Pregnancy week by week



Week 20 of Pregnancy

Congratulations!! You are now half way through your pregnancy. By now you definitely look pregnant and people finally begin to notice and congratulate you. If you haven’t already had your second trimester ultrasound, your doctor will schedule it sometime around now. This scan will give your doctor an opportunity to check for any malformations and overall well being of your little one.

Your body

You may feel aches in your abdomen as the ligaments on either side of the uterus stretch as your baby grows. This is necessary but, unfortunately, it can really hurt. You may find you get a brief stabbing pain below your bikini line; sometimes it can be a dull, achy pain, particularly if you have been on your feet all day. It is referred to as round ligament pain; it starts off feeling quite deep and can be bad enough to be worrying. If it stays, gets worse or you have any other problems like cramps, spotting or sickness then you need to see your doctor urgently.

By now, you will be able to feel the top of your growing uterus. This week your uterus should be in line with your belly button. If the top of the uterus is not in line with where it should be for your corresponding week, then your doctor would suggest you to get an ultrasound done. This is to check that your due date is correct and to check for intra-uterine growth retardation.  From this week onwards your uterus should grow about 1 cm every week.

You may start getting backache. This happens because your posture will change significantly throughout your pregnancy. As your belly grows, you will find yourself slouching or walking with your belly up front. This is because your centre of gravity changes and to avoid discomfort you tend to slouch more. But slouching will lead to more backache and other discomforts. It is important to maintain good posture while sitting, standing and climbing stairs.

Heat rashes are common during pregnancy and you might get them under your breasts. Combined with hormonal changes and an overheated body due to increased blood volume, continuous friction can make your skin perspire and damp. The result is rashes on your skin. Wear loose fitting cotton clothes and can use calamine lotion on affected areas.

As your uterus grows, digestive problems like heartburn, constipation, flatulence will become more pronounced. The pressure of your uterus on major veins can lead to swollen hands and feet. Other symptoms you may experience this week are will be increase in hair growth, increased vaginal discharge, headaches, leg cramps at night, oedema, or dizziness. Refer to our section on symptoms of second trimester to learn more.

Your baby

Your baby measures about 16 cm and weighs 320 g. He is doing somersaults- making most of the space before it gets too cramped in there! Remember, if this is your first pregnancy or if you have a larger frame, you may not yet feel these movements. Many times, these first movements are described as a flutter, or may feel like bubble or gas. The rapid growth your baby has gone through in the past weeks may be slowing down. Around this time, your immune cells are being transferred through the placenta to protect the baby from the viruses that you have had. His senses are developing as the nerve cells that respond to smell, light, and touch are maturing in the baby’s brain. Your baby can hear noises outside of the womb and may startle at loud sounds.  His legs are getting close to the final length and are very proportionate at this point. The lanugo is very thick around the head, neck and face.

Your baby’s movements should now be becoming stronger and stronger, as ossification continues and soft cartilage is turned into bone. As your baby’s arms and legs become harder and stronger, the strength of your baby’s kicks will be more noticeable. Your baby is now constantly on move as he practises using his new found motor skills and coordination as he tugs on the umbilical cord. However, as he is cushioned by amniotic fluid you will only be able to appreciate the stronger kicks.


If you haven’t already booked your antenatal classes, now is the time to do so. Enquire at the hospitals in your vicinity if they offer antenatal classes. It is better to complete them before week 34 of pregnancy in case your baby arrives a little early.



1) What is healthy weight gain during pregnancy? How much should I expect to put on?

Weight gain during pregnancy should be slow and steady. Weight of the baby accounts for only a small part of your total weight gain; rest of it is contributed by an increasing blood volume, water retention, increasing breast size, placenta and the amniotic fluid.  The amount of weight you should gain depends on your weight and BMI (body mass index) before pregnancy. Recommended total weight gain ranges for singleton pregnancies are:
  • If your pre-pregnancy BMI was low (BMI<19.8), meaning you were underweight; you should gain 12.5-18 kg (28-40 pounds) throughout your pregnancy.
  • If your pre-pregnancy BMI was normal (BMI 19.8-26), meaning you were normal weight; you should gain 11.5-16 kg (25-35 pounds) throughout your pregnancy.

  • If your pre-pregnancy BMI was high (BMI 26-29), meaning you were overweight; you should gain 7-11.5 kg (15-25 pounds) throughout your pregnancy.

  • If your pre-pregnancy BMI was very high (BMI>29), meaning you were obese; you should gain less than 7 kg (<15 pounds) during your pregnancy.

  • The range for women with twins is 16-20 kg or 35-45 pounds.
BMI is calculated as weight in kg divided by height in metre square (weight in kg/height in m2).

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