Welcome to your second trimester — for many women, the most comfortable of all three. With the arrival of this milestone, you’ll experience some welcome changes.
For starters, most of your early pregnancy symptoms will ease up or even disappear. You’ll likely feel less queasy (which means food may finally smell and taste good for the first time in a long while), your energy levels should be picking up and your breasts will still be bigger but will feel a lot less tender.
Most amazing of all: By the end of this trimester, the bulge in your lower abdomen may be looking less like the remains of a large lunch and more like the beginnings of a pregnant belly.
When does the second trimester start and end?
The second trimester starts around week 14 of pregnancy and lasts through about the end of week 27, or months 4 to 6 of pregnancy. In total, the second trimester lasts for about 14 weeks.
What are the symptoms of second trimester pregnancy?
Many of the earlier pregnancy symptoms — like nausea and breast tenderness — will subside during the second trimester, while others (like heartburn and constipation) may persist.
At the same time, new changes may pop up for the first time as your belly continues to grow and the levels of pregnancy hormones in your body keep rising. Here are some symptoms that can appear in the second trimester:
Congestion, caused by increased blood flow to the mucus membranes in your nose. You may even find yourself snoring for the first time! Fortunately there are some OTC medications that are safe to use during pregnancy.
Mild swelling of the ankles and feet, which is experienced by about 3 in 4 pregnant women, starting at about week 22 of pregnancy (though sometimes earlier) and lasting until delivery. To reduce puffiness, try to keep active, kick up your feet when you’re not moving, avoid long periods of standing or sitting, and sleep on your side.
Sensitive gums and even some bleeding — but be sure to see your dentist if your gums are bright red and bleed easily, as it could be a sign of gingivitis. While gingivitis is relatively harmless on its own, it can develop into a bigger problem if it’s not properly treated.
Leg cramps, which usually start in the second trimester and last through the third. It’s due not only to hormones and weight but also possibly a shortage of calcium or magnesium — so be sure to keep eating a healthy, well-balanced pregnancy diet.
Dizziness, which occurs when your blood vessels widen and relax — increasing blood flow to your baby, but slowing your blood pressure down. Take it easy, eat plenty of small meals and fill up on fluids to reduce symptoms.
Achiness in the lower abdomen — otherwise known as round ligament pain — as the ligaments that support your belly stretch to support your belly’s increasing size.
Varicose veins and/or hemorrhoids, a type of varicose vein — which, fortunately, should shrink or go away after pregnancy if you didn’t have them before you conceived.
Weight gain, as your appetite likely increases (or appears, if you were suffering from nausea and appetite loss in the first trimester) to support your growing baby. If you started out your pregnancy at a normal weight, expect to gain around a pound per week for a total of about 14 pounds during this trimester.
All of the above are perfectly normal and temporary — as are feelings of apprehension, irritability, forgetfulness and even frustration at looking not quite pregnant yet.
There may also be some big changes in the bedroom during the second trimester. Some pregnant people find themselves hotter than ever, with extra blood flowing to all the right spots. More often, however, pregnancy can make your sex life go a little haywire as you cope with your changing body and mood-killing symptoms.
A few things to keep in mind: Communication is key to avoiding resentment, so keep talking through the dry spells. And remember, sex won’t hurt — or emotionally scar — your fetus. (In fact, a little rocking and rolling may even lull baby to sleep.)
When should I call the doctor about second trimester symptoms?
Odds are that once you make it to your second trimester, it should be relatively smooth sailing for the next three months. But there are a few symptoms that always warrant a call to your doctor, including heavy vaginal bleeding, severe abdominal pain and fever over 101.5 degrees Fahrenheit.
Also keep an eye out for signs of gestational diabetes, which usually starts between around week 24 and week 28 of pregnancy, including extreme thirst, frequent and copious urination, extreme fatigue, and snoring. And not to worry: You'll be getting a glucose test during that same timeframe to know for sure.
Also talk to your doctor if you notice sudden weight gain, significant vision changes and severe swelling in the face and hands, which could be signs of preeclampsia.
How much does a baby grow in the second trimester?
Your baby is very, very busy in the second trimester, when fetal development really takes off. By week 18 of pregnancy, baby weighs about as much as a chicken breast, and can even yawn and hiccup.
