The Second Trimester of Pregnancy

13 weeks pregnant – 28 weeks pregnant

The second trimester of pregnancy is a time when many women feel much better. The tiredness of the first trimester is over and your nausea has most likely disappeared.

You aren't yet subject to the physical discomforts that may appear in the later weeks of pregnancy and you’re beginning to glow!

During this time, you may find you have an aversion to foods you once loved and cravings for foods you never cared for. Be careful to eat healthy, and not overindulge in “craving” foods that aren’t nutritionally sound.

At 15 weeks of pregnancy your uterus is just popping up above the pubic bone. You may not yet look outwardly pregnant, or you may have already popped out. There is a great variation in the time your pregnancy becomes visible. This usually occurs between 14 weeks and 20 weeks.

If this is your second or third pregnancy, you are probably showing sooner than a first-time mom because the muscles of your abdomen are a bit more lax, and the uterus tends to fall forward more easily because of the relaxation of the supporting ligaments.

You may be noticing tan-colored spots on your face or chloasma may occur on the forehead, nose, upper lip and cheeks. It will fade soon after birth. These skin changes are due to increased blood circulation -- darker colored skin around the nipples, on your face, and on the line that runs from your belly button to your pubic bone.

Use sun block to prevent spots from darkening due to sun exposure, and continue taking your prenatal vitamins. They are great for the baby and studies indicate that they may prevent excessive pigmentation.

In your second trimester you’ll feel your baby's first movement, known as "quickening." Your baby, who's been quietly maneuvering around since seven weeks, is big enough and strong enough to actually let their movements be felt between 18 weeks pregnant and 22 weeks pregnant (on average). Early fetal movements may feel like soft tapping, or "butterflies," just above the pubic bone.

During your monthly visits to your care provider, talk to him or her about any concerns or symptoms you have had or questions about your pregnancy.

Even if you may think they are insignificant, your doctor will want to know. To your doctor, there is no such thing as a silly question.

As you reach 19 weeks pregnant and later, you may find that heartburn is more likely to occur as your uterus pushes up against your stomach. Heartburn and constipation are caused from a slower digestive process that allows nutrition to reach your baby more efficiently.

When your baby "drops," (first-time moms only), usually in the final month of pregnancy, there will be considerably less pressure on your stomach.

Until then, eating several smaller meals throughout the day can work well if you are troubled by heartburn. Try not to eat right before bed. Sleep with your upper body slightly elevated. Antacids that contain calcium will provide heartburn relief, as well as this essential nutrient. Be sure to check with your doctor or midwife before taking any medications.

At 20 weeks pregnant you will be at the half way point! You're probably feeling wonderful now that you've regained your energy. Finally people are beginning to notice that you are indeed pregnant, as your uterus pushes your abdomen out at the belly button. Your care provider has probably been measuring the level of your fundus, or top of the uterus, with a tape measure. It should now be approximately 18 to 22 cm. if you are having one baby and your dates are accurate. After about 20 weeks, this measurement generally correlates with your dates.

Fundal height measurements assess growth from visit to visit. If the measurement is consistently "small" or "large," the first thing to look at is the accuracy of dating. More than one baby is a possibility if your uterus measures "large for dates." If the fundal height is "small for dates," this might be an indication that your baby is smaller than expected. Ultrasound would be performed for any inconsistency in fundal height. After about 36 weeks the measurement for fundal height becomes less accurate as your baby settles into your pelvis.

Your abdomen may start to itch a bit as stretching occurs, but always let your doctor or midwife know of any physical discomforts to be on the safe side.

You will also be able to hear the baby’s heartbeat through a Delee stethoscope. Some providers begin to use this type of listening device instead of a doppler. It is one of the most exciting moments of pregnancy!

You may be having some trouble taking deep breaths on occasion, particularly if you are short in stature, or overweight. Call your care provider if you exhibit signs of asthma, such as coughing, wheezing when you exhale, or difficulty breathing at any time, especially during, or following, a cold or respiratory tract infection.

Braxton Hicks contractions begin the process of ripening your cervix (softening and effacement), which just might mean an easier labor for you! Braxton Hicks contractions strengthen your uterus and are painless contractions that happen in your lower abdomen and groin area. If ever in doubt, check with your doctor or midwife regarding any changes in the way you feel.

Some other physical changes that may happen are larger breasts as your milk producing glands inside your breasts grow bigger, snoring, congestion, and nosebleeds brought on by increased blood circulation in your mucous membranes which cause the lining of your nose and airway passage to swell. The extra blood circulation may also cause bleeding in your gums while brushing and flossing.

Expanding blood vessels will cause occasional dizziness and maybe lower blood pressure. Try not to stand for long periods of time and don’t stand up too fast after sitting or lying down. You may experience leg cramps caused by the pressure from your uterus to the veins that return the blood from your legs. You also may have a normal vaginal discharge that is thin and white; if it is differently colored or tinged with blood call your care provider to be checked out. During your second trimester you also have an increased chance of bladder and kidney infections due to slower flow of urine and an increase in size of your uterus. Call your doctor if you suspect either one of these two infections.

Around 24 weeks pregnant, you may begin thinking about the actual birth more. You may have changed your original birth plan, or are devising one for the first time. Now is the time to research your options, and make sure your doctor or midwife is aware of your wishes regarding your birth plan.

Print Out and Create A Birth Plan

During this time stress incontinence may start happening. Urine can leak when coughing, laughing, exercising, changing positions, or any other minor movement. Due to the influence of hormones, and also to the compression of the bladder by the growing baby, you may develop this new symptom anytime during your pregnancy, but most commonly in your third trimester.

Women who already given birth may find that they have this troublesome symptom more often than those having their first baby. The muscles which support the pelvic floor and surround the vagina and urethra can be strengthened, minimizing the occurrence of stress incontinence.

Kegel exercises that strengthen the muscles of the pelvic floor, helping support the bladder, can reduce this problem, while also helping to get those important muscles ready for giving birth.

To help identify the muscles involved, consider the muscles that you would use to stop your urine stream. Practice slowly squeezing the same muscle throughout the day. Work up to 50 repetitions and hold the muscle tight for 8 to 10 seconds. After your baby is born, start doing Kegel exercises right away. Contracting muscles of the perineum can increase blood flow to the area to speed healing.

Though it's something no mom-to-be wants to think about in her second trimester, it is important to be aware of the signs and symptoms of preterm labor. This is something to discuss with your doctor or midwife early on, so that you are aware of the signs and know when to call them.