Pregnancy • Weeks 21–24
Pregnancy Sixth Month: Baby Development, Tests & Care
The sixth month covers weeks 21–24, when fetal movement often becomes more noticeable and the pregnancy moves toward the later second trimester. Learn about baby development, tests, nutrition, activity and important warning signs.
Quick Answer: What Happens in the Sixth Month of Pregnancy?
The sixth month is commonly described as weeks 21–24. The fetus continues rapid growth, becomes more active, develops hearing and continues maturing the lungs and nervous system. Many people feel regular movements during this period, although timing varies. Antenatal care continues, and gestational diabetes testing may be scheduled around 24–28 weeks depending on risk factors and the local care protocol.
What Happens During the Sixth Month of Pregnancy?
Weeks 21–24 are part of the second trimester. The fetus continues growing and developing essential skills, while your changing body may affect posture, sleep, digestion and comfort. Pregnancy experiences differ, so your obstetrician's assessment remains more important than a week-by-week checklist alone.
Baby Development
The baby continues developing hearing, movement, swallowing and breathing-related skills. The nervous system and other organs continue to mature.
Fetal Movement
Movements may feel like kicks, rolls, swishes or jerks. There is no universal number of movements that is normal for every baby; learning your baby's usual pattern becomes important.
Baby Development at 21, 22, 23 and 24 Weeks
Week 21: The baby is moving actively and developing waking and sleeping patterns. Hearing is developing, so sounds and voices may be perceived.
Week 22: The fetus continues gaining size and developing coordinated movement. The lungs and nervous system continue maturing.
Week 23: The baby continues developing body systems and may respond to sounds and movement. Pregnancy-related body changes may become more noticeable.
Week 24: Growth and organ maturation continue. If you have not felt any fetal movement by 24 weeks, contact your maternity or obstetric care team for assessment.
Sixth Month Pregnancy Symptoms: Weeks 21–24
As the uterus grows, some symptoms become more noticeable. Not everyone experiences all of these symptoms.
Backache
Changes in posture, abdominal growth and pregnancy-related ligament changes can contribute to back discomfort.
Heartburn
Hormonal and physical changes can contribute to reflux or indigestion. Smaller meals and remaining upright after eating may help.
Leg Cramps
Leg cramps can occur during pregnancy. Discuss frequent or severe cramps with your clinician.
Sleep & Comfort Changes
A growing abdomen, fetal movement and changing body position can make sleep and daily comfort more challenging.
Important Tests During the Sixth Month
Testing is individualized according to your pregnancy history, screening results, symptoms and local antenatal protocol.
| Test / Assessment | Typical timing or role | Why it may be discussed |
|---|
| 20-week / anatomy ultrasound | Usually around 18–21 or 22 weeks | Detailed assessment of fetal anatomy and development, with evaluation of the placenta and other visible structures. |
| Gestational diabetes screening | Commonly 24–28 weeks when indicated | Checks for diabetes that develops during pregnancy; earlier testing may be considered for people at higher risk. |
| Routine antenatal assessment | According to your care schedule | May include blood pressure, urine testing, symptom review, weight and other assessments. |
| Additional ultrasound or monitoring | Only when clinically indicated | May be recommended for growth concerns, multiple pregnancy, bleeding, placental concerns or other risk factors. |
Important: Screening tests estimate risk or identify conditions that need follow-up; they do not all provide a diagnosis. Your obstetrician should explain which tests are appropriate for your pregnancy.
Gestational Diabetes Testing Around 24–28 Weeks
Gestational diabetes screening is commonly offered between 24 and 28 weeks when indicated. Some people are tested earlier because of risk factors or previous pregnancy history. The exact test and preparation vary by healthcare system and clinical protocol.
If gestational diabetes is diagnosed, treatment may include nutrition changes, physical activity, glucose monitoring and medication when needed. Follow the plan provided by your pregnancy-care team.
Baby Movements at 6 Months
The NHS advises that most people begin to feel their baby's movements between 16 and 24 weeks. Movements can feel like fluttering, bubbling, rolling, swishing or kicks. If this is a first pregnancy, movement may not be noticed until after 20 weeks.
Reduced movement matters: Once you have started feeling your baby's usual movement pattern, contact your maternity or obstetric team immediately if the baby is moving less than usual, stops moving or the pattern changes. Do not wait until the next day and do not rely on a home Doppler to check fetal wellbeing.
Sixth Month Pregnancy Diet: What to Eat
Continue a balanced pregnancy diet that provides protein, fiber, iron, calcium and other nutrients required during pregnancy.
- Protein: eggs, dal, beans, lentils, paneer, yogurt, fish or other suitable sources.
- Iron: leafy greens, legumes, meat where appropriate and prescribed supplements.
- Calcium: pasteurized milk, curd, paneer and other calcium-rich foods.
- Fiber: vegetables, fruits, whole grains and legumes.
- Fluids: drink regularly and address persistent vomiting or dehydration promptly.
Foods and Substances to Avoid
- Avoid alcohol and tobacco exposure.
- Avoid raw or undercooked meat, eggs and seafood.
- Avoid unpasteurized milk and dairy products.
- Follow safe food preparation, storage and hand-hygiene practices.
- Discuss caffeine limits, herbal products and supplements with your clinician.
Exercise and Daily Activity at 6 Months Pregnant
For many people with uncomplicated pregnancies, appropriate moderate activity can continue. Walking is one practical option, while other activities should match your health, fitness level and obstetrician's advice.
