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Second Trimester of Pregnancy: What to Expect, Week by Week

Second Trimester

Written by - Anupama ChadhaLast updated: Sep 14, 2026

Medically Reviewed By

Dr. Dhanyashree D V

MBBS, MS (OBG), DNB (OBG) · 6 years experience

Second Trimester of Pregnancy: What to Expect, Week by Week

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16 min

AI-Generated Summary

Quick overview in 30 seconds

The second trimester of pregnancy spans weeks 14 to 27, often called the best stage as nausea and fatigue fade and your baby bump begins to show.
Common second trimester symptoms include body aches, skin changes like stretch marks and melasma, bleeding gums, nasal congestion, Braxton-Hicks contractions, vaginal discharge, hemorrhoids and leg cramps.
Stay healthy with light exercise, prenatal vitamins, a protein, calcium and iron-rich diet of around 2200 calories, and timely second trimester screening tests.
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Quick answer

The second trimester runs from week 14 to the end of week 27. Nausea usually settles, energy returns, and you will feel your baby move for the first time, typically between 18 and 22 weeks. Two appointments matter most: the anomaly scan at 18 to 22 weeks, and gestational diabetes screening at 24 to 28 weeks. This is also when iron and calcium supplements usually begin.

Key takeaways

The anomaly scan at 18 to 22 weeks is the most important appointment of this trimester. It checks your baby's organs and structure in detail. Book it in the correct window.
Gestational diabetes screening happens at 24 to 28 weeks, and in India a test is also recommended at your first visit.
First movements usually come between 18 and 22 weeks in a first pregnancy, and often earlier in later ones. Once a pattern is established, any change needs checking.
Iron and calcium supplements usually start from around 14 weeks in India, after the first trimester. Take them as advised, and report side effects rather than stopping.
After 20 weeks, pre-eclampsia becomes a consideration. Severe headache with visual changes, pain under the ribs, or sudden swelling of the face and hands all need urgent assessment.

What is the second trimester?

The second trimester covers weeks 14 to 27. For most women it is the most comfortable stage of pregnancy, which is why it is often called the golden trimester.

Nausea and extreme tiredness typically ease, appetite returns, and the anxiety of the early weeks usually settles once the first scans are behind you. You will start to look pregnant, you will feel your baby move, and you will have the clearest information yet about how the pregnancy is progressing.

It is also the trimester with the most scheduled medical activity. The anomaly scan, diabetes screening, anaemia testing and supplement changes all sit in this window, and getting them done at the right time matters more than anything else on this page.

Week by week: what is happening

Week	Your baby	Roughly the size of	What is happening for you
14	Can squint, frown and grasp	A lemon	Nausea often easing. Energy beginning to return
15	Bones hardening. May sense light	An apple	Iron and calcium supplements usually begin around now
16	Facial muscles developing	An avocado	Some women in a second or later pregnancy feel first movements
17	Fat beginning to form. Eyebrows and lashes appearing	A pear	Bump usually becoming visible
18	Hearing developing	A capsicum	Anomaly scan window opens
19	Vernix, the protective coating, forming	A mango	Round ligament pain common as the uterus stretches
20	Roughly the halfway point	A banana	Anomaly scan commonly done now. First movements often felt
21	Swallowing amniotic fluid	A carrot	Appetite usually strong
22	Eyebrows visible. Features more defined	A small papaya	Movements becoming more regular
23	Responding to sound and movement	A grapefruit	Braxton Hicks tightenings may begin
24	Lungs beginning to produce surfactant	A corn cob	Report any reduced movements from now. Diabetes screening window opens
25	Responds to your voice	A cauliflower	Backache and heartburn common
26	Eyes beginning to open	A coconut	Leg cramps and swelling may start
27	Around 900 grams. Sleep and wake cycles developing	A head of lettuce	End of the second trimester

Sizes and weights are approximate and vary. Your baby's measurements are confirmed on scan.

Scans, tests and appointments

This is the part of the article to act on. Timing matters for each of these.

What	When	Why it matters
Anomaly scan (TIFFA or level 2 scan)	18 to 22 weeks	A detailed check of your baby's brain, heart, spine, kidneys, limbs, face and abdominal organs, plus the placenta and amniotic fluid. The most important scan of the trimester
Quadruple marker test, if offered	15 to 20 weeks	A blood screening test for chromosomal conditions and neural tube defects, usually offered if the first trimester screening was not done
Gestational diabetes screening	24 to 28 weeks, and in India also at the first antenatal visit	Detects raised blood sugar in pregnancy, which is common and very manageable when found
Repeat haemoglobin	Around 26 to 28 weeks	Anaemia is very common in Indian pregnancies and is treatable
Blood pressure and urine check	Every visit	Screens for pre-eclampsia from 20 weeks onward
Tetanus or Td vaccination	As advised	Usually given in this trimester in India
Growth assessment	From around 20 weeks	Fundal height measurement begins to become meaningful
Antenatal visits	Usually monthly until 28 weeks	More often if your pregnancy is high risk

On gestational diabetes screening in India: national guidance uses a single-step test that does not require fasting. A 75 gram glucose drink is given whenever you attend, and blood glucose is checked two hours later, with a value of 140 mg/dL or above indicating gestational diabetes. Some hospitals use fasting-based criteria with different thresholds, so ask which test you are having and what your result means. Our guide to diabetes symptoms and management covers this in more detail.

