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I'm Pregnant
Second Trimester Pregnancy ConcernsSecond Trimester

Introduction

Sometimes pregnancy doesn’t go as expected which can be disappointing or scary. On this page, you’ll find information that can help you understand what is going on.

Learn about supports that are available to manage gestational diabetes, how to reduce your risk of preterm labour, what to expect if your baby is born preterm, and the grief supports available if you lose your baby.

Gestational diabetes

Gestational diabetes is diabetes that only happens during pregnancy. It can cause a baby to grow larger and faster. This may cause challenges during delivery. Your baby may also have low blood sugar at birth. Your health care provider will check the level of sugar in your blood later in the second trimester to find out if you have gestational diabetes. Some health care providers may also check the level of sugar in your urine at prenatal appointments.

You’ll receive additional support and care to learn how to manage the gestational diabetes if you have it. You can usually manage it with changes in your diet and physical activity level. You may also need to take medicine and test your blood sugar levels. Often you’ll be loaned a monitor to measure your blood sugars. If you are, remember to bring this monitor to the birth centre when you have your baby. Keep your gums healthy because gum disease can make diabetes harder to manage.

High blood pressure

High blood pressure during pregnancy can cause serious problems, like pre-eclampsia (high blood pressure and protein in the urine after 20 weeks of pregnancy). Your health care provider may check your blood pressure at every prenatal visit.

Call Health Link at 811 or your health care provider NOW if you have any of the following:

  • a headache that will not go away
  • a sudden weight gain
  • sudden swelling of your hands and face
  • problems with your vision
  • a very bad pain under your rib cage
  • sudden, unexplained nausea or vomiting

Preterm labour

Overview

Preterm (premature) labour is labour that starts between 20–37 weeks of pregnancy. About 7–9% of babies are born preterm. Preterm babies need extra care because they are born before their bodies are ready for life outside the uterus. If you go into preterm labour, your health care provider may try to stop the labour to give your baby a chance to develop more before birth.

Usually, the earlier your baby is born, the greater the likelihood that there will be challenges. Premature babies are more likely to have breathing, vision and feeding issues. They also get infections more easily.

Preterm labour can happen in any pregnancy. Half of all preterm births happen to parents with no known risk factors. To reduce your risk for preterm labour:

  • Go to all of your prenatal appointments.
  • Eat healthy foods, drink lots of fluids, be active and get lots of rest.
  • Use coping strategies to reduce your stress.
  • Cut down and quit alcohol, tobacco and tobacco-like products, cannabis and other drugs.
  • Practice safer sex to reduce your chance of getting an STI.
  • Prevent injuries and call your health care provider if you have been injured or fallen, or if you were in a motor vehicle collision and you weren’t taken to the hospital by an ambulance.
  • Talk with your health care provider about your working conditions.

Signs of preterm labour

Know the signs of preterm labour and to trust your instincts. If you think something’s wrong, call your health care provider or go to your birth centre—it can make a big difference to your baby’s health. Getting medical care may reduce the chance of preterm birth.

If you’re in preterm labour, your contractions will be monitored at the birth centre and your baby will be assessed. Your treatment may include bed rest, fluids and medicine to help your baby’s lungs mature. Medicine may be given to try to stop your labour. If your contractions stop, you may be sent home.

Call Health Link at 811 or your health care provider if you notice any signs that could be preterm labour:

  • contractions that may or may not hurt
  • abdominal cramps, that may feel like menstrual cramps or gas pains
  • diarrhea
  • a change in lower back pain
  • spotting or bleeding from the vagina
  • fluid gushing or leaking from the vagina
  • a change in or more vaginal discharge
  • discharge that smells bad or that is not white or clear
  • pressure in the pelvis or lower abdomen
  • a full or heavy feeling in the vagina

If your baby is born preterm

There are many reasons why babies are born preterm. If this happens, your baby may be moved to a neonatal intensive care unit (NICU) which could be in another hospital. Your baby will need supports as they are not ready for life outside your uterus. They may need help with breathing and staying warm. Special equipment like monitors and feeding tubes will be used to help care for them while they adjust to the outside world.

