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The Second Trimester | Johns Hopkins Medicine

What You Need to Know

  • During your second trimester prenatal visits, your health care provider will continue to check on your and your baby’s health, including monitoring the fetal heartbeat.
  • The second trimester is the most physically enjoyable for most women. Morning sickness usually lessens by this time, and the extreme tiredness and breast tenderness usually ease up.
  • Your fetus has now developed all its organs and systems and will now begin to grow in length and weight.
  • You may be able to feel the movement of the fetus for the first time at around 20 weeks. This phenomenon is called quickening.
  • A fetus born at the end of 24 weeks may survive in a neonatal intensive care unit.

Prenatal Visits During the Second Trimester

During your second and third trimester prenatal visits, your health care provider may check the following, depending on your current medical condition and the health of the fetus:

  • Any current symptoms or discomforts

  • Your weight

  • Your blood pressure

  • Urine test. This is done to find albumin, a protein that may indicate pre-eclampsia or toxemia, and glucose (which may indicate hyperglycemia).

  • Growth, size and development of the fetus

  • Size of the uterus. After approximately 12 weeks of gestation, the uterus can be felt through the abdominal wall.

  • Height of the fundus (top of the uterus), starting at 20 weeks of gestation

  • Fetal heartbeat

The Second Trimester: What to Expect

The second trimester marks a turning point for the mother and fetus. You will usually begin to feel better and start showing the pregnancy more. Your fetus has now developed all its organs and systems and will now begin growing in length and weight.

During the second trimester, the umbilical cord continues to thicken as it carries nourishment to the fetus. However, harmful substances also pass through the umbilical cord to the fetus, so care should be taken to avoid alcohol, tobacco and other known hazards.

During the second trimester, both your body and the fetus continue to grow.

Johns Hopkins Hospital Designated as Baby-Friendly

The Baby-Friendly Hospital Initiative, a global program launched by the World Health Organization and the United Nations Children’s Fund, has designated The Johns Hopkins Hospital as Baby-Friendly. This designation is given to hospitals and birthing centers that offer an optimal level of care for infant feeding and mother-baby bonding.

Learn more

The Second Trimester: Changes to Your Body

The second trimester is the most physically enjoyable for most women. Morning sickness usually lessens by this time, and the extreme tiredness and breast tenderness usually ease up. These changes can be attributed to a decrease in levels of human chorionic gonadotropin hormone and an adjustment to the levels of estrogen and progesterone hormones.

The following is a list of changes and symptoms that may happen during the second trimester:

  • Appetite may increase.

  • You may be able to feel the movement of the fetus for the first time around 20 weeks. This phenomenon is called quickening.

  • The uterus grows to the height of the bellybutton around 20 weeks, making the pregnancy visible.

  • The skin on the belly may itch as it grows, and there may be pain down the sides of the body as the uterus stretches. The lower stomach may ache as ligaments stretch to support the uterus.

  • The need to urinate often may decrease as the uterus grows out of the pelvic cavity, relieving pressure on the bladder.

  • Your nose may become congested, and you may experience nosebleeds. This is due to the increase in hormones (estrogen and progesterone) and blood flow that affect the mucous membranes and blood vessels in the nose.

  • Your gums become spongier and may bleed easily. This is due to the increase in hormones (estrogen and progesterone) that affect the mucous membranes in the mouth.

  • Varicose veins and hemorrhoids may appear.

  • You may have a white-colored vaginal discharge called leukorrhea. (A colored or bloody discharge may signal possible complications and should be examined immediately.)

  • The increasing weight gain may cause backaches.

  • Skin pigmentation may change on the face or abdomen due to the pregnancy hormones.

  • Heart burn, indigestion and constipation may continue.

The Second Trimester: Fetal Development 

Now that all the major organs and systems have formed in the fetus, the following six months will be spent growing. The weight of your fetus will multiply more than seven times over the next few months, as the fetus becomes a baby that can survive outside of the uterus.

By the end of the second trimester, your fetus will be about 13 to 16 inches long and weigh about 2 to 3 pounds. Fetal development during the second trimester includes the following:

  • The fetus kicks, moves and can turn from side to side.

  • The eyes have been gradually moving to the front of the face, and the ears have moved from the neck to the sides of the head. The fetus can hear your voice.

  • A creamy white substance (called vernix caseosa, or simply vernix) begins to appear on the fetus and helps to protect the thin fetal skin. Vernix is gradually absorbed by the skin, but some may be seen on babies even after birth.

  • The fetus is developing reflexes, like swallowing and sucking.

  • The fetus can respond to certain stimuli.

  • The placenta is fully developed.

  • The brain will undergo its most important period of growth from the fifth month on.

  • Fingernails have grown on the tips of the fingers and toes, and the fingers and toes are fully separated.

  • The fetus goes through cycles of sleep and wakefulness.

  • Skin is wrinkly and red, covered with soft, downy hair (called lanugo).

  • Hair is growing on the head of the fetus.

  • Fat begins to accumulate in the fetus.

