It’s 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’s 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?

The American College of Obstetricians and Gynecologists (ACOG) and most 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 moms-to-be. Reports show that 50 to 70% of those melasma cases begin in the second trimester. You’ll know you’ve 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 estrogen, 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 moms-to-be have a linea nigra, it’s 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’re expecting. But that doesn’t mean you’re 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. (Learn more about pregnancy-safe skin care.)

The same sunscreen advice holds true for linea nigra. Plus, it’s 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 moms-to-be, that can’t-poop pregnancy symptom strikes in the second trimester. While the uptick of the pregnancy hormones progesterone—which relaxes your bowels so they don’t work too hard to squeeze poo out—is partially to blame, it’s not the sole constipation culprit. The iron from your prenatal 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’s all about how much physical movement you’re getting, how much fiber you’re consuming, and how much water you’re 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’re drinking plenty of fluids. ACOG recommends downing 64 to 96 ounces (or 8 to 12 cups) of water every day. (Learn more about properly timing your second trimester water intake.)

Next, incorporate 20 to 30 minutes of moderate exercise into your routine three times a week. But if you’re 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’s also imperative to include more fiber in your diet by way of eating more fruits, veggies, whole grains, beans, nuts, and seeds. (Shoot for about 25 grams of fiber daily.) If you’re struggling to get enough fiber-rich foods into your diet, ask your healthcare provider about taking a fiber supplement. And while you’ve 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’s a common second trimester pregnancy symptom, impacting up to 30% of moms-to-be, especially in the second trimester. It’s 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’s 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’re 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, don’t 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 moms-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’s a good bet you have a UTI if it burns when you pee, it’s difficult to pee, there’s blood in your urine, and/or your urine appears cloudy.

Second Trimester Urinary Tract Infection Treatment and Prevention

Don’t 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’re diagnosed, your healthcare provider will likely prescribe a short course of pregnancy-safe antibiotics like penicillin, amoxicillin, cephalexin, or clindamycin. UTI symptoms usually fade within three days of taking antibiotics.

If you’re dealing with repeat UTIs in pregnancy, your doctor or midwife may recommend a lower dose of antibiotics daily. And if you’re dealing with pyelonephritis, you’ll 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 six to eight glasses of water a day, 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 moms. 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’s 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’ve got your doctor or midwife 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’s 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 six months—in fact, now’s 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.

 

Second Trimester Baby Prep:

• Your Ultimate Baby Registry Checklist
• Which Bassinet is Best for Baby Sleep?
• How to Write a Birth Plan (Plus, Free Birth Plan Templates!)
• Get Schooled on Newborn Screenings
• Study Up! Newborn Sleep Tips and Habits
  
  

REFERENCES 

• Jackson Health System: Understanding Each Trimester of Your Pregnancy
• American College of Obstetricians and Gynecologists (ACOG): How Your Fetus Grows During Pregnancy
• Cleveland Clinic: Melasma
• A clinical study of cutaneous changes in pregnancy. Journal of Epidemiology and Global Health. November 2016
• Cleveland Clinic: Linea Nigra
• Skin Changes and Safety Profile of Topical Products During Pregnancy. The Journal of Clinical and Aesthetic Dermatology. February 2022
• ACOG: Skin Conditions During Pregnancy
• Linea Nigra: Case Report of a Woman With a Pregnancy-Associated Linear Streak of Cutaneous Hyperpigmentation on Her Abdomen From the Umbilicus to the Pubic Symphysis. Cureus. November 2023
• Cleveland Clinic: Pregnancy Constipation
• Constipation, Hemorrhoids, and Anorectal Disorders in Pregnancy. The American Journal of Gastroenterology. October 2022
• Variation in urine osmolality throughout pregnancy: a longitudinal, randomized-control trial among women with overweight and obesity. European Journal of Nutrition. July 2021
• ACOG: How much water should I drink during pregnancy?
• ACOG: Exercise During Pregnancy
• ACOG: What can help with constipation during pregnancy?
• Mayo Clinic: Pregnancy week by week: What can help with constipation during pregnancy?
• Management of acute abdomen in pregnancy: current perspectives. International Journal of Women’s Health. February 2019
• Kaiser Permanente: Round Ligament Pain: Care Instructions
• Cleveland Clinic: Round Ligament Pain
• Kaiser Permanente: What you should know about round ligament pain
• The University of New Mexico Health: What to Know About Urinary Tract Infections During Pregnancy
• Urinary Tract Infection in Pregnancy. StatPearls. April 2024
• UT Southwestern Medical Center: UTIs during pregnancy are common and treatable
• UT Southwestern Medical Center: Baby (and tissues!) on board: Tips for managing pregnancy rhinitis
• Redefining Pregnancy-Induced Rhinitis. American Journal of Rhinology & Allergy. September 2020
• Mayo Clinic: Pregnancy week by week: 2nd trimester pregnancy: What to expect
• Nationwide Children’s: Pregnancy Rhinitis: Relief for Ongoing Nasal Congestion Is Possible
• American Dental Association, Healthy Mouth: Pregnancy and your dental health
• Centers for Disease Control and Prevention (CDC): Talking to Pregnant Women about Oral Health
• Cleveland Clinic: Pregnancy Gingivitis
• UT Southwestern Medical Center: Can I go to the dentist when I’m pregnant?

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Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.