The second trimester of pregnancy is often referred to as the "golden period" of pregnancy. For many women, it’s a time when the unpleasant symptoms of the first trimester—like morning sickness and fatigue—begin to fade, and energy levels return. As a group of physicians specializing in obstetrics we are here to help! Let us take you through what to expect during this exciting phase, offering both reassurance and practical advice.
Physical Changes and Symptoms
As you enter the second trimester, which spans from the start of week14 to the end of week 27, you’ll likely notice some changes in your body. One of the most welcome changes for many women is the reduction in nausea and vomiting (thank goodness!) that can make the first trimester so challenging. By the second trimester, your body has adapted to the surge in hormones, leading to an overall feeling of well-being.
However, new symptoms will start to appear:
- Growing Belly and Weight Gain: Your baby is growing rapidly, and so is your belly. You might start to "show" more noticeably as your uterus expands to accommodate your growing baby. Healthy weight gain during this period is essential for both your baby’s development and your own health. According to the American College of Obstetricians and Gynecologists (ACOG), there is little, if any, weight gain the first trimester, a typical weight gain during the second trimester is about 1 pound per week.
- Breast Changes: Your breasts may continue to grow and become more sensitive as your body prepares for breastfeeding. Some women experience the early stages of colostrum production, a yellowish fluid that is the precursor to breast milk.
- Skin Changes: You might notice changes in your skin, such as darkening of the skin around your nipples (areolae) or the appearance of a dark line down the middle of your abdomen, known as the linea nigra. Stretch marks are also common as your skin stretches to accommodate your growing belly.
- Increased Energy: Many women report feeling more energetic during the second trimester, which can be a welcome change after the exhaustion of the first trimester. Take advantage of this period to stay active, as moderate exercise is beneficial for both you and your baby. Learn more about exercising while pregnant.
- Aches and Pains: As your body changes, you may experience some discomfort, particularly in your back and legs and lower belly, often “round ligament pain” as your belly stretches. This is due to the added weight and the shift in your center of gravity. Regular exercise, good posture, and wearing supportive shoes can help alleviate these symptoms.
Learn more about what to expect during pregnancy and things no one tells you here.
Emotional Changes
The second trimester is also a time of emotional adjustment. You may feel more connected to your pregnancy now that the initial shock has worn off, and your baby bump is becoming more pronounced. This is also the time when many women start to feel their baby move, often described as flutters or "quickening." This can be an exciting milestone that makes the pregnancy feel more real.
We also want to recognize that there is often a time at the beginning of the second trimester when you almost feel as if you’re not pregnant due to first trimester symptoms waning, and Baby hasn’t started to move yet. This can be a worrisome time, wondering if you are still truly pregnant. Often there is nothing “wrong”. And regular prenatal visits can often alleviate this angst because we can normalize these worries and listen to Baby’s heartbeat.
It’s also normal to experience a range of emotions during second trimester, from joy and excitement to anxiety and fear. The latter can be especially true if this is your first pregnancy or if you’ve experienced complications in the past. Open communication with your healthcare provider about your feelings is crucial. They can provide support and resources, such as counseling or prenatal classes, to help you navigate these emotions.
What’s Happening with Your Baby?
By the end of the second trimester, your baby will grow from about 3.5 inches long and weigh around 1.5 ounces (around the size of a lemon) to about 14 inches long and 2 pounds (about the size of a cantaloupe). Here are some key developmental milestones:
- Fetal Movement: Around 18 to 22 weeks, you’ll likely start feeling your baby move. Initially, these movements may feel like flutters or bubbles, but as your baby grows stronger, the movements will become more pronounced. Sometimes movement is felt as early as 14-16 weeks if this is not your first pregnancy and your placenta is in the posterior of your uterus.
- Developing Senses: Your baby’s senses are rapidly developing during the second trimester. By the end of this period, they can hear your voice and even respond to light.
- Organ Development: Vital organs like the brain, lungs, and kidneys continue to develop and mature. The baby’s skeleton is also hardening from cartilage into bone.
