23 Weeks Pregnant

23 weeks pregnant: clearer movement and more practical planning

At 23 weeks pregnant, you are getting close to the end of the second trimester. Your bump is usually more noticeable, and fetal movement may feel easier to recognize than in previous weeks.

This is a useful time to review the results of a detailed fetal anatomy ultrasound if it has already been done, or to arrange follow-up if your clinician recommends it. It is also a good stage to think practically about maternity leave, work, newborn care, and upcoming pregnancy tests.

This content is educational only and does not provide a diagnosis or treatment plan. If you have bleeding, severe pain, dizziness, fainting, severe vomiting, fever, fluid leakage, clearly reduced fetal movement, or concerning symptoms, consult a licensed clinician in Saudi Arabia.

How is week 23 of pregnancy calculated?

Pregnancy age is counted from the first day of the last menstrual period, not from the day of fertilization. This means the fetus is usually about two weeks younger than the calculated pregnancy week.

If the last menstrual period is uncertain, your clinician may use previous ultrasound measurements and fetal biometry to confirm dating. You can use the pregnancy calculator for an initial estimate, then rely on the due date confirmed during second-trimester pregnancy follow-up.

What symptoms may happen at 23 weeks pregnant?

As the uterus grows and puts more pressure on the bladder, back, and pelvis, symptoms may become more noticeable. Possible symptoms include:

• Clearer fetal movement or light, intermittent kicks.
• Lower back, pelvic, hip, or groin discomfort.
• Mild occasional tightening, especially with tiredness or low fluid intake.
• Frequent urination or mild urine leakage when coughing, laughing, or moving.
• White vaginal discharge without bad odor or itching.
• Mild swelling in the feet or ankles, especially near the end of the day.
• Heartburn, bloating, constipation, or gas.
• Mild headaches or dizziness when fluids or meals are inadequate or when standing quickly.
• Leg cramps, especially at night for some women.

Some symptoms can be common in pregnancy, but severity and pattern matter. Sudden, severe, or worsening symptoms, especially with bleeding, fluid leakage, fever, strong headache, or sudden swelling, should be assessed medically.

Urine leakage or amniotic fluid?

At 23 weeks, the uterus can press on the bladder, and mild urine leakage may happen with coughing, laughing, or movement. However, it can sometimes be difficult to tell urine from amniotic fluid, so persistent or sudden fluid leakage should not be ignored.

• Urine often has a recognizable smell and may leak with bladder pressure, coughing, or movement.
• Amniotic fluid may appear as a sudden gush or a continuous trickle that does not stop easily.
• If the fluid is odorless, persistent, or does not seem like urine, contact your clinician immediately.
• Do not use tampons or rely on unproven home tests to identify the fluid.
• If leakage occurs with pain, contractions, fever, bleeding, or reduced movement, seek urgent care.

When in doubt, request a fluid leakage evaluation during pregnancy. Your clinician may perform an exam, arrange an amniotic fluid ultrasound assessment, or use other tests depending on your situation.

How is the fetus developing at week 23?

The fetus continues gaining weight, and the body begins to look more like a newborn, although fat under the skin is still developing. The muscles, bones, skin, and nervous system continue maturing.

• The fetus continues to gain weight over the next several weeks.
• The fine hair covering the fetal body, called lanugo, may become more noticeable.
• The lungs continue developing, but they are still immature.
• The fetus may respond to sound, movement, or your body position.
• Movements gradually become stronger, but they may still be irregular at this gestational age.
• The placenta and umbilical cord continue supporting the fetus with oxygen and nutrients.

Fetal growth cannot be judged by movement alone. Clinical assessment depends on ultrasound findings, gestational age, fetal measurements, amniotic fluid, placenta, and the mother's health.

How big is the baby at 23 weeks?

The fetus may weigh around half a kilogram and may measure about 28 to 36 centimeters from head to heel, with normal variation depending on true gestational age and measurement method.

At this stage, ultrasound reports usually use measurements such as head circumference, abdominal circumference, and femur length, and may estimate fetal weight. This estimate is not an exact final number; it should be interpreted with the full scan report.

Fetal movement at week 23

Many women feel movement by this stage, but the strength and pattern vary. Movement may feel like fluttering, bubbles, taps, or light kicks. If this is your first pregnancy or the placenta is anterior, movement may be less obvious.

