Second Trimester Symptoms and Solutions

It is time to bid a fond farewell to the tummy-turning and sleep-sapping challenges of your first trimester of pregnancy and welcome your second trimester, aptly dubbed the “honeymoon period.” You see, the second trimester is often when the symptoms of early pregnancy subside, leaving you feeling more rested and invigorated than you have in three months! Of course, that is not to say that the second trimester is a breeze. This stage of pregnancy is a period of rapid development for your baby-to-be, which means your body is rapidly changing, too! For the inside scoop on some of the most common second trimester symptoms—and how to handle them—keep reading.

When does the second trimester start?

Did you know that not everyone agrees to when the second trimester starts? For example, the NHS reports that it begins at week 13,  but the American College of Obstetricians and Gynecologists (ACOG) and most American providers agree that the second trimester starts at 14 weeks of pregnancy and extends until week 27 of pregnancy. There are 12 weeks in the second trimester.

Second Trimester Symptom: Hyperpigmentation

While the “pregnancy glow” gets all the hype, the truth is, the “mask of pregnancy” (aka melasma), is a super common skin disorder affecting up to 50% of mums-to-be. Reports show that 50 to 70% of those melasma cases begin in the second trimester. You will know you have got it if you start to notice brown or gray patches on your forehead, cheeks, chin, the bridge of your nose, and/or above your upper lip. You can likely thank the uptick of oestrogen, progesterone, and other pregnancy hormones for this. 

Another common skin-darkening result of pregnancy is called linea nigra. Here, a brown or light black line stretching from your navel to your pubic area seems to suddenly appear in your second trimester. Truth be told that line has always been there! But as your hormones continue to rise during your second trimester, the line becomes more and more visible. (Before pregnancy, that line was dubbed linea alba or “white line.”) While up to roughly 80% of mums-to-be have a linea nigra, it is often more noticeable on folks with darker complexions.

Second Trimester Hyperpigmentation Treatment and Prevention

The tricky thing about hyperpigmentation in pregnancy is that the hydroquinone, the go-to melasma treatment, should not be used when you are expecting. But that does not mean you are stuck with melasma until you give birth! Experts suggest melasma treatments containing alpha hydroxy acid (AHA), which are safe to use during pregnancy. To help diminish melasma in your second trimester and beyond, wear a wide-brimmed hat when out and always use a broad spectrum sunscreen, since UV exposure worsens melasma. If you can, opt for a physical sunscreen such as titanium oxide and zinc oxide, which sits atop your skin, as opposed to getting absorbed.

The same sunscreen advice holds true for linea nigra. Plus, it is thought that folic acid found in leafy greens and beans may help reduce the intensity of linea nigra. But linea nigra is completely harmless and often fades on its own shortly after delivery.

Second Trimester Symptom: Constipation

Up to 39% of people get constipated at some point during pregnancy—and for 61% of mums-to-be, that cannot-poop pregnancy symptom strikes in the second trimester. While the uptick of the pregnancy hormones progesterone—which relaxes your bowels so they do not work too hard to squeeze poo out—is partially to blame, it is not the sole constipation culprit. The iron from your pregnancy vitamins can slow things down, as can your growing baby, who places extra pressure on your bowel, making it difficult for waste to travel. The other big causes of constipation in pregnancy have nothing to do with your bun-in-the-oven status. Instead, it is all about how much physical movement you are getting, how much fibre you are consuming, and how much water you are drinking. (“Under-hydration” is a typical problem during the second trimester, which definitely ups the odds of constipation.)

Second Trimester Constipation Treatment and Prevention

First, make sure you are drinking 6 to 8 glasses of 200 ml of water every day. Next, incorporate 20 to 30 minutes of moderate exercise into your routine three times a week. But if you are new to the fit game, start with as little as 5 minutes of exercise daily until you can stay active for 30 full minutes. (Find out the safest way to exercise throughout your pregnancy.) 

It is also imperative to include more fibre in your diet by way of eating more fruits, veggies, whole grains, beans, nuts, and seeds. (Shoot for about 25 grams of fibre daily.) If you are struggling to get enough fibre-rich foods into your diet, ask your healthcare provider about taking a fibre supplement. And while you have got their ear, ask if a stool softener may be right for you.

Second Trimester Symptom: Round Ligament Pain

Those achy, crampy—or even sharp pains—you feel on either side of your baby bump, hips, or groin are called round ligament pain and it is a common second trimester pregnancy symptom, impacting up to 30% of mums-to-be, especially in the second trimester. It is at this point in pregnancy that the ligaments stretching from the top and sides of your uterus to your pelvic bones get quite a workout, trying to support your ballooning uterus. As those ligaments grow and stretch, they tighten, which can cause pain and discomfort. It is good to know that round ligament pain in pregnancy has been known to worsen with sudden movements, like sneezing, coughing, laughing, or standing too quickly.

