What changes occur during the second trimester of pregnancy?

Twenty weeks is the mid-point of the pregnancy:

• The uterus is growing into the abdomen, the fetus is active, and the woman can feel the fetal movement.
• The fetus is beginning to perform activities to refine and develop organ systems function in preparation for birth.
• The growing fetus also brings some discomforts. Some women experience indigestion and heartburn as the enlarged uterus puts pressure of the digestive system.
• There also may be leg cramps or swelling of the lower legs or feet, especially after standing for prolonged periods of time. Many women find that these discomforts are worse at night, making it difficult to find a comfortable position for sleep.

At 25 weeks the woman experiences a number of changes:

• The increased blood flow results in tingling of the hand, varicose veins and snoring.
• The relaxation of the pelvic ligament may result in symphysis pubis dysfunction and a change in gait.
• The growing uterus puts pressure on the stomach and may lead to heartburn or indigestion.
• On the positive side, the influence of hormones makes the hair seem thicker and the nails stronger.

For many women, the second trimester brings about several welcome changes. Nausea tends to subside or disappear entirely and your breasts become less tender. You will probably have increased energy and appetite. Perhaps the most exciting thing is that most women begin to feel the baby move at about 18 to 22 weeks. These first sensations, referred to as quickening, often feel like little fluttery movements or gas. Quickening, combined with the visual sign of a growing belly, may help make the pregnancy seem more real.

As the baby grows, so will your belly. At 12 weeks, your uterus is at the level of your pubic bone. Around 20 weeks, the top of your uterus (the fundus) may reach your navel and by the end of the second trimester, it reaches even higher, so it is right under your ribs. Women have tremendously varied responses to the changing shapes of our bodies.

Women often feel ambivalent as a result of the value our culture places on being thin. Many women try to live up to this cultural ideal, even while pregnant, with negative consequences. Unfortunately, images of big, powerful birthing mothers are largely absent from our culture. Recently, popular media have celebrated pregnancy as sexy, but only for celebrities with otherwise "perfect" bodies. Imagine if we were surrounded by images that embraced our roundness instead. Try not to allow narrow cultural lenses to rob you of the right to feel happy and proud of your pregnant body.

During your second trimester of pregnancy, you can expect the following changes:

• Nausea, breast tenderness and fatigue tend to diminish.
• You may feel more energetic.
• At the same time, you will likely gain weight, which may affect self-esteem.
• Libido typically rises.
• Lubrication increases again.
• Blood flow to the pelvis increases further and or­gasms may be more intense.
• As your belly grows, some sexual positions may become more uncomfortable.

Most women find the second trimester (week 13 through week 28) of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months.

You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move!

As your body changes to make room for your growing baby, you may have:

• Body aches, such as back, abdomen, groin or thigh pain
• Stretch marks on your abdomen, breasts, thighs or buttocks
• Darkening of the skin around your nipples
• A line on the skin running from belly button to pubic hairline
• Patches of darker skin, usually over the cheeks, forehead, nose or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy.
• Numb or tingling hands, called carpal tunnel syndrome
• Itching on the abdomen, palms and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.)
• Swelling of the ankles, fingers and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)

This answer is based on source information from the National Women's Health Information Center.

Most women's morning sickness goes away around week 13. This results in a renewed sense of energy for most women. Here’s a list of other changes you might expect throughout the second trimester of your pregnancy:

• Increased libido – increased levels of progesterone and estrogen in the body can make breasts, nipples and vagina more sensitive
• Change/increase in appetite – with possible cravings for sugary foods
• Weight gain – a pound every week or two from week 20 until the end of your pregnancy
• Heartburn
• Change in center of gravity
• Leg issues – cramping, swelling, spider veins, varicose veins, restless leg
• Vivid dreams
• Darkening skin (chloasma) – particularly around the upper lip, forehead, cheeks, nipples, inner thighs and along the line that runs from your naval to your pubic bone
• Lumpy breasts
• “Quickening” – the baby’s movement (starting around week 20)
• Extra oil – may develop acne or other related skin problems
• Braxton Hicks contractions – "practice" contractions that your uterus makes weeks before you are actually ready to deliver. (These "false" contractions are normal and are not dangerous.)
• Stretch marks – on the abdomen, rear or thighs (may not go away after you give birth)
• Water retention
• Edema/slow blood circulation
• Thicker/shinier hair – due to fluctuating hormone levels