Pregnancy Prep: 20 Weeks

When you're at 20 weeks, your body is going through some serious changes. If you’re feeling weird, that’s normal. (You feel weird sometimes, right?) On the bright side, this is a time to marvel at the inherent intelligence of a woman’s body.

20 Weeks: What to Expect

At 20 weeks, you may be feeling back pain, fatigue, and heartburn or indigestion. Here’s a snapshot of what to expect:

Back pain

The physical growth of your uterus and hormonal changes during pregnancy may cause a strain on your back muscles causing back discomfort.  In addition to carrying increased weight in the front of your body, the hormones of pregnancy relax the ligaments of our joints and pelvis, making them more flexible, which can contribute to back pain.  The American Congress of Obstetricians and Gynecologists recommends getting regular exercise to strengthen your back and stretch the muscles that support your back.  Watch your posture when you are standing or walking and be sure to wear supportive shoes.  Applying heat or cold therapy to your back is okay – we recommend trying both and doing what feels best.


While everyone is different when they are pregnant, many women describe a feeling of exhaustion, especially in their first trimester.  Our bodies are creating more nutrients to carry to our growing baby, and hormonal levels change. Couple this with the physical and emotional changes our bodies are going through, and many women will have decreased energy as a result. (For some women, decreased energy = constantly tired.) This is a normal part of pregnancy, and we recommend getting extra rest when you feel fatigued. Try getting in bed an hour earlier at night and letting yourself drift off. Squeeze a nap in during the day if you feel your body needs it.  You may need to adjust your current schedule or routine to accommodate some extra sleep in your first trimester. Know that this is okay and that this is what your body needs!

Heartburn or Indigestion

If you’re experiencing heartburn or indigestion, there’s a pretty fascinating reason why. During pregnancy, our bodies create a hormone called progesterone. Progesterone helps to thicken the lining of the uterus (making a healthy environment for the growing fetus), it helps the placenta to function throughout pregnancy (which is what is bringing the baby healthy oxygen and nutrients), and it stimulates the growth of breast tissue for development of breast milk.

Alas, progesterone also causes the valve between the stomach and esophagus to relax, preventing stomach acid from passing back into the esophagus, which causes irritation and the feeling of heartburn.  Many women experience the most heartburn in their third trimester, when the uterus has grown significantly larger and applies more pressure on the intestines and stomach, pushing what we eat back up into the esophagus.  

To minimize heartburn, eat smaller meals throughout the day, rather than three large meals.  Try to avoid spicy, greasy and fatty foods as these can contribute to heartburn.  After eating, wait an hour to lie flat, so the food you have eaten is well digested; prop yourself up with extra pillows when sleeping.  Some women find yogurt or a glass of milk to be a natural way to relieve symptoms of heartburn.  Always speak with your healthcare provider regarding over the counter medications that you might want to try to relieve heartburn.

Cool Facts about Pregnancy

1: When not pregnant, your uterus can hold about 30ml of fluid (a small medicine cup). When you are 40 weeks pregnant, your uterus can hold up to 20 liters of fluid.

2: Your body grows a brand new organ (the placenta) when you are pregnant. The placenta acts as the lifeline between you and your baby, and delivers oxygen, blood, and nutrients to your baby.

3: Your body starts to make breast milk as early as 20 weeks.

Did you know Boston NAPS has a private Facebook group for pregnant women and new moms? Click here to gain access to the group.  Want more hands-on or customized information about your pregnancy?

PregnancyNancy Stewart