Week 28 of Your Pregnancy

Not all experts agree on when each trimester begins and ends, but once you reach 28 weeks the American College of Obstetricians and Gynecologists (ACOG) considers you to be in the first week of your third and final trimester of pregnancy. You have just a few more months until you'll be considered full term.

This time will be filled with new experiences, new symptoms, and more prenatal visits.

Your Baby's Development at 28 Weeks

At 28 weeks pregnant, a baby typically measures about 10 inches (25.4 centimeters) from the top of their head to the bottom of their buttocks (known as the crown-rump length), and baby's height is over 14 inches (36.1 centimeters) from the top of their head to their heel (crown-heel length). This week, the baby's weight is about 42 ounces or 2 1/2 pounds (1,189 grams).

Brain

This week, your baby is in a period of rapid brain growth. Their brain tissue is developing the ridges and furrows that give the brain its well-known grooved and folded appearance.

Eye Movements

Babies begin having eye movements as early as 14 weeks, but these movements increase around 28 weeks. The higher frequency of eye movements is associated with REM sleep and healthy brain development.

Umbilical Cord

The umbilical cord carries blood between the placenta and your baby. It supplies your baby with nutrients and oxygen and aids the removal of their waste products. The umbilical cord was fully formed by week 12, but it has continued to grow in both diameter and length.

By the time a full-term baby is born, the umbilical cord will be between 1 and 3 feet (30–100 centimeters) long and over 1/2 inch (16 millimeters) wide.

Survival Outside the Womb

As each week passes, a baby's chances of survival outside of the womb go up and the risks of life-long health issues go down. With specialized care, a baby born prematurely at 28 weeks has a 94% chance of surviving outside of the uterus.

Explore a few of your baby's week 28 milestones in this interactive experience.

Your Common Symptoms This Week

As you move from the second trimester to the third trimester, you may see an increase in new symptoms and the return of past symptoms from previous weeks. Forgetfulness, nasal congestion, and skin changes may stick around while aches and pains tend to get a little worse.

Back Pain

Your growing uterus, stretching muscles, and the pregnancy hormones that loosen your joints to prepare for childbirth all can contribute to back pain. Research shows that low back pain occurs in about 50% of pregnancies. Back pain that radiates down your leg caused by pressure on the sciatic nerve (known as sciatica) is seen in about 1% of pregnancies.

Weight Gain

By 28 weeks, you may have put on about 19 pounds. The recommended guidelines for weight gain in pregnancy suggest that those with a pre-pregnancy weight in the "normal" range should gain approximately 1 to 5 pounds during the first trimester and about 1 pound per week thereafter.

Every pregnancy is different. Your health care provider will continue to monitor your weight gain at each and every prenatal visit and may advise you to try to gain more or less than the average guidelines. If you have any questions or concerns about your weight, be sure to talk to your doctor.

Self-Care Tips

The same healthy habits you've been keeping up to now should still be at the top of your list, but you may find that you need to make some tweaks to your routine to deal with new aches and pains. You'll also want to start setting aside some time each day to relax and bond with baby while you monitor their movements.

Dealing With Back Pain

In the weeks leading up to now, you may have already been dealing with pregnancy-related back pain, but for many, it tends to get worse as your pregnancy progresses.

To relieve discomfort from back pain or sciatica, try:

• Avoiding any heavy lifting
• Getting a prenatal massage
• Looking into acupuncture
• Paying attention to and adjusting your posture
• Resting when you have pain
• Staying within the recommended guidelines for weight gain
• Stretching and strengthening your muscles with exercise
• Trying not to stand up for long periods of time without rest
• Trying physical therapy
• Using a pillow or rolled-up towel as back support when sitting down
• Visiting a chiropractor trained in pregnancy care
• Wearing a supportive back and belly belt
• Wearing comfortable shoes and staying away from heels

Kick Counts

You can monitor your baby at home by keeping track of the movements you feel. Spending a little time each day feeling your baby's movements can also help to relieve any anxiety you may have about your baby's health and well-being.

Though your baby has been moving since their first weeks of pregnancy, health experts recommend beginning "kick counts" around 28 weeks.

There are two methods of performing kick counts (i.e., counting movements). Talk to your provider about which method they recommend.

• Lie down on your side and begin counting each movement you feel. You should count at least 10 separate movements within a 2-hour period; if you count 10 movements before the 2 hours is up, you can stop.
• Lie down on your side and count every movement you feel in 1 hour (this is your baseline). Do this count at least three times a week. You are looking for the number of movements to be the same as or more than the first baseline count you took.

