Your baby is the size of a bell pepper

20 Weeks Pregnant: Your Baby’s Development

Can you believe you’re now about half way through your pregnancy? There’s so much going on inside your ever-expanding bump at 20 weeks pregnant. Here are just some of the highlights.

Your little one is now covered from head to toe in a layer of ‘vernix’, a white, greasy substance that prevents your foetus’s delicate skin from drying out in the amniotic fluid. It also makes your foetus’s skin more slippery, making it a bit easier for him or her to pass through the birth canal, if you have a vaginal birth.

Your foetus is turning into a proper little gymnast! Sooner or later, in the weeks ahead – if it hasn’t happened already – you will experience the thrill of feeling his or her movements for the first time.

At first, this might feel like a fluttering or bubbling sensation in your tummy as your little one kicks, punches and turns somersaults.

The first few times, you may not even be sure that this is what you’re feeling, especially if this is your first pregnancy. In time, though, any uncertainty will fade away as the movements get progressively stronger.

Your little one could also be sucking his or her thumb – how cute is that? If you’re really lucky, maybe you’ll even get to see this at your mid-term ultrasound scan, which usually happens around the time you’re 20 weeks pregnant.

That thumb-sucking isn’t just for comfort. It’s helping to develop your little one’s sucking reflex that will be so vital for feeding after your baby is born.

The Size of the Foetus at 20 Weeks Pregnant

Now that you’re 20 weeks pregnant, your foetus is about the size of a bell pepper, measuring close to 25.6 centimetres from head to bottom, and weighing in at around 300 grams.

Check out the visual below for an illustration of what your little one might look like this week.

20 weeks pregnant

Mum’s Body at 20 Weeks Pregnant

Around this time, you might notice a dark line appearing down the middle of your belly, known as the ‘linea nigra’ (which just means ‘black line’ in Latin).

This is just a natural change in your skin’s pigmentation, as your tummy expands to make room for your growing bump. Don’t worry, this new look won’t last forever – it usually fades away within a few months after giving birth.

Common early pregnancy symptoms like morning sickness might be a thing of the past now. Many mums-to-be experience a burst of extra energy around this time, and you could also be walking on air if you’ve recently had the chance to catch a glimpse of your little one at the 20-week scan!

If you’re experiencing bouts of tiredness and sleeplessness, don’t worry. Every pregnancy is unique, and feeling tired can be natural during pregnancy, especially if your growing bump is making it harder for you to get comfortable in bed.

Lack of sleep and tiredness isn’t bad for your foetus, but it can be trying for you. Don’t feel shy about talking to your partner, other friends or family members, your midwife or doctor if a lack of sleep is getting you down. Read more about how your sleep patterns can change from one trimester to the next.

The safest sleeping position for you and your baby is on your side. It’s fine to support your bump with pillows as it gets bigger. Putting another pillow between your knees can also help. Pick up some more advice on how to get a better night’s sleep when you’re pregnant.

20 Weeks Pregnant: Your Symptoms

Here are some of the symptoms you may be experiencing at 20 weeks pregnant:

  • Constipation. This is a common complaint during pregnancy. It’s often due to the hormonal changes you’re experiencing. Ways to help avoid it include sticking to a healthy diet with plenty of fibre, and drinking enough water every day. Iron supplements can also cause constipation. Find out how to get more iron naturally through your diet, but ask your doctor before stopping taking any iron supplements you’re taking.

  • Stuffy nose. You might find your nose feels more blocked up than usual. This is caused by the veins in your nose swelling in response to hormones. It can be uncomfortable, but talk to your doctor before reaching for a nasal decongestant. These may not be safe to use during pregnancy.

  • Nosebleeds. Nosebleeds can occur more frequently when you’re pregnant. Again, it’s usually those pesky hormones that are to blame. Nosebleeds can be scary at first, but don’t panic – they’re rarely anything to worry about. To stem the bleeding, pinch the soft part of your nose just above the nostrils and keep holding firmly for 10-15 minutes while keeping your head tilted forwards. If the bleeding doesn’t stop, call your doctor or midwife straight away. Avoid blowing your nose or doing anything strenuous (including bending over) for at least 12 hours afterwards.

  • Lower back pain. As your bump expands and you gain pregnancy weight, your centre of gravity shifts forwards. This can strain your back, particularly towards the end of the day. Things you can do to prevent or ease the discomfort include wearing flat shoes, maintaining good posture and getting plenty of rest. Gentle exercise can also help strengthen your back muscles.

  • Strange dreams. If you’ve been having strange dreams or nightmares about your little one or childbirth, you’re not alone – lots of mums-to-be report this. If the dreams are stressing you out or making you anxious, talking to your partner or midwife about them might help. Relaxation or breathing exercises, or perhaps a little prenatal yoga, can also be great ways to lower your anxiety levels.

