Twin Pregnancy Week 20: Symptoms, Baby Size, Ultrasound & more

20 Weeks Pregnant With Twins or Multiples

Medically Reviewed By
Dr. Sabiha Anjum (Gynecologist/Obstetrician)
View more Gynecologist/Obstetrician Our Panel of Experts

You’ve reached the twenty weeks of your pregnancy. Your twins are growing just fine in your womb.    With a 20-week twin foetus present in your womb all safe and sound, the happiness and excitement would be infectious to everyone. Most women tend to be at their best behaviour and feel ecstatic around this time, while an unlucky few might still be battling the bouts of nausea. The good news is that all of it will pretty much come to an end because more important things are on their way. And these are not merely related to your own body, but also for the babies who will see some of the most significant changes in their own body in the coming months.

The Growth of the Babies At 20 Weeks

The 20th week of pregnancy holds immense importance for babies for their development, as well as for doctors since it provides a massive load of information about your kids, helping them make the right medical decisions.

One of the largest internal developments that your children have is the development of the ability to know how one flavour is different from the other. They might not be able to identify or pin it down to a specific one conclusively, but they can taste the difference. Around this week, babies start consuming the amniotic fluid, through which they get their nutrition. This fluid tends to change its taste based on what you’ve had in your meals. Most of the times the taste borders on sweet and resembles the same flavour as that of your breastmilk. Combined with the reflexive tendency to suck on their thumbs when they drink the fluid, this is the first nudging of the evolutionary process to learn to breastfeed.

The triplets or twins residing inside your womb are now beginning to form their own biological gender identities. Male babies will have developed a small penis while their scrotal sacs will start descending to form the testicles. This process is pretty gradual since the scrotum needs to finish growing entirely for the testes to descend in them. Similarly, female babies will have developed their ovaries inside, with more than 5 million eggs already formed inside it, which tends to reduce by the time they emerge out into the real world. Similarly, her uterus also approaches completion while her vaginal canal initiates its growth in this week, creating a miraculous companionship inside you.

What Is The Size of the Babies?

Most babies tend to grow by around an extra centimetre from the last week, coming to about 15 to 16 centimetres, when measured from their head to their butt. Their weight also increases by approximately 40-60 grams, which might be less for multiples. In any case, your little ones would now be as large as a small banana in this week.

What Is The Size of the Babies?

Common Bodily Changes

The completion of nearly half the pregnancy journey begins to put the body in a good sense of calm and stability. That being said, certain typical signs can affect the body’s behaviour much more intensely, than its physical appearance.

  • Whether you’ve been a fitness enthusiast or a woman who has had a fit body usually, the onset of the pregnancy and the growing belly would feel extremely weird around this time. In the usual state, the muscles that are present in the abdominal region, generally termed as abs, are arranged in a specific order, even if they may or may not be visible under your tummy fat. But once the uterus starts pushing your belly outside and attempts to make space for itself in the abdominal region, the muscles also need to move around and rearrange themselves to suit the changed structure. Women who have been used to seeing their muscles might be in for a weird vision when they lie down and see their stomach. This rearrangement is never painful, but very few women usually speak about lower back pain as a result of it.
  • The uterus expansion does not merely shift the organs in the abdominal region. It also begins to affect the ones present in the upper areas of your torso. All of this shifting starts affecting your diaphragm as well as your lungs. This might not make itself felt physical, but its effect would be pretty evident once you exert yourself or partake in an activity that increases your heart rate. Most women tend to mention about times when they find themselves taking short breaths or failing to take a large deep breath the way they could take before. Thankfully, this does not cause any problem to the pregnant mother, but care does need to be taken to make sure you don’t push yourself harder as a result of it.
  • While most changes might make you feel like the 20th week of pregnancy would be revolving around coming to terms with some more bodily changes that are discomforting to you, one of the welcomed effects is a high level of energy that revitalises your very core. With nausea levels falling and the excitement of holding your babies taking over you, this mid-pregnancy period would be one of the highly treasured ones in your life.

Common Bodily Changes

Symptoms of Twin Pregnancy at 20 Weeks

None of the signs that you might witness when pregnant with triplets or multiple babies is anything out of the ordinary from what you might have seen in the previous weeks. Most of them are just repeated irritations or only remnants of the past.

  • Water retention, boosted circulation, pooling of blood, and the ever-expanding uterus will all result in swellings and cramps in numerous areas of the body. The typical ones are your feet and legs, along with your face in certain areas. As long as the swelling doesn’t seem out of the ordinary, it all seems to be safe. Similarly, any stress on the abdomen or the back will result in an ache, which can usually seem to go away once appropriately massaged.
  • The stomach and intestines work in tandem to properly digest your food and help synthesise its nutrition. Their functioning depends heavily on their proper location within the body, and the levels of various hormones that regulate their activities. In pregnancy, the hormone levels are all over the place. Therefore, indigestion, passing farts, and constipation will be ever-present for quite some time.
  • Another sign of worry for women might be the discharge that continues to occur from the vagina. While it might look weird, it is normal. On the contrary, it is a strong sign that your body is functioning appropriately. Any foul smell or an odd colour of the discharge could spell the presence of an infection.

Twin Pregnancy – Belly At 20 Weeks

Once you have reached the 20th week of your pregnancy, most doctors would start measuring how large your belly is, and then continue doing so. This becomes another parameter to track the progress of your pregnancy. The measurements are usually taken from the front of the belly starting from the navel, around to your pubic bone.

The uterus sinks further below in the abdominal region, with the belly continuing to grow steadily, with an increased curvature. In the presence of triplets or multiples, the pressure can get too taxing for you, which can be reduced by using a maternity belt for support.

Twin Pregnancy at 20 Weeks – Ultrasound

The ultrasound that your doctor conducts around this period is one of the most crucial ones on all fronts.

If you have had regular checkups, you would be quick to notice the extended duration this ultrasound scan will take. This is because your doctor would observe your babies in-depth to understand if there are any anomalies or defects visible in their growth.

Similarly, you would be able to see your babies in more detail as well as listen to their strong heartbeats.

What to Eat

Balanced nutrition needs to continue through this week as well. This is also an excellent time to shift from a typical meal-eating routine to a one that is focused more on grazing through food throughout the day. Boiled and steamed food items remain at the top of the list, along with any nutritional supplements. Make sure your cravings don’t get in the way of a healthy diet.

What to Eat

Pregnancy Care Tips

Though things are changing, your pregnancy requires only the necessary tips to take care of itself effectively.


  • Start signing up for childbirth classes and discussing your birthing plans.
  • Focus heavily on maintaining high iron levels in your nutrition.


What You Need to Shop For

The mid-point of your pregnancy is a great time to indulge in some useful shopping. You can purchase necessities such as:

Being pregnant with twins at 20 weeks should put you in a position of happiness and confidence. You have safely got your babies this far and there’s just the same amount of time to go ahead. In no time, you will have the babies in your arms and your heart will be filled with joy about being a mother.

Previous Week: Twin Pregnancy Week 19

Next Week: Twin Pregnancy Week 21

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