Second Trimester Symptoms: Complete Guide to Weeks 13-27 of Pregnancy

The second trimester of pregnancy, spanning weeks 13 through 27, is often called the “honeymoon period” of pregnancy. Many women experience relief from early pregnancy discomforts like morning sickness and overwhelming fatigue. However, this trimester brings its own unique set of symptoms and changes as your baby grows and your body continues to adapt. Understanding what to expect can help you navigate this exciting phase with confidence.

Understanding the Second Trimester

The second trimester marks a significant transition in your pregnancy journey. During these weeks, your baby undergoes remarkable development, growing from approximately 3 inches to about 14 inches long. As your baby develops, your body experiences numerous changes to accommodate this growth. While many women feel their best during this period, it’s important to recognize and understand the various symptoms that may arise.

Common Physical Symptoms in the Second Trimester

Growing Belly and Expanding Uterus

One of the most noticeable second trimester symptoms is the visible expansion of your abdomen. Your uterus grows significantly during this period, rising above your pelvis and becoming more prominent. By the end of the second trimester, your uterus will have expanded to about the level of your belly button or higher. This growth is perfectly normal and indicates your baby is developing well.

You may notice your clothing becoming tighter, and maternity wear becomes a necessity rather than an option. Your body’s center of gravity shifts as your belly grows, which can affect your balance and posture.

Breast Changes and Development

Your breasts continue to grow and change during the second trimester as your body prepares for breastfeeding. You may notice:

• Increased breast size and fullness
• Darkening of the areolas (the area around your nipples)
• Visible veins beneath the skin due to increased blood flow
• Possible colostrum leakage, the first milk your body produces
• Montgomery’s tubercles becoming more prominent (small bumps on the areolas)

Investing in supportive, well-fitting maternity bras can help manage discomfort and provide necessary support as your breasts change.

Back Pain and Postural Changes

Lower back pain is among the most common second trimester symptoms, affecting up to 50-70% of pregnant women. Several factors contribute to this discomfort:

• The growing weight of your baby and uterus
• Hormonal changes, particularly increased relaxin, which loosens ligaments and joints
• Shifting center of gravity affecting your posture
• Weakening of abdominal muscles as they stretch

To manage back pain, maintain good posture, wear supportive footwear, use pregnancy pillows when sleeping, practice prenatal-safe stretching exercises, and consider prenatal massage if approved by your healthcare provider.

Round Ligament Pain

Many women experience sharp or jabbing pains in their lower abdomen or groin area during the second trimester. This is called round ligament pain and occurs as the ligaments supporting your uterus stretch and thicken to accommodate your growing baby. The pain typically lasts only a few seconds and is more common when you change positions quickly, sneeze, cough, or laugh.

Braxton Hicks Contractions

Often called “practice contractions,” Braxton Hicks contractions may begin during the second trimester, though they’re more common in the third trimester. These contractions feel like a tightening sensation in your abdomen that comes and goes irregularly. They’re typically painless or mildly uncomfortable and help your body prepare for labor.

Unlike true labor contractions, Braxton Hicks contractions are irregular, don’t increase in intensity, and often subside when you change position or rest. Contact your healthcare provider if contractions become regular, painful, or are accompanied by other symptoms, as this could indicate preterm labor.

Skin Changes During the Second Trimester

Hyperpigmentation and Melasma

Hormonal changes during pregnancy increase melanin production, leading to various skin changes. Melasma, sometimes called “the mask of pregnancy,” appears as brown or grayish patches on the face, particularly on the cheeks, forehead, nose, and upper lip. You may also develop a linea nigra, a dark vertical line running from your belly button to your pubic bone.

These pigmentation changes are common and typically fade after delivery, though this may take several months. To minimize melasma, wear broad-spectrum sunscreen with SPF 30 or higher daily, wear wide-brimmed hats when outdoors, and avoid excessive sun exposure.

Stretch Marks

As your skin stretches to accommodate your growing baby, you may develop stretch marks (striae gravidarum) on your abdomen, breasts, hips, buttocks, and thighs. These marks appear as reddish, purple, or brown streaks, depending on your skin tone. About 50-90% of pregnant women develop some degree of stretch marks.

While there’s no proven way to prevent stretch marks entirely, staying hydrated, maintaining steady weight gain within recommended guidelines, and keeping your skin moisturized may help. Remember that stretch marks typically fade to lighter, silvery lines after pregnancy.

Spider Veins and Varicose Veins

Increased blood volume and hormonal changes can cause small, red veins to appear near the surface of your skin, particularly on your face, neck, and arms. These spider veins are usually harmless and often disappear after pregnancy.

