How to have a healthy pregnancy: Second trimester

This post focuses on the second trimester of pregnancy and is the second in the series dedicated to pregnancy health. The first and third trimesters are discussed in separate posts.

Baby growth during the second trimester

The second trimester of pregnancy encompasses from the 4^th to the 7^th month of pregnancy (weeks 13 to 27 in the UK). The beginning of this period is often clearly marked by the sudden disappearance of morning sickness and an increase in energy levels. In terms of foetal development, the baby can grow from about 61mm to triple this size during this stage of pregnancy. The sex of the baby is revealed from around week 14, and the urinary system, bones and hearing develop, while hair and finger nails start to grow.  The expecting mum undergoes the most dramatic physical changes at this time with larger breasts, skin decolouration due to increase blood supply, and of course a growing abdomen. As the pregnancy is safer from miscarriages at this time, anxiety about this will subside but there may be other sources of anxiety related to changes in body shape, or fears about the future.

 In terms of TCM, the urinary system, bones, and hearing are all directly related to the Kidney energy, while healthy hair and nails are associated with plentiful Blood. Because of this, and the fact that all foetal development is rooted in the Kidney Essence of the mother, the growth of the baby at this stage takes a toll on Kidney and Blood resources of the expecting mother. In addition, as the Yang energy necessary to perform all this growing gathers and collects in the womb, too much heat may be generated causing fluids and Yin to dry up.

The most common symptoms that may appear at this time thus reflect the following TCM patterns:

• Blood deficiency: anaemia, insomnia, palpitations, anxiety, dizziness, leg cramps, absentmindedness, forgetfulness

• Kidney Yin deficiency: restlessness, night sweating, palpitations, anxiety, headaches, and high blood pressure.

• Excess internal heat: heartburn, feeling constantly hot, constipation with dry stools, nasal and gum bleeding, urinary tract infections

Women who did too much physical work during the first trimester, or who already had a tendency towards Yang deficiency prior to pregnancy, may present other symptoms that reflect the weakness of Yang energy such as feeling constantly cold and tired, oedema (water retention) in legs and feet, lower back ache, vaginal discharge, frequent urination, urinary tract infections, and shortness of breath.

Second trimester essentials:

While in the first trimester building up the Yang energy is most important in order to maintain the pregnancy, during the second trimester Yin and Blood need to be nourished and supported so that they do not become depleted from nourishing and sustaining foetal growth.

Nourishing Blood and Yin during pregnancy involves:

Enough rest: Although you may be feeling less tired than a few weeks ago, pushing yourself is not recommended. You can benefit from moderate exercise in the form of walks, gentle swims and/or pregnancy yoga classes provided you are not feeling exhausted. Afternoon naps are allowed if you can fit them into your routine and feel the need to have them. Remember your energy requirements go beyond yourself and the more energy you save at this stage, the more there will be for your baby to be strong and healthy!

Restful sleep can help restore the Blood and Yin

Restful sleep: Restorative sleep gives a chance for deep energies to gather and recover from the daily growth happening in the womb. When the Blood or Yin are depleted or out of balance, a common occurrence during the second trimester of pregnancy, our ability to sink into deep sleep may be compromised leading to restless and disturbed sleep, excessive dreaming, night sweating or feeling hot in bed, insomnia, etc. Paradoxically, good sleep allows the Yin and Blood to be restored and support healthy foetal development. Promoting good sleep is thus important for the mother and baby’s health at this stage. Self-help techniques include:

• Avoid the intake of stimulants including all types of caffeine, refined sugar, alcohol, drugs, and nicotine.

• Try to start winding down long before bed time. For this it may be a good idea to have a hot bath with calming essential oils such as chamomile or lavender. You could also burn these oils around you and listen to calming music for some time before bedtime. If you can, avoid watching TV, or being at computers right up to bedtime as this can prevent you from “switching off”.  Relaxation tapes may be useful to help you drift off if you find it difficult.

