20 Weeks Pregnant

You're halfway there

20 weeks pregnant:

What's happening with you:

Aside from feeling relieved and excited about reaching the midpoint of your pregnancy, you'll probably feel your belly is growing faster and more regularly from this week forward. Most women will have another prenatal appointment during week 20, and one of the first things your caregiver will check is the size of your uterus: by now the fundus (or top of the uterus) has reached your belly button, and it will grow nearly ½ inch each week. Since this rate of growth is fairly universal, if your uterus begins to exceed expectations, it could signal that you're carrying twins. On the other hand, every pregnancy is different, so don't panic if you don't measure the same as another mom-to-be with the same due date.

As your uterus grows, certain symptoms can become more pronounced. Digestive troubles like heartburn, gas and constipation are common, and the pressure of your uterus on major veins can lead to puffy legs and feet. Attention to posture and position is very important these days if you want to stay comfortable, but mood swings shouldn't be too much of an issue anymore: your volatile emotions are leveling out as your body adapts to the hormones, and many women find that their irritability is easier to control now.

What's happening with your baby:

Weighing in at 9 ounces, your baby is going through another growth spurt: limbs are getting longer, the skeleton is hardening and the various nerve centers of her brain are becoming distinct. In fact, a very important stage of nerve development begins right around now, as fetal senses become sophisticated enough for her to recognize her environment and your voice. Talking to your little one every day will develop your bond well before you get to meet each other in person!

Your baby is between 5 ½ and 6 ½ inches (or 14 to 16 cm) from her crown to her rump this week (10 inches from head to heel), which is around the size of a mango. The organs, bones and tissues of a 20 week old fetus are in their proper places, and if your baby is a girl, she already has about 2 million eggs in her ovaries. Vernix caseosa (the thick white substance that's secreted through the skin) covers her body, and she's breathing in amniotic fluid as she practices for life outside the womb.

Things to do this week:

Since you're pretty mobile these days, maybe even squeezing in some travel on the weekends, you should start to cart around some everyday essentials and emergency provisions. Set up a pregnancy first aid kit for the car and maybe even a streamlined version for your purse so you're never left high and dry.

Depending on your pre-existing conditions and current discomforts, you may need to start your kit off with a supply of prescription medication, but it's always good to include some non-prescription drugs like acetaminophen and antihistamine, too. Aside from the medications, bandages and antiseptic wipes that form the base of your kit, be sure to include a list of emergency numbers for you (and for anyone that may need to help you in a serious situation). There's no need to fear the worst whenever you step out your front door, but staying prepared takes very little effort and can make all the difference if something goes wrong while you're away from your home and your doctor.

Medical musts:

This week brings a big medical milestone for most expectant mothers: the first opportunity to see their baby since, well, it started looking like a real baby. The ultrasound transducer (or wand) will now be able to pick up a clear picture of your amniotic sac, placenta and unborn baby, and that picture should show your doctor or midwife how your baby has developed, how long he is and if there are any characteristics to be concerned about. The ultrasound will last for a half hour or so, and the technician may prod your belly a bit to position the baby for more accurate measurements.

If you're experiencing a high-risk pregnancy, you'll probably have had several ultrasounds by now, and if you're having a low-risk pregnancy, you may not have had any ultrasounds at all. Although many doctors agree that a 20 week ultrasound is not necessary for many women, this one can be special for any mom-to-be because now a baby gender test can return fairly accurate results. Of course, baby will need to cooperate if you are to get the view you need, and no reading is 100% accurate. The decision to find out or not to find out is a personal one, so think it through and tell the technician your choice before they start the test.

Tips for your partner:

If you've decided not to find out the gender, stay on the ball: you'll both be attending regular prenatal visits, and you can't expect every doctor and technician to know where you stand on the matter. Help your partner, yourself and your medical team by making it perfectly clear that any mention of the gender is unwelcome. One way to accomplish this without repeating yourself constantly is with name labels. That's right, those stickers with space for a name can work just as well for a sentence. Write down something simple like "Don't tell me the sex" and wear them on the front of your shirts every time you step into the office or clinic.

