20 weeks pregnant: baby's development, the 20-week scan and your mental wellbeing

If they stood up straight your baby would be around 26cm tall, nearly the length of an A4 piece of paper!

Your baby’s development this week 

Your baby’s skin is now coated in a white, creamy substance called vernix. This is thought to protect their skin while they're in the womb.

When you see your baby at the anomaly scan, you might see them sucking their thumb. They're practising their sucking reflex, which is important for when they start feeding.

Your pregnancy symptoms in week 20

Congrats – you’re halfway through your pregnancy!

Feeling cold

Most people feel warmer than usual during pregnancy. This is because of hormone changes and increased blood supply to the skin.

Some people feel colder than usual in pregnancy. This does not necessarily mean that there is something wrong. It may just be that your body is going into overdrive while it tries to cool down.

But there are some conditions that may make you feel cold where you need treatment. So, if you are feeling chilly, the best thing to do is talk to your midwife.

Are you feeling constipated? Or suffering from cramps, dizziness or bleeding gums?

Here’s our guide to 10 common pregnancy complaints (and how to avoid them).

Mental wellbeing

It's not uncommon to develop mental health difficulties such as depression or anxiety during pregnancy, even if you have never had an issue with your mental health before. You may find it helpful to complete a pregnancy and post-birth wellbeing plan to help you think about your mental wellbeing. It will also help you think ahead for after the birth.

Talk to your GP or midwife if you start feeling sad more than you feel happy. They will help you manage your symptoms and get any extra support you need. You may also find it helpful to talk to trusted friends and family, who will do what they can to help. 

Read more about the difference between hormonal changes in pregnancy and mental ill-health.

If you’ve experienced baby loss before, it may be difficult to manage any anxiety. Some people find it helpful to talk to other people going through the same experience. You could try joining the Tommy’s pregnancy and parenting after loss support group.

What to do in week 20

Can I trust pregnancy apps?

There are hundreds of pregnancy apps available and they can be fun to use. But it’s important that you don’t use these instead of your antenatal care or medical guidance from your midwife or doctor.

Find out more about pregnancy apps.

Anomaly scan

You’ll have your second scan, known as the fetal anomaly scan between 18 and 21 weeks. The reason for this scan is to check the physical development of your baby.

In most cases, the scan will show that the baby appears to be developing as expected. But sometimes they may show that you or your baby have an increased chance of health problems. Or you may be referred to a fetal medicine specialist for a more detailed ultrasound scan. 

We are here for you if this happens. You can contact our midwives on 0800 014 7800 or email [email protected].

The charity Antenatal Results and Choices offers specialised support for anyone with a suspected or diagnosed fetal anomaly. 

Read more about pregnancy ultrasound scans.

Keep up the healthy eating habits

You may be missing the days of eating and drinking what you want, but it’s important to keep going with the healthy eating habits. This means avoiding alcohol, limiting your caffeine and avoiding the foods that may harm your pregnancy.

Eating well can be harder if you’re on a budget or if you have limited cooking equipment or space. Here are some tips to help you eat well on a budget.

Coping with unwanted advice

“I was asked, on more than one occasion during my pregnancy, how I was going to feed my baby. It felt almost rude not to engage at first, but as my pregnancy progressed I knew I didn’t need any more pressure. Soon, if anyone asked me any invasive questions, I’d just say ‘I’ll talk to my partner and midwife about that’. People got the message!”

Every parent has a story about unhelpful advice, comments, or questions they received during their pregnancy.

These conversations are often well-intentioned and can sometimes be useful or encouraging. But they can also be unhelpful, intrusive, or even alarming.

Sometimes it can be hard to drown out the noise. It may help to vent to friends and family you trust about these conversations. But don’t be afraid to say that you don’t want to talk about something if you are feeling uncomfortable or anxious. You’ve got a lot to deal with at the moment, and you shouldn’t feel any pressure to listen to anything that doesn’t help you now.

1. NHS. You and your baby at 20 weeks pregnant. https://www.nhs.uk/pregnancy/week-by-week/13-to-27/20-weeks/ (Page last reviewed: 13 October 2021 13 October 2024)

2. NHS. Common health problems in pregnancy. https://www.nhs.uk/conditions/pregnancy-and-baby/common-pregnancy-problems/ (Page last reviewed: 8 March 2021 8 March 2024)

3. The Royal College of Obstetricians & Gynaecologists (February 2017) Maternal Mental Health – Women’s Voices https://www.rcog.org.uk/globalassets/documents/patients/information/maternalmental-healthwomens-voices.pdf

4. NICE (2015). Antenatal care. National Institute for health and care excellence https://www.nice.org.uk/guidance/ng201

Review dates
Reviewed: 11 July 2022
Next review: 11 July 2025