By the beginning of the second trimester of pregnancy, the organs and systems of the fetus are already formed and a period of active growth lies ahead. What is happening at this time in the body of the expectant mother, how is the baby developing and how to behave so that the pregnancy proceeds without problems?
The second trimester is the period from 13 to 28 weeks of pregnancy. The period of 13 weeks is considered the boundary between trimesters because by this time the complex processes of formation of the main organs and systems of the fetus are completed, which takes on the appearance of a small person and begins to grow and develop rapidly. The second trimester ends at 28 weeks, since at this time the fetus reaches such a stage of development that, with appropriate care, it is capable of life outside the womb. The average weight of a baby born at 28 weeks is 1000 g, height - 35 cm. Recall that the gestational age is calculated in obstetric months, each of which includes exactly 4 weeks, so pregnancy lasts 10 obstetric months, or 40 weeks, which corresponds to 9 calendar months.
This period is a fairly calm time for a pregnant woman, because such early troubles as toxicosis, sudden mood swings, etc. have already passed, and childbirth is still far away. It is in the second trimester that the expectant mother has the opportunity to fully enjoy her “interesting situation.” However, be careful - during this period it is possible.
2. How does the baby develop?
4th month. By the 13th week of pregnancy, the fetus is actively developing muscles and ligaments, as well as 20 baby teeth. The baby is actively moving in the uterus, but so far, at 13 to 16 weeks, the expectant mother does not feel this “internal movement.”
The first hairs begin to grow on the head of the fetus, and its entire body is covered with vellus hairs called lanugo. Usually, by the time of full-term pregnancy, lanugo disappears completely or remains in small quantities on the shoulders and ears. The skin of the fetus during this period is still very thin, blood vessels are visible through it, which gives it a bright red color, and subcutaneous fat is practically absent, so the baby’s skin is wrinkled.
During this period, the fetus is already able to empty the bladder: approximately every 45 minutes it urinates into the amniotic fluid, making its “contribution” to its formation.
By the end of the 16th week of pregnancy, the fetus reaches a height of 15-16 cm, a weight of 135 g and, floating freely in the amniotic fluid, can easily change position in the uterus.
5th month. By 17-20 weeks, the uterus reaches such a size that pregnancy becomes obvious to others, because at 20 weeks the fundus of the uterus is already 2 cm above the navel.
In the fifth month of pregnancy, the fetus has already formed the rudiments of permanent teeth, which are located above the milk teeth. The baby appears eyelashes and eyebrows, which are still colorless, since melanin, the pigment that gives them color, will begin to be synthesized later. The fingers and toes are fully formed, and an individual pattern appears on them - fingerprints. The sebaceous glands of the skin begin to work, and a whitish lubricant is formed from vellus hair and epithelial cells of the skin, which obstetricians call cheese-like for its characteristic appearance. At this stage, it covers the entire body of the fetus and performs a protective function, since the baby is in the aquatic environment for quite a long time before birth.
The muscles of the fetus' body reach such a degree of development that its movements become orderly and controlled: it can suck a finger, touch its body and face. The child is already showing movements of the facial muscles - he frowns, opens and closes his mouth, opens his eyes, but does not see yet.
In the fifth month of pregnancy, the baby’s intestines are already sufficiently formed; they contain villi through which nutrients are absorbed. The pancreas secretes insulin, a hormone that promotes the processing and absorption of glucose. When amniotic fluid is swallowed, which occurs normally, the process of formation of original feces - meconium - occurs in the child’s intestines; it goes away after birth.
By the end of the 20th week of pregnancy, the fetus's height is 20-21 cm, and its weight is 300-350 g. The baby has already grown so much that the doctor can listen to its heartbeat through the anterior abdominal wall with an obstetric stethoscope. If the expectant mother has a pronounced subcutaneous fat layer, then the baby’s heartbeat can be heard from a later date - from 22-24 weeks. The normal heart rate of the fetus is 120-160 beats per minute, that is, one beat of the mother’s heart corresponds to two beats of the baby’s heart.
6th month. At 21-24 weeks, the rapid growth and development of the fetus continues, movements become more and more active. He develops his own regime of alternating periods of rest and activity, which does not always coincide with the mother’s regime. The intensity of fetal movements is an excellent marker that allows a woman to monitor the intrauterine state of the baby, since changes in the nature of movements (excessively violent or, on the contrary, sluggish and infrequent movements) may indicate any problems during pregnancy.
By the end of the sixth month, the baby's growth slows down somewhat, but active weight gain begins. Brown fat, which has a high energy capacity, actively accumulates under the skin of the fetus, since its combustion produces a large amount of thermal energy, which plays an important role in maintaining a constant body temperature after the birth of the child.
During the second trimester of pregnancy, the fetal brain intensively develops, nerve cells - neurons - improve, and the degree of development of the central nervous system is such that the baby hears sounds coming from outside. Too loud and sharp sounds can frighten the baby, and soft, gentle music sometimes has a calming effect on him.
The fetus's way of understanding the world is through touch: it touches the umbilical cord, its arms and legs, and the walls of the uterus. While in the womb, the child may hiccup: at this time, the woman feels small internal tremors that occur at regular intervals. Baby hiccups are not a sign of pathology and are observed during the normal course of pregnancy.
At the sixth month, the child’s bone marrow is already functioning: it produces erythrocytes - red blood cells containing fetal hemoglobin, which is capable of saturating the cells with oxygen to a greater extent in comparison with ordinary hemoglobin, which is produced in the human body after birth. This adaptive mechanism creates reliable protection against hypoxia - insufficient oxygen supply under the influence of various unfavorable environmental factors and pregnancy complications. Before the bone marrow began to work, the synthesis of blood cells was carried out in the liver and spleen. The bone marrow also produces white blood cells—leukocytes—responsible for fighting infection.