Important Tests and Appointments
The second trimester is a critical time for prenatal screening and tests. These help ensure your baby is developing properly and allow for early detection of any potential issues.
- Ultrasound: Around 19-20 weeks, most women have a detailed anatomy ultrasound. This scan checks the baby’s development and can often reveal the sex of the baby if you choose to find out (and haven’t found out through blood testing during your first trimester).
- Glucose Screening: Between 24 and 28 weeks, you’ll likely have a glucose screening test to check for gestational diabetes, a condition that can develop during pregnancy and affect your baby’s health if not managed properly.
- Alpha-fetal protein blood test: If you choose to, you can get a blood test between 15-20 weeks that checks for neural tube defects (lack of closure of the spinal cord).
- Routine Checkups: Regular prenatal visits during the second trimester typically occur every four weeks. During these visits, your healthcare provider will check your weight, blood pressure, and the growth of your baby. They’ll also listen to your baby’s heartbeat and may discuss your birthing plan and any concerns you might have.
Tips for a Healthy Second Trimester
- Nutrition: Continue to focus on a balanced diet rich in fruits, vegetables, lean proteins, and whole grains. Your body needs additional nutrients, including iron, calcium, and folic acid, to support your baby’s development. Remember to take your daily prenatal vitamin and extra vitamin D if your doctor recommends it, Find more information on foods to eat more of and those to avoid during pregnancy here.
- Stay Active: Moderate exercise, such as walking, swimming, or prenatal yoga, can help keep you fit, reduce stress, and prepare your body for labor.
- Hydration: Drink plenty of water to stay hydrated (as your blood volume nearly doubles during second trimester), which can help reduce common pregnancy complaints like constipation and swelling.
- Sleep: As your belly grows, finding a comfortable sleep position can be challenging. Try sleeping on your side with a pillow between your legs for support.
Week-By-Week What to Expect
Week 14: Entering the Second Trimester
Baby's Development: Your baby is now about 3.5 inches long and weighs roughly 1 ounce, about the size of a lemon. The tiny fingerprints are forming, and the bones are beginning to harden. The neck is getting longer, and the baby can now make facial expressions, even frowning or squinting.
What You May Experience: As you enter the second trimester, you might start feeling more energetic as morning sickness subsides. Your risk of miscarriage also significantly decreases after this point. You may notice an increase in appetite as your baby starts to grow more rapidly. It’s a good time to focus on eating a balanced diet rich in nutrients.
Week 15: Hearing Begins
Baby's Development: Your baby is around 4 inches long and weighs about 2.5 ounces. The ears are developing, and your baby can now start to hear sounds, including your voice.
What You May Experience: As your baby grows, you may start to show more noticeably. Some women begin to experience nasal congestion due to increased blood flow.
Week 16: Feeling the Flutters
Baby's Development: Your baby is about 4.5 inches long, roughly the size of an avocado. Muscle tissue and bones keep forming, and the baby’s movements become more coordinated.
What You May Experience: You might start to feel your baby move, often described as flutters or "quickening." These early movements can be very subtle, so don’t worry if you don’t notice them right away.
Week 17: Fat Layers Develop
Baby's Development: Your baby is around 5 inches long and weighs about 5 ounces. Fat layers, important for regulating body temperature and energy storage, begin to develop under the skin.
What You May Experience: Your uterus continues to expand, which might cause round ligament pain—a sharp pain or jabbing feeling in the lower belly or groin.
Week 18: Gender Reveal
Baby's Development: At about 5.5 inches long, your baby is the size of a bell pepper. The reproductive organs are well-developed, and you might be able to find out your baby’s sex during the upcoming anatomy scan.
What You May Experience: This is typically when your anatomy ultrasound is scheduled, usually between weeks 18 and 20. This detailed scan checks your baby’s development and can reveal the gender if you wish to know.
Week 19: Sensory Development
Baby's Development: Your baby is about 6 inches long and weighs around 8.5 ounces. The brain is designating specialized areas for smell, taste, hearing, vision, and touch.
