BabyBlog (TM) .com Pregnancy / 2nd Trimester

You're Adjusting to the Precious New Life Inside of You.

Changes in Your Body

Most women find the second trimester of pregnancy to be easier than the first trimester, but it is important to stay informed about your pregnancy in this stage too. While you might notice that symptoms like nausea and fatigue are going away, you will see other new, more noticeable changes to your body. Your abdomen will expand as you gain weight and the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move! Many of the other symptoms you had in the first trimester might also continue, like constipation or leg cramps, so it is important to keep doing all of the healthy things you have already learned to help prevent or treat those symptoms.

Here are some things you might experience during this trimester:

Aches and Pains
As your uterus and abdomen expands, you might feel pains in your abdomen, groin area, or thighs. You also can feel backaches or aching near your pelvic bone from the pressure of the baby's head, your increased weight, and the loosening joints in these areas. Lying down, resting, or applying heat can help resolve some of these aches and pains. If pains do not get better after rest, it is best to call your doctor.

Shortness of Breath
As your baby gets bigger inside your body, there will be increased pressure on all of your organs, including your lungs. You might begin to notice that you are short of breath or might not be able to catch your breath. Try taking deep, long breaths and try to maintain good posture so your lungs have room to expand. You might be able to breathe more freely at night by using an extra pillow or by sleeping on your side.
If you sleep on your left side, you will relieve pressure on major blood vessels that supply oxygen and nutrients to the fetus. If you have high blood pressure, it is even more important to be on your left side when you are lying down.

Stretch Marks and Other Skin Changes
You might have heard stories from family members or friends about the dreaded stretch marks from pregnancy. Stretch marks are red, pink, or purple streaks in the skin, usually over the thighs, buttocks, abdomen, and breasts. They are scars caused by the stretching of the skin, and usually appear in the second half of pregnancy. Only about half of all pregnant women get stretch marks though. They can start out as pink, reddish brown, or dark brown streaks, depending on your skin color. While creams and lotions can keep your skin well moisturized, they do not prevent stretch marks from forming. Most stretch marks fade after delivery to very light lines.

Besides stretch marks, you might notice other skin changes in the second half of your pregnancy. You might notice that your nipples are darker than before becoming pregnant, or that you have a dark line on your skin that runs down your abdomen from your belly button to your pubic hairline, called the linea nigra. You also might have blotchy brown pigmentations on your forehead, nose or cheeks. These skin changes are called melasma or chloasma. They are more common in darker-skinned women. These skin changes are caused by pregnancy hormones, and most of them will also fade or disappear after delivery.

Tingling and Itching
Tingling and numbness of the fingers and a feeling of swelling in the hands are common during pregnancy. These symptoms are due to swelling of tissues in the narrow passages in your wrists, and they should disappear after you deliver your baby. It also is common to feel itchy as your pregnancy progresses. Pregnancy hormones and your stretching skin, especially over your abdomen, probably are to blame for most of your discomfort. About 20 percent of all pregnant women have some kind of itching. And many pregnant women also get red and itchy palms and soles of their feet. Only in rare cases do pregnant women develop a condition called cholestasis of pregnancy, which is itching along with nausea, loss of appetite, vomiting, jaundice and fatigue. This condition is a sign of a serious liver problem. In general, itching most often goes away after delivery. In the meantime, you can relieve itching with moisturizers. You can also use only gentle soaps, and avoid hot showers or baths that can dry your skin. Try not to get over-heated since heat rash can make the itching worse.

Changes in Your Baby

By the 26th week, your baby will weigh about 13⁄4 pounds and be about 13 inches long. With this growth comes the development of your baby's features, including fingers, toes, eyelashes, and eyebrows. Around the fifth month, you might feel your baby move! By the end of this trimester, all of your baby's essential organs like the heart, lungs, and kidneys are formed.

Prenatal Care

Visits and Tests
During the second trimester, your doctor will be able to see if your baby is developing in a healthy way and possibly see your baby’s sex. You will be offered screening tests to look for genetic birth defects. Birth defects result from problems with a baby’s chromosomes, part of his or her genes, which are passed down from both the mother and the father at conception. Even though most babies are born healthy, many genetic birth defects occur without a family history of that disorder. The risk for birth defects increases the most at the age of 35 and older. These are some of the tests that your doctor might offer you:

Screening Tests
Screening tests do not involve any risk to the fetus or to the mother. Screening tests give results in fractions or odds of having a birth defect, based on the mother’s age. So, although you will not receive a “yes” or “no” answer, women under the age of 35 will find out if their risk is as high as that of a 35 year old woman. For women over age 35, the tests help them find out if the risk for their age is increased or decreased.

