What to Expect at Your 20-Week Ultrasound
Expectant parents often look forward to the 20-week ultrasound—not just for the medical check, but for the magic of seeing their baby’s face for the first time. Known as the anatomy scan, this detailed exam typically takes place between the 18th and 22nd week of pregnancy and offers an incredible glimpse into how the baby is developing.
During this important ultrasound, specialists carefully examine the baby’s organs and body to check for healthy growth. For parents, it’s more than just a scan—it’s the first time they truly see their baby, making it one of the most unforgettable chapters of the pregnancy journey.
How Long Does the 20-Week Ultrasound Take?
A second-trimester ultrasound at the 20-week mark can take about 45 to 60 minutes. Several factors like the baby’s position, the parent’s comfort, and whether there are any issues that need closer checking can affect the actual time. Some people may spend more time, especially if the pregnancy is considered high-risk or if extra measurements are needed.
Parents should also factor in time spent waiting for the scan and for the provider to review the results. If a follow-up with the doctor is scheduled, this can add to the total appointment time.
This routine check helps confirm the gestational age, reviews major organs, and checks how the baby is developing in the second trimester. If you feel any discomfort during the scan, let your sonographer know—they can help you reposition or pause if needed.
What to Expect During the 20-Week Scan
During the 20-week ultrasound, a sonographer applies a special gel to the abdomen and then uses a handheld device to scan the area. This second trimester scan creates detailed pictures of the fetus using sound waves. The sonographer may ask the patient to change positions to help capture clear images of the baby’s organs and growth.
How to Get Ready for the Anatomy Ultrasound
Eating a regular meal or snack before the anatomy scan can be helpful, as this test can take around 45 minutes. A light meal may help the baby move, making it easier for the technician to get clear images. Most people do not need to drink extra water after 12 weeks of pregnancy.
Main Checks During the 20-Week Scan
The sonographer examines several parts of the baby’s body and the pregnancy environment during the 20-week ultrasound. They check the baby’s organs, such as the brain, heart, kidneys, and bladder, and look for normal growth in the face, chest, stomach, and limbs. The hands and feet are counted, and the genitals are examined for any concerns.
The sonographer checks the placenta for its position and health inside the uterus. They also measure the amniotic fluid to make sure there is a safe amount around the baby. The umbilical cord is examined to confirm it is connected properly and working as expected. They also measure the length of the cervix to help rule out problems like early labor.
Conditions the 20-Week Ultrasound Can Help Detect
The 20-week ultrasound checks the baby’s organs and body structures for signs of unusual growth or function. While this scan is often joyful, it’s also a powerful tool for spotting issues that may need extra care or attention. The scan focuses on the baby’s heart, brain, spinal cord, face, kidneys, bones, and abdomen to look for visible birth defects or structural problems, such as heart defects, spina bifida, or cleft lip.
Markers for some genetic conditions may also be identified during this scan. Potential indicators for conditions like Down syndrome or trisomy 18 and trisomy 13 are sometimes seen, especially if earlier antenatal screening was done. While ultrasound cannot diagnose a genetic disorder, it can show signs that suggest a further test, like amniocentesis or chorionic villus sampling, might be needed for a clearer answer.
Can the Baby’s Gender Be Determined?
At the 20-week ultrasound, many parents hope to learn whether they are having a boy or a girl. The technician looks for physical signs like a penis or scrotum for a boy, or vulva and labia for a girl. A clear image is needed for the gender to be identified, but the baby’s position can make this difficult sometimes.
While ultrasound can be quite accurate, there is always a small chance of an incorrect result. Medical guidelines may also affect whether the technician can share this information during the visit. Some families may also find out the gender earlier through noninvasive prenatal testing (NIPT), which looks at the baby’s chromosomes. Choices about knowing the baby’s gender can vary, and not every parent wants to find out.
Baby’s Appearance at the Middle of Pregnancy
At 20 weeks, the baby is about as long as a banana and weighs close to 10 ounces. Their body has a more human-like look, with arms, legs, fingers, and toes formed and in proportion. The face, neck, and spine are easy to spot on an ultrasound.
The baby’s skin is still translucent, giving them a ghostly glow on the screen. A creamy white coating called vernix protects it, making the baby look like they’re wrapped in a gentle film. By this stage, the heart, spine, and other major features can be clearly seen.
Deciding Who to Bring to the Ultrasound
Expectant parents are usually allowed to bring a support person to their 20-week ultrasound. Having a partner, close friend, or family member present can provide emotional support during this important appointment. Most clinics do not allow large groups or the entire family, as the medical team needs to focus on capturing clear images and detailed measurements.
Some clinics make exceptions for a brief visit near the end of the scan, especially if families want to share the moment together, such as discovering the baby’s gender. Check with the clinic ahead of time for their specific guest policy.
Number of Ultrasound Scans During Pregnancy
Most people have at least two ultrasound scans, one in the first trimester and another around the middle of the pregnancy. Sometimes, if the baby’s position makes it hard to see important details, the provider may schedule another scan a couple of weeks later. Extra ultrasounds might also happen if a healthcare provider needs to check on the baby’s progress.
Information Shared by the Sonographer
During the scan, the sonographer usually does not discuss detailed results or possible concerns. In many cases, they can share the baby’s gender if parents want to know. The healthcare professional typically explains basic details and helps keep parents comfortable during the scan. The doctor will share important findings or medical information about the baby’s health at a follow-up visit.
The 20-week ultrasound is more than a milestone—it’s a moment that blends science, reassurance, and wonder. It gives expectant parents a clearer view of their baby’s growth while offering valuable insights into their health and development. From tiny fingers to major organs, the anatomy scan helps paint a fuller picture of life in the womb.
