Week 28 of pregnancy (Days 196-202)

Baby

At 28 weeks, fetal weight is approximately 1kg and fetal length is around 38cms (from crown to heel). Body fat is continuing to build up beneath the skin, making its appearance less translucent and more flesh coloured. Bone structures are now fully formed. The bones are starting to harden, although they remain relatively soft, and will not harden fully until after birth. Also around this time, the fetus will turn to be head-down in preparation for birth.

This can happen at any point during the coming weeks and in some cases does not happen at all. The fetal position will by monitored by a midwife. At around this time, the eyes are able to open and blink and the head may turn in response to bright light shone from outside. Coughing, hiccupping and sucking are all now possible and the fetus continues to take ‘practice’ breaths. Sleep patterns may now include REM sleep (Rapid Eye Movement sleep). This means that it may be possible for the baby to dream!

You

You are now entering your third, and final trimester. Weight gain will continue throughout the rest of your pregnancy, and women usually find that they gain approximately 5kg during the third trimester alone.

Some women experience colostrum – the first breast milk – leaking from their breasts. This is perfectly normal, although some women find that they do not produce any breast milk until after their baby is born. If you are finding colostrum a problem, it may help to wear breast pads in your bra.

It is fairly common for women to experience sciatica during the latter stages of pregnancy. Sciatica during pregnancy is the result of the weight of the uterus, and/or the baby’s head, putting pressure on the sciatic nerve. The sciatic nerve runs through the lower back and legs and pressure on the nerve can cause shooting pains in the back and legs. If you are experiencing sciatica you may find it helpful to change your position frequently and get plenty of rest, but if you have any concerns, you should speak to your midwife or your Doctor.

You will be due to have a routine antenatal appointment around this time. During this appointment, you will have your blood pressure checked and your midwife will check for swelling in your feet and ankles. Both of these checks are to rule out pre-eclampsia. Around this time, many women start to think about their birthing plan and begin to make choices about the kind of birth they want, e.g. a home birth or a hospital birth, who they would like to be with them, and look at choices for pain relief during labour. You should discuss any issues you are concerned about with your midwife.

Symptoms to watch out for

Although unusual at this stage pre eclampsia is a potentially very serious condition. It is characterized by headaches, swelling of the legs and particularly the face, flashing lights or little black floaters in the eyes. When severe there can be pain below the ribs. There should be no vaginal bleeding or change in vaginal discharge at this stage. Fetal movements should in general be vigorous and frequent. They can be painful. There may be a few Braxton Hicks contractions. They should not be painful or more than once a day. A variety of minor symptoms are common particularly those related to greater pressure on the bones and muscles of the spine and pelvis. Skin complaints are also quite common. If severe, a consultation with a dermatologist may be helpful.

What is routinely offered on NHS

You will have a midwife check about this time. She will ask you questions about how you are feeling. She will check your blood pressure and urine for signs of pre eclampsia. She will feel your tummy and may use a tape measure to measure it. From this stage your tummy will increase in size from the top of the lump to the bottom by one centimetre per week. If she finds this is not the case you will be referred for a scan. The midwife will discuss antenatal preparation classes which are run locally.

What other care is available

You can be seen in a private clinic without a referral letter. You can see a midwife or a specialist to discuss any concerns you may have. There you can have an appointment with a midwife specialist and you can have a high quality ultrasound scan at short notice. You can have a detailed discussion with a specialist about any concerns you may have.

You may like to have a 4D ultrasound scan, many of these are mainly for bonding purposes, however it is important that every scan you have is at a recognised medical ultrasound clinic and with an accredited sonographer, as an entertainment scan may miss an important health issue that should be addressed.