What to Expect in the Second Trimester 

The second trimester of pregnancy is from week 13 through week 27 (months 4 through 6). The second trimester is usually a time when you feel your best. Morning sickness may have lessened or quit completely, you may have more energy, and you may have an increase in appetite. The second trimester is also a time when the baby grows quickly. You will likely begin to feel the baby move more frequently between 16 and 20 weeks of pregnancy. Below is a list of what to expect during this trimester.

Achiness in your lower abdomen

In your second trimester, you may notice some cramps or aches in your lower belly. Cramps are caused by your uterus expanding during pregnancy, as it puts pressure on nearby muscles and ligaments. During the second trimester ligaments also start stretching and can also cause cramps or even a sharp pain. Minor cramps are normal. To relieve the cramps or aches, try a warm bath, relaxation exercises, changing your position, or pressing a hot water bottle wrapped in a towel to your lower belly.


Due to babies growing size you may notice pressure in your back, making it achy and sore. To ease the pressure, sit up straight and use a chair that provides good back support. Sleep on your side with a pillow tucked between your legs. Avoid consistently carrying anything over 20 pounds. Wear low-heeled, comfortable shoes with good arch support. If you have persistent concerns about back pain, talk to your provider about possible physical therapy.

Bleeding gums

About half of pregnant women develop swollen, tender gums. Hormone changes are sending more blood to your gums, making them more sensitive and causing them to bleed more easily. Use a softer toothbrush and be gentle when you floss.

Braxton-Hicks contractions

You may start to feel these mild, irregular contractions as a slight tightness in your abdomen. They are more likely to occur in the afternoon or evening. Sex, intense exercise, dehydration, or a full bladder may trigger Braxton-Hicks contractions. To help relax, take a warm bath, change your position, or drink more water. If the contractions become regular or steadily increase in strength, contact your doctor. This could be a sign of preterm labor.

Breast enlargement

Your breasts are still growing as they prepare to feed your baby. Going up a bra size (or more) and wearing a good supportive bra can make you feel more comfortable.

Congestion and nosebleeds

Hormonal changes cause the mucous membranes lining your nose to swell, which can lead to a stuffy nose and make you snore at night. These changes may also make your nose bleed more easily. You can try using a humidifier to keep the air moist or use nasal saline spray.


It is normal to see a thin, milky white vaginal discharge early in your pregnancy. If the discharge is foul smelling, green or yellow, or bloody, call your doctor.


As your uterus expands during the second trimester, it presses against blood vessels and may cause you to feel dizzy at times. Other causes of dizziness are low blood sugar, dehydration, or hormone changes during pregnancy. Avoid standing for too long. Rise slowly from chairs or bed. Eat healthy meals and snacks, avoid hot showers and baths, hydrate with water, and try not to lie flat on your back.

Frequent urination

Is common in pregnancy due to increasing uterine size. Urinating frequently is not, however, a sign of adequate hydration. Clear urine is a better indicator of adequate hydration.

Hair growth

Pregnancy hormones can boost hair growth. The hair on your head may become thicker. You may also see hair in places you have never had it before, including your face, arms, and back.


Headaches are one of the most common pregnancy complaints. Try to get plenty of rest. Aspirin and ibuprofen should not be taken during pregnancy. Regular strength Tylenol is okay to take while pregnant. If you are having severe or persistent headaches not resolving with Tylenol, see your provider.

Heartburn and constipation

To relieve heartburn, try eating more frequent, smaller meals throughout the day and avoid greasy, spicy, and acidic foods (such as citrus fruits). For constipation increase fiber in your diet and drink extra fluids. Physical activity will also help with constipation.


Avoid constipation. Sitz baths, over-the-counter Preparation H and Hydrocortisone topically may be helpful.

Leg cramps

You may feel muscles in your legs contract and cramp in the second trimester. This often happens at night. To prevent cramps, try to stretch your leg muscles before you go to bed, get regular exercise, eat foods high in magnesium like beans or whole grains. Drink plenty of fluids, get the recommended amount of calcium and wear comfortable shoes. To ease leg cramps, stretching, ice, heat, or massage may help.


By the midpoint of your pregnancy (20 weeks) you will probably have started to feel the first delicate flutters of movement in you abdomen, which is often called “quickening”. Some women don’t experience this until after their sixth month of pregnancy

Skin changes

Changing hormone levels in pregnancy can make the skin on the face appear flushed. An increase in the pigment melanin can also lead to brown marks on the face and a dark line down the middle of the abdomen. All of these skin changes should fade after the baby is born. You may notice thin, reddish-purple lines on your abdomen, breasts or thighs. These stretch marks emerge as your skin expands to accommodate your growing belly. Unfortunately nothing has been shown to be helpful in preventing them; however, hydration can help with overall skin health.

Spider and varicose veins

Your circulation has increased to send extra blood to your growing baby. That excess blood flow can cause tiny red veins, known as spider veins to appear on your skin. Pressure on your legs from your growing baby can also slow blood flow to your lower body, causing the veins in your legs to become swollen and blue or purple. These are called varicose veins. There is no way to avoid varicose veins but you can prevent them from getting worse by getting up and moving throughout the day and propping your legs on a stool whenever you have to sit for long periods of time. Wear support hose for extra support.

Urinary tract infections

Bacterial infections in your urinary tract or bladder are common in the second trimester. You may have symptoms like pain or burning when you urinate, a frequent urge to urinate, cloudy or smelly urine, pain during sex, lower belly pain, or traces of blood or mucous in your urine. See your doctor if you develop any of these symptoms.

Weight gain

Morning sickness usually diminishes by the end of the first trimester. After that your appetite should return and will probably grow

Symptoms to have checked out in the second trimester

As a mom-to-be, you're focused on having a healthy baby. In the second trimester, it is important to know these symptoms and call your provider right away.

  • Severe abdominal pain or cramping
  • Bleeding
  • Severe dizziness
  • Rapid weight gain (more than 6.5 pounds per month) or too little weight gain (less than 10 pounds at 20 weeks into the pregnancy)
  • Jaundice
  • Vomiting

If you experience any of the above symptoms, call your doctor’s office right away. If you don’t get someone on the phone within a few minutes, head to the nearest emergency department.

Second Trimester To-Dos

  • Take advantage of a variety of prenatal classes at Pella Regional to learn what you need to know to feel better prepared for the arrival of your new little one
  • Get familiar with your employer’s maternity leave policy
  • Investigate child care options if applicable
  • Start doing Kegel exercises
  • Check your rings. It is common to have some swelling in your fingers as your pregnancy progresses. If your rings are feeling snug, take them off before they become too tight

Helping You Navigate the Insurance Maze

Because today’s insurance policies come with significantly higher co-pays and deductibles, you’re likely to face larger out-of-pocket expenses for your health care. Our team at Pella Regional help you prepare for the cost of your medical procedure, understand the payment process and avoid financial surprises.

Our team will review your specific insurance situation and your doctor’s recommended procedure. Then, staff will estimate your actual cost and work with you to find the best method of payment.

Preparing for a baby? Pella Regional also offers opportunities to pre-pay for your maternity care.

We understand that sometimes paying for deductibles, co-insurance, or copays may be difficult. If you are unable to pay all or part of your responsibility, please call the Business Office at 641.628.6700 to discuss options for financial assistance.

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