Changes During Weeks 17 - 20


Your baby's head, arms, legs, and body are now fully formed. Soft fine body hairs (lanugo) cover the body as well as a cheese-like coating (vernix), which protects the delicate skin. Scalp hair and eyebrows appear. Fetal movement increases.

By 20 weeks, your baby's head, arms, legs, and body are fully formed. Scalp hair, eyebrows, and toenails appear. Soft, fine body hairs called lanugo and a protective, "cheese like" substance calleded vernix caseosa protects the baby`s delicate skin. The baby now weighs about 1 pound and is about 7 ½ inches in length.


Your baby's movement will become increasingly noticeable to you. You may experience muscle cramps in your legs due to changing posture and/or inadequate nutrient intake. Due to circulatory and hormonal changes, your gums may become swollen and bleed more easily. At 20 weeks you`ve reached the halfway point of your pregnancy.

Approaching the Midpoint of Pregnancy

When experienced and expectant mothers talk of pregnancy, they often remark about how quickly -- and how slowly! -- these nine, special months pass. This may seem especially true now, for as you approach your 20th week of pregnancy, a time when body changes are more evident than ever, the midpoint of your pregnancy is nearing. Celebrating this special milestone can put any discomfort into a more positive perspective!

If you have not felt the small "fluttery" feeling of your baby's movement prior to this time, you most likely will between the 18th and 20th week of pregnancy. This is called "quickening". The time at which a pregnant woman first feels this sign of new life varies according to her body size and whether or not she's been pregnant before (second and third time moms often feel it sooner). You may also find that your baby is more active at certain times of the day, and that activity may be highest at night or when you`re resting.

This movement is important in another way, too, for it helps you begin to identify your baby as a separate person. With this realization come new concerns for your baby's well-being.

Other physical and emotional changes include the following:

  • An increase in fundal height (height of the uterus) - This is what doctors/midwives are determining when they measure your abdomen at your prenatal visits. Your uterus will have grown considerably by this time. At about 20 weeks, your uterus will be approximately at the level of your umbilicus (belly button).
  • The presence of colostrum - A thick, yellowish fluid may be leaking from your nipples. This is an indication that your breasts are getting ready to produce milk.
  • A change in self-image - You are probably wearing maternity clothes by this time, and more people are asking you about your condition. Expect to have some new positive and negative feelings about your body and the pregnancy process.

Discomfort during pregnancy

Some discomforts during pregnancy is normal. However, with proper precautions, you can minimize them. These discomforts are directly related to physical changes taking place in your body. They include:

  • Constipation - Even if you`ve never had this problem, it may be part of your pregnancy experience. There are several reasons; changes in bowel action due to hormone levels, the enlargement of the uterus, lack of fiber, lack of activity, and even the iron supplement you may be taking. The best solution is prevention. Be sure to:
    • Drink at least six 8-ounce glasses of fluids each day (water is the best choice)
    • Eat fresh fruits and vegetables
    • Increase the fiber level in your diet
    • Exercise regularly
    • Establish a regular pattern of daily bowel movements
    • Avoid straining or pushing to have a bowel movement
    • Only take laxatives or stool softeners as prescribed by our doctors and nurses
  • Hemorrhoids - If you are constipated, the odds of you developing hemorrhoids (enlarged veins in the anal area) increase. These can result in the anal area feeling itchy and inflamed. If you have had a hard bowel movement, you may find a small amount of blood on the toilet tissue in the stool. To help prevent hemorrhoids, avoid becoming constipated, avoid sitting or standing for long periods of time, and don`t strain or push when having a bowel movement.
  • Gas - Several of the same factors responsible for constipation and hemorrhoids can result in you feeling gassy or bloated. To lessen the problem, establish a regular pattern of daily bowel movements and avoid or cut down on the following:
    • Gas producing foods such as corn, onions, and cabbage.
    • Drinking through a straw (extra air is taken in with fluid).
    • Chewing ice.
    • Drinking carbonated beverages.
  • Round ligament pain - Round ligaments are bands of tissues found on either side of your uterus. Their purpose, quite simply, is to hold the uterus in place. As the uterus enlarges and these ligaments stretch, you may feel a brief tugging sensation in one or both sides of your lower abdominal area. These are most likely to occur when you stand up quickly or turn sharply. If this is your first pregnancy, you may feel this discomfort beginning at 20 weeks of gestation and any time thereafter. If you have been pregnant before, you may feel round ligament pain as early as 10 weeks and it may be even more noticeable.
  • Leg cramps - As your uterus enlarges, it places greater pressure on the blood vessels in your pelvis. This can result in muscle cramps in your legs, especially when you are resting. Other causes of cramps include a diet lacking some important nutrients and the pressure of your baby`s head on certain nerves. You may find it helpful to do the following:
    • Elevate your legs regularly throughout the day.
    • Extend your leg, straighten the knee, and flex your foot upward toward the ceiling for cramp relief.
    • Wear support hose, especially if you stand or walk frequently during the day.
    • Be certain your diet includes milk, cheese, and other foods high in calcium and phosphorus.
    • Keep legs uncrossed while sitting.
  • Backache - If you have had a history of back problems prior to your pregnancy, discuss this with your provider. During pregnancy, the increase in weight, breast size and uterine size can contribute to poor posture, back strain, and aches. Following are suggestions to help alleviate these aches:
    • Wear a good supportive bra throughout pregnancy.
    • Wear comfortable, flat shoes with a good arch support.
    • Consider a specially designed mattress or wedge for sleeping comfort.
    • Maintain good body mechanics and good posture.

If, however, you experience a low backache (occurring either intermittently or constantly) that seems to wrap around your abdomen to the front, and does not go away within one hour after you change position or rest, promptly notify your midwife/doctor. This could be a warning sign of preterm labor.

Reprinted with permisson from Her HealthCare.