Pregnancy- Week 20


Congratulations, you are now officially half way through your pregnancy. Although the average length of gestation is 40 weeks, it is still considered within a normal range to deliver 2 weeks either side of this. Try not to set your hopes on your due date as a guarantee that you will have your baby on this precise day. Your expected date of delivery is intended as a guide to plan towards, nothing more. If you have had an irregular menstrual cycle or are unsure of when you conceived, an ultrasound can give a fairly accurate estimate of your baby’s maturity and gestation.

At 20 weeks pregnant, you may find you are walking a little differently to accommodate that extra lump in your belly. This is because your centre of gravity is changing. Watch your posture and remember what your mother used to say “Don’t slouch and put your shoulders back”. It’s amazing how much more room this makes in a crowded tummy. If you have a desk job, spend some time thinking about the comfort of your chair. You may need to adjust the back and seat height so that you are avoiding unnecessary strain. Organise your work area so that it is working for you, not the other way around.


Ouch, my shoes are killing me!

Make sure you wear comfortable shoes so you are stable when you walk. If you’re used to wearing high heels, think about coming back down to earth in some flatter ones. Many women find they don’t fit into their usual shoe size during their 2nd trimester. Blame those pregnancy hormones again! In fact, it is normal for women to permanently go up as much as a full size in shoes after childbirth.


Oh! Can I have a feel?

Expect some interest and fascination about your pregnancy from others around now. Most people find expectant women a delight and show genuine interest in how they are going. Some will automatically want to reach out and touch your belly and feel for the baby. How you respond to this is entirely up to you. You may find it rather nice or alternately, a violation of your space and privacy. It is normal to feel protective towards your belly and subconsciously want to “shield” it from potential harm. Feel free to tell people, in the nicest possible way of course, that you’d prefer it if they didn’t put their hands on your tummy and that it makes you feel a little awkward. Otherwise, enjoy the attention and fuss which will undoubtedly come your way.


Your physical changes this week

  • When you are 20 weeks pregnant, don’t be concerned if an ultrasound locates your placenta lying low in your uterus. Although the placenta is well attached to your uterine wall, your uterus will grow upwards and enlarge so that it won’t necessarily stay in the same segment.
  • Your uterus is around the level of your navel this week. Your waist has gone and instead, you’ll find your body’s width is continuous from under your arms through to your hips. If you’ve had a baby before, it is likely you are showing more early than with your first. Those abdominal muscles have been stretched before and aren’t as taut as they once were.
  • Your heart has been increasing its blood pumping capacity and this week it is managing to pump out around 7 litres of blood every minute. Because of the effects of your pregnancy hormones, your blood vessels are more lax to allow for the extra blood flow. This means you could be finding you are developing varicose veins. Don’t be too horrified. They tend to settle after delivery and don’t generally cause ongoing problems.
  • You may be developing a heat rash under your breasts, in your armpits or between your legs. Your inner body temperature is up a couple of degrees from normal so you are probably more sweaty than usual. Avoid wearing anything other than cotton underwear next to your skin and make sure the sizing is right. Go for comfort rather than look. A light dusting of an absorbent talcum powder can be helpful after showering.
  • Chloasma; the darkly pigmented facial mask of pregnancy occurs in around 50-75 percent of pregnant mothers, so consider yourself lucky if you don’t get it. Also known as the butterfly mask, it tends to follow a pattern similar to a butterfly’s body over the nose, with the wing formation over the cheeks. Chloasma settles after birth but if it is worrying you in the meantime, think about using concealer or foundation to cover it up.
  • You could feel dizzy or faint this week, a common experience in the second and third trimesters. Avoid standing still for long periods or standing up quickly if you’ve been lying down. Allow your body to adjust as you go from being horizontal to vertical.


Your emotional changes this week

  • You could find yourself thinking about your labour and delivery this week. At 20 weeks, a certain mental shift occurs as it becomes obvious to you that this baby is going to need to come out at some stage. A very small percentage of women are genuinely terrified of labour and build up significant anxiety about it over the course of their pregnancy. If this is your experience, make sure you speak with your midwife or doctor about your concerns. Sometimes antenatal counseling becomes necessary.
  • If this was the week of your scan, you could be feeling much more emotionally connected with the baby than you have been. Many women hold back until the foetal screening scan confirms that all looks normal with their baby. This is completely understandable. Seeing your baby’s face for the first time is a momentous occasion, even if it is through a screen.
  • Is your partner feeling a little detached? Make sure he comes to the ultrasound and as many antenatal appointments as possible. Although you may be 100 percent baby focused, try to remember his experience of the pregnancy so far, is only through your symptoms. Give him time to develop his own relationship with the baby and don’t push him too hard or fast.


Your baby’s changes this week


  • By 20 weeks your baby’s external ears are perfectly formed. They are designed to channel sound waves towards the inner ear where noise can already be heard as it filters through your abdominal wall. This is why it is important to talk to your baby every day, so it can learn to recognise your voice as being familiar when it is born.
  • This week your baby is around 16.5 centimetres long from its head to bottom. Its skin is still coated in vernix caseosa, the white greasy coating which protects your baby’s tender skin from drying out.
  • Your baby is surrounded by around 320ml of amniotic fluid this week. The temperature of the fluid is maintained at a slightly higher degree that your own core temperature. This helps the baby to stay warm.
  • Lots of baby movements this week and you are becoming increasingly aware of them. They aren’t strong enough to cause you any discomfort and are a lovely way of reassuring you that the baby is going well.


Tips for Week 20

  • Try to elevate your legs and feet when you can, sit where possible and avoid standing still for long periods to time.
  • Avoid straining when you are having a bowel motion, or sitting on the toilet for lengthy periods. If you feel the need to move your bowels, don’t put it off. Ignoring your body’s signals can lead to problems long term so if you need to go, just do it!
  • Book in for your antenatal classes if you haven’t already done this. Even if you’ve had a baby before, consider a refresher course if you think you’ll benefit. Boost your knowledge on pregnancy and birth. It pays to be informed and to be an advocate for your own, as well as your baby’s health.
  • Look after your back. Avoid lifting heavy objects and twisting as you lift. Backache is common during pregnancy and it is easier to avoid a back injury than to recover from one. If you find yourself a bit sore, go for the natural fixes. Warm baths or showers, massage, heat packs and gentle exercise can all be effective. Consider seeing a physiotherapist if you a have continuous back ache.


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