Dr. Barra OBriain, MD,Local Family Physician Vancouver

discusses Blood Pressure During Pregnancy

The second trimester spans weeks 13 through 27 (roughly months 4 through 6). Often dubbed the “honeymoon phase” of pregnancy, early symptoms like nausea and extreme fatigue usually subside, replaced by increased energy and a visible pregnancy bump.

Fetal Development Milestones

  • Weeks 13–16: Fine hair (lanugo) covers the body, skeleton hardens, and the fetus can suck its thumb.

  • Weeks 17–20: You may feel initial movements (“quickening”). Eyebrows, eyelashes, and fingerprints form, and an anatomy ultrasound can reveal biological sex.

  • Weeks 21–27: Hearing develops—the fetus can respond to sounds outside the womb. Lungs develop air sacs, and skin is protected by a waxy coating called vernix.

Maternal Body Changes

  • Physical Shifts: Growing belly, weight gain, round ligament pain (stretching sensations in the lower abdomen), and skin changes like stretch marks or a linea nigra.

  • New Symptoms: Mild leg cramps, backaches, heartburn, nasal congestion, or mild swelling in feet and ankles.

Dr. Nardia Strydom, MD, Local Family Physician

discusses Rhogam and Pregnancy.

Signs to Watch For

  • Perinatal Anxiety: Intrusive thoughts about the baby’s movement or health, difficulty sleeping despite fatigue, or panic attacks.

  • Perinatal Depression: Persistent emptiness, loss of connection to the pregnancy, isolation, or difficulty feeling joy.

  • Depersonalization: Feeling disconnected from your changing body or unable to bond with the fetus.

Common Emotional Drivers in Trimester 2

  • Anatomy Scan Stress: The 20-week ultrasound brings relief for many, but waiting for results or navigating unexpected findings can provoke intense anxiety.

  • Body Image & Identity Shifts: As your bump becomes visible, rapid weight gain and physical changes can trigger body dysmorphia, loss of bodily autonomy, or feelings of discomfort.

  • “Reality Setting In”: Feeling fetal movement (quickening) makes the pregnancy concrete, which can trigger stress around birth preparation, finances, parental readiness, and relationship dynamic changes.

  • Hormonal Stabilization (and Surges): While mood swings may feel less erratic than in the first trimester, sustained high estrogen and progesterone levels still impact brain chemistry.

Dr. Karen Nordahl, MD, Family Physican, Vancouver

Second Trimester Exercise educational video.

Dr. Heather Jenkins, MD, CCFP, Local Family Physician

discusses Second Trimester of Pregnancy

Dr. Elise Balaisis, MD, Local Family Physician

discusses second trimester prenatal visits.

RD Andy Desantis, Toronto, Ontario

Educational video describing Tree Nut Allergies

True Allergy vs. Pregnancy Aversion/Intolerance

  • IgE Food Allergy: Involves the immune system. Symptoms include hives, swelling of the lips/tongue, nasal congestion, tingling in the mouth, or wheezing.

  • Food Intolerance or Aversion: Driven by hormones and an enhanced sense of smell. Symptoms are purely digestive (nausea, vomiting, aversion to certain textures or odors) without skin or respiratory involvement.

Why Allergies Shift in Early Pregnancy

  • Immune Reprogramming: The body transitions to a Th2-dominant immune state to prevent rejecting the embryo, which can make you more prone to histamine release and antibody (IgE) responses.

  • Hormonal Spikes: Surging levels of estrogen and progesterone affect mast cells and gut permeability, heightening sensitivities.

  • Overlap with Morning Sickness: Digestive symptoms like nausea, cramping, and bloating can make it hard to tell the difference between typical first-trimester morning sickness and a mild food reaction.

Tamarah Nerreter, Physiotherapist,

Fitness and Pregnancy

Tamarah Nerreter, Physiotherapist,

discusses exercise during each trimester

Tamarah Nerreter, Physiotherapist,

discusses dynamic warmup in pregnancy exercise

Dr. Karen Nordahl, MD, Family Physican, Vancouver

discusses Can Exercise Cause Miscarriage?

The second trimester is widely considered the ideal time to exercise during pregnancy. Energy typically returns, morning sickness fades, and physical activity helps relieve backaches, improve mood, and build stamina for labor.

Dr. Nardia Strydom, MD, Local Family Physician

What Does Baby Movement During Pregnancy Mean?

Key Second Trimester Modifications

  • Avoid Flat-on-Your-Back Exercises: Lying flat on your back after week 16 can allow the heavy uterus to compress the vena cava (a major vein), reducing blood flow to you and the baby. Use an incline wedge or opt for side-lying positions.

  • Watch Your Center of Gravity: As your belly expands, your balance shifts. Avoid movements with a high risk of falling or joint strain.

  • Be Mindful of Relaxin: The hormone relaxin loosens joints and ligaments. Avoid deep over-stretching, as it can cause ligament sprains or pelvic girdle pain.

  • Use the “Talk Test”: Exercise at a moderate pace where you can carry on a conversation without gasping for air.