Week by Week Pregnancy: 20 Week Pregnant

At 20 weeks pregnant, your baby is around 16.4 cm long from head to bottom and is roughly the size of a banana. You are now approximately halfway through pregnancy. Your baby continues to grow, move and develop, while a white, greasy protective coating called vernix caseosa covers their skin.

Week 20 can also be an exciting stage for baby movements. You may notice fluttering, bubbling, swirling or small kicks more clearly than before. Most people first feel their baby move between 16 and 24 weeks. If this is your first pregnancy, you may not notice movements until after 20 weeks.

This is also one of the most common times to have the 20-week screening scan. In England, the NHS scan is usually offered between 18 and 21 weeks and provides a detailed assessment of your baby's physical development.

You are approximately halfway through pregnancy.
Pregnancy is conventionally dated as around 40 weeks, making Week 20 roughly the halfway point. Your estimated due date is still an estimate, however, rather than a guaranteed date of birth.

Contents

• What Does Being 20 Weeks Pregnant Mean?
• Baby Development at 20 Weeks
• What Is Vernix Caseosa?
• What Do Baby Movements Feel Like at 20 Weeks?
• How Is Your Body Changing at 20 Weeks?
• Is 20 Weeks Halfway Through Pregnancy?
• What Can You See on an Ultrasound at 20 Weeks?
• What Are the Common Symptoms at 20 Weeks Pregnant?
• What Happens at the 20-Week Screening Scan?
• Frequently Asked Questions

20 Weeks Pregnant at a Glance

Week 20 highlight:
You have reached approximately the halfway point of pregnancy. Your baby is around 16.4 cm long and roughly the size of a banana. Movements may be becoming easier to recognise, and this is a common week to have your 20-week screening scan.

What Does Being 20 Weeks Pregnant Mean?

At 20 weeks pregnant, you are in the second trimester and approximately halfway through a pregnancy dated as 40 weeks. Your baby continues to grow while your womb expands and your pregnancy bump may become increasingly noticeable.

Your baby is active inside the womb. If you have already started feeling movements, you may find them easier to recognise this week. If you have not felt your baby move yet, this does not necessarily mean there is a problem.

Week 20 is also closely associated with the mid-pregnancy screening scan. Despite being commonly called the “20-week scan”, the exact timing can vary.

Baby Development at 20 Weeks

At 20 weeks, your baby is around 16.4 cm long from head to bottom and is approximately the size of a banana. Your baby continues to grow and gain weight while their body develops further.

Your baby's skin is covered by a white, greasy substance called vernix caseosa. This protective coating helps protect the delicate skin while your baby is surrounded by amniotic fluid.

Your baby can move their arms and legs, turn and change position inside the womb. Some of these movements may now be strong enough for you to recognise more easily.

For a broader look at how your baby changes throughout pregnancy, see our Baby Development in the Womb guide.

What Is Vernix Caseosa?

Vernix caseosa is the white, greasy protective substance that covers your baby's skin during pregnancy. It forms a protective coating over the developing skin while your baby is surrounded by amniotic fluid.

Some vernix may still be visible on a baby's skin after birth. It is a normal part of development in the womb.

Did you know?
Your baby spends months surrounded by amniotic fluid. Vernix caseosa provides a protective coating over the surface of the developing skin.

What Do Baby Movements Feel Like at 20 Weeks?

At 20 weeks, your baby's movements may feel like fluttering, bubbling, swirling, rolling or small kicks. If you have already started noticing movements, you may now find it easier to distinguish them from wind or normal digestive sensations.

Most people first feel their baby move between 16 and 24 weeks. If this is your first pregnancy, you may not notice movements until after 20 weeks.

There is no set number of movements that everyone should feel at this stage. As pregnancy progresses, what matters is becoming familiar with your own baby's usual pattern of movement.

If you have not felt your baby move yet:
Not feeling movement at 20 weeks does not necessarily indicate a problem. If you have not felt your baby move at all by 24 weeks, contact your midwife. They can check your baby's heartbeat and movements and arrange further assessment if needed.

How Is Your Body Changing at 20 Weeks Pregnant?

At 20 weeks, your growing womb can make your pregnancy bump more noticeable and continue to change your centre of gravity. These physical changes can affect your posture, balance and the way you move.

As the ligaments supporting your growing womb stretch, you may experience brief pulling or sharp sensations around the lower abdomen or sides of your bump. Backache, leg cramps, constipation, heartburn and occasional dizziness can also occur.

Changes in skin pigmentation may become more noticeable. You may develop a darker vertical line down the centre of your abdomen, known as the linea nigra.

