Second Trimester of Pregnancy

You made it through the first trimester! For most people, this means you should see an end to the extreme fatigue and morning sickness that made those first weeks tough.

During this next trimester, you’ll probably feel more energetic—take advantage of this by getting in some pregnancy-safe exercise, curating your registry and starting to prep your home for baby (aka nesting). Depending on your body type, you’ll likely see a baby bump appear soon, so now’s the time to build out your maternity clothing wardrobe. Your baby will also be very busy developing, putting on the pounds and starting to move around in there.

Here’s what to expect during your second trimester.

How long is the second trimester?

The second trimester of pregnancy lasts from week 13 through the end of week 27, or three months pregnant to about six-and-a-half months pregnant.

Baby’s development in the second trimester

Baby’s development is kicking it into high gear now—a lot happens during the second trimester. Baby starts the second trimester around 2.9” and 0.81 ounces, and by 27 weeks, they’re about 14.4” and 1.9 pounds. Go, baby, go!

They’ll begin to be measured in something called fundal height, which is basically the size of your bump, or the distance from your pubic bone to the top of your belly. This measurement is used as a way to make sure baby is growing.

What else is going on in there? By 16 weeks, their umbilical cord is fully developed. By 18 weeks, baby can hear lots of noises happening inside your body—your heartbeat being the loudest—but they probably won’t hear most noises outside your body until the start of the third trimester.

Baby is growing a soft coating of vernix caseosa, or “cheesy varnish” that prevents their skin from getting wrinkly in the amniotic fluid and protects against drying, temperature changes and bacteria in the first week after birth. The vernix sticks to baby’s skin with the help of lanugo, the soft, fine hair that also protects and warms their skin.

Baby is drinking amniotic fluid to practice for breast milk or formula once outside the womb, which means they’re also peeing and developing meconium (baby’s first poops). Most babies pass meconium within 48 hours after birth, though some do it in utero and develop meconium aspiration syndrome. These poops look gross and are sticky, but they don’t smell and are usually gone with the first day or two, replaced by other gross poops that come with breastfeeding or formula feeding.

By the end of the second trimester, baby will have developed regular sleep patterns, which usually means they’re lulled to sleep during the day by your regular movements and up and ready to party when you’re turning in for the night. Also, hiccups, which you’ll feel. So cute!

If you want to find out your baby’s sex, and you haven’t found out already via IVF sex selection or noninvasive prenatal testing, you’ll be able to at your 20 week ultrasound with about 80-90% accuracy (assuming baby cooperates!).

Second trimester pregnancy symptoms

Heartburn during pregnancy

The good news is that the nausea of your first trimester has probably passed. The bad news? More than half of pregnant people experience heartburn some time between the second and third trimesters.

Heartburn during pregnancy can happen for a couple of reasons: hormones and lack of space. “Rapidly changing hormones can contribute to increased laxity of the esophageal sphincter, which essentially acts as a barrier between the esophagus and the stomach,” Dr. Rachel Low tells Babylist. “However, when the sphincter relaxes, stomach acid can creep up into the esophagus, causing heartburn.”

You may get a brief break from heartburn for a few weeks in the second trimester as your body’s production of relaxin settles down, but don’t be surprised if it comes back toward the end of this trimester as baby gets bigger. “This is due to the physical changes that are going on as the uterus enlarges and the other organs within the abdomen begin to shift upward, creating pressure,” Dr. Low says.

If you’re suffering, here are some ways to relieve the discomfort:

• Watch what you eat. Avoid foods high in citric acid (oranges, lemons, limes) as well as fried foods and spicy foods, says Laura Erlich, fertility and obstetric specialist and founder of Mother Nurture Wellness.
• Watch when you eat. Eating smaller meals four to six times a day instead of three big meals can help keep pressure from building up in your esophagus. (You’re already limited on space with a growing baby; don’t limit it more with large meals.) Additionally, wait at least 30 minutes after eating before laying down, Dr. Low says.
• Drink low-fat milk. “Milk is naturally alkaline, meaning it can help decrease the acidity of excess acid and soothe the symptoms of heartburn,” Dr. Kelli Burroughs says. And go for low-fat or skim milk, as milk with higher fat content can actually make heartburn worse, she says.
• Talk to your doctor. If your heartburn is severe or doesn’t seem to be improving with lifestyle changes, there are prescription meds that could help. Avoid taking an over-the-counter antacid, though, without talking to your healthcare provider first.