By around week 21 you should be able to feel your little gymnast’s newly coordinated arms and legs as they give you little jabs and kicks.
By about week 23, your baby takes a cue from you and starts to pack on the pounds — and may even weigh double that amount by the next four weeks. At the end of your second trimester, you'll have a 2-pound human in your belly!
A few more exciting things going on this trimester:
Hair, skin and nails. By around week 16, baby’s first tiny hairs are starting to sprout — including, by week 22, eyelashes and eyebrows. The skin is now covered in lanugo, a downy “fur coat” that keeps baby warm until more fat builds up in the third trimester, and, by week 19, vernix caseosa: the greasy layer of oil and dead skin cells that shield the skin from acidic amniotic fluid. Both lanugo and vernix caseosa will shed before birth.
Digestive system. Baby’s digestive system was fully formed by the end of the first trimester. The next step: Starting to suck and swallow in preparation for life outside of the womb. Baby can also taste the foods you eat via your amniotic fluid — which research has shown can influence future food preferences outside of the womb. All the more reason to chow down on a healthy pregnancy diet filled with a variety of fresh fruits and veggies. Baby’s waste systems are working hard too: Although your placenta provides plenty of nutrition via your placenta, all of that swallowing means one thing — lots of peeing.
Senses. Baby’s ears and eyes are moving into their correct positions. By week 22 of pregnancy, the developing senses allow baby to smell, see and hear. Even sweeter? Those little eyes are beginning to open.
Heart. By 17 weeks, fetal cardiac activity is no longer occurring spontaneously, since it’s now regulated by the brain. By week 20, you should be able to hear your baby's heartbeat with a stethoscope. In week 25, capillaries begin forming to carry oxygenated blood through the body.
Brain. In addition to controlling your baby’s heartbeat and inducing kicks, by 26 weeks your baby’s brain will start blinking those little eyelids.
Second trimester checklist
Words to live by now: Eat well, exercise regularly and get plenty of rest. Here are the top to-do's for the second trimester:
Prepare for routine monitoring. At each checkup this trimester, your practitioner will check your weight, the size of your uterus, height of your fundus (top of your uterus) and the baby's heartbeat to ensure everything is progressing as expected.
Schedule your second trimester ultrasound. Also called your 20-week anatomy scan, this ultrasound usually happens between 18 and 22 weeks of pregnancy. Your doctor will measure the baby, check developing organs, determine the amount of amniotic fluid, and — if you like — clue you in on your baby's sex. Keep in mind that while it’s exciting to get a peek at your developing baby, only your doctor should perform ultrasounds, including 3D and 4D ultrasounds. In other words, avoid the keepsake versions from your local mall.
Get your glucose screening. About 1 in 10 pregnant women is diagnosed with gestational diabetes, which is why the American College of Obstetricians and Gynecologists (ACOG) recommends that all women be screened for the condition around week 24 to week 28 of pregnancy. If your test result comes back positive for extra glucose in your urine, it doesn’t always mean you have gestational diabetes — you’ll need further testing for a diagnosis. If you do have it however, your doctor will probably refer you to a nutritionist who can help you create a meal plan. You’ll also have to keep track of your blood sugar levels regularly.
Talk to your doctor about prenatal genetic screening. If you haven’t already and if you have certain risk factors, your doctor may suggest a genetic screening including NIPT or a quad screen, both of which are blood tests that look for increased risk factors for chromosomal or congenital conditions, such as Down syndrome. If either of these screenings comes back positive, your doctor may recommend amniocentesis (amnio) — where amniotic fluid is extracted and analyzed for genetic abnormalities — to get a more definitive diagnosis and check for other problems NIPT can’t detect such as neural tube defects. It’s up to you ultimately whether you get a genetic screening, so it’s a good idea to learn more about what these tests can tell you, what the benefits are and what to ask your doctor about them.
Get immunized. If you’re pregnant in cold and flu season, make sure to get the flu shot, and plan to get the Tdap vaccine in the third trimester to protect baby against whooping cough after birth.
Shop for maternity clothes. Now that your bump is finally starting to show, you’ll need a maternity wardrobe to match.
