24 weeks pregnant

Your baby at 24 weeks

Week 24 closes ACOG's 21-to-24 week band, and the changes it lists describe a baby that is starting to look and act more like a newborn. Kicks and turns are getting stronger. The sucking reflex is developing. Fat is beginning to form under the skin, although it has not yet filled out, so the skin still looks wrinkled and reddish, with blood vessels showing through. The ridges on the hands and feet that later become fingerprints and footprints are forming now.

There is a change in how this page measures your baby. Up to 20 weeks, the length is crown to rump, because folded legs are hard to straighten on a screen. From 21 weeks the size guide switches to crown to heel, so the figure here, 30 cm, is a stretched-out length and not a sudden jump in growth. The comparison, an ear of corn, is a rough picture only.

The weight comes from the WHO fetal growth charts (Kiserud and colleagues, 2017). They give 665 g as the middle estimated weight at exactly 24 weeks. The 10th percentile is 576 g and the 90th is 765 g, so a healthy baby can sit well above or below the middle line. Head circumference in the middle is 222 mm. These are estimates calculated from measurements taken on ultrasound, not readings from a scale, and your care team looks at the pattern across visits.

This is also a busier week for testing. The table on this page shows several checks whose windows open at 24 weeks, including the glucose test.

Your body at 24 weeks

Your bump is now unmistakable to most people around you, and your body is carrying noticeably more weight than it did in the first trimester. That extra load is a common reason for tiredness to return after a better middle of pregnancy; the NHS says later fatigue can come from the extra weight you carry. Sleep gets harder as well. The NHS suggests lying on your left or right side, using pillows to support your bump and put between your knees.

Swelling is common now. The NHS explains that your body holds more water in pregnancy, and it tends to collect in your lowest body parts, especially if it is hot or you have been standing a lot. Feet and ankles may swell by the end of the day.

On the appointment front, this is the start of the glucose-test window. ACOG says all pregnant people in the US should be screened, usually between 24 and 28 weeks. In England, the NHS offers testing in the same weeks if you have a higher chance of gestational diabetes; the questions at your booking visit decide this, and risk factors include a family history of diabetes or having had gestational diabetes before. The NHS adds that the condition usually has no symptoms, which is why testing matters.

Common symptoms around 24 weeks

• Swollen feet, ankles and fingers. Mild swelling that builds gradually is common. Rest with your feet up when you can, take regular short walks, and avoid standing for long spells in tight shoes, the NHS suggests. Rolling each foot in circles also helps blood flow.
• Back pain. Ligaments that soften and stretch for labor put strain on the joints of the lower back and pelvis. Bend at the knees, wear flat shoes, and use a firm mattress with a supportive pillow. Gentle exercise on all fours and antenatal yoga may also help.
• Heartburn. The pressure of a larger uterus and hormonal changes can send acid upward. The NHS suggests propping your head and shoulders up at night, leaving three hours between your last meal and bed, and eating smaller meals while sitting up straight.
• Restless nights. Frequent trips to the toilet and difficulty getting comfortable are common. Relaxing before bed and avoiding caffeine in the evening can help.

Tips for this week

• Ask about the glucose test. Find out whether you will be tested, when, and whether you need to fast beforehand.
• Learn the pattern, not a number. The NHS says you do not need to count kicks. Learn when your baby is usually busy and quiet, and treat a change in that pattern as the signal. If your midwife or doctor has asked you to count, keep doing what they suggest.
• Sleep on your side. The NHS says this is the safest position, and that if you wake on your back you can just turn over. Its warning about sleeping on your back concerns the period after 28 weeks, so you have time to build the habit.
• Put your feet up. Rest with your feet raised in the evening and take short walks during the day.
• Pack your questions for the next visit. Write down swelling, headaches or anything that worries you so you can raise it.

When to call your doctor or midwife

These are reasons to call now, not to wait for your next appointment. If you cannot reach your maternity unit or clinic, call your local emergency number.

• Call now if you have vaginal bleeding of any amount. Call your emergency number if the bleeding is heavy, or comes with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy.
• Call now if your baby moves less than usual, stops moving, or the pattern changes. Ring your midwife or maternity unit; the NHS says not to wait until the next day.
• Call now if you have a severe headache that painkillers do not ease, blurred vision or flashing lights, pain just below your ribs, sudden swelling of your face, hands or feet, or heartburn that medicine does not clear. These can be signs of pre-eclampsia, which the NHS says is most likely from 20 weeks.
• Call now if you have signs that ACOG lists for preterm labor before 37 weeks: regular or frequent tightening, mild cramps, pelvic or lower belly pressure, a constant low dull backache, a change or increase in discharge, or fluid that leaks or gushes.
• Call now if peeing hurts or burns, especially with a fever or pain in your side under the ribs.