It’s here! Week 20 is halfway to your baby’s due date! Remember that a due date is just an estimate, so your baby could come a few weeks earlier or later. Unless your doctor sees a medical need to start labor sooner, it’s good to wait until it begins naturally since labor is triggered by a protein your baby’s lungs create once they’re ready.

Your baby’s more visibly noticeable developments, like growing limbs and fingernails, have slowed, and if you could peek at him weekly, it would be harder to spot his growth and changes each week now. Most of them are happening within organs, instead, as they each prepare to support him in the breathing world.

Your Baby’s Development At 20 Weeks

At 20 weeks, your baby is about 10 inches long (about half the length he’ll be at birth) and weighs about 11 1/2 – 12 ounces. He has a lot of weight to pack on before birth!

Your baby is doing a lot of thumb-sucking, and his taste buds are fully developed. The jury is still out on how much the baby can taste of your diet through amniotic fluid, but research indicates that your food choices can affect his reactions later, so try to pass him a healthy variety!

Sometimes your baby even gets hiccups, which you may recognize if you feel a funny bubbly sensation that’s rhythmic! In some cases, this may be the first feeling you’re sure is your baby since you can recognize the pattern. Soon, you’ll be noticing his kicks and punches, too!

Quick Overview: Baby's Development At 20 Weeks Pregnant:

• Baby’s Growth: At 20 weeks, your baby measures about 10 inches long (half his birth length) and weighs 11.5–12 ounces.
• Weight Gain: He still has a lot of weight to gain before birth.
• Thumb-Sucking: Baby is actively sucking his thumb, and his taste buds are fully developed.
• Taste Exposure: Some research suggests that your diet may influence baby’s future food preferences through amniotic fluid.
• Hiccups: Your baby may experience hiccups, which can feel like a rhythmic, bubbly sensation in your belly.
• First Movements: Hiccups might be the first sensation you confidently recognize as your baby.
• Kicks & Punches: Soon, you’ll start feeling stronger movements like kicks and punches!

Mother’s Symptoms At 20 Weeks

Baby Movement

Now that you’re halfway through your pregnancy, your baby is moving around so much. You may feel movement even before you can identify it as movement—instead, you may identify what seems to be gas or even feel a bit nauseated in the next few weeks. This should be more comfortable as you become able to identify your baby’s movements, though.

Skin & Belly

As your skin stretches, you may notice some new symptoms: stretch marks and itching.

Some women feel self-conscious about the appearance of stretch marks, while others revel in them, but they can also cause physical discomfort. A gentle lotion or moisturizer can stop the itching and reduce the visibility of stretch marks — including reducing long-term scarring.

You may also have chloasma, dark patches of skin on your face. These may disappear on their own after your baby is born. Using sunscreen on your face can reduce the risk of these patches. However, treatments for them typically are not considered safe during pregnancy, so for now, prevention is the best step.

However, most women are now experiencing the ‘glow’ of mid-pregnancy! Add this to your thicker, fuller hair, and you may feel as gorgeous as you’ve ever known!

Digestive Difficulties

With the first trimester over, most women’s appetite increases. You’ll need extra calories (around 340 per day) to support your baby, and the cravings can be amped up.

Unfortunately, around this point, you may notice that you feel full much faster, even though you may still want to eat more. Your growing uterus means that other organs are getting squeezed, and you may be unable to eat as much in one sitting. Eating smaller, more frequent meals can help with this (in addition to helping with indigestion and heartburn).

Indigestion and heartburn can be treated with over-the-counter medications like Tums or Rolaids, but avoid any that contain aspirin, magnesium trisilicate, or sodium bicarbonate.

Most doctors will advise their patients that treating constipation with milk of magnesia or stool softeners is okay. Still, laxatives, especially with stimulants, should be avoided unless your doctor says to use them. They can cause contractions.

Expect cravings to continue through the end of your pregnancy, too. Try to meet your body’s needs when you satisfy these cravings, rather than just eating something yummy. If you have cravings for nonfood items, speak to your doctor.

Fatigue & Related Symptoms

Although you may get a burst of new energy as a second trimester gift, you may also become fatigued more easily and quickly than usual. As your lungs and heart do the extra work necessary to oxygenate your growing baby and your body, you may even have headaches and moments of dizziness or be short of breath.

While these symptoms are common, you should check with your doctor for anything severe, ongoing, or recurrent. A headache that doesn’t go away when treated can be a sign of severe conditions, so don’t ignore it! Any of these symptoms accompanied by chest pain (or chest pain by itself) warrant an immediate call to your doctor. You should also seek immediate medical attention if you faint or pass out.

Pain & Cramping

Some pain is normal during pregnancy.

Your legs and feet may be sore or have RLS symptoms, especially at night. Unfortunately, most medical treatments for RLS are not considered safe during pregnancy, so your doctor may advise exercise, warm baths, and/or massage to handle the discomfort. In some cases, an iron or folate supplement may be recommended.

You may also have round ligament pain, which is a stabbing or pulling pain in the lower abdomen that sometimes extends into the groin. Round ligament pain usually goes away with OTC pain medications and a shift in position (taking the weight off your round ligaments).

Pain that does not go away with meds or a shift in position should be reported to your doctor.

Weight Gain, Swelling, & Bloating

The exact weight gain will vary by now, but it can be around ten pounds for some women. Watch out for too-rapid weight gain, though! A pound a week on average is typical at this stage of pregnancy, but a sudden more considerable gain can be a sign of pre-eclampsia.