Varicose veins, which are larger, swollen veins that typically appear in the legs, may also develop or worsen during pregnancy. To minimize varicose veins, avoid standing or sitting for long periods, elevate your legs when resting, exercise regularly, and consider wearing compression stockings if recommended by your healthcare provider.

Skin Tags and Acne

Small, soft growths called skin tags may appear in areas where skin rubs against skin or clothing, such as under your arms, on your neck, or under your breasts. These are harmless and can be removed after pregnancy if desired.

Some women experience pregnancy acne due to hormonal fluctuations, while others notice their skin becomes clearer. Use gentle, pregnancy-safe skincare products and consult your healthcare provider before using any acne treatments.

Nasal and Respiratory Symptoms

Nasal Congestion and Stuffiness

Pregnancy rhinitis, characterized by nasal congestion without signs of infection or allergies, affects about 20-30% of pregnant women. Increased blood flow and hormonal changes cause the mucous membranes in your nose to swell, leading to stuffiness, congestion, and occasional nosebleeds.

To manage nasal congestion, use a humidifier to add moisture to the air, stay well-hydrated, try saline nasal drops or sprays, sleep with your head elevated, and apply petroleum jelly around your nostrils to prevent dryness and nosebleeds.

Nosebleeds

The increased blood volume and expanded blood vessels during pregnancy make nosebleeds more common. These are typically harmless but can be inconvenient. If you experience a nosebleed, sit up straight and lean slightly forward, pinch your nostrils together just below the bridge of your nose for 10-15 minutes, and breathe through your mouth. Contact your healthcare provider if nosebleeds are severe, frequent, or don’t stop after 20 minutes of pressure.

Digestive System Symptoms

Heartburn and Indigestion

While heartburn may improve for some women after the first trimester, others begin experiencing it during the second trimester. Progesterone relaxes the valve between your stomach and esophagus, allowing stomach acid to flow back up. Additionally, your growing uterus puts pressure on your stomach.

To minimize heartburn, eat smaller, more frequent meals, avoid trigger foods (spicy, fatty, or acidic foods), don’t lie down immediately after eating, sleep with your head elevated, and wear loose-fitting clothing around your abdomen.

Constipation

Constipation often continues or begins during the second trimester due to hormonal changes that slow digestion and the pressure of your growing uterus on your intestines. To combat constipation, increase your fiber intake through fruits, vegetables, and whole grains, drink plenty of water (at least 8-10 glasses daily), exercise regularly with your healthcare provider’s approval, and don’t ignore the urge to have a bowel movement.

Gas and Bloating

Hormonal changes and slower digestion can lead to increased gas and bloating. Eating slowly, avoiding carbonated beverages and gas-producing foods, staying active, and eating smaller meals throughout the day can help reduce these symptoms.

Circulatory System Changes

Dizziness and Lightheadedness

Your cardiovascular system undergoes significant changes during pregnancy, which can lead to occasional dizziness or lightheadedness. Your blood volume increases by up to 50%, your blood vessels dilate, and your growing uterus can compress major blood vessels when you lie on your back.

To prevent dizziness, rise slowly from sitting or lying positions, avoid lying flat on your back (sleep on your left side instead), stay hydrated, eat regular meals to maintain blood sugar levels, and avoid standing for long periods.

Increased Heart Rate

Your heart works harder during pregnancy, pumping more blood to support your baby. You may notice your heart rate increases by 10-20 beats per minute, and you might feel your heart beating faster or more forcefully, especially after physical activity.

Urinary System Symptoms

Frequent Urination

While frequent urination may decrease slightly during the second trimester compared to the first, you’ll still need to urinate more often than before pregnancy. Your growing uterus continues to put pressure on your bladder, and your body produces more fluids.

Urinary Tract Infections

Pregnant women are at higher risk for urinary tract infections (UTIs) due to hormonal changes and the pressure of the growing uterus on the bladder and ureters. Symptoms include a strong, urgent need to urinate, burning sensation when urinating, cloudy or strong-smelling urine, pelvic discomfort, and fever or back pain in more severe cases.

UTIs require prompt treatment to prevent complications. Contact your healthcare provider immediately if you experience any UTI symptoms. Your provider may prescribe antibiotics that are safe during pregnancy.

Vaginal Discharge

Increased vaginal discharge (leukorrhea) is normal during pregnancy. This thin, white, mild-smelling discharge helps protect the birth canal from infection and maintains a healthy bacterial balance. However, contact your healthcare provider if the discharge changes color (yellow, green, or gray), develops a strong odor, causes itching or burning, or becomes thick and cottage cheese-like, as these could indicate an infection.

