Pregnancy: The Second Month

African American couple smiling and hugging 
Physical changes in the second month of pregnancy

Your symptoms in the second month of your pregnancy will be similar to the previous month. These include fatigue, nausea, dizziness, frequent urination, food cravings or aversions, and mood swings. You might no longer enjoy the taste of alcohol or the smell of smoke, which is good, because these substances can be harmful to your growing baby. Your breasts will continue to become larger, your nipples will be more prominent, and small nodules may appear on the areola, which is the dark area surrounding the nipples.

You may start to develop a few other symptoms this month. You may have a slight white vaginal discharge. Increasing hormone levels may cause you to develop acne. Some women, on the other hand, find that their skin clears up toward the end of the month, resulting in that famous pregnancy “glow.” Your hair may be less manageable. You might have a chronic stuffy nose, which may be alleviated with the use of a humidifier. Your gums will become softer due to the hormones in your system, so make sure to maintain good dental hygiene. Hormones in pregnancy tend to make the intestines less efficient, causing constipation. To guard against constipation, make sure to eat a high-fibre diet and drink lots of water.

This month, cells in the ovary continue to produce a hormone called progesterone, which is important to maintain the pregnancy. The amount of blood circulating in your body will increase to meet the needs of the unborn baby. The increase in blood volume will make you feel warmer. Your abdomen will begin to swell ever so slightly. Your uterus is now the size of an orange but it is still hidden within your pelvis. The baby is moving gently but not enough for you to feel it. In order to avoid accidents that could harm your baby, make sure to get lots of sleep and exercise safely.

Your first medical visit

This month, you may have your first medical visit. From now until the end of your second trimester, you should visit your doctor or midwife once per month. This month, your health care provider will ask you questions about your health and medical history, your family’s medical history, and possibly your job, to help spot any potential risks to the pregnancy. Your health care provider will also:

  • run urine and blood tests to confirm the pregnancy and check for certain conditions that could affect your pregnancy
  • conduct a pelvic examination to confirm the pregnancy, check for cysts, and assess the pelvic bones, vagina, and cervix
  • do a Pap smear during the pelvic examination, to rule out abnormalities of the cervix, and swabs to check for infection
  • measure your height and weight: weight gain is normally about 0.5 kg to 1 kg per month in the first trimester, although some women lose weight during this time because of morning sickness
  • press or palpate your abdomen to feel the top of your uterus, called the fundus
  • check your blood pressure

Your health care provider is also there to answer any questions that you may have. You may find it easier to write down your questions before you go for your visit, so that you don’t forget anything important.

During your medical visit, your health care provider will start a medical record of your pregnancy, to which the results of tests and examinations will be added at each visit. In some cases, your provider will give you the record or a copy of it. Keep the record with you, in case you ever need medical attention, or if your care is shared between a number of different health care providers.

Medical tests in the second month of pregnancy

Since this is your first medical visit, your health care provider will conduct a number of routine tests. These will include a Pap smear to check for cervical abnormalities and swabs to check for infection, as well as urine and blood tests.

Urine testing is done to check for the presence of the following:

  • protein, which is a possible sign of kidney problems or pregnancy-induced hypertension
  • sugar, which is a sign of diabetes

Routine blood testing is done to assess the following:

  • hemoglobin and iron level, to check for anemia
  • infectious diseases such as HIV or hepatitis B
  • ABO blood grouping and rhesus (Rh) factor
  • immunities, especially to rubella and chicken pox
  • genetic diseases such as sickle cell anemia or thalassemia

You may also be given the option of undergoing a nuchal translucency measurement test. This test is usually done at 10 to 14 weeks of pregnancy. Using ultrasound, the fluid space at the back of the unborn baby’s neck is measured. This result is used, along with the mother’s age and the hormone levels in her blood, to determine the risk that the baby has a chromosomal abnormality. Because this test only estimates the chances of a baby having the disease, a positive result, combined with other abnormal findings, will mean you will be offered a diagnostic test such as amniocentesis or chorionic villus sampling. These diagnostic tests can definitively tell you about your baby’s chromosomes.

 For more information, see "Prenatal Testing."

Concerns this month

Bleeding

Vaginal bleeding in the first trimester affects 20% to 30% of all pregnancies. Vaginal bleeding may range from light spotting to severe bleeding with clots. In month two, there can be a number of causes for vaginal bleeding. Implantation bleeding may occur around the time that the fertilized egg implants into the uterus, and this is normal. Bleeding after vaginal intercourse is common during pregnancy because the cervix is more prone to bleeding on contact.

Miscarriage is a serious cause of first trimester bleeding. By far the most common reason for miscarriage is a problem with the chromosomes in the embryo. Other reasons for miscarriage include hormonal problems.

Emotional changes and depression in the first trimester of pregnancy

Usually, the first trimester of pregnancy is a time of great joy for the expectant mother. You will no doubt be excited and perhaps relieved when you discover you are pregnant. However, you may also have mixed feelings about your pregnancy. Unpleasant physical symptoms such as nausea or vomiting may make you feel resentful. You may feel frightened because of a bad experience with a previous pregnancy. You may be worried about the alcohol you drank before you knew you were pregnant, or whether you will be able to stick with your nutrition plan. You could be concerned about losing the baby. You might worry about whether you will be able to take care of a baby, or whether you can afford a child.

Self-esteem issues also come into play at this time. As your clothes become tighter, you might start to feel less attractive. If your professional activities are important to your self-esteem, you may feel isolated from peers and unable to meet the expectations of your superiors.

It is normal to have mood swings in response to all the changes you are going through in your pregnancy. These mood swings can range from elation to being upset, angry, or depressed. It is important to keep in mind that these feelings are normal during pregnancy. If you are getting into petty arguments with your spouse because of your mood swings, try to talk things over with him, to make sure the problems don’t escalate.

Some women may experience a depression that is so pronounced and continuous that it disrupts their normal functioning. This is called major depression, and it affects 4% to 12% of women during pregnancy. The incidence of major depression during pregnancy is not as high as during the postpartum period (12% to 28%). However, if you have depression during pregnancy, you are more likely to have postpartum depression. If you have any of the following symptoms of depression, check with your doctor:

  • feeling out of control
  • unpredictable tearfulness and spontaneous crying
  • feelings of sadness, melancholy, weary anger, or general despair
  • sleep disturbances
  • a total loss of sexual desire

Overall, though, most women simply have an intense and romantic sense of excitement in the first trimester of pregnancy. There is a feeling of joy, and of being more special than anyone else in the world.

How your baby is developing

Nicolette Caccia, MEd, MD, FRCSC

Rory Windrim, MB, MSc, FRCSC ​

9/11/2009


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