Coming at you from Dubai (6 weeks into relocating), and with a 35-week twin bump so big I have to assume a pretty compromising position just to write this post at my desk! My babies are very nearly fully cooked – my OB here will allow them to stay put until 37 weeks if they are so minded, then it’s time to hurry things along with an induction – so I want to take this time to reflect on and offer some second trimester tips before those 16 weeks become too distant a memory. If you missed it, you can read my first trimester reflections here. Note, there have been several twists and turns since I posted that blog. I can confirm that no one pregnancy is alike… and sometimes even one pregnancy can look and feel very different within the same gestation! As before, I’ll follow the pillars of my pre-natal wellness book Mind, Body, Bump to summarise essential second trimester considerations, plus tips especially relevant for mums of multiples.
I spent most of my second trimester throwing myself into my work and into the logistics of relocating a family, business and antenatal support system to Dubai in late January of this year. While a convenient distraction, I think I would have found similar projects to busy my mind, even if circumstances had been different.
Although the first trimester can feel like a slog while you wait for things to look ship-shape enough to share your good news with friends and family, the second trimester is the longest in your pregnancy and it is marked by the first substantial physical evidence that you really are growing a baby (or two)! Mentally keeping up with those physical changes is a challenge; it’s natural to have mixed feelings or anxieties about becoming a mother – whether it’s for the first time or you’re adding to your existing nest.
I stopped reading as many books in my second trimester – partly because I was short on time, but also because I wanted to tune into my own experience of this pregnancy and not colour it with too much outside influence. Unlike my first pregnancy, I chose to be completely oblivious about how big my babies were or what fruit they were most like during any given week. Instead, I looked down at my tummy and watched them grow organically. I couldn’t control all the outward distractions by way of deadlines or moving arrangements, but I could silence some of the extra noise about my pregnancy and choose to feel it rather than read about it.
Sound ironic coming from a pre-natal author? That’s precisely why I designed Mind, Body, Bump so you can quickly scan it for essential context without getting drawn into pages full of overwhelming text or opinion. I believe that understanding context is important for manifesting self-compassion during pregnancy, but cramming in facts and stats can draw you too far away from your own unique experience. Only you can create and grow your baby, and only you can truly understand what it means to do so.
The second trimester overview below is an extracted one-page summary of all the changes in your mind and body during the second trimester. It will help you to self-educate as efficiently as possible, then move onto experiencing all the weird and wonderful maternal adjustments for yourself.
It’s worth noting that one of the big second trimester decisions is of course whether to gender reveal at the 20-week anatomy scan. Again, some people crave more context than others. During my first pregnancy, the idea of becoming a mum felt so abstract to me that learning I had a daughter on the way was actually helpful to connecting with her while she grew inside me.
Had this pregnancy been a single pregnancy, we were planning to opt for the element of surprise. However, with the news of twins proving such a surprise in the first trimester, we went for a full reveal once again. Lucky we did, as it turns out the twins we thought were rocking a placenta each were in fact sharing one between them (Monochorionic and Diamniotic, for any twin mamas reading, or those otherwise interested in twin pregnancy classifications). Essentially, that put us on course for more monitoring and potentially fewer birth choices.
To manage anxiety overload, I set mini-milestones every couple weeks so I could focus on the things I could control day to day. This is essentially a goal-management strategy not unlike training for a triathlon, and it provided a framework for staying optimistic about the outcome of my pregnancy. If you come up against pregnancy challenges that require extra caution or management, try imagining how you’ll feel when you receive the best possible news at the next scan or appointment. Positive visualisation has a powerful effect on reducing stress hormones, which can only serve to mentally and physically improve the way you experience your pregnancy.
In the second trimester I was able to say goodbye to the hormonal headaches I experienced in my first trimester. While my energy levels never fluctuated much, many women report feeling far more motivated and active as pregnancy hormones begin to level off and provide a more stable foundation for mums-to-be. Like many second-or-more-time-mums, compounded with the additional growth of baby number two, the physical changes of pregnancy came much thicker and faster than they did with my first-born.
I continued to weight train throughout my second trimester, but cut high-impact exercise like jogging or jumping completely at this time. Subsequent pregnancies can prompt your center of gravity to shift faster, while muscle memory sees the joints and abdominal muscles give way more readily to the ‘relaxing’ effects of the pregnancy hormone relaxin. Plus, the physicality of keeping up with older children often requires moderating the intensity of exercise you do sooner than you felt necessary in earlier pregnancies.
I simplified my exercise selection, only practising compound exercises (think squats, deadlifts, cleans, etc that use many muscle groups at once) with which I was very familiar. Sometimes that meant doing them in isolation rather than as part of a larger circuit, or simply reducing the weight I was lifting. While I continued lifting about 80% of my pre-pregnancy weight throughout my second trimester during my first pregnancy, 70% felt plenty challenging and enjoyable enough this time around. The best way to decide if a challenge is appropriate for you at any given time in your pregnancy: consider whether you feel excited and motivated or anxious and worried before you perform an exercise. Exercise is a resource that should empower you during pregnancy, and enjoyment is fundamental to that empowerment. Fill your active pregnancy toolkit accordingly!