Feeling your baby move

Between 18 and 25 weeks pregnant (or earlier if you’ve been pregnant before), you’ll probably begin to feel your baby moving. So exciting! At first it feels like a light fluttering, known as “quickening,” but you’ll soon start feeling kicks, jabs and somersaults from your growing baby. As you get later in your second trimester, others may be able to feel baby moving around in there too just by placing their hand on your belly. At the beginning of your third trimester, you’ll start doing kick counts.

Leg cramps during pregnancy

You may start experiencing leg cramps during your second trimester, particularly when you’re sleeping, thanks to pregnancy weight gain, swelling and changes to your circulation that make it hard for your blood to get from your legs to your heart.

While they are super annoying and can disrupt your sleep, leg cramps aren’t serious. Drink water, stretch throughout the day, massage sore muscles and exercise regularly to help prevent them. Compression socks or stockings can also help get your blood flowing, particularly if you’re flying.

Stretch marks and other pregnancy skin changes

Your skin goes through lots of changes during your pregnancy. As your belly expands during your second trimester, you might notice stretch marks developing on your stomach (they also sometimes show up on your butt, thighs, underarms and breasts). They start out pronounced, ranging from dark brown to pink, depending on your skin color. They will eventually fade, though they’ll never completely go away, Dr. Nateya Carrington, ob-gyn and founder of Radiance Women’s Center, tells Babylist.

Not everyone gets stretch marks, and you can’t really do anything to prevent them from happening. You’ll see a lot of stretch marks creams on the market, but they haven’t been proven to do anything to reduce them or stop them in the first place, Dr. Carrington says.

Other skin changes caused by pregnancy can be relieved by creams and lotions. Your skin is more sensitive during pregnancy, so use gentle lotions to treat dry, itchy skin. If you notice dark spots appearing on your skin (that aren’t moles), it’s likely melasma, a common pregnancy skin condition caused by an increase in melanin, dermatologist Dr. Lisa Zhang tells Babylist. Consistent use of sunscreen (SPF 30 or higher) every time you’re outdoors can limit melasma from occurring, Dr. Zhang says. If you experience any skin darkening, it will likely go away on its own soon after your baby is born, though it may stick around for a few months.

Second Trimester Baby Bumps

What to eat—and what to avoid—during pregnancy

Now that your appetite is—hopefully—back, you’ll want to make sure you’re eating healthy and getting the good nutrients you and your baby need. The amount of calories you should aim for depends on your pre-pregnancy weight, how much weight you’ve gained during pregnancy and what trimester you’re in, registered dietitian Lyndsay Hall tells Babylist. In general, you should only add the caloric equivalent of one additional snack or small meal, Hall says.

The best foods to have while pregnant, Hall says, are foods high in:

• Calcium: dairy and dark, leafy greens like kale and spinach)
• Fiber: whole grains, fruits like berries, apples, bananas and oranges and vegetables like carrots, broccoli, artichokes and potatoes
• Protein: meat, eggs, cottage cheese, Greek yogurt, peanuts and peanut butter, pumpkin seeds
• Healthy fats: Avocados, cheese, dark chocolate, eggs, salmon, nuts, olive oil, full-fat dairy (though as we mentioned before: avoid high-fat foods if you have frequent heartburn)

There are also some foods you should avoid during your pregnancy, including:

• Fish containing high levels of mercury, like tuna, shark and other big fish
• Food with a risk of containing the bacteria listeria, like raw, soft cheeses, deli meats and hot dogs
• Alcohol. While you may hear some people say that a single glass of wine in late pregnancy isn’t likely to cause any harm, keep in mind that there is no evidence to support that any amount of alcohol is safe at any point in pregnancy, so the safest option is to avoid alcohol entirely.