• Drink calming teas such as chamomile, hops, lime flowers or passion flower tea half an hour before bedtime.

Acupuncture, especially when combined with Reiki, can promote relaxation and help restore sleep patterns in those who find self-help techniques ineffective.

Reducing stress: The same tips given for improving sleep apply here as stress levels can rise as a result of poor sleep and low energy levels. In addition, avoiding upsetting books or newspapers, films, and conflict in general may contribute to your emotional balance and your ability to cope with stressful situations.

Gentle deep breathing, pregnancy yoga, and meditation techniques can also provide you with tools to cope with everyday life stress. When things get too difficult, Reiki and Acupuncture can provide a space for relaxation and provide relief to emotional stress.

Eating nutritious food: Like in the first trimester, spices, stimulants, refined sugar, and toxins (from food preservatives and additives, alcohol, drugs, etc.) should be avoided throughout the second trimester of pregnancy as they can contribute to the symptoms of heat likely to happen at this time, and can harm the baby and destabilise the pregnancy. 

As I shared in a previous post on TCM healthy eating, consuming well-cooked and warm foods supports the digestive system and is therefore considered the best way to obtain energy from food. During the second trimester of pregnancy however, there may be a build-up of heat and it may be suitable to have a more cooling diet.  When symptoms such as heartburn and acid reflux, constipation, constant hunger, and generally feeling hot are present it is recommended to avoid deep-fried, roasted and barbequed foods and instead favour steaming and a moderate amount of raw salads. Peppermint and spearmint tea can really help cool down the digestive system and relieve the acidity, as does avoiding refined sugar, spices, stimulants, and rich/heavy foods.

Foods that nourish the Yin tend to be cooling and sweet in nature and are recommended for this stage of pregnancy. Particularly good ones include: Eggs, Tofu (from non-GM beans), white fish, aduki/turtle/kidney and black soya beans, coconut milk, sesame seeds, all dark green vegetables, , barley, quinoa, brown rice, and all sweet fleshy fruits such as mango, pear, and watermelon.

Nourishing the Blood is also important as Blood deficiency and anaemia can easily develop at this time. Yin nourishing foods will also contribute to nourish the Blood, while plenty of protein of either vegetable or animal origin, dark rich foods such as beetroot, molasses, dates, figs and unsulfured apricots should be part of your daily diet. It may be worth checking your iron levels if you are feeling exhausted and suffering from insomnia, constipation and/or cramps which could be signs of anaemia. Chinese herbal remedies or natural iron supplements can be taken at this time as they are more easily digestible and are less likely to produce uncomfortable side-effects such as constipation.

Meditation benefits mother and baby

 Quiet contemplation and relaxation: Many women experience deep personal changes during pregnancy. It is indeed a time where the wonder and beauty of the world can touch you as you feel part of the miracle of life.

You may feel frustrated by feeling that your brain does not work, but you may also realise that what you used to consider important now seems futile and that there are deeper, more important things that you would like to explore. Meditation and relaxation techniques, and spending time in nature, can help you connect with what goes on deeper inside you and will benefit you and the baby in many other ways as they can reduce stress and anxiety, and improve sleep and emotional balance.

Although it is less common to experience Yang deficiency symptoms during this time, some women will need to carry on following the same advice given for the first trimester. Because the growth of the baby draws on the Kidney energy of the mother, women experiencing lower back ache, coldness, swelling in legs and ankles, frequent and copious urination, heaviness and sluggish digestion, are more likely to need support from Acupuncture and moxibustion to protect the pregnancy even at this stage.

Pregnancy is not only a unique stage in the physical life of a woman, it can turn out to be a journey of self-discovery where imagination, creativity, and spiritual clarity can develop and flourish. Working on staying physically healthy during this time, will make room for the enjoyment of these other aspects of the pregnancy that could otherwise become masked by uncomfortable physical and emotional symptoms.