I’m in my 2nd Trimester (week 13-week 27)

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  • With the coming of your second trimester; you will be more energetic and feel like your previous self. Your morning sickness and fatigue will fade which will give you time for preparing for the baby. Most women find these three months to be the easiest and take out time for themselves.

    Changes:

    Backache: Your back will feel itchy and sore due to the pressure put by the extra weight you gained lately. Quick habits such as sitting up straight, sleeping sideways with a pillow between the legs, using a well cushioned/supported chair would help you reduce the pain. Avoid lifting/ carrying heavy things. If the pain gets unbearable, call for a pregnancy massage or ask your partner to caress the sore spots.

    Bleeding gums: With so many hormonal changes, the flow of blood to your gums increase; making it too sensitive and prone to bleeding. Almost 50% of women have testified this and advised to use a softer toothbrush or be gentle while flossing. Things will go back to normal once the baby is born.

    Breast enlargement: Your breasts will be getting bigger for feeding the baby with the tenderness almost gone. Get a bigger bra or order for a support bra for more comfort.

    Congestion and nosebleeds:  The hormonal changes will swell the mucus membrane lining the nose making you snore at night and causing you congestion. You can use saline water and other natural methods for curing this; before going for a decongestant. When bleeding, keep your head straight and put pressure on the nostril; this would help to stop the bleeding.

    Discharge: You will experience a thin milky white vaginal discharge (called leucorrhoea) in the initial time of the pregnancy. Call your doctor if the discharge is green, yellow, foul smelling, bloody and has a lot of clear discharge. You can also use a panty liner if it makes you more comfortable but don’t go for tampons as it can cause germs in the vagina.

    Frequent urination: You will get a break from having to go to the bathroom frequently. The reason behind this is that your uterus will rise away from the pelvic cavity. The frequency of urination will increase during the last the trimester of pregnancy.

    Headache: This is one issue most women complain about during pregnancy. Some techniques such as deep breathing may help. Avoid taking aspirin and ibuprofen during the pregnancy; but you can take acetaminophen after consulting your doctor.

    Spider and varicose veins: Due to the extra flow of blood for the baby during the pregnancy there can be spider veins on your body. These are tiny red veins. With the baby growing in the stomach the pressure on the lower part of the body increases resulting due to lack of blood circulation causing purple or blue swollen spots. These are called varicose veins and can be countered with a frequent walk in the house or using a stool to stretch after long hours of continuous sitting. Both these veins fade after the delivery of the baby.

    Weight gain: After the end of first trimester; you would have your appetite back; but be cautious with the amount of food you eat. The recommended amount is to eat an extra 300 to 500 calories a day and to gain about ½ to 1 pound a week in the second trimester.

    Red Flag Symptoms:

    · Bleeding
    · Cramping or severe abdominal pain.
    · Too little weight gain (less than 10 pounds at 20 weeks into the pregnancy) or rapid weight gain (more than 6.5 pounds per month)
    · Severe dizziness

  • With so many changes happening to your body it is important to consult a doctor for few medicines that can be useful. Prenatal vitamins are one of the most important medicines that should be taken during pregnancy. Apart from these there are few other herbal and vitamin medicines that can be taken after consulting your health care provider.

    You should avoid taking any OCT during pregnancy unless it is necessary.

    Have a list of medicines that can be taken during pregnancy. Consult your doctor for its usage or for adding to the list:

    Cold and Flu

    · Warm salt/water gargles

    · Saline nasal drops or spray

    · Tylenol (acetaminophen)

    Consult your doctor about using these medicines in the first trimester, especially in the first trimester.

    Rashes

    · Hydrocortisone cream or ointment

    · Caladryl lotion or cream

    · Oatmeal bath (Aveeno)

    · Benadryl cream

    Allergy

    · Benadryl (diphenhydramine)

    · Claritin

    Consult your doctor about using these medicines in the first trimester.

    Bacitracin

    · Polysporin

    · Neosporin

    · J&J First-Aid Cream

    Constipation

    · First Aid Ointment

    · Metamucil

    · Colace

  • A balanced diet is very essential in order for the baby to grow good and strong. The unborn baby gets all the nutrients from you; hence your diet is very important.

