Pregnancy Calendar at Week 23
What's Happening with the Baby
At 23 weeks of pregnancy, the baby starts making consistent breathing movements (previously, this was done sporadically with long breaks). A small amount of amniotic fluid enters the lungs, aiding in their maturation. These practice breaths occur at a rate of 50–60 times per minute. Occasionally, these breathing movements stop for 0.5–1 hour and then resume.
Sometimes, swallowing amniotic fluid causes the baby to hiccup. Expectant mothers may feel light, rhythmic twitches in their belly for a few minutes when this happens.
The baby now weighs 607 grams, reaching the size of an eggplant – 29.7 cm
By the 23rd week, the liver, bone marrow, spleen, lymph nodes, and thymus (thymus gland) are involved in the formation of new blood cells. By this time, the pancreas also starts functioning actively, synthesizing not only digestive enzymes but also insulin.
What's Happening with Mom
By the 23rd week of pregnancy, some women notice that their legs swell in the evenings and develop spider veins. These can be early signs of varicose veins, which occur due to impaired blood flow from the legs: the growing uterus puts more pressure on the pelvic veins. So, the appearance of spider veins is a reason to visit a phlebologist.
Many expectant mothers notice that at this stage, they experience more frequent urination. The reason is that the enlarged uterus puts more pressure on the bladder. If you constantly feel the urge to go to the bathroom, it's worth limiting the amount of fluid you drink, especially at night. It's also not recommended to hold it in for too long when you feel the urge. You can visit the bathroom every 3–3.5 hours. But if this process causes pain, see a doctor as soon as possible (it could be a sign of cystitis).
Uterus
Right now, it's located 4 cm above the belly button. At this moment, she is starting prenatal training, and because of this, the expectant mother may occasionally feel mild cramp-like pains, which are called practice contractions (false contractions). To ease the pain, she can lie on her left side. There's no need to worry if the pains are sporadic or last for a short period. However, if they persist for several hours, intensify, or occur more than 5 times in one hour, it's crucial to call a doctor immediately.
Belly
is gradually increasing in size and causing the skin to stretch. Because of this, a rash or itching may often appear. To prevent this, it's important to constantly maintain the skin's elasticity. One of the best moisturizers is olive oil, but other specialized cosmetic products will also work. Additionally, a line that runs from the belly button downward may appear or change color. This brown line appears on the belly due to increased melanin production. This shouldn't cause any concern, as it will disappear after childbirth.
Pains
Right now, back and lower back pain can intensify due to the constant increase in body weight. You might also experience painful sensations in the abdominal area. But don't be alarmed: at this stage, such sensations are rarely associated with anything dangerous. Usually, this happens due to muscle strain and is most noticeable during sudden movements. An expectant mom can alleviate such pains with the help of a prenatal support belt. Additionally, it's best to avoid wearing heels or sleeping on your stomach.
If you experience cramps in your calves, it could indicate a lack of calcium in your body. However, the headaches that have been bothering you up until now will most likely disappear by the 23rd week.
Discharge
The appearance of clear, watery discharge is normal at this time and shouldn't cause any concern. However, if it is accompanied by a pulling pain or itching, an unpleasant odor, redness, swelling, or urinary problems, it is most likely due to an infection that should be treated immediately. It's also important to distinguish normal discharge from amniotic fluid leakage, which should prompt an urgent visit to the doctor. Bloody discharge that may appear after a gynecological exam or intimate contact is not as dangerous now, as the risk of miscarriage is significantly lower than in the earlier weeks of pregnancy.
Medical Examination
Doctors
- A consultation with an obstetrician-gynecologist is necessary if a pregnant woman has any complaints.
Tests
- General urine analysis – helps identify kidney and bladder diseases. Often at this stage, a woman's urine may contain acetone, indicating poor liver function. It's also important to rule out diabetes and preeclampsia.
Examinations
- Ultrasound, if it wasn't done at 22 weeks. This examination is conducted to timely diagnose possible complications and rule out potential threats. During the ultrasound, the doctor will be able to assess how the pregnancy is progressing, examine the size and condition of the uterus, and determine the placenta's location. And don't worry if it shows that the placenta is not high enough – it can still move up later. And of course, if the baby is positioned well, you can find out the baby's gender now if you haven't been able to do so earlier.
Pregnancy Challenges
Overall, the 23rd week is generally a favorable time for the expectant mother. However, if you experience any of the symptoms listed below, you should seek medical attention immediately.
