What to Expect When You Are 20 Weeks Pregnant

You’ve hit the halfway mark! Congratulations on making it to the 20 week point in your pregnancy. This exciting milestone means you’re nearing the end of the second trimester. At 20 weeks, your baby is developing rapidly and your body is going through many changes as it accommodates your growing womb. This article will provide a comprehensive look at what you can expect during week 20 of pregnancy.

Key Takeaways: Week 20 Pregnancy

  • Baby is around 6 1/2 inches long and weighs about 10 ounces
  • You may start feeling baby move around more
  • An anatomy scan ultrasound will check baby’s development
  • Your belly continues expanding as baby grows
  • Backache, leg cramps, and other aches and pains are common
  • You may experience Braxton Hicks contractions
  • Your blood pressure will be checked for preeclampsia
  • Skin changes like stretch marks and darkening skin can happen
  • You’ll likely have an increased appetite and may start “eating for two”

Baby Development at Week 20

At 20 weeks pregnant, your baby is around the size of a small cantaloupe. From head to rump, your baby measures about 6 1/2 inches long and weighs approximately 10 ounces.

  • Growth spurt – This is a time of rapid development and your baby will nearly double in size over the next few weeks. Their organs, muscles, and nervous system are becoming more mature.
  • Hearing – The ear bones in your baby’s inner ear develop this week, allowing them to start picking up more sounds from the outside world. Your baby may even respond to loud noises like doors slamming or music.
  • Hair and skin – A covering of fine hair called lanugo now covers baby’s entire body for warmth. Their skin is also forming protective layers of fat and wrinkling as they move around the womb.
  • Face – Facial features become more defined. Eyebrows, eyelashes, and taste buds are forming. Lips, gums, and tongue are also developing.
  • Reproductive organs – External genitalia have developed enough to tell your baby’s sex via ultrasound. Testes descend for boys and girls now have primitive ovaries with developing eggs.
  • Swallowing – Your baby is gulping down several ounces of amniotic fluid per day and their kidneys are developed enough to start processing this fluid into urine.
  • Sleep cycles – Basic sleep cycles are starting to emerge and your baby may snooze for up to 12 hours a day. Their sleep and wake times are irregular at this stage.
  • Movement – You will likely start feeling your baby move around more as they gain strength. Quickening fluttery sensations should turn into rolls, kicks, swishes, and thumps.

Anatomy Scan Ultrasound

Your practitioner will recommend getting an anatomy scan ultrasound around 18-22 weeks. This key prenatal test checks for proper fetal development and screens for potential abnormalities. During the 30-60 minute scan, the sonographer will inspect all of your baby’s major organs and body parts. This includes the:

  • Heart – Checks structure and blood flow
  • Brain – Measures brain tissue/ventricles
  • Spine – Checks spinal alignment and closure
  • Face – Views facial features like the lips and nose
  • Kidneys – Confirms kidneys and bladder development
  • Stomach – Confirms stomach is in right place
  • Bones – Views bone structure and growth
  • Limbs – Checks arm and leg growth
  • Sex organs – Confirms “boy” or “girl”

The scan provides reassurance that your baby is developing properly without any major problems detected. You’ll also get amazing 3D images of your little one.

Changes to Your Body in Week 20

As your baby grows rapidly during the halfway point, your body adjusts to accommodate your expanding womb. Here are some common changes you may experience at 20 weeks pregnant:

  • Bigger belly – Your uterus reaches up to your belly button as it grows larger each week. Strangers will likely be able to tell you’re expecting now.
  • Stretch marks – Many women start getting reddish-purple stretch marks on their belly, thighs, breasts, and buttocks as skin expands. Moisturizing daily can help.
  • Aches and pains – Backache, leg cramps, pelvic pain, hip soreness, and other aches are common. Changing positions, massage, warm baths, and a belly support band can provide relief.
  • Braxton Hicks contractions – You may notice your belly tightening with these “practice” contractions. Changing activity levels often stops them. Stay hydrated and rest on your side.
  • Skin changes – Increased pregnancy hormones lead to darkening skin (linea nigra) on the belly and face (chloasma/mask of pregnancy). Moles and veins may also darken.
  • Increased vaginal discharge – More vaginal discharge is normal as your cervix softens and mucus increases to help prevent infections. Wearing panty liners and staying dry can help.
  • Digestive issues – Constipation, bloating, and hemorrhoids are common digestive complaints. Eat high fiber foods, exercise, and stay hydrated to keep your system regular.
  • Increased urination – Frequent pee breaks continue as your growing womb puts more pressure on your bladder. Urinary incontinence and leaking may start as well. Kegels can help strengthen your pelvic floor.
  • ** Sweating and body temperature changes** – You may sweat more and feel hotter as your metabolism increases. Your body temp may also seem higher. Stay cool and hydrated.
  • Dizziness – Changes in blood pressure and circulation can lead to occasional lightheadedness or dizziness, especially if you change positions quickly. Take it slow and easy.
  • Shortness of breath – Your expanding uterus presses up against your diaphragm and lungs, making it harder to take deep breaths. Sit upright and practice pursed lip breathing.
  • Swollen ankles and feet – Extra fluid retention can lead to swelling in your feet and ankles by the end of the day. Elevate your feet when possible and avoid tight socks.
  • Increased appetite – Hormone shifts and a faster metabolism result in more hunger around 20 weeks. Give in to cravings for healthy foods to fuel your baby’s growth.
  • Weight gain – Most women gain around 1 pound per week starting in the second trimester. Focus on eating nutritious foods instead of numbers on the scale.

