Week 24: Viable Outside the Womb

Week 24 is an important milestone in pregnancy. From now on, your baby is considered viable — meaning it has a real chance of surviving outside the womb with intensive medical support. Even though the lungs are still immature and the baby needs several more weeks, this is a turning point that brings reassurance.

Your baby weighs around 600 grams and measures approximately 30 cm from head to heel. The inner ear is fully developed, giving the baby a sense of balance. The baby notices when you roll over, bend down, or dance. Facial expressions are becoming more varied — the baby can wrinkle the forehead, close the eyes, and make grimaces.

This week is also typically time for a prenatal checkup and possibly a glucose tolerance test.

Baby's Development

Size and Growth

Length: About 30 cm from head to heel
Weight: About 600 grams
Comparison: The size of a corn on the cob

Key Developmental Milestones

Viability: Your baby now has a chance of survival if born prematurely, though intensive care is needed
Lung development: The lungs are producing more and more surfactant, but are still immature
Inner ear complete: Fully developed — the baby has a sense of balance and notices movement
Skin filling out: Fat is gradually being stored under the surface
Facial expressions: The baby wrinkles the forehead, closes the eyes, and makes grimaces
Taste sense: Taste buds are active — the baby prefers sweet flavors
Blood vessels: A fine network in the lungs is preparing for oxygen uptake
Adrenal glands: Producing hormones important for development and adaptation

Viability — What Does It Mean?

Week 24 is internationally recognized as the threshold of viability. From week 24, most hospitals with neonatal intensive care units will offer full intensive care for a premature birth.

Survival rates increase dramatically for every week:

Week 24: About 40–70 percent survive with intensive care
Week 26: About 80–90 percent
Week 28: Over 90 percent
Week 32: Over 95 percent

It is important to remember that the vast majority of pregnancies continue to term without complications. This milestone nonetheless gives many parents an extra sense of reassurance.

The Sense of Balance Is in Place

The inner ear is now fully developed, and the baby has a sense of balance. The baby clearly notices if you roll over, bend down, dance, or lie still. Many pregnant women find that the baby is more active when they rest — this is because your movements rock the baby to sleep during the day, and when you lie down, the little one wakes up!

Your Body

Common Symptoms

Prenatal checkup: A routine appointment is typically scheduled around this week
Glucose test: Between weeks 24 and 28, a glucose tolerance test may be offered
Itchy skin: The skin is stretching quickly — moisturizing helps
Heaviness: More pressure and heaviness in the pelvis as the baby grows
Sleep problems: Difficult to find a comfortable sleeping position
Heartburn: Symptoms may intensify now
Weight gain: About 0.5 kg per week is typical

Prenatal Checkup at Week 24

At a typical week 24 prenatal checkup, the following is checked:

Blood pressure: Important for detecting signs of preeclampsia
Urine sample: Checks for protein (sign of preeclampsia) and glucose (sign of gestational diabetes)
Fundal height measurement: Measures the uterus size to assess baby's growth
Heartbeat: Your midwife or doctor listens to the baby's heartbeat
Discussion: Review of any symptoms, questions, and how you are doing

Prepare by writing down questions in advance. Bring up topics that concern you — your midwife is there to help.

Good to Know

Glucose Tolerance Test

The glucose tolerance test (OGTT) is offered between weeks 24 and 28 to check for gestational diabetes. According to WHO and CDC, gestational diabetes affects around 7–10 percent of all pregnancies globally.

How the test works:

You fast overnight (at least 8 hours)
A fasting blood sample is taken
You drink a solution containing 75 grams of glucose
A new blood sample is taken after 2 hours

The test is harmless, but the glucose solution tastes very sweet. Some people feel nauseous. Bring something to eat afterward.

Who is offered screening? Risk factors include:

BMI over 25 before pregnancy
Previous gestational diabetes
A first-degree relative with diabetes
A previous baby weighing over 4,500 grams
Polycystic ovary syndrome (PCOS)
Ethnic background with higher prevalence of diabetes

Gestational diabetes can usually be managed with diet and exercise. Early detection is important for both your health and your baby's.

Itchy Skin

Itchy skin on the abdomen is usually harmless and is caused by the skin stretching. Use a good, fragrance-free moisturizer morning and evening. However, be aware that intense itching — especially on the hands and soles of the feet — can in rare cases be a sign of cholestasis of pregnancy, a liver condition that should be investigated with a blood test. Contact your midwife if itching is intense or persistent.

Sleep and Sleeping Positions

It is generally recommended to sleep on your side from week 20 onward, preferably the left side.

Why the left side is best:

Better blood flow to the baby
Relieves the liver (which sits on the right side)
Improves kidney function and reduces swelling
The placenta gets optimal blood supply

Pillow arrangement for good sleep:

A pillow between your knees relieves hips and pelvis
A small pillow under the belly provides support
A pillow behind your back prevents rolling onto your back
A long pregnancy pillow can support belly, back, and knees simultaneously

Other sleep tips:

Consistent bedtime and evening routine
Avoid screens right before bed
Don't drink too much right before lying down
Sleep with an elevated upper body for heartburn
Short daytime naps can compensate for restless nights

Swimming — Perfect Exercise Now

Swimming is especially beneficial during this stage of pregnancy.

