20 Weeks Pregnant
Congrats! During week 20 of pregnancy, you’re at the halfway point. If you’ve recently found out baby’s sex, you’re in a completely new mindset—are we right? Now, those baby names you’re throwing out are more likely to end up as baby’s actual name. When you find yourself in a baby store, you can start to picture those adorable outfits on your little boy or girl—so 20 weeks pregnant may be the time when you’re ready to start finalizing your baby registry too. Happy shopping!
At 20 weeks pregnant, baby is the size of a banana. They weigh about 10.2 ounces and measure about 6.5 inches from crown to rump. (Starting next week, baby will be measured from head to toe.) Baby's still got a lot of growing to do but has an excellent start!
Your stage in pregnancy is usually referred to by week, not month, but 20 weeks pregnant is five months pregnant. Because pregnancy is 40 weeks long, you’ve now hit the halfway point!
So what should you be feeling at 20 weeks pregnant? Making it to 20 weeks pregnant probably feels pretty darn good. Your first trimester is under your belt, and your energy levels may be rebounding, making you feel stronger. Plus, increased estrogen and progesterone hormones mean your sex drive is high, and as long as your partner is up for it too, things are probably happening between the sheets. Of course, it wouldn’t be pregnancy if you weren’t dealing with some annoying symptoms. After all, your body is hard at work. Right now, those symptoms likely include swelling, heartburn, leg cramps and a few other things. Here are some of the typical 20 weeks pregnant symptoms you may experience:
- Vaginal discharge. You can expect the discharge to keep increasing until delivery, a direct result of heightened hormone levels. But let your doctor know if the discharge is yellow, green or foul smelling.
- Leg cramps. Do stretches regularly, and drink plenty of water to prevent your legs from cramping.
- Heartburn and/or indigestion. As baby starts to crowd your digestive system, it might not work exactly as it did pre-pregnancy. Watch what you’re eating if you’ve got heartburn or an upset stomach—acidic and spicy foods can cause tummy troubles.
- High energy. Enjoy this energy (and libido) surge while it lasts! You might find yourself more fatigued in the third trimester.
- Swelling. Don't worry unless the swelling is sudden or severe. Mild swelling is normal and should subside after delivery. In the meantime, put up your feet whenever you can.
- Shortness of breath. As your uterus expands, it pushes against your lungs, causing you to feel short of breath. You might find this to be especially true if you’re 20 weeks pregnant with twins. Don’t push yourself too hard, and sit down and rest if you feel yourself gasping for air.
Starting around 20 weeks pregnant, your doctor will measure fundal height at each prenatal visit. Fundal height is the distance from the pubic bone to the top of your uterus. In centimeters, the fundal height should match your week of pregnancy, give or take 2 centimeters. So, for example, your 20 weeks pregnant belly should measure around 18 to 22 centimeters. It should continue to increase about a centimeter each week. A higher or lower fundal height could be the sign of a pregnancy condition, such as gestational diabetes, a growth issue or a breech baby, so if it doesn’t appear to be average, further testing may be necessary.
Curious as to where baby is at 20 weeks in your stomach? Your body is making room for the uterus to expand up towards your belly button, giving baby room to wiggle around. They still have plenty of time to get into the head-down birth position, which doesn’t occur until the third trimester.
At 20 weeks pregnant, weight gain is happening slowly yet surely. You may have gained around 10 pounds by now. Remember: You’re aiming to gain about 1 to 2 pounds per week.
Recommended pregnancy weight gain for moms of normal BMI is about 25 to 35 pounds. If you began pregnancy with a high BMI, your OB will likely advise that you gain a total of 15 to 25 pounds. If you were at a low BMI, 28 to 40 pounds will likely be the recommendation.
If you’re 20 weeks pregnant with twins or other multiples, don’t expect your doctor to measure your fundal height. That’s because it’s harder to say what’s average for moms-to-be carrying multiples. Instead, your OB will likely put more emphasis on your weight gain. Now that you’re 20 weeks pregnant with twins, you should aim to put on slightly more weight each week. In the first half of a twin pregnancy, the recommendation is about 1 pound per week, and in the second half, it’s about 1 to 2 pounds. That’s because healthy weight gain is gradual. Most OBs advise that twin moms-to-be of normal BMI gain about 35 to 45 pounds total during pregnancy.
Some moms-to-be at this point wonder, is baby fully developed at 20 weeks? Your 20-week fetus has come a long way but still has plenty of developing left to do at the halfway point in your pregnancy. There are a couple of important growth steps taking place around this time: A 20-week fetus has working taste buds and should have the sucking reflex—you may even catch baby sucking their thumb on the next ultrasound! They’re gulping down several ounces of amniotic fluid each day—that's significantly more than before. Plus, regular sleep/wake cycles start taking shape. And when baby is awake, you’ll know it because they’ll probably be more active. That new, fluttering feeling in your stomach—called the quickening—is your baby saying hello!
If you haven’t already had your mid-pregnancy ultrasound, you will very soon, since this prenatal test happens between weeks 18 and 22. This is a detailed ultrasound—you’ll see parts of baby you might not have dreamed possible, including the chambers of their heart, the kidneys, the brain hemispheres and even the sex organs—which means if you haven’t learned baby’s sex yet, you may be able to find out during the 20-week ultrasound (if you’d like). The technician and OB will look to see that everything seems to be developing properly and that baby’s growth is on track for a 20-week fetus.
If you’re 20 weeks pregnant with twins, the ultrasound technician will check to see if babies’ heads are approximately the same size. If they aren’t, more measurements will be taken to be sure neither twin is having growth problems.
What does baby look like at 20 weeks in the womb?
Truth be told, they may look a little gaunt, because baby fat hasn’t developed much at this point. But at 20 weeks, the fingernails are growing and baby’s delicate skin stays protected while in the amniotic fluid thanks to lanugo (fine, light hair) and vernix (a slick, white substance) covering baby’s body. Ask for printouts of the sonogram photos. These are wonderful keepsakes of your rapidly developing baby. How cute is that little nose?!
Use your energy
While you’ve got the stamina, get things done in advance of your third trimester. Put together a birth plan, figure out what you need for the nursery and make other preparations. Be sure to get plenty of sleep!
Decide where you’ll give birth
If you’re planning to have your baby at a hospital, now is a good time to schedule a tour of the maternity wing. While you’re there, check out the classes that may be offered on childbirth techniques, lactation, breastfeeding, infant care and other topics. If you want to give birth at home, you’ll need to find a midwife and discuss your options with your OB.
Learn about Braxton Hicks contractions
These contractions may take you by surprise if you’ve never experienced them. They can feel uncomfortable but don’t last long. You’re not going into labor with Braxton Hicks, but if you start to feel pain and the contractions don’t stop, see your doctor—they could be a sign of something else.
Reminders for the week:
Medical content was reviewed Novemember 2020 by Patricia Pollio, MD, a New York-based ob-gyn and director of the department of obstetrics & gynecology at Good Samaritan Hospital in Suffern, New York.