You are now in the sixth month of your pregnancy as your little one already looks like a tiny person. The 23rd week marks a milestone as if you had to deliver your baby now, he would have had considerable chances of surviving as about 25% to 35% babies born this week survive with proper medical attention .
Baby development during the 23rd week
Your baby looks almost like what he will look like at birth, with the face almost done developing and all the external organs and body parts in their proper place. Fat continues to develop as your baby grows fuller and chubbier every day . However, the skin layer grows faster than the fat layer, making your baby look a little saggy or wrinkly at this stage . At the same time, the developing veins and arteries just underneath the skin give your baby a reddish hue; it will go away gradually as the fat layer grows.
This is also the week when the protective keratin layer starts developing, so your baby’s skin can thicken as he grows inside the womb . The downy hair covering his body may grow thicker, allowing you to see it on an ultrasound .
Internal organ development
His lungs are now preparing for breathing after birth, as the capillary vessels and pneumocytes (specialized lung cells) begin to form . In the mean time, the vestibular system – the part of the brain that help to sense movement – matures and becomes active as the baby can already sense your movements .
Sensory organ development
The tiny bones in the inner ear keep maturing into the 23rd week, improving the baby’s hearing and balance . Researches show that your baby is less likely to be bothered by sounds he gets used to in the womb (e.g. the dog barking or the doorbell ringing) .
Those kicks and punches are growing so strong with the developing muscles and nervous system that you might even be able to see a tiny hand or feet poke from inside your abdomen! 
Another interesting thing to observe is your baby’s sleep and wake pattern, as he probably already has one. It is common for babies to remain quiet during the day, becoming active at night. However, the movement pattern might be a bit inconsistent at this early stage.
How big is your baby?
The baby has grown about 11.3 inches (28.7 cm) from crown to ankle, weighing around 16 oz (453.5 gm)  – as big as a large mango .
Belly and body changes in week 23
Your baby bump continues to grow while the hormone relaxin keeps loosening joints and muscles, making you feel clumsier every day . The uterus lies about 1.5 inches above your bellybutton during the 23rd week .
The symptoms of morning sickness, diarrhea and food aversions have probably been replaced by a new set of discomforts. However, there is nothing to worry about in case the early pregnancy signs refuse to go away or you think you are showing more than you should at this stage, as each pregnancy is unique and each baby has a different growth rate.
Most women notice a steady rate of weight gain by this stage – about a pound every week. This additional weight is essential for providing the fetus with all the necessary nutrients, while it also helps later with breastfeeding your baby . The total weight gain level should range from 25 to 35 pounds (35 to 45 pounds if carrying twins), distributed throughout the pregnancy. The range goes down to 15 to 25 pounds for overweight pregnancies .
23 weeks pregnant tests and ultrasound
Your blood pressure level is monitored regularly during prenatal visits as pregnancy increases the risk of high blood pressure and preeclampsia . Your doctor may also order a blood test to check for abnormal blood sugar levels if you have a history of diabetes.
An ultrasound performed this week shows your baby like a little doll sucking on his thumb and moving his arms and legs. Some couples opt or a 3D or 4D ultrasound to see their baby in detail; but, they are quite expensive and you may not get the desired result unless the baby is in a favorable position .
Pregnancy week 23 signs and symptoms
- Increased appetite
- Indigestion, gas and bloating 
- Joint, hip and back pain
- Round ligament pain
- Leg cramps
- Dry and itchy skin with or without rashes (especially around the belly, back and breasts) 
- Braxton Hicks contraction 
- Fluid retention and swelling (edema), especially of the feet and hands (due to the pregnancy hormones and increased blood volume) 
- Swollen and/or bleeding gums 
- Feeling out of breath along with pain in the lower ribs (due to growing uterus putting pressure on the bones)
- Emotional changes, anxiety, depression and unexplained crying 
- Dark patches on the face (mask of pregnancy) and other skin areas
- Numbness or tingling sensation in your fingers (due to the swelling that puts pressure on your nerves) 
- Sleep disturbances or insomnia 
- Frequent urination and occasionally leaking urine 
When to call the doctor
- Any kind of bleeding or spotting with or without symptoms like abdominal pain, back ache, nausea and vomiting or pelvic pressure 
- Lots of light yellowish or clear, odorless watery discharge (might indicate leaking amniotic fluid) 
- Excessive vaginal discharge, having yellow jellylike or thick white discharge along with burning while urination lower back pain or period-like cramping (might indicate complications like thrush  or yeast infection)
- Constant headaches along with extreme tiredness, vision changes, sudden swelling of the ankles and feet, palpitations and shortness of breath (might indicate preeclampsia) 
Tips for a healthy pregnancy and baby
- Stretching your hands and fingers frequently, especially if your work involves using the computer a lot as it helps reduce the tingling sensation; also, make sure your elbows are never higher than the hands while working 
- Reading to your baby, as it helps him relax while also getting used to your voice; playing some classical music is another good option for letting him relax 
- Making sure to consult with your doctor about travelling in pregnancy and finding out about necessary vaccinations and sun-blocks if you are planning to go for vacation in the second trimester 
- Practicing relaxation techniques, doing some light stretching and light exercises or prenatal yoga
- Following diet rich in fiber, vitamins, iron, calcium and folic acid
- Drinking lots of water as well as fresh vegetable and fruit juices to stay hydrated and reduce constipation, headaches, fluid retention  and even hemorrhoids 
- Practicing lying on your side (preferably left side) as lying on your back or stomach restricts the blood flow to your placenta; placing a pillow between your legs can provide better support to your knees, allowing you to have a good night’s sleep 
- http://www.babycenter.com/0_hemorrhoids-during-pregnancy_244.bc [/ref]