Second Trimester Guide: Pregnancy Weeks 13 to 27

The second trimester, weeks 13 to 27, is often called the most comfortable stage of pregnancy. Nausea usually settles, energy returns and you may feel your baby move for the first time.

This guide explains what is happening inside and outside your body, which scans and tests to expect, how to stay comfortable and when to call your doctor. To see which week you are in, try our pregnancy week calculator.

How You May Feel

Cleveland Clinic says morning sickness and first-trimester tiredness often fade, though some women continue to feel unwell or develop new symptoms. Common changes include:

• Better appetite
• Bleeding gums and occasional nosebleeds or a blocked nose, caused by hormones
• A darker line down the belly and darker nipples
• Stretch marks, swelling of the hands, feet and ankles
• Round ligament pain, a short sharp twinge at the side of the belly
• Back pain and leg cramps (see pregnancy back pain and leg cramps relief)
• A higher chance of urine and yeast infections

How Your Baby Develops

Cleveland Clinic and Womenshealth.gov describe these milestones:

• **Weeks 13 to 16:** Eyelids, eyebrows, eyelashes, nails and hair appear. The baby can stretch, make faces and suck a thumb. At 16 weeks the baby is about 4 to 5 inches long.
• **Around week 20:** The baby is about 6 inches long by Womenshealth.gov's measure, can hear and swallow, and is covered in a protective coating called vernix. The NHS describes the baby as about 25.6 cm from head to heel at this point, using a different measure.
• **Week 24:** About 12 inches long and about 1.5 pounds.
• **Weeks 26 and 27:** The NHS says the baby's eyes open for the first time, and the baby learns to blink.

Sizes differ by how and when they are measured, so treat these as rough guides.

Feeling Your Baby Move

Cleveland Clinic says first movements, called quickening, are usually felt around 18 to 20 weeks. They feel like flutters or bubbles. Movements may be irregular at first and become more regular closer to week 28. First-time mothers may notice them later.

If you are unsure whether what you feel is the baby, ask your doctor at your next visit. For later pregnancy, read about what to do about reduced baby movements.

Scans and Tests

• **Anatomy scan:** A detailed ultrasound often around 20 weeks that checks the baby's organs and the placenta. See ultrasound scans by trimester.
• **Blood tests:** Cleveland Clinic lists a blood count for anaemia, Rh factor and a repeat syphilis screen among routine tests. See anaemia in pregnancy.
• **Glucose test:** MedlinePlus says most women are screened for gestational diabetes at 24 to 28 weeks, earlier if risk is high. In the two-step method you drink a glucose solution and have blood drawn an hour later. A reading above 140 mg/dL (7.8 mmol/L) leads to a longer follow-up test. Procedures vary between clinics, so follow your doctor's instructions.
• **Regular visits:** Cleveland Clinic says visits are usually every four weeks unless your pregnancy is high risk.

Our guide to gestational diabetes explains what the results mean.

Staying Comfortable

• Exercise gently. Cleveland Clinic suggests about 20 minutes a day, with walking and swimming among the safest choices. Ask your doctor first.
• Sleep on your side and avoid lying flat on your back for long periods.
• Eat small, balanced meals and drink water. See foods to eat during pregnancy.
• Do gentle pelvic floor exercises, as the NHS suggests, to reduce leaking.
• Rub a cramping calf or pull your toes towards your ankle.

Tip: Keep a small notebook for questions and baby movements. It makes antenatal visits shorter and calmer.

Planning Ahead

The middle months are also a good time to prepare. The NHS suggests considering antenatal classes, which are useful even if you have children already, and asking about vaccines such as the whooping cough vaccine. It also recommends talking to your workplace about lighter duties or time for appointments, and starting to think about contraception and family planning after the birth. Having these conversations now leaves more time for the baby's arrival later. Our guide to vaccines during pregnancy explains the common ones.

If you have any long-term condition such as thyroid disease or high blood pressure, this is a good moment to review your medicines and tests with your doctor. Read our article on thyroid problems in pregnancy if this applies to you.

Things to Avoid

• Raw or undercooked meat, unpasteurised dairy, high-mercury fish and deli meats
• Alcohol, smoking and recreational drugs
• Hot tubs and saunas
• Contact sports and activities with a risk of falls
• Cleaning cat litter, because of the risk of toxoplasmosis

Myths and Facts

• **Myth:** The baby is safe from everything now. **Fact:** Warning signs still matter, so keep all visits.
• **Myth:** Swelling is always harmless. **Fact:** Sudden or extreme swelling with other symptoms can point to preeclampsia. See preeclampsia warning signs.
• **Myth:** You should eat for two. **Fact:** The NHS says you do not need extra calories until the third trimester.

When to be cautious: Womenshealth.gov says itching together with nausea, vomiting, jaundice or tiredness can signal a serious liver problem. Do not wait. Call your doctor the same day.

When to See a Doctor

Contact your doctor straight away if you have:

• Unusual or severe cramping or tummy pain
• Vaginal bleeding
• Fluid leaking from the vagina
• Regular contractions, more than four an hour, according to Cleveland Clinic
• Worsening breathlessness
• Sudden or extreme swelling or fast weight gain
• Severe headache or vision changes

For urgent help, see our emergency page.

Talk to a Doctor

The middle months are a good time to settle your care plan, birth preferences and questions. Book an appointment or call +91 944 103 0587. Learn about antenatal check-ups or see the third trimester guide for what comes next.

This article is for general awareness and is not a substitute for a doctor's advice.