The second trimester of pregnancy is the middle 3 months, or from the fifteenth through the twenty-eight week of gestation. This trimester is often the most enjoyable of the three. Your initial period of adjustment has passed, and fatigue and nausea are usually less of a problem. It is during this time that your pregnancy becomes obvious to the other people, and you may frequently be the center of attention. Your body, though larger, is not cumbersome, and you should find it fairly easy to move around.
The major physical changes that women experience during the second trimester include the following:
• The Uterus. The uterus begins to expand out of the pelvis and into the abdominal cavity by the fourteenth week. By the twentieth week, which is midway through the second trimester, the uterus is usually at the level of the navel.
A woman pregnant for the first time usually begins to feel the movements of the fetus at about 16 to 18 weeks. Women who have already borne at least one child often feel these movements earlier. When the movements are first perceived, the fetus is about 7 inches long and weighs less than 1 pound. The woman may also feel mild uterine contractions, called Braxton-Hicks contractions.
• Vagina. The tissues of the vagina continue to soften and become more elastic, preparing for the baby’s passage at birth.
• Pelvis. Hormones cause the cartilage to soften and widen to provide additional mobility and relaxation in the pelvic joints. This allows a large baby to pass through more easily.
• Breasts. Colostrum, a clear yellow fluid that precedes mature breast milk, is often present by 16 weeks.
• Circulation. By the end of the second trimester, the blood volume has increased by 40 to 60 percent and the heart has begun pumping more blood per beat. Edema (swelling) is common because of the increased blood volume, the pressure from the enlarging uterus, and the increase in estrogen. The fluid will tend to pool in your feet and hands when you stand for long periods. Resting on your side will improve your circulation and will help to relieve the edema. Increasing your protein intake will also help to decrease the swelling. If the swelling is sudden and involves the face, you should notify your doctor, since this may be a sign of pregnancy-induced hypertension.
• The Linea Nigra. The linea nigra is a dark line that extends from the navel to the pubic hairline. It is common and is attributed to the hormonal activity of pregnancy. It fades after delivery, although it may continue to be visible.
• Stretch Marks. Many women develop at least some stretch marks, or striae gravidarum, during pregnancy. Stretch marks appear when the connective tissue of the skin is stretched to the point of rupture. They are red or pink lines and may appear on the abdomen, thighs, or breasts. After delivery, they fade to white. Many women find that massaging oil or lotion into the vulnerable areas prevents stretch marks, although heredity seems to be a more important factor.
• Mask of pregnancy. Some women develop the mask of pregnancy, which consists of dark blotches on the face. This pigmentation is believed to result from increased levels of melanocyte stimulating hormone (MSH). Production of MSH drops after pregnancy, with the mask of pregnancy usually disappearing. Deficiency of folic acid, a B vitamin, may also be a cause. Your prenatal vitamins should include folic acid to meet your increased requirement.
Most women find the second trimester to be a more positive experience than the first, as they are now beginning to feel the movements of the life within them. Most husbands by now have accepted the existence of the pregnancy and are as excited as the woman about the movements of the baby. During this trimester, men frequently also become more aware of their wife’s growing dependence on them. As the pregnancy progresses, the woman may feel more vulnerable and may need her mate’s attention more. She may want him to become more involved with the pregnancy and the baby. In addition, she may become overly concerned for her husband’s safety. Meanwhile, the husband may share the woman’s interest in the pregnancy, or he may feel an increased creative interest in his work or hobby. He may gain weight or show other symptoms of pregnancy. These are all ways in which expectant mothers and fathers deal with the stresses and changes that are occurring. It is important for both partners to be aware of and to talk about their feelings, especially when friction arises between them.
A woman’s dreams may become very real during this trimester and are sometimes disturbing. Dreams are a way of bringing fears to consciousness, where they can be dealt with more easily. Dreaming about misfortune to the baby or to herself, or about giving birth to animals is common. If a woman refuses to acknowledge her fears, she may suffer increasing anxiety.