20 Weeks Pregnant – What to Expect

Pregnant woman sits on table talking to her doctor

Hitting the 20-week mark is a big moment—you’re officially halfway through your pregnancy! This stage often brings a new wave of energy, visible baby bumps, and some exciting milestones. From feeling those first baby movements to checking in on development with a detailed ultrasound, here’s what to expect at 20 weeks pregnant.

Key Takeaways

You’re halfway through your pregnancy journey!
It’s time for the detailed anatomy scan to check in on baby’s development.
You’ll likely start to feel those first little flutters.
You might feel more energetic and experience fewer early pregnancy symptoms.

Your Body at 20 Weeks Pregnant

At this point, you are five months pregnant and your uterus has grown to your belly button level, making your bump more noticeable. With that comes a mix of physical changes—some fun, some less so.

Hair and Nails

Thanks to pregnancy hormones, you might notice thicker, fuller-looking hair (due to less shedding). Nails often grow faster too—sometimes stronger, sometimes more brittle. Eating well can help support healthy hair and nail growth.

Growing Appetite

With nausea usually fading by this point, your appetite might be picking up. Your body needs more calories now, but focus on nutrient-rich foods like fruits, veggies, whole grains, and lean protein. Small, healthy snacks like yogurt, nuts, or fruit can keep hunger at bay. Most expectant parents gain about 1–2 pounds per week around this time, which is completely normal and expected as your baby’s growth accelerates.

Common Symptoms

Even with more energy, the second trimester isn’t symptom-free. Some things you might notice:

Round ligament pain – Sharp twinges in your lower belly or groin from your stretching uterus.
Leg cramps – Especially at night; stay hydrated and stretch your calves.
Heartburn / indigestion – Smaller, more frequent meals can help.
Swelling – Mild swelling in hands and feet is common. Elevate your feet when possible.
Itchy skin – Especially around your belly and breasts. Keep moisturizing.
Backaches – Caused by weight gain and posture changes. Supportive shoes and good posture help.
Constipation – A side effect of progesterone. Stay hydrated and increase fiber intake.
Increased discharge – Normal as long as it’s thin, white, and mild-smelling. Anything unusual should be discussed with your provider.
Nasal congestion and nosebleeds – Hormonal changes cause nasal swelling. A humidifier can help.
Varicose veins and hemorrhoids – Circulation and pressure changes are to blame. Avoid standing too long and manage constipation to help.

Don’t hesitate to bring up any new or worsening symptoms at your next prenatal visit—even common issues are worth discussing for reassurance or support.

Baby Development at 20 Weeks

Your baby is growing fast and reaching new milestones each week.

Size Comparison

A 20-week fetus is about the size of a banana—roughly 10 inches long from head to heel and weighing around 10.5 ounces. Keep in mind: these are averages!

What’s Developing

Vernix caseosa – A white, waxy coating is forming on baby’s skin to protect it from the amniotic fluid.
Lanugo – A soft, fine layer of hair helps keep the vernix in place.
Senses – Hearing is improving, and baby may start responding to your voice. Taste buds are forming too!
Movements – More noticeable flutters, kicks, and even hiccups as baby grows stronger.
Organs – Lungs continue developing, and the digestive system is working by swallowing fluid and creating meconium.
Reproductive system – If you’re having a girl, her uterus and ovaries (with eggs!) are already formed. If it’s a boy, the testicles are beginning to descend.
Brain – Rapid growth is happening, especially in areas linked to senses and movement.
Sleep cycles – Baby is starting to have more regular periods of rest and activity (though not always synced with your sleep!).

It’s also a good time to start noting baby’s patterns and movements when you feel them—those gentle kicks are not just exciting but also a good sign of growth and activity.

Things To Do at 20 Weeks Pregnant

Anatomy Scan Time

The detailed mid-pregnancy ultrasound (typically between 18–22 weeks) gives you and your provider a close look at how your baby is growing. Organs, limbs, the placenta, and amniotic fluid levels are all assessed. It’s also the scan where many find out baby’s sex—if you choose to know.

You may want to jot down any questions ahead of this appointment, from how your baby’s developing to what’s coming next in your care plan.

Stay Active and Nourished

Gentle exercise (walking, swimming, prenatal yoga) can boost energy, reduce discomfort, and prepare your body for labor. Make sure you’re also getting plenty of iron, calcium, protein, and staying well hydrated. Pelvic floor exercises (like Kegels) are also worth adding to your routine. Talk to your provider before starting anything new.

Consider Childbirth Education

It’s never too early to sign up for a childbirth education class like Birthly’s. These cover everything from labor and pain management to newborn care and postpartum tips and are a great way to help build confidence as you get closer to baby’s arrival.

Bottom Line

The 20-week mark is an exciting milestone in pregnancy, signaling the midpoint of gestation and an opportunity to assess both maternal and fetal health. With the anatomy scan completed or scheduled, now is the time to focus on continued prenatal care, monitoring symptoms, maintaining a balanced diet and regular activity, and preparing for labor and delivery. As pregnancy progresses, staying engaged in your care plan and taking advantage of trusted resources can promote better outcomes for both you and baby.