Pregnancy is measured in trimesters from the first day of your last menstrual period (LMP), totaling 40 weeks. Your second trimester begins at week 14 and ends at week 26. During this trimester, many women begin to "look pregnant."

• Normal Changes During Pregnancy
• Prenatal Visits
• Second Trimester Checklist
• Choosing a Health Care Provider for your Baby

Normal Changes During Pregnancy

The fetus is growing rapidly. At the beginning of the second trimester, the fetus is about six inches long. By the end of month six, the fetus resembles a small infant, except for its reddish, wrinkled skin. It will be 12 inches long at the end of the second trimester.

You may feel the baby moving (sometimes called "quickening") in month five. This may not be more then an infrequent fluttering feeling until month six. The fetus is protected by the amniotic sac and floating in amniotic fluid. There is still a lot of room for the baby to move.

You may notice that you have more energy. You will begin to gain weight this trimester. You should expect to gain about 25 to 35 pounds if you were an average weight before the end of the pregnancy.

Your circulatory system expands rapidly during the second trimester. By the end of your pregnancy you will have gained up to four pounds in increased blood volume, and an additional three pounds in fluid volume. It is important to stand and move around more frequently in order to improve your circulation.

Mild exercise, such as walking, will improve your general health, as well as help prevent problems. Drink plenty of fluids. Your feet may swell later in the pregnancy. Try to put your feet up frequently and get extra rest.

You may notice changes in your skin. You may look flushed, as if you are blushing, or you may develop brownish markings (sometimes called "the mask of pregnancy" or chloasma) on your face. Some women get a dark line down the middle of their abdomen (linea negra) from navel to pubic hair. You may also notice "stretch marks" (striae gravidarum) appearing on your abdomen, thighs or breasts. These changes are usually caused by increasing hormone levels, and will go away or fade dramatically after the baby is born. Wear sunscreen and a hat while outdoors.

Varicose veins, or veins that appear enlarged or close to the skin, especially in the legs, may appear in pregnancy. Get exercise (walking is great!), and don't stand for long periods without moving. Try to prop your legs up when you sit.

Exercise is an important part of a healthy pregnancy. It will help minimize many pregnancy-related problems, such as excess weight gain, varicose veins, problems sleeping and constipation. Exercise will also prepare you for delivery and ensure a faster post-partum recovery.

Your breasts may begin to secrete a yellowish fluid called colostrum. Breasts require no special preparation for breastfeeding.
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Prenatal Visits

You will be seeing your family practice physician, nurse practitioner, certified nurse midwife or obstetrician at weeks 16, 20, 24 and 28 (every 4 weeks). A detailed ultrasound will be performed in our clinic Radiology Department during your 4th or 5th month. This will evaluate the placenta, fetal size and fetal anatomy. See prenatal testing for more information about tests this trimester.
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Second Trimester Checklist

• Review the California Department of Health Expanded Alpha-Fetoprotein (AFP) Screening Program booklet (.pdf) for possible blood screening for birth defects.
  
  
• Blood tests are drawn: CBC (complete blood count) and an antibody screen
  
  
• Receive a Rh immune globulin injection if advised by your health care provider.
  
  
• Schedule an ultrasound with the Radiology Department.
  
  
• Receive the GTT (glucose tolerance test). All pregnant mothers receive routine screening for gestational diabetes between 24 and 28 weeks. See prenatal tests for more information about tests this trimester.
  
  
• Enroll in prenatal classes.
  
  
• Complete hospital pre-admission papers.
  
  
• Review your health care coverage.

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Choosing a Health Care Provider for your Baby

The second trimester is a good time to choose the person who will provide health care to you newborn. Both family medicine physicians and pediatricians are qualified to care for your newborn at the hospital after delivery, and provide care as your child grows. PAMF has a large active group of health care providers who are well-qualified to care for your growing family.
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