Some swelling or bloating is a common side effect of pregnancy. If it’s affecting your daily functions, speak to your doctor about dietary changes or other options for reducing this.

However, be aware that sudden or uneven swelling can be a sign of pre-eclampsia, and you should call your doctor immediately. The same goes for any swelling in your face.

Insomnia

Insomnia (complicated by heartburn, RLS symptoms, and anxiety about the near future) can be a persistent plague during pregnancy. Most doctors recommend fighting it through sleep hygiene habits, like keeping your bedroom cool and dark, turning screens off before bedtime, and keeping a routine.

Medication is typically only recommended or prescribed if nothing else is working and a lack of sleep is interfering with your day-to-day routines or putting you in danger.

20 Week Pregnancy Symptoms Quick Recap:

• Baby’s movement increases, sometimes mistaken for gas or nausea.
• Stretch marks, itching, and chloasma (dark facial patches) may appear; many experience the pregnancy glow and thicker hair.
• Increased appetite but feeling full quickly due to organ compression; indigestion, heartburn, and constipation may occur.
• Fatigue, headaches, dizziness, and shortness of breath are common as the body works harder.
• Leg and foot pain, RLS, and round ligament pain may cause discomfort, especially at night.
• Weight gain, swelling, and bloating are normal, but sudden or uneven swelling could signal pre-eclampsia.
• Insomnia may worsen due to heartburn, RLS, and anxiety.

When To Contact Your Doctor

Labor Signs

If you think you may be going into labor, you should call your doctor. Medications can be administered to stop labor and give your baby more time to be ready to enter the world.

One of the most significant signs of early labor is regular contractions that become more frequent and don’t stop with a change in position. These contractions may also feel like a lower backache or like intense pressure and a need for a bathroom.

The other is a rupture of the amniotic sac. You may have a gush of fluid, or there may be a trickle. Amniotic fluid is clear and watery but may contain strands of mucousy material and/or blood or bloody streaks.

Losing your mucous plug – a gob of mucousy material that blocks the entrance to your cervix- can be a sign that your cervix is dilating. Some women will lose bits of mucous for several weeks before going into labor, but seeing any signs of it this early in pregnancy warrants a check with your doctor.

Pre-Eclampsia Signs

Pre-ecalampsia is a serious complication of pregnancy and requires special monitoring. The signs can appear earlier, but are most common from the 20-week mark on.

As mentioned above, some swelling is normal during pregnancy, but there are signs that it may be abnormal. These include facial swelling and sudden swelling. Swelling that is more prominent on one side of the body than the other is also a red flag.

Severe headaches that don’t go away and vision changes are also warning signs, as are severe nausea and vomiting.

You should contact your doctor immediately if you have any of these symptoms.

Pain & Bleeding

While spotting is normal in early pregnancy, by this point in pregnancy, you should not see any bleeding. (Though there may be some blood if the cervix is irritated, such as after an internal exam.) Report any spotting to your doctor and seek emergency care for any heavier bleeding.

Any severe pain, or pain that doesn’t go away with a change of position or pain meds, should prompt a call to your doctor.

What Should Mom Be Doing At 20 Weeks?

Ultrasound

It’s time for your anatomy scan! This ultrasound, which may take much longer than your last one, allows your doctor to measure the baby’s body parts and organs, ensuring everything is developing as it should. It’s sometimes called an anomaly scan, as your medical provider will look for any anomalies or anything that stands out as outside normal development. This scan will provide an opportunity for early intervention if there are any concerns.

It’s also a good peek at your baby! You’ll get to watch your little one doing acrobatics, and maybe even smiling or sucking a thumb! This is also the scan in which the baby’s sex is often identified.

Some practices prefer to perform ultrasounds when the patient has a full bladder, so you may want to check with the front desk before you make any pit stops.

Nutrition

Continue meeting your baby’s nutritional needs with a variety of healthy foods. Keep taking your multivitamin! If you find it hard to swallow or are nauseous, experiment with different techniques to make it more tolerable.

Some women find that their stomachs are less upset if they take their vitamins in the evening. Taking it with food may make it more tolerable, as may be picking and choosing the right flavor and texture of beverage. Drinks that are thicker and stronger-flavored, like chocolate milk or orange juice, may work better than water for some women to get the pill down without tasting it.

Protect Your Body

Use sunscreen to protect your exposed skin during pregnancy. Wear loose, comfortable clothing, and choose a supportive bra and shoes. You may need new shoes by now- many women’s feet grow during the second trimester.

Try sleeping on your side at night, and use a pregnancy pillow or a few spare pillows for support.

Quick Recap Of What Mom Should Be Doing At 20 Weeks Pregnant:

• Ultrasound (Anatomy Scan): This test measures the baby’s body and organ development, detects anomalies, and may reveal the baby’s sex. Some clinics require a full bladder for better imaging.
• Nutrition: Maintain a healthy diet, continue taking a multivitamin, and adjust intake methods if it causes nausea.
• Body Protection: Use sunscreen, wear comfortable clothing, supportive bras, and shoes (as feet may grow).
• Sleep Support: Sleep on your side and use pregnancy pillows for comfort.

What To Look Forward To

The typical time for a pregnancy photoshoot is between 28 and 34 weeks, so if you’re doing one, that’s coming up soon!

If you’re taking a “babymoon,” a last trip with your partner before travel starts to require lugging baby supplies or hiring childcare, that should be soon, too!

You may also be planning a baby shower, which is usually recommended to be scheduled in the last two months of pregnancy.