You’ve made it to the halfway point of your pregnancy! At 20 weeks pregnant, you can start the countdown to the arrival of your baby.

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You’re now in month five of your pregnancy, and by 20 weeks, scans can usually reveal the sex of your child if you choose to find out.

“Around 20 weeks there is often a pregnancy milestone known as ‘quickening’, which is the first time that you feel your baby move,” says Dr. Philippa Kaye, London-based GP who specialises in paediatrics and gynaecology.

Here’s everything you need to know about being 20 weeks pregnant, from how your baby is developing to your 20-week scan and what benefits you may be able to claim.

Your baby’s development at 20 Weeks

By now, your baby will be around 25 centimetres long – about the same size as a banana. This might seem like a big jump from 19 weeks, when babies are estimated to be 15cm long, but this is because the way they are measured changes at 20 weeks.

Whereas in earlier weeks, babies are measured from the top of their heads to their bottoms, now, they are measured from their heads to their heels, because their legs aren’t as curled up.

“At your 20-week scan, you may see them moving around or even doing more intricate motions, like sucking their thumb,” Dr. Philippa says. Babies can kick, punch, and turn around at 20 weeks, too.

“Their organs will all be present and the skin is protected by a white waxy coating called vernix caseosa, which helps protect the skin from the amniotic fluid. Their skin will also develop a fine coating of hair, called lanugo hair, which helps them maintain their body temperature and help the vernix stick to the skin.”

Your baby’s genitals are fully formed, which is why scans can tell you their sex. Baby girls will have a fully formed uterus, and ovaries containing about seven million eggs (this decreases to one or two million before they are born, and again to a few hundred thousand by puberty). Baby boys’ testicles are also fully grown but won’t have descended out of their abdomens yet.

Your body at 20 weeks

“As your bump continues to get bigger, you might notice stretch marks or changes to the skin over the bump, and a darker line of pigmentation (the linea nigra) may develop down the middle of your abdomen, generally from the belly button downwards,” Dr. Philippa says.

Check out other members of the MadeForMums community’s bumps at 20 weeks.

As skin stretches, it can feel itchy, and it’s common for mums-to-be to have itchy bumps. If that’s you, check out our guide on how to relieve itching in pregnancy.

“Some women will report that their skin improves due to the impact of pregnancy hormones, while others report that their skin becomes spottier and greasier, again due to hormones,” she says. “Some will notice dark patches on their faces, sometimes called the ‘mask of pregnancy’ or chloasma, and others that their hair is shinier and thicker.”

You might feel like there are bubbles in your stomach, or like you need to pass gas — but this could be your baby’s first movements, known as ‘quickening.’

“If this is your first pregnancy you might not notice quickening until a bit later — often women notice it earlier in subsequent pregnancies,” Dr. Philippa says. But “if the placenta develops anteriorly, on the front of the womb, it can be more difficult to feel the movements of the developing baby.”

20 weeks pregnant symptoms

“As always, you might experience lots of symptoms or very few, aside from a growing bump,” Dr. Philippa says. “Having symptoms or not does not necessarily indicate an issue with the developing baby.”

“Some women will have difficulties sleeping, or feel tired, while others will feel more energised than in the first trimester. You may notice that you feel hotter than usual, have more tender breasts, are bloated and constipated, develop heartburn or indigestion, have nosebleeds, or have bleeding gums especially when you brush your teeth,” she says.

Here are some other common symptoms of being 20 weeks pregnant, with advice from Dr. Philippa on how to manage them:

  • Cramps, especially in the legs: “Try to ensure that you stay hydrated, and there are stretching exercises that you can do to help,” she says. “However, if you develop calf pain on one side, perhaps with swelling, seek urgent medical attention.”
  • Diarrhoea: “Constipation is a common symptom related to pregnancy but if you develop diarrhoea try to ensure that you stay well hydrated. If it persists, or if there is blood in the diarrhoea, seek medical advice,” she says.
  • Pelvic pain: “There may be some discomfort in your pelvis and lower back during pregnancy which is often related to the effects of pregnancy hormones relaxing the muscles and ligaments in your pelvis and lower back. Sometimes physiotherapy and other support is needed, and if it is severe please see your doctor.”
  • Swollen ankles: “Swollen ankles are a common symptom of pregnancy, but if the swelling comes on or worsens suddenly, and/or is associated with swelling of the hands, headaches or nausea/vomiting, please seek medical advice as these could be signs of pre-eclampsia or eclampsia,” Dr. Philippa says.

Tips for a healthy pregnancy

“Dietary advice remains the same throughout pregnancy,” Dr. Philippa says. That means no alcohol, limited caffeine, and dietary restrictions like avoiding certain cheeses, raw or undercooked meat, eggs that don’t have the Red Lion stamp, too much fish, and enoki mushrooms.

“From around 16 weeks of pregnancy it is advised to try and avoid lying on your back as the growing weight of your womb can compress the blood vessels to and from the uterus and baby,” Dr. Philippa says. Instead, “try to lie on your left-hand side to sleep and avoid exercise which involves lying on your back.”

You can also get a whooping cough vaccination at this time — it’s available from 16 weeks to week 32.

“This is given because whooping cough is increasing in the UK and by vaccinating you, as the pregnant woman, can protect your baby for the first few weeks of life until they have their own vaccinations,” Dr. Philippa says. “The vaccine will mean that you produce antibodies to whooping cough which pass through the placenta to give your baby protection.”

“If it is coming up to, or during flu season, from September to March you will also be offered a flu vaccine,” she says.

The NHS recommends you start doing pelvic floor exercises at this point, to prevent any leakage when you do things like laugh, sneeze, or cough.

Things to start preparing for now

Mums tend to have an ultrasound scan at 20 weeks, known as the anomaly scan. As we mentioned, you can usually tell the sex of your baby at this scan, using the three lines method.

“The baby’s organs and development as well as the placenta may be checked” at this scan, too, Dr. Philippa says.

You can also get what is known as the Maternity Certificate, or MAT B1 form, from your midwife or doctor at 20 weeks. You need this to claim maternity pay or benefits (like free prescriptions or dental care), as well as to confirm your pregnancy.

The NHS also recommends you start thinking about telling your employer that you’re pregnant. You have to tell them by 15 weeks before the baby is due (so before you reach 25 weeks pregnant), so you don’t have too long left. Once you’ve told your job that you’re expecting, you are entitled to maternity rights, can attend antenatal appointments during work time, and can ask for a risk assessment of your workplace.

Please note: this advice is not personalised or meant to replace individual advice given to you about your child by your doctor or medical team. As always, if you are concerned about your or your child’s health then please seek medical advice.

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