Sleep during your second trimester

The exhaustion of your first trimester should be gone, but as you move toward the latter part of your second trimester, you’ll find yourself faced with new sleep challenges.

As your belly grows and your body changes, you may find it harder to get comfortable at night. Pregnancy pillows will be your friend. Consider shopping for one now.

If you’re a back or stomach sleeper, this is a good time to start sleeping on your side, particularly your left, as it’s the best position for blood flow to the uterus. Of course, you can’t stay in one position all night, so if you wake up on your back, don’t freak out; just roll over and try to go back to sleep.

Sex during pregnancy

You may find yourself wanting sex more often during your second trimester—your morning sickness is gone, and all that estrogen may be kicking your libido into high gear, Dr. Mary Jane Minkin tells Babylist. On the other hand, if you’re just not feeling it, it could be due to increased progesterone, Minkin says, or any of the more annoying or painful symptoms of pregnancy. Be open and honest with your partner, and find other forms of intimacy to foster your connection.

If you are comfortable having sex, don’t worry about hurting the baby—they’re nice and cushioned in all that amniotic fluid—and experiment with positions that are comfortable for your changing body. Also, as long as your doctor says it’s okay and you don’t have certain pregnancy complications, you can keep doing it until you go into labor.

Weight gain in the second trimester

Most people have gained about eight to 10 pounds week 20, and will start gaining about one pound per week going forward. By the end of the second trimester, most will have gained 12-17 pounds, though you may gain less if you had a high BMI pre-pregnancy, or you may gain more if you had a low BMI pre-pregnancy.

About one-quarter of your weight gain is coming from extra fluids (here’s what makes up the rest), so swelling during pregnancy is completely normal, especially in your ankles and feet. If it gets uncomfortable, try staying off your feet, drinking lots of water and reducing your caffeine and sodium intake to manage it. If you have sudden, extreme swelling in your hands and feet, contact your doctor. It may be a sign of preeclampsia.

What is preeclampsia?

Some pregnancy complications can be scary. Preeclampsia is one of them. A condition that involves high blood pressure and damage to the kidneys or liver, it affects between two and five percent of pregnancies. It usually begins after 20 weeks of pregnancy.

What are preeclamsia symptoms?

• Blood pressure above 140/90 on two occasions and blood pressure above 160/110 at least once
• Upper abdominal pain
• Protein in the urine
• Swelling in the face or hands (not everyone experiences swelling)
• Vision changes, like blurry vision or seeing spots
• Headaches that don’t go away
• Vomiting (in the second half of pregnancy)

If you notice any of these symptoms, call your doctor as soon as possible. Know that preeclampsia is treatable, so getting the right care early enough is very, very important for you and baby.

Sources:

• Mayo Clinic: What’s the significance of a fundal height measurement?
• American Academy of Pediatrics: When can my unborn baby hear me? I’d love to be able to read and sing to them
• Indian Journal of Dermatology: Unraveling the Mystery of Vernix Caseosa
• Cleveland Clinic: Lanugo
• WebMD: What Is Meconium?
• Healthline: How Soon Can You Find Out the Sex of Your Baby?
• Dr. Rachel Low, ND
• Laura Erlich, founder of Mother Nurture Wellness
• Dr. Kelli Burroughs, MD, ob-gyn
• Cleveland Clinic: Quickening in Pregnancy
• Mayo Clinic: What causes leg cramps during pregnancy, and can they be prevented?
• Dr. Nateya Carrington, ob-gyn and founder of Radiance Women’s Center
• Dr. Lisa Zhang, dermatologist
• Lyndsay Hall: registered dietician
• American Pregnancy Association: Listeria During Pregnancy
• Centers for Disease Control and Prevention: Alcohol Use During Pregnancy
• American Pregnancy Association: Best Sleeping Positions During Pregnancy
• Dr. Mary Jane Minkin, ob-gyn and founder of MadameOvary.com
• Mayo Clinic: Pregnancy weight gain: What’s healthy?