What You Need to Know About the 20 Week Anatomy Scan - Baby Chick

What You Need to Know About the 20 Week Anatomy Scan

Halfway through your pregnancy and getting ready for your 20 week anatomy scan? We're answering all your questions about this routine scan.

Updated August 30, 2023

by Jessica Tzikas

Medically reviewed by Kristy Goodman

Obstetrician-Gynecologist Physician Assistant, MS, MPH, PA-C
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Congrats! You officially made it halfway through your pregnancy. Once women reach 20 weeks, they often feel pretty good—morning sickness has subsided, and you aren’t big enough to be burdened with too much back pain and extra weight. Another exciting part of this milestone is the 20-week ultrasound or anatomy scan. This may be your first time seeing the baby. During this scan, many parents-to-be find out the gender of the baby, and you get confirmation that baby is growing normally. The 20-week scan can be just as nerve-wracking as exciting, so we dive into what you can expect.

Everything You Need to Know About the 20-Week Anatomy Scan

What is the 20-week Anatomy Scan?

Although you often hear about it, most women aren’t sure why they need a 20-week scan. While this scan focuses on gender for the parents (for most, this will be when they can confirm whether it’s a girl or boy), it’s much more than that. During this scan, a sonographer will look at everything, from the baby’s bone structure to their heart valves, to determine whether or not they are growing correctly.1 They will study the heartbeat, check the amniotic fluid, and measure baby’s anatomy measurements. Your baby’s due date will be confirmed if this is your first ultrasound. While they analyze baby from head to toe, they will also look for certain anatomical anomalies that can be seen on the scan.

What Happens During the 20-Week Anatomy Scan?

I went into my scan not quite knowing what to expect—some other pregnant friends and moms told me that it was strictly an over-the-stomach ultrasound, while others said they had a transvaginal ultrasound.2 Similarly, some said that the scan was quick and easy, while others remember being there for over an hour or more, and even some had to come back on a different date because their baby was not cooperating. For me, my scan was somewhere in the middle. The sonographer did a quick transvaginal ultrasound first to measure my cervix (we still want it to be nice and long and thick at this point!). Then, the remainder of the appointment was a transabdominal ultrasound.3

Luckily for me, my baby was cooperating, so the sonographer could get a quick read on her measurements. She went over everything—counting fingers and toes, checking the spine, the brain, and the heart. As she went, she let us know what we were looking at and that everything was looking good. Following the ultrasound, we sat with the doctor to review the images and ask any questions.

How Can I Prepare for the Scan?

There isn’t much you have to do to prepare. I was advised to drink orange juice or other sugary drinks about 20 minutes before the appointment to get baby moving, but most doctors will tell you just to come as you are. Ensure you are hydrated and don’t empty your bladder until you arrive—some sonographers want your bladder to be full, while others don’t. Ensure you get this confirmation. Otherwise, you may have to chug water in the doctor’s office. You may also want to wear loose clothing and eat a balanced meal beforehand in case the appointment takes longer.

Also note: your scan will likely occur at a Perinatologist’s office or radiology center, and most of these offices do not allow children, even in the waiting room.4 If you have other children, try to organize someone to watch them while you are at your appointment.

What if Something is Wrong?

I had tons of anxiety leading up to my scan thinking of this possibility. The good thing about getting this scan is that if something does show up, you have plenty of time to either fix the problem or truly understand it before giving birth. Many problems that show up during the scan, like placenta previa, resolve themselves before birth, so there is usually no need to stress too much if you get some unexpected news. Whatever you find out on that day, be sure to ask the doctor as many questions as possible so you leave as informed as possible.

While the 20-week scan may bring a bit of anxiety for mothers-to-be, it is also an exciting time to see your baby and possibly learn the gender if you don’t know it already. We left our appointment with adorable new pictures to show family and friends and the feeling that this is truly happening. 20 weeks down, 20 (ish) to go!

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Jessica is a writer and editor with a focus on all things lifestyle. Whether she is discovering the latest restaurants, staying up-to-date on new styles, helping brides plan their wedding,… Read more

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