Second trimester · Pregnancy week by week
Week 20 of pregnancy
Baby is the size of a banana. About 6.50 inches, 300g.
Week 20 is the halfway point and the threshold for preeclampsia diagnosis. Black women have a 60% higher rate of preeclampsia and 3x higher preeclampsia-related mortality, per the CDC PMSS. Source
What's happening with the baby
The fetus is now around 10 inches long head-to-toe. Hair and nails grow. The fetus produces meconium (first stool) in the intestines. Sucking, swallowing, and breathing patterns are coordinated.
What's happening for you
You're halfway through pregnancy. The bump is prominent. Most women feel kicks several times an hour during waking. Belly button may pop out. Stretch marks may appear on belly, breasts, or thighs.
Common (normal) symptoms this week
Daily fetal movements, prominent bump, stretch marks, mild edema in feet, lower back pain, occasional Braxton Hicks contractions, heartburn, congestion.
Call your OB or 911 if
- Severe headache not relieved by acetaminophen.
- Vision changes — blurred vision, light flashes, floating spots.
- Severe right-upper-quadrant or upper-abdominal pain.
- Sudden swelling of face, hands, or feet.
- Vaginal bleeding or fluid leakage.
- Decreased fetal movement after 20 weeks.
- Persistent contractions before 37 weeks.
Why this week matters for Black families
Late in the second trimester is when preeclampsia becomes diagnosable (after 20 weeks). Black women have a 60% higher rate of preeclampsia and a 3x higher rate of preeclampsia-related death. The diagnosis combines new-onset blood pressure ≥140/90 with signs of organ stress. Track your own blood pressure between visits if you can — many Black-led OB practices recommend a home cuff at this stage. If your readings trend up, call your OB before the next appointment, not at it.
What to do this week
20-week anatomy scan if not done. Detailed BP review with OB. If your readings have crept above your baseline, name it. If you don't have a home cuff, ask about getting one — for high-risk patients, daily BP tracking is standard of care now. Discuss labor plans, hospital tour scheduling.
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References
- CDC Pregnancy Mortality Surveillance System.
- ACOG Practice Bulletin 222 — Preeclampsia.
Last medically reviewed: .
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