The 20-week appointment marks the halfway point of your pregnancy, making it a milestone in its own right. You've spent the past five months building and growing a human, and now you're halfway through, mama. Remember your first prenatal appointment? That was ages ago!
At this point, you might be waiting with bated breath to get a visual of your baby's growth—to get a glimpse of that cute button nose in profile, or even to find out your baby's assigned sex or get an updated due date. And now's your chance.
The 20-week appointment typically involves an anatomy scan, which means you'll get an ultrasound to take sonogram photos of your placenta, uterus and cervix, as well as check in on baby's size, bone and organ development.
This appointment will take longer than your previous ultrasounds, as the ultrasound technician will need to take plenty of pictures and measurements to make sure they've covered everything. Prepare to spend anywhere between 45 minutes to 75 minutes (on the longer side if you're considered high-risk), and be sure to factor in extra time in the waiting room.
Wondering more about how you can prepare for this appointment—and the results?
Here are 8 questions to ask during your 20-week anatomy scan appointment.
1. What does the 20-week anatomy scan look for?
The 20-week scan is an important diagnostic and screening tool. While you're lying on the table, the technician will be taking sonogram photos and measurements of both your anatomy and your baby's and logging them all into a chart for your doctor to review.
The ultrasound technician performing your scan may start with a vaginal ultrasound probe to get a good view of your uterus, ovaries and cervix, then move to an external probe to better view the baby, plus your placenta and its location, as well as the umbilical cord.
With an external ultrasound transducer (wand), the technician will move the probe over your abdomen (here's where that warm jelly comes in) and look at your baby's overall size, plus their face, spine, limbs and internal organs, such as their brain, heart, lungs, kidneys, as well as their genitalia, and the amount of amniotic fluid present.
The technician will also be looking for potential markers of genetic disorders, such as Down syndrome or trisomy 18 or 21.
2. Can my partner or family member join?
Some hospitals and clinics have specific rules about who can be in the room with you during the appointment—and now even who can be in the waiting room, given current COVID restrictions. If you'd like someone to go with you, ask the front desk administrator what's possible.
3. How soon will I receive results?
If you're interested in finding out your baby's assigned sex, your ultrasound technician should be able to let you know during this appointment. (Ultrasound techs usually aren't able to directly share most of the results they discover during this visit with you, but assigned sex is one they're able to disclose).
After your ultrasound, the technician will submit a write-up of their findings for the radiology doctor to review, and that physician will in turn submit their report to your obstetric care provider. This may only take a day or two, but it could take longer, so be sure to ask your technician when you can expect to hear about the findings.
4. Should I worry if something abnormal pops up?
While an ultrasound can offer a helpful glimpse into what's happening with your baby's growth and development, it's not a highly accurate tool. In some cases, your fetus may not have been in an ideal position during the scan, which could make the results less reliable.
As Diana Spalding, MS, CNM states in The Motherly Guide to Becoming Mama: "A 2013 study reports that ultrasounds are good, but not perfect, at identifying abnormalities. They detect 70% to 90% of nervous system problems, 40% to 50% of heart problems, 25% to 70% of urinary tract problems, 46% to 100% of abdominal and digestive problems, 20% to 50% of bone problems, and 7% to 55% of cleft lips and palates. Technology advances all the time, but it is important to keep in mind that an ultrasound is a tool, and not a flawless one."
If your doctor has any concerns, they'll likely schedule a follow-up scan in two weeks to take another look. Be sure to talk to your doctor or midwife about any of your own worries that may arise.
5. Are we still on track for the due date?
The anatomy scan is a good way to check your baby's growth to see if they're on track for your estimated due date. After taking more measurements, your doctor or midwife should have a better idea of whether your baby is tracking along earlier or later than previously thought.
6. How accurate is the sex determination?
If your technician declares you're having a girl but you could've sworn you've got a boy brewing in there, feel free to ask them to take another look. But know that in most cases, ultrasound sex determinations are highly accurate.
Ultrasounds technicians are specially trained in reading sonograms and usually hit this right on the nose. One small study in 2014 found that for anatomy scans after 14 weeks gestation, ultrasound technicians' sex predictions were 100% accurate. (Pretty impressive, if you ask me!)
7. Can I get a picture?
Don't forget to ask for a selection of printed sonogram photos to take home and hang on your fridge/show off to your relatives/paste in your baby book/stare at for hours (those tiny feet!). It's a sweet marker of this magical point in time—and will help you cherish the memory.
8. What happens next?
While your ultrasound technician may not be able to share the results with you right away, if you have any questions or concerns about your anatomy scan or the results, be sure to follow up with your doctor or midwife after the appointment. At that point, you can also ask what to expect at your 24-week appointment!
Are you pregnant, mama? Sign up for Motherly's pregnancy class, where we'll walk you through everything you need to know about this beautiful journey.
Kearin M, Pollard K, Garbett I. Accuracy of sonographic fetal gender determination: predictions made by sonographers during routine obstetric ultrasound scans. Australas J Ultrasound Med. 2014;17(3):125-130. doi:10.1002/j.2205-0140.2014.tb00028.x