By now, it may seem that your pregnancy is drawing out forever, but you’ve made it to the point where you’re feeling more of the baby’s growth! These days, you may notice noticeable changes in the baby’s movements and positions from one day to the next.

Meanwhile, your body is making more big changes. Your pregnancy is becoming more visible, and you may feel more tired than you have since the first trimester. There’s a long way yet to go, but you may find that it suddenly starts moving really fast; so now’s a good time to get prepared!

Your Baby’s Development At 23 Weeks

Your baby may be having dreams! He now has noticeable REM (rapid eye movement), which is the sleep stage associated with dreaming.

By now, the average fetus is about 12-13 inches and weighs about 1 1/3 lb. That’s only a tiny physical growth from last week, but much of your baby’s current development is centered more on organs preparing for life outside the womb rather than on increasing size. His brain is currently carrying out critical developmental tasks, too!

He’s developing patterns of sleep and wakefulness, and his limbs are more proportional to his body now (though his head is still big for the rest of him). You may notice specific patterns in behavior, like that he is active right after a meal or when you lie down.

All that motion builds the muscles he will need once he’s born! (If you haven’t felt your baby move yet, speak to your doctor!)

Quick Overview: Baby's Development At 23 Weeks Pregnant:

• Your baby might be dreaming now, with noticeable REM sleep.
• Average fetus size: 12-13 inches, weighing 12-13 inches long, about 1 pound.
• Limbs now proportional, but head still larger.
• Baby developing clear activity patterns, like movements after meals or lying down.
• Regular movement helps build muscles for after birth.

Mother’s Symptoms At 23 Weeks

Pain & Cramping

A new pregnancy pain may crop up this week: rib pain. Your rib cage is expanding to make room as your uterus shoves other organs out of its way, and this can feel uncomfortable or even painful.

Resting can help ease this, as can OTC pain meds.

Add this to the ongoing pains and discomforts of the second trimester:

Round ligament pain can feel like a stabbing sensation or a pulling sensation in your lower abdomen as your ligaments stretch to accommodate your heavier uterus. This usually eases with a change in position.

Leg cramping and restless leg symptoms – the sudden urge to move your legs – can be common in pregnancy. Getting enough potassium and iron might help reduce cramping. Since most RLS medications are considered risky during pregnancy, the most common advice includes exercise, massage, and warm baths. There may be exceptions in extreme cases where quality of life is impacted.

Backache is also common. A belly band and supportive shoes may help. (Note that contractions can feel like back pain for some women, so if your ‘backache’ comes in waves and timing it shows a predictable pattern, contact your doctor.)

Braxton-Hicks contractions, or ‘practice’ contractions, are normal now. They are typically not painful. They usually are not regular, and should go away when you change positions. If you have contractions that do not go away and that get stronger and more frequent, they may be labor, and you should notify your doctor.

Headaches, Shortness Of Breath, Chest Discomfort

As pressure increases on your lungs, you may notice that you get short of breath or fatigued more quickly. You may also experience dizziness or headaches. These can be caused by both the pressure on your lungs and the increased blood volume.

While these symptoms can be normal, severe headaches should be reported to your doctor, as should any headache, dizziness, or shortness of breath accompanied by chest pain. If you pass out, seek medical care immediately!

Digestive Complications

Pregnancy can bring many digestive symptoms, including heartburn, indigestion, constipation, and diarrhea. The first defense against these is dietary: getting enough fiber and avoiding trigger foods can help.

If heartburn and indigestion persist, most doctors approve Tums, Rolaids, and similar medications. Antacids that contain aspirin, magnesium trisilicate, or sodium bicarbonate are not considered safe in pregnancy.

There are also limits on the allowable medications for constipation. Stool softeners are generally considered safe, but ask your doctor before using laxatives, and avoid options that include stimulants.

Diarrhea can be a sign of early labor, so if you have symptoms that persist, contact your doctor.

Cravings are common in pregnancy. You can balance satisfying cravings with choosing healthy foods. Check out our page, which explains more about what specific cravings may mean.

Skin & Breasts

You may have stretch marks on your belly, breasts, and sometimes other areas of the body by now. A gentle lotion or moisturizer may reduce any physical discomfort (itching, pulling) caused by these and can even reduce the appearance and the potential for long-term scarring.

You may notice that your nipples and areolae are larger than before, and the color may darken. You may even leak colostrum. If so, consider using nursing pads for extra protection. These are available in a variety of reusable and disposable styles. They can protect your clothing and reduce your discomfort. If you suffer cracked or bleeding nipples, contact your doctor.

You may also see spider veins, in which your veins are visible through your skin and may have a ‘spidery’ or tree-like pattern. This is usually nothing to worry about and goes away on its own, but if there is any pain associated with it, you’ll want to check in with your doctor.

Insomnia & Other Sleep Problems

In a few months, you’re going to be extremely sleep-deprived. Unfortunately, you may already be. So many factors during pregnancy can cause sleep disturbances.

You may find that getting comfortable becomes more difficult as your body changes. Extra pillows, such as pregnancy pillows, can help with this.

Elevate your upper body and try to have your last meal of the evening at least a few hours before lying down to minimize the effect of heartburn on sleep. Getting enough water can also help (although it may also give you another reason to stay awake: running to the bathroom).

Sometimes, though, even with no other symptoms, pregnancy can bring a bout of insomnia. Doctors typically recommend combatting this with measures like sleep hygiene: keep your room cool, dark, and comfortable; shut off screens a while before bed; keep a routine; and try to relax before sleep.

However, medications may be used to treat persistent insomnia that is severe enough to cause dangerous fatigue during waking hours. This is one of many conditions in which a doctor and patient discuss the balance of risks and benefits to decide whether medication is appropriate.

