Pregnancy Week 19: Getting Ready for Your Anomaly Scan

7 min read

Quick answer: At 19 weeks you are preparing for the 20-week anomaly scan, offered to all pregnant women in England between 18 weeks and 20 weeks and 6 days. This detailed ultrasound takes around 30 minutes and checks your baby's brain, heart, spine, face, kidneys, abdomen and limbs, plus growth and placenta position. Your baby is about 15.3cm crown to rump, and vernix is forming on the skin.

What parents need to know

Week 19 is an exciting one: your 20-week anomaly scan is just around the corner, and your baby continues to grow rapidly. This important scan is one of the most anticipated milestones of pregnancy, giving you the chance to see your baby in detail and check that all is developing as it should be.

Baby's size	About 15.3cm crown to rump, roughly a mango
Anomaly scan window	18 weeks to 20 weeks and 6 days (England)
Scan length	Around 30 minutes
Uterus position	Now reaches your navel

How big is your baby at 19 weeks?

Your baby is now roughly the size of a mango, about 15.3cm from crown to rump. Your baby is also putting on weight and the body is becoming more proportionate.

What's happening with your baby?

This week, a waxy, cheese-like coating called vernix caseosa is beginning to develop over your baby's skin. This protective coating shields the skin from the amniotic fluid and will be present at birth (though first babies often have more of it than subsequent ones). Your baby's brain is developing at a phenomenal rate, with millions of nerve cells forming. The five senses (sight, hearing, smell, taste, and touch) are all developing. Your baby can already hear your voice, and familiar voices may be particularly soothing to them after birth.

Your baby may be developing a sleep pattern too, with periods of activity and rest that you might already be noticing. Many babies become most active in the evenings when their mother is resting.

Two babies stand indoors looking out a window in a black and white photograph.

What's happening in your body?

Your uterus now reaches your navel (belly button), and your bump is unmistakably visible. You may notice your belly button beginning to flatten or pop out as your uterus expands — this is entirely normal and returns to its usual position after birth.

Skin changes may continue: stretch marks on the abdomen, breasts, or thighs are common from the second trimester onwards as the skin stretches rapidly. While moisturiser and oils can't prevent stretch marks (which are caused by changes to the collagen structure beneath the skin), they can help with dryness and may reduce discomfort. Stretch marks fade significantly in the months after birth.

What is the 20-week anomaly scan?

The anomaly scan, offered to all pregnant women in England between 18 weeks and 20 weeks and 6 days, is a detailed ultrasound examination of your baby. It's sometimes called the structural scan or mid-pregnancy scan. It checks your baby's development in detail, looking at the brain, heart, spine, face, kidneys, abdomen, and limbs. The sonographer measures your baby's head, abdomen, and thigh bone (femur) to check growth. The placenta's position is also checked: if it's low-lying (placenta praevia), you may be offered an additional scan later in pregnancy.

The anomaly scan looks for signs of 11 conditions. Most are physical differences in your baby's anatomy, such as open spina bifida, cleft lip and serious heart conditions, but it also checks for signs of Edwards' syndrome and Patau's syndrome. It cannot find every condition. If something is found that requires further investigation, you'll be referred to a specialist or offered additional tests. The scan usually takes around 30 minutes.

Finding out your baby's sex

Some NHS trusts offer to tell you your baby's sex at the 20-week scan, while others do not due to the difficulty of determining this reliably in all positions. If finding out is important to you, check with your hospital beforehand. You can also choose not to find out and keep it a surprise. There's no right or wrong approach. It's entirely personal.

When to get help

Some symptoms in pregnancy can be a sign of something serious and need checking quickly. This is who to contact, and how soon.

Call 999 if:

you're bleeding from your vagina and the bleeding is heavy (soaking a period pad soon after putting it on), or you also have severe pain in your tummy, pain in your shoulder, or feel sick, faint, dizzy or lose consciousness
you have severe difficulty breathing (you're gasping, choking or not able to get words out) or your chest feels tight or heavy
you have pain and swelling in one leg and you also feel short of breath or have chest pain. A blood clot in the leg can travel to your lungs, which can be life-threatening
you have possible signs of sepsis, such as breathing very fast, being confused or having slurred speech, blue, pale or blotchy skin, a rash that does not fade when you press it, or a very high or very low temperature. Being pregnant makes sepsis more likely
you do not feel you can keep yourself safe (a mental health emergency is as serious as a physical one)

Always call 999 if you think it's a life-threatening emergency, no matter what stage of pregnancy you are.

Call your midwife, maternity unit or early pregnancy unit now if:

your baby is moving less than usual, you cannot feel your baby moving anymore, or there is a change to your baby's usual pattern of movements
you have light bleeding or spotting, even if you have no pain or only mild tummy pain
you have stomach pain that is severe or does not go away after you've rested for 30 to 60 minutes, or stomach pain with regular cramping or tightenings, lower back pain, or pain when you pee
you have a gush or trickle of fluid from your vagina, which could be your waters breaking, or vaginal discharge that's unusual for you
your skin is very itchy (for example, it keeps you awake at night), the palms of your hands or soles of your feet are itchy, or the itching is worse at night. This can be a sign of a liver condition called intrahepatic cholestasis of pregnancy (ICP) that needs urgent treatment
your breathlessness comes on suddenly, you're out of breath when you're lying down, or you're breathless and also have chest pain or feel dizzy
you have pain or swelling in one leg, usually in the calf or thigh. This could be a blood clot (deep vein thrombosis, or DVT), which is more likely when you're pregnant
you have a high temperature (38C or above), or you feel hotter than usual or shivery. A high temperature can be a sign of an infection, so it's important to get it checked

If your baby's movements change, do not wait until the next day: call immediately, even if it's the middle of the night. Do not use a home doppler to check the heartbeat yourself. Even if you hear a heartbeat, this does not mean your baby is well.

If you cannot reach them, or you're not sure what to do, call NHS 111.

Speak to your midwife or GP if:

you have not felt your baby move by 24 weeks. Most people start to feel movements between 16 and 24 weeks. If this is your first baby, you might not feel them until after 20 weeks
you're worried about your mental health, or stress, anxiety or low mood are affecting your day-to-day life. If you need urgent help for your mental health, call 111 and select the mental health option, or ask for an urgent GP appointment

Your week 19 checklist

This week:

This week

Confirm your 20-week anomaly scan appointment.
Discuss with your partner whether you want to find out your baby's sex.
Moisturise your skin daily for comfort.
Continue exercising gently.
Note any questions you want to ask the sonographer.

Sources: NHS, Tommy's, NCT. General information, not medical advice.

Sources & further reading

General information, not individual medical advice. Speak to your GP, midwife or health visitor about your baby’s needs.