Congrats, mama, you’ve made it to the second trimester! You may have been able to successfully hide your bump for the past three months, but you’re on the verge of some significant changes. For black women and all women, the second trimester is when your pregnancy comes into full bloom. This is a great time to start working on your birth plan. Whether you opt to deliver at home or in a hospital, with painkillers or without, it’s best to have a clear vision for one of the best days of your life.
Black women face a higher risk of complications during the second trimester, but most problems are avoidable. Here is everything you need to know to communicate with doctors and nip health risks in the bud.
What Every Black Woman Should Know About the Second Trimester
The second trimester takes place between weeks 14 and 26. Many call this “The Golden Period” as side effects like nausea and tiredness disappear. You will even start to feel flutters for the first time between 16 and 20 weeks, an effect known as “the quickening.” At 20 weeks, the uterus has expanded to the height of the belly button, and most women will begin to show. Your baby will have eyelashes, nails, eyebrows, and even hair by month four.
Second Trimester Tests
During the second trimester, your doctor will perform tests on the Rh factor of your blood. Most people test positive for the Rh factor, but if your result is negative, your doctor can prescribe injections of Rh immune globulin (Rhogam). This treatment prevents the development of antibodies that could hurt your fetus. You’ll also have an ultrasound where you can learn the gender of your baby. These scans aren’t always accurate, so try to hold off on painting the nursery until the outlook is more definite in the third trimester. Remember that you have the right to say no to any tests you don’t feel comfortable with.
Common Second Trimester Symptoms
The positives of entering the second trimester include more energy, improved sleep, and less morning sickness. Many people consider the second trimester the best time of their pregnancy, but this period still has downsides. Many women experience an increase in appetite, leading to weight gain and stretch marks. You may now experience back pain, emotional instability, and lower extremity swelling. Pains and aches in the uterus, belly, and stomach are typical as the fetus continues to grow and exert pressure. Skin conditions like varicose veins, pigmentation, and darkening nipples are also common.
GERD (Acid Reflux)
Pregnancy hormones are responsible for heartburn in both the second and third trimesters. High progesterone levels cause the muscle that sits between the esophagus and stomach to relax, allowing acid from your stomach to move upward. Dietary change is one of the best ways to prevent or reduce heartburn. While there are no universally “banned” foods, common diet triggers include:
- Acidic foods, such as citrus fruits and tomatoes
- Greasy or fried meats
- Spicy foods
- Carbonated beverages
If the thought of ditching coffee and spicy enchiladas is too much to bear, there are other lifestyle steps you can take. For example, you might space out your meals by eating six smaller meals throughout the day instead of three. Eating speed also matters, as eating slowly can reduce heartburn, while eating quickly has the opposite effect. Other steps to prevent heartburn include:
- Wearing loose clothing
- Drinking between meals, but not with meals
- Chewing sugar-free gum
- Limiting caffeine
- Propping yourself up with pillows at night
Over-the-counter medications like Rolaids, Mylanta, Tums, and other antacids are all safe during pregnancy. However, consult your doctor before taking these or other new medications.
Leg cramps affect almost half of all women during pregnancy. Hormonal changes, increased dehydration, and lower circulation are the most common causes of this condition. Many pregnant women report that their cramps often flare at night. You can avoid or reduce leg cramping by stretching your calf muscles before bed, exercising regularly, and drinking plenty of fluids to stay hydrated. If this fails, a hot shower, warm bath, or ice massage can increase circulation and soothe aching muscles. Magnesium supplements are also available over the counter to reduce leg cramping, and physicians agree that they are safe for most pregnant women. Most cases of leg cramping are not serious and will subside over time. Call a doctor if you have swelling, pain, or redness that does not go away.
During pregnancy, your body produces more estrogen and progesterone. These hormones affect the mucous membranes of your mouth, making your gums more sensitive to brushing and flossing. In some cases, estrogen and progesterone may even cause bleeding or make your teeth loose. Sixty to seventy-five percent of pregnant women suffer from gingivitis. The condition is characterized by red, shiny, or bleeding gums. Additionally, stomach acid from morning sickness can strip teeth of their enamel. Combine this with the fact that the pH balance of your mouth changes during pregnancy, and the result is a recipe for cavities.
You can lower the odds of tooth decay and discomfort easily at home. To improve dental health, try the following:
- Treat inflammation with a saltwater rinse. Combine one teaspoon of salt with one cup of water and gargle.
- Switch to a softer toothbrush.
- Rinse your mouth with antacid after vomiting. A cheap and easy formula is to combine one teaspoon of baking soda with a cup of water.
The best way to prevent cavities is to limit sugary foods, even when eating for two. Make sure to have regular checkups at six-month intervals, just as you did before becoming pregnant. Dental X-rays are still safe during pregnancy but remember not to accept any oral medicine without consulting your prenatal care provider.
