The Second Trimester: A Guide to Midpregnancy

Morning Sickness

The nausea of early pregnancy typically fades away sometime in the second trimester. But it might take several weeks before that happens.

Growing Breasts

You may notice your breasts gradually getting bigger. It may make you more comfortable to switch to a larger or more supportive bra, or even a sports bra.

Dental Issues

Your gums may be a bit more sensitive and may even swell or bleed when you brush or floss. That’s because your hormones are affecting your mouth’s membranes. If you’re feeling irritated, you can switch to a softer toothbrush and do saltwater rinses.

It’s important that you continue to see a dentist regularly while you’re pregnant. Dentist visits are “perfectly safe for the baby,” says Cynthia Flynn, M.D., a board-certified ob-gyn in Orlando, Florida.

Linea Nigra

You may notice a dark line running from your belly button to your pubic bone. This is called a linea nigra and is common, but not everyone has one. “A lot of women have it,” says Yen Hope Tran, D.O., a board-certified ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California. “It’s not very obvious, and it happens where most people can’t see it.” It should disappear in the months after your baby arrives.

Stretch Marks

As your belly grows, you may develop lines known as stretch marks on your belly, breasts, buttocks, or thighs. Stretch marks can appear black, silver, purple, or reddish-brown. You unfortunately can’t prevent all these marks, but most will fade eventually. Keeping the area moisturized may help minimize their appearance.

Nasal Issues

Your body is making more blood these days, which can make the nose’s mucous membranes bleed more easily, Tran says. You may also feel congested more often than usual. It’s also common at this time to snore or breathe more heavily while sleeping.

Reduce stuffiness with saline drops or a saline rinse. Use a humidifier by your bed and/or put petroleum jelly on the edges of your nostrils to help keep skin moist to avoid nosebleeds, suggests Tran.

Vaginal Discharge

It’s normal to have a white or sticky vaginal discharge during the second trimester, Tran says. Contact your doctor if discharge smells strong, is bloody, or has color other than white or clear, or if you have soreness, itching, or pain in your vaginal area. Those symptoms can be signs of a vaginal infection, she says.

Leg Cramps

Leg cramps are common during pregnancy and often happen at night. To help prevent them, Tran suggests stretching and massaging your legs before going to bed. When you do get a cramp, stretch the calf muscle that’s hurting. Or soothe it with a warm bath, hot shower, or ice pack. There are supplements that can help with this, as well, but check with your doctor before adding any medications or vitamins.

Headaches

If you’ve cut back on caffeine, it makes sense that you would experience some headaches, says Michelle Y. Owens, M.D., a board-certified ob-gyn, and professor who is the chief of maternal fetal medicine at the University of Mississippi Medical Center and serves as the clinical director of Mae, a resource that supports pregnant Black women. Changes to your blood vessels are also happening in pregnancy that may be contributing to those headaches, she says.

“It may be a benign symptom associated with pregnancy,” Owens says. “But it can also signal something more serious.” This can include preeclampsia, which is a dangerous pregnancy complication, or another underlying condition. Let your doctor know if you’ve had a change in how often you’re getting headaches compared to pre-pregnancy, says Owens.

Your doctor is likely to approve that you take Tylenol (acetaminophen), but other medications may be prescribed if Tylenol doesn’t resolve the pain.

Round Ligament Pain

During pregnancy, the uterus expands as the baby grows, and the ligaments that hold the uterus in place can feel tension or stress. This can cause round ligament pain, which is discomfort felt in the pelvic area. It’s a dull, achy or sudden, sharp pain that can radiate from the groin into the vagina.

“Women have described it as taking their breath away,” Owens says. “It feels like something is falling out of them.”

Owens adds that “this pelvic discomfort is common, but it can be really unsettling to experience it when you don’t know what it is.” Soothe the pain by taking Tylenol, using heating pads, or sitting down and relaxing, she says.

Second-Trimester Emotions and Mental Health

During the second trimester, you might be less distracted by tough symptoms like nausea and fatigue, and so you might find your mind working overtime. A common concern during midpregnancy is worrying about labor and delivery.

Knowing what to expect during childbirth can help ease your emotions. “Taking a childbirth class can definitely help alleviate anxiety around the process of labor,” says Josephine Urbina, M.D., a board-certified ob-gyn at the University of California, San Francisco.

Taking a tour of the hospital and maternity ward, either in person or virtually, can soothe nerves, too, Urbina says.

“Make a list of your specific concerns and take them to your ob-gyn visit,” Flynn says. “That is part of what these visits are for.” If you’re not seeing an ob-gyn and are seeing a midwife or family physician, you can talk to them, as well.

