23 Weeks Pregnant: Baby Development, Symptoms and Tips
Short Answer: At 23 week pregnancy, your baby is about 29 cm from head to heel, roughly the size of a large mango or a grapefruit, and weighs around 500 grams. The skin is wrinkled and see-through, the hearing is sharper, the lungs are getting ready to make the substance that keeps them open after birth and your baby moves, startles and hiccups often. The top of your womb is about 2 to 3 cm above your navel. You may notice swelling in your feet, backache, tightenings, more discharge and clumsiness. This week, learn what happens if you go into early labour, ask about the glucose test and a hemoglobin check, treat any itching or smelly discharge quickly and keep taking iron and calcium. Call a doctor for heavy bleeding, severe pain, fever, fluid leaking, regular tightenings or a severe headache with blurred vision.
Pregnancy weeks are counted from the first day of your last period, not from conception. Twenty-three weeks pregnant means about twenty-one weeks since conception. You are in your sixth month with about 17 weeks to go. For the week before, read our guide to 18 weeks pregnant, for the next, 20 weeks pregnant, and to follow the whole journey see our pregnancy guidelines week by week.
Week 23 at a glance
| Detail | At 23 weeks |
|---|---|
| Trimester | Second |
| Months | About 5.5 |
| Baby’s length | About 29 cm (11.4 inches), head to heel |
| Baby’s weight | About 500 grams |
| Heart rate | About 120 to 160 beats per minute |
| Weeks to go | About 17 |
| Size comparison | A large mango or a grapefruit |
| Height of womb | About 23 cm from the pubic bone |
Your baby at 23 weeks
Growth. Your baby is gaining weight steadily, and weight will keep rising faster than length. Most of the baby’s fat is yet to come, which is why the skin still looks loose.
Skin. The skin is thin, wrinkled and see-through, with a reddish colour because tiny blood vessels show underneath. Fat is building up and will smooth the skin over the coming weeks. Vernix, a white creamy coating, protects it, and fine lanugo hair covers the body. Fingerprints and toe prints have formed.
Face. The eyebrows, eyelids and lips are well formed. The eyes can move under the lids, and your baby can sense bright light through your belly, though the eyes stay closed. Tooth buds are forming in the gums.
Hearing and startle. Hearing keeps improving. Your baby hears your heartbeat, your voice, your stomach and loud sounds from outside, all muffled by fluid and tissue. A sudden loud noise can make your baby jump, and you may feel it as a quick movement.
Balance. The inner ear is developed enough for your baby to sense position and movement, so your baby may become more active when you lie down or turn over.
Brain. The brain is growing fast, and the connections between nerve cells keep multiplying. This continues through pregnancy and into early childhood, and good food, sleep and care all help.
Lungs. The airways have branched and the blood vessels in the lungs are growing. Your baby practises breathing movements, though the lungs are full of fluid. In the next few weeks the lungs begin to make surfactant, a substance that stops the tiny air sacs from collapsing after birth. Surfactant is the main reason very early babies need breathing support.
Digestion and urine. Your baby swallows amniotic fluid and passes urine, which adds to the fluid. The waste called meconium builds up in the bowel and is usually passed after birth.
Movement. Your baby kicks, rolls, punches, stretches and has hiccups. Sleep and wake cycles are clearer, and many babies are busiest in the evening.
Genitals. In girls, the uterus and ovaries are in place. In boys, the testes are moving down toward the scrotum.
Chances at birth. At 23 weeks, a baby born very early has a small chance of survival, even with intensive care, and survival rises quickly with each week after 24 weeks. In places with limited newborn intensive care, the chances are lower. This is why preventing preterm birth, and getting to a well-equipped hospital fast if it starts, matters so much.
Your body at 23 weeks
Womb. The top of your womb is about 2 to 3 cm above your navel, and a tape measure from the pubic bone reads about 23 cm. Your doctor may measure this at each visit as a quick check of growth. A difference of up to 2 cm either way is normal.
Bump. Most people have a clear bump now, and others notice it for the first time. If it is your first baby, the bump may still be small, and your height, build and muscle tone affect how you show. Your navel may flatten or pop out and returns to normal after the birth.
