28 Weeks Pregnant

The third trimester will bring a lot of growth for your baby, who’s continuing her development and gearing up for the big day.

As for you, you might find yourself dealing with new pregnancy symptoms, as well as a few lingering ones from your previous few weeks. Let’s explore what’s happening with you and your baby this week.

At 28 weeks, your baby is the size of a head of lettuce, measuring about 14.8 inches long and weighing just under 2¼ pounds. 1

One piece of very good news this week is that almost all babies born at this stage can survive with the right care, so you can officially relax about the (slim!) chance of a premature birth.

Here’s what else is happening this week:

• Skin: Your baby is continuing to accumulate fat, which helps smooth out her skin and make it less wrinkled.
• Brain development: Her brain is starting a period of rapid growth; it will grow four-fold in the third trimester. Her cerebrum is developing deep grooves, increasing its surface area. 2
• Sensory development: Your baby’s senses of hearing, smell, and touch are now developed and functional. She can hear sounds from the outside world and respond to touch. 34 If you press your belly, you might feel a little answering kick.
• Breathing practice: Your baby is actively practicing her breathing, which helps to strengthen her lungs. She isn’t breathing air yet, of course, just the amniotic fluid that cushions her in the womb. 5
• Sleep cycles: Your baby is developing distinct sleep cycles, including REM sleep, which means she might be dreaming. She’s also now blinking her eyes. 6
• Positioning: As your due date nears, your baby should start getting ready for birth by transitioning into a head-down position. Don’t worry if your baby is in a “breech” position (feet down); most babies get themselves into a head-down position in time for delivery. 2
• Immune system: Your baby’s immune system is still developing, with the placenta guiding this process. 7

Start counting your baby’s kicks

As your little one gets more and more active, you’ll need to pay attention to her movements. The way to do this is by using kick counts. This involves counting the kicks, taps, or rolls you feel within a set time frame. A typical goal is to feel 10 movements within two hours. 8

If you don’t count 10 movements within 2 hours, speak with your doctor. Moreover, if you notice a decrease in your baby’s activity from her usual baseline, contact your doctor immediately.

As your baby grows, your body is also changing to accommodate her. New changes you might observe are:

• Sensitive skin: Your skin may be more sensitive than usual due to your changing hormones, which can lead to dryness, itchiness, or rashes. You may also experience a darkening of the skin called melasma, often known as “the mask of pregnancy.” 9
• Swelling: Your feet and ankles may be swollen as your body is retaining more water than normal. 10

Contractions

Notably, you may notice Braxton Hicks contractions. These are “practice” contractions that can feel like a tightening of your abdomen. In fact, many women mistake them for the real deal. But unlike true labor contractions, they’re typically irregular and not painful.

As long as they don’t become regular or start hurting, Braxton Hicks contractions aren’t anything to worry about, although they can be a little intrusive when you’re trying to relax. That said, if they do become painful, see your doctor right away to make sure you aren’t going to go into premature labor.

You could also try using a pregnancy tracker app to time how regular your contractions are.

Other symptoms at 28 weeks

Alongside these changes to your body, you may see new symptoms pop up this week, too. These could include:

• Leg cramps: You may get leg cramps, especially at night, due to your hormonal changes and the added weight your legs are carrying lately.
• Hemorrhoids: Many women suffer from swollen blood vessels in the pelvic area, which can be very uncomfortable and may cause light bleeding.
• Weird dreams: It’s common to get vivid and bizarre dreams during the third trimester, especially if you’re having trouble sleeping.
• Stuffy nose: Your nasal passages could become inflamed. This is known as pregnancy rhinitis, and can leave you with a stuffy nose. 11
• Bleeding gums: Your teeth and gums are more sensitive to plaque, which can cause them to become inflamed and bleed.
• Leaking breasts: You might see the first signs that your milk is coming in during pregnancy. Your breasts may have already started producing colostrum, a yellowish substance that’s the first form of breast milk.
• Fatigue: Unfortunately, you might be feeling more tired again as your body works hard to support both you and your baby
• Back pain and sciatica: You may get backaches in the third trimester due to your growing belly and changes in your posture. Moreover, your baby’s head, coupled with your growing uterus, can put pressure on your sciatic nerve, leading to tingling, numbness, or sharp, shooting pain along your buttocks and legs. 12

What symptoms should you watch out for?

Most of the third-trimester symptoms are normal and nothing to worry about. However, certain symptoms can indicate complications that you need to see a doctor for. You’ll need to be aware of the telltale signs.

Signs of preeclampsia

Preeclampsia is a serious (potentially life-threatening) condition that causes persistent high blood pressure in pregnant women. Common symptoms include: 13

• Sudden and severe swelling on your face, hands, and feet
• Blurred vision (or other major visual changes)
• Severe headaches

These symptoms don’t necessarily mean you’ve got preeclampsia, but if you have any of them, contact your doctor immediately to rule it out (and get the treatment you need if it turns out you do have it).

