2nd Trimester of Pregnancy

2nd Trimester of Pregnancy: Weeks 14 through 26

Welcome to your second trimester of pregnancy! The 2nd trimester is usually the time that most women feel their best during pregnancy.  It’s also a good time to begin planning for your birth! A good place to begin is to write a birth plan. 

Changes to Your Body

What Does it Feel like to be Pregnant During the Second Trimester of Pregnancy?

Some of the symptoms you may have experienced during the first trimester such as morning sickness and fatigue should begin to disappear or at least ease up a bit this trimester.  You should even begin to have some more energy, making this a great time to tackle some items on your to-do list that may have been put off in the 1st  trimester.   

And more good news!  You should start to see the beginnings of a true baby bump by the end of the 2nd trimester of pregnancy.  For those who’ve been pregnant before, you will likely begin to show a bit earlier than in your previous pregnancy.

Some Common 2nd Trimester Pregnancy Symptoms Include:

• Heartburn.   Tip: try eating smaller meals, more often. Avoid drinking while eating. You can safely take an over-the-counter antacid such as Tums or Rolaids.
• Growing Breasts. You should start to feel a little less breast tenderness this trimester. However, your breasts are growing so you may find that you need to go up a bra size or even two.
• Sciatica (feels like shooting pain down your lower back and legs).  Sciatica is really common. It happens because your center of gravity shifts during pregnancy and the hormone Relaxin causes your ligaments to loosen. While it usually develops during the third trimester, some pregnant women experience it as early as the 2nd trimester. Tips: try using a heating pad, prenatal massage or see a chiropractor to help ease the pain.
• Headaches.  Very common.  Avoid aspirin and ibuprofen. If you’re getting frequent headaches, talk to your healthcare provider about taking acetaminophen (Tylenol) during pregnancy.
• Aches and pains.  You may be having pain in your back, abdomen, groin, your thighs or all of the above.  Tip: try treating yourself to a prenatal massage. Also wear comfortable, supportive shoes as much as possible.  
• Leg cramps. (Also known as “charley horses” – ouch!).  If you get a charley horse, you’ll want to quickly straighten your leg, heel first, and wiggle your toes around to stop the cramping. Also to limit leg cramps try taking a walk or exercising each day and be sure drink plenty of water.   You can also try increasing your magnesium intake, either an oral supplement or you can apply a magnesium spray to your legs which you can easily make yourself.
• Bleeding Gums. Most moms experience soft or bleeding gums at some point during pregnancy due to hormonal changes.   Be sure to see a dentist during pregnancy. 
• Stretch Marks.   Extremely common, about 90% of woman get pregnancy stretch marks. Stretch marks appear because your skin is growing too quickly which causes the middle layer of your skin (called the dermis) to tear. Try not to worry,  stretch marks should fade after baby arrives although they may not completely disappear. Tips: while many believe stretch marks are genetic, there are some things you can try to improve your skin’s elasticity.  Try drinking plenty of water, at least 64 ounces each day.  Also be sure to eat a whole foods diet.
• Increased Appetite.  You will likely have a much better appetite in the 2nd trimester now that your morning sickness is beginning to wane!  Here is a post on healthy foods to include in your diet.
• Hemorrhoids. About half of pregnant women experience these during pregnancy. The best thing you can do to avoid getting painful hemorrhoids is to eat foods high in fiber (think avocados, apples, artichokes, beets, strawberries, oats, lentils). Things you can  try to alleviate pain include: take a warm bath and add baking soda, apply witch hazel or over the counter products such as Tucks medicated pads, ointments or creams to reduce swelling, and avoid sitting for long periods of time. 
• Vaginal Discharge. It’s normal to have daily discharge (called “leukorrhea”) that is clear or white in color and thin to milky or mucousy in consistency. This is normal response to your body’s shifting hormones during pregnancy.
• A Dark Line Running Down your Stomach.  You may notice a line running from your belly button to the top of your pubic area, this is known as Linea nigra and is due to pregnancy hormones. It’s nothing to worry about and it should begin to fade following your baby’s birth.  
• Skin Changes. Patches of tan or brown most commonly on the face (also called the “mask of pregnancy”).  Again, this is nothing to worry about and should begin to fade after your baby is born.
• Itchiness (also referred to as pruitus). Very common. Some moms experience itching all over while others only feel itchy in certain places such as their feet, hands, feet, or abdomen. Note: if  you experience extreme itching, call your health care provider right away as it could be a sign of a serious liver condition called Cholestasis of pregnancy.  
• Swollen Feet and Hands.  It’s common to experience swelling in your feet or hands beginning around the 5th month of pregnancy. The swelling is caused by the increasing volume of blood and fluids you are carrying around these days as well as the added pressure from your growing baby which may affect blood flow to your legs, ankles, and feet.  Avoid being on your feet for long periods of time. Also, try elevating your feet so that they are above your heart several times a day to reduce swelling.  You should also drink plenty of water to flush extra fluids and sodium (salt) out of your body. Some women find compression stockings to be helpful to combat swelling. 

