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The 2nd trimester of pregnancy and PCOS

2nd trimester of pregnancy and PCOS

The second trimester of my pregnancy was full of so many amazing changes! You’re finally potentially in the clear of those crappy first trimester symptoms, such as nausea, vomiting, or food aversions. However, for some these persist throughout pregnancy. Everyone is different…don’t forget that! But as you continue to progress through the second trimester, your risk of miscarriage also continues to decline, which definitely helps ease those concerns from the first trimester.

You’re also starting to show! Yep, turns out there is actually a baby in there! While many of us feel the side effects of having a baby in our bellies in the first trimester, we don’t start seeing changes in our body until the second trimester. For me, this posed some unexpected difficulties, which I’ll dig into more shortly. 

Some other things to look forward to this trimester include your 20-week ultrasound, a glucose tolerance test for gestational diabetes risk, thyroid concerns, and possible food cravings or aversions. Now remember, these are things that stick out in MY pregnancy. Everyone is bound to experience things a little differently.


Miscarriage Risk

This is a biggie. Once I entered my second trimester, I felt a sense of relief. However, that didn’t stop me from being extremely happy and excited one minute to feeling terrified of being an exception to the rule, in terms of my miscarriage risk, the next minute. While women with PCOS are more likely to have a miscarriage, rate of miscarriage decreases to 5% after 12 weeks so take a deep breath! There is only so much we can control here. In times of anxiety surrounding miscarriage, I had to remind myself there is no point in causing stress over something I can’t control. If anything, the stress will have more adverse side effects than the risk of miscarriage itself. Here is where trust in your body and utilizing positive affirmations can be very advantageous.

Body Image Changes

While this seems like an obvious one. I struggled here. I’m a dietitian and for the most part, have always had control over how my body looks with my diet and lifestyle. During the initial few weeks of my body changing in the 2nd trimester, I honestly felt “chubby”…just being honest here. I wasn’t feeling the baby yet so I didn’t yet have that connection or bond yet with the baby. My clothes were all starting to fit very tightly, but I wasn’t big enough to fit into maternity clothes. There was about a 2-week time frame here where I really struggled with this transition mentally. 

I finally decided to go out and buy myself some maternity clothes. I felt so much better after! It was like a sign to myself that this WAS real and I was accepting the process for whatever it had in store for me. Pregnancy is a truly amazing thing and sometimes you just have to surrender yourself to it and enjoy the journey! My biggest recommendation during this transition is to allow yourself some grace. Initially I felt guilty about feeling the way I did, but in all honesty I had never experienced anything like it before so I was bound to run into some (minor) roadblocks. Once I got over this hump, I seriously did not look back. My belly continued to grow, I started feeling baby kick (which never gets old!), and had way more energy than I did in my 1st trimester. All things to celebrate!

20-Week Ultrasound

GUYS. This was one of the coolest memories I have from my whole pregnancy. The night before my ultrasound, I thought I felt a tickle of some sort in my belly and I thought, “I wonder…”. Up until that point, I had not felt the baby kick yet or I really couldn’t decipher if it was bowel sounds or baby moving. I was in complete awe when they started the ultrasound and I saw a baby moving in my belly…and I mean moving! She was wiggling around like crazy! It was a complete revelation that there was actually a human being growing inside of me. And the best part? My husbands’ reaction. Watching his face light up when he saw the screen of her little body moving around is a memory I’ll never forget. This is potentially my favorite memory from pregnancy (still TBD as I have 3 weeks left at the moment!).

Glucose Tolerance Test

This is a glucose test that is used to diagnose gestational diabetes during pregnancy. Gestational diabetes can pose several risks to pregnancy including excess birth weight, preterm birth, high blood pressure, stillbirth, and risk of obesity and type 2 diabetes later in life. 

Because of our inherent insulin resistance, women with PCOS are more likely to develop gestational diabetes risk. Therefore, if you know this is something you struggle with, it is beneficial to ask your doctor for this screening earlier in your pregnancy. Normal testing is done at 24-28 weeks, but if you have PCOS, I highly recommend getting tested in the first trimester (or early second trimester) and later in pregnancy again. If your practitioner is not willing to do the glucose tolerance test that early, ask for a hemoglobin A1c minimum so you know where you stand early on. 

This is also why it is still important to do your best with continuing a PCOS-friendly diet and lifestyle during pregnancy. While every woman experiences different challenges during pregnancy, managing your intake of carbohydrates continues to be an important area to focus on during your PCOS pregnancy. Just like when you’re not pregnant, the goal is not to avoid carbs, but to pair them with fat/protein and choose whole grains over refined grains as much as possible. Continued exercise can also be very beneficial here. Although you may need to modify your type of exercise based on your growing belly, continued exercise can help with improving insulin sensitivity, not to mention maintaining healthy weight gain throughout your pregnancy. Shoot for 30 minutes 3x/week minimum in a way the feels good to your body and baby.

Thyroid Concerns

I bring this up because many of us women with PCOS also struggle with thyroid issues. Research has shown that thyroid irregularities are more common among women with PCOS than the healthy population. With that being said, our thyroid hormone needs continue to increase as pregnancy progresses due to our increasing metabolic needs for the developing baby so it’s imperative that your practitioner test your thyroid levels if you have hypothyroidism before pregnancy or have concerns of hypothyroid at any point during your pregnancy. 

Screening and testing is recommended at 4-6 weeks gestation then every 4-6 weeks until 20 weeks gestation, then at 24-28 weeks, and 32-34 weeks. If left untreated, hypothyroid issues in pregnancy can lead to complications, such as miscarriage, preeclampsia, anemia, premature birth, and postpartum hemorrhage. I had mine tested a few different times because I was paying attention to my body and noticed some of my hypothyroid symptoms worsening. Being your own advocate can make a big difference! As a reminder, hypothyroid symptoms may include cold intolerance, low libido, hair loss, excessive fatigue or muscle achiness, dry skin, or feeling depressed.

Food Cravings and Aversions

Fortunately, I did not experience any food aversions during my 2nd trimester so I got lucky! I did however, start to really crave more dairy, something I had been limiting (but not entirely avoiding) prior to pregnancy. Craving dairy in pregnancy is often common due to the iodine content and the increasing iodine needs (about 50%) during pregnancy. So what did I do? I ate the dairy! Listening to your body is SO IMPORTANT during pregnancy (and all the time for that matter). 

When I did crave dairy, I did my best to eat full-fat, quality dairy. Although sometimes it was that full-fat custard ice cream from Culver’s and I wasn’t mad about it! I continued to exercise and also tried to keep these types of indulgences to a minimum. In my opinion, it’s better to eat the food and move on then obsess about it and waste mental space on it, especially if you follow a PCOS-friendly lifestyle normally. Plus, the more you avoid and restrict, the more likely you are to binge on it later. Not too mention, cravings like this can mean something as I mentioned earlier about iodine needs during pregnancy.

2nd trimester pregnancy and PCOS

The 2nd trimester or what my doctor likes to call “the happy trimester” was truly a wonderful experience and I can’t complain. I hope you found this helpful! What questions do you have for me about 2nd trimester challenges and PCOS? Feel free to drop a comment below!


4 thoughts on “The 2nd trimester of pregnancy and PCOS

  1. So happy for you Liz! Congratulations!!

    1. Thanks Julia! I hope you are well!!

  2. Hi Liz, love your post and amazing photos(including the one of you and Adam). Glad your feeling so well. It is such a special time in your life. Soak it up!

    1. Thanks Aunt Dee!

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