By the 24th week of pregnancy, the internal organs of the fetus are sufficiently formed, but the lungs remain significantly immature, in which the synthesis of surfactant has already begun - a substance that does not allow them to collapse on exhalation. However, its quantity is not yet sufficient for the full functioning of the lungs in cases of premature birth of a child, so in this case he will not be able to breathe on his own - he will need artificial ventilation, intensive care and the administration of a medicine containing a synthesized surfactant. At this stage, the baby’s breathing occurs through the placenta, in which gas exchange occurs between the body of the mother and the fetus. While in the womb, the baby begins to make the first breathing movements; this does not mean that he is breathing - such movements are necessary for complete blood supply to the chest organs and the development of the respiratory muscles.
At the end of the second trimester of pregnancy, the fetus reaches an average weight of 900 g and a height of 34 cm.
The same processes, but with some features, will occur.
3. What happens to the expectant mother?
From the beginning of the second trimester, the expectant mother’s well-being improves significantly. The troubles of early toxicosis recede: as a rule, by the 14-16th week of pregnancy, nausea, vomiting, and the general weakness associated with them are a thing of the past, as the processes of rapid hormonal changes characteristic of the beginning of pregnancy are stabilized and the placenta begins to function. But, it's possible.
In the second trimester, the expectant mother’s body experiences an intensive increase in circulating blood volume (CBV): by the end of pregnancy, there is 1500 ml more blood in the body than at the beginning. This is necessary for the full functioning of the so-called “third circle of blood circulation” - the uteroplacental one, which forms during the progression of pregnancy.
The increase in circulating blood volume is an important adaptive mechanism. Firstly, it provides intensive blood supply to the placenta and the developing fetus, and secondly, it prepares the pregnant woman’s body for the upcoming blood loss during childbirth, which is inevitable after the placenta is separated. It has been established that the greatest increase in blood volume is observed precisely in the second trimester, therefore during this period the load on the cardiovascular system increases, which needs to “pump” a larger volume of blood. The pulse rate increases (the norm for pregnant women is 80-90 beats per minute), slightly, by about 10-15 mm Hg. Art., blood pressure rises.
After one week of pregnancy, the fundus of the uterus begins to rise higher and higher, and therefore the tummy begins to protrude forward and becomes rounded, stretching the skin of the anterior abdominal wall. Due to the individual structure of the skin, it does not always have time to adapt to the rapid stretching of the growing uterus, which leads to the formation of stretch marks - stretch marks. During pregnancy, they are red or even purple in color due to translucent blood vessels, but over time they fade and become less noticeable.
Undoubtedly, the most memorable and exciting moment of the second trimester is the appearance of fetal movements felt by the expectant mother: pregnant women clearly feel how a new life is growing and developing inside. Many mothers look forward to this unforgettable moment, listening to their feelings for a long time. Women describe the first movements of the fetus as “the swimming of a fish”, “the fluttering of a butterfly”. Sometimes expectant mothers experience sensations similar to active intestinal motility. As pregnancy progresses, fetal movements become more obvious and distinct, and it becomes impossible to confuse them with anything else. Since women who are carrying a baby more than once are well familiar with these sensations, they begin to feel them 2-3 weeks earlier than those expecting their first baby. As a rule, primiparous women first feel fetal movements at 20 weeks, multiparous women at 18 weeks. Also, a little earlier (at 17-18 weeks), first-time mothers with an asthenic build, with unexpressed subcutaneous fat, can feel the baby’s movements for the first time.
Towards the end of the second trimester, many pregnant women notice the appearance of yellowish discharge from the nipples, which often causes concern. There is nothing wrong with this - this is how colostrum is released. You should not squeeze it out of the mammary glands, since mechanical stimulation of the nipples provokes an increase in the tone of the uterus.
In the second half of pregnancy, in response to fetal movements, the uterus may become toned for a short time: in this way, it begins to “train” before childbirth. If the uterus relaxes on its own, the duration of its tone is several seconds, and it is not accompanied by pain, then this phenomenon can be considered as a variant of the norm.
4. Possible problems.
At this stage of pregnancy, the uterus is growing rapidly. Therefore, typical complications of this period can be associated not only with pregnancy, but also with problems in the functioning of internal organs due to the large size of the uterus.
Threat of miscarriage. One of the most common complications of both the first and second trimester is the threat of termination of pregnancy. It is always a consequence of some kind of problem either on the mother’s side (somatic diseases, excessive mental or physical stress, the presence of an infectious process, etc.) or on the fetus’ side; this complication can be caused, for example, by placental insufficiency.
Manifestations of the threat of miscarriage are painful contractions of the uterus. They are felt as an aching, nagging pain, a periodically occurring feeling of “heaviness” in the lower abdomen lasting more than 2 minutes, with a frequency of more than 7 times a day. If these symptoms appear, you should contact your doctor as soon as possible for timely diagnosis and treatment. The time factor in the development of this complication is very important. Firstly, the earlier treatment is started, the more effective it will be: in this case, the woman will not experience significant dilatation of the cervix. Secondly, with increased tone of the uterus, the placental vessels are in a state of spasm - narrowing, which leads to a decrease in the supply of oxygen and vital nutrients to the fetus and becomes the direct cause of the development of oxygen starvation - fetal hypoxia, and with a long-term threat of miscarriage - even intrauterine delay. fetal growth. Treatment of threatened miscarriage includes eliminating the causative factor that caused this complication, eliminating all psycho-emotional and physical stress, as well as taking medications that reduce the tone of the uterus; these include GINIPRAL, magnesium preparations - MAGNESIA SULFULATE, MAGNE B6, MAGNEROT, antispasmodics.
