unusual color or strong smell, or if you have pain, soreness or itching in your vaginal area, contact the doctor because this may be an indication of an infection.
- Weight gain: Once your morning sickness ends and your appetite returns in your second trimester, you should begin to gain weight. Your doctor will guide you on much weight you should gain during your pregnancy. You do not need to stuff yourself with extra food, however. An extra 300 to 500 calories of healthy food per day during your second trimester should put you on track to gain the recommended one-half to one pound per week during this time.
You will probably need maternity clothes early in your second trimester. By the time you reach the end of the second trimester, you will have gained between 16 and 22 pounds. The baby will only weigh about two pounds. Exercise is important during the second trimester, both to help you stay in shape and manage your weight and to help get your body ready for the hard work of labor and delivery. Here are some ideas for pregnancy-appropriate exercises to try during your second trimester.
- Kegels: Kegel exercises help strengthen the pelvic floor muscles. These will help you push during delivery. Strong pelvic floor muscles also reduce the risk of incontinence after delivery. Practice Kegels by contracting the muscles like you are trying to stop urinating mid-stream. Hold that contraction and then release it. Repeat the exercise. You can do these multiple times every day.
- Prenatal yoga: Prenatal yoga is designed specifically for pregnant women’s changing bodies. You will stretch and strengthen your muscles, practice controlled breathing and learn relaxation techniques.
- Swimming or water aerobics: Both water aerobics and swimming are excellent exercises for pregnant women. They are low-impact, so they will not add stress to your legs, back and lower body. Just the feeling of being almost weightless in the water helps rest your body and relieve pain in your feet and back.
- Walking: Walking gets your blood moving and helps build cardiovascular strength. It burns fat and calories and builds muscle, so you will look and feel better during and after your pregnancy. The lean muscle developed burns off weight gain from pregnancy much faster than weight gained from fat.
Not all exercise in pregnancy is good exercise. Always check with the doctor before beginning any exercise routine, especially if you are pregnant!
- Avoid any exercise that involves heavy lifting or exhaling heavily. This can raise your blood pressure to a dangerous level.
- Do not lie flat on your back while exercising. This position may cause the baby to compress the vena cava – one of the largest blood vessels in your body that carries blood to your baby.
- Eat a small snack for a calorie and energy boost about one hour before you exercise. Stay hydrated by sipping water during exercise.
- Be very careful with your balance during any pregnancy exercises. As your baby grows and your body changes, your balance and coordination change, too. You may be more prone to dizziness, too.
Fetal Development During the Second Trimester
Over these weeks, your baby’s organs will develop, she will begin to swallow and to hear sounds outside your belly. She will begin to move around, and you will begin to feel her move, too. Hair will grow on your baby’s head, and she will develop definite sleep and wake cycles that you can notice. By the end of your second trimester, the baby will be about 14 inches tall and weigh around two pounds, according to the American Pregnancy Association. Follow along with your baby’s development with our week-by-week checklist.
Second Trimester, Week 13 Gestational Age (Week 11 Fetal Development)
The baby’s intestines have moved from his umbilical cord, where they grew for the first few weeks, to his abdomen. His kidneys are making urine, and he is discharging it into the amniotic fluid that surrounds him in your uterus. Tissue that eventually will become bone has started to form around the baby’s head and in his arms and legs.
Second Trimester, Week 14 Gestational Age (Week 12 Fetal Development)
Your baby can now make expressions with her face, and she may even be sucking her thumb. Her arms are nearly the same proportion now as they will be once she is born. Her neck is becoming more defined. Her spleen has started forming red blood cells. Over the next few weeks, the baby’s sex will become obvious. In boys, the prostate gland appears. In girls, ovarian follicles for eggs start to form. The baby is now about three and ½ inches tall from the top of her head to her rump, and she weighs about one and ½ ounces.
Second Trimester, Week 15 Gestational Age (Week 13 Fetal Development)
The baby’s eyelids are still shut, but she can see light filtering into your womb from outside your body. She is growing rapidly, including developing skeletal bones. You will be able to see these on an ultrasound in a few weeks. The pattern of the hair on her scalp is beginning to form.
Second Trimester, Week 16 Gestational Age (Week 14 Fetal Development)
Sometime between now and 20 weeks, your obstetrician will probably offer you an ultrasound test. The baby is making more coordinated movements, and you can see him moving around during the ultrasound. The doctor may also be able to determine the sex of the baby if you want to know. The baby’s eyes are starting to face forward and to move, and his ears are close to their final position on his head. He can probably make sucking motions with his mouth. At this age, the baby is about four and ½ inches tall.
Second Trimester, Week 17 Gestational Age (Week 15 Fetal Development)
At 15 weeks after conception, your baby has started to grow toenails. You will probably start to feel her move sometime between now and the next several weeks. Some women don’t feel their baby’s movement until well into their sixth month of pregnancy, however. Your baby is also beginning to store a layer of fat under his skin. This will give him energy and help him stay warm after he is born.