One legal point. Determining or disclosing the sex of the baby is illegal in India under the PCPNDT Act. Your anomaly scan will check everything else in detail, but no one will answer that question.

When will I feel the baby move?

Between 18 and 22 weeks in a first pregnancy. In a second or later pregnancy, often between 16 and 18 weeks, because you recognise the sensation.

Early movements feel like flutters, bubbles, or a muscle twitch, and are easy to mistake for gas. They become unmistakable over several weeks.

What to know as the pattern develops:

There is no set number of movements to count. What matters is what is normal for your baby
From around 24 weeks, report any reduction or change in the pattern the same day
Do not try to make the baby move first. Cold drinks, sweet food, lying down and poking the bump are all commonly suggested and all waste time
Never assume the baby is short of room. Reduced movement in later pregnancy is not caused by lack of space
Go in however many times it takes. Repeat visits for reduced movements are appropriate and expected

Common second trimester symptoms

Symptom	Why it happens	What helps
Round ligament pain	Sharp, brief pain low down as ligaments stretch	Move slowly, change position. Severe or persistent pain needs checking
Backache	Shifting centre of gravity and softer joints	Pelvic tilts, walking, supportive footwear. See our back pain relief guide
Heartburn	Progesterone relaxes the valve at the top of the stomach	Smaller meals, avoid lying down after eating
Constipation and piles	Slower gut, pressure on pelvic veins	Fluids, fibre added gradually, walking. Treat constipation to prevent piles
Bleeding gums	Hormones exaggerate the gum's reaction to plaque	Soft brush, clean between teeth, get a dental cleaning. Dental care is safe in pregnancy
Nasal congestion and nosebleeds	Increased blood flow to the nasal lining	Saline drops, humid air, gentle blowing
Skin changes	Melasma, linea nigra, darkening of the areola	Daily sunscreen. Most changes fade after delivery
Stretch marks	Skin stretching, largely genetic	Moisturise for comfort. No product has been shown to prevent them
Leg cramps	Common at night, cause not fully understood	Stretch the calf, stay hydrated. Get haemoglobin and calcium checked
Braxton Hicks tightenings	Practice contractions	Irregular and usually painless. Rhythmic tightening before 37 weeks needs checking
Increased vaginal discharge	Hormones and increased blood flow	Normal if thin, clear or milky. Green, grey, frothy or itchy needs treating
Varicose veins and mild ankle swelling	Pressure on pelvic veins	Elevate legs, avoid long standing. One-sided calf pain or swelling is urgent
Dizziness	Blood pressure changes and blood volume shifts	Stand up slowly. Repeated fainting needs assessment

Our guide to the more awkward pregnancy symptoms covers several of these in more detail, along with the ones that are not just embarrassing.

Nutrition and supplements

Calories

Your energy needs increase in the second trimester, by roughly 340 extra calories a day. That is a large banana with a glass of milk and a handful of nuts, not an extra meal.

Focus on what those calories contain rather than a total number. Protein at every meal, dal, curd, paneer, eggs, nuts, vegetables, fruit and whole grains.

Supplements usually started now in India

Supplement	Typical guidance	Note
Iron and folic acid	Usually daily from around 14 weeks	Often causes nausea and constipation. Do not stop it yourself. Ask about taking it at night, with food, or changing formulation
Calcium	Commonly recommended from around 14 weeks under Indian guidance	Take iron and calcium at different times of day, since calcium reduces iron absorption
Vitamin D	As advised	Deficiency is very common in India

Ask your doctor to confirm your specific doses and timing, since protocols vary between hospitals.

Weight gain

Recommended total weight gain depends on your pre-pregnancy BMI, and Indian guidance uses lower BMI cut-offs than Western charts, because Indians carry more metabolic risk at lower body weights.

Most weight gain happens from now onward, at a steadier rate than in the first trimester.

Ask your obstetrician what range applies to you specifically. Both gaining too little and gaining too much matter, and a chart from a general website will not account for your starting point.

Tell your doctor about: sudden rapid weight gain over a few days, especially with swelling, or weight loss at this stage.

