Health & Fitness Pregnancy

See how you can maintain your health during second trimester (week 13 – 27)

second-trimester

So you have entered your second trimester, which is the most enjoyable period of your pregnancy. This is called the GOLDER PERIOD, because many of the unpleasant effects of early pregnancy disappear. But, now you need care and proper monitoring of your baby. In the second trimester, you can determine your baby’s gender through an ultrasound test. 

In the second trimester, your baby grows larger, and the belly looks big, a bump is visible. Most women find that the second trimester is a lot easier than the first, but it’s still important to be informed about your pregnancy during the second trimester. Properly understanding your pregnancy can help you make informed decisions and prepare for the big changes ahead.

Women should see a doctor about every two to four weeks during the second trimester of pregnancy. Tests that the doctor may perform during a visit include:

  • measuring your blood pressure
  • checking your weight
  • ultrasound
  • diabetes screening with blood tests
  • birth defect and other genetic screening tests

What happens to your body in second trimester?

body changes in second trimester

During the second trimester of pregnancy, symptoms that you may have experienced during the first trimester begin to improve. 

The following changes and symptoms may occur:

  • the uterus expands
  • you begin to show a larger abdomen
  • dizziness or lightheadedness due to lower blood pressure
  • feeling the baby move
  • body aches
  • increased appetite
  • stretch marks on the stomach, breast, thighs, or buttocks
  • skin changes, like darkening of the skin around your nipples, or patches of darker skin
  • itching
  • swelling of the ankles or hands

How much weight can I gain during the second trimester?

The amount of weight you can expect to gain during the second trimester will vary based on your pre-pregnancy weight. Your doctor should calculate your body mass index (BMI) early in your pregnancy to compare. Based on your BMI, your doctor can estimate how much weight you should gain.

BMI & estimated weight gain.

  • underweight, or have a BMI under 18.5, should gain 28-40 pounds
  • normal weight, or have a BMI between 18.5-24.9, should gain 25-35 pounds
  • overweight, or have a BMI between 25-29.9, should gain 15-25 pounds
  • obese, or have a BMI over 30, should gain 11-20 pounds

What skin changes occur during the second trimester?

skin changes during the second trimester

The second trimester can bring about several changes in your skin. You may be wondering at this time what’s normal and what isn’t.

Stretch marks

You may start noticing stretch marks on your belly as your belly continues to expand. These are areas where your belly is growing faster than your skin can keep up with. As a result, the skin tears slightly, and stretch marks are created. The breast and stomach are the areas that enlarge mostly during pregnancy, so you will most likely see the marks on these areas. 

Not every prego will get stretch marks, but many do. A variety of creams claim to reduce stretch marks, but they haven’t been proven to do so. They can, however, make your skin less itchy. Avoiding excessive weight gain during your second trimester also can help reduce the incidence of stretch marks. Talk to your doctor if you’re concerned you have gained too much weight.

After you give birth, your stretch marks will most likely begin to fade. However, it can be difficult to completely eliminate them.

Dark lines over your body

Dark lines (linea nigra), often appears in your second trimester of pregnancy, usually around five months. This is a dark, usually brown line that runs from your belly button to your pelvis. Some women also have the line above the belly button. 

Will I have back pain during second trimester?

 

back pain during the second trimester

Gaining 15 pounds weight suddenly within three months can lead to several discomforts, including low back pain. Your growing belly can also place extra stress on your back.

Ways to reduce second trimester-related lower back pain include:

  • avoiding lifting heavy items
  • avoiding high-heeled shoes
  • maintaining good posture whenever possible
  • applying heat or cold in 10-minute increments to your back
  • sleeping on your left side with a pillow between your legs
  • getting pregnancy massages
  • sitting in supportive and straight-backed chairs

What other body changes may occur?

Leg cramps are common in pregnancy and often happen at night. If you develop a leg cramp, stretch the muscle. You can prevent future cramps by:

  • staying active
  • drinking plenty of fluids
  • stretching your calf muscles before bed

Dizziness:

During pregnancy, your blood vessels dilate. This causes your blood pressure to drop. Sometimes your blood pressure might drop too much, and you may begin to feel dizzy. Staying hydrated and lying on your left side can help you manage dizziness.

Vaginal discharge:

You might notice a sticky, clear or white vaginal discharge. This is normal. Contact your health care provider if the discharge becomes strong smelling, unusual in color, or if it’s accompanied by pain, soreness or itching in your vaginal area. This could indicate a vaginal infection.