Weight. A person of normal weight usually gains about 0.4 to 0.5 kg a week. By now most people have gained about 5 to 8 kg in total, though it varies.
Blood and heart. Your blood volume has risen by up to 40 percent, and your heart works harder. You may feel warmer, sweat more, notice a faster pulse or feel dizzy when you stand up quickly. Blood pressure may start to rise after 20 weeks, so every visit includes a blood pressure check.
Skin and hair. A glow is common, but so are acne, dry skin and dark patches on the face (melasma). A dark line down the belly (linea nigra) is common. Stretch marks can appear on the belly, breasts, hips and thighs. Genetics matters more than any cream. Hair often looks thicker, and nails may grow faster or split.
Breasts. They are larger and heavier. A few drops of thick yellow fluid, called colostrum, may leak. Wear a supportive, wire-free cotton bra, and use breast pads if you leak.
Appetite. Your appetite is likely strong. You need about 300 extra calories a day, not double.
Mind. Vivid dreams, forgetfulness and mood swings are common. Many people feel closer to the baby now.
Movement and hiccups
At 23 weeks, most people feel movement on most days. It can feel like flutters, rolls, kicks, bumps, a sudden jolt from a startle or small rhythmic jumps, which are usually hiccups. Hiccups are normal and may last a few minutes. They are not a sign of distress.
- Learn your baby’s usual pattern, for example more movement after meals or in the evening.
- An anterior placenta, which sits at the front of the womb, can soften the feeling.
- Movement is irregular, so do not worry if one day is quieter than another.
- If you have not felt movement by about 24 weeks, tell your doctor at your next visit.
- From about 28 weeks, doctors advise paying close attention to movement. If you notice a clear drop later in pregnancy, call your doctor the same day, and do not wait until the next day or rely on a home Doppler.
Common symptoms and what helps
| Symptom | Why it happens | What helps |
|---|---|---|
| Backache | Growing womb, loosening joints, posture | Flat supportive shoes, good posture, side-sleeping with a pillow, gentle stretches |
| Round ligament pain, a sharp pull in the lower belly or groin | Ligaments stretch as the womb grows | Move slowly, rest, warm bath |
| Braxton Hicks tightenings | Practice contractions | Drink water, rest, change position |
| Leg cramps, mostly at night | Circulation and mineral changes | Calf stretches before bed, drink water, ask about calcium |
| Swollen feet and ankles | Fluid retention | Raise your feet, avoid long standing, drink water |
| Heartburn | Relaxed valve at the top of the stomach | Smaller meals, avoid spicy and oily food, stay upright after eating |
| Constipation, piles | Slow gut, iron tablets, pressure | Fibre, water, daily movement, do not strain |
| Dizziness, light-headedness | Blood pressure changes, low blood sugar | Eat regularly, stand up slowly, sit if you feel faint |
| Stuffy nose, nosebleeds | More blood flow to the nose lining | Saline spray, a humidifier, lean forward and pinch the nose for a bleed |
| Bleeding gums | More blood flow to the gums | Soft brush, gentle flossing, dental check |
| Headaches | Hormones, tiredness, dehydration | Rest, fluids, ask your doctor before taking medicine |
| Tingling hands | Fluid squeezing a nerve at the wrist | Shake and raise your hands, wrist splint at night |
| Hip and pelvic pain | Loosening joints, sleeping position | Pillow between knees, change position often |
| Mild breathlessness | Growing womb, hormones | Rest, good posture |
| Clumsiness | Shifting centre of gravity, loose joints | Slow down, avoid heels, hold stair rails |
| Itchy belly | Skin stretching | Moisturiser, loose cotton clothes |
Fainting. If you feel faint, sit or lie on your left side and drink water. Do not lie flat on your back. Faint spells that happen often, or with chest pain, a racing heart, a headache or vision changes, need a doctor.
Do not take any medicine, including painkillers and herbal products, without asking a doctor or pharmacist. Paracetamol at the recommended dose is generally considered safe. Avoid ibuprofen, aspirin and diclofenac unless your doctor prescribes them.
