Pregnancy Week 20

What does my baby look like?

This week your baby is roughly the size of a banana and keeps growing quickly.

Your baby is now covered in a white, greasy layer called vernix. This coating helps protect the skin against the amniotic fluid and may also make it easier to move through the birth canal.

Your baby becomes more active every day. They may kick, turn, throw punches, and even suck their thumb, which helps develop the sucking reflex they'll need after birth.

What's happening with the baby this week?

Your baby keeps growing rapidly this week. Brain development is especially important, and body proportions are gradually becoming more balanced.

The pancreas also starts working and helps produce insulin, which plays a role in regulating blood sugar. This hormone helps the body use the energy needed for growth and store fat.

In a baby girl, the ovaries contain a large number of primitive egg cells. In a baby boy, the testicles continue their descent over the coming weeks.

What's happening in my body?

Your anomaly scan may take place this week. During this scan, your baby's development is assessed in detail and the placenta is examined as well.

Feeling your baby's movements for the first time can be incredibly moving. If you don't feel them clearly yet, that's normal too; how movements feel varies from person to person and, at first, they can seem like faint flutters or twitches. Bubbling or fluttering sensations in your belly may well be your baby moving.

Babies are often more active in the evening; they may settle down while you're moving around, thanks to the rocking motion. Movements usually become more noticeable in the weeks ahead. That said, if you have any concerns about your baby's movements, talk to your doctor.

You may feel sudden, sharp pains in your calves at night. This is often a cramp and is common in pregnancy. Gently stretching the muscle or pulling your toes toward your ankle can help ease it. Staying more active and doing suitable exercises may reduce cramps for some people.

Your growing womb may be straining your back

Lower back pain is common. As the womb grows, your back carries more of the load and your joints and ligaments become looser. Swimming, gentle stretching, suitable exercises, relaxation techniques, and warm or cold compresses when needed can all help.

As your skin stretches, you may feel itchy, especially around your belly and breasts. A cool compress and a moisturizer can help. However, if the itching is intense, it should be checked to see whether it points to a more serious issue.

Finding a comfortable sleeping position can get harder. Lying on your side with your knees bent and placing pillows between your legs, under your belly, and behind your back can help. A pregnancy pillow may also bring relief.

During this time, your hair may look fuller and your nails may seem to grow faster. This is often due to hormones and increased circulation. Increased hair shedding in the months after birth is common and usually temporary.

Constipation is common in pregnancy. Hormones, less physical activity, and the growing womb can all contribute. Constipation can also set the stage for hemorrhoids. Drinking plenty of water, eating fiber-rich foods, staying active, and checking with your doctor when needed can help.

The top of your womb is now getting closer to your belly button. Because of this, your belly button may flatten out or pop out. Some tenderness is normal; however, severe pain is not typical and may need to be evaluated.

Whooping cough vaccine

Around these weeks, the whooping cough vaccine may come up. The immunity that develops from the vaccine passes to the baby through the placenta and can help provide protection until the baby's first routine vaccinations.

Symptoms you might notice this week include:

• fatigue and trouble sleeping
• stretch marks
• swollen and bleeding gums
• round ligament pain
• nosebleeds
• bloating and constipation
• indigestion and heartburn
• tender breasts
• leg cramps
• dizziness
• swollen hands and feet
• urinary tract infections
• vaginal infections
• darkening skin or brown patches on the face
• oilier, more acne-prone skin
• thicker, shinier hair

Symptoms carried over from previous weeks, such as morning sickness, cravings, sensitivity to smells, mood swings, vaginal discharge, and light spotting, may continue as well. Any bleeding warrants medical evaluation.

Stretch marks are fine lines that form as the skin stretches while the baby grows. Using a moisturizer can soothe the skin. If you have questions about which oils or products to use during pregnancy, ask your doctor.

Keep up healthy eating habits

If the nausea and food aversions of the early weeks have eased, your appetite may have noticeably picked up. Even so, eating small, frequent meals is generally tolerated better than very large ones. This approach not only helps reduce complaints like heartburn and indigestion; it also spreads your energy more evenly throughout the day.

It's normal to crave certain foods and drinks strongly. Still, it's important to give up alcohol, limit caffeine, and be mindful of foods to avoid during pregnancy.

If your budget is tight or your options for preparing food are limited, eating well can be harder. Even so, try to make simple, balanced choices.

Eating nuts does not raise your unborn baby's risk of a nut allergy; some evidence even suggests the risk may go down. Nuts contain vitamin E, protein, and various minerals. Although they're high in fat, much of it is healthy fat. Still, enjoying them in moderation is the best approach.

Oral and dental health

Rising hormone levels can make you more prone to gum disease. That's why it's important to limit sugary foods and pay attention to your oral and dental care. Your gums may swell and bleed, and plaque can build up on your teeth more easily.

An alcohol-free mouthwash may help some people. Regular dental checkups are important too.

Don't forget to tell your dentist about the medications and supplements you're taking, such as folic acid. These can affect your treatment plan.

The 20-week ultrasound and anomaly scan

The fetal anomaly scan is usually done between weeks 18 and 21. Its aim is to assess the baby's structural development. During this evaluation, the baby's organs, measurements, and overall development are examined. The sonographer usually captures images over 20 to 45 minutes.

The external genitals may also be visible on the second-trimester ultrasound; because of this, some families learn their baby's sex at this scan.

In most cases, the scan shows that the baby is developing as expected. Sometimes, however, a more detailed evaluation may be needed, and a specialist review may be requested for it.

Coping with unhelpful comments

During pregnancy, you may get a lot of comments, advice, and questions from those around you. Some of it may be well-meaning; some, however, can be uncomfortable or worrying.

Don't hesitate to say you'd rather not talk about topics that make you uncomfortable. Right now, your well-being comes first.

You're halfway there!

You're at the midpoint of your pregnancy, in your fifth month. That said, not every woman gives birth exactly on her due date; labor can begin in the days before or after it.

Feeling cold

Most people feel warmer during pregnancy. Some expectant mothers, however, may feel colder. This doesn't always mean something is wrong; still, if you have a noticeable and persistent feeling of being cold, talk to your doctor.

Mental well-being

Mental health issues like depression and anxiety can develop during pregnancy. If you're not feeling well, don't try to cope on your own; seek support from your doctor and the loved ones you trust.

Can I rely on pregnancy apps?

Using pregnancy apps can be enjoyable. But they shouldn't take the place of the medical guidance your doctor provides.

Take a deep breath

A stuffy nose is common in pregnancy. Meanwhile, your baby's lungs keep developing too.

Swelling

Fluid retention in the ankles and feet can be uncomfortable. Wearing comfortable shoes, avoiding tight socks, and resting your legs can help.

How to prevent toxoplasmosis during pregnancy

Toxoplasmosis can be caught from raw or undercooked meat and from infected cat feces. During pregnancy, this infection can matter for the baby.

To protect yourself from toxoplasmosis:

• if possible, don't clean the cat litter box yourself
• if you have to clean it, wear disposable gloves and wash your hands thoroughly afterward
• clean the litter box regularly
• wear gloves when gardening
• wash your hands thoroughly after any contact with soil