Breast enlargement:

Much of the breast tenderness you experienced during the first trimester should be wearing off, but your breasts are still growing as they prepare to feed your baby. Going up a bra size (or more) and wearing a good support bra can make you feel more comfortable

Urinary tract infections:

These infections are common during pregnancy. Contact your health care provider if you have a strong urge to urinate that can’t be delayed, sharp pain when you urinate, urine that is cloudy or has a strong smell or you have a fever or backache. Left untreated, urinary tract infections can become severe and result in a kidney infection.

Heart burn:

It is a burning pain felt in the throat or chest, behind the breastbone, caused by stomach acid coming up the oesophagus (the tube that connects your mouth to your stomach) and irritating the lining.

  • In pregnant women, indigestion and heartburn can be caused by:
  • eating a big meal
  • eating high-fat foods
  • eating chocolate or peppermint
  • drinking fruit juice or caffeinated beverages (coffee, tea, cola drinks)
  • doing physical activity soon after eating
  • bending over
  • feeling anxious

It’s a good idea to take note of the particular foods, drinks or activities that give you indigestion while you are pregnant.

Way to reduce heart burn:

  • Skip foods and drinks that can make it worse, such as citrus; spicy, fatty (especially fried or greasy) foods, caffeine and carbonated drinks.
  • Eat several small meals throughout the day.
  • Take your time when eating.
  • Drink liquids between, not during meals.
  • Avoid eating or drinking for 3 hours before bedtime.
  • Resist the urge to lie down after meals.
  • Raise your head when you sleep.
  • Talk to your doctor about medicines that are safe to take for heartburn during pregnancy.

What dental changes may occur during Second trimester pregnancy?

dental changes during second trimester

Increased hormones can heighten your risk of bleeding during the second trimester. You also have a lot more blood flowing through your body. As a result, you can experience increased bleeding. This bleeding can occur in your nose due to airway swelling. You may also notice snoring and increased congestion. You may also notice some blood on your toothbrush when you brush your teeth. The increased blood volume can cause your gums to become softer and more vulnerable to bleeding. You may wish to use a softer-bristled toothbrush during pregnancy.

Here’s how you can reduce bleeding:

  • avoiding secondhand smoke
  • breathing in steam from a vaporizer or hot shower
  • placing warm, moist towels over your face

Don’t give up on your dental routine, however. Brushing and flossing are still vital. You can talk to your dentist if you’re concerned your gums are bleeding too much.

What is round ligament pain? And how long it may last?

Round ligaments are ropey bands of tissue kind of like bungee cords that connect the uterus to the groin area. When your baby bump grows up and out during pregnancy, these round ligaments are stretched from the groin area upward into the abdomen and hip areas. Usually you’ll feel sharp, sudden pain on one or both sides of your lower belly. This pain isn’t constant. It comes and goes and for many women it may stop in later pregnancy.

Generally, round ligament pain during pregnancy is most frequent during the second trimester, but it may continue into the third trimester as well. The actual pain itself lasts only a few seconds at a time, but overworked ligaments from an especially active day can leave you feeling achy for hours.

Even though it’s considered one of the normal aches and pains that come with being pregnant, round ligament pain can be frustrating. The best way to ease your discomfort is to prevent it from occurring, when possible. 

Here are the ways that can help you cure this pain; 

  • Move more slowly: Take your time when getting up from sitting or lying down.
  • Stretching: General stretched like pelvic tilts and rocks can help relieve the pain, as can prenatal yoga. Just be careful not to overdo it!
  • A bath: This can help soothe your round ligament pain—just make sure the water is warm, not hot.
  • Consider a pain reliever: Depending on the severity of pain, you might want to take a pregnancy-safe pain reliever 
  • Wear a belly belt: The wide, rigid belts are worn under your belly to help support your bump and relieve round ligament pain and hip discomfort.

What is gestational diabetes? 

What basically diabetes means? When you eat food, the body breaks down sugar and starches from food into glucose that is used as a source of energy. Pancreas (an organ behind your stomach) makes a hormone called insulin that helps your body keep the right amount of glucose in your blood. When any person diabetes, your body doesn’t make enough insulin or can’t use insulin well, so you end up with too much sugar in your blood.

