The second trimester is often when you get to really see your newest family member for the first time. While earlier ultrasounds can show some features, the ultrasound done around 20 weeks lets us look at all those little parts, from heart and lungs to fingers and toes. And of course, if you haven’t learned already (or even if you have), this is usually the best time to confirm the gender of your baby. At this point, if Pinterest and Etsy browsing for baby clothes hasn’t already become your favorite pastime, it probably will :)
From the OBGYN standpoint, with the exception of the 20 week ultrasound to assess your baby’s anatomy, our testing is generally pretty limited. Visits continue every 4 weeks during the period, and each visit will include listening to your baby’s heartbeat. After 20 weeks, we will begin to measure the fundal height (measurement from the pubic bone to the top of the uterus) in order to ensure your baby is growing well.
The only downside of the second trimester is that we do perform one of the 2 least favorite tests of pregnancy: the screening for gestational diabetes. It’s kind of a tossup as to whether this test or the check for group B strep in the third trimester is the least favorite of moms-to-be. Since this test isn’t so fun, I’d like to take a minute to explain what it is and why we do it.
The way we do screening for gestational diabetes is as follows: you get to drink a sugary drink provided by the lab and then have your blood drawn an hour after. If you pass, you’re done, and if you fail above a certain level, we begin management for gestational diabetes right away. If you fall in the middle, we do a second round of testing (a 3 hour version) to determine if you have gestational diabetes. We know all moms have some element of insulin resistance during pregnancy (we want your blood sugar to be a little higher than your baby’s so that he/she can eat); however, some moms are over-achievers :) For those moms, dietary modifications and in some cases medical management may be indicated. Glucose control is one of the most important aspects of pregnancy as uncontrolled gestational diabetes can lead to larger babies, increased risk of birth trauma to baby/mom or need for cesarean section, and in severe cases, even increased risk of stillbirth. So, yes, it’s not a fun test, but it is important.
The last important milestone for the second trimester is that around 23-24 weeks is the very earliest that babies have a chance to survive outside of mom’s body. That being said, we much prefer that your little one gets to stay inside awhile longer. Complications from prematurity can generally be minimized the further pregnancy progresses, so even if you’re finding that the second trimester isn’t a total breeze, remember that after 20 weeks, you’re over halfway to getting to see your baby in person and that cute little face will be totally worth it :)
Dr. Nick