Vaginal infections: thrush and bacterial vaginosis
Hormones change the balance of germs in the vagina, so infections are common in pregnancy, especially in hot, humid weather.
| Thrush (yeast) | Bacterial vaginosis | |
|---|---|---|
| Discharge | Thick, white, like cottage cheese | Thin, grey or white |
| Smell | Usually none | Fishy, stronger after sex |
| Itching | Often strong, with redness and soreness | Mild or none |
| Burning on passing urine | Sometimes | Sometimes |
What to do. See a doctor before you treat yourself. A swab or exam confirms which infection it is. Thrush is treated with an antifungal pessary or cream that is safe in pregnancy. Bacterial vaginosis needs an antibiotic your doctor prescribes, and it matters because untreated it can raise the risk of early labour. Do not use douches, scented soaps or perfumed products, because they upset the balance.
Prevention. Wear loose cotton underwear, change out of wet or sweaty clothes quickly, wipe from front to back, dry well after washing and avoid tight synthetic clothes. Control your blood sugar if you have diabetes, since high sugar feeds yeast.
A discharge that is green or yellow, has a strong smell, comes with pain or a fever, or is watery or bloody needs a doctor the same day.
If you go into labour early
Most pregnancies go to term, but you should know what to do if labour starts before 37 weeks. Preterm labour signs include regular tightenings, more than four in an hour, that do not stop with rest and water, a steady low backache, pelvic pressure, a change in vaginal discharge or fluid leaking.
What to do. Lie on your left side and drink water. If the signs continue for an hour, or at once if you have bleeding or fluid leaking, go to a hospital that can care for a newborn. Call the national emergency number 999 if you need help getting there. Take your prenatal records.
What the hospital may do. The doctors will check your blood pressure, urine, baby’s heartbeat and cervix. They may try to delay labour for a short time. For pregnancies between 24 and 34 weeks, they may give you steroid injections, called antenatal corticosteroids, which speed up the baby’s lung development and lower the risk of breathing problems and some other complications. They may give magnesium sulfate, which protects the baby’s brain, and antibiotics if your waters have broken. Steroids work best if given one to seven days before birth, so getting to hospital early matters.
Ahead of time:
- Ask your doctor which hospital you would use if labour started early, and whether it has a special care unit for newborns
- Keep a note of your blood group and prenatal records, and bring them to every visit
- Plan transport at any hour, and keep emergency numbers in your phone
- Ask your doctor if you are at higher risk, for example because of past preterm birth, twins, a short cervix or high blood pressure
You can lower your risk by attending your visits, treating urinary and vaginal infections quickly, avoiding tobacco, managing blood pressure and diabetes and not lifting heavy loads or standing for long hours.
When to call a doctor
| Usually normal | Call a doctor soon |
|---|---|
| Short, sharp pulls in the lower belly | Severe or constant abdominal pain |
| Mild, irregular tightenings that stop with rest | Regular tightenings that come more often and do not stop |
| Milky white discharge | Watery fluid leaking, or foul, itchy or coloured discharge |
| Occasional headache | Severe headache with blurred vision, flashing lights or upper belly pain |
| Tiredness, mood swings | Fainting, chest pain or sudden breathlessness |
| Mild swelling of feet late in the day | Sudden swelling of the face and hands, or one swollen, painful calf |
| Light spotting after sex | Bleeding that soaks a pad in an hour, or with clots |
| Occasional nosebleed | Any fever, burning urination or back pain |
Pre-eclampsia. A serious blood pressure condition that can develop after 20 weeks. Signs include a severe headache that will not go away, blurred vision or flashing lights, sudden swelling of the face and hands, pain under the ribs on the right side, vomiting and rapid weight gain. It needs urgent care.
Fever. In Bangladesh a fever can also mean dengue, so do not treat it at home. See a doctor straight away.
If you feel sad, anxious or hopeless for more than two weeks, tell your doctor. If you ever have thoughts of harming yourself, seek help right away.
