You’ve made it to the halfway mark! At 20 weeks, your belly is now a bump. Your appetite is back in full force. You may have even felt your baby moving.
Here’s what you need to know at this stage:
Have you felt your baby move? One of the changes in your body this week might be those little pokes and jabs you feel when your baby moves around in your uterus. This is called quickening. Women who have already experienced childbirth may have started feeling these sensations a few weeks ago.
Your belly is also getting much more noticeable these days. First-time moms may only have started showing in the last few weeks. And from this point forward, you may gain around a pound per week.
Your baby is about 10 to 11 inches from the top of the head to the bottom of the feet. Another way to visualize this is that your baby is around the length of a banana.
Hair is already growing on your baby’s head, and a fine, soft hair called lanugo is beginning to cover their body.
If you’ve watched birthing shows or witnessed a birth, you probably saw the thick, whitish substance that covers a baby’s body in the womb. This coating is called vernix caseosa, and it’s starting to form this week. Vernix is like a protective skin cream, and it keeps your baby’s skin from wrinkling or pruning.
This week will typically bring a fun event: seeing your baby on your 18- to 20-week ultrasound screen! Commonly referred to as an anatomy scan, this ultrasound will give you a better idea of how your baby is developing.
In addition to getting information about how your baby is measuring, the sonographer will go through all the baby’s major organs and systems to see if they’re functioning properly.
This exam can give you information about your amniotic fluid levels, the location of your placenta, and even the sex of your baby, if they’re not camera shy. Many women choose to bring their partners or a support person to this appointment if allowed. Check with your doctor or healthcare professional to determine their COVID-19 policies before you arrive.
This is a longer ultrasound, and you should plan for it to last at least 45 minutes. You can expect a sonographer to apply gel to your abdomen and use an ultrasound wand, or transducer, to get an image of your baby. Before you’re done, the sonographer may insert a transvaginal ultrasound wand into your vagina to check your cervix.
If your little one isn’t wanting to make an appearance, you may have to move into some interesting positions to get them to flip around. You may also be asked to drink something or walk around to get your baby to move.
Image quality will vary greatly depending on several factors, such as your weight or scars from pervious surgeries like cesarean deliveries and tummy tucks.
You may want to avoid using lotions on your tummy for a couple of days prior to your ultrasound. Some lotions contain ingredients that can affect the quality of your ultrasound images.
While the actual procedure shouldn’t be painful, it’s long, and holding certain positions may be uncomfortable at times. If you’re uncomfortable, speak up, and the sonographer will work with you to find a better position.
During the scan, you’ll be able to hear your baby’s heartbeat during the ultrasound, and you’ll go home with a few pictures of your baby!
Your babies have typically grown to 6 inches long and about 9 ounces each. They can hear you by now!
Plan for your anatomy scan to take a lot longer than if there was just one baby. That’s because each baby will need to be measured and have their organs checked. Just like pregnancies with one child, this ultrasound will check in on your babies’ health. Typically, you can also learn the sex of your babies if you want.
You’re in the middle of your second trimester. Your appetite is likely back to normal, or it has increased. Nausea and fatigue may have disappeared during your second trimester. You may experience body aches, stretch marks, and changes in your skin.
You may also experience the following symptoms:
At this time, vaginal discharge can increase due to increased blood flow to the area and hormones. Typical vaginal discharge during pregnancy looks milky and has a bit of an odor. You can wear panty liners and change your underwear more frequently if it bothers you.
It’s important to note that some types of vaginal discharge are unusual. Discharge that has a green or yellow color and has a strong odor isn’t typical. If you’re noticing bleeding, signs of a yeast infection, or signs of a sexually transmitted infection, it’s important to discuss it with your doctor or healthcare professional.
Another thing to keep an eye out for is if there is a stream or steady trickle of water. This could be a sign of premature labor or a tear in the amniotic sac. If you notice this, tell your doctor or healthcare professional immediately.
Leg cramps are common for many women during pregnancy. They’re usually in the calf muscles and often happen suddenly and at night. Doctors aren’t sure what causes leg cramps, but they may be due to inactivity or deficiency in certain nutrients. More research is needed to determine their cause.
You can try some of the following to get relief:
- Get daily exercise.
- Stretch and practice relaxation techniques.
- Use massage and heat on the affected area.
- Talk with your doctor or healthcare professional about taking nutritional supplements.
- Take a calcium-containing antacid at bedtime.
Heartburn or indigestion
At this time, your growing baby is putting additional pressure on your stomach. In addition, pregnancy hormones can cause the valve at the entrance to the stomach to relax, making it easier for stomach acids to travel up the esophagus.
To help relieve this pain, avoid lying down after meals and rest with your head elevated at night. You can also slowly eat smaller meals throughout the day. If you know which foods bring on heartburn or indigestion, it’s best to avoid these. If heartburn and indigestion is a frequent issue, your doctor may be able to prescribe medication to help, too.
While pregnant, your body water volume can increase by up to 8 liters, which can mean you begin to swell, especially in the hands, feet, legs, and ankles. Swelling is generally highest at the end of the day, as water has gathered at the lower areas of your body due to gravity.
For typical pregnancy swelling, try the following:
- Elevate your feet throughout the day when possible.
- Wear compression stockings.
- Avoid being outside in super hot, humid weather.
- Wear supportive shoes.