What You May Experience: As your belly grows, you may experience skin changes like darkening around the nipples or a dark line running down the center of your belly (linea nigra). Your baby’s movements may also become more noticeable.
Week 20: Halfway Point
Baby's Development: Your baby is now about 6.5 inches long and weighs approximately 10.5 ounces, about the size of a banana. The baby’s skin is coated with a white, greasy substance called vernix caseosa, which helps protect the skin in the amniotic fluid.
What You May Experience: This is the halfway mark of your pregnancy! You may notice that your belly button is starting to pop out, and your baby’s movements are becoming stronger and more consistent.
Week 21: Digestive System Development
Baby's Development: Your baby is about 10.5 inches long (measured from head to heel) and weighs around 12 ounces. The digestive system is developing, and the baby is starting to swallow small amounts of amniotic fluid, which is an important part of digestive system development.
What You May Experience: You might start to feel Braxton Hicks contractions—mild, irregular tightening of the uterus—as your body begins practicing for labor. These are usually painless.
Week 22: Hair and Eyebrows
Baby's Development: Your baby is about 11 inches long and weighs about 1 pound. Hair is becoming visible on the head, and eyebrows and eyelashes are also developing.
What You May Experience: Increased blood circulation might give you a “pregnancy glow.” However, you may also notice some swelling in your feet and ankles, which is normal but should be monitored.
Week 23: Hearing Your Voice
Baby's Development: Your baby is now about 11.5 inches long and weighs around 1.1 pounds. The baby’s hearing is improving, and they can recognize your voice. The bones in the middle ear are hardening, and the inner ear is fully developed.
What You May Experience: As your baby’s kicks and movements become stronger, you may be able to see them from the outside. You might also experience heartburn or indigestion as your uterus presses against your stomach.
Week 24: Viability Milestone
Baby's Development: Your baby is about 12 inches long and weighs around 1.3 pounds. The lungs are developing "branches" of the respiratory "tree" as well as cells that produce surfactant, a substance that helps the air sacs in the lungs inflate after birth.
What You May Experience: This week marks the point of viability, meaning that if your baby were born now, there is a chance of survival with medical assistance. You might experience increased back pain as your center of gravity shifts.
Week 25: Rapid Growth
Baby's Development: Your baby is around 13 inches long and weighs about 1.5 pounds. The baby’s skin is starting to smooth out as more fat accumulates underneath, and they are growing rapidly.
What You May Experience: As your baby grows, you may notice more pronounced movements and stronger kicks. Some women also start experiencing swelling in their hands and feet.
Week 26: Preparing for the Third Trimester
Baby's Development: Your baby is about 14 inches long and weighs around 2 pounds. The baby’s eyes are starting to open, and they can respond to light. The nervous system is continuing to mature, and the baby is practicing breathing movements in preparation for life outside the womb.
What You May Experience: As you approach the end of the second trimester, you might begin to feel more tired again as your body continues to support your growing baby. It’s a good time to start thinking about touring the hospital at which you will be delivering, taking childbirth/newborn classes, and your birth plan.
When to Call Your Doctor
While the second trimester is generally a more comfortable phase of pregnancy, it’s important to stay vigilant for any signs that something might not be right. Contact your OB/GYN if you experience any of the following:
- Severe abdominal pain or cramping
- Heavy bleeding or spotting
- Severe headaches or vision changes
- Sudden swelling in your hands or face
- Decreased fetal movement after 22 weeks
Learn more about the week-by-week development of your baby throughout your whole pregnancy here.
Only One More Trimester to go!
The second trimester is often a time of joy and anticipation as you prepare for the arrival of your little one. By staying informed about the changes happening in your body and your baby’s development, you can better navigate this exciting time. Regular checkups and open communication with your healthcare provider are key to ensuring a healthy pregnancy.
If you have any questions or concerns your doctor should always be your number one resource. Never hesitate to reach out with any questions. Remember no question is “dumb” and you should never be embarrassed to talk to your doctor about anything!