    Although you are pregnant; it doesn’t mean that you need to eat for two. You need to have a balanced diet covering all essential nutrients

    Nutrients

    1st 2nd 3rd
    Pregnancy Trimester

    Source of Food

    Health Benefits

    Zinc

    12 mg/d

    Flesh foods, liver,

    fish and milk contain a lot

    of zinc, all types of

    Pulses and nuts.

    Degree of Prenatal iron supplementation is likely to be inversely proportional to the maternal zinc status.

    Calcium

    1200 mg/d

    Milk and Milk Products

    Green leafy vegetables

    Amaranth, cauliflower greens, curry leaves, Nuts and Oilseeds

    Rajmah and soyabean

    Coconut dry, almond, mustard seeds and sunflower seeds

    Cumin seeds, Fish (katla, mrigal,pran and rohu)

    Buffalo’s milk, cow’s milk and goat’s milk.

    Cereals and Legumes Ragi, Bengal gram (whole),

    Baby's bones need calcium for development. Calcium is also essential for the development of tooth buds.

    Iodine

    200 ug/d

    Food that is grown in Iodine rich soil, water and salt

    Iodine helps in the growth of thyroxine molecule which plays a major role in metabolism of macro-nutrients.

    Fluids are very essential and need to be taken in plenty during the pregnancy. Also take folic acid tablets (400 micrograms) each day during the initial 12 weeks of pregnancy.

    With so many dos comes the don’ts as well i.e. things that you should avoid during the pregnancy

    · Eggs that are raw or lightly cooked or the food containing them( the eggs should be at all time thoroughly cooked)
    · Excess intake of Vitamin A should be avoided.
    · Excess of liver products should also be avoided.
    · Raw or undercooked meat, poultry, fish, and shellfish
    ·Smoking, alcohol
    · Unpasteurized milk and dairy Products, including soft, mould ripened cheese.

  • Here is a list of prenatal tests that can be performed during the second trimester of your pregnancy:

    MSAFP (Maternal serum alpha-foetoprotein) and multiple marker screening: Second trimester offers one or the other screening on routine. A doctor should be consulted on the pros & cons and the suitability of this optional genetic screening test. The test tells you the measure of alpha-foetoprotein, which is s protein produced by the foetus. If the level is abnormal; it may indicate chances of Down’s syndrome or a neural tube defect such as spina bifida. This can be confirmed with the help of an ultrasound or amniocentesis.

    Hormones such as estriol and HCG can also be checked using the blood drawn for MSAFP; such test is called triple test. Adding a marker called inhibin-A to the screen is called as quad marker. The detection rate of Down’s syndrome can be boosted using this quad marker. It picks up about 75% defects of neural tube & 75%-90% of Down’s syndrome cases. Although good, about 3% to 5% of the women who will have this screening test will have an abnormal outcome; but a very little percentage of those women will actually have a baby with genetic problem.

    Ultrasounds: These can be done at any time during the pregnancy but are usually offered during the week 20. This can be done due to the following reasons:

    · Investigating complications such as placenta previa (a low-lying placenta) or slow foetal growth
    · Checking for multiple foetuses
    · Detecting malformations like cleft palate
    · Verifying a due date
    · If there are complications of genetic abnormality, you may be referred to a specialist or for more genetic testing. You can also try the three-dimensional sonograms which can give you a better view.

    Glucose Screening: It is done at 24 to 28 weeks. It is a routine test for pregnancy induced diabetes which can result in many complications and health problems for you and the child. The blood sugar level is tested after you have had a glass of a special soda. If the results come out to be high; you might be prescribed to take a more sensitive glucose-tolerance test, in which you will have to drink a solution of glucose on an empty stomach and get your blood drawn every hour for 2-3 hours.

    Amniocentesis: This is a test that is performed between 15 and 18 weeks of pregnancy and is done for women who are 35 and older, or for those who have a higher risk of genetic disorders or whose MSAFP test is suspicious. A needle is inserted through the abdomen to the amniotic sac and the fluid is withdrawn that contains the foetal cell.

