Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
We offer many resources to help you and your partner prepare for your baby. Learn about what to expect during and after pregnancy including labor and delivery, breastfeeding, and when to call us.
Most women are very glad to move into the second trimester of their pregnancies. After the morning sickness and fatigue you'll likely experience early in pregnancy, the middle part of your pregnancy is often the time when you'll feel the best. The second trimester spans the time between 14 weeks to about 28 weeks of gestation. This is an exciting time during pregnancy when the baby is growing rapidly and when you often feel more energy, so enjoy it!
Between the third and sixth month of pregnancy, your baby will grow very quickly! At the beginning of this trimester, your baby is about 3 inches long and weighs only 1 ounce, but by the end of the trimester he or she will be 11 to 12 inches long and will weigh up to 1½ pounds.
If you could see your baby:
You should start to feel your baby moving sometime between 18 and 22 weeks as its muscles become more active. At first, the fetal movements feel like fluttering or "butterflies." As your baby grows and becomes stronger, its movements will also become stronger.
As your baby continues to develop past 20 weeks gestation:
You may notice that your baby kicks and stretches more. Your baby can hear your voice or other nearby sounds and might respond to a loud noise by kicking. Amazing as it may seem, your baby will recognize your voice and your partner's voice right after birth if you talk to the baby daily while you are pregnant.
During your pregnancy, there are many kinds of prenatal tests that can help you learn more about your baby's health. All prenatal testing is optional, though many kinds of tests are a routine part of every pregnancy. We can discuss your options and decide which tests might be a good option for you.
These are tests that we recommend for all pregnancies to check the health and development of your baby. These routine prenatal tests are safe for you and your baby. During your second trimester we may recommend tests for:
In addition, we routinely offer an ultrasound test during your second trimester of pregnancy.
Certain blood tests can help you find out if you have a higher or lower chance of having a baby with certain birth defects, but they can't make a definitive diagnosis. These are optional prenatal tests, and are very safe for you and your baby. Serum-integrated screening, sequential integrated screening, and quad tests are examples of optional screening tests. These tests are most effective when done at a certain stage of fetal development. Depending on which trimester you are in, we can discuss which screenings are available for you.
While there is no test that can detect all potential problems, these tests can diagnose certain kinds of birth defects. Prenatal diagnostic tests are more invasive than other prenatal tests, and there is a very small associated risk of miscarriage. Some women choose diagnostic tests based upon their family history, or their age during their pregnancy. Examples of diagnostic tests are amniocentesis and chorionic villus sampling.
Breast milk is the perfect food for your baby. There are many health benefits for you and your baby. According to the American Academy of Pediatrics, breast milk is the only food that your baby will need during the first 6 months of life. We recommend that you continue to breastfeed your baby for up to 1 year if you are able to. Even after you introduce solid foods, you can continue breastfeeding for as long as you wish.
Breastfeeding decreases your baby's risk for many types of infections and allergies. Benefits include:
Benefits to you may include:
There are rare medical conditions where breastfeeding is not advised. We can talk further if this applies to you.
You and your baby will be more successful at breastfeeding if you are prepared. You can begin preparing now and continue throughout the last weeks of pregnancy. Suggestions for how to prepare include:
Take a class, read a book, or read our article on breastfeeding for more information. Talk to women who've had successful breastfeeding experiences. Remember, breastfeeding is a learned skill and takes practice.
To locate classes near you, search our health class directory or contact your local Health Education Center or department.
Breastfeeding does take time, but it is time well spent. You're giving your baby the best possible food, holding your baby close, and making a strong connection. Breast milk is the best food for your baby and has all the nutrition your baby needs for the first 6 months of life. The longer you breastfeed, the greater the benefits will be for you and your baby.
Get phone numbers of hospital lactation consultants, your local Pediatric Department, or members of your local La Leche League. Have these numbers ready so you can call after you and your baby go home from the hospital. For breastfeeding questions, call the 24-hour helpline at 877-4-LALECHE.
Expressing and storing your breast milk allows you to get extra milk from your breasts that can be given to your baby when you're not there.
All new mothers will need help in the beginning, so ask your friends and family to plan to help out. After the baby arrives, they can assist with meals, shopping, and the care of older children. This will allow you to spend plenty of time with your new baby.
If you're preparing to breastfeed (or just thinking about it), the second trimester is a good time to recognize your nipple type. Some nipple types require extra preparation so that you can breastfeed successfully. Our article on breastfeeding has more information, or ask us if you aren't sure what type of nipples you have.
Pregnancy hormones cause the digestive tract to relax and function more slowly, which can cause constipation. As your uterus enlarges, this can also cause constipation.
What you can do:
Heartburn (sometimes also called reflux) is caused by stomach acid coming up into your esophagus (the tube connecting your mouth to your stomach). Heartburn during pregnancy is caused by a hormone which relaxes the stomach sphincter (valve) that keeps the acid out of the esophagus. This same hormone causes a delay in stomach emptying so that more acid builds up.
What you can do:
If your heartburn is still a problem, please let us know. There are prescription medications that you can use.
As pregnancy progresses, leg cramps, breathlessness, contractions, the frequent need to urinate, and an active baby may all interfere with your sleep.
What you can do:
You may need to try various options in order to find a comfortable position.
Lying on your side is better for you and the baby now that you are in your second trimester. When you are lying on your back, the weight of your uterus and your baby rests on the vena cava, the largest vein in your abdomen. When there is pressure on that vein, your blood pressure can go down and you may feel dizzy or light-headed.
Leg cramps are common in mid to late pregnancy. They usually occur late at night and may wake you up. They may be caused by the pressure of the enlarged uterus on nerves or blood vessels in your legs, from lack of calcium, or occasionally from too much phosphorus in your diet. What you can do to prevent leg cramps:
What you can do to relieve leg cramps:
As your baby grows, your pregnancy hormones can trigger changes in your skin. These changes should fade away after your pregnancy. These skin changes are not usually treated during pregnancy. If you’re worried, talk to us about your concerns.
Please call our Appointment and Advice line right away if you're experiencing:
After 24 weeks, please call Labor and Delivery if:
In your second trimester, I'll recommend that you make an appointment to see me each month beginning at 24 weeks gestation. I will also advise you to register for a number of pregnancy-related classes to assist you in having a healthy pregnancy, labor, and childbirth.
I will perform an exam to evaluate your health and the health of your fetus. My staff can schedule you for several recommended classes, including:
In your second trimester, it's time to complete any prenatal screening or diagnostic tests you’ve requested. My staff will schedule you for any of these tests that you request, and our Prenatal Testing Options online health tool can help you know what to expect during the different types of testing.
Subscribe to our Healthy Beginnings newsletter. The newsletter is delivered to your e-mail inbox every week of your pregnancy, and it has information and answers to common questions as your pregnancy progresses.
The following online Emmi programs may help you as you approach your due date:
You can connect with me in a variety of ways, depending on the situation and what is most convenient for you at the time. I am available online, by telephone, or in person.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay current on your health status and to collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments as needed. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
My specialty colleagues are readily available to assist me if I need additional advice about your condition. In some cases, I may contact them during your visit, so we can discuss your care together. If we decide you need a specialty appointment after that discussion, we can often schedule it the same day or soon thereafter.
As part of our commitment to prevention, additional members of our health care team may contact you to come in for a visit or test. We will contact you if you are overdue for cancer screenings or conditions which may require monitoring.
As your personal physician, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available 24/7 so that you can access and manage your care where and when it is most convenient. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.
This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.