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20 weeks pregnant - all you need to know

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

20 weeks infographic.

What does my baby look like in week 20? 

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 starts to nurse.

Your pregnancy symptoms in week 20

Are you feeling constipated? Perhaps you’re suffering from cramps, dizziness or bleeding gums?

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

The linea nigra

Noticed a dark vertical line going up your belly? This is called a linea nigra and sometimes appears around this time. It's nothing to worry about and will disappear eventually after the birth.

Mental wellbeing

It's not uncommon for women to become mentally unwell in 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.

If you start feeling sad more than you feel happy and the feeling doesn't go away the important thing to do is to talk to someone. Your GP or midwife will be able to tell if you need extra support. Read more about the difference between hormonal changes and mental ill-health.

What to do in week 20

Anomaly scan

Many of you will have your anomaly scan this week - it will show how your baby is growing, check the health and position of your placenta, and highlight any visible problems with the way your baby’s body is developing.

It also gives you the chance to see your baby in amazing detail. Is he sucking his thumb in your ultrasound pictures?

Check out our FAQs about antenatal care.

What are the benefits of pilates during pregnancy?

Pilates strengthens and stretches your core muscles, and helps your body cope with carrying the extra weight of your growing baby. It can also help prepare you for childbirth and for recovering afterwards.

'Pregnancy yoga was seriously relaxing and "me time".'Michelle, mum of one

In particular, it’s well worth toning up your pelvic floor muscles, doing the exercises as often as you can.

Find out more about pilates in pregnancy.


Lennart Nilsson (2009) A Child is Born, Johnathan Cape

Macdonald S, Magill-Cuerden J (2012) Mayes’ Midwifery, 14th edition, London, Ballière Tindall

NICE (2008) Antenatal care for uncomplicated pregnancies,Clinical guideline [CG62] Last updated: January 2017.

RCOG (2006) Recreational Exercise and Pregnancy: Information for you, London, Royal College of Obstetricians and Gynaecologists:

Royal College of Psychiatrists, Mental health in pregnancy, London RCP, 2012

National Institute for Health and Care Excellence, Antenatal and postnatal mental health: clinical and service management guidance, clinical guideline 45, London NICE, 2007.

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    Last reviewed on June 26th, 2018. Next review date June 26th, 2021.

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    Please note that these comments are monitored but not answered by Tommy’s. Please call your GP or maternity unit if you have concerns about your health or your baby’s health.
    • By Tolu (not verified) on 19 Mar 2020 - 12:33

      Am 20weeks now, my under lower abdomen is heavier, I can't sit, or sleep am just feeling cramp, should I b worry

    • By Grace tina (not verified) on 3 Mar 2020 - 08:23

      I was confirmed pregnant but I went for a scan at 17weeks and my sonographer told me I had fibriod about 2.4cm each.av been worried,what do I do

    • By Mary (not verified) on 23 Jan 2020 - 13:22

      Pls I want for scan and it say my placenta is in posterior position, is any hope me to deliver through vagina by myself.

    • By By Peace (not verified) on 2 Jan 2020 - 22:44

      I am 20 weeks pregnant and haven't gone for any scan yet or for atenatal, and I usually feel a sharp pain at my abdomen each time I try bending down, but for two days now I have not been feeling the sharp pain. And I'm worried. I hope all is well with my baby. Thanks

    • By ABI (not verified) on 10 Dec 2019 - 14:22

      I am 20 weeks pregnant. I first felt my baby's kick 9 days ago. since then, all I feel are something that feels like bubbles in my tummy? anyone experienced that before?
      I always think my baby is farting when I feel it. hhahahaahaa

    • By Mandy (not verified) on 13 Mar 2020 - 13:59

      Those are only kicks, so dont worry. I have been feeling this as well and im also 20 weeks pregnant

    • By Crux (not verified) on 3 Dec 2019 - 12:42

      I am 20weeks pregnant and my sonographer scanned me and told me that i am having Fibriod in my uterus... And since then I have been so worried.

    • By Candela Fernandez (not verified) on 14 Nov 2019 - 22:52

      Hi, 20 weeks pregnant and I had my second scan a week ago and everything was normal. Since the beginning of check ups everything has been normal but this week I noticed i just suddenly gained a lot of weight. Should I be worried about it? Thank you!

    • By Midwife @Tommys on 19 Nov 2019 - 12:20

      Hi Candela - here is a link to weight gain in pregnancy page. I hope you will find this helpful, Tommy's Midwife

    • By Bianka (not verified) on 11 Nov 2019 - 15:05

      hi! so today i found out that I'm around 20 weeks pregnant. I ignored the symptoms i had, not even thinking that i might be pregnant. I had no morning sickness, no extraordinary cravings, only hectic nose bleeds en cramps and obviously weight gain. I listened to my baby's heartbeat and felt him/her kicking. My question is: the midwife told me that i have a very busy baby in my tummy, as i am sitting now, i can feel him/her kicking. Some times, too much! Is it a bad thing? Must I be worried?