Tests coming up
| Test or step | When | What it does |
|---|---|---|
| Glucose test | 24 to 28 weeks, or earlier if you have risk factors | Screens for gestational diabetes |
| Hemoglobin check | Second and third trimesters, or as advised | Looks for anaemia |
| Blood pressure and urine check | Every visit | Screens for pre-eclampsia and infection |
| Anti-D injection | About 28 weeks, if you are Rh negative | Protects future pregnancies |
| Whooping cough vaccine | About 27 to 36 weeks | Protects your newborn |
| Tetanus-diphtheria vaccine | During pregnancy, as your doctor advises | Protects you and your baby |
| Flu vaccine | Any trimester, in flu season | Protects you |
| Growth scan or repeat placenta scan | If advised, often about 32 weeks | Checks your baby’s size, fluid and placenta position |
The glucose test. Gestational diabetes is common and usually has no symptoms. South Asian women have a higher risk. Ask your clinic exactly how to prepare, whether to fast and how long the test takes. Eat normally in the days before, and do not cut carbohydrates. If you have gestational diabetes, it is manageable. Most people control it with food choices, walking and checking blood sugar, and some need tablets or insulin.
Anaemia. Anaemia is common among pregnant women in South Asia. The World Health Organization defines it as hemoglobin below 11 g/dL in the first and third trimesters, and below 10.5 g/dL in the second. Ask for a hemoglobin test now. If it is low, your doctor may increase your iron dose, change the type or advise a longer treatment.
Food and supplements
Iron. Keep taking iron-folic acid tablets as prescribed. Take iron away from tea, coffee and milk, and with something sour such as lemon. Dark stools are normal on iron.
Calcium. The World Health Organization advises calcium supplements from about 20 weeks where people’s diets are low in calcium. Calcium helps your baby’s bones and teeth and lowers the risk of high blood pressure in pregnancy. Take it at a different time from iron.
Iodine. Use iodised salt in your cooking, and do not cut salt out completely. Iodine supports your baby’s brain development.
Eat more of:
- Protein: eggs, well-cooked fish, chicken, lentils (dal), beans and milk
- Iron-rich foods: leafy greens (shak), lean meat and lentils, with lemon or guava for vitamin C
- Calcium-rich foods: milk, yogurt, and small fish such as mola eaten with the bones
- Fruit and vegetables: a variety of colours every day
- Whole grains and fibre: brown rice, whole wheat roti and oats
- Healthy fats: well-cooked oily fish, nuts and seeds
- Water: about 8 to 10 glasses across the day, more in hot weather
Limit: caffeine to about 200 mg a day, which is one or two cups of tea or a single small coffee. Limit sweets, sugary drinks, juice and fried snacks. Large portions of white rice and bread push blood sugar up, so pair carbohydrates with protein and vegetables.
Avoid: alcohol, all tobacco (including zarda and jorda), raw or undercooked meat, fish and eggs, unpasteurized milk and cheese, unwashed produce, large predatory fish such as shark and swordfish, high-dose vitamin A supplements, unripe papaya and herbal tonics your doctor has not approved.
Weight gain. Total gain over the whole pregnancy depends on your weight before pregnancy, and Asian-specific BMI ranges may apply, so ask your doctor.
| Weight before pregnancy | Recommended total gain |
|---|---|
| Underweight | 12.5 to 18 kg |
| Normal weight | 11.5 to 16 kg |
| Overweight | 7 to 11.5 kg |
| Obese | 5 to 9 kg |
Sleep, exercise and posture
Sleep. Sleep on your side, ideally the left, with a pillow between your knees and another under your belly. Doctors advise against sleeping flat on your back from about 20 weeks. If you wake on your back, simply turn over. A long body pillow helps. Keep a regular bedtime and avoid screens at night. Hot, humid nights and power cuts can disturb sleep, so use a fan, wear loose cotton clothes and keep water by your bed.