Heartburn. The main hormone of pregnancy, progesterone, reduces the tone of the smooth muscles of the gastrointestinal tract, which manifests itself in the form of heartburn, which quite often overshadows the second half of pregnancy. Heartburn is an unpleasant burning sensation or, less commonly, a feeling of heaviness, fullness, or a lump behind the sternum, which is caused by reflux and irritation of the mucous membrane of the esophagus with acidic gastric contents as a result of relaxation of the esophageal sphincter - a muscular “lock” that does not allow stomach contents to be thrown back into the esophagus. In the vast majority of cases, this problem can be overcome by split meals - at least 5-6 times a day in small portions - and the exclusion of foods that provoke heartburn from the diet: their list is individual for each pregnant woman. Among medications, antacids are used - drugs that neutralize hydrochloric acid, which is produced by the cells of the gastric mucosa - GAVISCON, MAALOX, RENNY, etc.
Anemia. This complication is associated with a decrease in the level of hemoglobin and red blood cells - erythrocytes. As pregnancy progresses, iron reserves are actively consumed not only for the needs of the mother, but also for the full development of the fetus. Therefore, in the presence of chronic diseases that prevent the absorption of iron or lead to its increased consumption: gastritis, gastric ulcers, liver diseases, hemorrhoids, as well as heavy menstruation or an unbalanced diet, which leads to pregnancy, anemia is one of the most common complications . This diagnosis is made when the hemoglobin level decreases below 0 g/l; in 90% of cases, anemia in pregnant women is iron deficiency. With anemia, the delivery of oxygen to cells and tissues deteriorates, which leads to a complicated course of pregnancy: the threat of miscarriage, placental insufficiency. Childbirth can be complicated by birth abnormalities and obstetric hemorrhages. To treat anemia in pregnant women, iron preparations are prescribed - SORBIFER, MALTOFER, FENULS, etc.
Convulsions. These unpleasant and often painful spastic muscle contractions most often occur in the area of the legs, but can also be observed in the area of the arms, neck, etc. Cramps appear in the second trimester of pregnancy, since it is during this period that intensive growth of the fetus occurs, and therefore occurs active consumption of calcium, magnesium, potassium. Due to the fact that the expectant mother’s body does not always have time to replenish the deficiency of these microelements, convulsions occur. Other possible reasons for their appearance are a decrease in blood sugar levels, which can be observed with an improper diet, as well as the presence of varicose veins of the lower extremities due to impaired blood outflow from the legs and the development of tissue hypoxia.
If a cramp occurs, you need to pull your leg with your foot towards you to ensure tension in the muscle, and then massage the spasmed muscle in the direction from the periphery to the center.
In case of periodic occurrence of seizures, it is necessary to conduct an additional examination in order to identify diseases that may be their cause. If serious causes of cramps are excluded, it is recommended to rest with elevated legs to improve blood flow, and take foot baths with sea salt to activate blood circulation. In such cases, multivitamin preparations with microelements are used; if necessary, in addition to multivitamins, calcium, potassium and magnesium preparations can be prescribed: CALCIUM D3 NYCOMED, MAGNE B6, MAGNELIS, PANANGIN, ASPARKAM.
Edema. In pregnant women, edema appears quite often; it is caused by the accumulation of fluid in the intercellular space and, as a result, an increase in tissue volume. Most often, they first appear on the legs, then on the arms, stomach, and face.
The reasons for the development of edema in expectant mothers are as follows:
- The pregnancy hormone progesterone promotes fluid retention in the body.
- The outflow of blood from the lower extremities is hampered due to compression of a large vessel - the inferior vena cava - by the pregnant uterus.
- Edema during pregnancy can be a symptom of serious kidney disease, the cardiovascular system, and a complication such as gestosis, in which, in addition to edema, protein appears in the urine and high blood pressure. If edema occurs, further examination is required to diagnose its possible causes. A slight fluid retention in pregnant women in the absence of underlying pathology does not pose a serious danger. In this case, to reduce swelling, the doctor will recommend wearing special tights with a compression effect to prevent the development of venous insufficiency of the lower extremities. To optimize kidney function, the doctor will prescribe renal herbal preparations, herbal medicines - CANEPHRON, PHYTOLYSIN. Treatment methods will depend on the specific situation, the severity of edema, as well as the presence of concomitant pathology.
5. How to behave?
In the second trimester, the expectant mother can fully enjoy her “interesting position”, since the troubles of the early stages of pregnancy have passed, and the tummy is not yet so large as to limit the woman’s activity to one degree or another. In this regard, you can gratefully accept the care and attention of your loved ones, but you should not give up moderate physical activity, household chores, and walks in the fresh air.
- If you are going to attend childbirth preparation courses or a school for a young mother, it’s time to take care of her choice: if you want to undergo thorough preparation, then you need to attend classes starting from 20-22 weeks or even earlier - this will depend on the type of courses chosen.
- Don’t forget about choosing the right clothes, since today there are a huge number of models for pregnant women. Clothes should not squeeze the stomach; the fabric should contain predominantly natural fibers. If you wish, you can choose clothing models that will be useful for the postpartum period. It is also important to choose the right underwear, which must be “breathable”, perform a good supporting function, but at the same time not squeeze the body and not make breathing difficult.
- The right choice of shoes is a matter of not only convenience, but also the safety of the expectant mother and baby, since due to the softening of the ligaments, the mobility of the joints, including the knees and ankles, increases, which increases the risk of twisting the leg or falling. You will have to forget about high heels and platform shoes for a while. The heel height should not exceed 4 cm; it’s time to replenish your wardrobe with ballet shoes or moccasins, which will serve you well during walks with your baby.
