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What Happens to Your Body During Each Stage: Second Trimester (Weeks 13 to 27)

31 March 2026

The second trimester of pregnancy is considered a more relaxed period than the first, as nausea and fatigue typically subside. However, it also brings significant physical and medical changes. Regular prenatal follow-up is vital for identifying changes that require special attention and referrals for essential pregnancy screenings.

Physical changes and symptoms

During this stage, the abdomen begins to expand, the uterus rises above the pelvis, and the breasts begin preparing for breastfeeding. Heartburn, urinary frequency, back pains, and changes in sleep patterns are common. Physical activity can improve general wellbeing and provide relief for both body and mind.

Prenatal check-ups and screenings

The second trimester includes essential screenings, such as the early and late anatomy scans, the triple screen (maternal serum screening), and the glucose challenge test for gestational diabetes. Additionally, prenatal care emphasizes fetal movement monitoring starting at week 24, as well as risk assessment for preterm birth or congenital anomalies.

Seeking immediate medical attention

In cases of heavy bleeding, high fever, a decrease in fetal movement, or unusual pain, seek immediate care at an Emergency Room or an urgent care center.

Emotional aspects

As the pregnancy becomes more tangible, questions regarding maternal identity and body image may arise. It is advisable to prioritize open communication and self-care. If distress becomes overwhelming, or persists for more than two weeks, seek professional support.

Pregnancy is a period characterized by constant physical and emotional shifts. It is typically divided into three trimesters—each bringing its own unique changes. In this article we will outline the medical procedures, essential tests and ways in which to maintain a healthy lifestyle for both you and your fetus during the second trimester (weeks 13 to 27).

Please note: Certain symptoms, such as heartburn or sleep difficulties, may carry over from the first trimester of your pregnancy. It is recommended to read the article about the previous trimester. Even in the second trimester, it is important to maintain a proper diet, to take recommended vitamins and dietary supplements, to be in the recommended range of weight gain and take vaccinations, as necessary.

During your pregnancy, you should attend regular prenatal check-ups with your OB-GYN. In addition to these visits, a medical team is available to address your questions, including prenatal care nurses, Tipat Halav, nurses, and midwives. We recommend checking with your HMO regarding the services available to you.

Medical prenatal follow-up

During this trimester, it is recommended to attend three prenatal follow-ups visits with the medical team, around weeks 16, 20, and 24. During these visits you will discuss the following issues:

Mood, general well-being, constipation, nausea, heartburn, appetite. If necessary, you will be referred for some tests or appropriate care.

At this stage, most women begin to feel fetal movement around week 20. During these weeks, it is normal to feel the fetus intermittently. Starting from week 24, it is recommended to begin monitoring fetal movement at least three times a day intentionally. During your follow-up visit, you will be guided on how to do it correctly. Example: Lie on your side (the left side is recommended) for half an hour. Place your hands on your stomach until you feel at least three to five movements. If you did not feel sufficient movements, it is recommended to consult with your HMO's Nurse Advice Line as soon as possible or go to a medical center (hospital or HMO).

Routine tests will include weight measurements, blood pressure, maternal pulse, and screening for edema (swelling) in the face and hands (where needed). Additionally, your medical team will follow up on your dietary supplements, vaccinations, dietitian counseling (as needed), physical activity, and more. It is important to inform your medical team if you have difficulty swallowing pills, so they can provide a suitable alternative. 

Your test results

The medical team will review your blood tests, ultrasound, and urinalysis, and if necessary, you will be referred for additional tests.

Referrals for routine prenatal testing

You will receive explanations regarding the prenatal tests you need to perform, as well as referrals for further laboratory testing, such as protein and leukocytes in urine.

Gestational diabetes risk assessment

A review of your medical history will include your past pregnancies and births, if any, as well as your weight, and existing test results. Based on this information, you will be referred for the appropriate test: 50g or 100g Glucose Tolerance Test (GTT), or home glucose monitoring.

Important note: If you have had difficulty with glucose monitoring in the past, share this with your medical team so you can select the option best suited for you.

Preterm birth risk assessment

Your preterm birth risk assessment will be evaluated based on your prenatal test, medical history, and previous pregnancies and births. If you are found to be at high risk for preterm birth, you may require high-risk pregnancy follow-up, including cervical length measurements or preventative treatment to reduce risk.

Congenital heart defect risk assessment

Based on your medical history (including past medication use), family history (including genetic predisposition, and results from previous prenatal tests), your physician will determine if a fetal echocardiogram is required.

Physical changes

During the second trimester, the uterus rises above the pelvis, the abdomen becomes more prominent, and the breasts continue to develop in preparation for breastfeeding. They become larger and fuller, including the appearance of colostrum (the initial milk secretion). Additionally, the nipples become darker and small white bumps, known as Montgomery glands, may appear around the nipple; these are a natural part of the milk duct system.