Targeted ultrasound – The best time to receive this test is between 18 and 20 weeks of pregnancy. Most major problems with the way your baby might be formed can be seen at this time. Some physical defects such as clubbed feet and heart defects may not be seen. Your doctor also will be able to see if your baby has any neural tube defects, such as spina bifida. In most cases, if you want to find out the sex of your baby, you can ask your doctor during this test. This test is not the most accurate for finding out whether your baby has Down syndrome. Only 1 in 3 babies with Down syndrome may have an abnormal 2nd trimester ultrasound.
Maternal serum marker screening (“the triple test”)–This test which looks for birth defects such as Down syndrome, trisomy 18, or an open neural tube defect, is usually given between 15 and 20 weeks of pregnancy. It involves giving a sample of your blood to look for 3 chemicals produced by the pregnancy: alpha-fetoprotein (AFP) (made by the liver of the fetus), and two pregnancy hormones, estriol and human gonadotropin. Higher levels of AFP are linked with open neural tube defects. In women age 35 and over, this test finds about 80% of fetuses with Down syndrome, trisomy 18, or an open neural tube defect. In this age group, there will be a false positive rate (having a positive result without actually having a fetus with one of these health problems) of 22%. In women under age 35, this test finds about 65% of fetuses with Down syndrome, and there is a false positive rate of about 5%.
Nuchal translucency screening (NTS) – This new type of screening is offered between 11 and 14 weeks of pregnancy. It involves an ultrasound exam to look at the thickness at the back of the fetus’ neck combined with a blood test by sticking your finger to look at two proteins produced by the pregnancy. This test finds 90% of cases of Down syndrome and 97% of cases of trisomy 18. The false positive rate is about 5%. This test is not yet widely used, and not all doctors have access to it. In some cases, health insurance might not cover it. In England and in the United States, doctors who use the test feel that it is a good option for many women.

Diagnostic Tests
Diagnostic tests can give definite answers about whether your baby has a birth defect. But, unlike screening tests, they are invasive or present a risk of miscarriage. Amniocentesis and chorionic villus sampling (CVS) are the two most commonly used. Both tests are more than 99% accurate for finding these problems. These tests also can tell you your baby’s sex. In most cases, results take about two weeks.

Amniocentesis – This test is performed in pregnancies of at least 16 weeks. It involves your doctor inserting a thin needle through your abdomen, into your uterus, and into the amniotic sac to take out a small amount of amniotic fluid for testing. The cells from the fluid are grown in a lab to look for problems with chromosomes. The fluid also can be tested for AFP. About 1 in 200 women have a miscarriage as a result of this test.
Chorionic villus sampling (CVS) – This test is performed between 10 and 12 weeks of pregnancy. It involves your doctor inserting a needle through your abdomen or inserting a catheter through your cervix to reach the placenta. Your doctor will then take a sample of cells from the placenta that can be grown in a lab to look for problems with chromosomes. This test cannot find out whether your baby has open neural tube defects. About 1 in 200 women have a miscarriage as a result of this test.

When to Call Your Doctor
Now is a good time to learn the signs of pre-term or premature labor. Premature labor occurs when a woman has labor before she reaches the 37th week of pregnancy, or three weeks before her due date. If you and your doctor see any symptoms of pre-term labor early, there is a better chance of stopping it. If symptoms are not treated, they can progress to repeated contractions that might cause the cervix to dilate (open) and cause an early birth of the baby. Premature babies need intensive care in the hospital after birth to help with their breathing, feeding, and regulation of body temperature.

Any woman can have pre-term labor, but some women have a higher risk because of problems with the uterus or placenta, or because of having had a pre-term birth with another pregnancy. Don't forget to drink plenty of water to keep from becoming dehydrated, especially in warm weather, since dehydration can cause pre-term labor.

Call your doctor right away if you have any of the following symptoms of pre-term labor:

Contractions — You may or may not have pain, but your abdomen or stomach will get very hard (a feeling like it is tightening) and then relax, on and off.
Menstrual-like cramping — You may or may not be uncomfortable with these cramps, but they feel like the cramps you can get before or when you start your menstrual period.
Gas-type pains — Feels like sharp pains in your stomach, or like a stomach virus. You also can have diarrhea or nausea.
Low pelvic pressure — Feels like the baby is putting a lot of heavy pressure down very low inside.
Low backache — Can be a strong or a dull ache.
Blood from your vagina — Can be either light spotting or more blood like during a menstrual period. Blood can be red or brown in color.
Increased discharge from your vagina — Much more discharge than what you are used to during your pregnancy. Can even be a sudden gush of a lot of water, or a small trickle or leak of water that is continuous. Discharge can be watery, pinkish, or brownish in color.

Caring For Yourself

Make sure to continue the healthy behaviors that you learned in your 1st trimester to care for yourself and the precious life inside of you.

Weight Gain

Everyone gains weight at different rates, but on average, it is normal to gain about one pound per week, or about three to four pounds per month during this trimester.