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Second Trimester FAQs

For expectant mothers, pregnancy is usually accompanied by many questions. While patients should always feel comfortable asking their healthcare provider about any concerns that arise, knowing what to expect can be extremely helpful in easing fears and concerns for moms-to-be.

In today’s article, Dr. Radha Rani Padhy of Keystone Women’s Care answers some frequently asked questions related to the second trimester of pregnancy.

What kind of physical changes start to happen during the second trimester?

Major physical changes occur during this trimester, and by the twentieth week the uterus grows to be behind the mother’s navel and a small protruding belly is noticeable. The expanding uterus may cause some aches and pains, lower back pain and leg cramps. It’s common to have sharp pain on one side, usually provoked by sudden movement.  This pain results from the stretching of the round ligament that attaches the uterus to the abdominal wall.

Mild contractions, a feeling of slight tightness in the abdomen, may occur with physical activity or after sex, and vaginal discharge may increase due to hormonal changes. The highlight, however, is the beginning sensations of fetal movement as “butterflies in your tummy” between 16 to 20 weeks.

What are common concerns that mothers have during this time?

Naturally, many mothers have concerns about the baby’s development. Other common concerns include fears about the labor and delivery process, adjusting to their evolving body image and rapid physical transformation and childcare both at home and when parents return to work.

What kind of emotional changes are or will be taking place?

The unpleasant symptoms of the first trimester generally have resolved by this time, thereby causing a burst of energy and an improved mood. Use this to your advantage! Be productive and tackle your “to-do” list for the baby. Now is a great time to enroll in childbirth classes, to familiarize yourself with your employer’s maternity and paternity leave policies, to shop for maternity clothes, and to research breast feeding and how to best incorporate it into your lifestyle. Breast feeding is a wonderful way to bond with your baby and has been scientifically proven to enhance your baby’s emotional well-being.

Many patients also experience forgetfulness and difficulty concentrating. There is no such thing as a “pregnancy brain” or “baby brain,” but these symptoms are normal, no matter how attentive and organized you were before pregnancy. Simply focus on the positive aspects of the pregnancy and accept all the nuances.

What are common tests that will be run during this time?

Your healthcare provider will do a complete blood count to check for anemia or low platelets and a glucose test to check for gestational diabetes. Your ultrasound will check on your baby’s development including the heart, heart rate, kidneys, bladder, stomach, brain, spine and sex organs. This ultrasound will also check the placenta, amniotic fluid levels and any markers that may indicate an increased risk of a chromosomal abnormality (Down syndrome, Trisomy 13 and Trisomy 18). You may choose to find out the baby’s gender at this time.

Fundal height (the top of the uterus to the pubic bone) is measured starting at 24 weeks, and genetic screening will be offered to assess the risk of any chromosomal abnormalities. Remember, any abnormal result on a screening test will need to be confirmed on a diagnostic test to detect if a genetic abnormality truly exists.

A Tdap vaccine will be offered to protect the newborn from pertussis, also known as whooping cough, which can be life-threatening. It is also recommended that everyone 11 years of age and older who has not previously received a Tdap vaccination be vaccinated two weeks before coming into close contact with the newborn baby. This creates a circle of protection around the baby known as “cocooning.”

What do doctors generally recommend when it comes to over the counter medications, diet and physical activity during this trimester?

Expectant mothers should continue prenatal vitamins (ensure there is at least 400mcg of folic acid), and continue with 30 minutes of moderate exercise per day as long as there are no medical or obstetric complications. Always ask your provider before starting any medications, whether they are obtained over the counter or through a prescription. Quitting smoking can be an ongoing struggle. Always ask for help as it is readily available.

Sexual intercourse is okay at any time during pregnancy as long as you do not have the following conditions: are at risk for preterm labor, have unexplained vaginal bleeding, are leaking amniotic fluid, the cervix begins to open prematurely or the placenta partly or entirely covers the cervical opening.

What warning signs should cause concern?

As the uterus expands, it starts exercising its muscle mass which may result in occasional irregular and painless contractions that feel like tightening sensations of the abdomen. However, if you start experiencing more than six contractions per hour, contractions that last two or more hours or painful contractions with heavy vaginal discharge, call your provider immediately as these may be signs of preterm labor.

Other reasons to call your provider immediately during any trimester include: heavy bleeding or bleeding that lasts longer than a day, severe abdominal or pelvic pain (especially if accompanied by a fever or bleeding), a fever greater than 102 degrees Fahrenheit , a severe and persistent headache (especially with dizziness, faintness or visual disturbances), severe shortness of breath or chest pain, inability to urinate or painful urination, leg pain with redness or swelling, heavy or foul-smelling vaginal discharge and a low mood, loss of pleasure and thoughts of harming yourself or others.

What else should expectant parents know about this trimester?

This trimester is known to be the “honeymoon” phase of the pregnancy because of the heightened energy and optimism. Enjoy this phase before the queasiness and discomforts of the final trimester begin.

Now is a good time to take a vacation and spend precious time with family and friends. Go out and experience activities that you may not be able to do once the baby comes. Above all, enjoy your sleep as it will soon be in short supply.


This article contains general information only and should not be used as a substitute for professional diagnosis, treatment or care by a qualified health care provider.