Exercise. The standard advice for healthy pregnancies is about 150 minutes of moderate activity a week, such as 30 minutes of brisk walking on most days. Swimming, prenatal yoga, stationary cycling and pelvic floor exercises are good choices. You should be able to talk while you exercise. Avoid hot yoga, lying flat on your back during exercise, contact sports, heavy lifting and anything with a risk of falls. Stop and call your doctor if you have pain, bleeding, dizziness or trouble breathing.
Pelvic floor. Squeeze and lift the muscles you use to stop urine flow, hold for a few seconds and release. Do a few sets a day. Strong pelvic floor muscles help with bladder control during and after pregnancy.
Posture. As your belly grows, your centre of gravity shifts forward. Stand tall, keep your shoulders back, avoid high heels and use a chair that supports your lower back. Lift by bending your knees. A support belt can ease back pain, so ask your doctor.
Work, money and planning
- Maternity leave. Under Bangladesh’s labour law, working mothers in the private sector are entitled to 16 weeks of paid maternity leave, eight before and eight after the birth. Government employees receive six months. Check your own contract and plan when to tell your employer.
- Place of birth. Choose a hospital or clinic with a qualified doctor or midwife, a way to handle emergencies, a blood supply and a newborn care unit. Ask what the delivery package covers and what an emergency would cost.
- Mode of delivery. Many births in Bangladesh are by C-section, and some are not medically needed. Ask your doctor when a C-section is recommended and what a vaginal birth involves.
- Money. Start a simple budget for prenatal care, delivery and baby costs, and ask about hospital packages.
- Classes. Ask about classes on labour, breathing, newborn care and breastfeeding.
- Dental care. Dental treatment is safe in pregnancy, and gum disease is linked to early birth.
- Partners. Come to appointments if you can, share chores, feel the baby move and listen. Talk about names, birth plans and parenting.
- Baby shopping. You do not need to buy everything yet. Make a list and wait for sales and hand-me-downs.
If you feel unsafe at home, tell your doctor or a trusted person. In Bangladesh you can call the national helpline 109 for support with violence against women and children. It is free.
Checklist for this week
- Ask about the glucose test and how to prepare
- Ask for a hemoglobin and blood pressure check
- Take iron-folic acid and calcium as prescribed, at different times, and use iodised salt
- Learn the signs of preterm labour and pre-eclampsia
- Choose the hospital you would go to in an emergency, and plan transport
- See a doctor for any itching or smelly discharge
- Ask about the tetanus-diphtheria, flu and whooping cough vaccines
- Check your home for standing water and use mosquito protection
- Sleep on your side, and keep up daily walks and pelvic floor exercises
- Save your doctor’s number and the nearest hospital’s emergency number
FAQ
How big is the baby at 23 weeks?
About 29 cm from head to heel and 500 grams, roughly the size of a large mango or a grapefruit. Sizes vary a little between babies.
Can I feel the baby move at 23 weeks?
Most people do. If you have not felt movement by about 24 weeks, tell your doctor.
Can a baby survive if born at 23 weeks?
A few do in well-equipped hospitals with intensive care, but the risks are high. Survival improves quickly with each week after 24 weeks. Go to hospital early if you have signs of preterm labour.
What is the 24-week milestone?
Many hospitals treat 24 weeks as the point at which they offer full intensive care and steroid injections, because survival rises sharply from then. Ask your doctor what your hospital offers.
Are hiccups in the womb normal?
Yes. They feel like small rhythmic jumps, and they are not a sign of distress.
Why do I have so much discharge?
Hormones increase milky white discharge. A strong smell, itching or a green or yellow colour needs a check.
Is it normal to feel dizzy at 23 weeks?
Yes, blood pressure changes and low blood sugar are common causes. Stand up slowly and eat regularly. Call your doctor if you faint or feel dizzy with a headache, chest pain or vision changes.
Is it safe to exercise at 23 weeks?
Yes for most healthy pregnancies. Walking, swimming, gentle yoga and pelvic floor exercises are good. Avoid contact sports, heavy lifting, hot yoga and lying flat on your back during exercise.
Note: This article gives general information and does not replace advice from your doctor or midwife. Every pregnancy is different. Call your doctor or go to a hospital if you have bleeding, severe pain, fever, fainting or any symptom that worries you.
