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When you’re pregnant, you’ll likely have a lot of questions about what is happening to your body during each trimester and what is happening with your baby’s development week by week. Jade Elliott spoke with Leah Moses, a certified nurse midwife with Intermountain Healthcare, about some of the most common questions she has women ask when they come in during their second trimester for prenatal visits and to explain why going to those visits are the best way to help you and your baby stay healthy.
The middle part of your pregnancy is called the second trimester. It is made up of weeks 13-14 through about weeks 26-27. Many women enjoy this middle part of pregnancy as your body has had time to adjust to being pregnant, morning sickness may subside, and your baby is not so big that you feel quite uncomfortable yet.
It’s also an exciting time, as an ultrasound is typically done during the second trimester, at about 18-20 weeks, and you can see how the baby is developing and find out the gender if you wish (if your baby is in an ideal position to identify the gender). This is also the trimester when you get to start feeling your baby move.
Your body during the second trimester
As morning sickness eases, your appetite may increase. If you’ve had unusual food cravings, these may ease or change. Your growing appetite supports your rapidly growing baby.
Hormones may prompt your body to produce more pigment (coloration). And increased blood flow can boost oil gland secretion. Together, these can cause a variety of changes in your skin.
Some women have rosier cheeks, smoother and softer skin — the “glow” effect of pregnancy. But many other women have new acne, and some develop discoloration in their face (the “mask of pregnancy”).
During pregnancy, your blood volume increases by 30 – 50%. You may notice that the veins on your breasts, legs, and abdomen are more visible. You may also have a stuffy nose — a byproduct of increased blood flow to the membranes in your nose.
Round ligament pain is common in the second trimester of pregnancy. This is brief pain in your lower abdomen, hip, or groin. It’s caused by the stretching of the round ligament that supports the uterus and connects it to the front of the groin area.
Pregnancy brings changes to your hair. For one thing, your hair is growing faster. It’s also falling out less. These are temporary effects of hormonal changes. You may also notice changes in your hair’s texture and color. Your hair may be curlier, oilier, dryer, straighter, coarser, etc.
By about 21 weeks, you may have felt your baby move. The sensation may be subtle — a fluttering or bubbling feeling, perhaps like tiny popcorn pops. Later on, you’ll feel definite kicks and rolls as your baby moves inside you.
If this is your first pregnancy, you may not feel or recognize your baby’s movements just yet. Experienced mothers, however, often report feeling their baby move as early as 16 weeks of pregnancy.
By about 22 weeks, you probably have gained 10 or more pounds. The new weight is distributed throughout your body and to your growing baby. Your doctor or midwife can help determine a healthy pregnancy weight gain for you.
In general, a pregnant woman can expect to gain 2 to 4 pounds in the first 12 weeks of pregnancy, and slightly less than a pound per week for the rest of her pregnancy.
Don’t use your pregnancy as an excuse to overindulge with huge portions or sweet treats. For good nutrition during pregnancy, you only need about 300 extra calories a day. Make sure these extra calories come from nutrient-rich foods. Go for extra portions of fruit and vegetables — not extra sodas or desserts.
Glucose tolerance test
Between 24-28 weeks, during the end of the second or beginning of the third trimester, your doctor or midwife will recommend a glucose tolerance test, which screens for diabetes. The screening tests how your body processes sugar and will help determine if further testing is needed to determine if you have gestational diabetes.
Depending on the results, your doctor may suggest some changes to your diet and/or test you again later in the pregnancy or talk to you about a treatment plan. Treating diabetes during pregnancy is extremely important to protect the health of both mother and baby.
Postpartum depression or peripartum mood disorders
If you find yourself prone to tears or quick anger, you’re not alone. Many women report intense mood swings, particularly in the first and third trimesters. It’s a lot like what many women experience in premenstrual syndrome (PMS). You may also feel distracted and forgetful. This is normal and common.
Many women have heard of postpartum depression, but may not know that it can begin during pregnancy and can manifest not just as depression, but as anxiety or obsessive compulsive disorder. The best term is peripartum mood disorders, as that covers the time during pregnancy and after childbirth and the various ways behavioral health conditions can manifest. Pregnancy and childbirth are major life changes that can add stress. And stress can be a factor in your mental health.
Intermountain healthcare providers practice under a mental health-integration model, where primary care providers screen patients for behavioral health conditions. Talk to your doctor or midwife if you have symptoms of depression or anxiety that are severe or last longer than 2 weeks. These include sadness, trouble concentrating, guilt, worry, indifference, or changes in sleeping and eating patterns.
Baby’s development during the second trimester
When the second trimester starts, your baby is about 3 inches long “from crown to rump.” This means your baby is being measured from the top of its head to its bottom (instead of head to toe) because the legs are curled up to the baby’s stomach.
At this time, your baby’s head is the biggest part of their body. But, by the end of the second trimester, the rest of your baby’s body will grow to 9 inches—or even longer.
- Your baby will start to hear sounds, such as your heartbeat, by about the 18th week of pregnancy. Your baby’s hearing will improve, and they will be able to hear your voice.
- Your baby’s eyes may open as early as the 20th week. Before this, the eyelids have been sealed shut. However, your baby’s eyes cannot see anything until the third trimester.
- Your baby will have fingerprints and footprints by the end of the second trimester.
- Fine hair and a white waxy substance cover and protect your baby’s skin. The skin is thin, loose, and wrinkled
- Your baby’s digestive system will start to function. The baby also will begin to produce and release urine, which becomes amniotic fluid.
- Your baby’s nervous system develops and your baby will be able to feel all your movements and their environment by the end of the second trimester.
Your baby is moving almost all the time throughout your pregnancy. However, you won’t start to feel it until about the 20th week. At first, you may notice a fluttering feeling. It can be hard to tell if this is your baby or something else. Soon enough, the movements will become very noticeable. Your partner may be able to feel the baby move as well. You might even be able to see your belly move when your baby “kicks.”
Your baby’s movements are helping them prepare for life outside your body. Muscles grow stronger as your baby learns to kick, suck, and open and close their hands. Your baby also practices making faces, such as frowning, smiling, and squinting.
After 20 weeks, about 10 movements an hour is baseline for a healthy baby. You may not notice movement as much when you’re busy or moving. Movements are more noticeable when you’re quiet or resting.
As you go through your second trimester it’s important to keep your prenatal appointments so you and your provider can help improve your and your baby’s chances for a safe and healthy pregnancy and delivery.
For more information about pregnancy or to find a women’s health provider, visit intermountainhealthcare.org
Intermountain offers online childbirth preparation and breastfeeding classes or you can call your local hospital for more information.
Other pregnancy resources:
The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.