Sydney Obstetrician Gynaecologist
RN, MBBS, FRANZCOG

What To Expect When You're Pregnant : 2nd Trimester

13 to 28 Weeks

It’s your second trimester and if you had morning sickness earlier, you may be feeling much better. Read on for information about how to keep you and your baby healthy during these vital mid-term weeks.

How You May Feel

Physically

For lots of women, this trimester is easier. Morning sickness should be improving and you should notice increased energy levels. You’ll be developing a baby bump and should start feeling the baby move from about 18 weeks. You may also have unusual cravings and notice some of the inconveniences of pregnancy including constipation, hemorrhoids, skin discolouration, and enlarged and tender breasts.

Emotionally

By now, you’ll be getting excited and as you’ve probably told friends, family and work, it’s all becoming very real. Take time now to focus on your partner and enjoy some regular quality time together before baby arrives.

What you can expect from me

Over the next few months, I’m here to answer any questions or concerns you or your partner may have about any aspect of your pregnancy. At your 16 week visit I’ll give you a form for an 18 to 20 week morphology scan (it’s a detailed look at the baby), which is when you can find out your baby’s gender (if you choose) and placental location. If your placenta is at the front (anterior) this can decrease your ability to feel the baby’s movements. I’ll also measure your blood pressure, listen to baby’s heart-rate and measure your abdomen. If you were screened for chromosomal abnormalities, we’ll discuss your results.

At your 20 week visit This is when we can discuss the results of your morphology scan and check your abdomen measurements to estimate how the baby is growing. I will do a foetal heart check and ask you about the baby’s movements. I’ll also test your blood pressure and do a quick ultrasound scan so you can see your baby.

I will screen you for depression and anxiety and check if you are booked into antenatal classes. These are best done after 30 weeks and both North Shore Private Hospital and The Mater have very comprehensive programs.

At your 24 week visit  I will give you forms for blood tests that diagnose anaemia, low iron stores, and diabetes in pregnancy.

We will give you a reminder to have a whooping cough vaccine that helps to protect your baby from this disease for the first few months after it’s born. Read more about whooping cough. Partners and other immediate family members will need this vaccination too if they have not had it in the past  10 years. If they are unsure of their immune status, they can check with their General Practitioner.

A useful app to download is the “Save the Date to Vaccinate”. It is an NSW health app that will provide you with useful reminders when to have any vaccinations.

We will also check your blood pressure and abdomen measurement, check baby’s heartbeat, discuss foetal movements, and do an ultrasound of the baby.

At your 28 week visit We’ll discuss the results of your blood tests and if you were diagnosed with gestational diabetes, we’ll talk about management. To read more about gestational diabetes,click here. If you were found to be anaemic, I’ll recommend next steps. We’ll also recheck your blood pressure and abdomen measurement, check baby’s heartbeat, discuss foetal movements and do a quick ultrasound scan so you can see your baby.

If your blood type is Rh negative, I’ll also give you an anti-D injection. Read more about anti-D on the Red Cross Australia website

If you have developed a medical complication during your pregnancy or have a high risk pregnancy I will see you again at 30 weeks. I will advise you of this at the time

Questions you may have

Can I still fly?

Most airlines allow pregnant women to travel domestically up to around 36 weeks. Internationally, there are more restrictions as to the gestational age after which you must stop flying. However, policies vary with each airline, so ask about restrictions when you book your flight. Don’t forget to take into account how far along you’ll be on the return trip, too. If necessary and assuming you’re healthy enough, I can give you a letter confirming your fitness to fly. Make sure you have travel insurance that covers for pregnancy.  Some insurance companies will also offer insurance that covers you if you give birth / require neonatal care. The safest time to travel is during the 2nd trimester provided it is an uncomplicated pregnancy. Before you book flights consider the standard of medical care at your chosen destination just in case you need help. Some countries have reciprocal healthcare arrangements with Australia – so check with Medicare. Travelling to developing nations is not encouraged during pregnancy for many reasons including risk of disease. Visit Victorian Govt Pregnancy and Travel for more.

If I’m flying, what precautions must I take?

The changes associated with pregnancy make your blood more ‘sticky’ and therefore at risk of developing a blood clot. It is important, when flying to keep your circulation flowing. Wear knee-high compression stockings on long haul flights and drink plenty of water. Keep mobile and walk around. For more information, checkout RANZCOG’s Travelling During Pregnancy information sheet

When do I have to start sleeping on my side?

From around 28 weeks, as your baby grows it can place pressure on your major blood vessels if you lie on your back. Lying on your back for an extended period can make you feel dizzy. Don’t be worried if you go to sleep on your side and wake up on your back. This happens regularly and shouldn’t have serious adverse effects on your baby’s health. Just shift your position and go back to sleep.

Can I find out the sex of my baby now?