Please note that some symptoms from the first trimester may continue into the second. While nausea and extreme fatigue subside around week 13 for most women, many others continue to experience heartburn and mood swings. Heartburn, caused by hormonal changes and the growing pressure of the uterus on the stomach, may intensify as the fetus grows. If these symptoms do not improve or interfere with your daily functioning, utilize dietary solutions and consult your healthcare team regarding safe medication options.

Common symptoms

The growing abdomen

Prenatal changes, including abdominal bloating and abdominal muscle weakness, make the abdomen appear more prominent. From week 12, your uterus begins to rise above the pelvic bones, and your abdomen begins to show. By week 20, the uterus reaches the level of the belly button.

As your body changes and you gain weight, you may experience a sense of heaviness or back pain, particularly in the lower back; while this can be uncomfortable and challenging, it is quite normal. If the pain persists, consult your physician about ways to find relief.

Important to know: Appropriate physical activity, and pelvic floor strengthening help to reduce pain, heartburn, constipation and fatigue.

Frequent urination

During pregnancy, your body produces more urine, and the uterus presses on the bladder. As a result, you may find yourself needing to use the bathroom frequently throughout the day.

Please note: If you experience pain, burning, or bleeding during urination, you should inform your physician, who may refer you for a urinalysis.

Sleep disorders

During the end of the first trimester, the severe fatigue usually passes. Sleep is essential for health; however, this is exactly the period where most women find it difficult to have a good and consistent night sleep due to several reasons: frequent trips to the bathroom, heartburn, discomfort while lying down, and frequent feelings of being overheated.

What can you do? Improve your sleeping position using pillows; ensure a proper room temperature, and choose breathable, comfortable sleepwear and bedding. It is also recommended to maintain a regular bedtime each night, and refrain from heavy meals or screen time an hour or two before bed.

Stretch marks

A dark line in the center of the abdomen, known as Linea Nigra, is a common and normal occurrence. Additionally, stretch marks may appear in various areas, including abdomen, thighs, and breasts. You may occasionally experience a sense of dryness or itching around these marks; this can often pass after applying moisturizer immediately after showering.

If you feel a persistent itching, it is important to inform your primary care physician.

Edema (swelling)

Swelling, especially in the legs, is a frequent symptom during the second and third trimesters of pregnancy. This is due to fluid retention and the pressure of the uterus on your veins. To help reduce the swelling, it is recommended to keep your legs raised while resting, and, if necessary, consult your primary care physician regarding the use of compression stockings.

Please note

Please note

If swelling appears unusually fast, or if there is a sudden and heavy swelling in the legs, hands, or face, this could be an early sign of preeclampsia. In such a case, it is essential to contact your OB-GYN or an Obstetric Emergency Room without delay for immediate clinical diagnosis and treatment.

Checkups

  • Weeks 14-16: Early anatomy ultrasound scan to detect structural abnormalities and evaluate fetal growth.
  • Weeks 16-20: Second-trimester screening – Triple Marker Screen (AFP test). This blood test measures levels of Alpha-fetoprotein (AFP), HCG, and Estriol, and the results are integrated with first-trimester screening data.
  • Weeks 19-24: Late anatomy ultrasound scan (Level II Ultrasound).
  • Weeks 24-28: Complete Blood Count (CBC) and Glucose Challenge Test (GCT) to screen for anemia and gestational diabetes.

When to seek medical care

In the following cases, seek an immediate medical assessment at the Women’s Health Center (during the morning), or the ER (in the evening):

  • Heavy bleeding, (more than a typical period).
  • Severe abdominal pain.
  • Loss of consciousness or fainting.
  • Persistent vomiting.
  • High fever.
  • Unusual headaches.
  • Regular contractions or pressure occurring before week 37.
  • Decreased fetal movement.
  • Suspected leaking of amniotic fluid (water breaking).
  • Direct abdominal trauma or car accident.
  • Unusual sense of physical distress.

Emotional changes

As pregnancy nausea subsides and the experience becomes more concrete, fetal movement and ultrasound scans encourage the formation of an initial emotional bond, while also raising questions about future motherhood.

Many women begin to contemplate their maternal identity, the shift in family status, and the integration of career, relationship, and parenting. Occasionally, you may experience a decline in body image or a sense of vulnerability.

Recognizing the need for self-care, including rest, dividing household responsibilities, engaging in calming physical activity (such as prenatal yoga), and having open conversations with your partner, can enhance your sense of control and security.

For further information on emotional changes during pregnancy

Please note: If concerns regarding the health of your fetus or the upcoming delivery begin to dominate your day, interfere with your sleep, or affect your functioning, or if persistent negative thoughts cause significant distress for more than two weeks, seek immediate assistance.