During the period of pregnancy, some women develop a high sugar level, which is a medical language known as Gestational diabetes mellitus (GDM). GDM or gestational diabetes mostly develops in the 24th to 28th week of pregnancy. It can affect the mother as well as the baby’s health. Gestational diabetes usually goes away after you have your baby. As we know, the placenta supports the baby and helps to grow. Hormones from the placenta help the baby develop and get nourished. But these hormones also block the action of the mother’s insulin in her body. This problem is known as insulin resistance. Insulin resistance makes it hard for the mother’s body to use insulin, which ultimately leads to hyperglycemia and results in GDM.

Who is more likely to have gestational diabetes mellitus?

  • Mother older than 25
  • the overweight or obese person
  • the one who had a history of GDM with past baby
  • may have a polycystic ovarian syndrome
  • Prediabetes At this stage person’s blood glucose levels are higher than normal but not high enough to be diabetes.
  • Positive Family history

Can GDM causes problem in pregnancy? If yes then what are those? 

The first and most common problem is seen cesarean birth which commonly known as C- Section. Women can have normal vaginal delivery, but the ratio of NVD is lesser in women with GDM as compare to normal to women.

Blood pressure during pregnancy;

High blood pressure (hypertension), i.e, the force of blood against the walls of the blood vessels, is too high. It can stress the mother heart and can cause heart problems. When pregnant women develop hypertension may give the signs that some of the organs like kidneys may not be working properly. In medical language, Preeclampsia is another name for hypertension during pregnancy.

Signs of preeclampsia:

  • high protein in urine
  • vision problems
  • Headache.
  • Edema ( swelling )
  • This can increase the risk of premature birth.

Preeclampsia affects every system in the body, including the placenta.

The placenta is responsible for providing nutrients to the baby. Though preeclampsia typically occurs during the third trimester for first-time pregnancies, some people develop preeclampsia during the second trimester.

What is premature birth?

premature birth

Premature birth: The birth before the 37 weeks is considered as premature birth, that may need to have a c-section if have complications during pregnancy,  may need to have labor induced before your due date. Inducing labor means your provider gives you medicine or breaks your water (amniotic sac) to make labor begin.

What emotional changes may occur during second trimester pregnancy?

emotional changes during the second trimester pregnancy

Mood swings

Pregnancy is a transition point in a woman’s life and during this a person’s emotions can be up and down. Some women’s emotions don’t change that much when they are expecting, but it’s not unusual for women to have mood swings, especially during the early and late stages of pregnancy. 

It’s not entirely clear why these mood fluctuations occur, because a number of changes are happening in a woman’s body, and they are all tied to her emotions. 

One key reason may be a flood of hormones. Some women are sensitive to changes in estrogen, while others are affected by rising levels of progesterone or stress hormones.

Anxiety

Often anxiety and fear can go hand in hand that the fear of uncertainty that often comes with pregnancy can lead to anxious thoughts. 

Anxiety is a normal emotion and people have it for a reason, on a biological level, both the anxiety and fear systems in the brain ramp up during pregnancy. These changes help ensure that a woman keeps her baby safe, cared for and protected after she gives birth. 

If a woman has had anxiety in the past, she is more at risk of having it during her pregnancy because of the increased stress she may experience.

Fear

Fear is another common emotion during pregnancy. In the first trimester, a woman may be afraid of having a miscarriage or doing something that will affect her baby’s health; in her second trimester, she may start to question whether she will be a good mother and be frightened by the enormous responsibilities of caring for a newborn. By the end of her pregnancy, a woman may be scared of being in pain during labor or concerned that something could go wrong during delivery. 

Body image issues

During the second and third trimesters, as a woman’s baby bump becomes more visible and she gains more weight, she may feel dissatisfied with her body and its appearance, and this may affect her self-esteem.  Some pregnant women marvel at their rapidly changing bodies and feel radiant, while others worry about the weight gain and regaining their figures after delivering. 

These changes to a woman’s look, shape and perceived attractiveness may bring up a complicated mix of feelings, Kimmel said. Some of these body images concern may mean accepting the fact that a woman is pregnant and her body is changing as a result.