    Foetal Doppler ultrasound: This test uses sound waves to check the blood as it moves through the blood vessel. It determines the normality of blood flow to the placenta and foetus.

    Foetoscopy: A foetoscope is a thin, flexible instrument used to see the foetus by the doctor. This test can detect diseases or defects that cannot be determined by other tests such as ultrasound, amniocentesis and chorionic vilus sampling. As this test has risks for both mother and baby; it is quite an uncommon procedure and only recommended if the abnormality chances of the baby are high.

  • Suitable exercises that should be done during pregnancy

    · Swimming

    · Yoga

    · Brisk walking

    · Low impact aerobics

    · Stationary cycling

    Exercises that should not be done during pregnancy

    · Activities with risk of fall

    · Activities with risk of abdominal trauma

    · Scuba diving

    · High altitude activities

    There are times when you should contact your physician. If the following symptoms arise, you should call for a doctor:

    · Headache

    · Decreased foetal movement

    · Vaginal bleeding

    · Dizziness

    · Muscle weakness

    · Calf pain or swelling

    · Preterm labour

    · Dyspnoea before exertion

    · Chest pain

    · Amniotic fluid leakage

    The Start:

    · Be active on a daily basis.

    · Drink plenty of fluids

    · Clothing should be appropriate

    · During hot and humid environments you should avoid vigorous exercises.

    · Consult your doctor before taking up any exercise programme

    · Adequate calorie intake

    · You should start strenuous exercise if you were inactive before pregnancy.

    Supine position exercises are advisable only for the first trimester of the pregnancy. Exercise of isometric type such as weight lifting must be avoided as they may cause decrease in splanchnic blood flow and uterine perfusion.

    Exercises involving greater risks of fall such as balance exercises, the ones which require sudden change in position etc. should be avoided.

    Kegel’s manoeuver:

    The muscles of pelvic axis and birth canal are relaxed and contracted during this exercise. This exercise helps in strengthening of the muscles helping to provide support to the content of abdomen which prevents uterus or bladder from falling through these muscles, especially after having children.

    Exercises to strengthen the stomach:

    These exercises ease backache and help in strengthening the abdominal muscles:

    · Put your knees under the hips under the shoulders with fingers facing forward and lift your abdominal to keep your back straight.

    · Try to pull your abdominals to raise the back up and curl the trunk, making your head relax.

    · Keep this position for some time and then slowly return to the initial first position.

    Pelvic tilt exercises:

    · Stand keeping your shoulders and your bottom against a wall.

    · Make your knees soft.

    · Try pulling your belly bottom to your spine so that your back flattens on the wall.

    · Keep still for four seconds and then return back to the first initial position.

    Pelvic floor exercises:

    Your pelvic floor gets under great strain during pregnancy and childbirth; these exercises help in strengthening the muscles of the pelvic floor.

    Exercises related to foot:

    The swelling in the ankles can be reduced using these exercises in which you need to bend your foot vigorously up and down and have to rotate one way and then the other way. This also improves the blood circulation and prevents cramp in the calf muscles.

    Relaxing Exercises:

    These exercises help to relieve stress and are very beneficial for the woman’s body.

    Protecting your back

    · You must always sit straight with your bottom against the back of the chair.

    · Whenever picking something; never bend your back but use your knees to bend.

    · You should always stand tall.

    Relative contraindications to exercise during pregnancy

    · Women who have restrictive lung disease

    · Preterm labor

    · Intrauterine growth retardation

    · Premature rupture of membrane

    · Pregnancy induced hypertension

    · Placenta previa

    · Women who have cardiac disease

    Always consult your doctor before taking up any exercise as each body has its own way of dealing with pregnancy.

  • What about making love in the second trimester?

    If the first trimester has been normal in terms of your sex life; there is no good reason to stop it. If you were not having sex in the first trimester due to vomiting, nausea etc. , this trimester is a better time to go for it.

    Will my sex life change?

