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In week 23 of pregnancy, your baby is continuing to develop quickly. Movements are becoming clearer and you will start to notice a sleep-wake cycle.

Sounds and movements around you may trigger a reaction. For example, the baby may wake up if there is a loud noise, or react to you having a warm bath or drinking a glass of icy water.

This article is part of a series of articles on what to expect each week in pregnancy.

Take a look at the other articles in the series:

First trimester:fertilization, implantation, week 4, week 5, week 6, week 7, week 8, week 9, week 10, week 11, week 12.

Second trimester:week 13, week 14, week 15, week 16, week 17, week 18, week 19, week 20, week 21, week 22, week 23, week 24, , week 25, , week 26

Symptoms

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Dental care is especially important during pregnancy.

By now, you will have gained around 12 to 15 pounds (5.4 to 6.8 kg), and your bump will be clearly showing.

Throughout pregnancy, you will be experiencing a number of physical changes and symptoms.

As your uterus presses down onto your bladder, there may be some leakage of liquid, probably urine. If this happens, you can use panty pads to soak it up.

If you think this may be amniotic fluid, seek medical advice immediately. Also, call your doctor right away if you have any vaginal bleeding or feel uterine contractions or increased pressure into your pelvis.

Other symptoms may include:

  • tingling hands
  • red palms and soles of feet
  • swollen ankles and feet
  • heat rashes
  • skin tags
  • stretch marks
  • a dark line down the center of the abdomen, known as the linea nigra
  • darkening of the areola, the area around the nipples
  • darkening of skin freckles and possibly patches of facial skin, known as chloasma

You may also have:

  • difficulty sleeping
  • increased appetite
  • bloating and indigestion or heartburn
  • snoring and sleep apnea
  • forgetfulness
  • breathlessness, as your baby pushes up against your lungs
  • bleeding gums

Throughout pregnancy, there is a greater risk of a urinary tract infection. If you experience symptoms such as pain, burning, and urination problems, see a health professional.

Hormones

Hormonal changes will continue to affect your body and how you feel.

Mood swings are common in the first and last trimesters of pregnancy, due to hormonal fluctuations. Let your doctor know if you feel sad, lose enjoyment over your expected baby, or begin to feel tearful.

Findings of a study involving 47 women, published in 2014, found that those who were pregnant scored over 11 percent lower on memory tests than those who were not. The researchers believe this may be to do with plasma hormone levels, which are higher during pregnancy.

Keeping a note of appointments and other important items on a wall calendar or in a diary can help you remember what you need to do.

Baby development

Your baby now weighs around 1 pound (0.45 kg), and is 11 to 14 inches long or 28 to 36 centimeters (cm), and is about the size of a papaya. Their weight will nearly double in the next 4 weeks or so.

Developments that are underway at 23 weeks include:

Bones: Ear bones are hardening, and the baby can recognize maternal sounds, such as the mother's heartbeat.

Head: Eyebrows and eyelashes are forming and vision is improving.

Lungs: The lungs are formed but are still maturing. Your baby is practicing the movements that will be needed to breathe after birth. However, they continue to get all their oxygen from the placenta until then.

Lanugo: The hair that covers your baby's body, will darken around this time. It may be visible on an ultrasound scan.

Things to do

By this point in your pregnancy, you should have already completed or be completing genetic testing, but you may soon undergo testing for gestational diabetes.

This involves a blood test, and it usually takes place in week 24 to 28, unless you are at high risk or have symptoms. In this case, it may be done earlier. Your doctor will also likely check your blood counts to screen for anemia at this time.

Dental care

During pregnancy, hormonal changes can make the gums more sensitive and susceptible to plaque, and this can lead toinflammation.

It is even more important than usual to follow good dental hygiene practices at this time.

These include:

  • brushing your teeth twice a day for 2 minutes with a soft toothbrush and fluoride toothpaste
  • avoiding sugary and acidic snacks and drinks, opting instead for water and raw vegetables
  • avoiding mouthwashes that contain alcohol
  • rinsing your mouth with plain water after any episodes of vomiting, but do not brush, as the acid in your mouth could damage your teeth

It is a good idea to visit a dentist for a thorough cleaning during pregnancy to reduce the risk of dental problems.

Be sure to tell the dentist that you are pregnant, as this may affect which treatments you can have, for example, fillings, or if your dentist performs x-rays of your teeth.

If you need to upgrade your dental care, click here to find products for purchase online.

Lifestyle: Stress

There are many possible causes of stress and anxiety at this time. Those with a history of depression may experience symptoms.

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It is not unusual to feel stressed during pregnancy.

Other triggers of stress include the following:

  • uncertainty about being a parent
  • fear of harming the unborn baby
  • shifting perceptions about your own body and identity
  • concerns about relationships
  • financial worries
  • physical discomfort
  • how older siblings will react
  • fear of delivery
  • being a single parent

People who already had problems with relationships, substance use, a mental health condition, or social issues, such as housing, may face additional strain.

If you can discuss your fears with a loved one, a health provider, or a counselor, they may help you find a solution.

Will stress affect my baby?

Some research has suggested that stress may affect the unborn baby in the following ways:

Biological: Some studies have linked preterm delivery to significant levels of anxiety and depression during pregnancy. Studies are conflicting, but some show an increased risk of low birth weight in pregnancies affected by depression.

Mental health: The increased levels of stress hormones may lead to problems with cognitive development and concentration in the child. Severe stress may affect neurological development.

Behavioral: Newborns whose mothers experienced extreme anxiety/depression during pregnancy have been found to cry more and to respond more irritably to normal and unusual sounds.

Physical health: Maternal anxiety has been linked to some health issues as the child grows up, including a higher incidence of rashes, asthma, and shortness of breath.

Pregnancy stress and ADHD?

One media report suggested in 2017 that ADHD may be linked to stress during pregnancy.

However, an analysis of the research on which the story was based, carried out by the U.K.'s National Health Service (NHS), has described this as "unfounded."

The study looked at stress in pregnancy, but it did not investigate or confirm a link with ADHD.

More medical research is needed to determine if there is a clear association found.

Coping with stress

If you are experiencing symptoms of depression or anxiety, ask your health provider for advice.

Start by checking that you are following a healthful diet and getting enough exercise and sufficient sleep.

It may help to:

  • call a friend or family member for a chat
  • do some yoga, tai chi, meditation, or relaxation exercises
  • have a warm bath and listen to some soothing music
  • join a group or online chat community for expectant mothers

Avoid turning to food to relieve your stress. You can end up piling on the pounds that will be harder to lose after delivery.

If you have questions regarding your pregnancy, be sure to contact your health care provider.

Research news on pregnancy from MNT

Antidepressants during pregnancy linked to autism

A new study, published in JAMA Pediatrics, finds a link between antidepressant use during pregnancy and an increased risk of autism in offspring.

Maternal smoking could harm offspring's later-life aerobic fitness

A new study provides yet another reason why mothers should refrain from smoking during pregnancy; it may harm the later-life aerobic fitness of male offspring.