Call Your Healthcare Provider Right Away if You Experience any of the Following:

• Severe Nausea or vomiting
• Jaundice (this is when your skin or eyes turn a yellowish color)
• Extreme swelling
• Rapid weight gain (Note: if you suddenly gain a lot of weight very quickly or have extreme swelling, it could be a sign of preeclampsia and you should call your Doctor or Midwife right away)
  • Note: If you’re high-risk for preeclampsia, be sure to ask your Obstetrician or Midwife about taking low-dose aspirin. Studies have found that taking a small, daily dose of aspirin after the first trimester can reduce preeclampsia by as much as 24 percent.
• Bleeding or fluid leaking from your vagina
• Dizziness
• Fever (temperature over 101 degrees F) or chills
• Contractions that are regular, painful or are accompanied with bleeding (Braxton Hicks contractions are normal)
• Extreme or increased itchiness or itching that gets worse at nighttime

What Changes are Happening Week by Week in Baby & Mom During the 2nd Trimester?

Pregnancy Week 14

Baby is the size of an orange.

Your baby is growing and is a little over 4 inches in length and weighs around 2 ounces. Baby’s brain is also working hard as your baby practices how to frown, pucker, and breathe by taking amniotic fluid in and out of the lungs. She’s also starting to make urine and her body is covered in baby fuzz hair called lanugo.  Your baby’s intestines are already gearing up for baby’s first bowel movement (known as meconium).

What’s Happening With You

You should begin to feel less tired in the second trimester thanks to your placenta. Your body has been busy creating this very important organ and now that it’s almost fully formed, your body can finally take a rest, giving you some much appreciated energy boost.   Another piece of good news is that your risk of miscarriage drops.

Pregnancy Week 16

Baby is the size of an avocado.

Your growing baby will soon be large enough for you to feel his movements or “flutters”, even though he only weighs about 6 ounces.  But don’t panic if you haven’t – if you’re a first time mom, you may not feel baby’s movements until around 20 weeks.

Baby has also developed miniature fingerprints! If you think that’s amazing, consider that if your baby is a girl, her ovaries already carry the eggs she’ll have into adulthood. You are walking around with the seeds of your grandchildren.

What’s Happening with You

Only 4 weeks to go until you are at the halfway mark! If you haven’t yet experienced typical food cravings, you may begin experiencing them now.  Try to reach for healthier alternatives whenever possible.  

Pregnancy Week 18

Baby is the size of a large pomegranate.

Tiny person can hiccup, wiggle, kick, suck, make faces, and more! Perhaps more importantly, she can listen to your voice! The baby can hear and listens for you. She hears your heart, breathing, digestive sounds, and other noises. These sounds and your voice comfort her.

What’s Happening with You

Getting comfortable at bedtime can be difficult in pregnancy, even before your belly fully pops.  Try sleeping on your side and place a pillow under your belly and another between your bent knees.  Read more about getting a good night’s sleep.

Pregnancy Week 20

Baby is the size of a banana.

Your baby has been busy growing, and now measures about 16 cm long, about the length of a banana. For baby girls, her uterus and ovaries are now fully formed and are filled with a lifetime’s supply of eggs! For boys, his testicles have begun to descend into the scrotum.

