INFOGRAPHICPREGNANCY

20 Weeks Pregnant: Ultrasound Info, Belly Changes, Cramping & More

By Chaunie Marie Brusie, B.S.N., R.N.
Reviewed by Alyssa Quimby, M.D.
March 02, 2023
20 weeks pregnant baby size diagram with common symptoms and ultrasound info

Can you believe you’ve reached the halfway point in your pregnancy? You’re halfway to 40 weeks (the typical due date for most pregnancies), which is a major milestone.

What is 20 weeks pregnant in months? You’re four and a half months pregnant, right in the middle of the fifth month. That’s right in the middle of your second trimester, too.

Twenty weeks of pregnancy ushers in a few other important milestones, like your baby’s anatomy scan ultrasound to check how they’re developing. You may also feel more movement from your little one, and new pregnancy symptoms.

Here’s more about what you can expect at 20 weeks pregnant.

Baby Size, Development, and Milestones at 20 Weeks Pregnant

At 20 weeks of pregnancy, your baby is approximately the size of a banana, just over 10 inches long. Now that your fetus is growing larger, measurements can be taken from the crown of the head to the bottom of the heel. Your baby is losing that curled up tadpole look and is looking more and more like the baby you’ll recognize when you hold them in your arms.

Here are some other important physical development and milestones for your future baby at 20 weeks:

  • The brain has developed to control motor movement.
  • They can hear now, too.
  • Vernix—a white, creamy-looking material that protects your baby’s skin while they’re swimming in amniotic fluid—now fully coats their body.
  • Their digestive system is working, although they’re still getting all the nutrients they need through the placenta.
  • In female babies, reproductive parts like the uterus and vagina have now fully formed, including all the eggs they will have in their lifetime!
  • Your developing baby is capable of thumb-sucking now, setting the stage for the sucking reflex they’ll need to eat when they’re born.

20 Weeks Pregnant Symptoms

In the second trimester, many pregnant people feel their best—their bump isn’t too difficult to manage (yet), their energy has improved, and they’re not feeling as nauseated as in the first trimester. But you may be feeling new symptoms at 20 weeks pregnant.

Baby Kicks

Your baby has been active for several weeks now, but this week, you may start to feel “flutters” as they move.

If you’re not feeling any movements yet, that’s okay, too. Most often, pregnant people start feeling their baby kick or move between 18 and 22 weeks into pregnancy, but it can be later. And a few factors influence when people feel the baby kick, such as the size of the fetus, the person’s body type, and where the placenta is (if it’s in front of the baby, it may block the feelings of movement), so talk to your doctor if you have questions.

Vaginal Discharge

In your second trimester, you may notice sticky discharge. Healthy vaginal discharge is white or clear and totally normal. You should talk to your provider, though, if you notice a change in your pregnancy discharge color, smell, or texture, or if the discharge causes irritation. This could point to a possible infection.

Physical Discomfort

Your bump may be starting to grow, and some pregnant people will start to feel discomfort in their pelvis. Sharp feelings or cramping at 20 weeks pregnant are possible as your expanding uterus stretches nearby ligaments, called round ligament pain.

You may also feel other symptoms, like:

At 20 weeks pregnant, Braxton Hicks contractions aren’t common but they can happen for some people. These practice contractions are more likely to start later in pregnancy around 37 weeks or so. Braxton Hicks contractions feel like a tightening or squeezing of your belly and tend to go away after a few minutes with rest. (True labor contractions will keep happening at regular intervals!)

Call your ob-gyn or midwife anytime you feel abdominal pain or tightness that doesn’t go away or becomes more frequent. This could be a sign of preterm labor.

Digestive Changes

Pregnancy hormones may slow down digestion, which can lead to constipation. And constipation, combined with pressure from your growing baby, can also lead to hemorrhoids.

If you’re experiencing discomfort from constipation, hemorrhoids, or both, be sure to talk to your doctor. There are safe remedies that can help ease the symptoms and ensure you’re moving your bowels more regularly.