Is 20 Weeks Halfway Through Pregnancy?

Yes. Because pregnancy is conventionally dated as around 40 weeks, Week 20 is commonly described as the halfway point.

This does not mean that you have exactly 20 weeks left until your baby is born. Your estimated due date is an estimate rather than a fixed date, and the length of pregnancy naturally varies.

If you are unsure about your pregnancy dates, you can use our Pregnancy Week Calculator and Due Date Calculator.

You are within the 20-week screening scan period.
The scan examines your baby's physical development in detail. It can provide important information about your pregnancy, but it cannot detect every possible health condition.

In Part 2:
We will look more closely at the 20-week ultrasound, your baby's size, what is examined during the screening scan, common pregnancy symptoms, abdominal and pelvic pain, vaginal discharge, swelling, nutrition, exercise and sleep.

What Can You See on an Ultrasound at 20 Weeks?

At 20 weeks pregnant, an ultrasound can provide detailed views of your baby's head, brain, face, spine, heart, arms, legs and several internal structures. You may also see your baby moving, stretching their arms and legs or changing position during the scan.

This is one of the most common stages for the 20-week screening scan. Rather than simply providing a general view of your baby, the sonographer systematically examines physical development and takes measurements to assess growth.

If your baby's position allows, the external genital area may also be visible. However, whether you can be told your baby's sex depends on the view available and local hospital policy. Finding out your baby's sex is not the purpose of the screening scan.

How Big Is Your Baby at 20 Weeks Pregnant?

At 20 weeks, your baby is around 16.4 cm long from head to bottom and is roughly the size of a banana.

These measurements are approximate. Babies do not all measure exactly the same at a particular stage of pregnancy, and ultrasound measurements are interpreted by healthcare professionals alongside your gestational age and other clinical information.

What Happens at the 20-Week Screening Scan?

The 20-week screening scan examines your baby's physical development in detail. In England, it is usually offered between 18 and 21 weeks. The NHS fetal anomaly screening programme uses a screening window of 18 weeks to 20 weeks + 6 days.

The scan screens for 11 physical conditions. The sonographer examines different parts of your baby's body, takes measurements to assess growth and checks the placenta.

Areas examined include your baby's brain, face, heart, spine, kidneys, abdomen and bones. However, the scan cannot detect every health condition or developmental difference.

The 20-week scan is a screening test.
A scan in which no concerns are identified cannot guarantee that your baby has no health conditions. Similarly, an unexpected finding does not necessarily provide a diagnosis. Further scans, diagnostic tests or specialist appointments may be offered if needed.

How Long Does the 20-Week Screening Scan Take?

The 20-week screening scan usually takes around 30 minutes. The exact length can vary depending on your baby's position, how easily the required views can be obtained and whether anything needs to be examined more closely.

If your baby is in a position that makes some views difficult to obtain, the sonographer may ask you to move around or change position. If the examination cannot be completed, you may be offered another appointment.

Can You Find Out Your Baby's Sex at the 20-Week Scan?

It may be possible to see your baby's external genital area if they are in a suitable position. However, finding out your baby's sex is not the medical purpose of the 20-week screening scan.

Whether the sonographer can tell you may depend on your baby's position, how clear the view is and the policy of the hospital where your scan takes place. It may not always be possible.

What Are the Common Symptoms at 20 Weeks Pregnant?

At 20 weeks, your growing womb and ongoing hormonal changes can cause a range of second-trimester symptoms. What you experience and how strongly you experience it can vary considerably.

You may notice stretching discomfort around the sides of your abdomen, backache, headaches, dizziness, nosebleeds, constipation, bloating, indigestion, heartburn or leg cramps. Mild, gradual swelling of your feet or ankles can also occur.

Increased vaginal discharge and skin pigmentation changes such as linea nigra may also become more noticeable.

Is Abdominal Pain Normal at 20 Weeks Pregnant?

Mild, short-lived abdominal discomfort can occur at 20 weeks. Stretching of the ligaments supporting your growing womb, constipation and trapped wind are among the common causes.

Round ligament pain can feel like a sharp, pulling or stretching sensation on one or both sides of your lower abdomen, particularly when you move suddenly. Mild discomfort that settles when you change position or rest is generally less concerning.

Contact your midwife or maternity service if the pain is severe, persistent or worsening, or if it occurs with vaginal bleeding, regular cramping, lower back pain, unusual discharge, fluid loss, a high temperature or pain when passing urine.

Can You Have Pelvic Pain at 20 Weeks Pregnant?