- Do not forget to regularly visit the antenatal clinic: in the second trimester you will have to do this more often than in the first - once every 2 weeks. This is dictated by the increasing load on a woman’s body, which necessitates more careful monitoring of the health of the expectant mother and fetus. Before each visit, it is necessary to take a general urine test - this fairly simple research method will help to timely diagnose such serious abnormalities as pyelonephritis, gestosis, and gestational diabetes. In the case of a normal pregnancy, blood tests are taken less frequently: in the second trimester, this study is carried out at 18-20 weeks. Of course, if indications arise: pregnancy complications, exacerbation or initial detection of any diseases, a blood test can be taken additionally and repeatedly.
In the second trimester, a triple screening test is carried out (screening means “sifting”, “selection”). This analysis allows us to determine the contingent of expectant mothers who need an in-depth examination in terms of identifying fetal malformations. The triple test involves examining three components, which include:
The optimal period for conducting a triple test is 16-18 weeks. It is worth remembering that the presence of deviations in the triple test results does not mean that the child will necessarily be born with congenital anomalies. Changing the analysis parameters is possible if there is a threat of miscarriage, gestosis, or intrauterine growth retardation. However, in order to be on the safe side, if there are deviations in the triple test, it is necessary to undergo additional research to clarify the condition of the fetus: for this, a consultation with a geneticist and an unscheduled ultrasound are prescribed. If there are indications and the patient’s consent, invasive diagnostic methods are used that are highly informative - sampling amniotic fluid (amniocentesis) or fetal umbilical cord blood (cordocentesis) to study the chromosomal set of fetal cells.
At 24-26 weeks, the doctor will prescribe a second scheduled ultrasound, which is performed on all expectant mothers, even in the case of a normal pregnancy. During an ultrasound, the size of the fetus will be measured to ensure that its size corresponds to the gestational age. The location and structure of the placenta, the structure of the internal organs of the fetus will also be studied in order to exclude developmental defects, and the sex of the baby will be accurately determined if its position in the uterus allows this.
Since during this period the fetus’s musculoskeletal system is actively developing, the expectant mother’s need for calcium increases. To prevent calcium deficiency in the body, on the recommendation of a doctor, take special medications - CALCIUM D3 NYCOMED, KALCEMIN. They can be prescribed in addition to multivitamin complexes. It is also necessary to consume foods rich in calcium: milk, cottage cheese, cheese, fish.
After the 24th week of pregnancy, it's time to think about buying a maternity bandage. This device will help to avoid many troubles, as it will relieve the growing load on the spine. The bandage also prevents the appearance of stretch marks on the abdomen, well supports the uterus in an optimal position, which reduces compression of the bladder and large vessels of the abdominal cavity. Due to the fact that there is now a large assortment of bandages on sale, the choice is a matter of your taste and body type.
At this stage, it can be easily felt through the abdominal wall. The height of the uterine fundus at the beginning of the 2nd trimester is approximately 13 cm (measured from the pubic symphysis to the highest point of the uterus), and by the 26th week it rises to 25-27 cm.
The volume of the abdomen increases gradually (by about 1 cm every week), and at the beginning of the second trimester it is 68-70 cm, and at the end - 78-82 cm.
Tests and medical examinations
During the second trimester, a woman visits her doctor once every three weeks. The day before, she takes urine and blood tests, based on which a specialist can judge the condition of the fetus.
At each examination, the doctor measures the woman's blood pressure. If the expectant mother has gained too many extra pounds and has high blood pressure, there is a risk of preeclampsia. This is a serious disorder, which is characterized by disruption of the urinary and cardiovascular systems, often manifested by edema and the presence of protein in the urine.
In addition, the doctor observing the woman enters the following indicators into the chart: weight, height of the uterine fundus, abdominal circumference. And starting from the 18-20th week, during the examination, the fetal heartbeat must be listened to using a stethoscope.
A vaginal examination is usually not performed during this period of pregnancy unless there are special indications.
Ultrasound
Ultrasound examinations in the second trimester are usually performed closer to the 20th week. Since all the organs of the fetus are practically formed, the doctor can judge the development of the heart, kidneys, brain, lungs, stomach, and gall bladder. Towards the end of this trimester, it becomes possible to assess whether the facial structures are correctly formed, and thus exclude developmental pathologies, for example, cheiloschisis (often called “cleft lip”) - a cleft of the upper or lower lip.
Screening
During the period from the 17th to the 19th week, a woman is prescribed second trimester screening. It includes an ultrasound and a biochemical blood test for hormones. Screening allows you to identify diseases such as Down syndrome, Edwards syndrome, Patau syndrome, neural tube defect, as well as anatomical pathologies of the fetus.
Quite often, if screening in the 1st trimester showed good results, only an ultrasound is done in the 2nd trimester, and biochemical analysis is not examined. However, in some cases, full screening is still recommended, for example, if the pregnant woman is over 35 years old, there were poor screening results in the 1st trimester, there is a long-term threat of miscarriage, and there have already been cases of children with chromosomal abnormalities being born in the family.
Starting from the 16th week, during an ultrasound, the doctor also evaluates the amount of amniotic fluid (amniotic fluid index).
What does a child look like?
During this trimester, the fetus develops very actively. The baby's weight at 14 weeks is 40 g, and his height reaches 10 cm; by the end of the trimester, these sizes will increase to 900 g and 36 cm, respectively.
Just imagine how much your baby will change in just over three months!
