Second Trimester Expectations

Congratulations, you made it through your first trimester of pregnancy! Your second trimester goes from week thirteen to week twenty-five (after your last menstrual period). There is still more to learn and experience. As your baby continues to grow, new experiences and symptoms will appear. As with your first trimester, it will help to be prepared for your second trimester by knowing what changes your body is going through and how your nutritional needs are affected during these months.

Your Baby's Development

By your second trimester, your baby is well developed. This stage of the pregnancy can be very exciting because you may start to feel your baby move at about eighteen to twenty-two weeks. If this is not your first pregnancy, you may even be able to feel movement earlier, at sixteen to eighteen weeks. Your baby looks like a small person now and is continuing to develop every week during this period.

Your Fourth Month (13 to 16 Weeks)

By your fourth month of pregnancy, your baby's fingers and toes are well defined. Eyelids, eyebrows, and nails are formed. Hair is starting to grow on top of the baby's head, and facial features are more prominent. The teeth and bones are becoming harder. The baby is moving her arms and legs and can even suck her thumb, yawn, and stretch. The baby is starting to now respond to outside stimuli. The nervous system is beginning to function, and the reproductive organs and genitalia are now fully developed. At this point your doctor may be able tell through an ultrasound if you are having a boy or a girl. The baby's heartbeat is now undeniably audible through an instrument called a Doppler. By the end of your fourth month, the baby is about six inches long and weighs somewhere around 4 ounces.

Your Fifth Month (17 to 20 Weeks)

During your fifth month of pregnancy, hair on the head, eyebrows, and eyelashes are filling in. A soft, fine hair, called lanugo, covers the baby's body. Meant to protect the baby, lunago is usually shed by the end of the baby's first week of life. Fat is beginning to form on the baby's body to help him stay warm and to aid in metabolism. The lungs, circulatory, and urinary systems are now in working condition. At this point, the retinas in the eyes are sensitive to light. The baby's skin is developing and appears transparent. Your baby can hear sounds such as your voice and heartbeat as well as sounds outside of your body. During this month, you may begin to feel the baby move as his muscles begin to develop. As the baby continues to develop, you will notice more movement. By the end of the fifth month, the baby is about ten inches long and weighs anywhere from 8 ounces to 1 pound.

Your Sixth month (21 to 25 Weeks)

During your sixth month, the baby is continuing to gain fat to keep its body warm. His or her growth rate is slowing down, but bodily systems such as digestion are continuing to mature. Buds for the permanent teeth are beginning to form, and the baby's muscles are getting stronger. The baby is very active and will respond to sounds and movement. The baby's body is becoming better proportioned. It is beginning to produce white blood cells that will help the baby fight infection and disease. You may begin to tell when the baby has hiccups by the jerking motions you feel. The baby's skin is more opaque than transparent and is wrinkled as the baby grows into it. The heart­beat at this point can be heard more easily through a stethoscope depending on the baby's position. By the end of the sixth month, your baby measures approximately twelve inches in length and somewhere around 2 pounds.

Changes in Mom

Some women consider this the easiest trimester of their pregnancy. The morning sickness and fatigue has subsided, but you haven't started experiencing some of the uncomfortable symptoms of the third trimester. By this time, you're finally starting to look pregnant, and you may need to begin wearing maternity clothes. You'll begin to feel your baby move during your second trimester. At first it may only seem like a fluttering movement, but as the trimester progresses there will be no question that you are feeling the little one move around. Other changes include an increase in blood volume to support the baby. This can give you occasional nosebleeds and bleeding gums and can make the veins just below your skin become more apparent. Increasing the humidity in your home will help to prevent nosebleeds. Your uterus is shifting, which will cut down on your need to go to the bathroom so much.

As the baby gets bigger, you may experience some common aches and pains, pelvic achiness, dizziness, heartburn, constipation, hemorrhoids, leg cramps, swelling in your feet and ankles, stretch marks, and backaches. Chapter "Dealing With Discomforts" offers tips on dealing with some of these mild discomforts. During this trimester, your risk for bladder infections increases because the muscles of the urinary tract relax.

