Pregnancy Week 23
Pregnancy Week 23
What to expect on pregnancy week 23
Pregnancy Week 23 brings continued growth, increasingly noticeable movement and important neurological development. Rapid eye movements become a clearer sleep-related feature, ridges that will contribute to fingerprints and footprints continue forming, and the lungs keep developing.
Pregnancy Week 23 Overview
The inner ears are registering more sound from the outside world and any moderately loud noise will startle the baby and you will feel a kick or squirm. If your baby was born prematurely at this time it would still have a chance to survive.
Not only will you feel kicks and jabs in your abdomen, you might actually see your abdomen move. The ever expanding uterus will make it difficult to sleep like you used to. During this time it is important to drink lots of fluids and stay active to ensure a healthy pregnancy.
Understanding Pregnancy Week 23
Pregnancy Week 23 is part of the second trimester and falls within a period of rapid fetal growth and neurological development.
The NHS describes the fetus as approximately 28.9 centimeters from head to heel, roughly comparable to a large mango.
The limbs are becoming increasingly proportional to the rest of the body, while fetal movement continues strengthening.
ACOG identifies Week 23 as an important sleep-development stage, with much of fetal sleep time spent in rapid eye movement, or REM, sleep.
Important Clarification About the Original Week 23 Guide
The original Week 23 guide has been preserved exactly above. Several statements need current medical context.
The Fetus Can Hear, but a Startle Response Is Not Guaranteed
Hearing has already been developing for several weeks by Pregnancy Week 23.
However, the statement that any moderately loud noise will definitely startle the fetus and cause a noticeable kick or squirm is too certain.
Current ACOG guidance specifically places the clearer startled movement response to loud sounds within Weeks 25 through 28.
At Week 23, it is more appropriate to say that the fetus can detect sounds and may move spontaneously while auditory and neurological systems continue maturing.
Survival at 23 Weeks Is Possible but Highly Uncertain
The original guide says that a baby born prematurely at this stage would have a chance to survive.
That statement is broadly possible, but it needs substantial medical context.
ACOG defines Weeks 20 through 25 weeks and 6 days as the periviable period.
Current ACOG information cites population-level survival-to-discharge estimates of roughly 23% to 27% for births at 23 weeks.
These percentages cannot predict the outcome for an individual infant.
Outcome is influenced by many factors including exact gestational age, birth weight, fetal sex, whether the pregnancy involves multiples, antenatal treatment, circumstances of delivery and access to advanced neonatal intensive care.
Visible Abdominal Movement Is Possible but Not Guaranteed
The original maternal guide says you may see the abdomen move from kicks.
This is possible. The NHS specifically notes that over the coming weeks fetal kicks can become strong enough that movement may be seen through the abdomen.
However, timing varies according to fetal position, placental location, body anatomy and other factors.
Hydration and Activity Are Healthy Principles, but Not Guarantees
Drinking adequate fluids and staying physically active are generally healthy pregnancy habits.
However, neither can “ensure” a healthy pregnancy or prevent every pregnancy complication.
Individual medical conditions may also require changes to exercise or fluid advice.
How Big Is the Fetus at Pregnancy Week 23?
The NHS gives a Week 23 head-to-heel length of approximately 28.9 centimeters.
That is roughly comparable to the size of a large mango.
The fetal limbs are now increasingly in proportion with the rest of the body.
Growth continues rapidly during the remaining weeks of the second trimester.
Hearing Development During Pregnancy Week 23
The fetal auditory system has been developing for several weeks.
At this stage, sounds from inside and outside the pregnant person's body can reach the fetus through maternal tissues and amniotic fluid.
These sounds are filtered and do not reach the fetal ear in exactly the same way that they would be heard after birth.
The ears and auditory nervous system continue developing.
Maternal and environmental sounds form part of the fetal sound environment.
The brain pathways involved in sensory processing continue maturing.
Fetal hearing should not be considered equivalent to mature newborn hearing.
Will Loud Sounds Make the Fetus Kick at Week 23?
Not necessarily.
Fetal movement can occur after many different internal and external stimuli, but it is difficult to assign a particular kick to one sound with certainty.
Current ACOG guidance describes a more definite startled movement response to loud sounds during Weeks 25 through 28.
Week 23 is better described as an important stage of continuing hearing and nervous-system development.
Rapid Eye Movement Sleep at Pregnancy Week 23
REM sleep becomes a particularly interesting Week 23 developmental feature.
Mayo Clinic notes that the fetus starts having rapid eye movements at Week 23.
ACOG similarly states that at Week 23 much of fetal sleep time is spent in REM sleep.
These rapid eye movements occur beneath closed eyelids.
Fingerprint and Footprint Development
Week 23 is also an important stage for the hands and feet.
Mayo Clinic states that ridges form on the palms of the hands and soles of the feet.
These ridges provide the foundation for the unique patterns that eventually become fingerprints and footprints.
ACOG places this developmental process within the broader Weeks 21 through 24 period.