Here's what else happens to the fetus during this period:
muscles and ligaments are actively forming;
the rudiments of milk and permanent teeth are formed;
the first hairs appear on the head, and the body is gradually covered with vellus hairs called lanugo;
the baby begins to write, that is, his urinary system is already functioning and he is able to excrete urine directly into the amniotic fluid;
fingers and toes are fully formed;
The sebaceous glands begin to work, and gradually a vernix (cheese-like) lubricant is formed on the skin - a protective layer that protects the skin of the fetus until birth;
the child can suck fingers, touch his face, the umbilical cord;
meconium, the original feces, begins to form in the intestines, which normally leaves the child’s body on the first day;
the baby is actively moving, and by the 20th week, most mothers already feel slight tremors;
the fetus begins to hear sounds from the outside, later he can even react to them, depending on whether he likes them or not;
the lungs begin to produce surfactant, a substance that will prevent the walls of the alveoli from sticking together immediately after birth;
the fetus begins to hiccup, there is a version that this is how it trains the respiratory organs.
What happens in the 2nd trimester of pregnancy: sensations
The second trimester is considered the most favorable during the entire pregnancy. Usually at this moment toxicosis, which worries many women in the first months, subsides. The expectant mother seems to have new strength, she feels cheerful and tolerates pregnancy quite easily in the absence of pathology.
Stomach ache
Unpleasant sensations in the lower abdomen may occur after the 20th week of pregnancy. They are usually caused by the uterus enlarging and the round ligament that supports the uterus stretching. They do not last long and pass within 3-5 minutes.
Pain can also occur during physical activity or overexertion. In this case, it makes sense to change your lifestyle and exercise.
The cause of nagging pain may be uterine hypertonicity; women usually say: “The belly is like a stone.” In this case, the doctor will recommend resting more often, perhaps prescribing antispasmodic medications, as well as wearing a bandage.
An intestinal disorder can cause nagging pain in the abdominal area. Then you need to change your diet and carefully monitor the quality and quantity of food consumed.
Lower back pain
The belly of the expectant mother greatly increases in volume, which inevitably leads to a shift in the center of gravity. The spine receives additional stress, and when walking a woman involuntarily arches it. Towards the end of the second trimester, such pain may become more frequent. In any case, it is better to tell your doctor about this.
As a preventative measure, you should stop wearing high-heeled shoes and attend special sports classes for pregnant women.
Discharge
Vaginal discharge in the second trimester is normal, the only question is what quality it is. If the discharge is clear or whitish and odorless, then there is no need to worry.
It is necessary to consult a doctor if the discharge becomes yellow-purulent, green, has a cheesy consistency and has an unpleasant odor. This most often indicates an infection that must be treated before birth so as not to infect the baby. The second trimester in this sense is favorable in that a larger number of medications are approved for use, which means it will be easier to cope with the infection.
But any medications can only be used as prescribed by a doctor!
Nausea
Nausea, which regularly worries the expectant mother during the first trimester, usually goes away by 14-16 weeks. However, a little later, after the 20th week, heartburn may appear. This is due to the fact that under the influence of progesterone, the tone of the smooth muscles of the gastrointestinal tract decreases and the acidic contents of the stomach are thrown back into the esophagus. Coping with this problem is quite simple: just change your diet.
What you can and cannot do in the 2nd trimester of pregnancy
Since the second trimester is the most favorable period of pregnancy, you should enjoy it to the fullest. For example, now is the time to start attending any sports classes for expectant mothers (if there are no contraindications), pick up courses to prepare for childbirth, and make renovations (if you were planning to prepare the room for the baby).
Proper nutrition and diets
The issue of creating the right diet in the second trimester plays a special role - it is during this period that expectant mothers gain excess weight most quickly. Therefore, several important rules must be followed:
eat fractionally - often and a little at a time. 6-7 meals of 200-250 g each is an ideal approach to nutrition, which, among other things, will help get rid of heartburn;
To prevent anemia, you need to include boiled beef, apples, spinach, and buckwheat porridge in your diet. As for liver dishes, consult your doctor, since today offal in the diet of expectant mothers causes a lot of controversy among obstetricians and gynecologists, probably it’s all about their quality;
Try to eliminate salt from your diet as much as possible. Avoid all pickles, smoked meats, and sausages - they greatly retain water in the body and become one of the causes of edema, which is extremely undesirable throughout pregnancy;
Eat more vegetables and fruits, especially if you need a snack between meals.
replace “fast” carbohydrates with “slow” ones. Remove sweet pastries, white bread, candy, white rice, potatoes, and sweet juices. Include vegetables in your diet (cabbage, zucchini, cucumbers, lettuce, herbs, low-fat cottage cheese, bread).
Sex, in the absence of contraindications, is very beneficial for a woman’s physical and emotional health. Moreover, many expectant mothers say that it was during pregnancy that they experienced completely new and unusual sensations.
Contraindications
Of course, pregnancy is not a disease, but it is at least reasonable to follow reasonable rules during the period of bearing a baby. Therefore, here is what it is recommended to avoid:
smoking and alcohol;
active participation in repairs (wallpapering, painting walls, etc.);
strength training in the gym (crunches, push-ups, lifting dumbbells and squats with them, jumping, etc.);
lifting heavy objects (if possible, let other family members carry bags from the store);
long business trips, which are not only physically exhausting, but also emotionally exhausting;
any nervous stress negatively affects the health of the fetus;
tasty but unhealthy food (except for sauces and smoked meats, mushrooms and nuts are dangerous);
long flights for vacation. If you decide to go on vacation, choose direct routes that last no more than four hours;
It is harmful to sit for a long time with your legs crossed. If you work in an office, try to take a break every 40-60 minutes;
During the ARVI and flu season, avoid visiting crowded places.