What to eat during second trimester?

diet during second trimester

A healthy diet consists of, protein, carbohydrates, fats, vitamins, minerals and plenty of water. A pregnant woman’s diet should be consist of, 

  • Vegetables
  • Fruits
  • Proteins
  • Grains
  • Dairy products

Women should also increase their calorie intake by 300 to 500 calories per day (if you haven’t done so already), make sure to get the most bang for your buck out of those calories by filling up on nutritious food. If you are expecting multiples, increase your caloric intake by around 500 to 650 calories, but your doctor will tell you exactly what is appropriate.

Protien in your diet will keep you satiated and help baby gain weight appropriately. A non-pregnant person should aim to get a half-gram of protein per pound of bodyweight per day, so if you weigh 150 pounds, you should be getting around 75 grams of protein per day. A pregnant woman should add an extra 25 grams to her daily diet. This extra 25 grams is about the equivalent of four eggs or a 3-ounce chicken breast. 

Source of protein:

  • Fully cooked fish or seafood
  • Meat
  • Chicken
  • Cheese
  • Milk
  • Nuts
  • Beans

If you eat a plant-based diet, you can find those 25 grams of protein by eating like one and a half cups of chickpeas. 

Calcium:

As baby’s bones and teeth continue to develop, calcium is needed to help them become denser and more structurally sound. Research shows that many women are not getting enough calcium. If you aren’t getting enough for both you and baby, the body will reallocate your stores to make sure he gets what they need.

Calcium Food sources:

milk, yogurt, cheese, calcium-fortified juices and foods, some leafy greens

Leafy greens and cruciferous vegetables not only contain calcium, but they also contain other vitamins and minerals that help the body absorb it, so make sure to get your greens.

Vitamin D and iron:

Vit. D is one of the special nutrients that help absorb the calcium and can be found naturally in milk, egg yolks and other fortified products. You should also consult with the doctor for vitamin D supplement during pregnancy.

Daily, 27mg of iron is recommended for a pregnant woman. The importance of iron continues through all the trimesters, to avoid developing anemia. It’s critical around the midpoint of pregnancy as the baby’s own blood supply grows. Like calcium, the body will make sure baby is getting enough iron first, so it will deplete your stores if necessary, increasing your chances of anemia a second time.

Source for iron:

meat, poultry, fish, dried beans and peas, iron-fortified cereal, or you may take a glass of orange juice in morning

A balanced diet high in vitamins and minerals has endless benefits during this phase of pregnancy, so now that you can hopefully stomach something more than white rice, aim to fill your plate with 50% of complex carbs (fruits, vegetables and whole grains), 30% of healthy fats and 20% protein to get the optimal mix of nutrients. It will help you feel your best, gain weight appropriately, boost your energy and make staying active easier, provided your doctor gives you the okay.

What exercise I can do during the second trimester of pregnancy?

exercise during second trimester

Before you start doing workout, consult with you doctor. Once he allowed you, move your body in a way that feels good to you. Keeping the body active and strong will give the mom-to-be more energy, a better night’s rest, strength as the growth of the belly continues, as well as help with making smarter nutritional choices. 

Strength training program three to four days a week can help mom prepare for labor and for the strength she will need for carrying and lifting her baby. On the other days of the week, cardio and/or prenatal yoga is a great way to help improve endurance, stretch tight muscles and focus on meditation.”

During the second and third trimesters, a pregnant woman should focus on building more strength in her back to help with the increase in weight on her front side. Women should do seated rows to help with the change in posture, as well as squats and pelvic-floor exercises.

Only a few movements are to avoid in the second trimester. 

Avoid extremely high-intensity/high-impact exercise where the breath is labored for an extended period of time, avoid lying flat on your back, and listen to your body if you feel you need to rest during your workout

Some tips for exercising during pregnancy: 

  • Wear loose, comfortable clothing if you are going for a non-stretch material.
  • Shoes are very important if you are going to be walking or jogging. Get a pair that fit well and have a good grip.
  • Always keep a sipper bottle handy to keep yourself hydrated.
  • If needed, rest in between sets. It is alright if it takes you over an hour for a 30-minute regime.
  • Keep some healthy snacks to have after exercising. You are going to be extremely hungry by the end of each routine.

Which exercise I can perform during second trimester pregnancy?

Walking

The simplest exercise you can do on a daily basis is walking. Make sure you wear comfortable clothing and a pair of shoes that has a good grip and provides support. The walk doesn’t necessarily have to be intense. A leisurely walk or a stroll in the park should do the trick. Walking every day for about 30 to 40 minutes ensures that your body is not sedentary and also keeps your heart healthy. Carry on in a comfortable and consistent speed, and do not forget to sway your arms and enjoy the activity.