Placental Abruption
Abdominal and back pain accompanied by bloody discharge can be signs of placental abruption. However, with timely medical intervention, proper treatment can help maintain the pregnancy, and it is possible to carry the baby to term even with a significant area of detachment.
Missed Miscarriage
When the development and death of the baby occur, this condition most often happens during the first trimester, but the risk remains in later stages as well. A missed miscarriage can only be diagnosed during an examination by a gynecologist and through an ultrasound. After diagnosis, to prevent inflammatory processes, a D&C (dilation and curettage) is performed.
Regular check-ups will ensure that everything is fine with your baby. If anything worries or concerns you, immediately consult your doctor. They will conduct an examination, listen to the heartbeat, and possibly refer you for an ultrasound. Warning signs include: sharp abdominal pain, bloody discharge, worsening health, and fainting.
Possible deviations from the norm:
- Uterine hypertonicity;
- Gestational diabetes;
- Varicose veins.
What You Can and Can't Do
At 23 weeks of pregnancy by obstetric terms, you're in the middle of the second trimester, the 6th month, and 21 weeks from the approximate conception date. The fetus is quite well-formed, and in the absence of intrauterine pathologies, the 23rd week is marked by the active development of the central nervous system and the brain. Compared to the first trimester, when the brain weighs 10 grams, by the 23rd week, it reaches 100 grams.
What EXPECTANT MOMS CAN Do:
- Continue taking vitamin complexes - necessary for the further normal development of the fetus;
- Have sex with your spouse if there are no contraindications (complicated or multiple pregnancies, risk of miscarriage);
- Take walks in the fresh air, engage in physical activities with appropriate physical exertion, and practice breathing exercises;
- Visit movie theaters, exhibitions, and theaters;
- Work - if feeling well, a woman can easily work up until her maternity leave, but it's important to avoid prolonged static body positions;
- Undergo treatment with synthetic and natural medications if necessary - treatment should be based on specialists' recommendations.
The fetus is already well-developed, and the risks of complications and negative outcomes in a healthy pregnancy at 23 weeks are significantly reduced. It's recommended to discuss permissions and restrictions with your healthcare provider.
What Expecting Moms Should AVOID:
Even though the risk of complications is low, women at 23 weeks are advised to consider their condition and follow some restrictions:
- Cut out smoked foods, pickles, salty snacks, sweets, fats, and carcinogens – poor diet increases the risk of complications (gestational diabetes, late-term preeclampsia, swelling, obesity);
- Reduce the intensity of physical activities – it's important to lessen the pressure on the pelvic floor and uterus, and limit strength exercises;
- Maintain sexual rest if sex causes pain or discomfort;
- Lower stress levels – a healthy emotional state makes pregnancy easier;
- Avoid long-distance travel by plane or train.
During pregnancy, it's important to be cautious about visiting public places. Avoid participating in mass events during periods of high epidemiological risk, and stay away from public pools and open bodies of water.
Proper Nutrition
As always, your diet should be balanced and nutritious. Your meal plan should include a sufficient amount of fats, carbohydrates, and proteins (with a focus on protein-rich foods).
Vitamins are very important, so don't forget to eat fresh fruits and vegetables daily. It's also necessary to maintain normal hemoglobin levels and ensure a daily intake of calcium.
It's best to avoid spicy, fried, smoked, and other unhealthy foods. Additionally, you should minimize your intake of salt, sweets, and flour-based products. Make sure to drink plenty of fluids (at least 1.5 liters per day). Besides water, it's beneficial to drink fruit drinks, fresh juices, and unsweetened compotes.
Ideally, you should:
- switch to fractional meals: 5–6 times a day, including three main meals (breakfast, lunch, dinner) and snacks;
- limit (or better yet, eliminate) beverages and foods high in caffeine (coffee, tea, energy drinks, chocolate, cocoa beans, cocoa, cola, mate). This substance is also found in some medications (Citramon, Coficil), dietary supplements (with guarana extract), and cosmetic products (coffee scrubs, creams with various extracts and oils).
Throughout pregnancy, expectant mothers should strive to maintain a healthy and well-rounded diet rich in essential nutrients. A great option is dishes with minimal heat treatment, which preserve as many nutrients as possible.
