What care should be expected under 24 weeks?

1. A respectful, listening assessment

Staff should not dismiss concerns. They should ask:

  • When movements were first felt

  • What has changed

  • Whether this is the first episode

  • Any pain, bleeding, fluid loss or infection symptoms

You should expect kindness and reassurance not “it’s too early to matter.”

2. Basic observations for the pregnant person

They should check:

  • Blood pressure

  • Temperature

  • Pulse

  • Any signs of infection

  • Abdominal pain or tenderness

This helps rule out things that could affect the pregnancy.

3. Clinical judgement about whether an ultrasound is needed

Under 24 weeks, CTGs cannot be used (they don’t work until around 26–28 weeks), but an ultrasound may be offered if there are additional concerns, such as:

  • Severe reduction or loss of movement after they have previously been consistently felt

  • Pain, bleeding, or concerns about fetal growth

  • Signs of infection or other complications

Hospitals vary, but a scan is more likely if movements have been consistently felt before and have suddenly decreased.

4. Safety-netting advice

Before leaving, the person should be told:

  • What to do if movements change again

  • That they can come back any time

  • Who to call (usually triage or EPAU)

  • What symptoms require urgent review (bleeding, pain, fluid loss, fever, worsening symptoms)

They should never be told:

  • “It’s too early for movements to matter”

  • “Come back only after 24 weeks”

  • “There’s nothing we can do”

Those responses are not best practice.

5. If they are pre-24 weeks and have never felt movements

The focus will be on:

  • Maternal wellbeing

  • Confirming the fetal heartbeat

  • Ensuring everything is progressing normally

It’s still appropriate to be seen if they are worried.

Why the pathway is different before 24 weeks

  • Movements can be inconsistent early on.

  • The fetus is too small for CTG monitoring.

  • The primary assessment tool is confirming the heartbeat and checking maternal symptoms.