Urinary tract infections (UTls) are among the most common types of bacterial infections during pregnancy. Bladder infections are at the top of list. Untreated, urinary tract infections can lead to dangerous kidney infections. Some women do not have symptoms at all. Others may feel a burning sensation while urinating, may have to urinate more often than normal, may have blood in their urine, and/or may feel like they have to go when they just urinated. To help prevent urinary tract infections, always drink plenty of water, urinate often, and don't wait a long time to urinate. If you feel you have symptoms of a urinary tract infection, see your doctor immediately.

Coping with Food Cravings

Though there is no agreed-upon explanation for them, food cravings are extremely common during pregnancy. There will be foods you can't seem to stomach, and there will be foods you just can't get enough of. Some experts blame raging hormones. Just as some women crave certain foods during their menstrual cycle due to hormones, the same thing happens during pregnancy. Some believe that in an opposite case from food aversions, the body's craving of a certain food signals a need for some nutrient or nutrients. Alternately, some scientists believe that cravings are the way the body takes care of getting its extra calories. Some of the most commonly craved foods for pregnant women include citrus fruits, chips, dairy products, spicy foods, ice cream, chocolate, and other sweet foods. In fact, women tend to crave sweet foods more during their second trimester than at any other time in their pregnancy. One thing is undeniable: A woman's taste preferences do change throughout her pregnancy.

Should You Give in?

Your food cravings may not necessarily be a problem or cause imbalances in your diet if you seem to be craving healthier foods, like fruit or milk. But what do you do when you are craving that hot fudge sundae? If high­calorie, high-sugar and/or high-fat foods are what you crave, you will have to exercise mind over matter on occasion. Giving in to cravings every time, especially if they are frequent and you are craving high-calorie foods, is a good way to pack on more pounds than you intended. In addition, if you seem to be craving and eating a lot of one certain food and not eating much of anything else, you may become deficient in important nutrients over time.

Do your best to fit your cravings into a nutritionally balanced diet. As long as you are eating a balanced diet and getting the essential nutrients you need for you and your baby, giving in to your cravings once in a while is probably fine. The bottom line is that indulging in your food cravings in moderation is harmless. You may find that your food cravings get less intense as your progress through your pregnancy.

Helpful Hints

Try some of these helpful hints to work cravings into your balanced diet:

• Eat a good, healthy breakfast. Skipping meals such as breakfast can increase the cravings for certain foods later in the day.
• Eat plenty of complex carbohydrates, such as whole-wheat breads, brown rice, whole-grain cereals, and pasta. Complex carbohydrates take longer to digest and therefore help to keep blood sugar levels consistent. Dips in blood sugar can cause cravings.
• Work the foods you crave into a nutritional diet. If you crave chocolate, try chocolate milk. If you crave ice cream, add sliced fruit such as bananas or strawberries your ice cream and give it a nutritional punch.
• Take a closer look at your total diet. Keep a food diary for a week or so and review it to make sure you are eating a balanced diet and getting the nutrients that you need.
• Indulge in your healthy cravings and try to find healthier alternatives to your unhealthy ones most of the time. For example, substitute nonfat frozen yogurt if you crave ice cream or pretzels if you crave chips.
• Think small when it comes to the portion sizes of your higher-calorie cravings. If you crave chocolate candy, instead of a whole candy bar grab a one-bite serving.
• Stay active, and exercise regularly. Exercise can help curb hunger and tame cravings.
• Make sure you have the emotional support that you need. Pregnancy can put you on a mood-altering roller coaster, and these mood swings may cause you to turn to food for comfort.
• If you crave nonfood substances and cannot resist the craving, talk to your doctor.

Healthier Alternatives

There are always healthier alternatives that you can turn to when you crave certain foods. It is fine to indulge on occasion, but try healthier alternatives more often. Keep in mind, though, that even healthier alternatives in large amounts can add unwanted calories and pounds. Everything in moderation!

