Quick answer: Week 20: Full organ checklist, soft markers explained, placenta position, next steps.
Week 20 puts you in the second trimester — often called the golden period of pregnancy, and for good reason. Energy typically improves, nausea subsides, and the pregnancy becomes physically and emotionally more comfortable for most women.
Baby Development This Week
At week 20, your baby is approximately the size of a banana — measuring around 6.5 in / 16.5cm. Halfway there! Baby swallows amniotic fluid and kidneys produce urine. All organs are now formed and the focus has shifted entirely to growth and maturation. Your baby is increasingly responsive to sound, light, and touch.
Symptoms You May Feel
Common week 20 second trimester symptoms include: round ligament pain (sharp, brief twinges on the sides of your abdomen as the uterus grows rapidly), Braxton Hicks contractions (occasional irregular tightening — harmless practice contractions), back pain as your center of gravity shifts forward, nasal congestion from increased blood volume, skin changes including the linea nigra (dark line down the abdomen) and possible chloasma (facial darkening), and for many women, a welcome increase in energy and libido compared to the first trimester.
Full organ checklist, soft markers explained, placenta position, next steps
The 20-week anatomy scan checks the brain (ventricles, cerebellum, corpus callosum), heart (four chambers, outflow tracts, valves), spine (continuity, skin covering), kidneys and bladder (present and functioning), stomach, abdominal wall closure, limbs and feet, face (lips, nose, cleft screening), and umbilical cord insertion. Soft markers — isolated findings that slightly increase chromosomal risk — are interpreted in context of age, prior screening, and whether they appear in isolation or combination. Placenta position is noted: grade 0–4 previa. If the placenta is low-lying, a repeat scan at 32 weeks is standard to assess migration. After this scan, discuss results with your OB even if told ‘everything looks normal’ — understanding what was checked is useful.
When should I feel the baby move at week 20?
Week 20 is the midpoint of pregnancy. By now, most first-time mothers have felt movement at least occasionally; it becomes more consistent and recognizable over the next few weeks. The anatomy scan (if not already done) should happen this week or within the next 2 weeks — after 22 weeks some structural findings become harder to assess. Growth at 20 weeks: approximately 25cm from head to heel and 300g. The uterus reaches the navel at approximately 20 weeks, which is why this is often called the halfway point.
Practical Tips for Week 20
- Start pelvic floor exercises (Kegels) now — 3 sets of 10-second holds, 3 times daily pays dividends postpartum.
- Consider a pregnancy pillow as your bump grows — better sleep protects energy and mood.
- Book prenatal/childbirth classes early — good ones fill up months in advance.
- Continue prenatal vitamins and increase iron-rich foods as blood volume expands significantly.
- Walk 30 minutes daily — the evidence for maternal and fetal benefits is consistent and strong.
- Begin researching your birth plan options and discussing preferences with your provider.
When to Call Your Midwife or OB
Contact your provider for: regular contractions before 37 weeks (more than 4 per hour), decreased fetal movement, severe headache with visual changes, sudden swelling of the face or hands, any bleeding, or fever above 101°F / 38.3°C. Trust your instincts — if something feels different or wrong, call.
Frequently Asked Questions
When should I feel the baby move at week 20?
First movements (quickening) are typically felt between weeks 16–25. First-time mothers usually notice them later than those who’ve been pregnant before. Early movements feel like flutters, bubbles, or light taps — easily confused with gas. They become unmistakable kicks and rolls as the weeks progress. If you have an anterior placenta (at the front of the uterus), it cushions movement and you may feel it later than expected.
Is lower back pain normal in the second trimester?
Very much so — it affects around 50% of pregnant women. Your growing uterus shifts your center of gravity forward, your ligaments loosen from relaxin, and your posture compensates in ways that strain the lumbar spine. Prenatal yoga, swimming, a maternity support belt, and sleeping with a pillow between your knees all provide significant relief. If pain is severe, radiates down the leg, or is accompanied by numbness or tingling, mention it to your provider.
When should I start buying baby gear?
Week 20 is a reasonable time to start researching — particularly big-ticket items like strollers, car seats, and cribs that may need to be ordered months in advance. Most parents wait until after the 20-week anatomy scan (when risk drops significantly) before major purchases. Baby showers are typically held in the third trimester, so let that guide the timing of purchases you expect as gifts.
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Related Reading
- 19 weeks pregnant: anomaly scan window opening
- 21 weeks pregnant: anatomy fully visible on scan
- Pregnancy symptoms week by week: what’s normal when
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