Pregnancy Week 23

What does my baby look like, and how big is my baby now?

This week your baby is about the size of a grapefruit. You're now in the sixth month of your pregnancy.

Your baby's arms and legs are now in proportion with the rest of the body. Over the coming weeks, you may notice your baby kicking and see your belly move.

Your baby's skin and organs

Your baby's skin may still look a little loose or wrinkly, because the skin is growing faster than the fat beneath it. Developing veins and arteries can give the skin a pinkish-red tone. As fat stores build up, the skin will fill out and become less see-through, so by the time your baby is born they'll have that plump, healthy look.

At this stage, your baby's organs and bones can still be made out beneath the skin.

Development of the reproductive organs

In baby girls, the ovaries have already formed; in baby boys, the testicles are still on their way down and usually settle into place just before birth or shortly afterward.

What's happening in my body?

This week, you might feel some soreness around your ribs as your rib cage expands to make room for your growing belly. As your baby presses on your lungs, you may also feel a bit more out of breath than usual. The best fix is to put your feet up and rest. If any pregnancy symptom worries you, talk to your doctor.

Darkening skin

You may notice a dark line running from your belly button down to your pubic area. This is called the linea nigra. Pregnancy hormones boost melanin production, which is what makes this line stand out, and it can show up alongside other color changes like darkening areolas and more noticeable freckles. It's expected to fade over the few months after birth.

Some women notice darkening on the face, especially around the nose, forehead, cheeks, and eyes. This is called the mask of pregnancy, or melasma. These skin changes usually fade noticeably in the months after birth.

Changes in your vision

During pregnancy, hormones, fluid retention, and changes in circulation can lead to mild vision changes. You might have temporary blurriness or become a bit more nearsighted. But if you experience temporary vision loss, severe blurriness, double vision, or flashes of light, call your doctor right away, as these symptoms can be linked to serious complications.

“Pregnancy brain”

Is “pregnancy brain” real? It's not entirely clear. Some believe forgetfulness during pregnancy may be caused by disrupted sleep, shifting hormones, stress, and changes in the brain. If you're forgetting names or having trouble focusing, you're not alone; many moms-to-be report feeling a bit of brain fog. Even so, research isn't clear on whether pregnancy brain truly exists or affects every expectant mother. Those who do notice it usually experience small, manageable moments of forgetfulness, and it doesn't mean you're any less smart or capable than usual.

High blood pressure

High blood pressure, or “gestational hypertension,” can be common in pregnancy. To help avoid it, stay as active as you can, cut out alcohol and tobacco (if you haven't already), and try to keep your pregnancy weight gain at the recommended pace. Talk to your doctor for guidance on this.

Whooping cough vaccine

If you haven't had the whooping cough vaccine yet, you have until week 32, so you can ask your doctor about it at your next checkup.

Watch out for falls

Your baby will be gaining weight quickly over the coming weeks. Since your center of gravity is shifting, move carefully and steer clear of activities that could raise your risk of falling.

If you're dealing with cramps, headaches, indigestion, or heartburn, check in with your healthcare provider. During these weeks, pregnancy symptoms can show up in all sorts of different parts of your body.

Symptoms you might notice at this stage

This week, your pregnancy signs may also include:

• fatigue and trouble sleeping
• stretch marks
• swollen and bleeding gums
• pain on the sides of your belly caused by your expanding womb (“round ligament pain”)
• hemorrhoids
• back pain
• nosebleeds
• indigestion and heartburn
• bloating and constipation
• leg cramps
• dizziness
• swollen hands and feet
• urinary tract infections
• vaginal infections
• darkening skin or brown patches on your face – this is called chloasma or the “mask of pregnancy”
• oilier, more breakout-prone skin
• thicker, shinier hair

You may also still be experiencing symptoms from earlier weeks, such as:

• mood swings
• morning sickness
• pregnancy cravings
• a heightened sense of smell
• sore or leaking breasts

Leg cramps

During these weeks, leg cramps can be common, especially at night. When a cramp strikes, massaging the calf muscle and pulling your toes up toward your shin can bring relief.

Feeling short of breath

Feeling short of breath now and then is common in pregnancy. It tends to come on gradually during the first or second trimester. It shouldn't be painful or come on suddenly, and it shouldn't be accompanied by other symptoms like wheezing or coughing. If you have any concerns about shortness of breath during pregnancy, talk to your doctor.

If you have severe shortness of breath, chest pain, or heart palpitations, call for emergency help or go to your nearest ER.

Signs of anemia

Signs of anemia can include fatigue, low energy, and pale skin.

Consider going organic

Fresh fruits and vegetables are an important part of a healthy pregnancy diet. Organic produce may contain fewer pesticides and artificial additives, but what matters most is eating fresh fruits and vegetables, whether they're organic or not. Rinse fruits and vegetables thoroughly under cold running water before eating them.

