20 Weeks Pregnant

You are almost 5 months through your pregnancy (4.5 months since conception). At this point in your pregnancy, your life is changing more and more every day. All in a wonderful way of course. By this point in your pregnancy, everything from your belly button to your pelvic bone is shifting place. If not already, you should already be in maternity clothes and constantly having people wishing you the best. If you go out in public, you are likely also already running into people who will be wanting to touch your belly to feel your baby. All these things are just some of the wonderful aspects to expect at 20 weeks pregnant.

What to Expect at 20 Weeks Pregnant

Overall, the second trimester is the best time of your pregnancy. Compared to all other trimesters, the second trimester is when you can start saying bye bye to morning sickness. Because your pregnancy hormones are starting to settle down, you will notice that the morning sickness will start to fade as suddenly as it came on. (Some women may not be this lucky). In addition to that, you can start looking forward to having a renewed sense of energy this week. For many pregnant women, the unpleasant pregnancy symptoms of the beginning weeks of pregnancy are likely no more.

Fetal Development This Week

There are some major fetal developments going on this week in your pregnancy. Here are some of the major developments you can look forward to.

Organ Development at 20 Weeks Pregnant

Fetal development at 20 weeks pregnant brings with it a wide range of changes. This gestational age is when all the major organs are developed and in place. Because of this, your baby is now poised to grow in size and gain weight. Your baby this week will continue practicing his swallowing reflexes. In fact, you can expect that he will be swallowing larger amounts of amniotic fluid this week. This will allow his digestive system to get a better workout. Practicing swallowing amniotic fluid is something that is completely normal and is something that you should not worry about.

In addition to swallowing amniotic fluid, your little one will be practicing passing stools as well. Your baby’s practice stools are called meconium, the dark sticky substance that will be your baby’s first bowel movement. This meconium production is a development from the previous week as a result of the digestive function [2]. This practice will allow your baby to make his first stool after birth that will quickly become be the first of many poopy diapers.

Baby Development Pregnancy Week 20

Baby Development Pregnancy Week 20

Sensory Organ Development

The sensory organs are continuing to develop at this gestational age as well. You will be glad to know that the small bones in the inner ear are now properly developed. In addition to that,  the characteristic external structures of the nose are beginning to form[3]. If your baby is at the forefront of this gestational age, then your baby could even begin to start opening his eyes at this point as well. This will be a great milestone as the eyelids of babies at 20 weeks pregnant are still usually fused shut. [4]. Another exciting development at 20 weeks pregnant is the fact that your baby will also have working taste buds at this stage as well [5].

External Appearance

As your baby grows, he will need continued protection, especially from the amniotic fluid that he will be floating in until birth. Lucky for your little one, vernix caseosa will have completely covered your little on at this point. Vernix caseosa is the waxy white substance produced by the fetal sebaceous glands [6]. The primary role of this substance is to protect him from the amniotic fluid, All the while, the transparent skin also starts forming fat layers underneath it. This accumulation of fat will plump your baby up so he is less skinny and more like the cuddle monkey he will be after birth.  

In addition to that, another neat change in your baby’s development this month has to do with his scalp. Many babies will begin to grow the first few hairs that will eventually be the hair that they are born with. This hair will also fall off a couple weeks after they are born as well. Once it falls out, it will make way for their lighter hair that will be permanent. [3].

How Big Is Your Baby This Week?

Your baby is continuing to grow this week. In fact, he is now almost as big as a banana. Your baby will be weighing in at around 10.2 oz (289.17 gm) [9]. His crown to rump length is about 6.5 inches (16.5 cm) while he is approximately 10 inches (25.4 cm) long from head to heel [10]. Your baby’s legs remain curled up in front of his body until the 19th week. Because of his position, it is nearly impossible for your sonographer to measure his length from head to feet. However, your doctor may do a fundal height measurement this week. Essentially, a fundal height measurement measures the distance from the top of your uterus to your pubic bone. This is done externally and requires nothing more than measurement tape.

If you are getting an ultrasound at 20 weeks pregnant, then you may find it interesting to know that the fundal height measurement usually matches the gestational age of your baby. As you progress through your pregnancy, your baby will begin to straighten up from the 20th week onward. This will enable your health care provider to measure his actual height.

Your Belly and Body Changes at Week 20

Your body is undergoing many changes apart from the obvious – the growing baby bump. With each and every passing day, you are likely to start feeling these changes as well. Your changing center of gravity due to your growing belly is something you will gradually begin to notice. This is thanks to the considerable weight gain that will be taking place over the next couple of weeks.[11].

