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What to expect in your second trimester – a four-part series

July 11, 2018

How to care for baby and you during each stage of pregnancy and beyond

The second trimester, which begins around week 13 and goes through week 28, is considered the “honeymoon” period, according to Sarah Shook, D.O., an OB/GYN who delivers at Northwest Community Hospital (NCH).

“It’s that time of the pregnancy when big changes start to occur; expectant mothers start to feel movement and energy returns.

“You are past the first trimester exhaustion and morning sickness, and you are not yet into the aches and pains of the third trimester,” Dr. Shook explains. “It’s the perfect time to make sure you are eating well and exercising because this is the time when you are most energized.”

Growing and stretching

Dr. Sarah Shook

In the second trimester, cramping can be common as the uterus begins to accommodate the growing fetus. “You may feel round ligament pain as well, a stretching pain that can travel to the groin,” Dr. Shook says. “This is completely normal.”

So are constipation and weight gain during the middle trimester.

“Constipation can be common throughout the whole pregnancy,” Dr. Shook says.

What’s that weird feeling?

If you start to feel something that’s similar to gas pains, that’s most likely quickening (feeling the baby move), which happens around week 19 or 20. “Some patients feel it sooner and some later, but I let my patients know that if they don’t feel it right at 20 weeks, don’t be alarmed,” Dr. Shook says.

As the uterus expands and baby begins to grow larger, most patients will start transitioning to maternity clothing to be more comfortable, Dr. Shook says, adding, “Yoga pants are a great investment.”

Sex drive

One common question Dr. Shook receives from patients is, “Is it OK to continue to have intercourse?”

“As far as having a healthy sex life goes, it’s absolutely safe to do unless your doctor tells you otherwise,” Dr. Shook advises. “It will not hurt the baby.”

Don’t be surprised if you notice an increase in sex drive as hormones surge.


Continue to eat as you normally would, adding only an additional 300 calories. Avoid the whole “eating for two” mindset.

“That’s such a misconception,” she says. “You should be eating lots of fruits, veggies, lean proteins, whole grains and regular small meals throughout the day. That’s the perfect way to do it.”

Patients may notice that their appetite isn’t quite what it was, and/or they can’t eat as much. Pack healthy, small snacks to help with this.

“Most of us don’t have to eat extra calories because the majority of us already get plenty with our American diets,” Dr. Shook says. “Keep this in mind because if you gain too much weight during the pregnancy, you’re putting yourself at risk for gestational diabetes, preeclampsia (high blood pressure and protein in the urine after the 20th week of pregnancy) and there have even been studies showing future risks of metabolic syndrome to infants.”


“Exercise is great for mom and baby (everything except contact sports),” Dr. Shook says. “It can be a great way to relax – prenatal yoga is one recommendation – and a fantastic way to strengthen the body and provide overall well-being during the pregnancy and beyond. I’ll always tell women to do what they normally did pre-pregnancy. For someone who has never been active, I tell them walking, jogging or yoga is great.”

What’s happening with baby?

By now, all of the baby’s organs have been formed and brain development continues, so it’s important for women to continue taking prenatal vitamins with a docosahexaenoic acid (DHA) supplement if it’s not already in the vitamin. DHA is an omega-3 essential fatty acid that serves as a primary building block for the healthy development of the brain, eyes, cells and nervous system.


Second trimester doctor visits typically include a spina bifida screen, a gestational diabetes screen and a full anatomy ultrasound, at which point the uterus will be measured to anticipate baby’s growth. This is when parents who want to find out the gender of their baby can do so.

“It’s such an exciting time,” Dr. Shook says.”From an educational standpoint, the 24- and 28-week visits are when I’ll typically remind patients to find a pediatrician, sign up for prenatal classes and order a breast pump so they have that ready at home when they deliver.”

Overall, the honeymoon period, Dr. Shook says, “is great for travel, a good time to work out, eat healthy and enjoy life. It’s the easiest out of the three trimesters as long as all is going well.”

Stay tuned for our next article, “What to expect in the third trimester.”

Dr. Shook is part of Northwest Women’s Consultants. Learn more about the NCH Women’s Center.