In some cases, the difficulty is in the home rather than the doctor's office. It's a tough situation when you and your partner can't agree on whether to find out or wait, but don't resent each other for this impasse. Remember that it's only ever an educated guess, and there are pros and cons to both sides. If mom-to-be decides to find out so she can better identify with the baby but you don't want to know, don't be too upset if the secret slips out before the baby. After all, this is (hopefully) the biggest secret you'll ever keep from each other, and with big secrets come big urges to tell!

This week's FAQs:

  • My legs and feet are starting to swell -- should I be worried?

    Swelling is one symptom that you may not be able to blame on your hormones, but rest assured you can blame it on some part of your body. For one, your body carries more fluid in pregnancy, and with gravity's help, it can collect in your legs. Also, your growing uterus will tend to put pressure on your interior vena cava, the large blood vessel that returns blood to your heart, which can lead to swollen extremities. About three out of every four mothers-to-be will experience swelling in the feet and ankles (known as edema) as their pregnancy progresses, and in most cases it's nothing to worry about. There is, however, a chance that your puffy ankles could indicate a more serious condition.

    Putting your feet up for a while and drinking plenty of water will relieve mild swelling, but if you start to experience calf pain or the swelling is much more pronounced in one leg, you could be suffering from a blood clot in the leg. If your face and hands become swollen as well as your legs and you experience rapid weight gain or a rise in blood pressure, contact your doctor right away -- these symptoms can signal the onset of a severe condition called preeclampsia, which could threaten you and your baby.

  • I'm sweating an awful lot these days. Is this normal? Is there anything I can do about it?

    Between your tendency to lose your breath and the added weight of your baby, you may find that a walk down the hallway can leave you feeling like you've run two miles. It's no surprise that you have developed an ability to perspire on cue, since you are using more energy to move yourself around, your metabolism is soaring and your increased blood volume will raise your temperature by a full degree. Sweat is simply how your body keeps itself cool.

    Of course, sweating uncontrollably can be annoying and embarrassing, so you'll want to help your body to stay cool in other ways. Dress in layers to better regulate your body temperature and stick to natural, breathable fabrics like cotton, hemp or linen. Avoid mid-day sun and be sure to stop exercising before you feel thirsty and overheated. If it's your appearance that worries you, you may want to carry around a handkerchief to dab at beads of sweat on your face and neck.

  • Now that I'm halfway through my pregnancy, is it true that I don't have to worry about miscarriage?

    Well, not exactly. Your chances of having a miscarriage drop considerably after week 12, but in rare cases, a late miscarriage will occur between the end of the first trimester and week 22. After that week, an early delivery is considered a premature birth instead of a miscarriage. Unless your doctor detects a problem with your placenta, such as placenta previa, your uterus or your hormones, your chances of carrying your pregnancy to full term are good from this point on.

    Not every problem can be detected on an ultrasound before it's too late, and you'll need to recognize the signs of miscarriage so you can act quickly. As with most pregnancy complications, vaginal bleeding in pregnancy is one of the earliest and most serious signs that something is wrong, whether it's light but constant bloody discharge for several days or sudden, heavy bleeding with cramping. Try not to panic if you experience bleeding (up to 25% of pregnant women will experience some form of benign bleeding at some point in their pregnancy), but do call your doctor at the first sign of blood or unfamiliar cramping.

Helpful hint:

Now that your pregnancy is half over, do you find that you're worrying about becoming a parent? If it's your first baby, there are a lot of unknowns ahead; if it's your second, you may wonder how the new addition will affect the family circle. It may seem unlikely now, but your body and your instincts will be well-prepared for the role and you'll drift through those first days of your newborn's life smoothly and easily. Nine months of pregnancy teaches you about yourself and your abilities, and you'll become attuned to your baby's needs and comfort as you go through your pregnancy. If you are anxious or run into little problems (such as trouble breastfeeding) after the birth, rest assured that there will be plenty of resources at your fingertips to help you.


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