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2nd Trimester

Patient Education > How the Baby Develops

Second Trimester
14 to 27 Weeks


The pregnancy is moving along and soon you’ll be at the halfway point. By now, you’ve probably adjusted to the fact that you are, in fact, pregnant; it’s not going away, and soon you’ll have a new life in yours. The excitement is starting to build as your body changes and grows. The second trimester is a “lovely” (says who?) time in the pregnancy. You’re not too large to enjoy doing many of the same activities you did while not being pregnant, yet you’re big enough for everyone to remark on your condition and share the joy with you (translation: make fun of you).

Physical Changes

Of course, your most obvious physical change in the second trimester is that increased expansion of your uterus—meaning the baby is growing, and you’re expanding in size to accommodate it. Up until now, you probably haven’t had to put on maternity clothes, perhaps only loosening your belt a little. This is the time to break out the new clothes. As you gain weight during this trimester, it will all seem to go to your fast-disappearing, former waistline, now slightly resembling a beach ball.

THAT ITCHY BELLY AND STRETCH MARKS


Along with that expanding belly, comes stretching skin. It seems as if the more the skin stretches, the “itchier” it gets, almost as if the skin is popping from its seams. Scratching doesn’t really do any good. The best remedy is to use creams to alleviate the dryness of the skin. Stretch marks are a common occurrence during pregnancy. Be prepared for them. Stretch marks can vary in color, ranging from purple to pink initially, but eventually they become silver or white. They usually appear on the lower half of the abdomen, but also can occur on the breasts and thighs. At present there is no effective treatment to prevent stretch marks from occurring. In addition, it’s very difficult to eliminate them once they have appeared. Surprisingly, stretch marks are not caused by weight gain, but are usually the result of the stretching of normal skin. There is very little you can do to prevent them, and there may be a genetic predisposition or component to whether or not you get them. Or you may not get stretch marks from the one pregnancy, but will get them on others.


Your blood volume will continue to expand. This is a continued effort to increase the amount of blood flow to the uterus and the developing baby. In addition, the increased blood volume will compensate you, the mother, for the blood loss you will experience after the baby is born.

Your blood pressure should go down slightly because the vascular system has less resistance to blood, and the blood vessels are relaxing to allow more blood to flow through. This is a good thing, as long as your blood pressure doesn’t get too low. If it’s too low, it can reduce the blood flow to the baby. Because of the vascular changes, it’s a good bet that you may feel dizzy from time to time, especially as you sit or stand up from a lying down or prone position. This dizziness will pass as your body adjusts to the new change in position, and blood flow is restored to your brain.

Your respiratory rate is increasing slightly during this time. There can be a perception that you’re not getting enough oxygen, but the truth is that you’re taking more breaths, and you’re actually getting as much air as your body requires. You may find it harder to breathe because there is more compression of the diaphragm as the uterus displaces other organs, such as the intestines, liver, etc. This is normal.

Ever notice that pregnant women walk slightly differently than other people almost as if they’re walking a tightrope at all times? In many ways, they are. Your balance will be altered as your abdomen starts to project outward. And your shoulders will lean backward to compensate for the change in your center of gravity. You may also have more back discomfort and pain during the second trimester. Part of the reason for the pain involves your change in posture, but it could also be from the hormonal changes affecting your ligaments.

The hormone relaxin prepares the birth canal by loosening the ligaments so the baby can pass through it. Because of this loosening in the pelvic region, the back doesn’t receive as much support as it used to—ergo, the pain. It’s particularly vital to practice good lifting habits at this time, since you could easily injure or put out your back. Remember that the better the shape you’re in before the pregnancy, the less likely you’ll be to have pain and discomfort during the pregnancy.

