Prenatal Care – Prenatal Visits in the Second Trimester
Thankfully, complications in the second trimester of pregnancy are rare. For this reason, unless you have a medical condition that needs monitoring, you will generally see your care provider infrequently during this period. However, because visits are few and far between, it makes sense to know the signs of potential problems, such as preterm labor, that should prompt you to call in.
At each prenatal visit during this trimester (about every 4 – 6 weeks) your care provider will check your weight and blood pressure. You will also be asked to give a urine sample, which is checked for protein and sugar. Protein is rarely found at this point in pregnancy, but if it is present it may be a sign of preeclampsia. Sugar-in the urine can be a sign of gestational diabetes.
At every visit after 12 weeks, you can expect to hear your baby’s heartbeat with a device called a Doppler. After 20 weeks your care provider will start to measure the size of your uterus with a tape measure to check your baby’s growth. During the early part of this trimester, you will be given the option of tests to check for Down syndrome or other chromosomal abnormalities. If you have had first trimester testing or chorionic villus sampling, your care provider should offer you isolated testing for neural tube defects (spina bifida) using the blood test for alpha-fetoprotein (AFP).
Most, care providers will also order an ultrasound between 18 and 21 weeks to make sure your baby is well-formed.
Calling your care provider
Although most women will have a normal, healthy second trimester, you should be aware of situations in which you need to call your care provider immediately.
Vaginal bleeding
Any vaginal bleeding should prompt you to call your care provider. Most vaginal bleeding in pregnancy comes from the cervix and is not usually serious. Vaginal spotting often occurs after intercourse because the cervix has a lot of fragile blood vessels on the surface. This does not mean that intercourse is harmful. Any vaginal bleeding more than spotting should prompt an immediate call to your care provider. You may have placenta previa (where the placenta has implanted over the cervical opening) or placental abruption (where the edge of the placenta has started to peel away from the wall of the uterus). If you are more than 24 weeks pregnant and you have any bright red bleeding that soaks your underwear, call your care provider or go to the hospital right away.
Increased vaginal discharge
Vaginal discharge often increases with pregnancy. However, if you notice a sudden and abrupt increase in your discharge, and especially if it is thin and mucousy, you should call your doctor. In some cases, increased discharge results from your cervix opening up (called cervical insufficiency).
Sudden vaginal pressure
As your baby grows, a gradual increase in pressure is normal. However, if you feel sudden vaginal pressure, or have the constant feeling that you have to have a bowel movement, call your care provider at once because this may be a sign of preterm labor.
Gush of clear fluid
If you have a large gush of clear fluid that soaks your clothes call your care provider immediately; sometimes this is a symptom of the amniotic sac breaking. While urinary incontinence increases during pregnancy, you should not attribute a gush of fluid to loss of bladder control unless you are absolutely certain this is the case.
Diarrhea with abdominal pain
If you have diarrhea with a lot of abdominal pain, you may want to check in with your care provider in case you are in preterm labor.
Starting childbirth classes
By the middle of the second trimester you might start thinking about childbirth classes. Whether you want to take classes or not depends on how you learn best; they are not compulsory. Some women prefer to read about childbirth and ask their care provider any questions they have. Other women may prefer to learn directly from a labor expert, and have a chance to ask questions face-to-face.
Childbirth classes can be helpful for partners, allowing them to address their anxieties and ask questions. Classes are often offered through the facility where you plan to deliver. Some women prefer an independent class. Such classes are often designed around a particular philosophy of managing labor pain, and the information they provide may be biased against receiving pain medication in labor.
What you choose is a personal decision. The bottom line is that the class fits with your philosophy and still supplies you with factual information about labor.