Swelling & Other Potential Signs Of Pre-Eclampsia

Headaches that don’t go away, especially if they’re intense, can be an early warning sign for pre-eclampsia. Contact your doctor immediately if OTC meds or hydration doesn’t ease your headache.

Some bloating or swelling during pregnancy is normal, but if it’s sudden, affects the face, or is more prominent on one side of the body, it’s a possible sign of preeclampsia, and you should call your healthcare provider.

Vision changes are also an important symptom to watch for. These may include blurring or dark spots.

Though weight gain is normal during pregnancy, sudden, too-rapid gain should also be checked out. The average normal weight gain in the second trimester is about 1lb per week, but this can vary widely depending on your starting weight, whether you’re pregnant with one baby or multiples, and other factors, so watch for anything that differs from what has been normal for your pregnancy.

23 Week Pregnancy Symptoms Quick Recap:

• Dreams: Baby experiencing REM sleep, possibly dreaming.
• Size: Fetus about 12-13 inches, limbs becoming proportional, head still larger.
• Movement & Muscle Growth: Active after meals or lying down; helps muscle development.
• Pain: Round ligament (sharp/pulling lower abdomen), leg cramps, restless legs, backache (watch for rhythmic patterns).
• Contractions: Braxton-Hicks normal; painless tightening.
• Breathing & Fatigue: Shortness of breath, dizziness, fatigue, headaches (watch for severity).
• Digestive Issues: Heartburn, indigestion (safe meds: Tums/Rolaids), constipation (limited safe options), monitor persistent symptoms.
• Stretch Marks & Spider Veins: Common; moisturizing may relieve discomfort.
• Swelling: Normal unless sudden, severe, or uneven (possible preeclampsia).
• Vision Changes: Blurred or dark spots (contact doctor immediately).
• Weight Gain: Steady is normal; sudden/unusual gain requires monitoring.

When To Contact Your Doctor

Pre-Eclampsia

As described above, any symptoms of pre-eclampsia should be reported to your doctor immediately. This serious condition requires monitoring for your and your baby’s safety. These symptoms include severe headaches that don’t go away with medication, sudden or severe swelling, swelling that affects the face or is more significant on one side of the body, sudden rapid weight gain, and vision changes.

Pre-Term Labor

If you are experiencing any signs of preterm labor, contact your doctor.

Contractions that become more intense and frequent are a sign of labor. Call your doctor if you have contractions that don’t stop when you change positions, rest, and hydrate. (The National Institutes for Health draws the line at six contractions in an hour, but your doctor may prefer you to call for fewer than that.)

Passing the mucous plug, a mass of material that blocks the opening of your cervix, is a sign that your cervix may be dilating or thinning. Some women may lose their mucous plug, or pieces of it, and have it reform, especially late in the third trimester, but if you think you’ve lost your mucous plug at this point, check with your doctor. It may be clearish or may have bloody streaks or a pink tinge.

Rupture of membranes, or water breaking, is a sign of labor. If you think your water has broken this early in your pregnancy, seek medical care.

Some other possible signs of labor include lower back pain, severe vomiting and nausea, vaginal bleeding, and pressure in the pelvic are.

Remember that your doctor can frequently stop preterm labor and help you maintain your pregnancy for long enough to bring your baby into the world safely, or even to term, so if you think you’re in labor, do not put off seeking care!

Other Symptoms To Report To Your Doctor:

Several other symptoms may not seem as urgent or emergent, but your doctor may want to treat them right away rather than wait for your next appointment.

Any sign of infection, such as a malodorous discharge, vaginal swelling or itching, should be reported to your doctor. Cracked or bleeding nipples warrant an immediate call. (Your doctor may call in a prescription without a visit.)

Signs of dehydration, including inability to pass urine, extreme fatigue, dry mouth, dizziness, and extreme thirst should be reported to your doctor. If you can’t remedy it by consuming water, you may need fluids via IV.

Pregnancy hormones can set off mood swings, but severe mental health symptoms should be reported to your doctor.

It’s always okay to operate with an abundance of caution during pregnancy, so if something seems wrong, call your doctor.

What Should Mom Be Doing At 23 Weeks?

Do your best to get sufficient rest and nutrition. Try to avoid extreme stress, and avoid putting too much physical stress on your body. Stay active, but be cautious about any strenuous activity.

Now is a good time to prepare your house for a baby since you may feel more fatigued in the next trimester. Plan where you’ll put your crib, bassinet, and/or playpen. You may even want to set up changing stations in different parts of the house. This can be simple: a blanket to spread under your baby, diapers, wipes, rash creams, and a spare onesie or two.

Some women say they like to deep-clean their homes at this point since they’ll be too tired to do it after the baby comes, but if you find yourself among them, do so with caution. If you’re cleaning with chemicals, keep the area well-ventilated; if you’re lifting and moving things, don’t overdo it.

Quick Recap Of What Mom Should Be Doing At 23 Weeks Pregnant:

• Rest: Aim for adequate rest and nutrition; manage fatigue.
• Prepare home: Set up baby spaces (crib, playpen, changing stations with diapers, wipes, creams, extra clothes).
• Deep clean: Optional deep cleaning at this stage can help later.
• Safety first: Watch fatigue and avoid strenuous tasks; rest as needed.

What To Look Forward To

This can be one of the most fun parts of pregnancy. As the weeks go on, you’ll feel your baby’s movements more and more. You may even start feeling that you can recognize some aspects of his personality: is he active or more laid-back? It can be fun to make predictions, too: are you incubating a soccer star, gymnast, or a ballet dancer who’s already practicing the spins?

After your next appointment (maybe two), your doctor will likely change your visit schedule to every two weeks instead of once monthly to keep a closer eye on your baby’s development and your health!