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Prenatal care in your second trimester

Trimester means 3 months. A normal pregnancy is around 9 months and has 3 trimesters.

Your health care provider may talk about your pregnancy in weeks, rather than months or trimesters. The second trimester begins at week 14 and goes through week 28.

Routine prenatal visits

In your second trimester, you will have a prenatal visit every month. The visits may be quick, but they are still important. It is OK to bring your partner or labor coach with you.

Visits during this trimester will be a good time to talk about:

During your visits, your doctor or midwife will:

  • Weigh you.
  • Measure your abdomen to see if your baby is growing as expected.
  • Check your blood pressure.
  • Sometimes take a urine sample to test for sugar or protein in your urine. If either of these is found, it could mean you have gestational diabetes or high blood pressure caused by pregnancy.

At the end of each visit, your doctor or midwife will tell you what changes to expect before your next visit. Tell your doctor if you have any problems or concerns. It is OK to talk about any problems or concerns, even if you do not feel that they are important or related to your pregnancy.

Lab tests

Hemoglobin testing measures the amount of red blood cells in your blood. Too few red blood cells can mean that you have anemia. This is a common problem in pregnancy, although easy to fix.

Glucose tolerance testing checks for signs of diabetes which can begin during pregnancy. In this test, your doctor will give you a sweet liquid. An hour later, your blood will be drawn to check your blood sugar levels. If your results are not normal, you will have a longer glucose tolerance test.

Antibody screening is done if the mother is Rh-negative. If you are Rh-negative, you may need an injection called RhoGAM around 28 weeks of gestation.

Ultrasounds

You should have an ultrasound around 20 weeks into your pregnancy. An ultrasound is a simple, painless procedure. A wand that uses sound waves will be placed on your belly. The sound waves will let your doctor or midwife see the baby.

This ultrasound is typically used to assess the baby’s anatomy. The heart, kidneys, limbs, and other structures will be visualized.

Ultrasound can detect fetal abnormalities or birth defects about half the time. It is also used to determine the sex of the baby. Before this procedure, consider whether or not you want to know this information, and tell the your ultrasound provider your wishes ahead of time.

Genetic testing

All women are offered genetic testing to screen for birth defects and genetic problems, such as Down syndrome or brain and spinal column defects.

  • If your doctor thinks that you need one of these tests, talk about which ones will be best for you.
  • Be sure to ask about what the results could mean for you and your baby.
  • A genetic counselor can help you understand your risks and tests results.
  • There are many options for genetic testing. Some of these tests carry some risk, while others do not.

Women who may be at a higher risk for these problems include:

  • Women who have had a fetus with genetic abnormalities in earlier pregnancies
  • Women age 35 or older
  • Women with a strong family history of inherited birth defects

Most genetic testing is offered and discussed in the first trimester. However, some tests can be performed in the second trimester or are done partly in the first and second trimester.

For the quadruple screen test, blood is drawn from the mother and sent to a lab.

  • The test is done between the 15th and 22nd week of pregnancy. It is most accurate when done between the 16th and 18th weeks.
  • The results do not diagnose a problem or disease. Instead, they will help the doctor or midwife decide if more testing is needed.

Amniocentesis is a test that is done between 14 and 20 weeks.

  • Your doctor or caregiver will insert a needle through your belly and into the amniotic sac (bag of fluid surrounding the baby).
  • A small amount of fluid will be drawn out and sent to a lab.

When to call your health care provider in your second trimester

Call your health care provider if:

  • You have any signs or symptoms that are not normal
  • You are thinking of taking any new medications, vitamins, or herbs
  • You have any bleeding
  • You have increased vaginal discharge or a discharge with odor
  • You have a fever, chills, or pain when passing urine
  • You have moderate or severe cramping or low abdominal pain
  • You have any questions or concerns about your health or your pregnancy

References

Gregory KD, Niebyl JR, Johnson TRB. preconception and prenatal care: part of the continuum. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 6.

Williams DE, Pridjian G. Obstetrics, In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 21.

Update Date: 6/11/2014

Updated by: Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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