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Second Trimester

Round Ligament Pain and Discomfort

As the pregnancy continues into the second trimester, lower pelvic pain, hip pain and lower back pain can occur. This can all be normal discomfort in pregnancy. Our recommendations on pain relief during pregnancy include:

  • Pregnancy support belt/ pregnancy girdle
  • Chiropractor, massage therapist, acupuncturist
  • Prenatal yoga or stretching
    • Tip: Hands and knees position with a heating pad on your low back helps!
  • Heating pad, warm bath or shower to help relax the muscles
  • Localized pressure in the impacted area with a tennis ball for at home massage
  • Increase water intake to make sure muscles stay hydrated
  • Change position frequently
  • Sleep with a pillow between your knees
  • Tylenol 325 mg tabs, take 2 every 4-6 hours

Fetal Movement

Around 18-22 weeks we anticipate you to be feeling fetal movement. It will begin as intermittent flutters and progress to pronounced rolls, squirms and kicks or punches. Usually around 24-26 weeks family and friends can also feel external fetal movement.

If you have concerns that baby doesn’t seem to be moving well at any given time we recommend you find a quiet place to rest. Lay on your side, – either side doesn’t matter which – have a cold glass of ice water and maybe some crackers with peanut butter, then let your baby move for you. We anticipate a healthy baby to give you approximately 6-10 movements in one hour. Most babies will move and reconfirm their safety within the first 20-30 minutes you are laying down and paying attention to only their movements. If you reach the complete hour and have not felt 6-10 movements, please call the office or On-Call provider for further instructions.

Anatomy Scan

Between 19-21 weeks pregnant we recommend an ultrasound to evaluate the pregnancy’s progress. Included in this ultrasound is evaluating for physical abnormalities. We examine the brain, face, heart, fingers, toes and everything in between. If your baby is cooperative and willing to share we are happy to tell you the sex of your baby at this time. As is consistent with all ultrasounds there are limits to technology and there is a risk that not all abnormalities will be identified.

Gestational Diabetes Testing

It is recommended to screen pregnant women for Gestational Diabetes between 24 and 28 weeks pregnant. We do this with a simple blood test. First you will drink an orange beverage consisting of 50 grams of sugar. We ask that you complete drinking it in 5 minutes or less. We then let you relax in the waiting room for 1 hour. After that hour, we draw your blood. If you have a routine OB visit scheduled for the same day, you will see the provider during your 1 hour wait.

We will contact you if your results indicate need for further testing to diagnose Gestational Diabetes.

There is no recommendation to fast prior to this screening test, however, we always recommend a healthy pregnancy diet consisting of fruits, vegetables and protein.

Signs of Preterm Labor

Between 24-35 weeks pregnant there is a risk for preterm labor. We recommend you learn these signs and symptoms and watch for them. If you feel you are experiencing severe symptoms please contact the On-Call provider for further instructions.

  • Regular Painful Contractions, approx. 6 contractions in 1 hour
  • Rupture of membranes, “water breaking”
  • Heavy vaginal bleeding
  • Severe back ache, feels rhythmic, “patterned”


If your blood is RH negative, you will be given RhoGam. If an RH negative mom is exposed to blood from an RH positive baby, it causes the mom to create antibodies against the RH factor. The job of these antibodies is to attack the RH factor. Often this does not cause problems in the current pregnancy, but it can cause problems in future pregnancies. These antibodies may cross the placenta and fight the babies red blood cells. RhoGam is given to prevent these antibodies from forming. Since we do not know if the baby is RH negative or positive, we treat all moms who are RH negative in pregnancy.

When the baby is born, we will check the baby’s blood type.  If the baby is RH positive, you will need to get another shot of RhoGam after the baby is born.

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