Slow Jogging

Slow jogging is only recommended for those who have a healthy pregnancy. If you get your regular checkups, and your medical practitioner has advised you, you may include slow jogging into your exercise regime. There are, however, some rules you must stick to to make the exercise safe for you and your baby. Jogging should be done only on flat surfaces for you to maintain a pace without getting tired. In case you feel tired while jogging, do not continue; sit immediately and relax for a while. You can also prefer running on a treadmill but at a slow and controlled speed.

Yoga

Yoga can help you stay fit and also improve your mental and emotional health. With the hormonal fluctuations in the second trimester, it could become difficult for you to cope with stress. Yoga is one of the most recommended exercises to improve flexibility and avoid stiffness. In case you are a pro, you may continue yoga practice, but avoid positions that could put your health or your baby’s health in jeopardy. If you are new at it, consider getting some guidance through yoga classes. You may begin with the breathing exercise and slowly incorporate simple yoga poses.

Cycling

Exercising on a stationary bike is the best way to improve muscle strength. When you are in the second trimester, your belly starts growing, and this is the time you actually shouldn’t put a lot of stress on your abdomen. Sitting on an exercise bike and cycling may prove to be the best exercising option for you, as long as it isn’t making you uncomfortable and there are no risk factors.

Swimming

Swimming can help you relax your muscles and get all the me-time you need. You can also consider practising swimming exercises that do not put any exertion on the abdomen. Swimming for about 30 minutes can be a great exercise for the second trimester.

Exercise and foods to avoid during pregnancy:

Crunches

Crunches are great exercises for shaping the area around the abdomen. However, it is especially an exercise to avoid during pregnancy first trimester. The pull in the lower abdominal muscles can cause undue stress to the uterus and the baby.

Sauna/Hot Yoga

Exposure to excessive heat is harmful to the developing baby and for this reason hot sauna baths or hot yoga techniques must be avoided during pregnancy.

Heavy Weight Lifting

Exercises that involve weight training by lifting weights, cause a pull in the abdomen putting pressure on the uterus. Overhead shoulder presses also put a strain on the lower back.

Lying on the Abdomen

Lying on the abdomen and doing exercises can be very harmful to the foetus. After the first trimester, even lying on the back can be a little uncomfortable. Exercises in both these position cause discomfort and can be avoided.

Back Bending Exercises

Exercises and yoga postures that involve bending of the back, for example, the sun salutation, must not be done during pregnancy. These postures create an unnecessary pull in the uterus, which can affect the fetus.

Foods to avoid:

  • Energy drinks
  • Caffeine
  • Alcohol
  • Unpasteurized milk – soft ice creams
  • Pre packaged salads
  • Peanuts
  • Supplements containing vitamin A
  • Raw or uncooked meat

Prenatal care during COVID-19 pandemic:

During the COVID-19 pandemic, your top priority should be your safety. To do this, you need to limit in-person contact by reducing in-person visits at your doctor’s office and the hospital and replacing some in-person care with virtual prenatal care

You are not required to purchase any equipment to prepare for your virtual visits. However, some patients may choose to purchase devices to monitor their blood pressure and/or check their baby’s heart rate, for their own reassurance. If you choose to monitor these, you can do so before your appointment and share your values with your doctor or midwife at your virtual visit.

Should I continue to have prenatal visits? I’m worried about being exposed to COVID-19.

Prenatal visits are important to ensure maternal and fetal health. However, given the current global pandemic we are facing, many obstetricians are either increasing the interval between visits or encouraging telehealth visits. Ask your obstetric health provider if you should buy a blood pressure cuff for use at home and monitor your baby’s movements. If you have any concerns about your health or your baby’s health, please call your obstetric team. We recommend that women talk to their obstetrician about their prenatal care and continue to attend appointments as long as their obstetrician feels it is appropriate.

Does becoming ill with COVID-19 increase risk of miscarriage or other complications?

An increased risk of miscarriage or fetal malformations has not been documented in pregnant women who are infected with COVID-19, according to the CDC. Based on data from other coronaviruses, such as SARS and MERS, the American College of Obstetricians and Gynecologists notes that pregnant women who get COVID-19 may have a higher risk for some complications, such as preterm birth. However, this data is extremely limited, and the infection may not be the direct cause of preterm birth.