The second trimester is the period from 14 to 26 weeks. The unpleasant sensations of early toxicosis have already disappeared, and my appetite has increased.
The formation of important organs and systems of the fetus has already occurred; in the second trimester they begin to grow and function rapidly, so you should continue to eat properly.
Read our articles on nutritionIn the firstAndthirdtrimester, as well as about the general principles of nutrition during pregnancy.
Basic Rules
The goal of rational nutrition in the second trimester is to supply the body with building materials, and since further normal growth of the fetus and the development of its organs requires more nutrients, the daily calorie content of food should increase by 300 Kcal.
In addition, the unborn baby requires more vitamins and minerals, therefore, their consumption by the mother should increase compared to the first 14 weeks.
In the second trimester, the brain actively develops, which requires magnesium, iodine, and phosphorus. The bone skeleton continues to form, which means you need more vitamin D.
The energy value of the daily diet in the second trimester of pregnancy is 2400-2800 kcal (2500 is enough for the average woman).
The mother's body's need for protein increases, up to 2g per kg of weight. The protein content should be 120-140 g, of which 60% is of animal origin, the fat content also increases to 85 g, and 80% should be of plant origin. But the amount of carbohydrates is reduced to 300 grams (upper limit).
Diet
Meals in the second trimester should be fractional, up to 5-6 times a day. The growing uterus puts pressure on both the stomach and intestines, and overeating or even eating the amount of food equal to “non-pregnant” food causes heartburn and disrupts intestinal motility, which leads to constipation.
In addition, frequent and small meals promote better absorption of nutrients. The last meal should be no later than 2 hours before bedtime.
Cooking
All dishes must be steamed or baked, but without crust. Cooking and stewing of foods is allowed. This culinary treatment allows you to preserve vitamins, which are very necessary for mother and baby in the second trimester.
In addition, fried foods increase the load on the liver and gallbladder, which are already working double duty.
Salt and liquid
The second trimester of pregnancy is a period in which gestosis of the second half often occurs. Therefore, it is worth giving up salty foods and limiting salt intake to 6 grams, maximum 10 grams per day. Salt retains fluid in the body, which leads to swelling.
The same goes for liquids. Fluid intake, including soups, should be no more than 1 liter per day. Drinking a lot of water increases the load on the kidneys, and they are already functioning in an enhanced mode.
Alcohol
Everyone knows about the dangers of alcohol, especially during pregnancy. In the second trimester, the brain, cardiovascular and other important systems actively develop, so drinking alcohol even in small quantities can lead to the birth of a disabled child. Beer “loads” the kidneys, and wine is not only allergenic, but also increases blood pressure.
Product distribution
It is advisable to consume protein foods (meat and fish) in the first half of the day, and lactic acid products and fiber in the second half. Protein foods stay longer in the digestive tract, so it should be given at the time of day when the intestines actively peristalt.
Vitamins in the second trimester
The second trimester of pregnancy is often accompanied by iron deficiency anemia, so the need for iron and vitamin C, which helps better absorption of iron, increases. It is necessary to give preference to foods rich in iron and ascorbic acid.
The same goes for calcium. In the second trimester, the fetal skeleton is actively formed, and if a woman does not want to lose a couple of teeth, she should pay attention to fermented milk products.
Iodine promotes the development of the thyroid gland in the fetus and is involved in the formation of the nervous system,
Potassium prevents miscarriage and improves the functioning of the cardiovascular system,
Sodium prevents the development of edema.
However, you need to be careful with the selection of microelements, since their excess in the body is also undesirable. Therefore, it is better to trust your doctor in this matter.
Essential vitamins:
- Vitamin C promotes better absorption of calcium and iron, which are necessary for the bones of the fetus and prevent the development of anemia, and also stimulates the immune system.
- Vitamin A is responsible for the genetic makeup and development of the retina in the fetus.
- Vitamin E prevents miscarriage.
- Vitamin D is essential for skeletal development.
- Folic acid, as well as magnesium and phosphorus, affect the development of the nervous system.
Prohibited Products
The list of prohibited foods includes those that increase gas formation and putrefaction in the intestines, since the longer the pregnancy, the more problems with stool.
In addition, dyes, preservatives and other chemical additives are potentially harmful to the growing fetus.
You should avoid spicy, smoked and salty foods; they irritate the gastrointestinal tract, contribute to heartburn and can provoke gestosis.
You should not get carried away with animal fats, so as not to overload the gallbladder, as well as simple carbohydrates, which lead to rapid weight gain and can affect the weight of the fetus.
You should pay special attention to allergenic products; allergies will not bring pleasant sensations to the mother, and in the future it may also appear in the child.
Heavy and difficult-to-digest foods contribute to constipation, so you should also avoid them.
List of prohibited products:
- fresh pastries, white bread, culinary products, cakes and pastries, pancakes and pancakes;
- fast food, semi-finished products;
- sweet carbonated drinks (simple carbohydrates and gas);
- legumes;
- chocolate, cocoa, strong tea and coffee (cause constipation and excite the nervous system);
- sausages, smoked meats, lard;
- marinades, pickles, mustard, horseradish, pepper;
- strawberries, nuts (hazelnuts and peanuts), honey - allergens;
- ice cream, milkshakes, condensed milk;
- canned meat and fish;
- mushrooms in any form (hard to digest);
- fatty meat, fish, poultry;
- yolk (excess cholesterol), raw and fried eggs;
- limit butter, fatty sour cream;
- caviar red and black;
- blue cheeses (risk of infection), sharp and fatty cheeses;
- raw meat and fish (sushi, stroganina) are sources of salmonella and toxoplasma.
