28 Weeks Pregnant

Welcome to the third trimester! Now that you’re 28 weeks pregnant, it won’t be long before you meet your little one!

This trimester, you’ll feel your baby move more than ever, so start keeping kick counts. You’ll also enter the time that most women find to be the most physically awkward. (It’s okay to have your partner tie your shoes and even shave your legs if needed.)

Meanwhile, your baby will be going through the last stages of preparation for birth and filling out that wrinkled skin with a layer of protective fatty tissue so that by the birth day, your little one will be just the right size for your arms.

Your Baby’s Development At 28 Weeks

Now, at 28 weeks pregnant, your baby is about (on average) 15 inches long and weighs about 2.5 pounds.

The baby’s skin is covered in a waxy layer called vernix caseosa, which protects and waterproofs its delicate skin until birth.

This last trimester is a significant period for brain growth. Your baby’s brain will approximately triple in weight between now and birth! A baby’s body weight will do the same, with the average baby at birth around 7.5lb.

Your baby’s movements are also now consistent enough to do kick counts!

Mother’s Symptoms At 28 Weeks Pregnant

Many symptoms may stay consistent throughout pregnancy, while others only crop up temporarily or appear later in pregnancy. For instance, hopefully, your nausea from the early weeks has vanished, but it may have been replaced with heartburn.

One tricky part of pregnancy is determining which symptoms need medical attention, which can be treated at home, and which treatments are safe. For example, swelling might seem minor but, under some circumstances, calls for immediate contact with your doctor. Round ligament pain may feel dire but typically doesn’t cause any danger to you (other than pain) or to your baby.

Let’s break down some of the symptoms you might feel by this point in pregnancy, starting with some of the most serious ones.

Signs Of Preeclampsia

If you have preeclampsia, your doctor will monitor your pregnancy more closely. You may have to deliver your baby early. Many of the red flags for possible preeclampsia are common pregnancy symptoms but more extreme.

Swelling can be caused in pregnancy by fluid retention and greater blood volume. Unfortunately, it can also be caused by hypertension, and when it’s severe, it may be a sign of preeclampsia. Any sudden or severe swelling or involving the chest or face requires a call to your doctor. So does swelling, which is more prominent on one side of the body. Any swelling at all that is accompanied by chest pain should prompt an immediate call.

Sudden weight gain is also a potential sign. Even though you should be gaining weight at this point in pregnancy, it shouldn’t be so sudden or rapid that it stands out as different from other weeks.

Headaches can also be normal due to increased blood volume, hormones, stress, mild dehydration, and other factors. However, severe headaches, as well as headaches that don’t ease with medication, rest, or hydration, are a warning sign.

Any vision changes can also be a sign of preeclampsia. If you have spots in your vision, blurry vision, or any other changes, you need to contact your doctor.

Signs Of Pre-Term Labor

At this point in your pregnancy, your baby has a good chance of surviving outside the womb. However, keeping the baby on the inside for twelve more weeks will give him a better chance at being healthy and strong, and every week between now and then, it will improve potential outcomes. So, if you’re in labor now, you need to get medical attention. Your doctor can stop labor and help you hold on until it’s safest to deliver your baby.

Contractions are an obvious sign of labor — or are they? You will likely have Braxton Hicks contractions throughout the third trimester. You may feel a squeeze, and it may even be visible. Your stomach area can become hard and tight. However, these are not labor contractions; you shouldn’t let them worry you.

There are a few key differences between Braxton Hicks and actual labor. Most women say Braxton hicks contractions are not painful, while labor contractions may be (though early ones may not be, and placenta position can affect how they feel in different pregnancies). Labor contractions become more frequent over time, and more intense, and they don’t stop when you change position. If you’re unsure, drink some water, lie down, find a comfortable resting position, and watch the time.

Rupture of membranes,or having your water break, is a major sign that labor is imminent or underway. You may have a trickle or a gush. However, labor can start without this happening, so don’t rely on it as the sole sign!

If you think your water has broken, seek immediate medical care.

Several other symptoms may be signs of preterm labor, too. Severe nausea and vomiting, severe diarrhea, lower back pain, and pressure in the pelvic area could all mean that labor is starting.