Signs of preterm labor

Labor is considered preterm if it happens before week 37. Look out for the following signs: 14

• Your water breaking
• Regular contractions (every 10 minutes, or more often)
• Change in your pregnancy discharge (leaking fluid or fresh blood)
• A dull ache in your lower back

Try not to panic if you notice any of these symptoms. The odds are against you giving birth prematurely, and as mentioned, even if you do, your baby will be viable. However, you’ll still need to get medical attention right away.

Many moms claim the third trimester is the hardest. While this stage of pregnancy does present challenges, there are ways to ease your discomfort and keep both you and your baby healthy:

Stay hydrated

You need to drink plenty of water throughout your pregnancy. Staying hydrated can also alleviate some of your symptoms, such as dizziness, hemorrhoids, and Braxton Hicks contractions.

While plain water is the best option, you can also drink fruit juices, though you should make sure they’re pasteurized to reduce the risk of infection. 15

Eat well

Make sure you’re eating a balanced pregnancy-friendly diet and only giving in to your cravings in moderation. Your baby will be absorbing a lot of iron during this trimester, so be sure to eat plenty of foods that are high in iron, such as chicken, beans, and spinach. 16

If you’re dealing with hemorrhoids, try adding more fiber to your diet. Moreover, eating smaller meals more frequently throughout the day (rather than just a few big meals) is a good way to manage bloating and gas, as well as avoid overtaxing your digestive system.

Lucky for you, there are plenty of healthy pregnancy snacks to choose from, whether you want to chow down on a couple of granola bars or a bowl of plain yogurt with fruit.

Get comfortable

As your little one gets bigger by the minute, she’ll put much more strain on your body. Try to find ways to get comfortable, such as wearing more comfy shoes or sitting in supportive chairs. You can also try using a maternity support belt to relieve backaches and pelvic girdle pain (symphysis pubis dysfunction).

If you’re really struggling with aches and pains, work with a physical therapist to help relieve it and increase your strength as your pregnancy progresses.

Get moving

While you probably can’t run any marathons at 28 weeks, you should try to stay moderately active. Regular, pregnancy-safe exercise helps relieve aches, pains, and constipation. Just make sure you speak to your doctor before starting any new exercise regime.

Look after your skin

You can use calamine lotion for itchy spots, but avoid products with harsh chemicals. 17 While most rashes during pregnancy are normal, have your doctor or a dermatologist take a look at them to rule out any complications.

As you get closer and closer to your due date, you’ll need to start preparing for your baby’s big entrance:

Get a RhoGAM injection

Find out whether or not you’re Rh-positive or Rh-negative. The Rh factor is a protein found in most people’s blood—being Rh-positive means you have it, whereas those who are Rh-negative don’t. 18

If you’re Rh-negative, make sure you get a RhoGAM shot this week to prevent any potential complications with an Rh-positive baby. Without it, your body could produce antibodies that attack your future Rh-positive baby’s red blood cells.

Make sure you’re up to date with vaccinations

If you haven’t already, you’ll need to get all your necessary vaccinations. The “Tdap”—short for tetanus, diphtheria, and pertussis (whooping cough)—is one of the most important, as whooping cough is especially dangerous for newborns.

Getting a flu shot is also safe during pregnancy, and it’s a good idea (something that’s true every year, not just when you’re expecting).

Take childbirth classes

With the big day fast approaching, you should enroll in childbirth classes to prepare for labor and delivery.

You can schedule classes through your local hospital or even find online classes. Research what’s covered in the classes beforehand, and try to pick one that teaches you infant CPR. There are also specialized classes out there if this is your second time, you’re carrying multiples, or you’re attempting a vaginal birth after cesarean (VBAC).

These classes are also a great way to meet other expectant mothers. If you’d feel more comfortable with some support, you can go with your partner, a family member, or one of your friends.

Look for a pediatrician

It’s a good idea to look for your baby’s pediatrician 3 months before your due date, so start researching your options now. Ask your family, friends, or your doctor for recommendations and set up meetings to get to know them.

Consider your birth plan

While this isn’t strictly necessary, you may want to consider making a birth plan and discussing it with your doctor or midwife. If you have any special requests, such as a birthing pool, you’ll need to arrange those in advance.

Prepare your baby’s nursery

Begin setting up your baby’s nursery and stocking up on essentials like bottles, blankets, and, of course, diapers. If you haven’t got one already, you’ll need to buy your baby’s crib. It’s better to avoid drop-side models of cribs, as they’re generally less structurally sound. 19

Think about circumcision

If you’re having a boy, start thinking about whether or not you want to get him circumcised.

Circumcision isn’t usually medically necessary, and most of the reasons that parents choose to have their babies circumcised are cultural or religious. Ultimately, it’s up to you to decide whether or not to do this, but you can discuss it with your doctor if you’re having trouble deciding.

As you enter your third and final trimester, it’s natural to feel a little nervous. You have a little homework you have to do to prepare for the big day, but hopefully, this will be more exciting than stressful. Now’s the time when you can really start to look forward to welcoming your baby into the world.

You’ll be in regular contact with your doctor throughout this trimester, and they’ll always be willing to answer any questions or concerns you may have. You’ve done great so far, and you’ve only got a few more weeks to go, so keep up the good work!