    • By Midwife @Tommys on 11 Nov 2019 - 16:03

      An active baby is nothing to worry about. be reassured by the movements x

    • By Richel taghoy (not verified) on 8 Nov 2019 - 12:35

      Hi. I am 20 weeks and 1 day pregnant and I cannot feel the movements of my baby.I'm so worried coz I had a miscarriage before.

    • By Ali (not verified) on 21 Nov 2019 - 02:36

      Hi, I didn’t feel movement with my first baby until around 23 weeks. I was the same with second. Now I’m on my third I can feel movement earlier. Hopefully you have a scan soon for reassurance. If not give your gp or midwife a call just for some reassurance x

    • By Jasmine (not verified) on 7 Sep 2019 - 02:19

      I am now 20 weeks pregnant and my baby moves a lot to the point I feel like it’s moving too much. I’ve been able to feel my baby move since I’ve been 17 weeks. The movements really hurt me and I try to rub and hold my belly to calm him down but that doesn’t work. Should I be worried? This is my third child I’m pregnant with also and neither of my other two pregnancies were as painful as this one or they weren’t as active as this one was until my third trimester.

    • By Nitu roy (not verified) on 30 May 2019 - 12:38

      In 19 week i was went to doctor checked me and prescribe madicine...but doctor does not prescribe for anomaly scan or terget question is that iam in now 20 week, as i had not doing this test, in future weither i get any problem regarding growth of baby?? Any serious i will face in future??? Pliz help me..i got tense..

    • By Mandy (not verified) on 13 Mar 2020 - 14:04

      You should contact your doctor and make an appointment to get a requisition for ultrasound scan and then go for your ultrasound. You'll have to call the ultrasound clinic to make an appointment where you want to get the scan. You have yo just followup with your GP. This is what i did

    • By Nitu roy (not verified) on 30 May 2019 - 12:36

      In 19 week i was went to doctor checked me and prescribe madicine...but doctor does not prescribe for anomaly scan or terget question is that iam in now 20 week, as i had not doing this test, in future weither i get any problem regarding growth of baby?? Any serious i will face in future??? Pliz help me..i got tense..

    • By Nitu roy (not verified) on 30 May 2019 - 12:28

      20 week pragnancy now i face belly i over come from this their is any complication??ples asist me what might i do?

    • By Shakera (not verified) on 2 Feb 2019 - 04:37

      I'm now 20 weeks pregnant, and I have four fibroids and two ovarian cysts. I found out in October then at the end of the month going into November I found out also about my pregnancy. The first time I found out the fibroids measured from 3cm,4cm & the biggest one was measuring 7cm, the cysts measured 2 &3cm. The baby didn't showed up in the scan yet as it was too early. I'm sure they are now growing with my baby as I can feel one on the left side of my tummy and it's very uncomfortable. Do u think I'll go full term with my pregnancy? I'm schedule for an scan in two weeks time.

    • By Midwife @Tommys on 14 Feb 2019 - 14:53

      Hi Shakera, Thank you for your comment.

      Going full term will all depend upon the location of the fibroids and the cysts. Are they in the uterus at all? Sometimes as the pregnancy grows, so do the fibroids, so you should have additional monitoring if this is the case. It is difficult to say if you will go full term, it will depend if the fibroids are causing you any problems or the baby's growth is effected, but again please feel reassured that you will be monitored. Women who have fibroids and cysts do go on to have healthy pregnancy's so keep all your antenatal appointments and scans and if you have any questions then you must ask at your appointments so that you are fully informed of what is happening and you have a clear understanding of your plan of care. Hope this helps, Take Care, Tommy's Midwives x

    • By Sophie litherland (not verified) on 28 Dec 2018 - 20:33

      Im o rehsus negative with my scan baby had my blood test at 16 weeks to determine weather babys mine or positive should i be worried as i havent heard anything yet x

