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Pregnancy: 2nd Trimester Part 1
Dr. Isabel talks about the importance of diet and exercise during the second trimester of pregnancy.
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Summary for HealthiNation's Pregnancy

Hosted by Dr. Isabel Blumberg, OBGYN


Pregnancy lasts about forty-weeks, starting with a woman's last menstruation and ends with the baby's birth. Pregnancy can be divided into three trimesters, based on the development of the baby.

The First Trimester (0-14 weeks)

Signs & Symptoms

During the first trimester of pregnancy, you won't see much change in your physical appearance, but you may feel these common symptoms:

  • Exhaustion
  • Cramping
  • Skin breakouts
  • Tender breasts
  • Spotting
  • Other common PMS symptoms
  • Frequent urination
  • Backaches
  • Leg cramps
  • Mood swings
  • Nausea and vomiting. This is most often referred to as "morning sickness". The term "morning sickness" can be misleading because many women experience these symptoms throughout the day. Taking a vitamin B6 supplement can help ease the nausea. You should also try to avoid fatty, acidic, or hard to digest foods. Also, as long as you stay hydrated and can maintain a healthy diet and weight, the nausea and vomiting should not affect the baby.

Expected Weight Gain In The First Trimester

Most women will not see significant weight gain during this trimester. On average, you should expect to gain about one pound per month during the first trimester. If you are normal weight when you conceive, you should expect to gain a total of 25 to 35 pounds throughout pregnancy.

Diet & Nutrition

There is a common misperception that because you're technically eating for two, you should eat twice as much. Typically, you should plan to eat an extra 300 calories a day throughout your pregnancy.

You should maintain a healthy diet, rich in nutrients, protein and calcium. Anemia is common in pregnant women, so you should make sure to get plenty of foods full of iron. Continue taking prenatal vitamins, which contain folic acid.

There are many foods to avoid, which include:

  • Foods High In Mercury. Examples include tuna fish, raw foods like sushi, undercooked meats, and eggs.
  • Soft, Unpasteurized Cheeses. Examples include bleu cheese and feta. Pasteurized means food has been heated to destroy potentially harmful viruses and organisms.

Also, consult your doctor before taking prescription and over the counter medications.

What's Happening Inside

This is the time when the baby's cells will organize into what will become organs like the heart and lungs. The umbilical cord, which connects the baby to the placenta, will begin to form. This cord will provide all the nutrients and oxygen the baby will need until birth. Fingers and toes will begin to develop and the ears, upper lip and nose will become more recognizable by week eight.

Common Tests & Procedures

Throughout these first fourteen weeks, you should plan to visit your obstetrician once a month to keep track of your baby's progress. You should also consult your obstetrician before taking any prescription or over the counter medication.

  • Ultrasound. By week 10 you'll be able to hear your baby's heartbeat through an ultrasound. An ultrasound uses high-frequency sound waves to scan a woman's abdomen to create an image of the baby on a computer screen. They will be used throughout pregnancy to monitor your baby's heartbeat, movement and breathing, as well as determine your baby's size, due date and gender.
  • Genetic Counseling. Along with an ultrasound, your obstetrician will discuss several different procedures that can help determine your baby's progress. In fact, your doctor may recommend seeing a genetic counselor during the first two trimesters if you are 35 years of age or older, or if you have a family history of genetic problems like downs syndrome and cystic fibrosis.
  • Chronic Villus Sampling, or CVS. This test is usually performed between weeks 10 and 13. in 99% of cases, CVS will detect these genetic abnormalities. Because there is small chance of miscarriage as a result of this test – approximately 1% - it is not always performed.

A Note About Miscarriage

One of the hardest things to think about is losing the baby, or having a miscarriage. Miscarriage is actually very common, especially during the first trimester. Here are some signs and symptoms that may indicate a miscarriage:

  • Mild to severe back pain
  • Weight-loss
  • Appearance of white or pink mucus
  • Painful contractions that occur every five to 20 minutes
  • Brown or bright red bleeding
  • A sudden decrease in the signs usually associated with pregnancy

Most miscarriages will occur in the first 13 weeks. If you have these symptoms, you should call your doctor. She will advise you on the best course of action. It's important to note that having a miscarriage is common and doesn't necessarily affect your ability to have a baby in the future.

The Second Trimester (15-27 weeks)

Common Symptoms

You may start to feel the baby move and kick, although many first-time moms don't feel this movement until week 20. During the rest of your pregnancy, you can expect to gain one to two pounds per week. This increase in weight happens because your baby is growing quickly.

During this period, many women notice the exhaustion, nausea and vomiting experienced in the first trimester decrease. You may feel more energetic and develop the "glow" of pregnancy as the baby starts to show more significantly.

Diet & Exercise

Here are some guidelines to help you maintain a healthy exercise and diet program that will be healthy for you and your baby:

  • Try to find non-weight bearing activities, such as swimming or cycling on a stationary bike.
  • You should also avoid over-heated gyms and make sure to continually hydrate your body.
  • Continue taking pre-natal vitamins rich in folic acid;
  • Eat foods that are full of protein, fiber, nutrients, carbohydrates and iron;
  • Avoid unpasteurized foods, uncooked meats or foods that contain mercury.

What's Happening Inside

By the beginning of this trimester, features like eyebrows and fingernails start to grow.