- Stay hydrated and avoid overheating.
- Use comfortable footwear and avoid activities with significant fall or abdominal-trauma risk.
- Take breaks if you become tired or uncomfortable.
- Follow any exercise restrictions given by your obstetrician.
- Stop activity and seek medical advice if you develop bleeding, fluid leakage, severe pain, fainting or significant breathlessness.
Sixth Month Pregnancy Do's and Don'ts
Do's
- Attend scheduled antenatal appointments.
- Complete the anatomy scan and recommended screening.
- Ask when gestational diabetes testing is due.
- Take prescribed prenatal supplements.
- Stay appropriately active and hydrated.
- Learn your baby's usual movement pattern.
Don'ts
- Do not drink alcohol or smoke.
- Do not self-medicate.
- Do not stop prescribed medicines without medical advice.
- Avoid raw, undercooked and unpasteurized high-risk foods.
- Do not ignore reduced fetal movement or pregnancy warning signs.
When to Seek Medical Care During the Sixth Month
Contact your obstetrician or seek urgent medical assessment for symptoms that are severe, sudden, worsening or unusual for you.
- Vaginal bleeding
- Fluid leaking from the vagina
- Severe or persistent abdominal or pelvic pain
- Regular painful contractions or significant pelvic pressure
- Severe headache, vision changes or sudden marked swelling
- Fever or feeling acutely unwell
- Fainting or severe dizziness
- Reduced, stopped or noticeably changed fetal movement after you have established a usual pattern
Sixth Month Pregnancy Care in Hyderabad
My Health Hospitals provides obstetric and gynecology services at its Kukatpally and Tarnaka branches. Antenatal care should be individualized according to gestational age, medical history, screening results and pregnancy risk factors.
Obstetrics & GynecologyAntenatal Care
Dr. Swetha Reddy
Obstetrician & Gynecologist
Pregnancy Sixth Month – FAQs
The sixth month is commonly described as weeks 21 to 24. Pregnancy is medically dated in weeks, so your obstetrician should use the exact gestational age when planning tests and follow-up.
The fetus continues growing rapidly, developing stronger movements, hearing sounds from outside the womb and maturing the lungs, nervous system and other body systems.
Common symptoms can include a growing abdomen, backache, pelvic or round-ligament discomfort, heartburn, constipation, leg cramps, skin changes, sleep difficulty and increased awareness of fetal movement.
Yes. Most people begin noticing movement between 16 and 24 weeks, although timing varies. By this stage, movements may feel like kicks, rolls, swishes or jerky movements.
The mid-pregnancy anatomy scan is an ultrasound usually performed around 18 to 21 or 22 weeks depending on local practice. It evaluates fetal anatomy and development and may also assess the placenta and other pregnancy structures.
Your clinician may review the anatomy scan, routine antenatal checks and screening results. Depending on your risk factors and local schedule, gestational diabetes testing may be planned for 24 to 28 weeks.
Testing for gestational diabetes is commonly performed between 24 and 28 weeks when indicated. Earlier testing may be recommended for people with higher risk factors.
Continue supplements recommended by your obstetrician. Iron, folic acid, calcium, vitamin D or other supplements may be advised based on your diet, laboratory results and pregnancy needs.
Aim for a balanced diet containing protein, vegetables, fruits, whole grains, calcium-rich foods, iron-rich foods and adequate fluids. Food choices should also follow pregnancy food-safety guidance.
Avoid alcohol and tobacco, raw or undercooked animal foods and unpasteurized products. Follow safe food preparation and storage practices and ask your clinician about caffeine, supplements and herbal products.
For many uncomplicated pregnancies, walking and other suitable moderate activity are appropriate. Exercise should be individualized if your obstetrician has advised restrictions.
Backache is common as the abdomen grows and posture and ligaments change. Severe pain, pain with fever or urinary symptoms, bleeding, fluid leakage or other concerning symptoms requires medical assessment.
Mild intermittent discomfort can occur from ligament stretching, constipation or other pregnancy changes. Severe, persistent or worsening pain should be assessed promptly.
There is no universal number of movements that every baby should make. It is more useful to become familiar with your baby's usual pattern and seek prompt advice if movements become less than usual or change noticeably.
Comfort varies. As pregnancy advances, many people find side sleeping more comfortable. Discuss sleep positioning with your clinician, particularly if you have medical or pregnancy complications.
If you have never felt fetal movement by 24 weeks, contact your maternity or obstetric care team so the baby's heartbeat and wellbeing can be assessed.
Seek prompt medical care for vaginal bleeding, fluid leakage, severe or persistent abdominal pain, regular painful contractions, severe headache or vision changes, fever, fainting, or reduced or changed fetal movement.
Attend antenatal visits, complete recommended screening, follow your nutrition and supplement plan, stay appropriately active, monitor your baby's usual movement pattern and contact your maternity team when warning signs occur.
Medical note: This article is for general pregnancy education. Pregnancy care, screening, medicines, supplements, exercise restrictions and follow-up should be individualized by a qualified obstetrician or gynecologist. Do not use this guide to diagnose a pregnancy complication.
Need Antenatal Guidance?
If you are 21–24 weeks pregnant and have questions about fetal movement, tests, nutrition, gestational diabetes screening or pregnancy symptoms, discuss them with your obstetrician at My Health Hospitals.
Kukatpally: +91 9111674111 | Tarnaka: +91 9100001201
Kphb Branch
