Obstetrical Office Visit – Week 24


Twenty-four weeks is a huge milestone in the obstetrical world.  Traditionally, it is at this point your pregnancy has reached “viability”: this is the time when intervention on behalf of your baby, if needed, would be provided.  Recently, this milestone has been pushed to even earlier gestational ages thanks to our medical colleagues in the neonatal field.

Fetal movements can now be appreciated.  Rather than the subtle “flutters” you may have noted in the past several weeks, your baby’s movements will be easier to notice as stronger kicks.  This tends to be one of the more exciting times and seems to make the pregnancy even “more real” for my patients.  Given your baby’s size, (just over one pound, on average), you may not be able to discern a regular pattern.  This is why I typically do not recommend formal kick counts until the baby is larger, generally around 28 weeks.

Patients are encouraged to review and sign up for prenatal classes, if they choose to do so.  At my hospital, classes are very popular and can fill up quickly.  The classes  are quite informative, including labor & delivery expectations, infant CPR and breastfeeding.

I try to start discussion for your expectations for pain management.  Even this early in pregnancy, some patients have very firm expectations for coping with labor discomfort.  Some patients are interested in the natural approach, without any pain medications, and for those patients I recommend to research classes such as the Bradley method.  Patients may be interested in interviewing doulas or “labor coaches” to help with the labor process.  Doulas and patients can form intense relationships and a doula can be a great spokesman to convey a patient’s wishes for the labor when a patient may be unable to do so.  Other times, patients are already certain that their preferred pain management will be an epidural.  It is important to discuss options with your provider.

Your next office visit is in 4 weeks and will be one of the more busy appointments, including gestational diabetes screening as well as checking for anemia.  We also provide DTaP vaccine to provide immunization for your infant from whopping cough after delivery.  I realize that many patients are “leery” of vaccines when pregnant.  But I assure you, it is highly beneficial for your baby.  For more information on this vaccine, please review the CDC website on pregnancy and Whooping Cough.

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