28 Weeks Pregnant

Baby’s Development

Fetus ~37.6 cm (eggplant), weight ~1,000 g (2.2 lb) [1]. Third trimester begins. Brain: billions of neurons, complex folding. Eyes: can focus, sense light, blink regularly. REM sleep: regular, ~9-10 hrs/day. Lungs: surfactant production, breathing motions regular. Body fat: ~3-4% of body (will increase to 15% by birth). Skin: smoother, pinker. Movement: active, but space getting tight. Survival rate with NICU: 90%+ [2].

Pregnancy Symptoms

Third trimester begins. Symptoms: backache, heartburn (worsening), constipation, leg cramps, swelling (feet/ankles/fingers), headaches, Braxton Hicks (more frequent). Uterus ~7-8 cm above navel. Kicks very active. Round ligament pain, sciatica, pelvic pain. Heartburn, shortness of breath, frequent urination (head engages). Restless legs, hemorrhoids, carpal tunnel. Heart rate 80-100 bpm. Possible startle “snissing” [2].

Body Changes

Uterus ~7-8 cm above navel. Weight gain: 20-27 lbs by week 28 typical. Bump clearly visible. Stretch marks, linea nigra, melasma, visible veins, varicose veins. Breasts 2 cup sizes up, colostrum may leak. Possible “pregnancy mask” (melasma). Skin tags. Possible PUPPP rash. Heart rate elevated [2].

Tips for Week 28

• Begin prenatal visits every 2 weeks (from 28-36 wk) — increased monitoring. Blood pressure, urine, fundal height, weight, fetal heart rate.
• Glucose screening — if not done at 24-26 weeks, do now. 1-hour 50g test.
• Anemia check — CBC at 28 weeks. ~30% of pregnant people develop anemia. Iron supplementation (27 mg/day) often added.
• Tdap vaccine — if not given at 27 wk, this week. 27-36 wk window.
• Rhogam — if Rh-negative, 28-week shot prevents maternal antibodies from attacking fetal blood cells.

Things To Do (Checklist)

• Get glucose screening if not yet done
• Get Tdap vaccine (27-36 wk)
• Get Rhogam if Rh-negative (28 wk)
• Begin biweekly prenatal visits
• Address anemia (iron, vitamin C, B12, folate)

Frequently Asked Questions

Q: I’m anemic. What should I do? A: Hgb < 11 g/dL = anemia. Iron-rich foods (red meat, lentils, spinach), iron supplements (27 mg/day, with vitamin C for absorption, away from calcium). Stool softener (iron constipates). B12 and folate also matter [1].

Q: Why are my prenatal visits every 2 weeks now? A: Third trimester = closer monitoring. Blood pressure (preeclampsia), urine (proteinuria, GDM), fundal height (growth), fetal heart rate, weight. Catches problems early [2].

Q: I’m Rh-negative. What does Rhogam do? A: If your blood mixes with baby’s (often at delivery), your body may make antibodies attacking future Rh+ babies. Rhogam at 28 wk + within 72 hrs post-birth prevents this. Safe and standard [1].

For Dads

• Attend the 28-week appointment — third trimester starts, schedule increases. Be present, take notes, ask questions.
• Research stroller + car seat — compatible travel system (e.g., Britax B-Safe + B-Agile, UPPAbaby Mesa + Vista), infant car seat, all-in-one convertible. Safety + ease matters.
• Plan work + paternity leave — your employer policy, FMLA (12 wk unpaid), CA state PFL (8 wk paid bonding), short-term disability for recovery. Plan now.
• Read The Expectant Father Ch. 26 — third trimester reality, decisions, your role.
• Pray for continued growth and protection — third trimester is about weight gain, brain development, lung maturity.

Sources

1. ACOG — How Your Fetus Grows During Pregnancy
2. Mayo Clinic — 28 Weeks Pregnant
3. Expecting Better — Emily Oster (Chapters 13-14: Third Trimester)