Week 14 of pregnancy: Active Baby

By any definition you are now in the second trimester. For many people nausea has eased and appetite is back, sometimes strongly. In India this is when the national programme adds a daily iron-folic acid tablet and calcium tablets, plus a single deworming tablet, and the window for your second antenatal visit opens. Taking these tablets the right way makes a real difference to how well they work. Your baby, meanwhile, is busy moving, though you will not feel it for some weeks.

The 8.7 cm figure is still a crown–rump length, typically about 8–9 cm this week, and 43 g is an estimated average. From here, natural variation between healthy babies becomes more noticeable, so do not compare your scan too closely with a chart or app.

Every pregnancy is different - you may have some, all or none of these.

Bigger appetite

Hunger often returns as nausea fades. Regular meals with a healthy snack between them work better than large, late meals, and help you avoid long gaps. You need only a modest amount of extra food, not double portions.

Light-headedness

Blood pressure dips in mid-pregnancy. Stand up slowly, drink enough and do not skip meals. Fainting, or dizziness with bleeding or pain, needs medical review.

Groin twinges

Brief, sharp or pulling pain low in the abdomen or groin when you move suddenly is common from now. Moving more slowly helps; severe or constant pain is not normal.

Tiredness lifting

Energy often improves in the second trimester, and many people find this the easiest stage for work and exercise. If you still feel drained, breathless or very pale, ask for your haemoglobin to be checked.

• Iron-folic acid (IFA) tablets

  Routine

  Daily from the second trimester, through pregnancy

  India's programme gives one iron-folic acid tablet a day from the fourth month, for at least 180 days in pregnancy and six months after birth, to help prevent anaemia. If your haemoglobin is below 11 g/dl, your doctor will prescribe a treatment dose and recheck. In the UK and US, iron is usually given only if tests show it is needed.

• Calcium tablets

  Routine

  Twice daily from 14 weeks

  Calcium tablets, which contain a little vitamin D, are taken twice a day with meals from 14 weeks until six months after birth. Do not take both together, never on an empty stomach, and not at the same time as the iron tablet.

• Deworming tablet (albendazole)

  Routine

  Once, in the second trimester

  A single deworming tablet is given after the first trimester, preferably in the second, usually in front of the health worker. It is never given in the first trimester.

• Second antenatal visit

  Routine

  Between 14 and 26 weeks

  The next of your minimum four government visits falls in this window, with blood pressure, weight, urine and haemoglobin checks. In the UK, a quadruple blood test may be offered from 14 weeks if the combined test was missed.

Your doctor may prescribe different brands or doses depending on your blood tests. Take supplements as prescribed and do not stop them without advice; if tablets upset your stomach, tell your doctor rather than skipping them.

• 🌿Iron from plant foods is absorbed better alongside vitamin C. Add a squeeze of lemon to dal or palak, or have amla, guava or an orange with your meal.
• 🌿Good vegetarian iron sources include palak and other greens, rajma, masoor dal, chana and other pulses; for non-vegetarians, eggs, fish, chicken and meat add iron too. Avoid liver, which has too much vitamin A for pregnancy.
• 🌿Tea and coffee reduce iron absorption. Keep them at least an hour away from meals and from your iron tablet, and take the tablet with water rather than milk.
• 🌿ICMR advises about 350 extra calories a day in the second and third trimesters, more if you are undernourished. That is a modest addition to a balanced diet, not a second plate.

• •With more energy, the second trimester is a good time to settle into a routine you can keep up, such as a daily walk plus a few yoga or strength sessions a week.
• •In yoga, skip deep twists that squeeze the abdomen, headstands and shoulder stands, deep backbends and lying on your front. Hormones loosen your joints, so do not push stretches further than usual.
• •When getting up from the floor or bed, roll to your side first and rise slowly.

• •Set a simple routine for your tablets, with calcium at lunch and dinner and iron at a different time, away from tea. A phone reminder helps.
• •Eating for two is a myth. Your baby needs better-quality food, not double portions, and too much extra food can lead to excess weight gain.
• •The second trimester is usually the most comfortable time to travel if you need to; check with your doctor and carry your antenatal records.
• •Keep your MCP card updated with each tablet supply and test result.

• ?What was my latest haemoglobin, and is it normal?
• ?How and when should I take my iron and calcium tablets?
• ?When will I get the deworming tablet?
• ?When is my second antenatal visit?

• Collect your IFA and calcium tablets
• Set reminders to take them at separate times
• Move tea and coffee away from meals and tablets
• Ask about the deworming tablet
• Book your second antenatal visit