Week 20: Halfway There! 🎉
Congratulations — you're halfway through your pregnancy! This is typically the week for the detailed anatomy scan, where you can often learn the sex of your baby.
Medically reviewed by Samantha L. Fox, RN, BSN, MSN
Nursing Informaticist · United States Navy Nurse Corps · Last reviewed
Your baby is the size of a...
🍌 Banana!
👶 Baby Development
- ✓Baby is now measured from head to toe (not head to rump)
- ✓Swallowing more and producing meconium (first stool)
- ✓Can hear and recognize your voice
- ✓Taste buds are functional — baby can taste amniotic fluid
- ✓Nails cover the fingertips
- ✓Regular sleep and wake cycles established
💊 Common Symptoms
- •Visible baby bump — no hiding it now!
- •Feeling strong kicks and movements
- •Heartburn and indigestion
- •Shortness of breath as uterus pushes up
- •Swelling in hands, feet, and ankles
- •Leg cramps and restless legs
🩺Clinical Context — From a Nurse's View
You're halfway. The anatomy scan, if not done at 18 weeks, is happening now. Fundal height (centimeters from pubic bone to top of uterus) should be approximately 20 cm and within 2 cm of your gestational age. Movement is becoming consistent — most people feel daily, predictable patterns by 22-24 weeks. There's no value in formal kick counts at 20 weeks; that's a third-trimester practice. What's worth tracking now is whether the baby moves at all on a given day. A full day without any perceived movement at 20 weeks does warrant a call to your provider — usually it's positional, sometimes it's the placenta, occasionally it's worth a non-stress test. Preeclampsia surveillance starts here too: blood pressure should still be at or below your baseline. Anything climbing toward 140/90 with proteinuria, severe headache, RUQ pain, or visual disturbances is preeclampsia until proven otherwise.
Written by Samantha L. Fox, RN, BSN, MSN — Emergency Department nurse, US Navy Nurse Corps officer.
🚨 When to Call (or Go to the ER)
- !Severe headache, visual changes, RUQ pain, swelling — call same day (preeclampsia)
- !Vaginal bleeding — call
- !A full day without any perceived fetal movement — call
- !Severe persistent abdominal pain — call
✅ Normal — Even If It Feels Worrying
- ✓Bump clearly visible
- ✓Strong, predictable movements
- ✓Heartburn (progesterone relaxes the lower esophageal sphincter)
- ✓Slight shortness of breath
✅ To-Do This Week
- Attend your anatomy scan ultrasound! 📸
- Celebrate the halfway mark — you deserve it!
- Start planning the nursery in earnest
- Register for birthing classes
- Review your health insurance for delivery coverage
- Begin thinking about your birth plan preferences
🩺 Questions for Your Doctor
- ?Are all the anatomy scan measurements normal?
- ?Where is the placenta located?
- ?Is the baby's size appropriate for this stage?
- ?Should I be concerned about any findings?
- ?How often should I feel the baby move?
- ?What's the protocol if something looks unusual?
📚 References
- [1]ACOG Practice Bulletin No. 175: Ultrasound in Pregnancy. Obstet Gynecol. 2016;128(6):e241-e256.
- [2]ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260.
- [3]ACOG Practice Bulletin No. 229: Antepartum Fetal Surveillance. Obstet Gynecol. 2021;137(6):e116-e127.
Editorial review: Samantha L. Fox, RN, BSN, MSN. Last reviewed: see footer.
Your baby is the size of a...