The Second Trimester: Physical and Emotional Changes

Here is some of what you might experience:

- Changes in your body
- Emotional changes
- Warning signs your caregiver may need to evaluate

Your Body
This is a general guide to the changes pregnant women often experience. You'll probably feel less tired than in the second and third months; you'll often feel a delightful sense of physical well-being. This is a good time for vacations and projects.

Between 18 and 22 weeks, fetal movements can usually be felt; these start as vague flutters and gradually become more definite.

You'll experience a steady weight gain of about one-half to one pound per week, although individual weight gain varies. Avoid eating and activity patterns that result in too much (more than 35 to 40 pounds) or too little (less than 15 to 25 pounds) weight gain during the entire pregnancy. Your caregiver will tell you the right weight range for you. Eating a healthy, balanced diet should be your priority.

Hunger, stress, fatigue or noxious fumes may bring on headaches. Try rest, neck massage and avoiding the cause of the headache. Check with your caregiver before taking any medications.

You may have heartburn, a burning sensation in the upper abdomen (caused by the backup of acidic stomach contents into the esophagus). To minimize this, don't overfill your stomach and remain upright for two to three hours after eating.

Hormonal changes cause skin blemishes and increased pigmentation; they also cause swelling of mucous membranes lining the nose, mouth and vagina, which can result in a stuffy nose, minor nosebleeds and an increase in a white, nonirritating vaginal discharge.

Hormones slowing down the digestive tract can cause constipation (infrequent and/or hard stools). Some iron supplements can make it worse. To avoid constipation, drink plenty of fluids, eat lots of high-fiber foods and exercise daily.

Slight ankle swelling is normal and healthy; you may feel more comfortable wearing nonbinding support hose and elevating your feet while sitting. This can also minimize (though not eliminate) the tendency to develop a few early varicose (swollen) veins.

You may notice a change in gait and balance even before much weight gain or change in body shape has occurred. Joints and ligaments loosen during pregnancy; take care while exercising to avoid falling or straining muscles or ligaments.

Leg cramps, especially in the calves at night, often occur for no reason at all. They are more frequent in women with either insufficient or excessive calcium intake or inadequate potassium intake. Leg cramps are less frequent in women who exercise regularly.
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