Musculoskeletal Symptoms

Leg Cramps

Painful leg cramps, particularly in the calves, often begin during the second trimester and may worsen at night. The exact cause isn’t fully understood, but contributing factors may include increased weight, pressure on blood vessels and nerves, and possible mineral imbalances.

To prevent leg cramps, stretch your calf muscles before bed, stay active with regular exercise, stay hydrated, wear comfortable, supportive shoes, and avoid pointing your toes when stretching your legs. If a cramp occurs, immediately stretch the affected muscle by flexing your foot upward toward your shin, massage the muscle, apply heat or cold, and walk around once the initial pain subsides.

Carpal Tunnel Syndrome

Some women develop carpal tunnel syndrome during pregnancy due to fluid retention that puts pressure on the median nerve in the wrist. Symptoms include numbness, tingling, or burning in your hands and fingers, particularly the thumb, index, and middle fingers. The symptoms are often worse at night or upon waking.

To manage carpal tunnel symptoms, avoid sleeping on your hands, wear a wrist splint at night, take frequent breaks if performing repetitive hand movements, and try gentle hand and wrist stretches.

Dental and Oral Health Changes

Bleeding Gums

Pregnancy gingivitis affects about 50-70% of pregnant women. Hormonal changes increase blood flow to your gums and alter your body’s response to bacteria in plaque, making your gums more sensitive, swollen, and prone to bleeding during brushing or flossing.

Maintain good oral hygiene by brushing at least twice daily with a soft-bristled toothbrush, flossing daily (even if your gums bleed), rinsing with an alcohol-free mouthwash, and scheduling regular dental checkups and cleanings. Inform your dentist that you’re pregnant.

Baby Movement: Quickening

One of the most exciting second trimester symptoms is feeling your baby move for the first time, called quickening. First-time mothers typically feel movement between weeks 18-25, while women who’ve been pregnant before may notice it as early as week 13-16.

Initial movements feel like flutters, butterflies, or bubbles in your abdomen. As your pregnancy progresses, movements become stronger and more distinct. You might feel rolls, kicks, punches, and hiccups. Every baby has unique movement patterns, so don’t worry if your experience differs from others.

Emotional and Mental Health Symptoms

Mood Changes

While the second trimester often brings emotional stability compared to the first trimester, you may still experience mood fluctuations due to hormonal changes, physical discomfort, anxiety about pregnancy and parenthood, and changes in your daily life and routines.

Anxiety About Pregnancy and Parenting

It’s normal to experience anxiety during pregnancy, including worries about your baby’s health and development, labor and delivery, your ability to be a good parent, and financial concerns. Managing stress through prenatal education classes, connecting with other pregnant women, practicing relaxation techniques, and maintaining open communication with your partner and healthcare provider can help.

Pregnancy-Related Depression

Depression during pregnancy is common but often overlooked. About 10-15% of pregnant women experience depression. Symptoms include persistent sadness or emptiness, loss of interest in activities you once enjoyed, changes in appetite or sleep patterns, difficulty concentrating, feelings of worthlessness or guilt, and thoughts of self-harm.

If you experience symptoms of depression, contact your healthcare provider immediately. Treatment options are available and important for both your health and your baby’s wellbeing. Your provider may recommend counseling, therapy, support groups, or medication if necessary.

Changes in Energy Levels

Increased Energy

Many women experience a welcome surge in energy during the second trimester. The overwhelming fatigue of the first trimester often subsides as your body adjusts to pregnancy hormones and morning sickness improves. This is an excellent time to prepare your home for the baby, exercise regularly, tackle work projects, and enjoy activities before the third trimester brings renewed fatigue.

Sleep Changes

While you may have more energy during the day, you might still experience sleep difficulties due to difficulty finding comfortable positions, frequent urination, vivid dreams, leg cramps, and anxiety. To improve sleep, establish a consistent bedtime routine, use pregnancy pillows for support, sleep on your left side, limit fluids before bedtime, and create a cool, dark, quiet sleeping environment.

Appetite and Food Cravings

Increased Appetite

As morning sickness subsides, many women find their appetite returns with vigor during the second trimester. Your body needs additional calories to support your baby’s growth—approximately 300-350 extra calories per day during the second trimester. Focus on nutrient-dense foods rather than empty calories to meet your increased nutritional needs.

Food Cravings and Aversions

Food cravings and aversions can continue or begin during the second trimester, though they’re often less intense than in the first trimester. While the exact cause isn’t fully understood, hormonal changes and nutritional needs likely play a role. It’s fine to indulge cravings occasionally, but maintain a balanced diet overall.

