The second trimester: the comfortable stretch and what to get done

The second trimester, from week 14 to week 27, is often called the sweet spot of pregnancy. Morning sickness usually eases, your appetite and energy come back, and your bump starts to show without yet getting in the way. This article explains what is happening to you and your baby, which checks are coming up, and what is worth doing now while you feel well.

Why things get easier

By around 12–14 weeks the placenta takes over producing the hormones that sustain the pregnancy. Levels of hCG, the hormone linked to nausea, fall, and for most women the sickness gradually settles. Tiredness lifts and moods tend to steady.

The second trimester does have its own changes, though:

• Sharp twinges at the sides of the bump — the round ligaments supporting the womb are stretching. The pain is usually brief and comes with sudden movement, coughing or standing up.
• Heartburn and constipation — progesterone relaxes smooth muscle, so digestion slows down.
• A stuffy nose and bleeding gums — your blood volume rises and the mucous membranes swell.
• Skin changes — a dark line down the belly, darker nipples, sometimes patches on the face. These usually fade after birth.
• First movements — in a first pregnancy often around 18–20 weeks, earlier in later pregnancies. At first they feel like gentle flutters or bubbles.

How your baby grows

Over these weeks your baby grows from roughly the size of a lemon to that of a small cabbage. Fingerprints form, and your baby begins to hear sounds, including your voice and heartbeat. By the end of the trimester the eyes open and the lungs are busy preparing for breathing. For more detail, see the week-by-week pregnancy calendar.

Checks between weeks 14 and 27

In Uzbekistan antenatal checks are free at your family polyclinic. In the second trimester you can expect:

• A screening scan at 16–20 weeks — a detailed look at your baby's anatomy (heart, brain, spine, kidneys, limbs) plus the position of the placenta and the amount of fluid. Women at higher risk are referred for a second stage of screening at the regional Mother and Child Screening centre.
• A glucose test at 24–26 weeks and a 75 g glucose tolerance test at 24–28 weeks — to pick up gestational diabetes early. It often causes no symptoms, so the test matters even if you feel fine.
• If you are Rh-negative — an antibody test at 18–20 weeks and again at 28 weeks.
• Regular visits to your obstetrician-gynaecologist — blood pressure, weight, urine test, the height of your womb and your baby's heartbeat.

All results go into your exchange card. Keep it with you, especially when travelling.

What is worth doing now

This is a good window for tasks that become harder later on.

• Travel. If you are planning a trip, perhaps to relatives in another region, this is usually the best time. Discuss it with your doctor, take your exchange card, and stand up and drink water often on the way.
• The dentist. Dental treatment is safe now and important: gum inflammation should not be left until after the birth.
• Antenatal classes. Go with your husband. Learning about labour, breastfeeding and newborn care reduces anxiety for both of you.
• Shopping. Draw up a list of baby essentials without rushing and compare options. Many families traditionally wait until late pregnancy to buy things — that is your choice, but the list can be ready early.
• Paperwork and work. Find out how maternity leave works: the sick-leave certificate is issued at 30 weeks. Talk to your employer about your plans.
• Movement. Walking, swimming, pregnancy exercise classes — about 150 minutes of moderate activity a week unless your doctor advises otherwise.
• Sleeping on your side. From 28 weeks side-sleeping is recommended, so it helps to build the habit now.

Keep taking whatever your doctor has prescribed. In Uzbekistan potassium iodide is recommended throughout pregnancy, while iron is given only if blood tests show low haemoglobin or ferritin.

When to see a doctor

The second trimester is usually calm, but some symptoms need attention. Contact your doctor straight away or call an ambulance on 103 if you notice:

• spotting or bleeding from the vagina;
• a leak of clear fluid, which could be the waters;
• regular, cramp-like pains or lower tummy pain that does not ease with rest;
• a severe headache, flashing lights or spots in front of your eyes, sudden swelling of the face and hands;
• a temperature above 38 °C;
• after 24 weeks, your baby moving noticeably less or not at all;
• pain or burning when passing urine, or pain in your lower back on one side.

If in doubt, call. No good doctor will think your question is a waste of time.

The takeaway

The second trimester is a time to breathe out a little and look after yourself. Have your screening scan and glucose test on time, sort out your teeth, travel plans and paperwork, and start preparing for the birth with the people close to you. And take a moment simply to enjoy those first movements — it is the start of getting to know your baby.