Need for Vitamins and Minerals
At 23 weeks, women should enrich their diet with vitamins and minerals, monitor the quality of their food, and avoid aggressive products that affect the gastrointestinal tract. In the middle of the second trimester, it's important to balance the diet — this is crucial not only for the development of the fetus but also for preventing complications.
Vitamin A (Retinol)
Helps with normal weight gain, prevents anemia, and the daily dose should be 3000 IU. It is found in cheese, dairy products, seafood (especially rich in retinol are king prawns and mussels), and sea fish. Vitamin A can also be taken in capsule form.
Vitamin B9
At 23 weeks, as well as in the following months, it is the number one component. Folic acid ensures the normal development of the central nervous system and the brain. The daily requirement is 600-700 mcg. Foods rich in vitamin B9 include spinach, chicken or beef liver, game hearts, buckwheat, oatmeal, corn grits, and young cheeses.
Vitamin B1
Actively participates in the metabolism of fats and carbohydrates, is necessary for the formation of the neural tube and the central nervous system of the fetus, and for muscle mass growth. It is abundantly found in cashew nuts, almonds, pistachios, buckwheat, cabbage, tomatoes (cherry variety, homegrown greenhouse varieties), zucchini, and pattypan squash.
Vitamin B2
Serves more as a transport for essential minerals: zinc, iron, selenium, as well as vitamin A. Necessary for the formation of connective and muscle tissue, normalization, and maintenance of healthy hemodynamics. Found in bird eggs, chicken fillet, turkey, rabbit meat, beef, all green vegetables (spinach, sorrel, dill, parsley, cilantro), rice grains, and broths made from it.
Vitamin B3
Helps form healthy skin for the fetus, prevents pronounced stretch marks on the skin of a pregnant woman. Simultaneously lowers cholesterol and has a moderate detoxifying effect. Found in fresh potatoes, green apples, barley, buckwheat, and wheat germ.
Vitamin B5
Necessary for proper metabolism, normalization of metabolic processes due to its involvement in carbohydrate metabolism. The vitamin prevents an increase in "bad" cholesterol in blood plasma. Found in peas, beans, lentils, broccoli, walnuts, and chicken breast.
Vitamin B7
Actively participates in protein metabolism, regulates cholesterol levels, and at 23 weeks helps prevent intrauterine thyroid pathologies. Biotin is found in nutritional yeast, beef or chicken liver, bananas, whole milk (goat or cow). Its beneficial effect on the fetus is due to its role in the synthesis of glucokinase, which is necessary for the development of connective and muscle tissue.
Vitamin C
Has strong immune-boosting and antioxidant properties, and provides moderate detoxification effects. The daily dose at 23 weeks is 2-2.5 grams per day. It is found in lemons, mandarins, oranges, sorrel, garlic, kiwi, red and black currants, sea buckthorn, and rose hips. Ascorbic acid reduces the risk of gestational complications.
Vitamin D3
Produced by the adrenal glands, it aids in calcium absorption, which is necessary for the normal maturation of the skeletal system. It has the ability to accumulate in the tissues of internal organs, protecting the baby from rickets and severe bone deformities up to 3 months old. It is found in fish oil, sesame oil, red caviar, and sea fish, but for convenience, it is recommended to take it in water-based drops from the pharmacy.
Vitamin E
Vitamin E is essential for women's beauty and skin health, and it has a positive effect on the development of healthy tissues in the respiratory tract and lungs of the fetus. The necessary daily dose at 23 weeks is 10-15 mg. A deficiency increases the risk of fetal brain hypoxia. High concentrations of tocopherol are found in all plant extracts and oils (sea buckthorn, sesame, sunflower, olive, and high-quality palm oil).
Vitamin K
Vitamin K is required for the normal development of hard tissues and is essential for the normal growth of the fetus. It acts as a transporter of calcium and vitamin D, so the diet should include greens (parsley, cilantro, dill, arugula), pine nuts or walnuts, fresh or dried figs, dried apricots, prunes, white raisins, kiwi, currants, and bananas.
Vitamin P
Vitamin P belongs to natural bioflavonoids and has detoxifying, antioxidant, and anti-inflammatory effects. At 23 weeks, you should consume 30-45 mg, as the substance positively influences the development of the brain and cerebral cortex and mitigates acute allergic reactions by inhibiting histamine synthesis. It is found in ripe black plums, tomatoes, onions, cocoa beans, asparagus, and celery.