Tips for kick counts:

• Babies sleep in utero, which means you might have to wake your baby up to get them to move. Try talking to your baby or eating or drinking something sugary a few minutes before you feel for kicks.
• Rest in a comfortable, quiet place without distractions
• Schedule your count after a meal or snack (when a fetus tends to be more active)
• Try to perform the count around the same time each day
• You don't have to wait for "kicks"—wiggles, jabs, and squirming also count

Over time, you will get to know your baby's typical routine and patterns of movement. If you notice that your baby is moving less than usual, call your provider.

Advice for Partners

Reality might be very much kicking in right about now thanks to actual baby kicks. For many non-pregnant partners, pregnancy can feel abstract until they start to see or feel their baby's movements from the outside—typically at around week 28.

Your pregnant partner has likely started performing a daily kick count, and you can join in the fun, too. To increase your chances of feeling the baby move from the outside:

• Have your partner change positions
• Have your partner press on their uterus to encourage a response
• Talk to the baby or play music
• Try feeling for movement after your partner eats a meal or has a sugary drink or snack (which can bring on activity)

Be patient and keep trying. Sometimes, you just have to have your hand in the right place at the right time. You will have better chances of feeling baby as the weeks go on, and you might even be able to see the baby moving underneath your partner's skin.

At Your Doctor’s Office

The first prenatal visit of your third trimester often occurs during week 28. This appointment will be much like those you've had up to now as your doctor or midwife will:

• Answer your questions
• Ask you for a urine sample
• Check your body for swelling
• Discuss your symptoms
• Listen to your baby's heartbeat
• Record your weight and blood pressure

Belly Growth

Your provider might feel your belly to find the top of your uterus (called the fundus) and measure the distance from your pubic bone to the top of your uterus (known as the fundal height). This measurement helps your provider estimate the size of the uterus and your baby's growth.

Doctors measure fundal height in centimeters. The number often matches the number of weeks pregnant (within a centimeter or two). At 28 weeks, your fundal height will likely be about 28 centimeters.

Rh Factor

Early in your pregnancy, you had a blood test to check your Rh factor, a protein found in most people’s red blood cells. If you are Rh factor negative and your baby is positive, you have Rh incompatibility. This means that your body could make antibodies against your baby's blood and cause problems for their health.

If you are RH negative you will have another blood test during week 28 to check for these antibodies. Your provider will also recommend that you get a shot of Rhogam this week. This injection of Rh immunoglobulin kills any antibodies that your body already made and stops it from making more. You will get another shot of the immunoglobulin 72 hours after the baby is born to help protect any future pregnancies.

Special Considerations

There are several variations of normal when it comes to the location of the placenta. Your provider will have confirmed where your placenta was located in your uterus during one of your early ultrasounds. If your placenta was low-lying, or toward the bottom of your uterus, your provider will continue to monitor its location as your uterus grows.

Placenta Previa

Placenta previa is a placenta that is low in the uterus covering all or part of the cervix. Low-lying placentas detected in early pregnancy often move up in the uterus as the uterus gets bigger. If you were told you have a low-lying placenta at one of your early ultrasounds, it might have migrated up. However, some placentas stay low the entire pregnancy.

If you have been experiencing vaginal bleeding, your provider will want to screen you for placenta previa. Sometimes there are no signs and the condition is only seen on ultrasound.

If you are diagnosed with placenta previa, your provider might advise you to:

• Avoid sex
• Avoid lifting heavy objects
• Avoid strenuous exercise and physical activity
• Go on bed rest
• Go to the hospital for closer monitoring
• Take breaks from standing, get off of your feet, and rest throughout the day

When the placenta covers the cervix, it is covering your baby's way out of your uterus. This means you will need to have a Cesarean section (C-section). If you have a low-lying placenta, your provider will monitor its position with ultrasounds at 32 weeks and 36 weeks.

If your placenta is still covering your cervix, your provider will schedule a C-section—typically around 37 weeks before labor starts on its own. If you have significant bleeding, the surgery might be scheduled sooner to ensure the health of you and your baby.

A Word From Verywell

With the start of the third trimester, you're getting closer to meeting your baby. There will also be more challenges as your baby and body continue to grow and change. Use your additional visits with your provider to ask questions and learn how to deal with new symptoms. Don't hesitate to accept help at work and at home when you need it.