    You will find an increase in your libido in the second trimester due to the fact that you are regaining your energy. The blood flow to your genitals increases causing an intense desire for sex. Getting an orgasm will be easier and can also be multiple and intense.

    Mums-to-be often report that it takes time for the libido to set in once or to improve; but don’t worry if you can’t match your husband's sexual desire

    Make sure you tell your husband about what you want in bed; so that the whole experience is for good. The sensitivity of your breasts and private parts may still be there in the early second trimester.

    What positions should I go for in the second trimester?

    This trimester is the best time to have sex. You can find your most comfortable positions to do it. Most women find entering from behind or sideways as the most desirable.

    Can the baby be harmed due to sex?

    The baby is all safe in the amniotic sac of your uterus and wouldn’t mind you going about your business. She /he wouldn’t even understand what is happening.

    If your diagnosis indicates complications such as placenta previa or a history of cervical incompetence; it is advisable to stay away from sex. You can resume the same after consulting your doctor.

  • Foetal Development

    Week 13: Formation of Urine

    · Baby's intestines have come back to her/his abdomen from the umbilical cord.

    · Baby is beginning to form urine and is discharging it in the amniotic fluid.

    · Tissues that will later form bone are developing.

    Week 14: Sex of baby is apparent

    · Baby's arms have reached the final length.

    · Neck has become more defined.

    · Red blood cells form in the spleen.

    · For boys, prostrate appears and for girls ovarian follicles begin to form (May happen this week or next week)

    · Baby's weight would be 11/2 ounces (40 Grams) and he/ she will be almost 3 ½ inches long.

    Week 15: Bones develop

    · Growth is rapid

    · Skeleton is developing bones.

    · Scalp hair pattern are also forming.

    Week 16: Sucking motion can be made by the baby.

    · Eyes have begun to face in front and move.

    · Ears are reaching its final position.

    · Baby might be able to do the suck motion with her/his mouth.

    · Baby's movement can be detected in the ultrasound scans.

    · Baby might be more than almost 4 ½ inches long.

    Week 17: Fat Accumulation

    · Development of the toenails.

    · Fat begins to develop under baby skin which will keep him/her warm.

    Week 18: Hearing begins for the baby

    · Ears begin to stand out of his/her head.

    · Baby might be more than almost 5 ½ inches long and has a weight of 7 ounces (200 grams).

    Week 19: Uterus formation

    · Vernix Caseosa begins to cover all over the body; saving him/her from abrasions, chapping and hardening due to the exposure to amniotic fluid.

    · For girls, uterus and vagina may form this week.

    Week 20: The Midway point

    · You will feel baby's movement known as quickening.

    · Baby might be more than almost 5 ½ inches long from crown to rump.

    Week 21 Swallowing motion develops

    · Baby gains more weight.

    · Baby is more active and can swallow.

    Week 22: Baby's Hair can be seen

    · Baby's fine down-like hair called lanugo is now visible.

    · Baby's eyebrows might be visible.

    · Baby might be almost 7 1/2 inches long and has a weight of 1 pound (460 grams).

    Week 23: Footprints and Fingerprints Form

    Skin is wrinkled and from pink to red in color.

    · Rapid movements begin.

    · Tongue develops taste buds.

    · With intensive care; baby born in this week might survive.

    Week 24: Real hair can be seen

    · Baby is regularly sleeping and waking.

    · Real hair is showing on his head

    · Baby might be almost 8 inches (210 millimeters)and has a weight of  1 1/3 pounds (630 grams)

    Week 25: Response to your voice

    · Hands and startle reflex develop.

    · Baby responds to familiar sounds.

    Week 26: Fingernails of the baby develop.

    · Baby has fingernails.

    · The lungs of the baby have begun to produce surfactant which is a substance that allows the air sacs in the lungs to inflate and keeps them from sticking to each other when they deflate.

    · Baby might be almost 9 inches (230 millimeters) long from crown to rump and has a weight of   2 pounds (820 grams).

    Week 27: End of 2nd trimester

    · With the end of 2nd trimester; the baby's lungs and nervous system are continuing to mature.