Iron
A trace element in the blood, without which hypoxia of the brain and organ failure due to lack of oxygen in the blood quickly develop. Considering that the blood volume in a pregnant woman's body increases by almost a third, it is recommended to take at least 30 mg of iron. Overdose can lead to life-threatening consequences, which is more relevant to medications and dietary supplements. The problem of anemia lies in the incomplete absorption of iron from food due to vitamin deficiencies and poor dietary discipline. Iron is found in buckwheat with milk, apples, chicken and beef liver, and pomegranates.
Iodine
- a source of thyroid health. At 23 weeks, it is important to adhere to a daily dosage of 300 mg, especially in northern regions. For convenience, it is recommended to take pharmaceutical preparations, but iodine can also be obtained from seaweed, soy, asparagus, seafood, and fish oil.
Selenium
Necessary for the normal function of the central nervous system and cardiovascular system, which is especially important at 23 weeks of pregnancy. At the same time, it strengthens connective and muscle tissue. It is found in pumpkin seeds, sunflower seeds, beans, cornmeal, cod and tuna liver, and fish fillets.
Copper
The daily requirement is 1.5 mg, and during natural lactation, it increases to 2-2.5 mg. This trace element is involved in hemodynamic processes, the normal function of the cardiovascular system, and strengthens the skin. Copper actively participates in iron absorption and increases hemoglobin levels. It can be found in dried apricots, white and black raisins, figs, beet juice (from fresh or boiled beets), and young potatoes.
Calcium
Calcium is essential for forming healthy hard tissues in the fetus and preventing periodontal disease in pregnant women. It is found in cottage cheese, kefir, powdered boiled eggshells, and sour cream. If calcium absorption is poor, it is combined with vitamin D3. The daily requirement is 500 mg, and it is necessary to maintain calcium intake until the end of lactation.
Magnesium
Magnesium is necessary for the normal growth of the fetus and the prevention of anomalies and defects in the intrauterine development of the kidneys and hepatobiliary system organs. By the 23rd week, a lack of magnesium can lay the foundation for the development of preeclampsia, multi-organ failure in both the mother and fetus, and intrauterine hypoxia. It is found in sesame seeds, coriander, rice, various types of lettuce leaves, lentils, beans, and legumes. The daily dose should not exceed 500 mg.
Zinc
The mineral component is involved in the processes of osteogenesis, the growth and development of the fetus, and without it, the proper function of hematopoietic organs is impossible. Up to 15 mg of the substance is required per day. Dried pumpkin seeds, wheat germ, chicken and quail yolks, coconuts, and coconut milk are beneficial.
Phosphorus
It participates in the regulation of the acid-base balance in the stomach of a pregnant woman and is involved in the normal formation of bones and connective-muscular tissue. It positively affects the function of the liver and pancreas of the fetus. At least 1500 mg of the trace element is required daily. Phosphorus is found in dried fruits and nuts, candied fruits, tomatoes, bananas, kiwis, pomegranates, raspberries, and buckwheat porridge.
Sodium
It activates intercellular exchange, normalizes the function of the kidneys and adrenal cortex, which synthesize vitamin D3. Sodium regulates osmotic pressure and actively participates in the formation of a healthy nervous system at 23 weeks. The daily norm is 500 mg, and exceeding this amount causes edema in pregnant women. It is found in bread, salt, young cheeses, and river and sea fish (halibut, chum salmon, mackerel).
Silicon
The substance boosts immunity, prevents infections, and reduces the risk of diabetic nephropathy in women. The mineral has moderate antioxidant properties and helps maintain a woman's teeth and hair. It can be found in asparagus, black currants, raspberries, pineapples, avocados, beans, and fresh snap peas. The daily dose should not exceed 50 mg.
Cobalt
It remains active only in the form of vitamin B12. This trace element normalizes the function of blood-forming organs, participates in the transport of ferritin and iron, and increases hemoglobin levels in the blood. The daily dose for pregnant women at 23 weeks is 45 mcg. It is found in chicken breast, poultry liver, rabbit meat, white grapes, beef, and peanut butter.
Chromium
It improves the absorption of fats and proteins and is involved in carbohydrate metabolism. It prevents the risks of gestational diabetes in pregnant women and normalizes the water-electrolyte balance. It can be found in grapes, veal, lamb, young cheeses, and feta cheese.