This is typically the time that people get an anatomy scan, the ultrasound that measures baby’s organs and tells us the baby’s sex (which means you can finally narrow down that list of baby names).

You should be able to begin feeling your baby move around this time. You may notice that baby is more active at certain times of the day more so than at other times. This is because your baby has already begun to fall into sleep cycles with definite periods of sleep and periods of activity. 

Here is more information on what you can expect at the 20 week ultrasound

What’s Happening With You

Congratulations! You’re halfway there! Your growing baby is quickly taking up more and more space inside your uterus. You may even begin to feel a little out of breath from time to time, especially during physical activity like climbing a flight of stairs. This is completely normal and is due to your growing baby causing your uterus to press against your diaphragm, ultimately cramping your lungs. Try to slow down if you feel breathless and wait until the sensation goes away which shouldn’t take more than a minute or so.

Tip: Remember that your “due date” is more of a guess date. Even if we knew exactly when the baby had been in there for exactly 40 total weeks, bodies are not machines. It’s satisfying to know that the baby will choose its own birthday. Some people choose speak of their due date only in generalities to keep themselves (and others) from obsessing on a certain deadline for the baby’s arrival. “I’m due mid-february.” 

Pregnancy Week 22

Baby is the size of a Papaya

Your little papaya is almost 10 in length and weighs about 1 pound. The baby’s skin is now opaque and more normal-looking. Her facial features are more developed, and she has regular sleep and wake cycles. Major organs and systems are formed, but not mature.

While her body is well-proportioned, she hasn’t yet put on much baby fat.  Not to worry, during the final weeks of your pregnancy, your baby will build up her fat stores and fill out those sweet little arms and legs.

What’s Happening With You

By week 22, your growing belly may have started to “pop”.  About two weeks ago, the top of your uterus was flush with your belly button but this week, your uterus is inching higher and higher up your abdomen – about 2cm north of where it was 2 weeks ago.

Many women begin to feel their uterus contract around this time – these early, irregular contractions are known as Braxton Hicks contractions.  They are your body’s way of practicing for labor.  If your contractions become painful or regular, be sure to contact your health care provider. 

Pregnancy Week 24

Baby is the size of an Ear of Corn.

Your little one is almost 12” long. He’s almost six months old in there! Your little one’s brain is growing rapidly, taste buds are forming, and his lungs are becoming more complex as they continue to develop. 

What’s Happening With You

Soon it will be time to take the glucose test to check for gestational diabetes.  The 2nd trimester of pregnancy is a wonderful time to check off some of those items on your to do list. During this trimester you should have some more energy and your growing baby bump will not limit your movement as much as it will near toward the end of your pregnancy. 

Pregnancy Week 26

Baby is the size of a Rutabaga.

Your little one now has eyelashes, and she’s working on an immune system. Babies born at this time (after 25 weeks) have a much higher survival rate if born premature.  Your baby now weighs close to 2 pounds and is roughly 14 inches long, about the length of a 

What’s Happening With You

You may find that you have trouble remembering things (often called pregnancy brain), unlike before. As your baby bump continues to grow, you may find that this is the right time to buy yourself some comfortable fitting maternity clothes.

Common Prenatal Tests in the 2nd Trimester of Pregnancy

During your 2nd trimester of pregnancy, you can expect to have the following two tests done:

20 Week Ultrasound (also known as the Anatomy Scan)

Most second-trimester ultrasounds are done between 18-20 weeks to make sure the baby is developing normally as well as to examine the baby’s anatomy. Women who are considered high-risk may have multiple ultrasounds in their second trimester of pregnancy.

Glucose Tolerance Test

Usually done between 24-28 weeks, the glucose test checks to see if you have gestational diabetes (GD).  GD develops in some women during pregnancy and can lead to health problems for the baby if not diagnosed or treated. 

Other Tests Offered in the 2nd Trimester of Pregnancy

You can choose whether to have the following tests done that check for possible birth defects. Take time to talk with your provider about which tests are right for you, the benefits and risk of each and what the results will and will not be able to tell you. 