Not only did my bump continue to grow quicker during my second trimester, but so too did everything else. My ribcage expanded. My hips broadened. That ‘tilted bowl’ pelvic shift I described in my first trimester overview became more pronounced and required extra attention to manage it both during and beyond my workouts.
The clearest indication of change a-coming, that growing bump was integral to my early conversations with my daughter about how she might prepare to become a big sister. Talking about pregnancy with young toddlers feels bizarre when you still feel they’re your babies, but as I close in on the final weeks (maybe days!) of pregnancy I do feel that every conversation has helped to prepare my daughter. If anything, it has certainly helped me to ease any anxiety I have about becoming a mother to more than one child, and my ability to involve her in the journey ahead.
We read books about becoming a big sister, re-read books about what it was like to bring her home (be warned: All The Things I Wish For You, personalised by Papier, is enough to push even the least hormonal mum-to-be over the emotional edge!) and introduced toys that simulate cuddling and feeding babies. We even changed nappies for several of her favourite teddies. Finally, I involved her in most of my fortnightly bump-date pictures and encouraged her to count the weeks, kiss the bump and speak to her little sisters.
During a twin pregnancy, there is as much fascination with what’s happening inside the bump as there is with what’s happening to the bump itself. Extra monitoring is common practice to ensure that each baby is growing proportionately and not borrowing from the others’ resources – particularly in a monochorionic pregnancy where they share a single placenta. Here are some of the unique learnings I picked up during the second trimester of my twin pregnancy:
- Nothing is a given. Twin pregnancy classifications can be difficult to ascertain – and any potential complications even less predictable. Because multiple pregnancies are still relatively rare, the stats and science to support them is far less conclusive than the research supporting single pregnancies.
- Ask your sonographers to explain the status of the amnion (or amnions) during each scan. Understanding the anatomy at work during your gestation will help you put scary terms like TTS (twin to twin transfusion) into context. Knowledge is power, so use your check-ups to aid your self-education.
- That said, once you’ve had the reassurance you need at your scans, try to leave your fears at the hospital doors. Your body is a terrifically intuitive resource and will provide the most valuable insights into the progress of your pregnancy, so focus on what’s in front of you (or rather within you, in the case of your babies) and prioritise sensation over worry in the days and weeks between appointments.
- Eating for three requires mindful ingredient selection, not triple portions. There are many conflicting reports about how many extra calories you should eat to optimise a multiple pregnancy, but the most important consideration is how you feel. Your hunger is a highly reliable indication of when and how much you need to eat.
- If you are eating to fulfill your hunger, but you still feel low in energy, requesting extra blood tests for iron levels can help to rule out potential anaemia – a deficiency that is more common in expecting mums of multiples.
- Extra pelvic strain is normal, but that doesn’t mean you should ignore it. I found that unexpected coughs and sneezes could result in somewhat embarrassing leaks – not ideal when you work and live in leggings!
- I saw my post-natal women’s health physio for a pre-natal pelvic health assessment (I highly recommend following Jess @themamaphysio) and she reassured me that my pelvic floor was in fact stronger than it was in my last post-pregnancy check. She gave me some extra resources and training tips I put into practise so I could keep it that way despite the unpreventable extra strain on my pelvic organs.
- Among the most useful I found was ‘the knack’, which involves exhaling and lifting your support muscles when you feel a sudden cough or sneeze coming.
- Mix up your squeeze strategy. I tend to focus on engaging my pelvic floor on the exhale – particularly during weight training, which I outlined during my first trimester post. Jess also encouraged me to add some kegels on the inhale, or independently of the breath, to mirror the variety of circumstances when you’ll need to engage your pelvic floor in everyday life (like towing a tot on hip during the nursery run).
- My point? Even if your pelvic health check is one of reassurance rather than revelation, there is always something you can do to improve your experience or retain more control of your pregnancy.
- Validate any advice that sits uncomfortably. I don’t mean to argue over everything your doctors tell you, but in twin pregnancies many pre-natal practitioners err heavily on the side of caution. This is of course a sensible approach to a multiples pregnancy, but it is essential that your care provider also considers your individual needs. Sometimes that requires you to be an active self-advocate and to voice those needs clearly.
- One example of this is a suspected weak cervix. You may be given extra cervical scanning or intervention to monitor risk of pre-term labour. Bed rest may be more frequently recommended for expecting mums of multiples. Whether you are advised to do anything extra, or to do less of something, always be sure you understand why your doctor has issued this advice. There may be alternatives or compromises that better meet your needs while still managing risks or optimising babies’ (and mum’s) wellbeing.
- I was recommended reduced activity soon into my third trimester (but it’s possible that you could be given similar advice in your second trimester) and I had very collaborative conversations with my doctor to ensure that he was on board with me continuing to swim – an activity that puts less weight on your cervix than climbing the stairs! Inactivity and muscle deconditioning can have adverse effects on your pregnancy, and your ability to rise to the physical demands of birthing and supporting twins, so finding a middleground that keeps you moving safely is an important consideration. You deserve to have your wellbeing respected, too.
For more pre-natal wellness support, pick up your copy of Mind, Body, Bump today. After the upcoming spring launch of my first online course, I’ll be turning my attention to releasing a dedicated pre-natal course to support expecting mums with real-time videos inspired by and complementary to the Mind, Body, Bump book! Make sure you’ve signed up to my newsletter for updates on both courses.