Pregnancy-related pelvic girdle pain can occur at this stage. Pain may be more noticeable when walking, climbing stairs, standing on one leg, turning over in bed or getting in and out of a car.

Speak to your midwife or GP if pelvic pain is making it difficult to move around or carry out everyday activities. Early assessment and physiotherapy where appropriate can help manage the symptoms.

Is Vaginal Discharge Normal at 20 Weeks Pregnant?

It is normal to have more vaginal discharge during pregnancy. Healthy pregnancy discharge is usually thin, clear or milky white and should not have an unpleasant smell.

Speak to your midwife or GP if your discharge smells unpleasant, becomes green or yellow, or is accompanied by itching, soreness or pain when passing urine, as these changes can be associated with an infection.

White, cottage cheese-like discharge accompanied by itching or irritation may be associated with thrush. Ask your midwife, GP or pharmacist about treatment that is suitable during pregnancy.

Discharge or leaking fluid?
If you think you are continuously leaking watery fluid or experience a gush of fluid from your vagina, contact your maternity service for advice rather than assuming it is normal pregnancy discharge.

Is Swelling Normal at 20 Weeks Pregnant?

Mild swelling that develops gradually, particularly around your feet and ankles later in the day, can occur during pregnancy. Sudden or rapidly increasing swelling should be assessed.

Seek medical advice promptly if you develop a sudden increase in swelling of your face, hands or feet, particularly if this occurs with a severe headache, blurred vision or flashing lights, pain just below your ribs, vomiting or feeling very unwell. These can be warning signs of pre-eclampsia.

From around 20 weeks, it is particularly important to recognise possible signs of pre-eclampsia.
Pre-eclampsia usually develops from 20 weeks of pregnancy. Blood pressure and urine protein checks during antenatal care help healthcare professionals look for signs of the condition.

What Should You Eat at 20 Weeks Pregnant?

A varied and balanced diet remains important at 20 weeks pregnant. Your meals can include fruit and vegetables, higher-fibre starchy carbohydrates, pregnancy-safe sources of protein and dairy foods or suitable alternatives.

You do not need to “eat for two”. Rather than doubling your portions, focus on dietary variety, balanced meals and following pregnancy food-safety guidance.

If constipation is a problem, fibre-rich foods and adequate fluids may help support regular bowel movements.

Can You Exercise at 20 Weeks Pregnant?

If your pregnancy is progressing normally and your healthcare professional has not advised otherwise, staying active during pregnancy is generally encouraged. Walking, swimming and pregnancy-appropriate exercise can be suitable options.

Try not to exhaust yourself. A practical guide is the talk test: you should generally be able to hold a conversation while exercising. If you become noticeably breathless while talking, reduce the intensity.

As your centre of gravity changes, take additional care with activities where there is a risk of falling or losing your balance. Stop exercising and seek medical advice if you experience vaginal bleeding, severe or persistent pain, significant dizziness, fainting or feel unwell.

What Should You Know About Sleep at 20 Weeks Pregnant?

Your growing bump, heartburn, leg cramps or backache may make it more difficult to find a comfortable sleeping position. Sleeping on your side and using pillows to support your bump or between your knees may help reduce pressure on your back, hips and pelvis.

The NHS advises going to sleep on your side from 28 weeks of pregnancy. You can sleep on either your left or right side.

If you wake up on your back, there is no need to panic. Simply turn onto your side again before going back to sleep.

In Part 3:
We will cover what can be considered normal at 20 weeks, when to contact your midwife or maternity service, bleeding, warning signs of pre-eclampsia, baby movements, the 20-week screening scan, common myths, your Week 20 checklist and frequently asked questions.

What Is Normal at 20 Weeks Pregnant?

At 20 weeks, a growing pregnancy bump, increasing awareness of your baby's movements, mild stretching discomfort, backache and digestive changes can all be normal. Pregnancy symptoms vary considerably from person to person, so you may experience several of these changes or very few.

Headaches, dizziness, nosebleeds, constipation, bloating, heartburn, leg cramps and increased vaginal discharge can occur. Mild swelling of the feet and ankles that develops gradually, particularly later in the day, can also happen during pregnancy.

It can also still be normal not to have clearly felt your baby move at 20 weeks. Most people first notice movements between 16 and 24 weeks, and in a first pregnancy this may happen after 20 weeks.

How Can You Support a Healthy Pregnancy at 20 Weeks?

During the second trimester, continue to focus on a balanced diet, regular fluids, pregnancy-appropriate physical activity and attending your antenatal appointments.