If you wish to find out the sex of your baby, you can have the non-invasive prenatal screening test for chromosomal abnormalities blood test at 10 weeks or it may be possible to find out at your 18-20 week morphology scan.

How much weight will I put on?

Most women will gain around 10-15 kilograms over the course of the pregnancy. The timing of weight gain varies between individuals. If you are overweight, we will discuss your optimal weight during pregnancy and I may need to refer you to a dietician. Weight gain during pregnancy is mainly due to increased body water and fat. For the statistically minded, here’s where some of the extra weight comes from:

  • Foetus 3.2-3.6 kgs
  • Fat Stores: 2.7-3.6 kgs
  • Increased blood volume: 1.4-1.8 kgs
  • Increased fluid volume: 0.9-1.4 kg
  • Amniotic fluid: 0.9kg
  • Breast Enlargement: 0.45-1.4kg
  • Uterine growth: 0.9 kg
  • Placenta: 0.7 kg

Visit the Australian Heart Foundation site for a BMI calculator. A high BMI can have adverse health consequences during pregnancy. For example, high blood pressure, gestational diabetes, Caesarean birth, pre-term birth, large baby. For more on obesity during pregnancy, download a PDF here.

I have back / pelvic pain. Is this normal? What can I do?

Pregnancy is a time of many physical and physiological changes. As your baby grows, your body must adapt and this can lead to a variety of problems. For example back pain, separation of the pelvic bones and carpal tunnel syndrome. Although these are normal they can cause great discomfort and can be debilitating. Please talk to me about these issues and I can refer you for treatment with a physiotherapist or chiropractor. Here are several practical tips from The American College of Obstetricians and Gynaecologists to help with back pain:

  • Wear low heeled shoes with good arch support
  • Get help when lifting heavy objects
  • Squat down, bend knees and keep your back straight when lifting objects
  • Make sure chairs have good back support or use a small pillow to provide support
  • Apply heat or cold or have a massage

Remember, Panadol is safe to take in pregnancy and can really help to relieve discomfort. For more information, visit these links. http://www.recoveryshorts.com/ http://www.eggmaternity.com/collections/maternity

Do I need to change my eating habits?

Continue to eat a healthy balanced diet containing whole grains, vegetables, fruit, dairy foods and protein including cooked meat, fish, poultry and eggs. Most pregnant women only need to increase their kilojoule intake by around 10 percent. Approximately 340 kcal/day in 2nd trimester and 452 kcal/day – in other words don’t eat for two. Read more about eating habits in the >RANZCOG planning for pregnancy pamphlet and Women’s Health pregnancy and weight gain

Can I continue my exercising?

Pregnancy is an ideal time for positive lifestyle changes, including increasing physical activity and eating a healthier diet. One main benefit of exercise is that it may help prevent excessive gestational weight gain and maintain or improve fitness. Now that you’ve regained your energy, do around 30 minutes of low impact exercise every day, including swimming, yoga, pilates or walking. Checkout this handy article on pregnancy and exercise or download this helpful pdf.

When do I book antenatal classes?

I recommend you book as soon as possible as classes tend to be very popular. Book them for around your 30 week mark, so you remember all the information. If you book them earlier, you may forget all you need to know.

Can I have sex in the second trimester?

Absolutely. As long as there are no issues with the location of the placenta. Talk to me or find out more here.

What situations should I consider an emergency?

If you experience vaginal bleeding, regular painful contractions, leaking fluid or decreased foetal movements, don’t hesitate to call the hospital where you’re booked. Remember Panadol is safe to take in pregnancy and can really help to relieve discomfort.

What if I’m having more than one baby?

Double congratulations! A multiple pregnancy means more visits and can involve more complications. Babies can also arrive early. I’ll advise on any extra care you might need and be closely monitoring your health during your whole pregnancy. More info here.

What can my partner do?

Dad can help out in lots of ways, physically and emotionally. You’ll find loads of ideas here or see the special For Partners section on this website.

Things To Do and Checklists

Here are some simple steps to help you during your 2nd Trimester and a checklist of things to bring to your appointments.

Things to do:

  1. Take the time now, while you’re feeling better to start planning for your baby’s arrival.
  2. Shop for the nursery, pram, car capsule, change table, bath, high chair, clothes for baby. As long as you’re feeling up to it, tackle whatever you can to make things easier for when baby arrives.
  3. Now’s the time to start handing work over to colleagues and thinking of names for the baby.
  4. Most importantly, enjoy plenty of baby-free time with your partner and family.

Things to bring:

  • Please bring your blue antenatal card to each visit.
  • Any questions you and your partner may have.

Preparing for the new arrival: 3rd Trimester

Still Curious?

With so many public forums online, it’s easy to get opinion confused with verifiable fact. I think the best places to go for information (apart from calling me) are:

Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Royal College of Obstetricians and Gynecologists

Having a Baby, NSW Department of Health