In addition to that, your uterus is now three times as big as its original size. In fact, the top of your uterus should now be at the same level as your belly button [12]. According to the average, the growth of your uterus now should be roughly 1 cm every week until delivery [3]. Your protruding belly button will not be the only thing you will notice either. As your baby’s size increases, so will your baby movement at 20 weeks. Your baby is growing inside the uterus as those kicks and punches start to feel more like real fetal movements. These movements will be rather defined, so unlike the quickening in the earlier weeks, you should distinctively feel each kick.

20 Weeks Pregnant Ultrasound Scan

You will have your mid-pregnancy ultrasound around this week (if it wasn’t done last week) as it is usually performed between the 18th and 20th weeks [13]. The ultrasound in this trimester is commonly known as an anomaly scan. This is performed so that your doctor can evaluate fetal growth. During this exam, the sonographer will screen for certain birth defects. The major birth defects that will be scanned for include neural tube defects and Down’s syndrome. Along with that, your sonographer will confirm your due date as well[3].

Lastly, the ultrasound also allows your doctor to observe the baby’s limbs, fingers, and toes for any abnormalities. In addition to that, your doctor will assess the umbilical cord, placenta, and amniotic fluid. This is to make sure that your baby is getting everything necessary for proper growth [13]. Some neat things you can look forward to seeing include the straightening spine [11]. And of course, this will be a great opportunity for you to find out the gender of your baby if you so choose to do so [14].

In addition to the ultrasound, your OB/GYN will also offer routine checkups to make sure that everything is going well with you. Your doctor will take note of things such as your blood sugar, blood pressure, and any possible practice contractions (Braxton Hicks) you may be feeling. While it’d be a little earlier than the norm, it is not uncommon for some pregnant women to begin feeling Braxton Hicks contractions at 20 weeks pregnant.  

If you are expecting twins, then your twin pregnancy week 20 ultrasound will play out in a similar fashion. In a twin pregnancy, two babies are generally scanned separately to screen for any physical abnormalities. The appearance and size of the two babies are evaluated as well. Additionally, a sonographer will evaluate to make sure that both babies are experiencing the same growth rate [15].

20 Weeks Pregnant Ultrasound Picture

20 Weeks Pregnant Ultrasound Picture

Signs and Symptoms at 20 Weeks Pregnant

While not all pregnant women will have the same signs and symptoms at this stage in their pregnancy, there are some things you should look out for. Here are some of the most common symptoms to keep an eye out for.

  • Round ligament pain [16]
  • Joint, hip, rib, and back pain
  • Leg cramps
  • Indigestion and heartburn [9]
  • Gas and flatulence
  • Constipation
  • Feeling out of breath [7]
  • Swelling of the hands and feet
  • Swollen and/or bleeding gums
  • Itchy skin around the belly, back, and chest [17]
  • Sleep disturbances or insomnia
  • Emotional changes and mood swings
  • Occasional headaches and dizziness [4]
  • The belly button protruding outward with or without a little pain and soreness around the area [18]
  • Increased vaginal discharge [4]
  • Varicose veins  

When to Call the Doctor

If this is your first pregnancy, then you may feel that any slight change in your body is a cause for concern. This is, however, is not always the case. If you feel something slightly abnormal, it may just be a common pregnancy symptom – strange and new, but likely perfectly normal. However, if you do start to feel any of the following symptoms, this may be cause for concern. Here are some symptoms you should keep an eye out for and call your doctor about:

  • A constant headache or a migraine. These may be accompanied with vision changes, heart palpitations, changes in blood pressure, sudden swelling (of the hands and feet), and upper abdominal pain (might indicate preeclampsia) [19].
  • Severe itching without any skin rash (might indicate a rare liver disorder named obstetric cholestasis) [20].
  • Experiencing symptoms like stomach cramps, severe nausea, lower back pain, increasing pressure in the pelvic region, vaginal bleeding or spotting [21] or any kind of change in discharge (might indicate an open cervix [22] or a possible miscarriage).
  • Burning sensation during urination [23] along with considerable lower back pain and yellowish jelly-like or white thick discharge (might indicate an infectious condition like a yeast infection).
  • Extreme fatigue accompanied by excessive thirst, dry mouth, increased urination, and vision problems (might indicate gestational diabetes) [24].
  • Painful contractions that might indicate the onset of preterm labor (this will typically be a concern once you enter your third trimester as well).
  • Inconsistencies with blood sugar levels (especially if you have been diagnosed with gestational diabetes).
  • Increased appearance of varicose veins or other concerns with visible blood vessels. (An easy varicose veins treatment is putting your feet up so that additional pressure is not applied to them).