Around week 16, the baby's eyes will be sensitive to light and it will be able to make facial expressions like frowning and squinting. By week 18, it will develop the ability to swallow and hear. Around week 20, your "innie" belly button may "pop" and suddenly become an "outie." But, don't worry, it'll return to normal shortly after the baby's born. By week 24, you may notice an increase in the baby's movement in reaction to touch or sounds.

Common Tests & Procedures

In general, you should plan to visit your doctor once a month during this trimester to keep track of your baby's progress. Here are some tests your doctor may perform during this time:

  • Sonogram. At the halfway point, week 20, you'll likely have an ultrasound, also called a sonogram. This test uses high-frequency sound waves to scan a woman's abdomen to create an image of the baby on a computer screen. Your doctor will check the baby's development. This is often the first opportunity to learn the baby's sex and find out if there are multiples. If you are having multiples, you can expect more frequent trips to the doctor. He or she will make sure you and your babies are getting the care and nutrients you need.
  • Amniocentesis. If you didn't get a Chorionic Villus Sampling, or CVS test inthe first trimester, your doctor may recommend amniocentesis in the second trimester. This is a diagnostic test where fluid is drawn from around the baby with a needle, using an ultrasound as guidance. This fluid can be tested for genetic problems like spina bifida, downs syndrome and cystic fibrosis. This test is similar to a CVS test which we talked about in our segment on the first-trimester. Usually, an amniocentesis can be performed after 15 weeks and is recommended for women who will be 35 or older on their due date, or couples who have a family history of genetic problems. Because this is an invasive test, it's not recommended for all women, so you should talk it over with your doctor.
  • Glucose Screening Test. This test checks for gestational diabetes. This type of diabetes appears in about 4% of pregnant women and then usually goes away once the baby is born. This test is typically done between weeks 24 and 28.

Third Trimester (28-40 weeks)

Common Symptoms

During the final trimester of pregnancy, your body is getting ready for deliver. You can expect to feel many of the following symptoms:

  • General discomfort
  • Difficulty getting a good night's sleep
  • Pelvic pressure and vaginal discharge, as your cervix opens and prepares for delivery;
  • Heartburn
  • Swelling of the feet and hands
  • Tender breasts
  • Hemorrhoids
  • Appearance of stretch marks and varicose veins.

Diet & Exercise:

Like the other trimesters of pregnancy, you should maintain a healthy diet. You should continue taking pre-natal vitamins rich in folic acid; eat foods that are full of protein, fiber, nutrients, carbohydrates and iron; and avoid unpasteurized foods, uncooked meats or foods that contain mercury.

Exercising will become increasingly difficult, as your stomach gets bigger, but there are still some things you can do to stay active. Try low-impact exercises like walking or swimming. Avoid overheated rooms or gyms and don't do exercises that require laying on your back or cause bouncing, jumping or sharp movements.

In some cases, doctors will recommend bed rest, which is fairly common. Conditions that may cause bed rest are high blood pressure, vaginal bleeding and premature contractions.

Understanding Contractions

Contractions are a signal that you may be ready to deliver your baby. But there are different types of contractions you should understand. These include:

  • Braxton-Hicks Contractions. These premature contractions occur when the muscles of your uterus tighten for anywhere between 30 seconds and 2 minutes. It is your body's way of preparing for actual labor. Sometimes it's hard to determine if what you're feeling is Braxton Hicks or actual labor contractions. Mothers often describe Braxton Hicks as more uncomfortable than painful and they will eventually taper off and disappear. Actual labor contractions will get progressively longer, stronger and closer together. Braxton Hicks shouldn't increase in intensity or frequency. If these premature contractions are uncomfortable, there are a few things you can try:
    • Take a warm bath to help you relax.
    • Take slow, deep breaths and doing breathing exercises.
    • Drink a couple glasses of water.
    • Try changing your activity or position.

If you haven't reached 37 weeks yet, but are experiencing more than four contractions in an hour, or if you have vaginal bleeding or spotting, call your doctor.

  • Actual Labor Contractions. Once you've reached the 37-week mark, you should call your doctor when your contractions last 60 seconds each and are five minutes apart. This will be your body's way of telling you it may be time to deliver your baby.

What's Happening Inside

During the final trimester, the baby is using this time to put on weight and strengthen bones. Movements will become stronger and more frequent. The baby is actively breathing and sucking. And you may feel slight spasms in your uterus when the baby gets the hiccups.

Common Tests & Procedures

Because you're in the home stretch, you should plan to see you obstetrician once every two weeks between weeks 28 and 36. You may also be tested for the following conditions.

  • GBS, or Group B Strep. This is a specific bacteria doctors check for in the last trimester.
  • Anemia. Your doctor will want to make sure you have a healthy red blood cell count.
  • STDs. In some cases, you may also be tested again for sexually transmitted diseases.

Delivering Your Baby

Beyond 37 weeks, your baby will be considered full-term and are ready to deliver your baby. It is not uncommon for women to pass their due dates. Only 5% of women deliver on their due date - most have the baby one to two weeks late. You should consider the period past your due date as extra time for the baby to gain strength and for you to prepare for life with a newborn.

HealthiNation offers health information for educational purposes only; this information is not meant as medical advice. Always consult your doctor about your specific health condition.

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