Second Trimester, Week 18 Gestational Age (Week 16 Fetal Development)
You may be feeling your baby move inside you now, although it will be a few weeks longer before people can feel her move from outside. She can hear things now, and her ears have started to stick out from the sides of her head. She may be as tall as five and ½ inches from the top of her head to her bottom, and she may weigh up to seven ounces.
Second Trimester, Week 19 Gestational Age (Week 17 Fetal Development)
By now, your baby can hear your heartbeat from inside the uterus, as well as sounds that come from outside your body. He can even hear your partner’s voice speaking to him! The baby’s skin is very wrinkled and covered with a waxy coating called vernix caseosa. This substance is sometimes described as “greasy” or “cheesy,” and it is designed to protect the baby’s very delicate skin from exposure to the amniotic fluid. The skin can get chapped, hard or scraped without this coating. If you are having a girl, her sex organs such as her uterus and vagina begin to form. The baby measures around six inches tall and weighs about eight and ½ ounces by the end of this week.
Second Trimester, Week 20 Gestational Age (Week 18 Fetal Development)
This week of your pregnancy marks the halfway point between conception and delivery. You are almost certainly feeling your baby’s movements, called “quickening,” by now. Many women who have been pregnant before feel their baby move sooner than first-time moms. All the baby’s organs and bones continue to grow, and she keeps getting taller and heavier every week.
Second Trimester, Week 21 Gestational Age (Week 19 Fetal Development)
Your baby has learned to swallow by age 19 weeks, and he is getting ready to put on more weight. He is also becoming much more active.
Second Trimester, Week 22 Gestational Age (Week 20 Fetal Development)
The baby is now completely covered with a very fine, downy layer of hair called lanugo. This hair helps hold the waxy vernix caseosa protective layer on his skin. His eyebrows may be visible, too. The baby has grown to weigh almost one pound, and he measures seven and ½ inches from his head to his rump.
Second Trimester, Week 23 Gestational Age (Week 21 Fetal Development)
At 21 weeks after conception, your baby can sense motion. For instance, if you dance, your baby can feel it even though he is surrounded by the amniotic fluid and your body. He starts to have rapid eye movements under her closed eyelids, and he can hear better every day, too. His skin is still wrinkled, and almost translucent pink or red colored. The baby is starting to form fingerprints and footprints, and soon her tongue will have taste buds.
You may be able to see him moving under the surface of your abdomen. If your baby is a boy, his testes are descending from his abdomen. If the baby is a girl, she has a uterus and ovaries, including her entire lifetime supply of eggs. Some babies born at this stage may be able to survive with very intensive medical care.
Second Trimester, Week 24 Gestational Age (Week 22 Fetal Development)
By now, your baby is sleeping and waking regularly. Her brain is growing quickly. Her taste buds have developed, and she may be growing real hair on her head. She is nearly a foot tall, but only about eight inches tall from the crown of her head to her rump. She may weigh between one and one and 1/3 pounds by now.
Second Trimester, Week 25 Gestational Age (Week 23 Fetal Development)
Your baby recognizes your voice, your partner’s voice and other familiar sounds now, and she may be able to respond with movements. Her hands and startle reflex are also starting to develop.
Second Trimester, Week 26 Gestational Age (Week 24 Fetal Development)
The baby has fingernails now. Her lungs are starting to produce a substance called surfactant. This material helps the tiny air sacs in the lungs, called the alveoli, inflate when the baby breathes after she is born. Surfactant also keeps the alveoli from collapsing and staying stuck together when they deflate as the baby exhales. In the past week, the baby has put on a lot of weight. She now tips the scale at almost two pounds. She may have grown another inch, as well.
Second Trimester, Week 27 Gestational Age (Week 25 Fetal Development)
The baby’s lungs continue to develop, although they will not function completely for a few weeks yet. He practices breathing by inhaling and exhaling amniotic fluid, though. The baby also opens his eyelids again for the first time since your first trimester of pregnancy. He sucks his fingers, sleeps and wakes regularly, looks around inside your uterus and “practices” for life outside your body. His nervous system continues to mature, and he continues to grow rapidly. The 27th week marks the end of the second trimester of pregnancy.
Your prenatal visits during the second trimester will focus on ensuring the health of you and your baby. The obstetrician will check your weight and blood pressure, and chart the size of your uterus. The doctor does this by measuring the fundal height, or the distance between the top of your uterus (the fundus) to your pubic bone. You will also get to listen to your baby’s heartbeat during your visits to the clinic.
The doctor may recommend an ultrasound exam or other tests. In an ultrasound, you can see your baby moving inside your body. The doctor may be able to determine the sex of your baby if you want to know this information.
Let the doctor know if you have any symptoms that worry you. Call the doctor immediately if you experience any of the following problems:
- Uncontrolled or ongoing nausea or vomiting.
- Jaundice – yellowing of the whites of your eyes
- Extreme swelling
- Very rapid weight gain
Read the other guides in our three-part series:
Now you know some of the major things to expect during your second trimester of pregnancy. Call us at (913) 948-9636 to schedule your routine prenatal appointments or if you have any questions about the second trimester of your pregnancy. You can also contact us online here.