Normal Pregnancy

The Second Trimester of Your Pregnancy

The second trimester is the time many women begin to make important decisions concerning the birth of their baby: when to start their maternity leave, whether to hire a doula, and whether to write a birthing plan.

The second trimester is often referred to as the Golden Age of pregnancy. For most women, the nausea and extreme fatigue of the first trimester have ended and the third trimester aches and pains have not yet begun. The risk of miscarriage also declines significantly at this point in your pregnancy.

Sometime between weeks 16 and 20 of the second trimester is also when you get to experience those exciting first feelings of your baby. The second trimester is also the time when many women experience increased energy levels.

What You May Feel

Be sure to note the date on which you first feel fetal movement. This can help your doctor to accurately date your pregnancy.

Although you'll likely lose a few of the more bothersome symptoms of the first trimester such as nausea and extreme fatigue, the second trimester has some physical feelings all its own. While every pregnancy is unique, here are some of the changes you may see during weeks 15 through 27 of your pregnancy:

  • Increased appetite and easing of nausea and fatigue.
  • Abdomen beginning to expand - by the end of this trimester, the top of your uterus will be near the rib cage.
  • Abdominal and breast skin stretching and may feel tight and itchy, possibly with stretch marks.
  • Abdomen aches on one side or the other as the ligaments that support the uterus are stretched.
  • A dark line, known as the linea nigra, may appear down the middle of the abdomen, from navel to pubic bone.
  • Brown patches of skin on the face, known as the "mask of pregnancy."
  • The darker skin around the nipples, the areolas, may darken.
  • Swelling of feet and ankles.
  • Hip and back pain.
  • Feeling the uterus in the lower abdomen.

When To Call The Doctor

While your body undergoes many changes during your second trimester, there are some things that warrant a call to your doctor:

  • Heavy vaginal bleeding or clotting
  • Lighter bleeding that lasts for more than one day
  • Any amount of bleeding that is accompanied by pain, fever, or chills
  • Severe abdominal or shoulder pain
  • A severe or persistent headache, particularly one that is accompanied by dizziness, faintness, or visual disturbances
  • Dehydration
  • A fever of more than 101°F
  • Painful urination
  • A watery discharge from the vagina
  • Sudden swelling of the face, hands, or feet
  • The signs of premature labor: regular uterine contractions, lower back pain, a feeling of heaviness in the lower pelvis or abdomen, diarrhea, slight spotting, or bleeding, or a watery fluid or mucus discharge
  • A significant decrease in fetal movement after the 24th week of pregnancy.

Screening Tests

Doctors often recommend that if you are 35 and older, you undergo amniocentesis, a test used to detect Down's syndrome and other serious genetic disorders that are more common among babies born to older moms.

It is during your second trimester that your doctor may recommend screening tests for gestational diabetes and anemia. Your doctor will explain each of the screening tests and advise you of the precautions you must take if any of the test results are positive.

Gestational diabetes is caused by the hormonal and metabolic changes of pregnancy. It occurs in 2 to 10% of pregnant women, often with no warning signs. Generally, all pregnant women are screened for this condition because the screening test is relatively simple and the disease can be difficult to diagnose without the test.

Your doctor may also screen you for anemia at the same time as you are screened for gestational diabetes. Although you may have started your pregnancy with no signs of anemia, pregnancy can cause some women to develop iron deficiency.

If you are diagnosed with gestational diabetes, your doctor will closely monitor you during pregnancy to ensure that you and your baby have no health problems. If you are found to be anemic, your doctor will advise you on the steps you should take to ensure that you and your baby are getting adequate supplies of iron.

How Your Baby Grows

Knowing how your baby grows and develops can help you prepare for the coming weeks.

During the second trimester, your baby is growing at an incredible rate. By the end of the 27th week, your baby will be nearly 12 inches long and may weigh 1 1/2 pounds.

During the fourth month of your pregnancy, here are some of the developments your baby is undergoing:

  • Eyebrows, eyelashes, and fingernails form.
  • Arms and legs can flex.
  • External sex organs are formed.
  • The skin is wrinkled and the body is covered with a waxy coating and fine hair.
  • The placenta is fully formed.
  • The outer ear begins to develop.
  • Your baby can swallow and hear.
  • The neck is formed.
  • Kidneys are functioning and begin to produce urine.
  • At the end of the fourth month, your baby will be six to seven inches long and weigh five ounces.

Here's what your baby is doing during the fifth month you are pregnant:

  • The sucking reflex develops. If the hand floats to the mouth, the baby may suck his or her thumb.
  • Your baby is more active and you may be able to feel the baby move.
  • The baby sleeps and wakes regularly.
  • Nails grow to the tips of the fingers.
  • Gall bladder begins producing bile, which is needed to digest nutrients.
  • In girls, all her eggs have formed in the ovaries.
  • In boys, the testicles begin to descend from the abdomen into the scrotum.
  • At the end of the fifth month, your baby will be nearly 10 inches long and weigh 1/2 to 1 pound.

At the end of the sixth month, your baby is 12 inches long and weighs between 1 1/2 and 2 pounds. Other developments include:

  • Real hair begins to grow.
  • The brain is rapidly developing.
  • The eyes begin to open.
  • Finger and toe prints can be seen.
  • The lungs are fully formed, but not yet functioning.