Authorized Products
Dishes consumed by a woman in the second trimester of pregnancy should not overload the gastrointestinal tract, ensure regular bowel movements and be easily digestible.
It is especially important to consume as much plant fiber as possible, which prevents constipation and contains a large amount of vitamins.
List of permitted products:
- whole grain or bran bread, yesterday's bread, dry biscuits (biscuits, crackers);
- porridges: buckwheat - protein and iron, oatmeal and millet - magnesium, all porridges are a source of fiber;
- carrots and juices from them - vitamin A, cranberries, lingonberries, currants, citrus fruits (with caution) - vitamin C, herbs and green vegetables - folic acid;
- rose hips, sea buckthorn, nuts, apricots and dried apricots - fiber and vitamin E;
- fish - polyunsaturated fatty acids, phosphorus, magnesium, vitamin D;
- boiled lean meat and poultry are a source of protein;
- low-fat fermented milk products - calcium, improve intestinal motility;
- freshly squeezed juices, green tea, rosehip decoction;
- figs, seafood (shrimp, mussels, squid, seaweed) - a source of iodine;
- egg white omelettes;
- vegetable oils - normalize intestinal function, sources of vitamin E;
- liver, pomegranates, green apples are sources of iron;
- cottage cheese, mild and low-fat varieties of cheese.
If a woman treats pregnancy responsibly and adheres to proper nutrition, she will avoid digestive problems (heartburn, constipation, flatulence), and will also significantly reduce the risk of developing pregnancy complications (preeclampsia, diabetes mellitus, gestational pyelonephritis). In addition, a sufficient amount of vitamins and microelements will ensure normal development of the fetus.
Consequences of poor nutrition in the second trimester
A total lack of vitamins and microelements can cause late miscarriage and the development of preeclampsia.
The second trimester of pregnancy is a golden time for the expectant mother. What happens to the baby during this period?
The rather difficult and capricious first trimester for many women, with its toxicosis and incomprehensible hormonal explosions, has ended. Now the condition of the expectant mother is noticeably improving. The strength and desire to create appears. You shouldn’t limit yourself in this impulse - after all, what could be more enjoyable than doing something you like? Even if you previously didn’t have enough time and energy for your favorite drawing, photography, music - now you have every right to afford it! And your baby, feeling that you are happy, will rejoice with you.
The very first and touching “date” with the baby using an ultrasound machine is already behind us. Now the future dad has probably fully realized the fact that you will have a baby, and even saw on the monitor screen his obvious resemblance to the future child. He begins to treat you and your rounding tummy even more reverently and tenderly. It is quite possible that this period will become your second “honeymoon”.
Your mood becomes more even, you are full of strength and energy. In addition, pregnancy turns from almost ephemeral, when you may not even be entirely aware of it, into quite tangible. You learn to communicate with your baby, to understand the signals of his such light, but endlessly pleasant pushes. At the same time, the weight does not increase to such an extent that it interferes with the ease of your movements. This is truly a golden time!
Child development during the second trimester of pregnancy
– this is the period from the beginning of the thirteenth to the end of the twenty-eighth week of pregnancy. According to statistics, this is a time of relative calm and stability. The weakness of the first trimester has already passed, and the “heavy” third with its fear of approaching labor has not yet arrived. It's time to enjoy your pregnancy and communication with your baby!
During this period, noticeable changes occur in the child. Let's look at them step by step.
Thirteenth week. The child's first cartilage appears. They are still very fragile, but soon they will become important parts of the skeleton. The formation of baby teeth is completed. The digestive system continues to develop. The intestines train to perform peristalsis. The pancreas begins to produce insulin. Vocal cords develop. There is rapid growth of the placenta.
Fourteenth week. The first fluff appears on the baby's body - lanugo. Thanks to it, a thin layer of original lubricant is formed on the child’s skin, protecting the skin. The proportions of the baby's body are changing - now the head is approximately a third of the body length. The gonads appear. They descend closer to the pelvis. The baby's muscles are getting stronger every day. The baby is actively moving, tumbling, pushing off the walls of the amniotic sac. This week the size of the fetus is about 10-11 cm, weight is 25 grams.
Fifteenth week. The brain is still actively growing and the skeleton is forming. The gallbladder begins to secrete bile. The arms can bend at the wrists and elbows. Hair growth continues on the head and eyebrows appear. Fruit size – 11-12 cm, weight – 50 grams.
Sixteenth week. The brain is growing rapidly. Toenails appear. The urinary system works more and more actively.
Facial muscles are formed. The baby can “make faces”: blink, frown, close and open his mouth. The salivary glands, palate and tongue are already formed. The baby begins to taste the food his mother eats. Meconium begins to collect in the intestines - the original feces, which is destined to be released immediately after the birth of the child. If the fetus is a girl, her ovaries are already descending into the hip area this week. Fruit size – 13-14 cm, weight – 80 grams.
Seventeenth week. The baby begins to accumulate “brown fat” - a subcutaneous layer that will help him independently maintain his body temperature. The skin becomes more matte. Skin folds begin to smooth out. This week, the child is already able to distinguish some sounds around him: the mother’s heartbeat and breathing, the work of her intestines, etc. The size of the fruit is 15-16 cm, weight is 100 grams.
Eighteenth week. Baby's eyes can perceive light. The auditory ossicles are formed. The baby can already hear you! It's time to start verbal communication with him.
The child is highly active, moves a lot, changes his position, pushes his mother’s stomach with his legs. He can already suck his thumb. The skeleton is almost completely formed, but so far all the bones consist of cartilage. From this week the process of ossification in large bones will begin. The size of the fruit is 17-18 cm, weight is 150 grams.