If your cervix is thinning and dilating, you may pass pieces of mucous plug. This can be whitish or may have pink or bloody streaks. Losing bits of it, especially after an internal exam, isn’t necessarily an emergency since it can be reformed. But it could mean your body is getting close to labor too soon, and you should check in with your doctor.

Shortness of Breath & Fatigue

Your lungs are under pressure, you’re carrying extra weight around, your center of gravity has moved, and your blood volume has increased. If you get fatigued or out of breath after less exertion than usual, that’s normal, and you should listen to your body and rest.

However, if this causes chest pain or if you pass out, you should seek immediate medical attention. If you are dizzy or lightheaded, you should put safety first—sit or lie down to avoid falling or passing out—and make sure you let your doctor know about this.

Digestive Difficulties

During pregnancy, your digestive system is under a lot of pressure, which can cause some hiccups (no pun intended) in its function.

Heartburn and indigestion are common in pregnancy. Drinking more water, avoiding trigger foods, and eating smaller, more frequent meals can help. Over-the-counter antacids like Tums and Rolaids are typically considered safe during pregnancy, but antacids containing aspirin, magnesium trisilicate, or sodium bicarbonate are not. If you’re not sure, check with your doctor.

Constipation is also a common symptom during pregnancy. Drinking more water and increasing fiber intake can help. In the meantime, most OBs give the okay to stool softeners, but laxatives can cause contractions, so don’t use them without your doctor’s recommendation. If you suffer hemorrhoids (also common in pregnancy!), your doctor may advise using witch hazel or may recommend an OTC cream or prescribe a medication.

You may also suffer urinary incontinence. Practicing Kegels can help (and also help shorten labor).

Cravings are almost a defining aspect of pregnancy, and nearly every pregnancy will involve them. It’s okay to indulge a little, and it’s OK to give your body what it’s asking for as long as you’re doing so safely and in moderation. You may wonder why exactly you are craving Rocky Road ice cream with strawberries and extra hot fudge sauce? Our pregnancy cravings guide will help you figure out what your body may really be asking for.

Pain & Cramping

A lot of discomfort and some pain are typical throughout pregnancy. Many people will suffer rib pain, round ligament pain, and/or pelvic girdle pain, which are normal and usually not a sign of any problem.

Your round ligaments support your uterus, and as it grows heavier, they stretch to accommodate, and mild or intense pain may be associated with this. It can feel like a stabbing or pulling and may extend into the groin. This should ease with a change of position, rest, and/or OTC pain meds.

Rib pain can be caused by your expanding uterus putting pressure on other organs so that they need more space inside your rib cage. As long as it’s rib pain and not chest pain, it’s nothing to panic about. It should improve in a few weeks when your baby drops lower into your pelvis to prepare for birth.

Pelvic girdle pain is pain in the bones that encircle your lower torso- the pelvic girdle. You may have pain in your lower back and hips, around your waist area, due to the extra weight of your baby and uterus.

You may also have pain or cramping in your legs, not only as they carry around extra weight and adjust to a changing center of gravity but even when you lie down. Pregnancy can produce restless leg syndrome (RLS) symptoms, which can feel like your legs need to jerk and move after you get still. It can feel uncomfortable or even painful.

Unfortunately, RLS medications aren’t safe during pregnancy, so your doctor may recommend exercise, massage, or warm baths instead. Severe symptoms have been shown to have a link to longer labor and even needing a c-section, so in some cases, your doctor may recommend or prescribe a vitamin supplement.

Some types of pain should raise a bit more concern, though.

If it feels like you’re having menstrual cramps, you need to contact your doctor. If you have chest pain, you must seek immediate medical care. Also, any pain that doesn’t go away with medication, rest, or hydration, any severe pain, or any pain that you’re just sure is not right is worth a call, just to check.

Sleep Disturbance

It will be hard to get enough sleep for the next year or more. Unfortunately, in many cases, the sleep deprivation starts long before the baby is born.

In addition to heartburn and RLS symptoms, your new body shape may make it hard to sleep. Tuck pillows around your back, legs, and belly for extra support!

Stress, anxiety, hormonal changes, and an increased heart rate can also make sleep difficult during pregnancy. Your doctor will likely want you to try sleep hygiene practices (keeping your room dark and cool, shutting off screens, and keeping a routine) first, but if they’re interfering with daytime life and safety (please don’t drive tired), they may prescribe or recommend melatonin or certain antihistamines. Don’t add any meds or supplements without your doctor’s approval!