Hair and Nail Changes

Hair Growth and Texture

Many women notice their hair becomes thicker, fuller, and shinier during pregnancy. This occurs because hormonal changes extend the growth phase of the hair cycle, reducing normal hair shedding. Some women also notice changes in hair texture or increased body hair. These changes are temporary, and hair typically returns to its pre-pregnancy state several months after delivery.

Nail Changes

Your nails may grow faster during pregnancy, but they might also become brittle, soft, or develop grooves. Keep your nails trimmed and moisturized, wear gloves when cleaning or washing dishes, and avoid harsh nail products and excessive exposure to water.

When to Contact Your Healthcare Provider

While many second trimester symptoms are normal, certain signs require immediate medical attention:

• Severe or persistent abdominal pain or cramping
• Vaginal bleeding or fluid leakage
• Severe headaches that don’t respond to rest or hydration
• Vision changes such as blurriness, spots, or flashing lights
• Sudden, severe swelling of your face, hands, or feet
• Persistent vomiting or inability to keep food or liquids down
• Fever above 100.4°F (38°C)
• Painful or burning urination with fever or back pain
• Decreased fetal movement after you’ve established your baby’s movement pattern
• Signs of preterm labor, including regular contractions, pelvic pressure, or low backache
• Thoughts of harming yourself or your baby

Managing Second Trimester Symptoms

Lifestyle Modifications

Making certain lifestyle adjustments can help manage many second trimester symptoms. Stay active with regular, moderate exercise approved by your healthcare provider, maintain a balanced, nutritious diet, stay hydrated by drinking plenty of water throughout the day, get adequate rest and prioritize sleep, practice stress-reduction techniques such as prenatal yoga or meditation, and avoid alcohol, tobacco, and recreational drugs.

Prenatal Care

Regular prenatal appointments are essential during the second trimester. During these visits, your healthcare provider monitors your baby’s growth and development, checks your blood pressure and weight, measures your fundal height (the distance from your pubic bone to the top of your uterus), listens to your baby’s heartbeat, performs necessary screenings and tests, and addresses any concerns or symptoms you’re experiencing.

The second trimester typically includes important screenings such as the anatomy ultrasound (usually performed between weeks 18-22), which examines your baby’s organs and structures, glucose screening for gestational diabetes (typically between weeks 24-28), and optional genetic testing if not completed in the first trimester.

Preparing for Parenthood

Use your increased energy during the second trimester to prepare for your baby’s arrival. Consider attending childbirth education classes, infant care classes, and breastfeeding classes. Research pediatricians and schedule interviews, create a birth plan, and start preparing your baby’s nursery. If you plan to return to work after delivery, research childcare options and review your employer’s parental leave policies.

Staying Healthy During the Second Trimester

Nutrition

Focus on eating a variety of nutritious foods including lean proteins to support your baby’s growth, calcium-rich foods for bone development, iron-rich foods to prevent anemia, folic acid for neural development, omega-3 fatty acids for brain development, and plenty of fruits and vegetables for vitamins, minerals, and fiber.

Exercise

Unless your healthcare provider advises otherwise, aim for at least 150 minutes of moderate-intensity exercise per week. Safe exercises during the second trimester include walking, swimming, prenatal yoga, stationary cycling, and low-impact aerobics. Exercise benefits during pregnancy include improved mood and energy, better sleep, reduced pregnancy discomfort, easier labor and recovery, and maintenance of healthy weight gain.

Hydration

Adequate hydration is crucial during pregnancy. Aim for 8-12 glasses of water daily, more if you’re exercising or in hot weather. Proper hydration helps prevent constipation, reduces swelling, prevents urinary tract infections, regulates body temperature, and supports increased blood volume.

Conclusion

The second trimester brings a unique set of physical, emotional, and developmental changes. While many women feel their best during this period, experiencing various symptoms is completely normal. Understanding what to expect helps you distinguish between typical pregnancy changes and symptoms that require medical attention.

Remember that every pregnancy is different. Some women experience many of these symptoms, while others sail through the second trimester with minimal discomfort. Stay in close communication with your healthcare provider, attend all prenatal appointments, and don’t hesitate to ask questions or voice concerns. With proper care and attention, you can navigate the second trimester confidently and prepare for the exciting arrival of your baby.

Take advantage of this “golden period” of pregnancy to prepare for parenthood, connect with your growing baby, and take care of your physical and emotional wellbeing. The energy and relative comfort of the second trimester provide an ideal opportunity to savor your pregnancy journey and create lasting memories.

Sources:

• American College of Obstetricians and Gynecologists – How Your Fetus Grows During Pregnancy
• Centers for Disease Control and Prevention – During Pregnancy
• Mayo Clinic – Second Trimester Pregnancy
• March of Dimes – Your Body During Pregnancy Second Trimester
• NHS – Pregnancy Week by Week