  • Swollen ankles, feet or fingers. Some swelling of the extremities is normal during pregnancy. The legs, ankles, feet and fingers are the most commonly affected. This is caused by water retention. It’s often worse at the end of the day. Try to avoid standing for too long, put your feet up whenever you can, and wear comfortable shoes and socks. You might even need to go up a shoe size. Gradual swelling is usually harmless, but sudden swelling could be a sign of a rare but serious condition known as pre-eclampsia. If your face, hands or feet start to swell up rapidly, call your midwife, doctor or maternity hospital immediately, especially if it’s accompanied by a severe headache, blurred vision, vomiting or a pain just below your ribs.

20 Weeks Pregnant: Things to Consider

  • At 20 weeks pregnant, you might be nearing your mid-pregnancy ultrasound scan, often known as the 20-week or ‘anomaly’ scan. This is usually offered sometime between 18-21 weeks. The aim of this examination is to make sure your foetus is developing properly, and to rule out certain conditions that can be detected during an ultrasound. At the scan, the sonographer will be taking a close look at your foetus’s bones, heart, brain, spinal cord, face, kidneys and abdomen.

  • During the 20-week scan you might also get the chance to find out whether you’re having a boy or a girl, if you’d like to. Let the sonographer know at the beginning of the examination if you would like to be given this information. Also, before you go in for the scan, check the hospital policy because not all of them allow the gender of the foetus to be revealed. Also, keep in mind, it’s never possible to be 100 percent certain of the gender, and if your little one is in an awkward position it can sometimes be impossible to tell.

  • You’re allowed to take your partner or a friend in with you to the ultrasound scan, so have a think about who you would like to have there with you. This is a great opportunity to share the experience of early bonding with your little one.

  • If you’re planning one last holiday before your new arrival puts other travel plans on hold, now is probably a good time. You’re well into the second trimester, so early pregnancy symptoms may have eased off a little, and moving around now is probably easier than it will be in the third trimester. Check with your doctor or midwife before planning any travel abroad, in case there are any issues that you don’t know about. If you do plan to travel abroad, it’s sensible to get health and travel insurance cover.

  • If you’re planning to fly, check the airline’s rules and regulations before booking your flights. It’s usually OK to fly at this stage of pregnancy, as long as you don’t have any complications and your doctor has given you the green light. Read about some other things to consider when travelling during pregnancy.

  • Is your partner feeling left out? There are plenty of ways to share the experience of your pregnancy. For example, you can take your partner with you to your ultrasound scans. Choosing a name together is another good way of involving your partner. If you’re stuck for ideas, check out these popular boy’s and girl’s names for inspiration. Taking your partner along to antenatal classes will help you both feel more prepared for after your baby’s birth, and you’ll also get the chance to meet other parents-to-be. Your doctor or midwife can advise you about what classes are available locally, but demand is often high so it’s best to book early. If you’re having a baby on your own, it’s still important to have a support network. Ask your midwife about self-help groups for one-parent families.

  • The ultrasound at 20 weeks might be your first peek at your baby, and this can make parenthood seem all the more real. See if you can get a printout of the ultrasound image so you can start your baby's first photo album. It might seem distant at 20 weeks pregnant, but in just a few months’ time, when your baby is born, you’ll be able to fill the album with many more prints.

20 Weeks Pregnant: Ask Your Doctor

  • Is your weight gain on the right track? If not, is there anything you could be doing differently?

  • Are there any medical risks associated with your chosen holiday destination? Do you have any complications that might affect how you can travel?

  • Can your doctor recommend a pediatrician?

  • Where can you find a hypnobirthing class in your area?

20 Weeks Pregnant: Your Checklist

  • Celebrate — you’re halfway there! Consider organising a date night with your partner to mark this milestone, or enjoy some “me time” as a way to reflect on what your body’s achieved so far and what’s to come in the second half of your pregnancy.

  • If you haven’t been offered a whooping cough vaccination yet at 20 weeks pregnant, talk to your midwife or GP about this important immunisation. The jab is voluntary, but without it your baby won’t have any protection against this dangerous disease in those first two months after birth when they can’t yet be immunised. If you get immunised around this time, the vaccine will pass to your little one through the placenta. Read more about whooping cough in babies.

  • Ask your doctor or midwife for a maternity certificate, also known as the MAT B1 form. You’ll need it to claim maternity pay and benefits.

  • Research nursery theme ideas and start thinking about how you would like to decorate your baby’s room.

  • Need help with finding the best baby name for your little one? Consider throwing a baby naming party.

  • Sign up for even more weekly pregnancy tips:

How we wrote this article
The information in this article is based on the expert advice found in trusted medical and government sources, such as the National Health Service (NHS). The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.