• Eat a varied and balanced diet.
• Drink fluids regularly throughout the day.
• Continue following pregnancy food-safety advice.
• Avoid alcohol and smoking.
• Do not stop prescribed medicines without speaking to a healthcare professional.
• Check before taking medicines, supplements or herbal remedies.
• Stay physically active if appropriate for your pregnancy.
• Continue pelvic floor exercises.
• Look after your teeth and gums.
• Attend your antenatal appointments and any screening you choose to have.

When Should You Contact Your Midwife or Maternity Service at 20 Weeks?

Many new symptoms can occur during pregnancy, but some changes should be assessed by a healthcare professional. Seek advice if a symptom is severe, persistent, getting worse or occurs alongside other concerning symptoms.

Contact your midwife, GP or maternity service if you experience:

• vaginal bleeding or spotting;
• severe, persistent or worsening abdominal or pelvic pain;
• regular cramps or tightenings;
• possible leaking of fluid from your vagina;
• unpleasant-smelling, green or yellow vaginal discharge;
• vaginal itching or soreness;
• pain or burning when passing urine;
• a high temperature;
• severe or repeated dizziness or fainting;
• vomiting that prevents you from keeping food or fluids down;
• significant pain, swelling, tenderness or warmth in one leg;
• sudden or rapidly increasing swelling of your face, hands or feet.

Some symptoms require urgent medical assessment.
Seek urgent medical help if you have heavy vaginal bleeding, severe abdominal pain, significant difficulty breathing, fainting, loss of consciousness or feel seriously unwell.

Is Bleeding Normal at 20 Weeks Pregnant?

Bleeding during pregnancy does not always mean there is a serious problem, but it should be assessed. The amount and colour of the bleeding, how long it lasts and whether you have other symptoms such as pain are all relevant.

If you experience vaginal bleeding or spotting at 20 weeks, contact your maternity service for advice. Seek urgent medical attention if the bleeding is heavy or accompanied by severe pain, dizziness, fainting or feeling seriously unwell.

What Are the Signs of Pre-eclampsia at 20 Weeks Pregnant?

Pre-eclampsia is a pregnancy complication that usually develops from around 20 weeks and requires medical assessment. Blood pressure and urine protein checks during antenatal appointments help healthcare professionals look for signs of the condition.

Seek medical advice immediately if you develop symptoms such as:

• a sudden increase in swelling of your face, hands or feet;
• a severe headache;
• problems with vision, such as blurring or flashing lights;
• severe pain just below your ribs;
• vomiting;
• feeling very unwell.

Sudden swelling is different from the mild swelling that can occur during pregnancy.
Gradual swelling of the feet and ankles can be common, particularly later in the day. A sudden increase in swelling, especially when accompanied by headache, visual changes or pain below the ribs, requires prompt medical advice.

When Is Abdominal or Pelvic Pain a Concern at 20 Weeks?

Mild abdominal discomfort can occur as your womb grows and the supporting ligaments stretch. Constipation and trapped wind can also cause abdominal discomfort during pregnancy.

Pregnancy-related pelvic girdle pain can make walking, climbing stairs, standing on one leg, turning over in bed or getting in and out of a car uncomfortable. Speak to your midwife or GP if pelvic pain is affecting your mobility or everyday activities.

Seek medical advice if abdominal or pelvic pain is severe, persistent or worsening, or occurs with bleeding, regular cramping, lower back pain, unusual vaginal discharge, leaking fluid, a high temperature or pain when passing urine.

Is It Normal Not to Feel Your Baby Move at 20 Weeks?

Yes. It can still be normal not to have felt your baby move at 20 weeks. Most people first feel movements between 16 and 24 weeks. If this is your first pregnancy, you may not notice them until after 20 weeks.

The first movements do not necessarily feel like obvious kicks. They can feel like fluttering, bubbling, swirling or gentle rolling sensations.

If you have not felt your baby move at all by 24 weeks, contact your midwife. They can check your baby's heartbeat and movements and arrange further assessment if necessary.

Once you regularly feel your baby moving, become familiar with their usual pattern.
If your baby is moving less than usual, you cannot feel them moving any more or their usual pattern changes, contact your midwife or maternity unit immediately. Do not wait until the next day.

What Should You Know About the 20-Week Screening Scan?

The 20-week screening scan is one of the key screening appointments of the second trimester. It examines your baby's physical development, includes measurements of your baby and checks the placenta.

In England, the NHS fetal anomaly screening programme offers the scan between 18 weeks and 20 weeks + 6 days. It screens for 11 physical conditions.

The scan can provide important information but cannot identify every possible condition. If your baby's position prevents the sonographer from obtaining all the required views, you may be offered another appointment to complete the examination.