Fetal Movement During Pregnancy Week 23
Kicks, turns and stretches generally become stronger during this stage of pregnancy.
The NHS notes that the fetal limbs are now in proportion and that movement may become strong enough over the following weeks for the abdomen itself to visibly move.
Leg movement may be clearly recognizable.
Arm and body movements can sometimes feel like small jabs.
The fetus continues rolling and changing position.
Some movements may eventually be noticeable from outside the abdomen.
Can You See Your Abdomen Move at Week 23?
You may be able to, although there is no fixed week when visible abdominal movement begins for everyone.
As fetal movements strengthen, the abdominal wall can occasionally shift or ripple with larger kicks and turns.
An anterior placenta or fetal position may make movements less obvious from the outside.
Visible movement is not required for a healthy Week 23 pregnancy.
Lung Development During Pregnancy Week 23
The fetal lungs continue developing throughout Weeks 21 through 24.
The NHS notes that the fetus practices breathing movements around this time.
These are movements of the chest and respiratory muscles rather than breathing air.
Oxygen continues reaching the fetus through placental circulation.
The lungs remain immature and require substantial additional development before they are ready to function outside the uterus.
Skin, Lanugo and Developing Body Fat
The fetal skin remains thin and wrinkled at this stage.
ACOG places early fat formation beneath the skin within Weeks 21 through 24.
Fine lanugo continues covering the body and helps hold vernix against the developing skin.
The fetus remains much leaner than a full-term newborn because major fat accumulation occurs later in pregnancy.
What Does Premature Birth at 23 Weeks Mean?
Pregnancy Week 23 is within what ACOG calls the periviable period.
This describes an extremely early gestational period in which survival outside the uterus may be possible in some circumstances but remains highly uncertain.
ACOG cites survival-to-discharge rates of approximately 23% to 27% among births at 23 weeks in the data used for its guidance.
A population percentage cannot tell a family what will happen to one individual infant.
Factors That Can Affect Outcome
Even several additional days of fetal development can matter at very early gestational ages.
Fetal size and birth weight are important parts of individual prognosis.
Antenatal medications and neonatal resuscitation can influence outcomes.
Access to highly specialized maternal-fetal and neonatal intensive care is important.
Pregnancy Week 23 Development Timeline
Kicks, turns and stretches continue becoming increasingly noticeable.
Rapid eye movements become an important feature of fetal sleep.
These ridges contribute to future fingerprints and footprints.
The fetus receives sounds through the maternal body and amniotic environment.
Breathing-related structures and practice movements continue maturing.
Early fat develops under the still-thin fetal skin.
Maternal Changes During Pregnancy Week 23
The uterus and abdomen continue expanding as fetal growth progresses.
Movement may now feel increasingly obvious, and some pregnant people may even notice the abdominal surface shift with stronger activity.
The NHS lists several possible Week 23 symptoms including sleeping problems, backache, rib discomfort, heartburn, constipation, dizziness, leg cramps and swelling.
Your breasts may also begin leaking small amounts of colostrum, the early milk produced before mature breast milk.
Sleeping During Pregnancy Week 23
The growing abdomen can make old sleeping positions feel less comfortable.
Rib discomfort, heartburn, fetal movement, needing to urinate and general pregnancy-related physical changes can also interrupt sleep.
Pillows placed around the abdomen, back or between the knees may make resting positions more comfortable.
If poor sleep becomes severe or is related to breathing problems, significant pain or other concerning symptoms, discuss it with your healthcare professional.
Rib Pain and Breathlessness at Week 23
The NHS notes that rib pain can begin around this stage as the rib cage adapts to the growing pregnancy.
Some people may also feel slightly more breathless than usual.
Pregnancy changes oxygen requirements, blood circulation and the space available for abdominal and chest structures.
Hydration During Pregnancy Week 23
Adequate hydration is important throughout pregnancy.
Fluid needs differ according to body size, climate, diet, physical activity and medical circumstances.
ACOG specifically advises drinking plenty of water before, during and after exercise.
Possible signs of dehydration during exercise include dizziness, dark-yellow urine, reduced urination or a racing or pounding heart.
Staying Active at Pregnancy Week 23
For healthy people with uncomplicated pregnancies, regular physical activity is generally encouraged.
ACOG recommends at least 150 minutes of moderate-intensity aerobic activity each week for most healthy pregnant people.
The NHS gives the same general 150-minute weekly target and notes that activity can be divided into shorter sessions.
Brisk walking can provide moderate activity for many pregnant people.
Pregnancy-appropriate strength, mobility or stretching activities may support comfort.
Drink water before, during and after exercise.
Moderate exercise generally still allows you to carry on a conversation.
Exercise recommendations may need to be modified if your pregnancy has specific complications.
Possible Pregnancy Week 23 Symptoms
Changing body shape and other pregnancy symptoms may interrupt sleep.
The growing abdomen can contribute to musculoskeletal discomfort.
Digestive changes may continue causing reflux and indigestion.
Hormonal effects on digestion can continue.
