Second Trimester
Most women describe the second trimester as the "honeymoon phase" - Nausea eases, energy returns, and the bump becomes visible. It is also when baby becomes unmistakably real.
What's Happening: Weeks 14–27
The second trimester is the period of rapid foetal growth and sensory development. The placenta is now fully functional - Your primary hormonal support shifts from the corpus luteum to the placenta. Track exactly how far you've come with our trimester progress tracker.
Weeks 14–15: Systems Coming Online
Baby
Facial expressions form - Baby can squint, grimace, frown. Digestive system is working. Baby swallows amniotic fluid and begins producing urine.
Your Body
Energy often returns. Nausea eases for most women. Skin changes may appear - Linea nigra, melasma (chloasma) are common.
Week 16: First Movements (Maybe)
Baby
Baby is now 11–12cm. Bones hardening. May begin to 'feel' sound - Heart rate increases to music. Possibly your first flutters if experienced mum.
Your Body
Fundal height reaches about halfway to navel. Round ligament pain may begin as uterus lifts out of pelvis.
Weeks 17–18: Active Baby
Baby
Myelin begins forming around nerves. Sweat glands developing. Fingerprints unique. Skeleton visible on X-ray.
Your Body
Backache may begin. Blood pressure often dips (second trimester nadir) - Some feel dizzy. Healthy weight gain begins.
Week 19–20: Halfway Point - Anomaly Scan
Baby
Anatomy fully visible on ultrasound. All major organs assessable. Vernix (waxy coating) begins forming on skin. Lanugo (fine hair) covers body.
Your Body
Uterus reaches navel at Week 20 (fundal height ~20cm). This is the typical time for the anatomy scan.
Weeks 21–22: Viability Threshold Approaching
Baby
From Week 22, foetal viability outside the womb is possible with intensive NICU support (survival rates vary widely). Hearing is developed - Baby responds to your voice.
Your Body
Braxton Hicks contractions may begin (painless tightening). Not a sign of labour - Just uterine practice.
Weeks 23–25: Lung Development Begins
Baby
Surfactant production begins - Critical for breathing after birth. Baby opens eyes for first time. Responds to light shone on abdomen.
Your Body
Belly visibly growing. Swelling in ankles common. Carpal tunnel syndrome can start (nerve compression from fluid).
Weeks 26–27: End of Second Trimester
Baby
Baby weighs about 900g. Patterns of activity and rest emerge. Brain is rapidly developing surface complexity (sulci and gyri forming).
Your Body
Glucose tolerance test typically done at 24–28 weeks. Sleep gets harder. Baby's movements are strong and regular.
Second Trimester Symptoms
Round ligament pain
NormalSharp, shooting pain in lower abdomen or groin - Typically lasts seconds. Ligaments supporting the uterus stretch rapidly.
Move slowly when changing position. Support belly with pillow when lying down. A pregnancy support belt can help.
Back pain
NormalPosture shifts as the centre of gravity changes. Ligaments loosen (relaxin hormone). The psoas and piriformis are commonly affected.
Physio referral - Singapore GPs can refer. Prenatal yoga strengthens the right muscles. Sleep with pillow between knees.
Swollen ankles and feet
Normal / watchIncreased blood volume and fluid retention, especially in Singapore's heat. Gravity pools fluid in lower legs by end of day.
Elevate feet when seated. Compression socks. Swimming is excellent. Sudden severe swelling with headache or visual changes → see doctor immediately (pre-eclampsia sign).
Skin changes
NormalLinea nigra (dark line from navel to pubic bone). Melasma on face. Stretch marks beginning on belly, hips, or breasts.
Linea nigra and melasma fade after birth. Moisturiser may reduce stretch mark discomfort - Evidence on prevention is weak.
Heartburn / acid reflux
NormalProgesterone relaxes the lower oesophageal sphincter. Growing uterus pushes stomach upward.
Small meals. Avoid lying flat after eating. Raise head of bed. Gaviscon is safe in pregnancy - Confirm with pharmacist.
Nasal congestion
Normal'Pregnancy rhinitis' - Increased blood volume causes swelling of mucous membranes.
Saline nasal spray. Elevate head when sleeping. Decongestant nasal sprays should be discussed with your doctor.
Leg cramps
NormalCommon at night. Cause unclear - Possibly magnesium or calcium. Made worse by Singapore's heat and dehydration.
Stretch calves before sleep. Magnesium supplement (discuss with doctor). Stay hydrated. Banana daily.
Increased appetite
NormalNausea is gone. Baby growing rapidly. Normal to feel hungry again - Focus on nutrient-dense choices.
200–300 extra kcal/day is the rough guide for T2. Not 'eating for two' - Quality over quantity.
Warning Signs - Seek Medical Review Immediately
- ⚠Sudden severe headache, visual disturbances, swelling in face/hands (possible pre-eclampsia)
- ⚠Vaginal bleeding - Any amount after Week 14
- ⚠Pain or burning on urination with fever (urinary tract infection - Can trigger preterm labour)
- ⚠Decreased or absent foetal movement after Week 20 (establish your baseline and report changes)
- ⚠Fluid leaking from vagina (possible premature rupture of membranes)
- ⚠Regular painful contractions before Week 37
Feeling Baby Move - Quickening
What does it feel like? First movements are often described as flutters, bubbles, or a gentle tapping. By 24–25 weeks, movements become unmistakable kicks, rolls, and jabs.
Anterior placenta: An anterior placenta (placenta at the front of the uterus) cushions movement - You will feel kicks later and more faintly. This is normal and does not indicate any problem.