Breast & Skin Changes

You’re noticing many visible changes in your body now, too. You may have visible veins in your breasts and other areas. You likely have stretch marks on your stomach, which may show up on your chest, hips, and other areas of your body. You may even have spider veins.

None of the above are dangerous or a medical concern, typically. You can use cocoa butter or another gentle lotion on stretch marks if they are itchy, uncomfortable, or painful. If there’s any pain associated with visible veins, check in with your doctor.

Pregnancy causes significant changes in breasts, too. You have already noticed increased size and weight. Now you may notice that your nipples and areolae have grown larger and darker, and you may even leak colostrum. (Check out our guide to different types of nursing pads to avoid leaks, stains, and discomfort from dampness.)

A more alarming change may be small lumps. Don’t panic! These are often just clogged milk ducts. They are usually not painful. They may shift location, change size, and typically feel smooth. By contrast, Bass Cancer Center explains that malignant lumps tend to be irregularly shaped, and feel ‘fixed’ in place. It’s always okay to have your doctor check if you’re not sure!

One change that should raise concerns is cracked or bleeding nipples. If this happens, contact your doctor — though there are OTC creams for this, your doctor may prefer to prescribe one to prevent infections.

When To Contact Your Doctor

Pre-Term Labor

If you believe you may be in labor, you should seek medical attention right away. The National Institute for Health defines “frequent” contractions as six or more in an hour, but you may want to call your doctor for fewer than that if they’re clearly becoming more frequent and intense over time or with any other symptoms.

It’s also important to check in with your doctor if you have other signs of early labor, like lower back pain, severe nausea and vomiting, or passing your mucous plug.

You should seek medical care immediately if your water breaks.

Preeclampsia

Call your doctor immediately if you believe you may have symptoms of preeclampsia, including vision changes, severe headaches, or unusual or extreme swelling, especially coupled with chest pain.

Breathing Problems

It’s okay to be a bit out of breath after exertion, even milder exertion than would usually tax you. However, if you’re struggling to breathe or feel like you’re not getting enough air, call your doctor.

Baby Problems

By now, you should be feeling your baby move regularly. If your baby seems to go longer without moving, you can do kick counts. The Count The Kicks organization advises all pregnant moms to start doing kick counts in the third trimester, but you can also use them earlier (as long as you’ve been feeling your baby moving regularly) to ensure everything is okay.

First, lie down in a comfortable position. Start a timer or notice the current time. Pay close attention to your baby’s movements. How long does it take to feel ten? Doctors’ expectations may vary, but you should check in with your OB if you don’t feel ten kicks within two hours. (You can ask about your doctor’s specific expectations during an appointment.) If you’re tracking your baby’s usual movement patterns and notice a significant difference, it’s okay to check with your doctor.

If the baby’s movements decrease, call your doctor.

Other Reasons To Make The Call

Signs of dehydration, like not passing urine over an extended time.

Vaginal bleeding, or alarming discharge, or any sign of urinary tract infection or vaginal infection.

Any severe pain or anything that sets off your internal alarms and makes you feel that something is wrong is a sign of trouble.

What Should Mom Be Doing At 28 Weeks Pregnant?

Get vaccinated! If you haven’t had a whooping cough vaccine and an RSV vaccine, your doctor may recommend doing so now. These will help protect your baby.

Have you chosen a pediatrician? Some obstetricians may have a specific pediatric office they associate with, but that doesn’t mean you must choose that practice. You can ask around among your friends or local mom groups (there’s probably one on social media for your area), ask your OB for recommendations, or talk to other moms in your prenatal classes.

If you’re having pregnancy photos taken, those are coming soon! Most moms-to-be opt to have this keepsake made between 28 weeks pregnant and 34 weeks pregnant.

If your doctor has ordered a growth scan (a follow-up ultrasound), that should be within the next few weeks as well! This may be done if you have a higher-risk pregnancy, but it may also be scheduled if your baby was uncooperative at his anatomy scan a few weeks ago and didn’t allow your doctor or the ultrasound tech to get all the needed measurements.