The second trimester: what actually changes

The second trimester has a reputation as the best part of pregnancy, and for many people, that's accurate. The nausea that defined the first trimester usually eases. Energy returns. The pregnancy becomes visible. It's also when most of the major structural development is done and the risk of miscarriage drops significantly.

What gets better

Nausea and vomiting typically peak around weeks 8–10 and resolve by week 14 for most people. Not everyone — some continue to feel sick through the second trimester and beyond — but the majority find a real improvement.

Fatigue also usually eases. The extreme tiredness of the first trimester is driven partly by the massive surge in progesterone and partly by the body's rapid adjustment to pregnancy. As hormone levels stabilise, energy tends to return.

Breast tenderness, which can be severe in the first trimester, often diminishes as the body adapts to the hormonal environment.

What's new

The bump appears. For first-time parents, this usually becomes visible to strangers somewhere between weeks 18 and 22. For subsequent pregnancies, it often shows earlier because the abdominal muscles have stretched before.

Movement. Somewhere between weeks 18 and 22 (sometimes earlier for second or subsequent pregnancies), you'll start feeling the baby move. It starts as faint flutters — often described as bubbles or butterflies — and gradually becomes more distinct kicks and rolls. Partners can usually feel kicks from the outside by around week 24–26.

Round ligament pain. As the uterus grows, the ligaments supporting it stretch. This can cause sharp, stabbing pains on one or both sides of the lower abdomen, usually triggered by sudden movements like coughing, sneezing, or rolling over in bed. It's harmless but can be alarming if you don't expect it.

The anatomy scan

The anomaly or anatomy scan, usually offered between weeks 18 and 22, is the most detailed ultrasound of the pregnancy. A sonographer examines the baby's brain, spine, heart, kidneys, limbs, face, and placenta. The scan typically takes 20–45 minutes.

Most anatomy scans are straightforward. Occasionally, a "soft marker" is found — a finding that may or may not indicate a chromosomal condition and requires follow-up. If something is flagged, try to get clear information about what it means, what follow-up is needed, and what the realistic range of outcomes is before drawing conclusions.

If you want to know the sex of the baby, the anatomy scan is usually when it becomes visible — the sonographer can typically identify it with 95–99% accuracy at this stage, though it depends on the baby's position.

Glucose screening

Most providers offer a gestational diabetes screen between weeks 24 and 28. The standard test involves drinking a glucose solution and having your blood drawn an hour later to measure blood sugar response. If the one-hour test comes back elevated, a longer three-hour test is usually done to confirm or rule out gestational diabetes.

Gestational diabetes is manageable — usually through diet modification, sometimes with insulin — and with proper management, outcomes are typically good. The key is detection, which is why the screening is standard.