What to Expect in Weeks 20-to-24 of Pregnancy: Antenatal Care Guide

Weeks 20 to 24 of pregnancy are a time of significant growth for your baby and emotional milestones for you. This period includes key developments in your baby’s physical and sensory abilities and a deeper engagement with antenatal care.

This guide explores your baby’s development, your own changes, the importance of antenatal care.

Baby’s Development During Weeks 20–24

Week 20: Halfway There

At 20 weeks, your baby measures around 25 cm from head to toe and weighs about 300 grams. This week is particularly significant as it marks the halfway point of a typical 40-week pregnancy.

Development Highlights:

Hearing: Your baby can hear your voice and external sounds, and you may feel their movements in response to loud noises.

Anatomy Scan: The anatomy scan occurs around this time, offering a detailed assessment of your baby’s growth and organ development.

Movements: You’ll notice more pronounced flutters, kicks, and rolls.

Weeks 21–23: Refining Abilities

These weeks see rapid growth and the refinement of your baby’s senses and movements.

Physical Changes:

Fat accumulates under the skin, helping with temperature regulation after birth.

Fingernails and toenails are fully formed.

Sensory Development:

Your baby can sense light changes even with their eyes still closed.

Taste preferences start to develop based on the flavours of the amniotic fluid.

Week 24: A Viable Milestone

By 24 weeks, your baby is about 30 cm long and weighs approximately 600 grams. This week is significant as it marks the threshold of viability, where premature babies have a chance of survival with medical intervention.

Physical and Emotional Changes in the Mother

Physical Changes

As your pregnancy progresses, you may experience:

Increased Appetite: Your baby’s rapid growth demands more energy.

Stretch Marks: As your bump expands, stretch marks may appear on your belly, breasts, or thighs.

Braxton Hicks Contractions: These “practice” contractions may begin but are typically painless and irregular.

Emotional Shifts

Many women report feeling more emotionally connected to their baby during this stage, partly due to the ability to feel movements and see the baby during scans.

Antenatal Care During Weeks 20–24

The Anatomy Scan

The anatomy scan, usually offered between 18 and 21 weeks, is one of the most comprehensive scans during pregnancy.

Purpose:

To examine the baby’s organs, including the heart, brain, kidneys, and spine.

To check the placental position and amniotic fluid levels.

What to Expect: You’ll see detailed images of your baby, and your healthcare provider will share any concerns or follow-up recommendations.

Routine Antenatal Appointments

Around week 24, you may have an antenatal appointment to monitor your health and your baby’s well-being.

What’s Monitored:

Blood pressure and urine to check for conditions like pre-eclampsia.

Your bump’s size and shape to ensure consistent growth.

Discussions on antenatal vitamins and any symptoms you’re experiencing.

The 24-Week Abortion Limit: Context and Controversy

What is the 24-Week Limit?

In the UK, the 24-week abortion limit was established under the Abortion Act of 1967, later amended in 1990. It permits abortions up to 24 weeks of gestation, but exceptions are made beyond this limit if:

The mother’s life is at risk.

There are severe foetal abnormalities.

The baby would not survive outside the womb.

Statistics

According to the UK Department of Health and Social Care (2021 data):

99% of abortions occur before 20 weeks.

Abortions after 20 weeks are rare, accounting for less than 1% of procedures.

Post-20-week abortions often involve complex medical or personal circumstances, such as late diagnoses of severe foetal anomalies or risks to the mother’s health.

Why is the Limit Controversial?

The 24-week limit remains a point of debate for several reasons:

Medical Advances: Improvements in neonatal care have increased the survival rates of babies born before 24 weeks, leading some to argue for a lower limit.

Ethical Concerns: Pro-life advocates believe that viability should reduce the threshold, while pro-choice supporters stress the importance of personal autonomy.

Complex Cases: Many post-20-week abortions involve tragic circumstances, highlighting the need for compassionate, case-by-case considerations.

Evidence-Based Pregnancy Wellness Tips

1. Antenatal Yoga

Antenatal yoga is an excellent way to maintain fitness and manage stress during this stage of pregnancy.

Benefits:

Improves strength and flexibility.

Reduces back pain and tension.

Prepares the body for labour with controlled breathing exercises.

Consider joining pregnancy yoga classes or online programmes tailored for expectant mothers.

2. Antenatal Massage

As your bump grows, you may experience backaches, leg cramps, or swollen ankles. Prenatal massage, performed by a trained therapist, can provide relief.

Benefits:

Reduces muscle tension and improves circulation.

Promotes relaxation and better sleep.

Eases pregnancy-related discomforts.

3. Balanced Nutrition

Your baby’s rapid development during weeks 20–24 makes proper nutrition essential.

Key Nutrients:

Protein: Supports tissue growth for you and your baby.

Calcium: Builds strong bones and teeth.

Iron: Prevents anaemia and supports increased blood volume.

Foods to Focus On: Lean meats, dairy, leafy greens, and fortified cereals.

4. Stay Hydrated

Adequate hydration supports amniotic fluid levels, digestion, and overall energy.

Practical Tips for Weeks 20–24

Start a Birth Plan: Begin discussing your preferences for labour and delivery with your antenatal clinic.

Consider Antenatal Classes: Many expectant parents attend antenatal classes near me or virtual options during this phase to prepare for labour and newborn care.

Track Movements: Monitor your baby’s activity patterns and share any concerns with your healthcare provider.

When to Seek Medical Advice

Contact your healthcare provider or antenatal clinic immediately if you experience:

Persistent or severe abdominal pain.

Unusual or heavy vaginal bleeding.

Decreased or no baby movements after 24 weeks.

Symptoms of pre-eclampsia, such as severe headaches, swelling, or blurred vision.

Key Milestones to Celebrate

Seeing Your Baby’s Anatomy Scan: This scan provides a detailed view of your baby’s growth and health.

Feeling Consistent Movements: By week 24, your baby’s movements become more regular and noticeable.

Reaching the Viability Milestone: At 24 weeks, your baby has a chance of survival with medical intervention if born prematurely.

Conclusion

Weeks 20 to 24 of pregnancy are filled with growth, connection, and important decisions. From feeling your baby’s movements to attending the anatomy scan, this phase deepens your relationship with your baby. With proper antenatal care, wellness practices like antenatal yoga and massage, and support from your healthcare provider, you can navigate these weeks with confidence. The 24-week abortion limit adds a layer of complexity to this stage, underscoring the importance of compassion and informed decision-making.

Sources

NHS. “Your Pregnancy and Baby Guide: Week-by-Week Timeline.” NHS UK

Royal College of Obstetricians and Gynaecologists. “20-Week Anatomy Scan.” RCOG

Tommy’s. “Foetal Viability and the 24-Week Threshold.” Tommy’s UK

Department of Health and Social Care. “Abortion Statistics, England and Wales: 2021.” GOV.UK

Mayo Clinic. “Second Trimester Wellness and Care.” Mayo Clinic

American Pregnancy Association. “Prenatal Care and Nutrition.” American Pregnancy Association