What to Expect in the Second Trimester

Everything you need to know to sail through most women's favorite time of pregnancy.

Pregnant Woman in Pink Top Looking at Stomach
Photo: Ericka McConnell 

It happens around week 14 or so. The fatigue and morning sickness that may have marred your first trimester begin to subside. Perhaps for the first time in months, you feel healthy, sexy and energetic. Your moods start to smooth out and get even better when you feel your baby’s first fluttery kicks. You’ve left the stormy ocean behind and entered calm waters.

Here’s everything you need to know to really sail through most women’s favorite time of pregnancy: weeks 14–28.

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Second Trimester Symptoms

In the second trimester, the fluctuating hormone levels that can cause those wild first-trimester mood swings stabilize, helping you stay on a more even keel. Plus, you’re big enough to look pregnant but not so big that you’re uncomfortable.

“Since you feel better, you’re able to cope with any shifting moods and take them in stride,” says Linda Jenkins, a nurse, doula and childbirth educator in the San Francisco area. And if you kept your pregnancy a secret during your first trimester, you can finally share your excitement.

“I felt like a million bucks in my second trimester because I stopped feeling sick all the time,” says New Yorker Michele Olson, 33, who had a baby boy in January 2002. “I could enjoy feeling good, enjoy eating and enjoy the fact that I was pregnant.” As the threat of miscarriage decreases and women feel their baby move (at about 18 weeks) or see him on an ultrasound, many begin to relax and truly embrace their pregnancy. “It didn’t feel real to me until I felt the baby kick,” Olson says. “That’s when the fireworks went off.”

The second trimester is also when many women start to embrace their new identity.

“They reflect a lot on philosophical topics, like what kind of mother they will be and what kind of birth they want,” says Ann Dunnewold, Ph.D., a Dallas psychologist who specializes in the emotional aspects of pregnancy. Women often renew relationships with their mothers and begin to think seriously about how they want their labor and delivery to play out. During this trimester, your doctor will likely want to see you once a month; come prepared with any questions or concerns you may have.

Although many women feel upbeat in the second trimester, some are bothered by underlying fears about everything from what might happen during their labor and delivery, to their baby’s health, to whether they’ll be good mothers. Women who are undergoing prenatal tests may feel anxious until they learn their results.

And it’s not unusual to feel panic with every new ache or pain, spotting episode or Braxton Hicks “practice” contraction. Talking with your doctor or midwife, childbirth educator and other new moms during this time can help ease these anxieties.

“The more you understand that the way you feel is common, the more you can relax about it,” Dunnewold says. But if you find yourself worrying more often than not, you may want to seek professional help: Anxiety and stress may be linked to low birth weight and preterm delivery and may have other negative effects on the baby’s health as well. That’s true on the job, too, so do your best to cut back on both psychological and physical stress at work.

Second Trimester Tests

Most prenatal screenings are conducted in the second trimester. Here are the most common procedures:

Multiple Marker Screening

What it’s for: Screens for Down syndrome and other chromosomal abnormalities, as well as neural-tube defects, such as spina bifida.

Who gets it: Nearly all pregnant women.

When it’s given: Weeks 15–18.

How it’s done: Blood test.

Risks and drawbacks: False-positive results reported among 5 percent of test-takers.

What you should know: The test detects 66 percent of babies with Down syndrome. An abnormal result indicates an increased risk for this congenital condition and is followed by amniocentesis. An elevated alpha-fetoprotein (AFP) level, one of the chemicals measured in the test, points to an increased risk of neural-tube defects, low birth weight and other complications and is followed by an ultrasound.

RELATED: Prenatal Testing Basics: AFP and Multiple Marker Screening


What it’s for: Screens for Down syndrome, trisomy 18 and other chromosomal abnormalities. Also identifies the baby’s gender.

Who gets it: Women who will be 35 or older when they deliver, who test positive on multiple marker screenings, or who are at risk of having a baby with a genetic disease or chromosomal abnormality.

When it’s given: Weeks 15–18.

