Your pregnancy: The second trimester

Lots of women really enjoy the second trimester—that happy middle ground of pregnancy. With any luck, the nausea and fatigue of the first few months have ended, you’ve told people that you’re pregnant and you can quit ducking questions and comments and legit wear maternity clothes. But perhaps, best of all, you’ll also start to feel the baby move. Here’s what else you can keep in mind during the second trimester.

When does the second trimester start? When does it end?

Your second semester starts at week 13 and ends on the last day of week 27.

What are some of the pregnancy symptoms in the second trimester?

Tender, bigger breasts

Well, your boobs will continue to go on the magical mystery tour—they’ll probably still be a bit tender and continue to grow, along with your bump. The increase in blood volume while pregnant makes veins more visible all over your body, especially if you’re fair-skinned, but the “road map” effect is definitely more visible on your breasts. Because levels of the hormone melanin are increasing, your areolas (the dark area around the nipples) may start to become darker and bigger.

Bathroom trips, fatigue and dizziness

While the gonzo tiredness of your first trimester has hopefully let up, you may still feel fatigued if you’re not sleeping well because you’re getting up to pee more often—that’s because of increased blood flow to your kidneys and overactive hormones stimulating your kidneys to create more urine. Higher levels of the hormone relaxin mean that your muscles and ligaments are more relaxed, but this applies to your pelvic floor muscles, too, so you may be leaking a bit when you sneeze, cough, exercise or laugh (that’s your cue to work on those Kegel exercises, which will help with delivery and postpartum recovery, too). If your fatigue levels seem over the top, talk to your healthcare provider to be assessed for anemia and thyroid issues. Feeling dizzy or light-headed if you stand up too quickly? Again, talk to your healthcare practitioner, though it’s often due to dilated and distended blood vessels (yep, hormones again).

Aches and pains

Relaxin sometimes causes pain in the ligaments, often in the hips and pelvis. As well, the round ligament, which supports the uterus, has to stretch a lot to make room for your growing babe, leading to an uncomfortable pulling sensation if you move too quickly (like if you cough, sneeze or stand up too fast). Your bigger belly can also contribute to lower back pain. Try changing positions slowly but often. Your hormone levels might contribute to a stuffed-up nose or even a sinus infection if you’re unlucky, so rinse out your nasal passages with saline solution if you’re having trouble.

Hair and skin changes

Extra estrogen means that your hair may look thicker and extra-shiny (preggo bonus!). Estrogen and progesterone will also boost your levels of melanin, which gives your skin colour. Moles and freckles may look more pronounced, and you may see linea nigra, a vertical dark line that appears on your belly. Seeing dark patches on your face (your cheeks, nose, upper lip or forehead)? This is called chloasma, or “mask of pregnancy,” and 50 to 70 percent of pregnant women notice it to some degree. It’s more common if you have a darker skin tone. You can often minimize its progression by wearing sunscreen and a hat.

What kinds of medical tests and screenings take place in the second trimester?

Between 15 and 20 weeks pregnant, depending on what you discuss with your healthcare provider, you can decide on further testing for the likelihood of neural tube defects, such as spina bifida.

An ultrasound between 18 and 20 weeks is pretty standard. It’s mainly used to check your baby’s anatomy and size, amniotic fluid levels, the placenta and the umbilical cord, and you can often find out the sex of the baby if desired (of course, your baby may not cooperate!).

At every visit, your healthcare provider will continue to check your urine for excess protein levels, which could indicate pre-eclampsia.

Around week 26, most women do the glucose challenge test to check for gestational diabetes (this is not mandatory but generally recommended). For this test, you down a syrupy drink at your healthcare provider’s office and get your blood drawn an hour later. If the blood test signals high glucose levels, you’ll return for a glucose tolerance test, where you’ll fast for eight hours, consume the sweet drink again and have three blood tests at one-hour intervals. If you’re one of about 10 percent of pregnant women diagnosed with gestational diabetes, it means that your body isn’t able to produce enough insulin during pregnancy and you’ll need to make some changes to your diet and lifestyle to help control blood sugar levels and keep you and your baby healthy. Risk factors include having a family history of diabetes or a previous history of gestational diabetes, being over age 35, having a body mass index (BMI) of 30 or more and being of non-white ancestry, but many women with none of these risk factors can also have gestational diabetes.

When can I first start to feel the baby move?

For most first-time moms, those early flutters of feeling the baby move (also called quickening) can happen anywhere between 18 and 22 weeks (sometimes earlier if you’ve already had a baby because your abdominal walls are more relaxed). The size of your baby and position of your uterus can also play a role in when you will feel those first movements.

Weight gain during the second trimester

Whether you’re hitting the maternity stores, buying regular clothes a couple of sizes bigger or just borrowing from a friend, the second trimester is generally when you need to get at least a few different pieces to accommodate your expanding boobs, belly and butt. Weight gain is, of course, healthy and normal if it’s about one pound a week during the second and third trimesters, for a total of between 25 and 33 additional pounds. Exercise (about 150 minutes of moderate activity, such as walking, swimming and strength training, spread out over a week) is fine and recommended for women with uncomplicated pregnancies.

Increased sex drive during pregnancy

“Turned-on pregnant lady” isn’t widely discussed, but, yep, that’s a thing for many women. High hormone levels can crank up your sex drive, and increased blood flow to your sex organs, breasts and vulva and good feelings about your luscious self can put you in the mood. If this applies to you, then go for it, either solo or with your partner. The only thing to watch for is medium to heavy bleeding with intercourse, which should be discussed pronto with your healthcare provider (if there’s slight spotting, it usually means that the cervix got bumped during sex and is bleeding a little bit).

What’s happening with baby in the second trimester?

There are lots of cool happenings going on in there, from little things like fine-tuning fingerprints and facial expressions and being able to hear your voice (muffled but still) to bigger stuff like growing a protective coating called myelin around nerves and swallowing and breathing in amniotic fluid to get the digestive and respiratory systems ready for the outside world. Your baby grows a lot in the second trimester, too, going from the size of a peach to a slice of pizza.

Read more: Pregnancy by week 88 things nobody tells you about being pregnant