What to expect during your second trimester

A birth plan is a document that tells your health care provider what's important to you during labor and delivery. It is important to keep your plan flexible. You may have to adjust it if things change during delivery. Here are a few birth plan resources:

• UPMC: How to choose a birth plan
• UPMC Magee-Womens Hospital: A guide to your birth experience

Each labor and delivery is unique. Your health care provider considers you and your baby’s safety first. Talking to your health care provider, ob-gyn, or midwife throughout your pregnancy helps you develop trust and understanding. You will feel like an active partner in your baby's birth, even if something unexpected happens.

Your physical and emotional health continues to change as pregnancy progresses. These and other symptoms can appear during the second trimester: ¹

• You may develop a “baby bump” from the rapid growth that happens in the second trimester.
• A "pregnancy glow" could give you rosier cheeks from the higher blood volume that supplies nutrients to the fetus.
• Anxiety can stem from awaiting test results and thinking more about this major life change. Talk to your doctor if your anxiety is severe enough to make it difficult to sleep or enjoy your life.
• Heartburn may start earlier but increase in the second trimester as the uterus grows, puts pressure on the stomach, and pushes stomach acid up the esophagus. Hormones cause the esophagus muscles to relax more and let acid bubble up.
• An increased appetite will make you want to eat more to support your baby's growth. Talk to your health care provider about how many calories you need each day during your second trimester.
• Feeling fetal movement around 16 to 20 weeks resembles a flutter, like gas, or air bubbles bursting.
• You breasts will become larger as your body continues to grow and prepare for breastfeeding.
• Sore hips and an achy back can happen when hormones and weight gain throw off your balance. Your ligaments are also starting to relax to help your body stretch and widen your pelvis for birth. This can also reduce the stability of your joints and lead to pain.
• Stretch marks can show up as stripes on your belly, hips, or other areas as your skin stretches.
• Itchy skin can happen as your skin stretches and expands.
  
  

It’s important to be aware of your overall health throughout pregnancy. Here are some serious symptoms to be on the lookout for during the second trimester:

• A severe headache that doesn't go away or comes with blurred vision, nausea, and swelling of the face and hands. It could be a sign of pre-eclampsia.
• Difficulty breathing and having chest pain after eating or getting an insect bite can be dangerous.
• A fast-beating heart or chest pain caused by your blood supply increasing can strain your heart and cause heart palpitations (serious complications can cause chest pain).
• A fever above 100.4 could be a sign of an infection that could be dangerous to you and your baby.
• Pain when urinating could mean you have a urinary tract infection.
• Severe stomach pain could be contractions and preterm labor.
• Swelling, redness, and warmth in one leg that occur together could be signs of a blood clot.
• Thoughts of harming yourself can happen if you have depression in pregnancy.
• Vaginal bleeding could signal an issue with the placenta.

A Lamaze class is one of the many childbirth classes you can take during your pregnancy. Lamaze classes focus on coping strategies, breathing techniques, and other ways to keep yourself comfortable while giving birth.    Most women take this class during their third trimester. It is a good idea to start thinking about it in your second trimester. You can research classes at UPMC and find the one that is right for you.

It’s all about preference. There are classes about caring for your baby, yoga classes to keep your mind and body at peace throughout pregnancy, classes to prepare you for childbirth, and more. Your health care provider, ob-gyn, or midwife should be able to give you information about classes that fit your needs.

Some health plans may require you to pay for these classes, then reimburse you for them. Our maternity care managers can discuss which classes are available for reimbursement and help you submit the proper form.

• View a list of available classes
• Download a reimbursement form

Prenatal visits during the second trimester will be similar to first-trimester visits, but you will have them more often—every four weeks². Your doctor may see you more often than that if you have a health problem or high-risk pregnancy.

During these visits, your health care provider will:

• Check your weight and blood pressure, and do urine tests to check for health issues.
• Share information about pregnancy and birth.
• Start measuring your fundal height around week 24 to help track fetal growth.
• Provide a 20-week anatomy scan ultrasound to evaluate your baby's organs, size, and movement and measure the amniotic fluid level.
• Recommend tests, such as a quad screen blood test or an amniocentesis, to check for congenital disabilities.
• Give you an oral glucose screening test to confirm or rule out gestational diabetes.