23 weeks might not sound like anything big or important, but it's actually a rather massive milestone. Although it's best if your baby stays put for another 17 weeks, if he or she decided they wanted to meet you now, they do stand a chance of surviving outside of the womb.
This early on, the statistics aren't particularly favorable, with different studies indicating anywhere between an 11% and 25% survival rate, but this increases with each passing week until the start of your third trimester. From 28 weeks onwards, your baby may need a bit of assistance, but there shouldn't really be much, if any, risk.
Baby: What's Happening?
It seems like all this baby does is grow! He or she has been gaining weight steadily over the last couple of weeks, and now weighs just over one pound, but get ready for yet another growth spurt! Over the next 3 or 4 weeks, your baby is going to double in size! But don't panic, your bump won't double as well, it just means Baby will be filling more of the available space, and you may start to see lumps poking out through your abdomen, as tiny knees and elbows thrash about as Baby tries to get comfortable.
These sudden and quite impressive growth spurts don't stop once your baby is here. They'll continue well into childhood, but happen more so during your baby's first year. Your baby will grow and change more in their first year than at any other time, which is a startling thought!
Your baby's blood vessels are developing now, especially in the lungs; this helps the lungs develop and prepare for breathing once they're born. It's because of this that your baby has a chance of survival now; the lungs may begin to function, although Baby will still require a great deal of medical assistance and could be in a special care unit for weeks or even months until the lungs are mature enough to cope by themselves.
The noises your baby hears are now becoming much less fuzzy, and are more distinguishable. Your baby may react to your voice or to your partners, and may even be accustomed to regular sounds such as the doorbell or the dog barking. Scientists have suggested that babies who are subjected to regular noises in utero are less likely to be bothered by them after the birth, so as much as you don't want to have get the vacuum cleaner out, it may prove beneficial (it's good exercise too, and your house will look nice!).
You: What's Happening?
Your uterus measures about 23 cm, or about 9 inches, and you can probably feel it rise all the way up to your tummy button. Don't forget, fetal growth isn't an exact science (if it was, none of us would be terrified about giving birth to 10 lb+ babies!), so a few centimeters difference either way is nothing to worry about.
Depending on your location, you may be offered a further appointment with your Midwife this week. Some areas don't do this, but if you are invited in you may find it's a little different to your past appointments. While your cervix may, or may not, have already started to shorten (either is totally normal), if your cervix is particularly short at 23 weeks gestation, it could be a warning sign that your baby will make an early appearance.
There's nothing to worry about, this isn't common at all. Women whose cervix is shorter than 15 mm may be at a higher risk of a preterm birth, but this is only the case for fewer than 2% of the population. Even so, some healthcare authorities like to have a gander and see what's going on down there. Having your cervix checked isn't the most comfortable of activities, and it's certainly not the most dignified, but it takes no longer than a regular pap smear and you'll be on your way.
You may also be offered a glucose test around this point. Again, some places do offer this, some don't, and some offer it only to overweight or obese patients. A glucose test is important if you're at risk of diabetes, as gestational diabetes is a far more common complaint than it really should be, and could put a bit of pressure on your baby's pancreas.
Handy Hints
Knowing that your baby could survive being born this early, you might really start to be thinking about the birth. In fact, many Moms-to-be don't give the birth much thought until this point in the pregnancy! While it's important that you know what's what with regards to the birth beforehand, don't try and make any decisions until you've discussed it with your Doctor or Midwife, especially if this is your first baby.
You may wish to book a one-on-one appointment with your Midwife, or attend an antenatal class. Antenatal classes are a great way of meeting some local "bump buddies" who are roughly around the same gestation as you, and you'll have the chance to learn about the different pain relief options available, the pros and cons, and about any effects on the baby. Being able to ask questions and even see the devices can really help you figure out your own individual preferences. Just because your neighbor had a hypnobirth doesn't mean you have to!