20 Weeks Pregnant — Your Baby Is The Size Of A Slice Of Pumpkin Pie

by Team Scary Mommy
Originally Published: 
20 weeks pregnant
Scary Mommy

Welcome to Scary Mommy’s pregnancy week by week guide! We’re here to give you all the info about what to expect when you’re expecting: be it week by week symptoms, your baby’s development, your changing body, or ultrasounds and appointments. Here’s everything you need to know about week 20.

Your Body at Week 20 Pregnant

Halfway to the Finish Line

Welcome to week 20, you’re halfway through your pregnancy. Hopefully by this stage you are feeling energized, loving all your new cute and comfortable maternity clothes, and enjoying the tiny flutters you now recognize as your baby’s kicks. From this point on you should be gaining about ½ pound per week, but don’t stress out if it’s a little more or less as long as your doctor says you’re on the right track.

If you haven’t started sleeping primarily on your left side yet, this is definitely the week to start. Experts recommend women stop sleeping on their backs by 20 weeks pregnant as the weight of the uterus can put pressure on the vena cava, a major blood vessel. This in turn can leave you feeling dizzy, nauseous, and impede blood circulation to the baby.

What to Expect at Your 20-Week Anatomy Scan

This is a big week for many reasons: if you haven’t already done so with the NIPT test, this is the week you’ll find out your baby’s sex. If you would like to be surprised, make sure the technician knows before you get started.

The two-hour anatomy scan will also take a closer look at your baby’s fetal growth and development, paying close attention to their heart, kidneys, bladder, spine, and stomach. They will also measure the growth of the body and head. Make sure to drink water ahead of the exam as the ultrasound will be clearer to read on a full bladder.

Your Baby at Week 20 Pregnant

Poop, There it is

At 10 ounces and nearly 7 inches long, your baby is the size of a slice of pumpkin pie. Speaking of food, your baby is now developing taste buds and may even be able to taste strong flavors from foods like garlic or spicy food.

If you’re expecting a boy, his testicles will begin to descend this week and should be clear during the anatomy scan. And if it’s a girl, her uterus and ovaries are developing rapidly, as well has her vaginal canal.

The baby’s body is now covered in a protective creamy substance called vernix caseosa. This white, creamy substance shields the baby from amniotic fluid and keeps infections and bacteria at bay. It also serves as the baby’s personal space heater and helps it make its way out the vaginal canal.

The vernix is not the only new substance forming as this is the week the baby begins to produce his or her first poop. Called meconium, the dark, thick, sticky, green substance is comprised of all the cells, lanugo, mucus and amniotic fluid your baby has been ingesting up until birth and will pass as their first bowel movement after birth.

Your Symptoms and Health at Week 20 Pregnant

Check Your Blood Pressure

At this stage in your pregnancy, both you and your health practitioner should be paying extra attention to signs you may be developing preeclampsia. In addition to swelling, the condition can also cause other symptoms, like severe headache, vision problems such as blurring or flashing lights, and pain under the ribs. If you experience any of these symptoms, contact your doctor right away.


Now that your blood volume has doubled, your heart is working overtime even as your cardiovascular system is slowing down. All these changes can lead to low blood pressure and it’s important you don’t ignore signs of faintness and dizziness. When standing up from a lying or sitting position, do so slowly. Make sure to keep hydrated, as dehydration can bring on those symptoms, as well.

Varicose Veins

Hormonal changes and an increase in your body’s blood volume adds pressure on the veins, resulting in varicose veins in some women. Most women who get this symptom tend to see them on their legs, buttocks, and vaginal region. It’s important to keep feet elevated as much as possible for circulation, wear specialized compression stockings, keep hydrated, and stay active.


Hemorrhoids are actually varicose veins in your rectum, and often appear in conjunction with constipation. Increased weight on your pelvis, constipation, and prolonged periods of standing exacerbate pregnancy hemorrhoids. Warm baths with baking soda, witch hazel pads to reduce bleeding and inflammation, and a fiber-rich diet will all help with the pain and discomfort.

Double Trouble

It’s week 20 scan time! For some parents, this is the first time in which the babies’ gender is revealed (if you didn’t do the NIPT, or if you didn’t need extra scans because your twins’ have a placenta each). During this scan, the doctor will also extensively check all is well with your babies’ anatomy and that everything is looking as it should.

You’re also likely to feel more quickening this week, but if it’s your first pregnancy, you might think it’s just your stomach groaning. These movements will be fairly consistent for the next few weeks until the little roommates are too big to flip and summersault.

From this week on, your twins will be scanned every four weeks to ensure they continue to grow as they should.

The contents of this article have been medically reviewed by Ruth A. Tessler, M.D. in July, 2019.

Written by Maia Efrem.

Follow Preggo Nancy’s pregnancy journey week-by-week and share in her joy, her symptoms, and even her pregnancy cravings.

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