Formal daily movement counting is not started for every woman at this week, but you can begin learning what is usual for your baby. If you have been feeling movement and notice a clear reduction or a change that worries you, contact your clinician or request fetal movement follow-up.

Ultrasound and tests around week 23

By this stage, many pregnant women have already had the second-trimester ultrasound or anatomy scan, or may need follow-up if views were incomplete or a finding needs review.

• A detailed fetal anatomy ultrasound reviews major fetal structures, growth, placenta, and fluid, but it cannot detect every condition.
• A fetal growth ultrasound may be requested if measurements need follow-up or the pregnancy is high risk.
• A cervical length ultrasound may be discussed if there is previous preterm birth, contractions, or concerning symptoms.
• A urine test or urine culture may be requested if there is burning, pain, unusual urine smell, or contractions.
• A complete blood count CBC or ferritin test may be discussed if tiredness, dizziness, or palpitations are significant.
• Gestational diabetes screening or an oral glucose tolerance test OGTT may be planned for the coming weeks according to your clinician's protocol.

If a scan finding is unclear, it does not always mean there is a problem. Fetal position or image quality can be enough reason to repeat or complete the scan.

Hydration, headaches, and mild cramping

Regular water intake is important at this stage. Low fluid intake may worsen headaches, constipation, dizziness, mild cramping, or bladder irritation. Pale urine often suggests better hydration, while dark yellow urine may mean you need more fluids.

• Drink water throughout the day rather than taking a large amount at once.
• Increase fluids in hot weather or after activity unless your clinician has restricted fluids.
• Contact your clinician if a headache is severe, persistent, or occurs with visual changes or sudden swelling.
• Seek care for burning urination, lower abdominal pain, fever, or strong urine odor.
• Do not rely on high-caffeine drinks as your main source of fluids.

Work, maternity leave, and planning after birth

Week 23 can be a good time to organize work and maternity leave, especially if your workplace needs documents or early notice. There is no single correct time to stop working; the decision depends on your health, job demands, complications, and clinician advice.

• Review your workplace maternity leave policy.
• Ask what documents or medical reports are required.
• Discuss job duties with your clinician if your work involves long standing, heavy effort, travel, or exhausting shifts.
• Start thinking about baby care after birth if you plan to return to work.
• Write down questions for the next prenatal visit.

If work is physically demanding or the pregnancy is high risk, a birth planning and maternity leave consultation or closer follow-up may help you create a safer plan.

Nutrition and supplements at week 23

Continue folic acid or prenatal vitamins as directed by your clinician. Iron, vitamin D, or calcium needs can vary depending on test results, diet, and symptoms.

• Choose balanced meals with protein, vegetables, fruit, whole grains, calcium sources, and iron-rich foods.
• Do not use high-dose supplements without a test result or medical prescription.
• Your clinician may request a vitamin D test if symptoms or risk factors are present.
• Avoid unpasteurized foods, undercooked meat or eggs, and fish known to be high in mercury.
• Ask your clinician before using herbs or natural products, especially if you take medicines.

How can the partner help this week?

A partner can help arrange ultrasound and test appointments, review maternity or paternity leave plans, support hydration and rest, and help monitor symptoms that need medical contact.

It can also be helpful to start a practical discussion about the first weeks after birth: who can help at home, how sleep will be organized, and what childcare options may be needed if the mother returns to work.

When should you call a doctor or seek urgent care?

Request prompt medical assessment if any of the following occur:

• Vaginal bleeding or fluid leakage.
• A sudden gush or continuous trickle of fluid that does not seem like urine.
• Severe or persistent abdominal or pelvic pain.
• Regular contractions or clear pelvic pressure.
• A clear reduction or worrying change in fetal movement compared with what is usual for you.
• Severe headache, visual changes, sudden swelling, or upper abdominal pain.
• Fever, chills, severe pain when urinating, or unusual-smelling discharge.
• Severe dizziness, fainting, strong palpitations, or unusual shortness of breath.

These symptoms may require a pregnancy contractions evaluation or urinary tract infection evaluation during pregnancy or urgent follow-up, especially if you are under high-risk pregnancy follow-up.

What comes next?

Return to the week-by-week pregnancy guide, or continue to 24 weeks pregnant, when movement awareness and gestational diabetes screening planning become more important according to your clinician's plan.