Urinary Tract Infections (UTI)
During pregnancy, your kidneys output more glucose and hold urine for extended periods. As a result, pregnant women are at a higher risk of contracting a UTI. Contact your health care provider if you have a strong urge to urinate, pain when you urinate, cloudy urine with a strong smell, or fever or backache. UTIs are diagnosed with a urinalysis or urine culture during a visit to your doctor’s office. If you test positive, most are easily treatable with a prescription antibiotic. Left untreated, urinary tract infections can become severe and lead to kidney infections.
Serious Medical Complications
Though the aches and pains of pregnancy are unpleasant, they do not pose a serious health risk to you or your baby. However, there are potential health problems that you as a black woman and your healthcare provider should be mindful of in the second trimester. These conditions are preventable if spotted early.
Though expectant mamas have the green light to indulge, be careful not to overdo it. Too much weight gain can lead to elevated blood sugar and a diagnosis of diabetes. Gestational diabetes usually shows up around week 24. Between 2 and 10% of all pregnant women have this condition. According to the CDC, women of color are more likely to have gestational diabetes. This is something that black women need to be mindful of in the second trimester.
Many physicians order an oral glucose screening test between weeks 24 and 28 for gestational diabetes. The test is simple — you will drink a syrupy drink (called Glucola) and wait one hour before a blood draw. Your doctor may advise you to start insulin or alter your lifestyle to lower your blood sugar, depending on your results.
Preeclampsia is a form of high blood pressure that typically happens in the third trimester but can also appear during the second. This condition affects 5 to 8% of all pregnant women. The rate of preeclampsia is 60% higher in black women than in white women. Those at most risk are usually outside the typical pregnancy window of 20 to 40 and have a history of diabetes, high blood pressure, or kidney disease.
You may have preeclampsia if you experience any of the following symptoms:
- Swelling of the hands and face
- Pain on the right side of the stomach
- Vision loss
- Headache is not treatable with aspirin
Solutions to preeclampsia include bed rest, hospitalization, and medications to lower blood pressure. Your doctor may decide to induce an early delivery or perform a C-section in severe cases. Most cases of preeclampsia hypertension subside after your baby is delivered.
Pre-term Premature Rupture of Membranes (PPROM)
Most expectant mothers anticipate their water will break before delivery. This “water” is fluid from your amniotic sac, which protects the fetus from infection. When the sac ruptures too early, PPROM can signal a premature birth. Hospitalization, steroids, antibiotics, and medications like terbutaline are typically used to treat PPROMs. If treatment is ineffective, most pre-term babies can be helped through intensive care nursery services (NICU).
Though devastating, miscarriages are common and affect roughly 15% of all pregnancies. Most miscarriages happen before 12 weeks but can still occur in the second trimester. Intense cramping, spotting, or bleeding is a significant sign that something is wrong. If you experience these symptoms, seek medical attention. Miscarriages are usually expelled naturally without any intervention, but a doctor can also perform a dilation and curettage (D&C) procedure if there are complications.
A delivery is classified as “pre-term” if you give birth before 38 weeks. Roughly one in every ten births is pre-term. According to a study from the CDC, black women are 50% more likely to have a pre-term birth than Hispanic or white women. An early delivery can be frightening, but a fetus born in the second trimester (24 weeks) can survive on its own in a neonatal intensive care unit. Though pre-term babies are at a greater risk for complications, many go on to thrive as healthy infants.
Lifestyle factors and chronic illnesses like diabetes and kidney disease can lead to early deliveries. Other potential causes of early labor include:
- Bladder infections
- Getting pregnant quickly after a previous pregnancy
- Abnormal cervix
- Use of illegal drugs like cocaine
Adopting a healthy lifestyle from the beginning is a great way to improve your odds of delivering at the right time. Pre-term labor can also be stopped with tocolytics, corticosteroids, or magnesium sulfate. If these treatments are ineffective, your doctor may prescribe a steroid to speed up the growth and development of your baby’s lungs.
Choose the Right Pregnancy Team
The second trimester is the ideal time for your pregnancy plan to come into focus. Whether you prefer a doctor or a midwife, choose a healthcare provider who will listen to your unique needs. As a woman of color, you face an increased risk for birth complications. If you feel that your doctor doesn’t listen to you or answer your concerns, don’t be afraid to shop for someone new.
Your baby’s health is in your hands. As a black woman, creating good habits in the second trimester can set the course to keep your pregnancy on the right track. Though systematic issues in the healthcare system do exist, they do not have to stop you from having a happy and successful pregnancy. Good nutrition and healthy lifestyle habits are the keys to achieving the life you want for yourself and your baby.