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Second trimester of pregnancy

The second trimester of pregnancy – what to expect

The second trimester of pregnancy is the period from week 13 to week 28 and is the middle three months of your pregnancy. Often this is the trimester where you might tell friends and family that you are pregnant, as well as your employers. During this trimester, you should start to feel better from any of those early pregnancy symptoms like nausea and vomiting. Your energy levels should also improve and you should start showing a little bump. You will also have had your date scan at around 12 weeks, so will know when your baby is expected and have the reassurance of a viable pregnancy. The fetus will continue to grow and develop throughout these few months, taking on more features of a newborn.

Changes to your body

You will notice several changes to your body during the second trimester. Your uterus will grow and a bump will become visible. By around 20 weeks, it should reach the height of your belly button. You should also start to feel movements of your baby between 16 and 24 weeks and get used to their normal pattern of movement. In this trimester, it’s possible you might experience the following symptoms:

  • Constipation – high level so progesterone can lead to constipation and bloating. Make sure you are drinking plenty of water and eating a fibre rich diet. Being physically active will also help.

  • Heart burn – this can begin from the first trimester. Pregnancy hormones relax the valve between your stomach and your oesophagus allowing acid to reflux up the oesophagus. Avoiding heavy meals and food triggers such as spicy foods can help. Gaviscon can help to ease symptoms and if severe, a medication called Omeprazole may be prescribed.

  • Increased urination – hormonal changes can increase the frequency of urination and your growing uterus may also press on your bladder. Look of for any other changes that could indicate a urine tract infection, such as a change in smell or pain on passing urine. Urinary tract infections are common in pregnancy -please speak to your midwife of GP if you have concerns.

  • Increased appetite – you do not however need to eat for two. Try to eat three balanced meals a day with healthy snacks such as fruit or nuts in between.

  • Ligament pain – you may experience some pelvic pain as the pelvis and pelvic ligaments stretch to accommodate your growing uterus.

  • Bleeding gums – pregnant women are more prone to gingivitis or gum inflammation. Make sure you check in with your dentist or hygienist.

  • Weight gain – this is completely normal as your pregnancy progresses.

  • Back pain – carrying the extra wait can sometimes lead to musculoskeletal pain. Speak to your GP or midwife and ask for a physiotherapy referral if this is becoming problematic.

  •  Skin pigmentation or Melasma – this can occur due to hormonal changes but should reduce after pregnancy.

  • Varicose veins – the pregnancy can lead to increased pressure in the venous system and you may get varicose veins on the legs and sometimes on the vulva.

  • Haemorrhoids – swollen veins in the anus and rectum are a common feature in pregnancy and can lead to anal pain and bleeding. Avoid straining by keeping stools soft through drinking plenty of water and a high fibre diet. Ice packs and pads may also relieve symptoms.

  • A white coloured vaginal discharge – this is a normal response to hormonal changes. However, if you are concerned that your discharge is abnormal, has an odour, or is associated with symptoms such as vaginal/vulval itch or soreness then it could be a sign of an infection and you should speak to your midwife or GP. 

Do’s and don’ts in the Second Trimester

There are some important lifestyle considerations when you find out your pregnant, and healthy living is an absolute priority.

  • Smoking and alcohol consumption are not advised in pregnancy and caffeine should be limited to 200mg a day.

  • You can exercise as normal, but avoid contact sports or activities that could easily result in injury such as horse riding. During the second and third trimester, it is also advised to avoid exercise and activities where you are lying on your back for prolonged periods of times.

  • Aim to eat a well-balanced diet, rich in fibre and fruits and vegetables. There are some foods you need to stay clear of pregnancy – see our blog here (insert hyperlink). You do not need to eat for two!

  • It is advised that continue taking Vitamin D in the second trimester but Folic acid can be stopped by week 12.

  • To help keep your gums healthy, make sure your brush and floss regularly and book in with a dentist for a review.

  •  It is safe to continue to be sexually active, sexual intercourse does not harm the baby unless you have specific circumstances whereby you midwife or GP has advised caution.

  • Saunas, hot tubs and long hot baths or showers should be avoided as pregnant women are more prone to overheating and fainting. 


Whooping cough

Expectant mothers can protect their babies from birth by having the whooping cough vaccination whilst pregnant. The best time to get vaccinated is between weeks 16 and 32 of your pregnancy.



Pregnant women are at higher risk of developing complications from the flu virus, and it is therefore advised that they have the seasonal flu vaccine.


COVID-19 vaccine

It is strongly recommended to get vaccinated against COVID-19 if you are pregnant. Vaccination creates antibodies against the virus that can also help protect your unborn child. You can be vaccinated at any stage of your pregnancy. Pregnant women are more at risk of getting serious complications from COVID-19. There is no evidence that the vaccine is unsafe for the pregnancy.

Your baby

By the end of the second trimester, your baby should weigh 2-3 pounds. The fetus can move freely in the amniotic sack and you should be able to feel your baby’s movements and get familiar with their normal pattern. Movements can be felt from 19 weeks. The baby’s organs will continue to develop and their nervous system will form. Their digestive system will start to function and the baby will produce urine, which becomes amniotic fluid. Their eyes will move to the midline and may even start to open and their facial features will begin to look more like a newborn. Your baby will start to hear sounds from around the 18th week, and will be able to hear your heart beat. As the weeks progress, they will start to recognise your voice and speaking to your baby is encouraged. This is also the trimester where the baby’s sex can become clear on an ultrasound scan where the sonographer will be able to look at their sex organs and tell you if it’s a boy or a girl (if you want to know!).

Your care



For an uncomplicated pregnancy, you will be offered 2 ultrasound scans – one around weeks 11-14 (dating scan) and one weeks 18-21. The later scan is sometimes called the “anomaly scan” and is a detailed scan to check the baby is developing correctly and there are no concerns. Further scans may be booked should anything need to be monitored.




Your midwife or doctor will normally see you at weeks 14-16, 25 and 28. During each appointment, your midwife will:

  • Check your physical and mental health and wellbeing

  • Review any results or tests arranged

  • Check observations such as blood pressure and urine for infection and protein.

  •  Measure your bump to monitor fetal growth and may also listen in to baby with an ultrasound doppler.

  • Check that your baby’s movements feel normal to you.

  • At 28 weeks, you will also be given your first anti-D injection if you are Resus negative.

  •  If you have any risk factors for gestational diabetes, you will be offered a screening test to look for it called the Oral Glucose Tolerance Test (OGTT). This will occur between weeks 24-28. 

Dr Anna Cantlay

Dr Anna Cantlay - GP and Chief Medical Officer at For The Creators

Dr Anna Cantlay is an experienced NHS and private GP based in London.

Anna’s priority and passion is making healthcare convenient, accessible and personalised to you and your family. Anna is passionate about Womens Healthcare and is a Menopause specialist.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. For The Creators has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.

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