Second trimester prenatal visits

Second trimester prenatal visits

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During the second trimester (14 weeks to 27 weeks), you'll typically see your healthcare practitioner once every four weeks unless you have a condition or complications that call for more frequent checkups. Here's what you can expect your practitioner to do at each visit.

Not in the right place? See our other articles on prenatal visits:

  • What to expect at your prenatal visits
  • Your first prenatal visit
  • Third-trimester prenatal visits

Gather information

Your practitioner will probably start by reviewing your chart and following up on issues that were raised at your previous prenatal visit. She'll let you know about any test results that have come back.

Your practitioner will ask you specific questions:

  • Are you feeling nauseated?
  • Are you feeling the baby move yet? (And later: Is your baby moving as often as before?)
  • Have you been leaking fluid or had any vaginal spotting or bleeding?
  • Have you felt any contractions?

She'll also want to know how you're feeling in general, both physically and emotionally. Remember that these visits are your opportunity to address any questions or concerns you may have, so be sure to bring up whatever's on your mind.

Record your weight

Gaining an appropriate amount of weight will boost your chances of having a healthy pregnancy and baby. How much you should gain depends on your pre-pregnancy height and weight, as well as whether you're carrying multiples.

Some pregnant women find getting weighed at every checkup nerve-racking – especially as the numbers on the scale creep up into digits they've never seen before. If hopping on the scale bothers you, step on the scale backward during weigh-ins and tell your practitioner that you'd prefer to know your weight only if it's a concern.

If you have a history of an eating disorder like anorexia or are struggling with one now, be sure to let your caregiver know. She can help make sure that you get the support you need.

Check your blood pressure and possibly your urine

Protein in the urine can be a sign of a urinary tract infection or, if accompanied by high blood pressure, a sign of preeclampsia. Other symptoms of preeclampsia can include liver or kidney abnormalities, persistent headaches, or vision changes. If you have high blood pressure without these other symptoms, you could have gestational hypertension.

It's not uncommon to have a small amount of sugar in your urine once in a while during pregnancy, but if you have a large amount or it happens often, your practitioner will go ahead and order a blood test to check for gestational diabetes. (All women are routinely screened at the end of the second trimester.)

Listen to your baby's heartbeat

Your caregiver may have picked up your baby's heartbeat as early as 10 weeks, using a handheld ultrasound device called a Doppler. But it's more common to hear the heartbeat for the first time at around 12 weeks, depending on your baby's position in your uterus, your weight, and the accuracy of your due date.

Checking your baby's heartbeat will become a regular part of every prenatal visit. You may want to bring your partner along to share in the thrill of hearing this dramatic sign of the life you've created together.

Examine your belly

Your practitioner will feel your abdomen to get a sense of the size of your growing uterus and baby. From mid-pregnancy on, she'll use a measuring tape to check your fundal height – the distance between your pubic bone and the top of your uterus – to estimate your baby's size and growth rate.

From 20 weeks until 36 weeks or so, the measurement (in centimeters) should roughly correspond to how many weeks pregnant you are. So if you're 24 weeks pregnant, your fundal height should measure about 24 centimeters.

Your practitioner will also check your hands and feet for swelling. And if you have any particular physical complaints, she'll look into them now.

Discuss tests and procedures

If you did not opt for chorionic villus sampling (CVS) – a first-trimester diagnostic test for chromosomal abnormalities and other genetic problems – your practitioner will discuss screening and diagnostic tests with you during the second trimester.

Between 15 and 20 weeks, you may have a multiple marker screening, a blood test to measure the quantity of three or four substances (or "markers") that can give you information about your baby's risk for Down syndrome. One of the markers, AFP (alpha-fetoprotein), also provides information about your baby's risk of birth defects such as spina bifida.

(Ideally, the multiple marker screening is done in conjunction with first-trimester screening – a blood test and a special ultrasound scan called a nuchal translucency screening – because together the results provide a better assessment of the risk of abnormalities than either one does alone. If you had a cell-free fetal DNA blood test during your first trimester, you may be offered more screening tests in your second trimester as well.)

Your practitioner will also offer you amniocentesis, a test that can diagnose Down syndrome as well as other chromosomal abnormalities, genetic disorders, and neural tube defects. This test is usually done when a woman is between 16 and 20 weeks pregnant.

Amniocentesis carries a small risk of miscarriage, so women who choose to have the test are usually those who know they're at a higher risk for genetic and chromosomal problems. Some women choose to wait for the results of their first- and second-trimester screening tests before deciding whether to have amniocentesis.

If you're not having the multiple marker test or amniocentesis, you'll probably be offered screening specifically for neural tube defects during your second trimester. This includes either the AFP blood test or ultrasound or both.

Whether or not you choose to have any of these screening or diagnostic tests, most practitioners routinely order an ultrasound between 18 and 22 weeks to check for physical abnormalities and to verify the baby's due date. This may also be a chance to find out your baby's sex if you want to.

If flu season is here or approaching, your practitioner should talk with you about the benefits of getting a flu shot.

Perform blood tests

Between 24 and 28 weeks, you'll be given a glucose screening test to check for gestational diabetes, and possibly another blood test to check for anemia.

If you're Rh-negative but your baby's father isn't (or you don't know for sure), an extra tube of blood will be drawn for an antibody screen, which checks to see whether your body is producing antibodies against your baby's potentially Rh-positive blood.

If the blood test shows that your body is producing antibodies, your baby will be monitored for related problems for the rest of your pregnancy. If you're not, an injection of Rh immune globulin at 28 weeks will keep your body from producing antibodies.

Some practitioners will wait for the test results and administer the shot after it's been confirmed that you're not producing antibodies. Others choose to do the antibody screen and give the Rh injection at the same 28-week visit. (While the shot won't do any good if you're already producing antibodies, there's also no harm in receiving it.)

Provide other education and counseling

At the end of each appointment, your practitioner may briefly review her findings from the exam to let you know whether she has any concerns. She should also tell you about normal changes to expect before your next visit and warning signs that should prompt a call.

Toward the end of this trimester, she'll explain the importance of being aware of your baby's movements and alert you to the warning signs of preterm labor, preterm rupture of membranes, and preeclampsia.

Sometime during this trimester, your practitioner should talk to you about childbirth education classes. Ask her about the classes offered in your community or at the hospital or birth center where you plan to deliver.

You may also want to look into breastfeeding and baby care classes to take during your third trimester. And it's not too early to start thinking about choosing a doctor for your baby – your caregiver should be able to give you some good leads.

Watch the video: Your First OB Ultrasound. Oakdale OBGYN (July 2022).


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