    • By Midwife @Tommys on 9 Jan 2019 - 13:01

      Hi Sophie. You do not need to worry.
      At your first antenatal appointment you are likely to be offered several blood tests. One of the tests is to find out your blood group. Your blood may be in one of four groups: A, B, AB or O.
      The blood will also be either ‘rhesus positive’ or ‘rhesus negative’. People whose blood is rhesus positive have a substance known as D antigen on the surface of their red blood cells. Rhesus negative people do not.
      About 15% of women are rhesus negative. Being rhesus negative isn't usually a concern for a first pregnancy. But it might mean some extra care is needed to avoid problems if you get pregnant again.A woman with rhesus negative blood in pregnancy can be pregnant with a rhesus positive baby if the baby's father is rhesus positive. If any of the baby’s blood enters the woman’s bloodstream, the woman’s immune system can develop antibodies (infection-fighting proteins) against the rhesus antigens. This is known as sensitisation. A transfer of blood can occur during birth, or if the woman has a bleed or an injury. Production of the antibodies is not a problem in a first pregnancy, but when a woman with a rhesus negative blood type is pregnant next time with a rhesus positive baby, her antibodies can attack that baby’s red blood cells. This can result in a serious condition called haemolytic disease of the newborn, which leads to anaemia and jaundice in the baby.If the woman is given an injection of a solution called ‘Anti-D’, it will ‘mop up’ any rhesus positive antigens, preventing production of antibodies against the baby. Anti-D injections reduce the risk of a rhesus negative woman becoming sensitised.
      NICE recommends routine antenatal administration of Anti-D to all rhesus negative women in case sensitisation occurs. This can be given as a one-off dose at 28 to 30 weeks or as two doses at 28 and 34 weeks. It is quite safe for both the mother and the baby.
      All the best, Tommy's Midwife

    • By coleni (not verified) on 21 Nov 2018 - 06:31

      Hi. I am kind of bothered by the fact that I have hit my 20th week of pregnancy (Yes, it's my first pregnancy); but I am still unable to feel my baby. Not even a tiny bit or "butterflies" as they call it. Should I be worried?

    • By Midwife @Tommys on 21 Nov 2018 - 16:04

      No this is quite normal in a first pregnancy. You should start to feel movements in the next few weeks and if you haven't felt anything by week 24 speak to your midwife.

    • By Annika (not verified) on 22 Nov 2018 - 21:55

      I am 20 weeks and 2 days and have only felt my baby once. It was last week and it was only because I laid on my back all day and held my tummy all day long - it was such a faint feeling too that I wasnt sure if it was real. I went for my scan today and the lady said it was because my placenta is at the front acting as a barrier. She said there was no problem at all and it will move up but it does mean it takes a bit longer to feel it, and that my baby girl is perfectly normal and healthy! I hope this has you worrying a little less!

    • By Futhi (not verified) on 17 Sep 2018 - 21:36

      Is it normal to have abdominal pains. It Come and goes and its my first time being pregnant. I don't know what to do and I'm scared to take pain killers

    • By Midwife @Tommys on 20 Sep 2018 - 13:17

      Hi Futhi, Thank you for your comment.
      Experiencing lower cramping pains in early pregnancy can be normal as all the ligaments and muscles are stretching but if this pain is severe enough to take pain killers then it would be advisable that you are seen by your midwife, GP or antenatal day unit so that you can be checked over. It could be that you may have a urine infection that is causing this discomfort but please get checked over at this time. Take Care, Tommy's Midwives x

    • By Iwu (not verified) on 19 Jun 2018 - 14:30

      Can I know the sex if my baby without going for ultrasound?

    • By Midwife @Tommys on 21 Jun 2018 - 16:53

      Hi Iwu,
      It would not be possible to be able to know the gender of your baby without an ultrasound scan.
      Best wishes
      Tommy's midwife

    • By Kier (not verified) on 18 Oct 2018 - 15:17

      yes you can find out gender through a genetic test (blood test), you dont have to have ultrasound. i found out baby gender at 10 weeks through blood work.. later at 20 weeks I had an ultrasound which only re-confirmed again it was a girl.

    • By Midwife @Tommys on 22 Oct 2018 - 16:06

      You are correct, but many units have a policy of not disclosing the gender at this early stage and will only tell the parents the gender at the 20 weeks scan.

    • By Midwife @Tommys on 9 Nov 2017 - 15:16

      Thank you for your comment. I hope that you have had your 1st scan, midwife booking appointment and started your antenatal care. If you are 18-21 weeks pregnant you may be having (or already had) your fetal anomaly scan which is where the ultrasonographer checks that your baby is growing and developing normally.

      'At 18 to 21 weeks
      The second scan, known as the ‘fetal anomaly scan' shows:
      how your baby is growing
      the health and position of your placenta
      if there are any visible problems with the way your baby’s body is developing.
      Boy or girl?
      At your second scan, the sonographer may be able to see if your baby is a boy or a girl.
      Tell them if you would like to know – and tell them too if you don’t want to find out until the birth.
      The point of the scan is to check the health and growth of your baby and some hospitals may have a policy of not looking at gender. And your baby might be lying in a position that doesn’t let the sonographer see the gender.
      Just for fun, see whether old wives' tales can predict if you're having a girl or a boy on the BabyCentre website.'

      I have attached a link with more information that you may find helpful
      Take care

    • By Portis (not verified) on 9 Nov 2017 - 14:55

      I want to know my baby it's are boy or girl

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