Note that swelling is unusual if it affects only one side or part of the body, such as swelling in only one leg. High levels of swelling accompanied by high blood pressure and protein in the urine are also atypical and may be a sign of preeclampsia. If you’re experiencing unusual swelling, notify your doctor or healthcare professional immediately.
Stretching skin can be itchy! As your baby bump and breasts continue to grow, it’s not uncommon to feel itchy. To help relieve itchiness, moisturize regularly.
If itching is very intense, you’ll want to speak with your doctor or healthcare professional. They may be able to prescribe medications to help. They’ll also want to rule out a condition called cholestasis, which affects the liver. Cholestasis causes itching of the palms of hands and soles of feet in particular.
Anxiety and hormones can lead to disrupted sleep. If you previously liked to sleep on your back or stomach, finding a new sleeping position may also be throwing off your sleep. Additionally, you may find that frequent trips to the bathroom have you waking up multiple times in the night.
Getting exercise and using a maternity pillow to cradle your body while you sleep can help. Activities like journaling and talking to friends may help reduce anxiety.
Shortness of breath
Early in your pregnancy, you may experience shortness of breath due to an increase in the hormone progesterone. As pregnancy continues, your baby gets bigger and takes up more space inside you. This means that there’s less space for your lungs to fully expand.
While your baby is still getting plenty of oxygen, shortness of breath can be uncomfortable for you. To help your lungs, you can try to stand up straight with good posture and slow down some of your movements. You can also sleep propped up on pillows and lift your hands over your head to take pressure off your rib cage.
Cravings for certain foods vary from pregnancy to pregnancy. Though you may have heard that pickle or ice cream cravings have something to do with your baby’s nutritional needs, it’s not true.
If you’re experiencing unusual cravings, like chewing on ice, laundry starch, or clay, talk with your doctor or healthcare professional immediately. These types of cravings are symptoms of a disorder called pica, which can cause severe nutritional deficits during pregnancy.
Braxton-Hicks contractions can start this week as your body begins its early preparations for labor. These contractions are usually mild, unpredictable, and nothing to worry about.
You may experience a few contractions from sitting in a weird position, walking around too much, or being dehydrated. Lying down and drinking water should quell stronger ones.
If you notice pain or can time these contractions at regular intervals over the course of several hours, notify your doctor or healthcare professional. It could be a sign of preterm labor, which is a potentially serious complication.
In addition to an anatomy scan, also called the structural ultrasound, you may have a prenatal visit scheduled with your doctor or healthcare professional this week. Like previous visits, you can expect them to:
- record your weight
- check your blood pressure
- ask for a urine sample
- talk about your symptoms with you
- examine your body for swelling
- answer any questions you may have
Your doctor or healthcare professional may also feel the top of your uterus around your belly button and measure your fundal height. This means they will measure the distance from the pubic bone to the top of the uterus. Fundal height is measured in centimeters and frequently matches the number of weeks pregnant. So at 20 weeks, your fundal height is probably around 20 centimeters.
At this appointment, you’ll likely set a date for blood glucose testing. This is typically done around 24 weeks and helps determine if you have or are at risk of gestational diabetes.
It’s important to continue taking your prenatal vitamins and to attend your anatomy scan and all prenatal visits this week. Maintaining a balanced diet and exercising are also important for helping you feel your best.
Now that you’re halfway through your pregnancy, it’s also time to start thinking about what you’ll need when your baby arrives. Feeling prepared with the items you need and a birth and postpartum plan can help you relax mentally.
This week is a great time to start signing up for childbirth and baby care classes. Your hospital may conduct tours of the labor and delivery floor as well. Ask your doctor or healthcare professional about any offerings in your area.
You can also find private classes by doing a quick internet search. Search topics might include natural childbirth, labor techniques, nursing, baby safety, CPR, big brother or big sister training, and more.
If you experience any of the following symptoms, notify your doctor or healthcare professional immediately:
- unusual swelling, vision problems, and persistent headaches
- heavy bleeding or bleeding with severe cramps in the lower abdominal area
- signs of going into labor like regular contractions, water breaking, etc.
Remember, Braxton-Hicks contractions are common in pregnancy and typically nothing to worry about. Their function is to prepare your uterus for labor. These sensations should be mild and irregular. Any strong, painful, or regular contractions could be symptoms of preterm labor, especially if spotting or bleeding accompanies them.
If you experience anything that warrants an extra visit to your doctor or healthcare professional, they’ll examine you, monitor any contractions, and offer treatments, such as bed rest, for example, if necessary.
Now that you’re halfway through your pregnancy, it might seem like your baby is going to be here tomorrow! To help prepare, it’s a great time to:
- Continue to work on your birth plan and take a childbirth/postpartum/parenting prep course.
- Register for baby shower gifts.
- Schedule your next prenatal visit — generally about 4 weeks from now.
- Make sure you’re getting enough of the right nutrients and stock up on some prenatal vitamins.
- Take a prenatal exercise or yoga class.
You’ll want to avoid:
- spending long periods of time lying on your back
- smoking, alcohol, drugs, and consuming lots of caffeine
- activities that include a high risk of falling or trauma to the abdomen
Congratulations on reaching this major milestone in your pregnancy. Your due date may still seem far away, but you’re making steady progress toward the finish line.
Continue taking care of yourself by eating well, exercising regularly, and sleeping soundly.
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