Self Care for Second Trimester of Pregnancy (Gestational Age 14 - 28 Weeks)

Physical and Mental Health Changes

Physical Health:

Vaginal discharge
Muscle cramps
Heartburn
Swelling in legs and feet after sitting with legs dangling for extended periods
Breasts: Breasts will continue to enlarge.
Uterus: The top of the uterus will reach the navel by 20 weeks of gestation.
Bowel Movements: Bowel movements may become more difficult, potentially leading to constipation.

Mental Health:

Your mood will begin to stabilize, and you’ll adapt better to the changes.

Fetal Development

Gestational Age 16 Weeks: The fetus is about 12 cm long and weighs approximately 125 grams. The skin is thin and transparent. Fine hair starts to appear. The sex can be clearly distinguished.

Gestational Age 20 Weeks: The baby starts to kick and push. The body is about 16 cm long and weighs approximately 300 grams. This is an ideal time for an ultrasound to assess for any fetal abnormalities.

Gestational Age 24 Weeks: The baby can now distinguish sounds and open its eyes. This is a good time to bond with your baby by playing music or talking to stimulate development.

Gestational Age 28 Weeks: The body is approximately 25 cm long. The baby weighs about 1 kilogram. The baby’s brain develops further, and fat accumulates in the body throughout the week. The baby will start to grow rapidly, gaining 100-300 grams per week.

Complications Requiring Medical Attention

Vaginal bleeding
Contractions
Vaginal inflammation: Increased, lumpy, and itchy discharge that is yellow or green.
Bladder infection: Symptoms include painful, cloudy urination. If left untreated, it can trigger premature labor or lead to pyelonephritis (kidney infection).
Decreased or no fetal movement
Unexplained reduction in uterine size or weight loss

Essential Nutrients for Mothers in This Trimester You should increase your food intake by 300 kcal/day compared to before pregnancy.

Protein: Essential for building and growing cells and tissues. Sources include: fish, chicken breast, eggs, beans, tofu, milk, and dairy products.
Carbohydrates: Such as rice, noodles, bread, flour, taro, and potatoes.
Iron: Helps nourish the blood and prevent anemia. If you don’t get enough iron, it can affect the baby’s brain development. Iron-rich foods include: liver, egg yolk, red meat, seafood, fish, various beans, dark leafy green vegetables, and various whole grains.
Vitamin C: Aids in iron absorption. Sources include: oranges, lemons, kiwis, guavas, and dark leafy green vegetables.
Iodine: To prevent goiter and intellectual impairment in the baby due to iodine deficiency. Found in: seafood and sea salt.
Calcium: Helps build the fetal skeleton. Sources include: milk, fish, sesame seeds, leafy green vegetables, especially small fish and various seafood.
Water: Drink approximately 6-8 glasses of water per day to help improve your bowel movements.

Self-Care

Exercise: You can do simple exercises like brisk walking, swimming, or prenatal yoga.
Sexual Activity: If there are no complications, sexual activity can be normal. However, be mindful of positions that put pressure on the uterus and avoid vigorous activity.
Rest: Get at least 8-10 hours of rest per day, sleeping in a comfortable position that doesn’t cause discomfort.
Daily Activities: Be careful to avoid impacts to the abdomen, as this can directly affect the uterus and the baby.

Antenatal Care (Prenatal Care)

In every appointment, you’ll have your weight taken, blood pressure measured, and urine tested to screen for gestational diabetes and protein in the urine. This is particularly important for some mothers who may develop preeclampsia after 20 weeks of gestation, which doctors can detect by high blood pressure (above 140/90 mmHg) and possibly protein in the urine. The doctor will measure your fundal height to see if it corresponds to your gestational age and listen to the baby’s heartbeat.

The period between 18-21 weeks of gestation is important for the doctor to perform an ultrasound to check the baby’s health.
Between 24-28 weeks of gestation, if the doctor finds that you are at risk of developing gestational diabetes, they will perform a screening test. This involves you drinking a concentrated sugar solution and then having your blood tested to see if your blood sugar levels are within the normal range. For some mothers, the doctor may consider additional blood tests, such as hemoglobin levels, to monitor your health again before preparing for delivery.