Second Trimester Guide: Weeks 14-27

The second trimester is often called the "honeymoon period" of pregnancy. Many women find that first-trimester nausea fades, energy returns, and they begin to feel the baby move.

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What Happens in the Second Trimester

Weeks 14-16: Energy Returns

Many women feel significantly better in the early second trimester. Nausea usually subsides, and energy levels begin to improve.

Weeks 16-22: Quickening

Quickening is the first fetal movement the mother feels. In first pregnancies, this typically occurs at 18-20 weeks. In subsequent pregnancies, it may be felt earlier (14-18 weeks) because the mother recognizes the sensation.

Weeks 18-22: Anatomy Scan

The anatomy scan is a detailed ultrasound that checks the baby's development, including the brain, heart, spine, and other organs. ACOG recommends at least one standard ultrasound at 18-22 weeks.

Your Baby's Development

By Week 14

  • Baby is about 3.5 inches long
  • All major organs have formed
  • Baby can make facial expressions
  • Baby's neck is getting longer

By Week 20

  • Baby is about 6.5 inches long
  • Baby weighs about 10.5 ounces
  • Baby can hear sounds
  • Baby's skin is covered with vernix
  • You may feel the baby move

By Week 24

  • Baby is about 12 inches long
  • Baby weighs about 1.3 pounds
  • Baby's lungs are developing
  • Baby has sleep-wake cycles

Common Second-Trimester Symptoms

Back Pain

As your uterus grows, your center of gravity shifts, putting strain on your lower back. Good posture, supportive shoes, and prenatal yoga can help.

Round Ligament Pain

Sharp, brief pains in the lower abdomen or groin caused by stretching of the round ligaments that support the uterus. This is normal but can be uncomfortable.

Heartburn

Growing pressure from the uterus on the stomach can cause acid reflux. Eating smaller meals, avoiding spicy foods, and not lying down immediately after eating can help.

Nasal Congestion

Increased blood flow to mucous membranes can cause stuffy nose and nosebleeds. This is normal and usually resolves after delivery.

Leg Cramps

Painful muscle contractions, usually in the calves, often at night. Staying hydrated, stretching before bed, and getting enough calcium and magnesium may help.

The Anatomy Scan: What to Expect

The anatomy scan (also called the level 2 ultrasound) is usually performed at 18-22 weeks. It takes about 30-45 minutes and checks:

  • Baby's size and growth
  • Brain, spine, heart, lungs, kidneys, and other organs
  • Placenta position
  • Amniotic fluid levels
  • Cervical length (in some cases)
  • Baby's sex (if you want to know)

The sonographer will take measurements and may ask you to move around to get better views. It is not always possible to see everything in one session.

Second-Trimester Screening Tests

Quad Screen (15-22 weeks)

A blood test that measures four substances: AFP, hCG, estriol, and inhibin A. It screens for Down syndrome, Edwards syndrome, and neural tube defects.

Glucose Screening (24-28 weeks)

A blood test to screen for gestational diabetes. You will drink a sugary solution, and your blood sugar will be measured one hour later.

Hemoglobin/Hematocrit (24-28 weeks)

A blood test to check for anemia. Iron needs increase significantly during pregnancy.

Maternity Wear: When to Start

Most women need maternity clothes by weeks 14-20, though this varies. High-waisted leggings, empire-waist tops, and layered outfits can extend the life of your regular wardrobe.

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Invest in a few key pieces that fit well and feel comfortable. You will wear them for months, and they can be worn again in future pregnancies or after delivery.

When to Call Your Clinician

Contact your healthcare provider if you experience:

  • Regular contractions before 37 weeks
  • Fluid leaking from the vagina
  • Severe headache that does not resolve with acetaminophen
  • Visual changes (blurring, flashing lights, floaters)
  • Sudden swelling of hands, face, or eyes
  • Decreased fetal movement after 24 weeks

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Not medical advice: This guide is for informational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult your own clinician.