Stages of Pregnancy – 20 Facts About Your Second Trimester

Second trimester of pregnancy

A lot of exciting things happen in your second trimester! You’ll be relieved to know that any nausea and tiredness should start to resolve. Here, I’m going to go through some key things you may experience during this trimester to provide you with solutions and guidance.

1. Growing a bump

Every woman is different, some may notice a bump quickly appear or it may not be until around 20 weeks that you start to grow a visible bump, either way it will happen in the second trimester. If you travel by car, then it’s important that you ensure your seat belt is placed correctly with one strap going between your breasts and resting above your bump and the other sitting comfortably under your bump. Make sure you don’t put the seat belt directly over your bump.

2. Hot flushes during the second trimester

During the second trimester, you may get hot flushes. Try to wear layers of natural fibres such as cotton so that you can easily take them on and off. Now’s a good time to invest in some maternity trousers for maximum comfort throughout the second and third trimesters – they do make a difference.

3. You may start to feel movement

The first movements are usually around 14 to 18 weeks, if it’s your first baby. Don’t worry about monitoring movement until 24 weeks. Most hospitals won’t monitor you until then or consider it as ‘reduced foetal movement’ before 24 weeks. If you’re still concerned, private scans are an option, to put your mind at rest but be mindful of how many you will have as we do not know the long-term effects of several scans throughout pregnancy from an early gestation. After 24 weeks, the latest guidelines state that you should monitor the pattern and frequency of your baby’s movement rather than count the kicks.

4. Holidays and flying

This is the most common time to take a break during pregnancy. The decision yours but it’s best to consult your GP and the airline as to whether you can fly in the second trimester – most airlines will let you fly up to 28 weeks. If you do fly, then ensure you keep well hydrated on the flight and wear flight stockings to prevent blood clots. Walk up and down the plane and move your ankles around in circles to help circulation.

One of the most important things for you to pack is your hospital notes, whether your trip is abroad or in the UK – it’s essential that you bring them. If you do need to seek medical advice, the first thing a midwife or doctor will want to do is check your history and ensure that they don’t miss anything during diagnosis but without those notes they can’t get the history required.

5. Nose bleeds

It’s common to experience nose bleeds in the second trimester due to hormonal changes and you shouldn’t be concerned, although it can be a bit startling if you have never had one before as it’s fresh red blood! You can also have more mucous, so try to blow your nose gently as aggressive blowing can bring one on. I have seen a lot of women naturally tilt their head back but that’s dated advice and you should lean forward, pinch the soft part of your nose, below the bone, with a tissue until the bleeding stops. I usually recommend you carry some nice soft tissues around with you just in case you get one.

6. Linea nigra and skin changes

Some women experience significant skin changes in the second trimester, mostly darkening of the skin. Again this is hormonal and mainly to facilitate darkening of nipples so that your baby is able to see the his/her target! Some women get darker patches on the forehead or cheeks, if this is the case, ensure you protect your skin from the sun as much as possible. Wear both a hat and a UBV/UVA sensitive sunscreen.

Linea nigra means ‘back line’ in Latin. This vertical line may develop, starting at your umbilicus and leading down to your pubic area. Women with darker skin tend to develop a darker line but it may not be so obvious in women with lighter skin. Again, if you want to avoid further darkening then use sunscreen if you’re lucky enough to be enjoying some sunshine in your bikini. The changes usually go after birth but it’s important to use sun screen postnatally as darker skin patches/linea nigra may reappear in the sun. Hormonal contraceptives after birth may also enhance this. The copper coil is the only non-hormonal contraceptive available for women at present.

7. Itchy skin

A lot of women experience itchy skin around the abdomen during the second trimester. This is due to the stretching of the skin as your baby grows. To reduce the itching, use a soothing organic camomile lotion or 100% organic coconut oil. If you get itching on the palms of your hands, the soles of your feet or soothing lotions don’t provide any relief, it’s possible you’re developing a condition called Obstetric Cholestasis and would need a liver function blood test to check. The condition is treatable and will go postnatally if you have it, so call your midwife if you get those symptoms.

8. Aches, internal stretching and ligament pain

These pains are very common as your uterus is continuing to expand to accommodate your growing baby which means you may feel the internal stretching of your ligaments more at this time. To help your body with these changes try yoga, Pilates or swimming as soon as possible. Whilst you have the pain try to eleviate it with positioning, such as all fours or elevating your legs. If this fails to help, is coupled with lower abdominal pain or bleeding then you need to call your midwife for further advice.

9. Braxton Hicks

Some women experience these as early as 24 weeks. You may notice your tummy going tight and then relaxing and repeating this motion. If it’s painless and irregular it’s most likely Braxton Hicks. Your body is amazing and it’s practicing for labour already! This may happen on and off for a few weeks, be aware of it but continue with your day because your body is doing all the right things. If it’s painful and becomes regular, then you need to call your midwife as this could mean it’s not a practice run!

10. Anomoly scans

Your anomaly scan will be at 20 weeks and will be the last scan you’ll be offered by the NHS, unless complications develop. Here, your midwife will take a close look at your baby’s development and internal organs, this is the main reason for the scan but most people view it solely as a gender scan. Try not to feel nervous but be aware that it is more than a gender scan, so you can make an informed choice.