Benefits of swimming for pregnant women:

The water supports your weight and relieves the back
Reduces swelling in the legs
Strengthens muscles without stressing the joints
Improves circulation
Gives a pleasant feeling of lightness
Reduces pelvic pain

Practical tips:

Many pools offer specific classes for pregnant women
Water aerobics is a gentle alternative
Wear a swimsuit that provides good support
Drink water before and after swimming
Avoid very warm pools (above 32 degrees Celsius)

Preparing for the Coming Weeks

There are 16 weeks left until your due date. Some things worth starting now:

Practical:

Look into birth preparation classes
Start planning the nursery and equipment
Think about what supplies you need
Order any necessary items in advance

Administrative:

Notify your employer about your planned leave start
Familiarize yourself with your parental leave entitlements and how to apply
Start thinking about your birth preferences

For Your Partner

Provide support during the glucose test, or have a good breakfast ready afterward
Help with applying moisturizer to the belly — a nice daily ritual for both of you
Look into birth preparation classes and sign up together
Mark the milestone — your baby is now viable. That is a big thing!
Talk about how you plan to share parental leave

Tips for Week 24

Get the glucose test: Book an appointment if you haven't been called in yet
Moisturize your skin: Apply cream or oil to your belly, hips, and breasts morning and evening
Pelvic floor exercises: Continue with daily exercises — three sets of ten repetitions
Swim: Try swimming for relief and exercise — it feels wonderful
Prepare for your checkup: Write down questions you want to raise with your midwife
Sleep on your side: Lie on your left side with a pillow between your knees for best blood flow
Start thinking practically: There is a lot to do in the coming weeks — make a list and take it step by step

When to Contact a Doctor

Contact your doctor or midwife if you experience:

Intense itching all over the body, especially on the hands and soles of the feet
Dark urine or pale stools (could indicate a liver problem)
Regular contractions that do not ease with rest
Clearly reduced fetal movements
Severe headache that does not ease with over-the-counter pain relief
Sudden swelling in the face or hands
Persistent vision disturbances

Did You Know?

Viable from week 24: From this week, your baby has a real chance of surviving outside the womb with intensive medical support. The survival rate increases significantly for every week — from around 50 percent at week 24 to over 90 percent at week 28.
Your baby has a sense of balance: The inner ear is now fully developed. The baby notices when you roll over, bend down, or dance — and may react with movements! The baby's own movements send signals back to the brain, which learns to interpret position and movement.
Facial gymnastics: The baby can now wrinkle the forehead, close the eyes, and make various facial expressions. These expressions are not emotional reactions yet, but practice of the facial muscles the baby needs for mimicry, crying, and breastfeeding after birth.
Gestational diabetes is common: The glucose tolerance test offered now detects gestational diabetes in roughly 7–10 percent of pregnancies. Most cases are managed with diet and exercise, and the condition usually resolves after birth.
The adrenal glands are working: Your baby's adrenal glands are proportionally much larger than in an adult. They produce hormones that contribute to lung maturation and adaptation to life outside the womb.

Common Questions About Week 24

What happens during the glucose tolerance test?

You fast overnight, and a fasting blood sample is taken. Then you drink a solution containing 75 grams of glucose, and a new blood sample is taken after 2 hours. The test shows how your body handles sugar. The glucose solution tastes very sweet — some find it unpleasant. Bring a snack for afterward. The test is harmless for both you and your baby.

Is it normal to have sleep problems now?

Yes, very common. The growing belly makes it difficult to find a comfortable position, and frequent urination disturbs nighttime sleep. Side sleeping, preferably on the left, with a pillow between your knees is recommended. A consistent evening routine and avoiding screens right before bed can also help.

What does it mean that the baby is viable?

It means the baby has a chance of surviving outside the womb with intensive care. At week 24, the baby still needs a lot of medical support, but for every week that passes, the chances increase significantly. The vast majority of babies born after week 28 do well with modern medical treatment. Remember that most pregnancies continue to term without problems.

Can itching on my belly be dangerous?

Regular itching caused by the skin stretching is completely harmless and is relieved with moisturizer. But intense itching — especially on the hands and soles of the feet — can in rare cases be a sign of cholestasis of pregnancy, a liver condition that should be checked with a blood test. Contact your midwife if itching is intense or persistent.

What is checked at the week 24 prenatal checkup?

Your midwife measures blood pressure, takes a urine sample, measures uterus size (fundal height), and listens to the baby's heartbeat. You also talk about how you are doing, any symptoms, and any questions you have. Prepare your questions in advance — it's a good opportunity to bring up anything that concerns you.

Should I take the glucose test even if I don't have risk factors?

Speak with your midwife about your specific situation. Some healthcare providers offer routine screening to all pregnant women. Regardless, it is worth being aware of symptoms such as excessive thirst, frequent urination, and unusual fatigue — and mentioning them to your midwife.

Next week: Your baby recognizes your voice and reacts with kicks when you speak!