You’ll be encouraged to touch, talk and cuddle your baby skin-to-skin when your baby is ready. Being skin-to-skin helps to keep your baby warm and build attachment. If you’re planning to breastfeed, your health care providers will help you to pump or express your breastmilk to feed your baby until they’re ready to breastfeed. If your baby is in the NICU, health care providers will want you to take part in your baby’s care.

Having a premature baby can cause a lot of different emotions. The health care providers will give you the information and the support you need. You can ask any questions you have and talk with them about your concerns.

Parent in Neonatal Intensive Care Unit, cuddling premature baby skin-to-skin on their chest with a blanket over the baby’s back.
Reproduced with permission from Gantefoer, H. (2010)

If you’re a partner

Holding your baby skin-to-skin will help keep your baby warm and build attachment too!

Ask lots of questions and talk with each other about how you’re feeling and how best to support each other.

Miscarriage and stillbirth

A miscarriage can happen in the second trimester when you’re less than 20 weeks pregnant. They are much less common than in the first trimester. Learn more about miscarriage.

Stillbirth is the death of a baby after 20 weeks of pregnancy that happens before or during birth. This can happen during pregnancy or labour. The death of a baby is not something any parent expects—it shatters hopes and dreams. Losing a baby may be overwhelming and the grief can be deep for parents and their families.

Some people are surprised to learn that they will have to deliver their baby. Your health care provider will provide information on the options available.

If you’re a partner

Feelings of fear, anxiety, anger and grief are normal. You may also feel helpless at this time. You can provide emotional support and help communicate with health care providers. It’s also important that you get emotional support for yourself.

After a stillbirth

Each family has unique wishes and requests for the care of their baby after a loss. Your health care team will work with you to support your wishes. You’ll be asked if you want to see and hold your baby. This is part of the grief process and can help you make memories with your baby. You can bathe and dress your baby or take pictures. You’ll also be asked to name your baby and to register your baby as a stillbirth.

You’ll be offered an autopsy and other tests to see if the cause of your baby’s death can be found. An autopsy is the best way to find out the cause of death. If the cause of death can be found by autopsy, it may help answer the question “Will it happen again?” Some parents may find comfort in learning as much as possible about the death of their baby. The results may also improve care for your next pregnancy or for other parents. If you’re not sure about having an autopsy, ask your health care provider about other options such as an examination by a pathologist or a partial autopsy. You’ll also need to decide about burial or cremation. The birth centre will help you with the information that you’ll need to make these decisions.

Your physical and emotional health

As with any delivery, your body is going through some big changes and needs time to heal. Be sure to allow yourself time to rest and recover. It usually takes 4 to 6 weeks for your body to recover after delivery and you may continue to have vaginal bleeding during this time. Talk to your doctor or health care provider before you start using tampons or having sex again because there is a higher risk of infection for at least 2 weeks.

You can go back to normal activities such as work, school and driving when you feel ready. Parents in Alberta who give birth to a baby who is stillborn are eligible for maternity benefits.

For more information about physical changes and what to watch for after you go home from the hospital, talk with your health care provider or visit MyHealth.Alberta.ca – After Your Stillbirth: Your Physical Health.

The experience of grief and getting support

Everyone reacts and grieves differently after tragic losses. You may cry a lot or feel angry, hopeless, shocked or confused. Take as much time as you need to grieve the loss of your baby, to find support to cope with your loss and to find meaningful ways to remember.

Your health care team is there to guide you. You’ll be asked if you want to see a grief counsellor, spiritual advisor, social worker or public health nurse to help support you and your family, and to refer you to resources and supports in your community. Family and friends may also want to help you. Consider accepting the help they offer and tell them what they can do to help you when you’re ready.

To learn more about grief support, call Health Link at 811, talk with your health care provider or visit MyHealth.Alberta.ca – Stillbirth.