What To Expect In The 2nd Trimester Of Pregnancy.

The second trimester of pregnancy, between 13- 28 weeks can bring with it a wave of excitement and a new lease of life, as well as relief for some. 

The hormones have started to settle, which can mean common symptoms of early pregnancy may have started to subside.

During pregnancy and in particular the 1^st Trimester, many women experience a variety of symptoms that can range from nausea, sickness and fatigue to breast tenderness and mood swings. These symptoms can be reassuring, signalling that the pregnancy is progressing.  By the time you have entered your 2^nd Trimester, a change, or loss of these symptoms can bring anxiety.

So, what’s actually happening inside the body to make this change so noticeable, and why may you be feeling more energetic?

What To Expect In The 2^nd Trimester.

We’ll first start by looking at the physical and hormonal changes to the body at this time.

I’m a great believer that by having an awareness of what’s going on inside can really help us to understand the symptoms of pregnancy, as well as give a great deal of reassurance. The body really does undergo profound changes to accommodate your growing baby and at the beginning of the 2^nd trimester many birthing people find relief, not only from the nausea and sickness that has been forefront, but the extreme tiredness and fatigue….and the breasts may not be feeling so tender and sore.

Stretchmarks

There are more noticeable and exciting changes that occur as your uterus expands…yes, your tummy grows, and the pregnancy becomes more visible!! 

Now as that beautiful tummy grows the skin will stretch, and so you may also experience mild itching or rashes, as well as see stretch marks appear. They may also be noticeable on your breasts too, as the breasts increase in size preparing for milk production.  Stretch marks really do fade over time but moisturising daily and keeping the skin hydrated may help reduce the likelihood of them appearing.

Lower Back, Pelvic And Leg Pain

Unfortunately, the growing uterus can also put the back muscles under a little more under pressure, so you may notice an increase in backache as well as Pelvic Girdle Pain (PGP). The hormone Relaxin is totally responsible for this, with its job being to relax and soften the muscles, joints and ligaments that usually help keep your pelvic bone in alignment. Now it has to do this to help your pelvis expand for your growing baby and prepare for birth. 

You may notice this discomfort worse when you’re walking, or if you carry out activities lifting one leg, such as when you’re getting dressed. It can feel like a sharp pain in the pelvic area but actually can radiate to your thighs and perineum area. Either way it’s particularly uncomfortable and can affect your night-time sleeping routine too. I would always recommend chatting to your gynaecologist who may be able to give you some management techniques.

Weight Gain

Now you may also notice a little weight gain, mainly because your blood volume increases by 50% to meet the demands of baby’s growth.  This really isn’t something to worry about…and the blood volume will almost always return to normal 6-8 weeks after birth.

Embrace your changing body, it’s doing an amazing job…. while helping your nails become stronger and your hair thicker too! 

When Will We Feel Baby Move?

You may start to feel baby’s movement anywhere between 16 - 24 weeks which you may notice as a fluttering or a bubbling feeling. By 20 weeks your baby can hear sounds, including the sound of your heartbeat, and they are learning to recognise your voice, although the ears are not yet fully formed!

As we head towards the end of the 2nd trimester, your little one will be kicking and moving more and responding to sounds from outside the womb, so this is a great time to start interacting with your baby.  Reacting to their movements and kicks by touching your tummy and talking to them are great ways to build that attachment.

Your partner will be able to share in this experience too and may now be able to feel your baby kicking and moving by placing their hand on your tummy. You can even play them your favourite music, which they are able to recognise once they’re here, and you may find it even helps settle them!

What To Expect From Your Care?

How often you see your health professional will depend on your personal circumstances. For most people, visits will be every 4 - 6 weeks in the second trimester and may become more frequent being every 2 weeks towards the end of your pregnancy.

You will be advised to see your Midwife at around 16 weeks where your blood pressure and urine will be checked, as well as an overall wellbeing check for you and your baby. This may be the first time your Midwife listens to your baby’s heartbeat with a hand- held machine called a Doppler.  I know it can be very tempting to think about buying a home Doppler to use yourself, but I really don’t recommend it. If you have any concerns about baby’s movements being reduced, then please do contact your Midwife or the hospital at which you are booked to have your baby.

You will be offered a mid-trimester scan, known as the anomaly scan, which is recommended between 18 - 20+6 weeks. This is quite an in-depth scan that will look at the position of the placenta, the amount of amniotic fluid around the baby, your baby’s growth and development and baby’s structures in detail, meaning they will be able to identify any causes for concern.

You may be able to find out baby’s gender at this scan, but it’s not guaranteed as being accurate! 

Your next Midwife appointment around 24 weeks will be the first time that your tummy will be measured, to keep a track of your baby’s growth. This is of course unless you are on a care pathway that indicates routine growth scans, or you are following a private care pathway. 

Your Midwife will carry out a measurement, called the fundal height, measuring from your pelvic bone to the top of your womb. The measurement should be around the same as the number of weeks pregnant you are (give or take 2cm) and may be plotted on your personal growth chart. While individual measurements taken at each visit may not provide a complete picture on their own, they can collectively help track the overall growth and well-being of your baby.

Your blood pressure and urine will be checked again, and at every appointment following to check for signs of pre-eclampsia. You can find out more about this here Pre-eclampsia - NHS

Your doctor or midwife will also discuss any blood tests recommended for you at this stage in your pregnancy. This will totally depend on your individual health but could include an oral glucose tolerance test between 24 - 28 weeks to check for gestational diabetes. https://www.nhs.uk/conditions/gestational-diabetes/

With any care pathway, appointments and scans are really a choice, but I do think it’s important to engage regularly with your doctor or gynaecologist, or health professional, to enable you to communicate any concerns or unusual symptoms, giving an opportunity to detect any potential complications early on.

When Should I Seek Help?

Even though you may be feeling brighter with more energy, its still essential to remain vigilant about your health and well-being through out your pregnancy.

Contact your doctor, gynaecologist, or hospital immediately if you experience any of the following symptoms:

• Vaginal bleeding or constant, clear watery vaginal discharge.
• Severe nausea, vomiting or abdominal pain.
• Sudden blurry vision or a severe headache.
• Sudden swelling of the face, fingers or ankles.
• Regular, painful contractions before 37 weeks of pregnancy
• A change in your baby's movements (if you already feel them regularly).