It may be helpful to think about what the results of a test would mean to you and how it might affect your choices about your pregnancy.  What you choose depends on your wishes, how far along you are in your pregnancy and your family health history. You may choose to have no tests, one test, or several tests.

Triple or Quad Screening

This screening is usually done between 15-20 weeks of pregnancy. The triple screening measures the amounts of the following three substances in a pregnant woman’s blood: 

• alpha-fetoprotein (AFP), 
• human chorionic gonadotropin (hCG), 
• and estriol (uE3). 

When a test for the hormone inhibin A is included, it’s known as a quad screening. 

The amounts of these substances help your doctor understand the chance that your baby may have certain birth defects, such as Down syndrome, spina bifida, or anencephaly. These tests do not show for certain that your baby has a birth defect. You would need to have a test called amniocentesis (see below) to find out for sure if there is a problem.

Amniocentisis

During this test, a sample of the amniotic fluid that surrounds a baby is taken.  This is done to check for signs of problems such as neural tube defects, chromosomal disorders and other genetic problems. The amniocentisis test is usually done between 15-20 weeks in those who are thought to be at higher risk of having a baby with these disorders.

Percutaneous umbilical blood sampling 

Usually done after 18 weeks of pregnancy, this test examines fetal blood directly from the umbilical cord to detect disorders in the baby. It’s not done as often as other diagnostic tests (such as amniocentesis) but may be suggested if results from those tests are inconclusive. 

Things You Should be Doing During the 2nd Trimester of Pregnancy 

1. Continue Your Prenatal Visits. During the 2nd trimester of pregnancy you will typically see your provider once every four weeks, unless you have pregnancy complications that require more frequent visits.
2. Continue Exercising. It is recommended that you exercise for 30 minutes, 4 times per week.  One great exercise to begin doing is to sit on an exercise ball.  This will help to stabilize your core, open up your pelvis and can even reduce back pain. Tip: when you sit on the birth ball, your hips should be higher than your knees, concentrate on keeping your spine straight and just slightly forward.  You can practice gentle exercises like rocking your hips from side to side or in a figure 8. Bonus – you can use these same ball exercises in labor! 
3. Stay Hydrated.  Try to drink between 8-12 glasses of water each day.  
4. Take an Evidence-Based Childbirth Class.  A recent study found that those who attend an out-of-hospital childbirth education class have an increased chance of having a vaginal birth and a decreased risk of cesarean surgery. Pregnancy by Design offers a comprehensive, evidence-based online course called Beyond the Birth Plan which includes a birth personality assessment. 
5. Write a Birth Plan. Writing your birth plan is a great exercise to research your options and to share your top priorities for birth that you want your birth team to know during labor, delivery, and postpartum.  Here is a free guide on how to write a birth plan. 
6. Continue taking a prenatal vitamin.  If your prenatal vitamin is making you feel nauseous, talk to your provider to see about switching to a different brand.  Here is a post with more information on choosing a good prenatal vitamin.
7. Tour the place of birth where you are considering giving birth (unless you’re planning a home birth).  It also makes sense to do some research on the place of birth such as their c section rate, especially if you are planning a hospital birth. Here is a post with more information about hospitals and birthing centers. 
8. If you’re having a baby shower, create your baby registry. Consider adding a suggestion for people to give money toward a childbirth education class or toward postpartum help such as housecleaning services, meal delivery or a postpartum doula. 

Disclaimer: Pregnancy by Design’s information is not a substitute for professional medical advice or treatment. Always ask your healthcare provider about any health concerns you may have.  

Cited Research

Cleveland Clinic 2019. How to Handle Sciatica During Your Pregnancy.  

Gluck, O., Pinchas‐Cohen, T., Hiaev, Z., Rubinstein, H., Bar, J. and Kovo, M. (2020). The impact of childbirth education classes on delivery outcome. Int J Gynecol Obstet, 148: 300-304.

LeFevre ML. Low-dose aspirin use for the prevention of morbidity and mortality from preeclampsia: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force. Ann Intern Med 2014;161:819–26.