Common Myths About Being 20 Weeks Pregnant

Your 20-Week Pregnancy Checklist

• ☐ Check the dates of your upcoming antenatal appointments.
• ☐ Keep track of your 20-week screening scan appointment.
• ☐ Continue eating a varied and balanced diet.
• ☐ Drink fluids regularly throughout the day.
• ☐ Follow pregnancy food-safety guidance.
• ☐ Check that medicines and supplements are suitable for pregnancy.
• ☐ Stay physically active if appropriate for your pregnancy.
• ☐ Continue your pelvic floor exercises.
• ☐ If you have started feeling movements, gradually become familiar with your baby's usual pattern.
• ☐ Remember that it can still be normal not to have felt movements at 20 weeks.
• ☐ Do not ignore sudden swelling, severe headaches or changes in vision.
• ☐ Seek medical advice for bleeding, severe pain or other concerning symptoms.

Key Takeaway

At 20 weeks pregnant, your baby is around 16.4 cm long from head to bottom and roughly the size of a banana. You are approximately halfway through pregnancy, your baby's movements may be becoming easier to recognise, and this is a common stage for the 20-week screening scan. From around 20 weeks, it is also particularly important to recognise possible warning signs of pre-eclampsia.

Frequently Asked Questions

How big is a baby at 20 weeks?

At 20 weeks, your baby is around 16.4 cm long from head to bottom and is roughly the size of a banana. Individual measurements can vary.

How many months is 20 weeks pregnant?

20 weeks pregnant is commonly described as being around 5 months pregnant. However, because calendar months vary in length, healthcare professionals use weeks rather than months to date pregnancy more accurately.

Which trimester is 20 weeks pregnant?

At 20 weeks pregnant, you are in the second trimester.

Is 20 weeks halfway through pregnancy?

Yes. In a pregnancy conventionally dated as around 40 weeks, Week 20 is approximately the halfway point. This does not mean your baby will necessarily be born exactly 20 weeks later.

What do baby movements feel like at 20 weeks?

Early movements can feel like fluttering, bubbling, swirling, rolling or small kicks. They usually become easier to recognise as pregnancy progresses.

Is it normal not to feel movement at 20 weeks?

Yes. Most people first feel their baby move between 16 and 24 weeks. In a first pregnancy, you may not notice movements until after 20 weeks. Contact your midwife if you have not felt any movement by 24 weeks.

Do you have the 20-week scan at exactly 20 weeks?

Not necessarily. In England, the scan is usually offered between 18 and 21 weeks. The NHS fetal anomaly screening programme uses a screening window of 18 weeks to 20 weeks + 6 days.

What is checked at the 20-week screening scan?

The sonographer examines your baby's physical development, including structures such as the brain, face, heart, spine, kidneys, abdomen and bones. Measurements are taken and the placenta is also checked.

Can you find out your baby's sex at the 20-week scan?

It may be possible if your baby is in a suitable position. However, this is not the medical purpose of the screening scan, and whether you can be told may depend on the view available and local hospital policy.

Should you have a visible bump at 20 weeks?

Your pregnancy bump may be clearly noticeable by 20 weeks, but there is considerable normal variation in the size and shape of pregnancy bumps.

Can pre-eclampsia start at 20 weeks?

Pre-eclampsia usually develops from around 20 weeks of pregnancy. Symptoms such as sudden swelling, a severe headache, visual disturbances or severe pain below the ribs require prompt medical advice.

What happens at 21 weeks pregnant?

At 21 weeks, your baby continues to grow and gain weight. Movements may become easier to recognise as you progress through the second trimester.

Related Guides

• 18 Weeks Pregnant
• 19 Weeks Pregnant
• Pregnancy Week Calculator
• Due Date Calculator
• Baby Development in the Womb

References

• NHS – 20 Weeks Pregnant
• NHS – Week-by-Week Guide to Pregnancy
• NHS – Your Baby's Movements
• NHS – 20-week Screening Scan
• NHS – Pre-eclampsia
• NHS – Pelvic Pain in Pregnancy
• NHS – Stomach Pain in Pregnancy
• NHS – Vaginal Discharge in Pregnancy
• NHS – Vaginal Bleeding in Pregnancy
• NHS – Swollen Ankles, Feet and Fingers in Pregnancy
• NHS – Exercise in Pregnancy
• NICE – Antenatal Care

Medical information: This guide provides general information and is not a substitute for personalised medical advice, diagnosis or treatment. If you have concerns about your pregnancy or symptoms, contact your midwife, GP or maternity service.