It’s well known that strong abdominal muscles can help support the back, and being flexible and not overweight will reduce unnecessary strain on the back muscles. Keep exercising and staying fit! Often, women experience wrist or hand pain, which might be caused by carpal tunnel syndrome. Carpal tunnel can occur as the woman retains more fluid and the fluid may compress and entrap the nerves in the wrist. Doctors think this can be attributed to hormonal changes, but they’re not entirely certain of all the reasons. About 10–15 percent of women who get this condition may require some surgical treatment. It is actually pretty rare, though. You may be able to handle (pun intended) the situation by using wrist supports and avoiding repetitive wrist motion, such as typing on a keyboard (as the author could tell you). Urine production is way up during the second trimester, so you’ll be making frequent trips to the bathroom (if you haven’t found that out already). The uterus has a compression effect on the bladder, making it feel more full, even when it might not be full. Sleeping will start to get more and more uncomfortable the further you get into the pregnancy. In the last trimester, doctors advise women not to sleep on their backs.

During the second trimester, you should start trying to sleep on your side. The reason for this is that the great vessels (the vena cava and aorta) that carry the blood back to the heart run along the spine. The uterus can compress these vessels, allowing blood to flow more slowly, which will make you feel nauseous, light-headed, and could reduce the flow of blood to the baby.


The psychological changes that occur during this three-month period will vary from one woman to the next. Doctors aren’t clear exactly what causes these psychological shifts, but the blame still obviously remains those pesky hormonal rises that occur throughout the pregnancy (heck, throughout your life is more like it!). At times, you may feel as if you’re under a lot of negative stress that is tough to deal with, perhaps crying more frequently or experiencing mood swings. Some women have issues with their changing bodies, as they put on weight. Other common problems
that might exacerbate your mood include the following:

Fears about the upcoming pain in laborabout your ability to deliver a baby vaginallythat the pregnancy isn’t normal or progressing properlyabout being a good mother

In the second trimester, the visits to the doctor become more regular, occurring every four weeks on average (assuming a normal pregnancy). The doctor will check your vital signs, heart rate, and blood pressure, do a urinalysis (checking for protein or glucose), and review your symptoms and ask you how you’re doing.

The doctor might ask you general screening questions, such as

Have you had any bleeding?

Is the baby moving all right?


Have you experienced any problems?”


This is the time when the doctor will review any outstanding tests you might have taken and discuss their results with you.

Next, the doctor will check the fundal height of the uterus by taking a tape measure, placing one end over the pubic bone, and then measuring the distance from that point to the top of the uterus. The fundal height is measured in centimeters. After 20 weeks of pregnancy, the fundal height in centimeters should approximate the number
of weeks of the pregnancy to indicate normal growth (that is, it would be 20 cm. at 20 weeks).

The second trimester is aa—your changing body, your changing emotions, and that changing baby growing inside of you. It works best if you regard this interim, middle period in the pregnancy as a time for rest, relaxation, and preparation. Accept these changes and delight in them, and the time will pass quickly.


Each Month of the Second Trimester of Pregnancy your Doctor will Check :


Your Height and weight

The Foetal heart beat

The size, shape, and height of the uterus


Between the 20th and 30th weeks, you should be gaining aproximately 4.5 kg. If you gain significantly more than 4.5 kgs in these 20 weeks, you could be heading for a condition called pre-eclampsia.

Watch Out for....

Iron-deficency Anaemia

Sugar in urine; may be sign of Gestational Diabetes

High Blood pressure, may be a sign of Pre-eclampsia.


During the second trimester, your body will feel as if it is growing exponentially and daily, as the weight gain increases, the baby gets bigger, and you notice different changes in the way you walk and feel.

Be prepared for emotional ups and downs. It’s normal to experience highs and lows during pregnancy. Stay calm, take deep breaths, and focus on the joy that is coming to you soon.

Make sure that you keep tabs on your own body so that you can help the doctor better understand your condition at all times. Note if the baby is kicking and active. If you ever suspect that anything is wrong, alert your doctor immediately.

Get some cute maternity clothes that are fun to wear and help you enjoy the experience.

Changes in the Foetus..... Continue

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