Staying well: activity, travel and daily life

Area	Guidance
Exercise	Recommended in an uncomplicated pregnancy, around 150 minutes a week. Walking, swimming, prenatal yoga. Avoid contact sports, fall risk and overheating
Sleeping position	Any comfortable position is still fine now. Side sleeping is advised from around 28 weeks, so use this trimester to get used to it
Travel	This is the best trimester to travel. Check airline rules, move regularly on long journeys, and discuss any trip with your doctor first
Work	Usually fine. Discuss heavy lifting, long standing, night shifts or chemical exposure
Sex	Safe in an uncomplicated pregnancy, unless you have bleeding, placenta praevia, or your doctor has advised otherwise
Dental treatment	Safe, and this trimester is usually the most comfortable time for planned work. Do not postpone it
Footwear	Switch to low, supportive shoes. Balance changes as your centre of gravity shifts
Hot tubs and saunas	Avoid. Raising your core temperature is not advisable
Medication	Nothing new without your doctor. Avoid NSAIDs such as ibuprofen and diclofenac from 20 weeks, including pain balms and sprays

Warning signs: when to call a doctor

Seek care immediately if you have:

Any vaginal bleeding
Leaking of fluid, whether a gush or a trickle
Regular painful contractions or tightening, which before 37 weeks may indicate preterm labour
Reduced or changed baby movements, particularly from 24 weeks. Do not wait until morning
Severe headache with blurred vision, flashing lights or spots
Pain under the ribs or in the upper right abdomen
Sudden swelling of the face, around the eyes, or of the hands
A fit or seizure
Severe abdominal pain
Pain, swelling, warmth or redness in one calf
Fever
Fainting or collapse
Any fall or blow to the abdomen, even if you feel fine

The pre-eclampsia combination to memorise from 20 weeks onward: severe headache, visual changes, pain under the ribs, and sudden swelling of the face or hands.

Call your doctor the same day for:

Intense itching, especially on the palms and soles, without a rash. This needs a blood test rather than a cream
Burning urination, or pain in your side
Foul-smelling, green or grey vaginal discharge
Persistent vomiting
Repeated dizziness

Our full guide to pregnancy warning signs and when to call a doctor sorts these by urgency.

Frequently asked questions

How many weeks is the second trimester?
Weeks 14 to 27, counted from the first day of your last menstrual period.

When is the anomaly scan done?
Between 18 and 22 weeks. It is a detailed structural check of your baby's organs, and it is the most important scan of this trimester.

When is gestational diabetes tested?
At 24 to 28 weeks. In India, a test is also recommended at the first antenatal visit, so you may have two.

When will I feel the baby move?
Usually between 18 and 22 weeks in a first pregnancy, and often earlier in later pregnancies. Early movements feel like flutters or bubbles.

How much weight should I gain in the second trimester?
It depends on your pre-pregnancy BMI, and Indian guidance uses lower cut-offs than Western charts. Ask your obstetrician what range applies to you.

How many extra calories do I need now?
Roughly 340 extra calories a day, which is a snack rather than an extra meal. Quality matters more than the number.

Can I sleep on my back in the second trimester?
Any comfortable position is still fine now. Side sleeping is advised from around 28 weeks, so it is worth getting used to it during this trimester.

Is it safe to travel in the second trimester?
This is generally the best trimester for travel. Check airline rules, move regularly on long journeys, and discuss your plans with your doctor.

Are Braxton Hicks contractions normal?
Yes. They are irregular, usually painless, and settle with rest or a change of position. Rhythmic tightening before 37 weeks should be checked.

My iron tablets make me feel sick. Can I stop them?
Do not stop them yourself, since anaemia is common and matters. Ask about taking them at night, with food, or switching to a different formulation.

The bottom line

The second trimester is usually the most comfortable stage of pregnancy, and it is also the most scheduled. The anomaly scan between 18 and 22 weeks and diabetes screening between 24 and 28 weeks are the two things to get right, along with starting iron and calcium as advised. Enjoy the return of your energy, travel if you want to, and from around 24 weeks pay attention to your baby's movement pattern, because a change in that pattern is the one symptom never worth waiting on.

Sources

World Health Organization, recommendations on antenatal care for a positive pregnancy experience, and diagnostic criteria for hyperglycaemia in pregnancy
American College of Obstetricians and Gynecologists, second trimester care, weight gain in pregnancy, exercise, and preeclampsia
Royal College of Obstetricians and Gynaecologists, reduced fetal movements and intrahepatic cholestasis of pregnancy
National Institute for Health and Care Excellence, antenatal care and hypertension in pregnancy
NHS, your pregnancy week by week and the 20-week screening scan
Ministry of Health and Family Welfare, Government of India, national guidelines for gestational diabetes, Anemia Mukt Bharat, calcium supplementation in pregnancy, and the PCPNDT Act
Indian Council of Medical Research and National Institute of Nutrition, nutrient requirements in pregnancy
Federation of Obstetric and Gynaecological Societies of India, antenatal care recommendations

This article is for general information and is not a substitute for medical advice. Seek care immediately for bleeding, fluid leakage, reduced baby movements, severe headache with visual changes, or sudden swelling of the face and hands.

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