Nineteenth week. Thousands of neurons are formed and functioning. The functioning of the brain continues to improve, the child’s movements become more and more controlled. The rudiments of permanent teeth appear. In girls, the uterus and fallopian tubes are forming; in boys, the genitals are almost completely formed. Fruit size – 19-20 cm, weight – 200 grams.
Twentieth week. The baby's skin is already much thicker, with four main skin layers formed. The body becomes more and more smooth. It is covered with vernix lubrication - a special cover that protects the baby from negative influences until birth. Brain volume is growing rapidly. Fruit size – 22-23 cm, weight – 250 grams.
Twenty-first week. White blood cells begin to appear in the baby's blood, which protect the body from infections. The gastrointestinal tract is developing intensively. Now, when the baby swallows amniotic fluid, it is split into fluid, which will then be excreted through the urinary system, and fibrous components, which accumulate in the colon in the form of original feces.
The eyes are still hidden behind the eyelids. Arms and legs acquire correct proportions. Fruit size – 24-25 cm, weight – 300 grams.
Twenty second week. The eyelids and eyebrows are finally formed, and the nasolabial triangle has taken shape. The baby smiles, strokes his face, arms and legs. His perception is improving every day. Starting this week, he establishes a sleep-wake cycle. Fruit size – 26-27 cm, weight – 350 grams.
Twenty-third week. The baby has sufficiently developed respiratory, circulatory, urinary, alimentary and reproductive systems. The liver and pancreas stably perform their enzymatic functions.
The thyroid gland works almost at full capacity. The child is more and more active. The baby may hiccup - you will feel as if he is bouncing inside you. Fruit size – 28-29 cm, weight – 450 grams.
Twenty-fourth week. The child is actively growing and gaining weight due to the accumulation of fat. Sweat glands form in the skin. The face is fully formed. Eyelashes appeared. A surfactant is formed - a special lipid film covering the alveoli. It ensures the elasticity of the lung tissue, its extensibility, and maintains the lungs in a straightened state.
The baby becomes more crowded in the uterus, it is already difficult for him to tumble freely, as before. Fruit size – 29-30 cm, weight – 550-600 grams.
Twenty-fifth week. The formation of the genital organs is completed: in girls the vagina is formed, in boys the testicles descend into the scrotum.
The baby can already grab the leg with his hand. It is this week that the baby decides which hand is his dominant one. It depends on this whether he will be right-handed or left-handed. Fruit size – 31-32 cm, weight – 700 grams.
Twenty-sixth week. All sense organs are finally formed, except for smell - it will begin to work only after birth. Swallowing and sucking reflexes are improved. The capillaries are fully formed.
The child is able to distinguish not only light and darkness, but also some shadows visible through the mother’s tummy. In case of premature birth at this stage, the baby may already survive. Fruit size – 32-33 cm, weight – 850 grams.
Twenty-seventh week. All systems and internal organs of the baby are functioning. By the end of this week, the baby begins to open his eyes. The skin is still wrinkled from being in water. The baby's size is 33-34 cm, weight is 1000 grams.
Twenty-eighth week. The baby continues to actively grow and develop. It responds well to light. The layers of the retina are differentiated. The baby's weight this week is about 1200 grams.
In the period from 24 to 28 weeks, the baby’s higher parts of the cerebral cortex develop. This affects the development of the mind, creativity, and hearing. Therefore, joyful emotions are very important during this period. It is useful for mom to pamper herself with drawing, music, dancing, visiting exhibitions, theaters, and also just walking in nature.
To ensure that the second trimester of pregnancy proceeds as smoothly and safely as possible for your baby, listen to these simple tips:
1. Don't forget about healthy eating and proper lifestyle. If possible, it is best to spend the second trimester of pregnancy away from the dusty stuffy city, in the fresh air and in a joyful atmosphere.
2. Moderate physical activity and leisurely pleasant walks are still necessary.
3. Take care of comfortable clothes made from natural fabrics - during this period you will have to update your wardrobe due to the growth of your beloved baby. You definitely need to buy a comfortable, supportive bra as your mammary glands are getting larger.
4. If the pregnancy is normal and doctors have no concerns, you don’t have to deny yourself sex. The main thing is to limit the pressure on the stomach.
5. During this period, weak irregular contractions of the uterus may appear - the so-called false contractions. This is normal training of the uterus for the upcoming birth. If contractions become painful and regular, you should immediately consult a doctor!
6. During this period, skin changes are possible - darkening of the skin around the nipples and the line from the navel to the pubic bone. Don't forget to use sunscreen when outside.
7. If you experience dizziness, try to drink more fluids and do not suddenly change your body position - from sitting or lying to standing.
8. Another not very pleasant companion of the second trimester is leg cramps. Massaging the calf muscles before bed will help, as well as drinking plenty of fluids, a warm bath, and ice massage.
9. The appearance of white vaginal discharge is considered normal - it performs a protective function. If the discharge has a strong odor, is green or yellow in color, and is accompanied by irritation, you should consult a doctor.
10. Don't forget to enrich your diet with vitamins. Folic acid will reduce the risk of preeclampsia, vitamin E will have a positive effect on the timeliness of birth, vitamin A will contribute to the normal development of skin and bones, as well as the baby’s vision. B vitamins will help with brain and nerve development.
11. It will be useful to attend courses for future parents. There they will help you both theoretically and practically prepare for the upcoming birth and avoid many fears.
12. It is at this time, when you have enough energy and strength, that you can start buying a dowry for the child. Such pleasant chores will give you a lot of positive emotions and allow you not to worry about something not being ready. And your baby will definitely be grateful to you for it!