Birth Series: The Second Trimester
The second trimester is usually the favorite trimester for women. This is when your bump is beginning to gently show, but your pants still fit with an extender! Your shirts are becoming a little tight, but your bump is so adorable, you love showing it off. The morning sickness begins to become a distant memory and now you feel this new burst of energy, and are feeling wonderful! (That “burst” of energy is just the energy you were missing in the first trimester)
So in this trimester you will see your body begin to change a lot more from the outside. Your belly begins to grow as your uterus is still expanding with baby growing too! You are probably feeling more hungry due to your body’s additional energy expenditure growing another human, thus also weight gain is very common in this trimester. However that is not the cue to go to the all you can eat buffet, a pregnant woman does not usually need more than 300-500 additional calories. Of course if you are carrying multiples, or have any specific conditions – that fact could vary depending on the situation.
So if you have been pregnant, you are aware of the amount of testing available to you for your baby. If you have never been pregnant, I think it is good to be aware that there is a variety of testing highly recommended, as well as optional during pregnancy. During the first trimester, most doctors will recommend you get the first trimester bloodwork panel that begins the process for looking for risks of the fetus having birth defects. This isn’t the only bloodwork that is generally taken, but it is usually the first panel to be completed, and this occurs between 11-13 weeks.
In my first trimester blog, I think I left out a very common missed detail about the first trimester confirmation ultrasound. It is done transvaginally, not in the traditional way people picutre ultrasounds happening on their abdomen. However in the second trimester, the next ultrasound that is done is the 20 Week Anatomy Scan. This ultrasound is very detailed and takes the longest due to all the measurements they take. It is done via abdomen, and they look at every body part: hands, feet, heart, brain, lungs, face, and they measure bones such as the femur and humerus. This is the most fascinating ultrasound they do, and gives them wonderful information in regards to your growing baby! They look at other factors too such as amniotic fluid level, cervix measurements, and placental placement. There are various risks with abnormal findings of each of those factors, so it’s always checked via ultrasound, even if your ultrasound technician doesn’t say those out loud during the procedure.
There is a second trimester blood panel is called the AFP screening and it is typically done between 15-20 weeks of pregnancy. It is completed to check the levels of AFP in the mother’s blood that might indicate potential birth defects. There are other follow up tests if anything shows up abnormal or your doctor thinks that further testing is warranted.
That sums up MOST of the testing, but there is one other important test that you should be aware of. The Glucose test for gestational diabetes. Gestational diabetes is defined as high blood sugar that is found during pregnancy, and can increase your risk for high blood pressure, high birth weight, and dangerous conditions such as preeclampsia. Given all the risks that are associated with gestational diabetes, it is important to test for this between weeks of 24-28 of gestation. The testing itself isn’t too bad, most doctors perform the non-fasting test first which is where woman drinks a cup of liquid containing glucose. Then after one hour, they will do a blood draw to check your glucose levels and depending on the results will determine if you need to perform the 3 hour fasted glucose test or not.
Another important note about the second trimester is in regards to physical activity and exercise. This may be the phase where you have more energy, but this is also the phase where since your body is changing and growing, you have to adapt or modify the movements due to growing belly. Social media has been exploding with fitness recommendations about pregnancy, and then there is also still some old school medical providers that follow the heart rate recommendation for weight/cardiovascular training while pregnant. Neither extremes are appropriate for everyone. That being said, it is important to note that is rare occasions where there is a high risk pregnancy with certain comorbidities that it would be appropriate to caution with certain types of exercise. However for the sake of this blog’s information purposes, we are not talking about those situations. In regards to your average, normal, healthy pregnancy and mother – continuing exercise for overall health benefits is highly recommended in the research and evidence in modern medicine. So they best recommendation at this time is adjust your workouts based on how you are feeling mentally and physically, and as your advance in your growing belly you may have to wean off of plyometric movements such running, jumping, burpees, and movements similar to those. If you have any questions or concerns about exercise modifications with pregnancy it would be best to seek out a consult from your local physical therapist!
Now if you are having new symptoms such as uncontrolled urination while you are jumping, running, exercising during pregnancy, I would highly recommended seeking a physical therapist that specializes in the pelvic floor to help resolve this issue. This is NOT normal during pregnancy, and if you are experiencing this, it can helped with physical therapy interventions from a skilled pelvic floor specialist. So please keep that in mind 🙂
To summarize the second trimester on a happy note, this is the phase where you and your baby grow and can physically see and feel the changes! This is also the phase where most women begin to feel their baby move and kick! So enjoy this phase while you are in it, and use it to learn and adapt with your body as it continues to nurture your little one.