After Week 28: You should feel a pattern of regular movements. There is no specific "kick count" endorsed by all guidelines, but if you notice your baby has been unusually quiet for several hours, contact your maternity team. Use our kick count tracker to log daily movement patterns.
The Anatomy Scan (Anomaly Scan) - Week 18–22
The mid-pregnancy anatomy scan is the most detailed ultrasound of your pregnancy. It takes 30–60 minutes and is typically done between Weeks 18 and 22. It is offered to all pregnant women in Singapore. For a full overview of screening and anomaly scan results, see our pregnancy FAQ.
What is assessed:
Head & Brain
Head circumference, biparietal diameter, cerebellum, choroid plexus, facial profile
Heart
Four chambers, outflow tracts, great vessels - Screening for congenital heart defects
Spine
Full spine integrity - Spina bifida screening
Abdomen
Kidneys, bladder, stomach, abdominal wall - Checking for gastroschisis, diaphragmatic hernia
Limbs
Arm and leg bones measured - Length, symmetry, club foot screening
Placenta
Location, appearance - Placenta praevia identified if placenta covers the cervix
Amniotic fluid
Volume assessment - Low (oligohydramnios) or excess (polyhydramnios) identified
Growth biometrics
Femur length, head circumference, abdominal circumference → estimated foetal weight
Glucose Tolerance Test (GDM Screening) - Week 24–28
Gestational diabetes mellitus (GDM) affects 15–25% of pregnant women in Singapore - One of the highest rates in the world, linked to dietary patterns and ethnic risk profiles (South Asian and Chinese women have higher baseline risk). Screening is standard at 24–28 weeks.
How the 75g OGTT works:
Night before
Fast for 8 hours. Water is fine. No food, no juice, no gum.
Morning of test
Go to polyclinic or lab. Fasting blood glucose taken first.
Glucose drink
Drink 75g glucose solution (very sweet). Stay at the clinic.
1 hour
Blood glucose measured 1 hour after the drink.
2 hours
Blood glucose measured 2 hours after the drink. You're done.
Diagnostic thresholds (WHO 2013 / HPB Singapore):
| Timepoint | Normal | GDM Diagnosed If ≥ |
|---|---|---|
| Fasting | < 5.1 mmol/L | 5.1 mmol/L |
| 1-hour post-glucose | < 10.0 mmol/L | 10.0 mmol/L |
| 2-hour post-glucose | < 8.5 mmol/L | 8.5 mmol/L |
Nutrition in the Second Trimester
Second trimester is when appetite returns and nutritional needs increase. Aim for 300 extra calories per day - Quality matters more than quantity. Use the nutritional requirement calculator for personalised caloric targets. Iron needs increase significantly as blood volume expands.
Iron (27mg/day)
Blood volume increases 40–50%. Iron deficiency anaemia is the most common nutritional deficiency in Singapore pregnant women.
Sources: Red meat, dark leafy vegetables, fortified cereals, tofu, tempeh, tau kwa, clams
Calcium (1,000mg/day)
Foetal bones hardening rapidly - Peak calcium demand is in T2 and T3.
Sources: Dairy, fortified soy milk, tofu (set with calcium), ikan bilis, broccoli, kai lan
Protein (70–100g/day)
Baby's muscle and organ growth. Particularly important if vegetarian or if GDM is diagnosed.
Sources: Eggs, fish, tofu, legumes, chicken, lean beef, Greek yoghurt
Omega-3 DHA (200–300mg/day)
Brain and eye development peaks in T2 and T3. Most important time to supplement.
Sources: Salmon, sardines, mackerel, DHA-enriched eggs, algae-based DHA supplement (suitable for vegetarians)
Birth Planning - Start in the Second Trimester
You don't need to have all answers by Week 20. But beginning to think about and discuss the following now means you can make more informed decisions before you are in active labour. Learn about your birth options in Singapore, including epidurals, water birth, and caesarean choices.
Where to deliver
Options: KKH, NUH, SGH (restructured hospitals - Subsidised). Thomson Medical Centre, Raffles Hospital, Mount Alvernia, Gleneagles (private).
Timing: Decide by Week 28 to register
Restructured hospitals have 24/7 obstetric teams and NICU on-site. Private hospitals offer more privacy and choice of OB but cost significantly more.
Subsidised vs private
Options: Subsidised (B2/C class): significant cost reduction. Private OB at restructured hospital or fully private hospital.
Timing: Decide before booking delivery package
Delivery packages typically cover antenatal visits from Week 28 onwards. Check Medisave claimable amounts and Medishield Life coverage.
Pain management
Options: Epidural (most effective), Entonox (gas and air), IV pethidine, sterile water injections, TENS machine, hypnobirthing.
Timing: Discuss at antenatal visits; decide before labour
Epidurals are widely available at all major Singapore hospitals. You do not need to decide now - But understanding your options reduces fear.
Vaginal vs caesarean
Options: Planned vaginal delivery (medically advised for most), planned elective caesarean (available at private hospitals), emergency caesarean pathway.
Timing: Discuss if high risk in T2
Elective caesareans without medical indication are available in Singapore but are not covered by Medishield Life. Maternal request caesareans are more common in private hospitals.
Cord clamping & placenta preferences
Options: Delayed cord clamping (30–60 seconds recommended by WHO, now standard at KKH). Cord blood banking (private banks like Cordlife, StemLife).
Timing: Cord blood banking: register by Week 34
Delayed cord clamping significantly increases neonatal iron stores. Cord blood banking is a personal and financial decision - Do your research.
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