What Happens in the Second Trimester
The second trimester spans weeks 14 to 27, often the most comfortable stretch, when you feel the first movements, have the anatomy scan around 18 to 22 weeks, and complete glucose screening at 24 to 28 weeks. Early nausea and fatigue usually ease. New aches like round ligament pain and back pain are common as your belly grows.
Weeks 14-27 at a glance
Many people find the second trimester easier than the first. Energy often returns and nausea tends to settle. Your uterus rises out of the pelvis, your belly becomes visible, and you begin to feel the baby move.
Prenatal visits usually continue about every four weeks during this trimester unless your provider recommends a different schedule. Two milestones anchor this trimester: the detailed anatomy ultrasound and screening for gestational diabetes.
Common second-trimester symptoms
- Round ligament pain, brief sharp pulls in the lower belly or groin as ligaments stretch
- Back pain as your center of gravity shifts forward
- Skin changes such as a darker line down the abdomen or darkened patches
- Nasal congestion and occasional nosebleeds
- Mild swelling in the feet and ankles
- Leg cramps and heartburn
Second-trimester milestones and tests
| Milestone | When | What it is |
|---|---|---|
| First movement (quickening) | 16-25 weeks | First flutters; often 18-25 weeks in a first pregnancy, earlier if you have been pregnant before |
| Anatomy ultrasound | 18-22 weeks | Head-to-toe scan of organs, spine, heart, limbs, placenta, and fluid; can often show sex |
| Glucose screening (1-step initial) | 24-28 weeks | A 50 g drink, then one blood draw at 1 hour; no fasting needed |
| Follow-up glucose test if needed | After a high screen | A 3-hour, 100 g test to diagnose gestational diabetes |
Feeling movement
First movement, called quickening, is usually felt between 16 and 25 weeks. In a first pregnancy it often comes later, around 18 to 25 weeks, because you have not felt it before. An anterior placenta (one at the front of the uterus) can cushion movement and delay when you notice it.
Early movements are irregular and easy to miss. A consistent daily pattern of stronger movement typically develops closer to the third trimester.
Recommended total weight gain by pre-pregnancy BMI
| Pre-pregnancy BMI | Category | Total weight gain |
|---|---|---|
| Below 18.5 | Underweight | 28-40 lb |
| 18.5-24.9 | Normal weight | 25-35 lb |
| 25.0-29.9 | Overweight | 15-25 lb |
| 30.0 and above | Obese | 11-20 lb |
Call your provider right away if you have
- Vaginal bleeding
- Fluid leaking or a gush of fluid from the vagina
- Regular or painful contractions before 37 weeks
- Severe or constant abdominal pain
- A severe headache, vision changes, or sudden swelling of the face and hands
- Pain or burning with urination, or fever over 100.4 F (38 C)
Reflects ACOG and Cleveland Clinic prenatal-care guidance and IOM/CDC weight-gain ranges, 2024-2026.
Related questions
- What does the anatomy scan check?
- Performed at 18 to 22 weeks, the anatomy ultrasound reviews the baby's brain, heart, spine, kidneys, stomach, and limbs, plus the placenta, umbilical cord, and amniotic fluid. It also measures growth and, if you wish, can often show the baby's sex.
- When will I feel the baby move?
- Most people feel first movements between 16 and 25 weeks. In a first pregnancy it is common not to feel them until 18 to 25 weeks. A placenta at the front of the uterus can make early movements harder to notice.
- What happens during the glucose screening test?
- At 24 to 28 weeks you drink a 50-gram glucose solution and have one blood draw an hour later; no fasting is required. If that result is high, a longer 3-hour test is done to confirm or rule out gestational diabetes.
- How much weight should I gain in the second trimester?
- Total pregnancy weight gain depends on your pre-pregnancy BMI, ranging from about 11 to 40 pounds for a single baby. After the first trimester, gain is often roughly steady week to week. Your provider will track your trend and adjust the target if needed.
- Is round ligament pain dangerous?
- Round ligament pain is a common, normal part of the second trimester as the uterus stretches. It is usually brief and triggered by movement. Call your provider if pain is severe, constant, or comes with bleeding, fever, or contractions.
Sources & further reading
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