Proper absorption and assimilation of all necessary trace elements and minerals require adequate daily intake. A balanced diet helps prevent vitamin deficiencies; however, to improve hemodynamics and blood composition, the intake of dietary supplements and synthetic vitamins is necessary.
Important! Choose a multivitamin complex based on the recommendation of your obstetrician-gynecologist.
Helpful Tips
If your legs start to swell by evening, it's a good idea to consult a phlebologist about it. When you get home, lie down for a while with your legs elevated. You can place a pillow under your knees or prop your legs up on the back of the couch.
Also, do special exercises for your legs to improve blood flow. For example, while standing in place, rise onto your toes and then lower onto your heels, or stand up from a chair using your heels, and so on.
With each passing week of pregnancy, a woman experiences more unpleasant symptoms: back pain, leg swelling, calf cramps... If, after a day at work, the future dad can give a relaxing massage, his partner will be very grateful. Here are a few simple tips:
- Shoulder and back massage – use circular motions, gently rubbing in massage cream with your palms. It's best if the expectant mom is kneeling on the couch or sitting with her back turned. Pay special attention to the lower back area.
- Calf massage – gently rub the muscles, applying a bit of pressure, but not too much, to restore blood circulation and relax the body.
- Finish the massage with gentle strokes.
Exercises for Expecting Moms
Physical activity is essential for expectant mothers to feel better and prepare for childbirth. Together with your doctor, you can choose an appropriate level of exercise. It's best to prioritize walking, including on elliptical machines, swimming, and special routines designed for expectant mothers.
However, it's better to avoid running and other high-impact exercises: they can cause a sharp increase in blood pressure, which is not recommended for expectant mothers.
It's also recommended to focus on bodyweight exercises, relieving overall tension, and strengthening the pelvic muscles (to prepare for childbirth). Be cautious with exercises performed while lying on your back, such as various twists and those that put strain on the pelvic and abdominal areas.
Discomforts During Pregnancy
During pregnancy, a mother's immune system is weakened, so preventing illnesses, especially during cold and flu season, becomes particularly important.
Acute Respiratory Infections
ARVI, ARI, accompanied by fever, cough, runny nose, and sore throat. As soon as possible, see a doctor who will examine you and prescribe treatment. It's also recommended to drink plenty of fluids, gargle with a baking soda and salt solution with chamomile, use inhalations if you have a cough, and use saline or sea water for nasal congestion. To reduce fever, acetaminophen or children's fever reducers that are safe for expectant mothers and babies can help.
Heartburn
As the uterus grows, it pushes against the abdominal organs, causing heartburn and shortness of breath in women. Your doctor can help adjust your diet and recommend ways to alleviate these uncomfortable symptoms. We want to note right away: this condition is not dangerous for the baby, but it does cause discomfort for the mother.
Constipation
As the uterus grows, it gradually starts putting pressure on the intestines, which can cause some expectant mothers to experience difficulty with bowel movements. Doctors recommend adjusting the diet and increasing physical activity in such cases.
Candidiasis
Yeast infection – a fungal condition that usually occurs due to a weakened immune system, hormonal changes, or after exposure to cold. Symptoms include cottage cheese-like vaginal discharge with an unpleasant sour smell, sometimes accompanied by itching and burning in the lower abdomen. It is treatable and safe for the baby. It is crucial to complete the treatment course before giving birth!
Varicose Veins
Hormonal changes, weight gain (week by week), and an increasing blood volume in the body of the expectant mother can negatively affect the condition of her blood vessels: a feeling of heaviness and burning in the legs appears, spider veins become visible, due to blood pooling in the lower extremities. This condition worsens the well-being of the expectant mother, so prompt treatment after consulting a phlebologist is necessary.
Checklist
- Visit an OB-GYN if you have any concerning questions or symptoms.
- Quit bad habits, including avoiding secondhand smoke.
- Stock up on comfortable maternity clothes.
- Drink 8-12 glasses of water a day.
- Continue taking the special vitamin complex prescribed by your doctor.
- Get prenatal massages to ease your overall condition.
- Avoid high heels (to prevent varicose veins, tendon and ligament injuries, and falls).
- Monitor your weight gain (weigh yourself in the morning, on an empty stomach, in light pajamas, and no more than once a week; it's best to record the results).
- Add apples, kiwi, pineapple, natural yogurt, and warm milk to your diet if you have heartburn.
- Get compression garments/stockings (especially if you have a flight coming up).