11. Haemorrhoids (piles)

These may occur due to the increased blood flow and the increasing weight of your baby. You can help to prevent them by regular bowl movements and eating a high fibre diet so you don’t strain on the loo. If they develop, however, warm baths may help to soothe any discomfort, you can also get creams over the counter, so speak to your pharmacist but, of course, let them know you are pregnant first.

12. Increased headaches

Some women experience headaches due to hormonal changes and possible dehydration if you aren’t drinking enough water. Continue drinking two litres of water per day to prevent them or take paracetamol, which is safe to take during pregnancy, if they continue. The condition pre-eclampsia doesn’t usually develop in the second trimester but it’s not unheard of, so if your headaches are coupled with visual disturbances, swelling and/or upper abdominal pain, you need to call your midwife to get your blood pressure and urine tested to out rule this.

13. Indigestion and heartburn

As your baby is growing rapidly during this period, there’s less room for your body’s usual daily digestion and the movement of the gut during digestion slows. The relaxing of the lower oesophageal sphincter (muscle) allows stomach acid to leak back up causing heartburn. You can help reduce the acidity naturally through your diet and by trying to eat little and often rather than big meals. In my experience, pastry, spices and fruit juice are the most commonly reported triggers.

Be conscious of your positioning whilst eating too, try to sit upright to take pressure off the stomach and try not to eat a meal less than two hours before bed. If you wake up in the night with heartburn, leave a glass of milk by your bedside as this can sometimes provide quick relief, allowing you to go back to sleep. You can also get medication from your midwife or GP if it’s severe and none of the above helps.

14. Sex!

Everyone is different when it comes to having sex during pregnancy. Some women feel more confident and have a higher sex drive. Others simply don’t feel like it and some stop having sex around this time. What you need to know is that it’s safe, healthy and natural. Some partners think they will hurt their baby, your cervix is closed (which protects and supports your baby) so there’s absolutely nothing dangerous about having sex during pregnancy. If you feel up to it – go for it! If not, that’s fine and don’t feel concerned just do what suits you but don’t let fear put you off.

15. Your boobs may keep continuing to grow!

During the first trimester, your boobs may become very sore but this should resolve by the middle of your second trimester. You may now notice they have continued to grow, one may even be marginally bigger than the other. That’s normal and is due to hormonal preparation. Make sure you change your bra and wear the right bra size so you are comfortable.

16. Urinary tract infections (UTI)

Due to progesterone, your kidneys start to slow their offloading to the bladder making it easier for bacteria to grow, plus your immune system is slightly suppressed so your body doesn’t fight it off as well. Hydration really is important as it does prevent a lot of symptoms including those caused by a UTI. As soon as you start to feel a burning sensation whilst peeing, drink water! Try to flush it our naturally within 24 hours by drinking a glass of water with a tea spoon of baking soda and eat fresh (ideally organic) blueberries and cranberry capsules/pure juice. If this doesn’t reduce the symptoms, then you may need antibiotics to cure it and prevent the infection from spreading, you can get these from your GP, so don’t wait until your next midwifery appointment.

17. Talking to your bump

Your baby can hear your voice at around 22 weeks and will distinguish your voice from others, so you can talk to your bump and your baby will hear you. Don’t feel pressurised to do this and don’t do anything that makes you feel uncomfortable or awkward as your baby will hear you talking all the time anyway but I personally think it’s good for bonding. A top tip – you may want to play your baby music as several studies have shown that babies recognise music they heard regularly in the womb and this can have a calming effect on newborns.

18. Symphysis Pubis Dysfunction (SPD)

This is most common in the third trimester but ensuring good positioning throughout the second trimester may help reduce the discomfort if it develops at this time and prevent worsening later in the third trimester. The cause is a combination of things such as hormones, foetal positioning/weight and previous injuries. Guidelines recommend that you are as active as possible and avoid activities that cause pelvic pain.

Wear flat, supportive shoes and try to evenly distribute your weight, so don’t stand on one leg when putting on jeans, try sitting on the bed instead. Keep your knees together when getting in and out of bed or the car – a plastic bag on the seat can help you manoeuvre If it’s comfortable, sleep on your left side with one pillow between your legs – pregnancy pillows can really help with getting comfortable as your bump grows.

19. Preparation is key

Book antenatal classes for both you and your partner as it’s really key to understanding what’s to come and helps you to make an informed decision. NHS classes can get full quickly which is why I suggest you look into classes available towards the end of the second trimester. Their schedules vary in length, frequency and delivery. The more knowledge you have surrounding your pregnancy, birth choices and pain relief in labour, the better. Read up and do your own research too, midwives and doctors refer to NICE guidelines nationally, so if you did want to read up on something particularly important to you, that’s a credible and trustworthy source.

20. Weird dreams

Some women report having weird, vivid dreams. A few women have told me that they have dreamt about ex-partners, giving birth to a fully grown children and being around or looking after lots of animals. This is normal and is due to both your hormones and emotional state. You and your body are going through a lot of changes and sometimes it’s reflected in your dreams. No matter how weird and wonderful they are don’t worry, in fact, try to enjoy them. It’s your minds way of coping with your thoughts through-out the day and they don’t mean you still have feelings for an ex or will give birth to a big baby!

What have you experienced during your second trimester?

Marie Louise, The Modern Midwife - 20 facts about the Second Trimester of pregnancy
Marie Louise, The Modern Midwife

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Marie Louise, The Modern Midwife

Marie Louise is a senior midwife, maternity educator and managing director of Marie Louise Maternity