Your baby continues to grow fast, from a small fetus at the start of the trimester to a fully formed baby at the end of Week 26. You will start to feel your baby move at around the middle of the trimester and, as the baby increases in size and strength, these movements will become more vigorous and defined.
The second trimester is the time in pregnancy when most women feel at their best. The unpleasant early symptoms, such as tiredness and morning sickness, have usually disappeared; you are starting to look pregnant, but your bump is not so large that it hinders you; and you feel optimistic that your pregnancy is now ‘safe’, because the placenta rather than just the maternal hormones is now fully supporting the pregnancy.
Significant changes to your body are taking place over the next few weeks:
- Many women experience a heightened sex drive in pregnancy, and especially in the second trimester when they are feeling at their best.
- The volume of red blood cells rises rapidly in the early weeks of this trimester to catch up with the increase in the blood’s water content that took place earlier on in your pregnancy.
- The amount of blood being pumped through the heart (your cardiac output) also increases during this time, though less so in the last few weeks of the trimester.
- The volume of blood pumped by the heart at every beat (your stroke volume) similarly increases.
- The blood vessels dilate (meaning that your ‘peripheral resistance’ decreases), thanks to the relaxing effect of progesterone. As a result, some women find that their blood pressure is actually lower at this stage than it was before they became pregnant.
- The heart increases slightly in size and pumps more powerfully, but not faster.
- At the start of the second trimester, 25 per cent of blood flow (five times more than when you are not pregnant) is directed to the uterus to support the growing fetus and placenta.
- A greater amount of blood than normal is also directed at your skin and mucous membranes.
- Your kidneys are filtering an extra half litre of blood every minute until the end of your pregnancy and their filtering capacity is around 60 per cent higher than normal.
IS SEX SAFE?
Fears that intercourse in later pregnancy can trigger premature labour are unfounded. While it is true that semen contains prostaglandins and that artificial prostaglandins are used to ripen the cervix when labour is induced, semen alone cannot trigger labour unless the cervix is ready to start dilating (usually at term). However, you may be advised to avoid sexual intercourse if:
- you have had previous premature labours (in case your cervix has already started to dilate)
- you have threatened premature labour
- you are bleeding (until you have seen your obstetrician and been reassured that all is well)
- an internal examination has revealed that your cervix is shortened or slightly dilated
- you have placenta praevia (see box above).
Week 17: Hypertension (high blood pressure) sometimes occurs in the second trimester, particularly if you are overweight, over 40 or have diabetes. While hypertension can be problematic for the pregnancy in itself, it is also an indicator, later in pregnancy, of the serious condition of pre-eclampsia.
Week 18: This is the time when the fetal movements (known as ‘quickening’) can first be felt, although first-time mothers may not be aware of these until Week 20. It may feel like an odd, ‘fluttering’ sensation deep inside your abdomen, and
is often mistaken for wind.
Week 19: You probably experienced some minor abdominal aches and pains in the first trimester, as the ligaments in the pelvic area were adjusting to the pregnancy. These can continue throughout the second trimester, but if you experience any sudden pain, contact your GP or midwife.
Week 20: You are now halfway through your pregnancy! Your heart is pumping 7 litres per minute round your body and you will almost certainly look pregnant to others by now. While you generally feel very well by this stage, some women are still suffering from morning sickness, while others can develop temporary but painful conditions such as carpal tunnel syndrome. If you have not already started feeling your baby move, you may do so around this time.
Week 21: By this week, the fundus will have just reached your navel. Hormonal changes that occurred from the start of pregnancy can make your skin very dry and itchy, so make sure you use a good moisturiser (it doesn’t really matter which one, as long as you apply plenty of it).
Week 22: The pigmentation of your nipples, areolae, genitalia and moles also increases and by this week they have usually darkened; a dark line, called a linea nigra, running down the middle of your abdomen may also be noticeable. That said, if you have archetypal English fair skin with freckles, don’t be disappointed or worried if you don’t see one: your pregnancy is still fine!
Week 23: If you are feeling fit and well and there are no complications with your pregnancy (which may require you to attend hospital appointments), now is a good time to plan either a short break or longer holiday. It will possibly be the last time for a while that you will be able to indulge in a little ‘me time’, so enjoy yourself!
Week 24: By this time, you will probably start to get a sense of when and how much your baby moves in any given day, and whether the movements increase if, for example, you are lying down or exercising. If you have not felt your baby move at all by this stage, contact your midwife without delay, as she will check the baby’s heartbeat. If necessary, further ultrasound testing can be arranged.
Week 25: Back pain can become a problem and you need to take care of your posture when sitting and standing, as well as finding ways to safely bend down and pick things up.
Week 26: While you will only put on a little weight during the first trimester, in the second trimester you will be gaining about 0.5 kg per week, so that by the end, you will be around 6–6.5 kg heavier. If you have gained much more or much less than this, your GP or midwife may bring this to your attention at your antenatal checks.