  • Eyelids are beginning to open, and the eyebrows and eyelashes are visible.

  • Fingerprints and toeprints have formed.

  • Rapid growth is continuing in fetal size and weight.

  • The 20th week marks the halfway point of the pregnancy.

A fetus born at the end of 24 weeks may survive in a neonatal intensive care unit.

Second trimester | Pregnancy Birth and Baby

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The second trimester of pregnancy is a time when many women will feel energised and well. You will become visibly pregnant, but you won’t be so heavy that getting around is difficult. This is also a time of rapid growth and development for your baby, and you may find yourself busy with health checks and planning for the birth.

What is the second trimester?

Trimesters are a helpful way to think about pregnancy because the changes that happen to you and your baby fall into 3 broad categories of early, middle and late pregnancy, as reflected in the first, second and third trimesters.

The second trimester represents the middle part of your pregnancy, from weeks 13 to 26. For many women, one of the best things about this trimester is that nausea might begin to settle.

What happens to your body?

Your body will undergo some major changes during the second trimester. Your uterus will grow, and you may feel some discomfort or aches as uterine ligaments stretch. You will start to feel your skin stretch around your belly and your breasts, which may cause mild itching. Some women get stretch marks in these areas, which tend to fade over time.

Although your baby weighs less than a kilo, your blood volume will increase to meet the demands of all the growth happening inside you, which will mean you will gain some additional weight.

Your emotions

Pregnancy can be a wonderful and exciting time, but it’s also important to expect to feel some occasional days of heightened anxiety or low mood.

Sometimes one or both parents experience difficult emotions during pregnancy, such as being worried about the birth or about coping as a parent.

Feelings of anxiety are not uncommon, and some women will experience symptoms of a condition called anxiety disorder. Antenatal depression is a mood disorder that includes intense emotional changes beyond those you might expect during pregnancy.

If you are worried about feelings of anxiety, low mood or depression, you could:

  • see your doctor, obstetrician, child health nurse or midwife
  • phone Pregnancy, Birth and Baby on 1800 882 436
  • call PANDA - Perinatal Anxiety & Depression Australia on 1300 726 306

What happens to the baby?

During the second trimester, your baby will grow from being around 7. 5cm, and weighing 30 grams in week 13, to around 23cm and 820 grams at week 26.

Your baby will be able to move freely within the amniotic sac in your uterus. By about week 19 (or sooner if this isn’t your first pregnancy), you may feel this movement – as a faint tickling or fluttering. During these 3 months, your baby’s organs will continue to develop and the liver, pancreas and kidneys all start to function. This is also the time when babies might start to suck their thumb. By week 20 your baby can hear sounds, including the sound of your heartbeat, and they are learning to recognise your voice, although the ears are not yet fully formed.

What can you expect at your antenatal visits?

Regular antenatal visits are an important part of staying healthy and making sure your baby is healthy. How often you see your health professional will depend on your personal circumstances, but for many women, visits will be every 4 to 6 weeks.

At all visits during your second trimester, you will have your blood pressure checked, and your hands and feet will also be checked for swelling. You might be weighed, have blood taken for tests and have your urine checked.

Your doctor or midwife will check your abdomen to monitor your baby’s growth and will listen to your baby’s heartbeat. If you didn’t have an ultrasound in your first trimester, you may be offered one at around 18 to 20 weeks.

How to stay healthy

Eating well and staying active is as important as ever during pregnancy - it's good for your physical and emotional health, and good for your baby too. Light-to-moderate exercise in pregnancy is usually safe: consider walking, swimming, yoga and stationary cycling in your second trimester. High-impact exercise and activities where there is a risk of falling, getting hurt (especially around the stomach) or overheating are not recommended.

Your choice of food during your pregnancy is also important – but that doesn’t mean ‘eating for two’. What you eat during your pregnancy has been shown to affect how your baby grows as well as your baby’s health later in life.

Things to consider in the second trimester

Parental leave – discuss with your partner and then with your employer:

  • How will you share the care of your baby with your partner (or other family members)?
  • When do you plan to start your leave?
  • When you intend to return to work?
  • When is a good time to share your pregnancy news with your employer?
  • Will your role at work change after your baby is born?

Antenatal classes:

  • Ask your midwife or doctor about antenatal education available in your area.
  • Consider going to classes together with your birthing partner – not only will you learn a lot about how to prepare for labour, you’ll meet people who will share their experience of becoming parents.

Your pregnancy journey

Follow your pregnancy week-by-week to find out how your baby is growing and what is happening to your body.

Sources:
NSW Health (Having a baby), Royal Women's Hospital (Pregnancy and birth), Raising Children Network (Pregnancy week-by-week), Women's and Children's Health Network (The first 3 months of pregnancy: the first trimester), Queensland Health (How much weight will I gain during pregnancy?), Healthy WA (Emotional health for parents during pregnancy and after the birth)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: May 2021


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Related pages

  • Pregnancy week-by-week
  • Third trimester
  • First trimester

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