How it’s done: A long, thin needle is inserted through your abdomen into the sac around your baby to withdraw a sample of amniotic fluid.

Risks and drawbacks: Can be uncomfortable and cause mild cramping or spotting. About one in 200 women will have a miscarriage.

What you should know: Amniocentesis is offered starting at age 35, which is when the risk for Down syndrome is equal to the risk of miscarriage from the test. To minimize risk, have it performed by a physician experienced in the procedure.

RELATED: Should You Get Amniocentesis?

Glucose Screen

What it’s for: Screens for gestational diabetes, which affects about 5 percent of pregnant women. Women who are over 30, overweight, have had a large baby previously or have a family history of diabetes are at higher risk. Who gets it: Nearly all pregnant women.

When it’s given: Weeks 24–28.

How it’s done: Blood test one hour after drinking a sugar solution.

Risks and drawbacks: None reported.

What you should know: About 15 percent of all test results are deemed abnormal; if yours are, you’ll take a lengthier glucose-tolerance test at a later date. Approximately 85 percent of women with elevated blood sugar in the screening test turn out to have normal levels, says OB-GYN Stone.

RELATED: What to Expect from a Glucose Tolerance Test

Second Trimester Health

Now that you’ve got your energy and appetite back, start to focus on healthful lifestyle habits.

Eat right for two

Expect to gain about 12 pounds in the second trimester, though this can vary, depending on your prepregnancy weight, says New York OB-GYN Joanne Stone, M.D. Get an extra 300 calories a day from nutritious foods such as fruits, vegetables, whole grains and protein sources; drink at least eight glasses of water daily; consume at least 1,000 milligrams of calcium daily; and continue taking prenatal vitamins and avoiding potentially harmful substances.

Keep (or start) moving

The American College of Obstetricians and Gynecologists recommends that pregnant women exercise moderately for at least 30 minutes on most days. If you didn’t work out before, start slowly (with your doctor’s approval) by walking, swimming or pedaling on a stationary bike. If you’re already fit, continue your regimen, but adjust it to avoid spills.

Take it easy at work

If you’re usually on your feet all day, look for ways to sit down as often as possible: Prolonged standing may cause pregnancy complications.

Get into sex

You’re over the fatigue and nausea of the first trimester and not yet huge. Take full advantage of this window of opportunity.

Second Trimester Planning

Make the most of your energy, mobility and good mood to prepare for giving birth and to get your home ready for your newborn. Dallas nurse-midwife Rebecca Burpo, C.N.M., suggests this timeline:

Week 14: Sign up for a prenatal-yoga class. Yoga can build strength for labor and help improve your flexibility, agility, balance and posture.

Week 16: Tell your employer you’re pregnant if you haven’t already done so. Be ready with a plan for your maternity leave as well as ideas about who will cover for you during your absence.

Week 18: Tour your hospital’s maternity ward.

Week 20: Think about whom you want present at your baby’s birth, and begin discussing it with family.

Week 22: Sign up for a childbirth-education class, as they fill up quickly. Choose a session that you can complete before your 36th or 37th week.

Week 24: Start shopping for baby furniture and nursery accessories. (Leave painting and furniture-refinishing to others; fumes can pose a hazard.)

Week 26: Begin thinking about your birth plan. Talk to other women about their labor and delivery experiences, and discuss your options with your doctor.

Second Trimester Baby Development

During the second trimester, your baby begins signaling its presence. Between weeks 16 and 20, most women notice a fluttering that may be mistaken for gas. Between weeks 20 and 22, you feel kicks, turns and other movements, and between weeks 23 and 27, they come in waves as the baby develops waking and sleep patterns. (Call your doctor if you don’t feel the baby move by 22 weeks.)

Between weeks 18 and 22, your doctor will use ultrasound to gauge your baby’s development and check for visible problems. Three percent of babies have a major anomaly, Stone says, and ultrasound can detect two-thirds of them.

RELATED: Second Trimester Fetal Development: Images of Your Growing Baby

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