The second trimester

The second trimester of pregnancy starts at week 13 and lasts until week 28. The second trimester has its fair share of discomforts, but doctors consider it a time of reduced nausea and greater energy.

What weight gain should I expect in the second trimester?

At the start of the second trimester, your baby weighs nearly 1.5 ounces. When you reach the end of this trimester, they’ll weigh almost 2 pounds. That’s a lot of growth in a few months. The rate of growth will only increase in your next trimester.

The increase in your baby’s weight will cause an increase in your own weight. Your body will continue to increase your blood and fluid volume, which adds weight. Soon, you will start to feel your baby move.

The amount of weight you can expect to gain during the second trimester will vary based on your pre-pregnancy weight. Your doctor should calculate your body mass index (BMI) early in your pregnancy. Based on your BMI, your doctor can estimate how much weight you should gain. According to the Institute of Medicine, women who are:

  • underweight, or have a BMI under 18.5, should gain 28-40 pounds
  • normal weight, or have a BMI between 18.5-24.9, should gain 25-35 pounds
  • overweight, or have a BMI between 25-29.9 , should gain 15-25 pounds
  • obese, or have a BMI over 30, should gain 11-20 pounds

If you were very sick in your first trimester of pregnancy, you may have lost weight or your weight may have stayed the same. You may gain weight in the second trimester to compensate for this loss.

Your doctor will weigh you and estimate your baby’s weight with each monthly visit. Ask them if you’re concerned you’re gaining too much or too little weight.

What skin changes should I expect in the second trimester?

The second trimester can bring about several changes in your skin. You may be wondering at this time what’s normal and what isn’t. Here are a few examples of common changes that occur during your second trimester.

Stretch marks

As your belly continues to expand during the second trimester, you may start to notice some stretch marks. These are areas where your belly is growing faster than your skin can keep up with. As a result, the skin tears slightly and stretch marks are created. You will most likely see them on your stomach and your breasts. These areas enlarge the most during pregnancy.

Not every mom-to-be will get stretch marks, but many do. A variety of creams claim to reduce stretch marks, but they haven’t been proven to do so. They can, however, make your skin less itchy. Avoiding excessive weight gain during your second trimester also can help reduce the incidence of stretch marks. Talk to your doctor if you’re concerned you have gained too much weight.

After you give birth, your stretch marks will most likely begin to fade. However, it can be difficult to completely eliminate them.

Linea nigra

Linea nigra, or dark line, often appears in your second trimester of pregnancy, usually around five months. This is a dark, usually brown line that runs from your belly button to your pelvis. Some women also have the line above the belly button. The dark line is caused by the placenta creating more hormones. These are the same hormones that can also cause melasma and make your nipples appear darker.


Melasma is also known as the “mask of pregnancy.” It’s another symptom associated with increased amounts of estrogen and progesterone. This causes the body to make more melanin, a brown pigment. In addition to linea nigra, you may also notice patches of brown or darkened skin on your face.

Pregnancy makes you especially sun-sensitive. You should wear sunscreen with an SPF of 15 or greater on your face before going outdoors. This can prevent melasma from getting worse while you’re pregnant. Doctors don’t usually recommend treating melasma. For most women, it goes away after childbirth.

Your doctor can prescribe topical medications to lighten the pigmented areas if your melasma doesn’t go away after you give birth. Always talk to your doctor about the safety of using these topical items and breast-feeding.

What discomforts should I expect in the second trimester?

Adding 15 pounds of weight in three months can lead to increased discomfort, particularly in your lower back. Your growing belly can also place extra stress on your back.

Ways to reduce second trimester-related lower back pain include:

  • sleeping on your left side with a pillow between your legs
  • avoiding lifting heavy items
  • avoiding high-heeled shoes
  • sitting in supportive and straight-backed chairs
  • maintaining good posture whenever possible
  • getting pregnancy massages
  • applying heat or cold in 10-minute increments to your back

Round ligament pain

The round ligament supports the uterus, and stretches as the uterus grows. Ligaments contract in a similar way to muscles. When these ligaments are stretched from pregnancy, anything that makes them contract quickly can cause pain. Actions that make these ligaments contract quickly include:

  • standing up quickly
  • coughing
  • laughing
  • sneezing

Changing positions slowly or flexing you’re your hips before coughing or sneezing can help this pain. You should only feel this pain for a few seconds. Call your doctor if this pain is severe or if it lasts for several minutes.

Varicose veins

Added weight can also lead to sore legs and varicose veins. Your growing uterus places extra pressure on a large vein that travels to the legs, called the vena cava. When the uterus pushes excessively on the vena cava, varicose veins can form. These are noticeable veins in the legs that can sometimes make standing uncomfortable.

Ways you can relieve painful varicose veins include:

  • propping your legs up whenever possible
  • avoiding sleeping on your back, which puts extra pressure on your vena cava
  • wearing support hose, which promote blood flow back from your feet
  • avoiding sitting with your legs crossed
  • stretching your legs frequently

Always check with your doctor to make sure there aren’t any reasons you shouldn’t wear support hose. Also, let your doctor know if varicose veins cause you so much pain that you have trouble walking.

Leg cramps

Leg cramps are common in pregnancy and often happen at night. If you develop a leg cramp, stretch the muscle. You can prevent future cramps by:

  • staying active
  • drinking plenty of fluids
  • stretching your calf muscles before bed


During pregnancy, your blood vessels dilate. This causes your blood pressure to drop. Sometimes your blood pressure might drop too much and you may begin to feel dizzy. Staying hydrated and lying on your left side can help you manage dizziness.

Bleeding gums or nose

Increased hormones can heighten your risk of bleeding during the second trimester. You also have a lot more blood flowing through your body. As a result, you can experience increased bleeding. This bleeding can occur in your nose due to airway swelling. You may also notice snoring and increased congestion.

Ways to relieve or reduce nosebleeds include:

  • avoiding secondhand smoke
  • breathing in steam from a vaporizer or hot shower
  • placing warm, moist towels over your face

You may also notice some blood on your toothbrush when you brush your teeth. The increased blood volume can cause your gums to become softer and more vulnerable to bleeding. You may wish to use a softer-bristled toothbrush during pregnancy. Don’t give up on your dental routine, however. Brushing and flossing are still vital. You can talk to your dentist if you’re concerned your gums are bleeding too much.

What is the outlook?

The second trimester is a time when your pregnancy feels even more real. You will start to sense your baby moving. You’ll also start to appear pregnant to the outside world. While the second trimester has its share of discomforts, there are many ways to reduce the pain.