Baby Care Guide ↗
Evidence-based. References guidelines from ACOG, CDC, and WHO.
Informational only, not medical advice. Always consult your OB/GYN or healthcare provider.
Welcome to week 24 — a quietly enormous milestone. This is the week most NICUs consider babies “viable,” meaning if born now with intensive care, baby has a real (if difficult) shot at survival. You’re nearing the end of the second trimester, your bump is clearly a baby bump, and you’re about to enter glucose-test season. Let’s break down what’s happening.
📌 Key Takeaway: According to ACOG, week 24 marks the medical viability threshold — survival rates jump from around 50% at week 24 to 90%+ by week 28 with NICU care. This guide walks you through baby’s development, key tests, and what to expect this week. For broader context, see our second trimester guide.
Baby’s Development at Week 24
Baby is now about the size of an ear of corn — roughly 11.8 inches (30 cm) crown-to-heel and weighing about 1.3 pounds (600 grams). Most of this gain in the next 16 weeks will be fat and muscle, not length.
What’s happening this week:
- Lungs are developing alveoli (air sacs) and beginning to produce surfactant — the substance that lets lungs expand at birth
- Inner ear is fully formed; baby has a sense of balance
- Taste buds are developing on the tongue
- Skin is still translucent but starting to thicken
- Brain is rapidly developing
- Sleep-wake cycles are emerging
- Baby can hear your voice clearly now
- Vestibular system lets baby sense your movement
What “Viability” Actually Means
Week 24 is significant because it’s the earliest point most US hospitals will offer active resuscitation for a premature baby. Survival statistics from NIH and Children’s Hospital data:
Of course, the goal remains carrying to term (37+ weeks). The “viability” milestone is reassurance, not a target.
Common Symptoms at Week 24
Strong, Distinct Baby Movement
If you weren’t sure that was a kick before, you definitely know now. You may feel hiccups (rhythmic, repeating taps) for the first time.
Belly Button “Outie”
Many women’s belly buttons start to flatten or pop out around now. Returns to normal postpartum.
Backaches and Pelvic Pressure
Your uterus is now well above your belly button. Lower back, hips, and pelvis carry the extra weight.
Braxton Hicks Contractions
These “practice contractions” are short, painless tightenings of the uterus. Hydration helps. If they become regular or painful, see our Braxton Hicks vs real contractions guide.
Stretch Marks
Pinkish or purplish marks may appear on belly, breasts, hips, or thighs. Genetics is the biggest predictor. They fade significantly postpartum.
Itchy Belly
Stretching skin = itchy skin. Moisturize liberally. Important: severe itching, especially of palms and soles, can signal cholestasis — call your OB.
Swelling in Feet and Hands
Some mild swelling is normal. Sudden, dramatic, or asymmetric swelling needs evaluation. See our swollen feet in pregnancy guide.
Heartburn
The uterus pushes upward on your stomach. See pregnancy heartburn relief for safe options.
Snoring and Sleep Disruption
Pregnancy rhinitis + weight gain + position changes = more snoring. Side-sleeping (especially left) and elevating your head helps. See pregnancy insomnia by trimester.
Restless Legs
Especially at night. May be linked to iron levels — see restless legs in pregnancy.
Tests This Week (or Coming Soon)
Glucose Challenge Test (24-28 weeks)
You’ll drink a sweet glucose solution and have blood drawn one hour later. If your number is above the cutoff (usually 130-140 mg/dL), you’ll do a 3-hour confirmatory test. This screens for gestational diabetes — see our gestational diabetes diet and gestational diabetes guide.
Iron-Deficiency Anemia Screen
A CBC may be repeated. Iron needs are highest now. See iron-rich foods in pregnancy for dietary support.
Tdap Vaccine (27-36 weeks)
You’ll get the Tdap (tetanus, diphtheria, pertussis) vaccine soon to pass whooping cough protection to baby.
Anti-D (RhoGAM) at 28 Weeks (if Rh-negative)
If you’re Rh-negative, you’ll receive an injection around week 28 to prevent antibody formation.