You may also want to speak to a therapist. Postpartum Support International has a directory where you can find mental health professionals who specialize in mental health during pregnancy and postpartum.

Tran says that her practice is seeing a rise in pregnant patients who are experiencing anxiety and depression. “We used to do depression screening after pregnancy,” she says. “Lately, we’re using the test to screen for depression and anxiety during pregnancy.”

Tran suggests trying journaling, yoga, massage, and building a support system to help you handle these feelings. “Continuing to have sex during pregnancy helps [some] people cope with stress,” she adds. A wide range of emotions is typical throughout pregnancy. Allow yourself to practice extra self-care and continue to do things for yourself that recognize and address the additional stress you might be experiencing.

If you’re managing difficult feelings, support can help greatly. It’s a good idea to see a therapist who can help you plan for what life will be like after your baby is born. You can reach out to others in the pregnancy community for additional support.

Second-Trimester Doctor Appointments

During the second trimester, you’ll typically see the doctor every four to six weeks, Urbina says. These appointments will be to determine whether your baby is growing as expected and to check you for any signs of health problems.

Your provider will note your weight and test your urine for infections. They’ll also listen to the baby’s heartbeat, Urbina says. They may measure the size of your uterus as well. Usually around 19 to 20 weeks, you’ll get an ultrasound to see how the baby is doing. Adds Owens, “We use all this information and interactions to make sure everything is progressing as it’s supposed to.”

Second-Trimester Tests

During the second trimester, your doctor will likely want to check on you and your baby with several blood screenings and tests.

Quad Test

During the second trimester, you’ll likely get a set of blood tests called the quad test or the multiple marker screen. Your blood will be screened for AFP (alpha-fetoprotein), a protein made by the fetal liver that is in your amniotic fluid. You’ll also be screened for three different pregnancy hormones: HCG (human chorionic gonadotropin), estriol, and inhibin A.

If levels are abnormal, your baby may have an incorrect due date, or it could mean your fetus has an increased risk of chromosomal abnormalities, open–neural tube defects such as spina bifida, or defects in their abdominal wall. If you have abnormal test results of AFP or other markers, you may need more tests to find out exactly why.

Glucose Tests

You will probably take the glucose challenge test during the second trimester, around 24 to 28 weeks into your pregnancy. This test measures your body’s response to sugar (glucose) to screen for gestational diabetes, which is high blood sugar during pregnancy.

You’ll drink a sugary solution. Your blood sugar level will be measured one hour later. If your test results are outside the standard range, you may need a three-hour test called the glucose tolerance test to better identify whether you may have gestational diabetes.

If you do, your doctor will teach you how to control the condition and keep you and your baby healthy through diet, exercise, and possibly medication.

Second-Trimester Ultrasound

A midpregnancy ultrasound exam is typically done around weeks 18 to 22 of pregnancy. The ultrasound technician will do a scan of your baby’s anatomy to make sure growth and development appear to be on track. You may also get to find out your baby’s sex, if you didn’t find out during first-trimester testing.

Your doctor may recommend—or you may decide to do—additional testing, such as the CVS (chorionic villus sampling) or amniocentesis, depending on the results of your first-trimester screenings and the risk of genetic conditions, based on family history and your age.

Fetal Development in the Second Trimester

Your fetus will continue to grow and develop during the second trimester, Owens says. You’ll likely start to feel them kick, move, and even turn from side to side. You might even notice times when your baby is awake or asleep, depending on how much movement you feel—and you may notice a pretty typical routine for that.

Hair is growing on the baby’s head, the bones are hardening, and the lungs are developing. The eyes are moving slowly to the front of the face, and the eyelids may even be starting to open. The ears are moving to the sides of the head, and your baby will start to hear your voice!

The placenta becomes fully developed in the second trimester, and your fetus is beginning to suck and swallow. Fingers and toes won’t be webbed anymore and will separate into digits with fingerprints and toe prints.

By the end of the second trimester, your fetus will be around 13 to 16 inches long and will weigh about 2 to 3 pounds. They would likely be developed enough to survive outside the uterus with the help of intensive care.

Enjoy this sweet spot of pregnancy. At the end of the second trimester, you’ll be two-thirds of the way done. Now that you know all about the physical and mental changes of the second trimester, as well as how your baby is growing and developing, you probably want to know what’s happening next. Read up on what’s in store for you in our guide to the third trimester.

You May Also Like:

• Questions about Birth Plans? We’ve Got Answers
• The First Trimester: A Guide to Early Pregnancy
• The Third Trimester: A Guide to Late Pregnancy
• The Fourth Trimester: A Postpartum Guide to Life with a New Baby