What to Expect in the Second Trimester

Somewhere around the start of the fourth month, a lot of people notice they can get through an afternoon without needing to lie down. The queasiness that shaped the early weeks often fades, the bump starts to show, and the pregnancy begins to feel real in a new way. This middle stretch, the second trimester, is often described as the most comfortable part of pregnancy. Often, though not always: some people feel wonderful, others carry on feeling sick or tired, and both experiences are common.

What follows is a general picture. Your midwife, obstetrician or doctor knows your history and is the right person to ask about anything specific to you.

When the second trimester starts and ends

It is usually counted from about week 13 or 14 until the end of week 27, though different services draw the lines slightly differently. Weeks are counted from the first day of the last period, not from conception, which is why dates can seem a little off at first.

Changes in your body

The womb grows up out of the pelvis during these weeks, and many of the changes follow from that. Commonly reported ones include:

• A visible bump, sooner in a second or later pregnancy than in a first.
• More energy for many, as early tiredness eases.
• Sharp twinges low on either side of the belly when standing up or turning, often from the ligaments that support the womb stretching.
• Heartburn and indigestion, especially after large meals or when lying down.
• A blocked nose or nosebleeds, linked to the extra blood flow of pregnancy.
• Skin changes such as a dark line down the belly, darker patches on the face, or stretch marks.
• Backache as posture shifts to carry the weight forward.
• Leg cramps, often at night.
• Tightenings of the belly that come and go, sometimes called practice contractions.

Most of these are a nuisance rather than a worry. If something is painful, persistent or simply does not feel right, it is always reasonable to check.

A word on remedies

Heartburn, colds and aches tempt everyone towards the medicine cupboard. Not every product that is fine outside pregnancy is suitable during it, so ask a pharmacist or midwife before taking anything new, even something you have used for years. Our guide to choosing and using over-the-counter medicines explains how to read the labels and what to ask at the counter.

Feeling the baby move

First movements are often described as flutters, bubbles or a gentle tapping, and they can be easy to mistake for digestion. People who have been pregnant before tend to recognise them earlier. Some first-time parents feel nothing definite until close to the end of this trimester, and that can still be within the usual range. Over the following weeks the movements become stronger and more regular, and you will gradually learn your baby's own pattern.

Once a pattern has settled, a change in it matters. If movements slow down, stop or feel different, contact your maternity unit straight away rather than waiting until the next day.

Appointments and checks

Care during these months is usually a mix of routine checks and a few specific tests. Exactly what is offered and when depends on where you live and your own health, but a typical pattern looks like this:

Check	What it involves	Why it is offered
Routine antenatal visits	Blood pressure, urine test, questions about how you feel; later, measuring the bump	Spotting changes early, for you and the baby
Mid-pregnancy scan	A detailed ultrasound, often around the middle of the trimester	Looking at the baby's development and the placenta
Screening blood tests	Depends on local programmes and earlier results	Some conditions are screened for at this stage
Blood sugar test	Offered to some or all, often towards the end of the trimester	Checking for diabetes that can start in pregnancy

Ask what each test is for and what happens with the result. You can always take time to decide about optional screening. If the scan offers the chance to learn the baby's sex, you can choose to find out or not.

Everyday life in the middle months

Sleep

Sleep can be easier than in the first weeks, then harder again as the bump grows. Many people find lying on one side with a pillow between the knees and another under the belly more comfortable. Ask your midwife about the position advice used where you live, as guidance on sleep position changes in later pregnancy.

Movement and work

Staying active, with walking, swimming or pregnancy-adapted classes, is usually encouraged unless you have been told otherwise. At work, this is often the time to tell an employer if you have not already, and to ask about adjustments such as more breaks or a change from heavy lifting.

Getting ready

With more energy, many people start thinking about the practical side: antenatal classes, a place for the baby to sleep, and the first few things to buy. Our checklist of newborn essentials for the first six weeks keeps the shopping list sensible. There is no need to have everything sorted by the end of these months.

Feelings

A growing bump makes the pregnancy visible to everyone, and the comments that follow are not always welcome. Worry, excitement and impatience can all show up in the same week. Some people find writing things down helps them notice how they really feel; our piece on keeping a pregnancy journal has ideas for getting started. If low mood or anxiety is affecting daily life, mention it at your next appointment, or sooner if it feels urgent.

Signs that need a prompt call

Contact your midwife, maternity unit or doctor without delay if you notice:

• bleeding from the vagina, or a sudden gush or steady trickle of fluid;
• regular, painful tightenings or period-like cramps;
• severe or constant pain in the belly;
• a severe headache, problems with vision, or sudden swelling of the face, hands or feet;
• a fever, or burning when passing urine;
• persistent itching, especially of the hands and feet;
• fewer movements, or a change in the usual pattern, once movements are established.

For heavy bleeding, collapse or anything that feels like an emergency, call your local emergency number.

Looking back, looking ahead

If the early weeks were hard, it can help to compare: our overview of what to expect in the first trimester covers the changes that come before these months. After week 27 the third trimester begins, with its own set of preparations, but the middle months are a good moment to rest when you can and enjoy the bump while it is still easy to carry.