Prenatal Screening and Tests

Your practitioner will monitor your health and your baby’s development closely during the halfway point in pregnancy:

  • Weight and blood pressure – Your weight gain and blood pressure will be checked at each visit to ensure you’re within a healthy range and screen for concerns like preeclampsia.
  • Urine – A urine sample will be taken to check protein and sugar levels and screen for infections.
  • Fetal heart rate – Your baby’s heartbeat will be monitored to ensure it falls within the normal range of 120-160 bpm.
  • Measuring fundal height – Your doctor will measure from your pubic bone to the top of your uterus to gauge fetal growth.
  • Glucose screening – A glucose challenge test screens for gestational diabetes around 24-28 weeks. If failed, a glucose tolerance test will confirm.
  • RH factor – If you are RH negative blood type, you’ll get a shot of Rhogam around week 28 to prevent complications.
  • Triple/quad screening blood tests – These optional blood tests help assess risks for genetic disorders like Down syndrome and neural tube defects. Results take 1-2 weeks. Discuss pros and cons with your practitioner.

Bring up any questions or concerns you have about your health or your baby’s wellbeing so your provider can address them promptly. Staying on top of prenatal care ensures the best outcome.

Tips for Week 20 of Pregnancy

Here are some tips for a healthy, comfortable 20th week of pregnancy:

  • Stay hydrated by sipping water steadily throughout the day. Dehydration can trigger contractions.
  • Give in to food cravings but make healthy swaps when possible, like fruits instead of sweets. Your body needs extra nutrition right now.
  • Take belly selfies and watch your body change week-to-week. Your bump will grow rapidly in upcoming weeks.
  • Shop maternity clothes sales and consignment shops. You’ll need roomier tops, pants, bras, and underwear as you expand.
  • Take relaxing warm baths to soothe aches and pains. Add Epsom salts or essential oils for extra pampering. Check water temp first.
  • Try side sleeping with a body pillow for comfort and to help alignment. Use pillows to prop up knees and support bump.
  • Move your body every day with short walks, prenatal yoga, and light strength exercises to boost energy and circulation. Check with your provider before starting any new exercise regime during pregnancy. Walking and swimming are excellent.
  • Communicate openly with your partner about physical and emotional changes. Share baby name ideas and make birth plans.
  • Relax and reward yourself during this busy period of work and preparing your home. Do activities you enjoy like reading, hobbies, and spending time with loved ones.
  • Start looking into childbirth, breastfeeding, and newborn care classes. Many are held around 20 weeks.
  • Discuss maternity leave and any necessary work accommodations with your employer if you haven’t already.

Frequently Asked Questions

What if I haven’t felt the baby move much by 20 weeks?

It’s common not to feel consistent movement until after 20 weeks, especially with a first pregnancy. Your placenta position can also muffle sensations. Hydrate, rest, and monitor movement. Report any major decrease to your provider right away. But lack of feeling movement is common and normal up to 20 weeks.

Is it safe to travel during my 20th week of pregnancy?

Travel is usually fine until the last month of pregnancy as long as you take precautions. On trips under 2 hours, stop and walk every hour or two. Stay hydrated. Avoid locations with Zika virus. Bring all medications and a copy of medical records. Get your provider’s okay first for air travel or longer trips.

Are pregnancy skin changes like stretch marks permanent?

Stretch marks, melasma, and other skin changes will likely fade and improve postpartum but may not disappear entirely. Using creams and lotions daily throughout pregnancy and after delivery can help minimize permanent changes. Stay out of the sun, use sunscreen if needed and wear hats, avoid tanning beds. Time and moisturizing will help skin bounce back after birth.

What can I do about pregnancy congestion and nosebleeds?

Nasal stuffiness and nosebleeds are common as pregnancy hormones swell mucus membranes. Use a humidifier, saline spray, and nasal strips. Gently blow nose. OTC decongestants are okay for short stints if approved by your provider, but avoid overuse. Drink fluids, use a cool mist vaporizer at night, avoid irritants like smoke. Call your practitioner if frequent nosebleeds don’t stop with 10 minutes of pressure.

In Summary

The halfway point of pregnancy is an exciting milestone. At 20 weeks, rapid growth means more frequent fetal movement and a belly that’s noticeably pregnant.

An anatomy scan ultrasound confirms your baby’s development while your changing body takes some adjustment. While aches, pains and other symptoms are common, focus on nutrition, exercise, comfort and self-care measures.

With just 20 more weeks to go until you meet your little one, take time to enjoy the magic of pregnancy and prepare your home and heart for the arrival of your baby.

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