Your Body and Mind at 20 Weeks Pregnant

Here’s a look at some of the physical and mental changes you might encounter this week.

20 Weeks Pregnant Belly

Many first-time expectant parents see some visible sign of their baby bump starting around 20 weeks. Exactly when you start to show can depend on your body type and other factors. It’s an exciting milestone for many people, and that bump will only continue to grow!

Skin Changes

Hormone-related skin changes are common in the second half of pregnancy. You might notice the linea nigra, a dark line running from your belly button down to the pubic bone. Or you may see darkened areas on your face, called pregnancy melasma.

Many skin changes disappear after pregnancy. But some darkened spots, especially on the face, may remain after giving birth. If they bother you, treatments are available after pregnancy that can help lighten their appearance.

Breast Changes

You may have already noticed your breasts becoming larger and more tender. Around 20 weeks, prominent blue veins may appear. Some people may also experience small amounts of colostrum leaking at times (like during sex). This is the first type of milk the body produces, and leaking is normal.

Anxious Feelings

It’s common to feel nervous about the ultrasound at 20 weeks pregnant. If you’re feeling this way, there are a few things you can do:

  • Have an honest conversation with your provider about how you’re feeling and ask questions
  • Bring your support person to the appointment
  • Try practicing some anxiety-management tools (such as deep breathing and meditation) before and during your ultrasound or as you wait for results

Preparation & Tips at 20 Weeks Pregnant

This week’s tips can help keep you and your pregnancy healthy and comfortable.

Go for Your Ultrasound at 20 Weeks Pregnant

As part of prenatal testing, a provider will use ultrasound to check that your baby is developing properly. This week 20 ultrasound, or midpregnancy ultrasound, is an anatomy scan. That means it will primarily look for physical concerns or conditions that can affect a baby’s bones, heart, brain, spinal cord, face, kidneys, or abdomen. It helps your provider detect or rule out issues like Down syndrome, cleft lip, spina bifida, and heart problems.

Many times, an ultrasound tech will perform the scan, and then a doctor or midwife will read the results, so you may have to wait a few minutes up to a few days to know exactly what was found. You won’t be able to ask an ultrasound tech specific health questions. But in most cases, they can tell you the expected sex of your baby, if you want to find out.

Everything looks as expected with this scan for most people. But if anything looks off, you may need some follow-up testing or treatment. Your provider will let you know.

Sleep on Your Side

If you haven’t already started, it’s recommended to start sleeping on your side at this point in your pregnancy. The risk of major complications is small, but sleeping on your back could put pressure on some of the blood vessels that run to your baby. This could restrict blood flow.

To help avoid any risk, sleep on your side. If that’s a new sleeping position for you, using a pregnancy pillow will be a game changer.

Snack Healthfully

Now that morning sickness may have eased a bit, it may be easier to fuel your body with nutritious foods. The American College of Obstetricians and Gynecologists recommends that pregnant people in their second trimester eat about 340 extra calories per day to fuel their growing baby.

Consider snacking on foods with omega-3s, which are good for brain health and development. These foods include flaxseed, broccoli, cantaloupe, kidney beans, spinach, cauliflower, and walnuts.

Need some snack inspiration? Try our recipe for Apple Peanut Butter Crunch Rings.

Connect with Your Baby

This week can be a challenging one for some pregnant people. It may help to try our week 20 pregnancy activity called Turn It Around.

The point of this activity is not to discount your feelings or fears, but to reframe them in ways that may help you navigate them more calmly. This activity can help you connect with your baby by seeing hard things in a new light.

What Others Are Talking About at 20 Weeks Pregnant

The further you get into your pregnancy, the more questions you might have about your and your growing baby’s health. Be sure to ask your pregnancy care provider about any concerns you have. And you can always browse our community, where users post questions and share experiences, one pregnant parent to the next.

Some conversations from experts and users that you might be interested in this week:

Want to know more about your pregnancy week by week?

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