Second Trimester Round Ligament Pain Treatment and Prevention

Your ligaments are going to stretch in pregnancy no matter what, but there are ways to help avoid and quell round ligament pain. For starters, avoid lying flat on your back, lifting heavy objects, and standing for long periods of time. As for “dos,” change position slowly and lean forward, placing your hands under your bump if you are going to laugh, sneeze, or cough. When resting, lay on your side with your knees bent and place pillows between your legs and under your belly. Consider wearing an elastic belly band to support your growing bump, too.

Whatever you do, do not stop moving! Activities that flex your hips can help ease pain. (Try getting on your hands and knees and lowering your head toward the floor, while keeping your rear in the air.) And gentle activities like swimming, water aerobics, and yoga can help take the weight off your uterus, back, and joints, allowing your round ligaments time to rest.

Second Trimester Symptom: Urinary Tract Infection

Urinary tract infections are the most common complication during pregnancy, impacting about 1 in 10 mums-to-be, often during the first and second trimesters. Why are UTIs so common in the second trimester? You can at least partially blame hormonal changes. Specifically, the increase in progesterone relaxes the smooth muscles in your urinary tract, which makes it easier for bacteria to creep into the bladder and kidneys. Plus, your growing uterus puts the literal squeeze on your ureters, easily obstructing the flow of urine. It is a good bet you have a UTI if it burns when you wee, it is difficult to wee, there is blood in your urine, and/or your urine appears cloudy.

Second Trimester Urinary Tract Infection Treatment and Prevention

Do not drag your feet if you suspect you have a UTI—if ignored, a urinary tract infection can morph into a dangerous kidney infection (aka pyelonephritis) that can lead to preterm labor, premature delivery, septic shock, or worse. Once you are diagnosed, your healthcare provider will likely prescribe a short course of pregnancy-safe antibiotics like nitrofurantoin or pivmecillinam. UTI symptoms usually fade within three days of taking antibiotics.

If you are dealing with repeat UTIs in pregnancy, your doctor or midwife may recommend a lower dose of antibiotics daily. And if you are dealing with pyelonephritis, you will need to get IV antibiotics at the hospital. Before you get to the point of meds, do your best to dampen your UTI risk by drinking plenty of six water, wearing breathable cotton underwear, emptying your bladder throughout the day and for-sure after sex.

Second Trimester Symptom: Rhinitis

While you may assume your congestion and runny nose are due to a cold or allergies, these nasal symptoms may point to pregnancy rhinitis (aka gestational rhinitis), a common ailment in the second and third trimester affecting approximately 20% of expectant mums. Here, the extra fluids in your body work with the uptick of placenta-derived human growth hormone (HGH) to increase nasal symptoms. Because the symptoms of pregnancy rhinitis can often worsen when you lay down, your precious pregnancy sleep may be disrupted, too. Pregnancy rhinitis typically lasts six weeks or longer, but for most, symptoms usually resolve two weeks after delivery. (Fun fact: A 2020 report found that those carrying female babies were more likely to have pregnancy rhinitis than those carrying male babies.)

Second Trimester Rhinitis Treatment and Prevention

Good ol’ saline drops or a saline rinse can help relieve congestion in pregnancy. Also helpful: drinking plenty of fluids, elevating your head and using a humidifier during sleep, and regularly engaging in moderate-intensity exercise.

Some experts warn that it is not a good idea to use over-the-counter nasal decongestants during pregnancy, while others note that taking a decongestant that includes pseudoephedrine may be helpful. Talk with your healthcare provider before taking any medication during pregnancy—and this is especially true for decongestants if you have high blood pressure. (While you have got your provider on the line, ask about using OTC nasal strips, too.)

Second Trimester Symptom: Gingivitis

Did you know that higher than normal hormone levels during pregnancy affect the way your gums react to plaque? That is one of the main reasons pregnancy gingivitis is incredibly common, affecting 60% to 75% of all pregnant folks, according to the Centers for Disease Control and Prevention (CDC). Symptoms—including red and swollen gums, bleeding while brushing, and tenderness—often become more severe during your second trimester—and continue for the duration of your pregnancy. Gingivitis is an early stage of gum disease that may get aggravated by the shifting hormones of pregnancy. While gingivitis during pregnancy usually goes away after delivery, it should still be a priority to prevent and treat gingivitis, especially since some studies link gum disease to preterm birth.

Second Trimester Gingivitis Treatment and Prevention

The best way to prevent and treat pregnancy gingivitis is pretty standard: brush your teeth twice daily, floss at least once a day, and gargle with a warm saltwater (one teaspoon of salt in one cup of warm water) daily. See your dentist as normal, meaning every 12 to 24 months—in fact, now is the time to get an appointment on the books. Your second trimester is considered the safest trimester to get dental treatment. And if your gingivitis symptoms are severe or worsening, your dentist may be able to prescribe a special mouthwash or oral antibiotics to help.

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