Losing Your Girlish Figure

In your second trimester of pregnancy, you will begin to gain more of your pregnancy weight. You should experience a steady weight gain of about 1 pound per week in your second trimester, although the rate of weight gain differs from woman to woman. Even though you may be losing your girlish figure, keep in mind that proper weight gain is a good thing in pregnancy. No matter how much some pregnant women hate to admit it, they struggle with their changing figures. Don't beat yourself up about feeling a little unhappy. lt is very normal, and you should give yourself permission to experience both the joys and frustrations of watching your body change in so many ways.

Working on a Positive Body Image

Some women become upset every time they step on the scale and see the rising needle. If you worked hard to stay in good shape before pregnancy, pregnancy weight gain and the changes in their body can be tough to take. It is very normal for your physical self-image to fluctuate over the course of your pregnancy. The challenge for many women is to establish a healthy attitude and self-image about their changing weight and body image. During your first trimester, a positive self-image can be difficult when you always feel nauseous. However, by the second trimester, you should feel much stronger and healthier, making a positive self-image much easier to grasp. While many of the changes your body will go through seem to be beyond your control, certain strategies may help you to fully embrace the changes your body is going through and make your pregnancy a more positive experience.

Take Action

By working on a positive body and self-image before you even become pregnant, you can take much of the anxiety out of body changes during pregnancy. A positive body image is not about what you look like but how you feel about yourself. It is essential to remember this during pregnancy because you cannot control many of the changes in your body. Understand why your body is going through the changes that it is. Knowing that the changes are due to your growing and developing baby will make it easier to embrace them as positive. Maintain a healthy diet and caloric intake, and welcome the knowledge that you are feeding yourself and your baby with essential nutrients that will help her grow and develop properly. Failing to control your diet and giving in to the impulse to eat unhealthy foods can make you feel less in control and give you feelings of negative self-image. Instead of worrying about what extra calories will do to your body, begin instead to think of what they are doing for your baby's body.

Alert: If you are not yet pregnant and you suffer from an eating disorder due to very negative body image, be concerned about recovery before considering pregnancy. Women with eating disorders can be at a much higher risk for miscarriage, pregnancy complications, and birth defects.

With your doctor's permission, develop a regular exercise program and stick to it. Women who exercise regularly during pregnancy maintain a higher self-esteem. Remaining active throughout your pregnancy can help lessen feelings of depression, stress, and worries over weight gain and body image. Define the attributes you find attractive in yourself and accentuate them to help make you feel better about yourself. Pamper yourself by doing things that make you feel good and that will help you to build your self-image. Keeping your weight gain within healthy, recommended limits can help make you feel better about your body size. Too much or too little weight gain can sabotage your efforts for a positive body and self-image. Most important, keep your eye on the prize at the end of the journey. Each time you begin to feel fat or your self-image seems to slip, think about that beautiful, healthy baby you are going to have: Keep in mind that this change is temporary. There will be plenty of time to regain your figure after your baby is born. Take a positive attitude and see the beauty and importance of the changes in your body. It is up to you!

Nutritional Concerns

As with your entire pregnancy, good nutrition and proper weight gain are essential during your second trimester. During this period, most women begin to experience decreased symptoms of morning sickness (though some may get morning sickness throughout pregnancy). It's a good thing these symptoms decrease for most because starting now, you need to begin to boost your calorie intake. The guidelines in Chapter "Eating For Two" can help you to eat a healthy diet and properly add 300 calories each day. The nutritional concerns in this stage of pregnancy come from the digestive troubles that most women begin to experience.

As your pregnancy progresses into the second trimester, your baby continues to grow, which causes your stomach to work a little slower. Some women experience an intolerance to milk products at this time. Since calcium and other nutrients in dairy products are so essential to good health, especially during pregnancy, it is important to find an alternative. Guidelines in Chapter "Important Issues" can help you to deal with this problem. Other digestive problems women may experience as they enter the second trimester include gas, indigestion, and heartburn. Constipation can become a problem during the second trimester and continue until the end of your pregnancy. It is important to deal with these discomforts so that they don't interfere with your efforts to eat a healthy diet and don't turn into more complex complications. Tips and guidelines in Chapter "Dealing With Discomforts" can help you to relieve these symptoms while still eating a healthy diet.