Watch your salt intake

Balanced salt intake matters during pregnancy. Processed foods often contain high amounts of salt. The recommended daily salt intake is about 6 grams (one teaspoon). It can help to check the labels on packaged foods and choose lower-salt options.

Limit your caffeine

During pregnancy, it's recommended to keep caffeine under 200 mg a day. Even if you've gone over that amount, the risk is low; still, try to cut back from here on. If you'd like to reduce your caffeine, you might swap tea and coffee for herbal teas, smoothies, or water.

Cravings

Your appetite may have increased, and you might be having intense cravings. The exact cause of cravings isn't fully understood, but hormonal changes are thought to play a role. It's usually fine to give in to your cravings in moderation, but try not to let unhealthy snacks take the place of a balanced diet.

Stay active

Staying active during pregnancy has benefits for both you and your baby. Exercise generally won't harm your baby, but it's important to warm up well, drink plenty of water, and respect your own limits. How much movement or exercise you need depends on how active you were before pregnancy and whether you have any health conditions.

Give Pilates a try

Pilates is an exercise practice that can be beneficial during pregnancy. It can support muscle tone, strength, and flexibility. If you're new to Pilates, working with an instructor experienced in pregnancy is the safest approach.

Protect yourself from the sun

During pregnancy, your skin can be more sensitive to the sun, and it can burn even on cloudy days. If you're going outside when the sun is strongest (usually between 11 a.m. and 3 p.m.), cover up and find some shade. Remember to:

• choose a broad-spectrum (UVA/UVB) sunscreen with a high protection factor (SPF 30+)
• apply a thick layer of sunscreen to all exposed skin

Hair treatments

If you're past the first trimester, you can start thinking about straightening, perming, or similar hair treatments. That said, pregnancy hormones can change how your hair responds to chemical treatments. There's also a small chance these products are absorbed through the scalp, which can't be completely ruled out, so it may be wise to be a little more cautious with hair treatments. Data on hair dye is limited; treatments like highlights are generally considered safer because the dye isn't applied directly to the scalp. Still, if you'd like to be careful, you can check with your healthcare provider about it.

Steps to help prevent urinary tract infections

As your growing womb presses on your bladder, your risk of developing a urinary tract infection can go up. There are some steps that may help lower that risk:

• Try to drink plenty of water.
• Keep an eye on the color of your urine; dark urine can be a sign you're not getting enough fluids.
• Don't hold your urine for long periods.
• When you go to the bathroom, try to empty your bladder completely.
• Leaning slightly forward while you pee can help some people.
• Wipe from front to back.

Learning to relax

Managing stress is important during pregnancy. If you're feeling tense, relaxation techniques can help. These techniques can help not only with pregnancy-related anxiety, but also with staying calm during labor and in the busy days after birth. Yoga can be a great stress reliever for some people. Picturing a calm setting, relaxing your muscles one by one, and breathing in deeply through your nose and slowly out through your mouth can all be soothing too. A warm bath can also help you relax, but be careful not to make the water too hot, since very hot water can affect your blood pressure and cause dizziness.

Trouble sleeping

During pregnancy, falling asleep or sleeping through the night can get harder. With so much changing in your body and mind at once, this is common. If you're having trouble getting comfortable, placing a pregnancy pillow between your legs and resting with your knees slightly bent can help.

Doula support

You might consider working with a doula who can support you during birth. A doula is a trained birth coach who can provide emotional and practical support during labor. You can talk to your healthcare provider to learn more about this.

Keep track of your baby's movements

During these weeks, you may feel your baby's kicks and movements more clearly. There's no set number of movements you're supposed to feel – every baby is different – but try to get to know your baby's pattern of movement.

If you're ever worried about your baby's movements, don't wait until the next day to get help. If you think your baby is moving less or has stopped moving, contact your doctor or a healthcare facility right away. Hospitals are open around the clock.

What's happening this week?

As your baby gets ready for life outside the womb, you're reaching new milestones in your pregnancy. Right now your baby is practicing breathing and starting to develop clearer sleep-wake patterns. Your baby will also keep growing quickly over the coming weeks.

Your emotional wellbeing

During pregnancy, your mental wellbeing is just as important as your physical health. Feeling stressed, tense, or anxious from time to time can be completely natural. But if you're finding it hard to cope with these feelings, it's important to share that with your healthcare provider.

Leaking colostrum

You may notice a thin, yellowish fluid called colostrum leaking from your breasts. If you're planning to breastfeed, this is the first nourishing milk your baby will get. Colostrum has more protein and less fat and sugar than mature breast milk, which can make it easier for your baby to digest in the first days after birth. Leaking colostrum can start during pregnancy; it doesn't happen for everyone, and whether it happens or not isn't a problem in itself.

Losing a baby

Sadly, not all pregnancies go according to plan, and some women and their partners have to cope with the tragic loss of their baby. Before 24 weeks this is called a miscarriage, and after that it's called a stillbirth. This can be a huge shock, but there are trained people who can support you through your grief after a loss.