What to Expect at 23 Weeks of Pregnancy: Preparing for Labor and Self-Care

Highlights

• The fetus measures about 20 cm and weighs approximately 450 grams.
• Rapid brain and central nervous system development.
• Improved functionality of major organs and systems, including circulatory, digestive, and urinary systems.
• Fetal movements are more pronounced and recognizable.
• Maternal body undergoes visible and internal changes, including increased belly size and mild discomfort.
• Balanced nutrition, physical activity, and regular check-ups remain essential.

In This Article

1. Fetal development at 23 weeks
2. Fetal movements and interactions
3. Maternal physical changes
4. Common discomforts and warning signs
5. Nutrition and vitamin recommendations
6. Physical activity during pregnancy
7. Sexual health
8. Prenatal tests and ultrasounds
9. Practical tips for expectant mothers

Fetal Development at 23 Weeks

At 23 weeks, the fetus is about 20 cm long, weighs approximately 450 grams, and resembles the size of an eggplant. Key developments include:

• Brain and CNS: Rapid maturation continues; the brain now weighs around 100 grams (up from 2 grams at 2 months). This supports cognitive and motor functions.
• Blood production: The spleen joins in producing white blood cells and sorting red blood cells.
• Limbs and nails: Fingers and toes lengthen, nails form, and fat starts developing under the skin for thermoregulation. The skin is still wrinkled and reddish.
• Digestive and urinary systems: The fetus swallows amniotic fluid, which is processed and excreted as urine. Particles in the stomach form meconium in the intestines.
• Motor activity: Kicks, stretching, grabbing the umbilical cord, and facial expressions increase. Sleep and wake cycles become more regular. Hiccups are common and can be felt as gentle twitches.
• Sensory organs: Eyes and ears continue to develop; the fetus reacts to light and sound.
• Respiratory exercises: The fetus practices breathing movements by inhaling amniotic fluid, about 60 times per minute.
• Genital differentiation: Male and female organs are clearly visible on ultrasound.

At this stage, all major systems are practicing functions necessary for life after birth.

Fetal Movements

Fetal movements become more noticeable and identifiable. Previously mistaken for gas or minor tugs, the kicks, rolls, and stretches now clearly indicate fetal activity.

• On average, a fetus moves around 100 times per day, but the mother may feel about 10 movements daily, which is normal.
• Sudden increases or decreases in movements should prompt medical consultation.

Maternal Physical Changes

By the 23rd week, a mother may notice:

• Visible changes: Enlarged belly, stretch marks, and pigmentation lines (linea nigra) from the navel to the pubic area.
• Internal changes: The uterus is approximately 4 cm above the navel, exerting pressure on surrounding organs, including the diaphragm. This may cause shortness of breath.
• Discomforts:
  • Itching due to skin stretching
  • Lower abdominal and back pains
  • Braxton Hicks contractions (normal, painless uterine practice contractions)
  • Digestive issues (heartburn, constipation, gas, rare nausea)
  • Frequent urination, mild dizziness, or headaches
• Dental health: Calcium deficiency may affect teeth and gums; supplementation may be recommended.

Warning Signs and Medical Attention

• Suspicious vaginal discharge: Yellow, green, dark brown, foul-smelling, or with unusual texture should prompt a gynecological check.
• Bleeding: Any blood-like discharge requires immediate medical attention.
• Excessive uterine tone: Could be caused by low progesterone, severe early pregnancy complications, Rh incompatibility, or inflammation; urgent consultation is necessary.

Nutrition at 23 Weeks

Balanced nutrition supports maternal health and fetal development:

• Iron-rich foods: Buckwheat, liver, apples, beef to prevent anemia.
• Calcium sources: Dairy products such as milk, cheese, and yogurt to support fetal bone growth.
• Avoid: Alcohol, strong coffee, processed foods, fried and excessively salty or spicy dishes.
• Limit sugar and refined carbs: Replace with dried fruits, nuts, and whole grains.
• Hydration: Prefer water, herbal teas, compotes; avoid excessive intake to prevent edema.

Vitamins

• Prenatal vitamins are often recommended to supplement dietary nutrients.
• Always consult a gynecologist before starting supplementation to ensure the right type and dosage.

Physical Activity

Despite increased belly size, maintaining activity is essential:

• Prenatal yoga: Supports flexibility, posture, and breathing.
• Water aerobics: Strengthens muscles and reduces swelling.
• Light gym workouts: Treadmill or stationary bike with minimal strain.
• Outdoor walks: Daily walking helps maintain fitness and prevents excessive weight gain.

Sexual Health

• Sexual activity is generally safe unless complications exist (e.g., risk of miscarriage, multiple pregnancy, placenta previa, infections).
• Discomfort or pain should prompt temporary abstinence and consultation with a healthcare provider.

Prenatal Tests and Ultrasound

• Standard prenatal tests: blood count, urine analysis, and blood sugar check.
• Gynecological visit includes measuring weight, blood pressure, fundal height, abdominal circumference, and fetal heartbeat.
• Ultrasound may be performed if medically indicated to assess fetal growth, organ development, and detect potential issues.
• Ultrasound can also provide an opportunity to determine the baby’s sex.

Tools and Assistance

• Educational resources: Books, articles, and videos on nutrition, exercise, and labor preparation.
• Pregnancy tracking apps: Weekly updates on fetal growth and maternal changes.
• Prenatal classes: Childbirth preparation and parenting guidance.
• Support networks: Online forums, healthcare hotlines, parent communities.
• Maternity aids: Pillows, support belts, and compression garments.