Cramps may occur during the second trimester.
Small amounts of colostrum may appear before birth.
Healthy Eating During Pregnancy Week 23
Continue eating a varied, balanced diet rather than trying to dramatically increase portions.
The NHS notes that there is no need to eat for two and that routine additional calories are not generally needed until the third trimester.
Include vegetables, fruits, whole grains, protein foods and other nutrient-rich options according to your individual dietary needs.
Continue any prenatal vitamin or supplement plan recommended by your healthcare professional.
Prenatal Care Around Pregnancy Week 23
Continue attending scheduled prenatal visits and follow-up testing.
Your healthcare professional may assess blood pressure, weight, uterine growth, symptoms and fetal movement depending on your care schedule.
If you have concerns about contractions, bleeding, fluid leakage or possible premature labor, seek professional guidance promptly.
Do not wait for a routine appointment if symptoms suggest a possible urgent pregnancy problem.
Pregnancy Week 23 and Your Estimated Due Date
Pregnancy Week 23 is based on gestational age, conventionally counted from the first day of the last menstrual period.
Our Pregnancy Due Date Calculator can help estimate an expected delivery date using relevant pregnancy dating information.
An estimated due date remains a planning estimate rather than a guaranteed delivery date.
Clinical dating and ultrasound information may also be used by your healthcare professional when appropriate.
What Happens After Pregnancy Week 23?
Pregnancy Week 24 brings continued growth of the lungs, brain, skin and nervous system.
Movement remains active and the fetus continues developing features needed for later life outside the uterus.
Week 24 remains part of the medically complex periviable period, and outcomes following extremely premature birth still vary substantially.
Every additional week of pregnancy generally brings significant development at this stage.
Pregnancy Tools You May Find Useful
Estimate your expected delivery date from relevant pregnancy dating information.
Estimate your current gestational week using an appropriate pregnancy starting date.
Estimate a possible conception date or range while recognizing natural biological variation.
See approximately how much estimated time remains until your expected due date.
When Professional Healthcare Guidance Is Important
Week-by-week pregnancy guides provide general educational information and cannot assess fetal wellbeing or predict the outcome of an individual pregnancy.
Seek prompt professional assessment for heavy bleeding, possible fluid leakage, regular painful contractions, significant pelvic pressure, severe abdominal pain, fainting, fever, severe breathing difficulty or other concerning symptoms.
If fetal movement has already become familiar and then becomes markedly reduced, stops or changes significantly, contact your maternity service promptly.
Pregnancy Week 23 FAQs
What happens during Pregnancy Week 23?
During Pregnancy Week 23, fetal movement remains strong, rapid eye movement sleep becomes a clearer developmental feature, fingerprint and footprint ridges continue forming, and the lungs continue developing.
How big is the fetus at 23 weeks?
NHS guidance describes the fetus as approximately 28.9 centimeters from head to heel at Pregnancy Week 23, roughly the size of a large mango.
Can the fetus hear at Pregnancy Week 23?
Yes. Hearing has been developing for several weeks, although a guaranteed startle response to every moderately loud sound should not be expected.
Will loud sounds always make the fetus kick at Week 23?
No. The fetus can hear sounds, but ACOG places a clearer startled movement response to loud sounds within the later Weeks 25 through 28 period.
Does the fetus have REM sleep at Week 23?
Yes. ACOG identifies Week 23 as a stage when much of fetal sleep time is spent in rapid eye movement, or REM, sleep, and Mayo Clinic notes that rapid eye movements begin around this week.
Can a baby survive if born at 23 weeks?
Some infants born at 23 weeks survive with intensive neonatal care, but survival is uncertain and serious complications are common. Outcomes depend on many factors beyond gestational age.
Can you see fetal movement through the abdomen at Week 23?
Some pregnant people may begin noticing visible movement of the abdomen as fetal kicks and turns strengthen, but this does not happen at exactly the same week for everyone.
Is trouble sleeping common at Pregnancy Week 23?
Yes. Sleeping problems are among the symptoms that can occur at Week 23 as the abdomen grows and pregnancy-related physical changes continue.
Should I stay active and hydrated at Week 23?
For many uncomplicated pregnancies, regular moderate physical activity and adequate hydration are healthy choices. Individual exercise restrictions should be discussed with a healthcare professional.
What happens during Pregnancy Week 24?
During Pregnancy Week 24, fetal growth continues, lung and skin development progresses, movement remains active and the pregnancy remains within the medically complex periviable period.
Medical References and Further Reading
Mayo Clinic:
Fetal Development: The Second Trimester
American College of Obstetricians and Gynecologists:
How Your Fetus Grows During Pregnancy
ACOG:
Changes During Pregnancy
ACOG:
Understanding and Navigating Viability
ACOG:
Extremely Preterm Birth
Next: Pregnancy Week 24
During Pregnancy Week 24, fetal growth continues, the lungs and nervous system keep developing, movement remains active and the fetus continues preparing for later life outside the uterus.
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