The second trimester is, for many women, the easiest three months of pregnancy. It is called the honeymoon period of pregnancy. As one enters the second trimester of pregnancy, the morning sickness and fatigue should be fading, leaving one feeling more energetic and like their old self again. During the second trimester, your baby is growing quickly.

Changes in Your Body

1. Frequent Urination: The uterus will rise away from the pelvic cavity during the second trimester, giving a brief break from having to keep going to the bathroom

2. Quickening: By the midpoint of pregnancy (20-22 weeks) one will probably have started to feel the first delicate flutters of movement in their abdomen, which is often called
“quickening.” If you aren’t feeling your baby move yet, don’t worry. Some women don’t experience quickening until their sixth month of pregnancy.

3. Skin changes: Pregnant women often look as though they are “glowing” because changing hormone levels make the skin on the face appear flushed. An increase in the pigment melanin can also lead to brown marks on the face (often called the “mask of pregnancy”) and a dark line (linea nigra) down the middle of the abdomen. All of these skin changes should fade after the baby is born. You may also notice thin, reddish-purple lines on your abdomen, breasts, or thighs. These stretch marks emerge as your skin expands to accommodate your growing baby.

Although many creams and lotions claim to prevent or eliminate stretch marks, there is little evidence that they actually do. Using a moisturizer can help soften your skin and reduce itchiness. Most stretch marks should fade on their own after you deliver.

4. Discharge : It’s normal to see a thin, milky white vaginal discharge (called leukorrhea) early in your pregnancy. You can wear a panty liner if it makes you feel more comfortable. If the discharge is foul-smelling, green or yellow, bloody, or if there’s a lot of clear discharge, consult your doctor.

5. Breast enlargement: Much of the breast tenderness you experienced during the first trimester should be wearing off, but your breasts are still growing as they prepare to feed your baby. Going up a bra size (or more) and wearing a good support bra can make you feel more comfortable.

6. Weight gain: Morning sickness usually diminishes by the end of the first trimester. After that, your appetite should return, and will probably grow. But be aware of how much you’re eating as one needs about an extra 300 to 500 calories a day during the second trimester, and you should be gaining about less than half kilogram per week.

Important tests to be done in the second trimester of pregnancy

1. Ultrasound: A second-trimester morphology ultrasound is performed trans-abdominally usually between 18 and 20 weeks gestation. This ultrasound will check baby’s anatomy or structure, measurements of the baby, it’s heart rate and rhythm, position of the placenta and amount of amniotic fluid around your baby. Sometimes a tran-svaginal ultrasound is also needed to check for a low lying placenta, length of the cervix or there may be another indication to have this type of scan. Routine ultrasound is one of the best methods we have of checking your baby and helping detect if you are at increased risk of certain pregnancy complications. A normal ultrasound is reassuring for parents and doctors, but it is not perfect.

2. Glucose screening: Typically done at 22 to 24 weeks, this is a screening test for gestational diabetes, which can result in overly large babies, difficult deliveries, and health problems for you and your baby. This test measures your blood sugar level two hours after you’ve had 75 grams glucose.

Vaccinations during second trimester

1. Tetanus Toxoid (TT) is given in the 2nd trimester of pregnancy, followed by the second dose of TT after 4 weeks. Tdap (Tetanus diphtheria acellular pertussis) may be given in place of 2nd dose of TT. It’s safe and will help protect your baby against whooping cough in the early months of life when he or she is most vulnerable

2. Influenza vaccination: It is recommended for mothers from 26 weeks onwards. In case of a pandemic the influenza vaccine can be given earlier to protect the mother. The inactivated influenza vaccine (as opposed to live attenuated vaccine) is recommended in pregnancy. This offers protection to the mother ( pregnant women are at a higher risk of lung failure) and to the newborn for the rest 6 months of life.

Nutrition and supplements

1. Diet: It is actually a myth that you need to “eat for two” during pregnancy. You do need extra calories, but a gradual increase in calories as your baby develops. Daily calories should be around 2,200-2,500 calories/day for a normal weight person. These extra calories should come from nutritious foods, such as lean meats, low-fat dairy products, fruits, vegetables, whole grains & lean meats.

2. Iron Folic acid (IFA): IFA supplementation (100 mg elemental iron and 500 mcg of folic acid) is provided every day for at least 100 days, starting after the first trimester, at 14–16 weeks of gestation followed by the same dose for 100 days in post-partum period. IFA tablets should be taken preferably two hours after a meal

3. Calcium supplementation: Oral swallowable calcium tablets should be taken twice a day (total 1g calcium/day) starting from 14 weeks of pregnancy up to six months post-partum. Calcium tablets should not be taken empty stomach since it causes gastritis and should not be taken together with Iron Folic Acid (IFA) since calcium inhibits iron absorption.