Tips for a Healthy Pregnancy and Baby

Pregnancy might be out of your control in the sense that your body will be operating on its own schedule. However, there are some things that you can do to ensure that you have as close to a healthy pregnancy as possible. Here are some great tips to keep in mind during your pregnancy:

  • Make sure to follow a proper dental health routine (brushing and flossing regularly). Additionally, be sure to go in for dental checkups to avoid conditions like gingivitis in pregnancy [8].
  • Avoid any kind of x-ray unless absolutely necessary as it might hurt your baby [25].
  • Practice sleeping on your side (preferably left side as this promotes proper blood circulation). Sleeping on your stomach is probably not comfortable anymore (due to the growing belly), and sleeping on your back may reduce blood flow to the fetus by putting pressure on a major nerve [27].
  • Follow a diet consisting of plenty of iron-rich foods. Some popular that are foods rich in iron include spinach, dried beans, dry fruits, lean red meat. Iron-rich foods are important before your baby’s birth as it is necessary for hemoglobin production in your baby. Adequate iron intake also lowers your chances of developing anemia [26].
  • Make healthy food choices to avoid excessive weight gain, especially in the case of twin and overweight pregnancies.
  • Do prenatal yoga or some light exercise regularly to keep the abdominal and pelvic muscles flexible.

Final Thoughts

Getting to 20 weeks pregnant is exciting! There are so many rapid changes happening. In fact, you might even find yourself wanting time to slow down so that you can enjoy these changes. Luckily, thanks to your hormones starting to settle down a bit, you will find that this week brings with it renewed energy. For many pregnant women, this is a great time to start enjoying and relishing in your pregnancy.


  1. http://www.babycentre.co.uk/20-weeks-pregnant
  2. http://www.babycenter.com/6_your-pregnancy-20-weeks_1109.bc
  3. http://www.pampers.com/diapers/20-weeks-pregnant
  4. http://www.whattoexpect.com/pregnancy/20-weeks-pregnant.aspx
  5. http://www.bellybelly.com.au/pregnancy-week-by-week/20-weeks-pregnant#.U7DzJpSSxvA
  6. http://www.kidspot.com.au/Pregnancy-Second-trimester-Your-babys-progress-Week-20+5752+115+article.htm
  7. http://www.babycentre.co.uk/s1001617/20-weeks-pregnant
  8. http://similac.com/pregnancy/20-weeks-pregnant
  9. http://pregnant.thebump.com/pregnancy-week-by-week/20-weeks-pregnant.aspx
  10. http://www.babycenter.com/slideshow-baby-size
  11. http://www.bounty.com/pregnancy/20-weeks-pregnant
  12. http://www.medicinenet.com/fetal_development_pictures_slideshow/article.htm
  13. http://www.babycentre.co.uk/a557390/anomaly-scan-20-weeks
  14. http://www.babycenter.com/0_all-about-ultrasounds_329.bc
  15. http://www.parents.com/pregnancy/stages/fetal-development/twins-a-closer-look-at-your-developing-babies/#page=7
  16. http://www.parents.com/pregnancy/week-by-week/your-changing-body/#page=20
  17. http://www.babycenter.com/0_itchy-skin-during-pregnancy_9450.bc
  18. http://www.birth.com.au/aches-and-pains/what-is-not-normal#.U7KYh5SSxvA
  19. http://www.medicinenet.com/pregnancy_induced_hypertension/article.htm
  20. http://www.babycentre.co.uk/a536367/itchy-skin-during-pregnancy
  21. http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/pregnancy-weeks-17-18-19-20.aspx#close
  22. http://www.uptodate.com/contents/cervical-insufficiency
  23. http://www.bellybelly.com.au/pregnancy-week-by-week/20-weeks-pregnant#.U7KyU5SSxvB
  24. http://www.babycentre.co.uk/a2058/gestational-diabetes
  25. http://www.babycentre.co.uk/x536412/is-it-safe-to-have-an-x-ray-during-pregnancy
  26. http://americanpregnancy.org/weekbyweek/week20.htm
  27. http://www.webmd.com/baby/features/sleep-soundly-during-pregnancy [/ref]