What Black Women Should Know About the Second Trimester

What Black Women Should Know About the Second Trimester

What Black women need to know about the second trimester of pregnancy, including common symptoms and possible complications.

Updated December 28, 2023

by Dr. Nicha Cumberbatch

Physician Assistant, Doula, Birth Educator, DMSc, PA-C

Medically reviewed by Stephanie Sublett

Board-Certified OB/GYN, FACOG, IBCLC

Congrats, mama, you’ve made it to the second trimester! You may have been able to hide your bump successfully for the past three months, but now you’re on the verge of some significant changes. The second trimester is when your pregnancy comes into full bloom and is a great time to start working on your birth plan. Whether you deliver at home or in a hospital, with painkillers or without painkillers, it’s best to have a clear vision for one of the best days of your life. However, Black women face a higher risk of complications during the second trimester, but most are avoidable. If you’re a Black woman, here is everything you need to know about communicating with doctors and nipping health risks in the bud during your second trimester of pregnancy.

What Black Women Should Know About the Second Trimester

The second trimester occurs between weeks 14 and 26.15 Many call this “the golden period” as side effects like nausea and tiredness disappear. You will even 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 hair by month four.2

Below, we’ll explore tests, common symptoms, and possible complications in the second trimester of pregnancy for Black women, plus tips for choosing your healthcare team:

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.1

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, you have the right to say no to any tests you don’t feel comfortable with.1

Common Second Trimester Symptoms

The positives of entering the second trimester include more energy, improved sleep, and less morning sickness. Many consider the second trimester the best time of their pregnancy, but this period still has downsides. Many women experience an increased 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 grows and exerts pressure. Skin conditions like varicose veins, pigmentation, and darkening nipples are also common.2 So, let’s further explore some common second-trimester symptoms:

GERD (Acid Reflux)

Pregnancy hormones are responsible for heartburn in both the second and third trimesters. High progesterone levels cause the muscle 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:3,4

  • Acidic foods, such as citrus fruits and tomatoes
  • Greasy or fried meats
  • Spicy foods
  • Chocolate
  • Coffee
  • Carbonated beverages
  • Alcohol

If the thought of ditching coffee and spicy enchiladas is too much to bear, you can take other lifestyle steps. 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:3,4

  • 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 safe during pregnancy. However, consult your doctor before taking these or other new medications. There are also safe prescription medications for heartburn, so if your symptoms are not being well-controlled with over-the-counter products, please talk with your OB-GYN.3,4

Leg Cramps

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.4

Most cases of leg cramping are not severe and will subside over time. However, you should call a doctor if you have swelling, pain, or redness that does not go away.5

Dental Issues

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 cause bleeding or make your teeth loose.6

60-75% 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, and your mouth’s pH balance changes during pregnancy, which is a recipe for cavities.6

You can lower the odds of tooth decay and discomfort easily. To improve dental health, try the following:6

  • Treat inflammation with a saltwater rinse. Combine one teaspoon of salt with one cup of water, then gargle.
  • Switch to a softer toothbrush.
  • Rinse your mouth with an antacid after vomiting. A cheap and easy formula combines 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 safe during pregnancy, but remember not to use oral medicine without consulting your prenatal care provider.6

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, bloody urine, or a fever or backache.7

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.7

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 should be mindful of as a Black woman in the second trimester. These conditions are preventable if spotted early:

Gestational Diabetes

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 Centers for Disease Control and Prevention (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.8,9

Many physicians order an oral glucose screening test between weeks 24 and 28 for gestational diabetes. The test is simple — you drink a syrupy drink (called Glucola) and wait one hour before a blood draw. Depending on your results, your doctor may advise you to start insulin or alter your lifestyle to lower your blood sugar.16


Preeclampsia is a form of high blood pressure that typically occurs in the third trimester, but it can also appear during the second. This condition affects 5-8% of all pregnant women, but the rate of preeclampsia is 60% higher in Black women than in white women. There are many risk factors for preeclampsia, including a history of preeclampsia in a prior pregnancy, chronic hypertension, diabetes mellitus, kidney disease, and carrying multiple gestations like twins or triplets.10,11,17

You may have preeclampsia if you experience any of the following symptoms:17

  • Swelling of the hands and face
  • Vision changes, like seeing spots or blurry vision
  • Headache that will not go away
  • Bruising
  • Pain on the right side of the stomach
  • Dizziness
  • Sudden weight gain
  • Difficulty breathing
  • Nausea or vomiting

Solutions to preeclampsia include hospitalization, delivery, and medications to lower blood pressure. Your doctor may induce an early delivery or perform a C-section in severe cases. Most cases of preeclampsia and hypertension subside after you deliver your baby.17

Preterm Premature Rupture of Membranes (PPROM)

Most expectant mothers anticipate that 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. Most preterm babies can be helped through intensive care nursery services (NICU) if treatment is ineffective.12


Miscarriages are incredibly devastating. Unfortunately, they 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 of something 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.10

Preterm Labor

A delivery is classified as “preterm” if you give birth before 37 completed weeks of pregnancy. Roughly 1 in every 10 births is preterm. According to a study from the CDC, Black women are 50% more likely to have a preterm 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 preterm babies are at a greater risk for complications, many go on to thrive as healthy infants.13,14

Lifestyle factors and chronic illnesses like diabetes and kidney disease can lead to early deliveries. Other potential causes of preterm labor include:13

  • Smoking
  • Bladder infections
  • Getting pregnant quickly after a previous pregnancy
  • Abnormal cervix
  • Use of illegal drugs like cocaine
  • Infections

Adopting a healthy lifestyle from the beginning is a great way to improve your odds of delivering at the right time. You can also stop preterm labor 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.14

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 Black woman, you face an increased risk for birth complications.18 If your doctor doesn’t listen to or answer your concerns, don’t be afraid to find 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 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.

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Dr. Nicha Cumberbatch Physician Assistant, Doula, Birth Educator, DMSc, PA-C
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Nicha Cumberbatch is a certified Physician Assistant, a birth advocacy educator, and a doula advocate mentor. She, as part of a Doctorate in Medical Science completion project, is currently conducting… Read more

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