GUIDE
Your baby can now hear external sounds clearly, and their lungs are developing surfactant — a critical substance for breathing.
At the size of a grapefruit, your baby is approaching the viability milestone, and every day of development matters.
Be prepared from day one
Your baby is about the size of a grapefruit — roughly 11.5 inches long and weighing just over 1 pound. This week marks important advances in both hearing and lung development.
Your baby can now hear external sounds clearly. While internal sounds — your heartbeat, breathing, and digestion — have been audible for weeks, your baby can now pick up voices, music, and environmental noises from outside your body. Loud or sudden sounds may startle them, and you might feel a kick in response. Research suggests that babies begin developing preferences for sounds and music they hear frequently in the womb.
The lungs are reaching a critical stage of development. Cells in the lungs are beginning to produce surfactant, a complex substance that coats the inside of the air sacs (alveoli) and prevents them from collapsing with each breath. Without adequate surfactant, breathing is extremely difficult. The lungs are not yet mature enough to function independently, but this early surfactant production is a vital step toward eventual viability.
Blood vessels in the lungs are also developing, preparing for the moment when they will need to exchange oxygen and carbon dioxide with the air. Your baby continues to practice breathing movements by inhaling and exhaling amniotic fluid — these rhythmic chest movements help the lungs and diaphragm develop.
Since last week, your baby's sense of touch continues to refine, and the face looks increasingly like the baby you will meet at birth.
At 23 weeks, your uterus extends about an inch above your belly button, and you may feel like your belly has grown noticeably in just the past few days. The growth is rapid now, and your body is adjusting in multiple ways.
Swollen feet and ankles are becoming more common as your uterus puts increasing pressure on the veins returning blood from your lower body. Gravity does the rest — fluid pools in your feet and ankles, especially if you have been standing or sitting in one position for a long time. Elevating your feet, rotating your ankles, staying hydrated, and wearing comfortable shoes without restrictive seams can all help. Sudden or severe swelling, especially in your face or hands, is a different story — call your provider.
Braxton Hicks contractions may be happening more frequently. They are still practice contractions and should remain irregular and painless. If they start coming at regular intervals or are accompanied by pain, pelvic pressure, or any fluid leakage, contact your provider right away.
"Pregnancy brain" — forgetfulness, losing your train of thought, misplacing things — is real and common. Research suggests that the brain actually undergoes structural changes during pregnancy that may affect short-term memory and focus. It is temporary and has nothing to do with intelligence. Give yourself grace, and lean on lists and reminders.
Every pregnancy is different. New symptoms may appear while others ease up — your body is constantly adapting.
This week brings both bonding opportunities and practical planning. Take advantage of your remaining second trimester energy.
Your baby can hear external sounds clearly now. Reading aloud, talking about your day, or playing music are all ways to bond and stimulate auditory development. Your baby will recognize your voice at birth, and this familiarity begins now.
Calf stretches before you get into bed can reduce the frequency of nighttime leg cramps. Stand facing a wall with one foot behind you, heel on the ground, and lean forward gently. Hold for 30 seconds on each side. If a cramp strikes, flex your foot (toes toward your shin) to help it release.
It is not too early to research pediatricians. Ask friends for recommendations, check which providers are in your insurance network, and consider scheduling meet-and-greet appointments. Many pediatric practices welcome expectant parents for a brief visit to see if the practice is a good fit.
If you have not already, get the details on your company's parental leave policy — how much time, paid versus unpaid, and any paperwork deadlines. If you plan to take FMLA leave, some employers require 30 days advance notice.
When in doubt, call your provider. Signs of preterm labor — regular contractions, pelvic pressure, fluid leaking — require prompt evaluation.
Week 24 is a major milestone — the viability threshold. Your baby will be the size of an ear of corn, and this is typically when the glucose screening test for gestational diabetes is done.
If you are dealing with heartburn or back pain, know that these symptoms often persist through the third trimester — but there are effective management strategies.
This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider with any questions about your pregnancy.
