Welcome to the second trimester! By now, you’ve gotten through some of the early complaints of pregnancy. You may even be on the other side of things like morning sickness. You’ve established care with a doctor or midwife that hopefully you like and feel comfortable with. You’ve made it through the first prenatal visit and some early visits with your provider and are hopefully feeling less intimidated by the whole process. So, what can you expect at the second-trimester appointments?

Estimated reading time: 6 minutes

Frequency of Second Trimester Appointments

Most women see their doctors or midwives every four to six weeks in the second trimester (1). This varies a little, based on your health, age, and whether your baby has any special needs or circumstances. If your doctor is keeping an eye on any concerns, he or she may need to see you more often. Most moms and babies are low risk, and you can expect to see your healthcare provider every month or so.

At Each Second Trimester Appointment

There are some things that you can expect at each appointment throughout your second trimester. Most of them are things you’ve already experienced at your first trimester visits.

Weigh in – Some women don’t like this part, but your doctor or midwife uses this stat to keep an eye on your nutrition and watch for trouble. For example, a sudden weight gain can signal preeclampsia (2).

Questions – Your provider will ask a variety of questions, which may include any or all of the following:

• Are you feeling nauseated?
• What other symptoms have you been feeling?
• Have you felt the baby move yet? (And later, is she moving as often as usual?)
• Have you had any bleeding or noticed any leaking fluid?
• Have you felt any contractions?

Pee in a cup – Your urine is sent to a lab to check for protein (which can suggest high blood pressure or preeclampsia,) sugar (which could mean gestational diabetes,) and bacteria (which may mean a urinary tract infection.) (3)

Blood pressure – Your provider will check this at each visit because hypertension (high blood pressure) can restrict the flow of blood to your baby, interfering with his growth. It can also mean preeclampsia. (2)

Listen to baby – Listening baby’s heartbeat — also called fetal heart tones or FHT — can help tell your doctor or midwife that your little one is doing well. It’s also really cool for you, no matter how many times you’ve experienced it!

Measure your belly – This won’t start at the beginning of the second trimester, but once they do start taking measurements — starting at around 24 weeks gestation — they’ll measure your fundal height at every visit. This helps track your baby’s growth to make sure that he or she is growing as expected.

At One Second Trimester Appointment

There are some tests that will typically only be done once in the second trimester, rather than repeated at every appointment.

Ultrasound

Between 18 and 22 weeks, you’ll have an ultrasound. This gives your provider important information including:

• How your baby is developing
• Whether there are any visible abnormalities
• Where your placenta is attached and whether it looks healthy
• How much amniotic fluid is in your uterus
• How many babies you’re carrying and what position they’re in
• Confirm that your estimated due date is accurate

If you don’t mind looking through a technical article that is not written for a layperson, A pictoral guide for the second trimester ultrasound is really interesting. It shows exactly what the ultrasound tech is looking at on those screens. (Because if we’re being honest, it sometimes just looks like you need to adjust the antenna on grandma’s old TV.)

Glucose screening

This test — done between week 24 and week 28 — detects high glucose levels, as this may indicate gestational diabetes. You’ll drink a sugary drink that many people describe as tasting a bit like flat orange soda (though some offices have multiple flavor options.) You’ll wait there in the office for an hour, and then they’ll take a blood sample.

This blood test tells your provider whether your body is able to get your blood glucose level back down to an acceptable level within the hour. If your level is higher than 140 mg/dL on the one-hour test, you will need to come back for a more in-depth three-hour test. (3)

Read more about this screening in our article Glucose Screening in Pregnancy: What to Expect.

Other Screening Tests

Early in the second trimester, you may be offered several other screening tests that check for things like genetic disorders, chromosomal abnormalities, and neural tube defects. Finding these things early can allow for early treatment and give parents time to prepare for a child with special healthcare needs. These tests don’t diagnose any condition, but rather give a heads-up that there may be a problem so that further testing can be done.

• Alpha-fetoprotein (AFP) test – Usually done between 16 and 18 weeks of gestation. An elevated AFP level may mean that there are problems with the baby. And a connection has been found between a low level of AFP and Down syndrome (1).
• Triple screen test – This test checks the AFP level in your blood and also the amounts of human chorionic gonadotropin (hCG) and unconjugated estriol (a type of estrogen that the placenta produces) (1). This test must be done between weeks 10 and weeks 14 of pregnancy.
• Quad screen test – This test is the same as the triple screen but adds the measurement of inhibin-A. It can be done between weeks 14 and week 20 (2).

Talking to Your Doctor or Midwife

At every appointment, in the second trimester and throughout your pregnancy, you will have time to talk to your provider. You should bring up any questions or concerns that you may have. A good caregiver will never make you feel rushed or that your questions are unimportant.

Second trimester appointments may mean talk about labor and birth, as well as recommendations for the best childbirth class. Plan to discuss the signs of early labor, signs of preeclampsia, advice about whether you can travel (many couples like to take a “babymoon” trip before the third trimester hits) and have a conversation about birth plans.

As always, we encourage you to keep the lines of communication open so that you feel as supported, educated, and empowered as possible!

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

References:

1. Glade, B.C., Schuler, J.  (2011).  Your Pregnancy Week by Week, 7th edition.  First Da Capo Press
2. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.
3. Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2016). Pregnancy, Childbirth, and the Newborn: The Complete Guide. Minnetonka: Meadowbrook Press.

Here are some other birth articles and stories we know you’ll love.

• How Often to Feed a Newborn (& How to Know If Baby Is Getting Enough)
• Anatomy of Breastfeeding
• Benefits of Skin to Skin Contact After Birth

• Week 16 Pregnancy: Ultrasound, Belly Bump & Symptoms
• Your First Prenatal Visit: What to Expect
• What to Do After a Positive Home Pregnancy Test
• Week 25 Pregnancy: Tiredness & Symptoms