What You Can Do This Week
Start Tracking Fetal Movement
Around weeks 24-28, providers ask you to do daily kick counts. Pick a time when baby is usually active. See our how to count baby kicks guide.
Sleep on Your Left Side
Left-side sleeping optimizes blood flow to the placenta. A pregnancy pillow helps. See sleeping positions in pregnancy for details.
Hydrate Heavily
Aim for 80-100 oz of water daily. Helps with Braxton Hicks, constipation, swelling, and amniotic fluid.
Watch for Preterm Labor Signs
Now that you’re past viability, knowing the signs of preterm labor matters more than ever. See our preterm labor signs guide.
Start Birth Education
Birth classes are typically 6-8 weeks long. Sign up now if you haven’t, especially for in-person classes that fill up.
Tour Your Hospital or Birth Center
Hospital tours are usually offered between weeks 24-32. Knowing the layout reduces day-of-labor stress.
Begin Choosing a Pediatrician
You’ll want a pediatrician selected before baby arrives. Many practices offer “meet the pediatrician” visits for expectant parents.
Plan Your Babymoon (If You Want One)
Most airlines allow flying through week 32-36, but it’s most comfortable around weeks 22-27. Always carry medical records when traveling.
Red Flags This Week
According to ACOG, call your OB urgently for:
- Regular contractions before 37 weeks (more than 4 in an hour)
- Severe headache that doesn’t respond to acetaminophen
- Vision changes (spots, blurriness)
- Severe upper-right abdominal pain
- Sudden swelling in face or hands
- Severe itching, especially palms and soles
- Decreased baby movement (after you’ve established a pattern)
- Any vaginal bleeding
- Fluid leak (could be amniotic fluid)
- Fever above 101°F
Looking Ahead to Week 25-28
Your bump grows visibly week to week now. Glucose test results return within days. Soon you’ll move into the third trimester — see our pregnancy week 28 and third trimester guide for what’s coming.
Frequently Asked Questions
How big is my baby at 24 weeks?
About 11.8 inches (30 cm) crown-to-heel — roughly the size of an ear of corn. Weight is around 1.3 pounds.
Why is 24 weeks called the viability milestone?
This is the earliest gestational age where survival with NICU care typically becomes a real possibility (50%+ in many hospitals). It’s a medical and emotional checkpoint, not the end goal — full term is still ideal.
Can I feel hiccups at 24 weeks?
Yes — many moms feel rhythmic, repeating taps that last 1-5 minutes. That’s baby hiccups, completely normal.
What is the glucose test like?
You’ll drink a sweet, syrup-like solution (usually flavored orange or lemon) and have blood drawn exactly one hour later. Not fasting. Mildly nauseating for some — bring crackers.
Can I sleep on my back at 24 weeks?
ACOG recommends sleeping on your side after 20 weeks. Left side is preferred. Brief back positions during the day are fine.
💡 Related Resources: After baby arrives, visit our sister site baby.chparenting.com for newborn care, sleep training, feeding guides, and developmental milestones.
Final Thoughts
Week 24 is one of those quiet checkpoints — the moment when baby moves from “developing” to “could survive with help if needed.” It’s reassuring to cross. Continue building healthy habits, prepare for the glucose test, and savor this stretch of pregnancy. The third trimester (and the more visible discomforts that come with it) is just a few weeks away.
References
- ACOG — Periviable Birth: https://www.acog.org/clinical/clinical-guidance/obstetric-care-consensus/articles/2017/10/periviable-birth
- NIH — Premature Infant Survival: https://www.nichd.nih.gov/health/topics/preterm
- Mayo Clinic — Fetal Development Week 24: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/
- March of Dimes — Premature Birth: https://www.marchofdimes.org/find-support/topics/birth/preterm-labor-and-premature-birth
Further Reading
Medical Disclaimer: This article is for general informational purposes and is not medical advice. Discuss specific symptoms or concerns with your OB or midwife.
Written by
Vega LinFounder & Editor — Mother of 2 (Taiwan)
Vega writes Pregnancy Guide from the intersection of evidence-based research (ACOG, CDC, WHO) and her own experience as a mother of two. Completing her Master's in Digital Innovation at Tunghai University. Read more →
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