Sleep on your side. While pregnancy sleep is usually easier to catch in the second trimester than in the first or third, you will want to start sleeping on your side now, since the weight of your growing uterus puts pressure on the vena cava (the vein bringing blood from your lower extremities back up to your heart), which can interfere with circulation.
Keep doing your Kegels. Keep your pelvic floor in shape for birth by getting in the habit of doing Kegels regularly — aim for three sets of 20 every day.
Decide if you’ll find out baby’s sex during your second trimester ultrasound. If you’re still undecided about a "gender ultrasound," think about the pros and cons of finding out your baby’s sex before birth.
Make prenatal workouts a priority. Given all of the benefits of exercise for you and your baby, it's a good idea to pick up a pregnancy-friendly workout, if you haven't already.
Bump up your caloric intake. If you were at a normal weight before getting pregnant, you’ll need about 300 to 350 additional calories a day during the second trimester. That’s less than you might think though — only about a glass or two of milk and a bowl of oatmeal.
Track your weight gain. Now that you should be steadily gaining weight, your doctor will likely recommend that you keep track of it every week.
Take baby bump pics. While you’ll likely want to wait until the third trimester to have your “official” baby bump photo shoot, it’s a smart idea to schedule it now — and in the meantime, take plenty of selfies as souvenirs of your ever-growing bump.
Think about taking a babymoon (even if it looks more like a staycation). Since first trimester nausea should be quelled, now’s a good time to take some me-time before baby’s arrival.
Envision your baby shower. While you won’t be the one actually planning your baby shower, you can certainly let your host(s) know any theme or décor requests you have. If it’s your second or third pregnancy, think about having a baby sprinkle.
Create a baby registry. On that note, you’ll also need to create a baby registry for your shower guests and other well-wishers.
Keep considering baby names. You still have time, but if you haven’t landed on a baby name yet, it’s a good idea to keep reviewing your options.
Look into childbirth classes. While you likely won’t start taking one until the third trimester, start looking into your childbirth class options and try to find a program that offers your preferred method.
Think about where you want to give birth. In a hospital? Birthing center? At home? Start looking into your options now. You’ll want to take a hospital or birthing center tour in your third trimester, but you might want to schedule it toward the end of your second trimester.
Start looking into child care. If you’re planning to go back to work after your maternity leave, it’s not too early to start looking into your local child care options — whether day care, nanny, babysitter or relative.
What to avoid during the second trimester
With the worst of the nausea behind you, you might be feeling a lot like your old, pre-pregnancy self. But now that you’re in your second trimester, there are a few more things you should steer clear of, including:
Elective ultrasounds. Your baby does a lot of growing in the second trimester, so there’s certainly plenty to see. Resist the urge however, to schedule a 3D or 4D sonogram at a prenatal portrait center. While there are no known risks of ultrasounds during pregnancy, ACOG says that they should only be used for medical reasons — and performed by a qualified medical professional.
Sleeping or doing exercises on your back. Some experts say that you should avoid lying flat on your back during pregnancy, since the entire weight of your uterus and baby will rest on your back, intestines and vena cava (the main vein that shuttles blood from your lower body to your heart).
Hot tubs and saunas. Nothing sounds better to your aching, swollen feet than a soak in a nice, hot bath. Unfortunately, hot tubs and saunas are definite no-no's during pregnancy, as is anything that raises your body temperature to more than 101 degrees F. If you take a bath, use a thermometer to keep the water temperature lower — around 97 to 98 degrees F.
Hot yoga. Like hot tubs and saunas, anything that raises your internal thermostat by more than 1.5 degrees F should be avoided. While yoga is particularly good for the pregnant set — it can get you moving and lower your stress levels — you’re better off doing it under cooler conditions.
Raw or undercooked foods. Your appetite might be back, but you should still continue to avoid raw or undercooked seafood, eggs and meat. You can celebrate with a medium-rare steak once baby has arrived.
Unpasteurized dairy and juices. Are food aversions a thing of the past? Alas, some foods are still off the table. Soft cheeses, for example — like Brie, goat cheese and feta — that are made with unpasteurized milk are a no-go because they haven’t been treated to kill bacteria. Juices, including OJ and apple cider, can be unpasteurized too. Check the label to make sure everything you eat is made with pasteurized products, or stick to hard cheeses like Swiss or cheddar.
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