Congrats! You’ve officially reached the halfway point of your pregnancy. By 20 weeks, many women start to feel more like themselves again. Morning sickness often eases, energy returns, and the physical changes of pregnancy feel more manageable.

This milestone also brings the 20-week ultrasound, commonly called the anatomy scan. While many parents look forward to seeing their baby or learning the sex, this scan plays a much bigger role. It gives your care provider a detailed look at how your baby is developing and helps confirm that everything is progressing as expected. Because it can feel both exciting and nerve-wracking, here’s what to expect and how to prepare.

What Is the 20 Week Anatomy Scan and Why It Matters

Although you often hear about it, many women aren’t sure why the 20-week anatomy scan is needed. While some parents focus on learning their baby’s sex at this appointment, the scan serves a much more important medical purpose.

During the anatomy scan, a sonographer examines the baby’s bone structure and heart valves to be sure they are developing as expected.¹ They also evaluate the heartbeat, check amniotic fluid levels, and take detailed measurements of the baby’s anatomy from head to toe.

If this is your first ultrasound, your due date may also be confirmed at this appointment. As part of the scan, providers look for certain anatomical differences that can sometimes be identified at this stage of pregnancy.

Related: What Are They Looking for at Your 8-Week Ultrasound?

What to Expect During the 20 Week Ultrasound

I went into my scan not fully knowing what to expect. Some friends said it would be an abdominal ultrasound only, while others mentioned having a transvaginal ultrasound as well.² Experiences also varied on how long the scan took, often depending on the baby’s position and cooperation.

For me, the experience landed somewhere in the middle. The sonographer began with a brief transvaginal ultrasound to measure my cervix, which we want to remain long and thick at this stage of pregnancy. Then, the rest of the appointment was completed using a transabdominal ultrasound.³

Luckily, my baby was cooperating, which allowed the sonographer to review her measurements efficiently. She carefully checked her fingers and toes, along with the spine, brain, and heart, explaining what we were seeing along the way. After the ultrasound, we met with the doctor to review the images and ask any remaining questions.

How to Prepare for Your 20 Week Anatomy Scan

There isn’t much you need to do to prepare for your anatomy scan. I was advised to drink orange juice or another sugary drink about 20 minutes before the appointment to help get the baby moving, but many providers will simply tell you to come as you are.

Stay hydrated and ask ahead of time whether your provider prefers you to arrive with a full or partially full bladder. Some sonographers have specific preferences, and confirming this in advance can save you from having to drink water quickly once you arrive. You may also want to wear loose, comfortable clothing and eat a balanced meal beforehand in case the appointment runs longer than expected.

It’s also helpful to know that anatomy scans often take place at a perinatologist’s office or a radiology center. Many of these offices do not allow children, even in the waiting room.⁴ If you have other children, try to arrange childcare ahead of time.

Related: Second Trimester of Pregnancy Checklist

What If the Anatomy Scan Finds a Problem?

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 anatomy scan can bring some anxiety, it’s also an exciting milestone in pregnancy. Seeing your baby move, hearing reassurance from your provider, and bringing home new images can make everything feel very real.

We left our appointment with photos to share and a renewed sense of confidence that everything was progressing well. Twenty weeks down, about twenty to go.

Frequently Asked Questions About the 20 Week Anatomy Scan

These are some of the most common questions parents have before and after a 20 week anatomy scan.