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Week 28

Welcome to the 3rd and final trimester!

Over the next few weeks, you will probably start to feel a bit more uncomfortable and tired.

What's happening in my body?

You may be getting a bit of heartburn and indigestion. That's down to your growing baby and hormones affecting your digestive system.

Your back will also be under strain, due to the extra weight you're carrying around. Your joints and ligaments will also be looser than usual.

Your ankles, feet and face could be puffing out a bit, particularly when it's hot.

This is probably due to water retention, but get it checked out, just in case it's pre-eclampsia. This is a condition where you may feel perfectly well, but then your blood pressure can get dangerously high, very quickly.

Rest can help with a lot of your symptoms, so make sure you get lots of it – but if you are worried about anything at all, talk to your midwife or doctor, or call NHS 111.

RSV vaccination

RSV (respiratory syncytial virus) is a common virus which can cause a lung infection in small babies called bronchiolitis. This condition can make it hard for your baby to breathe and to feed.

The NHS recommends having the RSV vaccination at around week 28. It can be given later, right up until you go into labour. The vaccination can reduce the risk of getting severe bronchiolitis by 70% in your baby's first 6 months of life.

The immunity that you get will be passed on to your baby through the placenta and then offer protection from the day they are born.

Find out more about the RSV vaccine on NHS.UK

Have you had your whooping cough jab?

The whooping cough vaccination is usually offered to pregnant women at around week 20 but you can have it from week 16 to week 32.

Whooping cough is on the rise – but you can protect your baby from this dangerous condition by having a vaccination. If you have not had it yet, speak to your midwife or a GP.

Read more about whooping cough vaccination in pregnancy on NHS.UK.

Three ways to bust germs

Make sure you know about some of the harmful infections in pregnancy so you can do your best to avoid them.

Here are 3 ways you can protect your unborn baby:

  1. Wash your hands regularly with soap and water for at least 20 seconds, particularly if you're in contact with children or nappies, as they could carry a virus called CMV (cytomegalovirus).
  2. If you have a cat, wear gloves when emptying the cat litter tray, or ask someone else to deal with it. Cat poo can contain a bug that causes the dangerous toxoplasmosis infection. You should also wear gloves when gardening, in case you come into contact with animal poo.
  3. If you have not had chickenpox, let your doctor or midwife know if you come into contact with anyone who could be infectious. The disease can be spread from 2 days before spots appear until they have all formed scabs – usually 5 days after spots appeared. Avoid being around anyone with chickenpox until they have no new blisters or moist crusts on their spots.

Coronavirus (COVID-19)

If you're worried about COVID-19, have a look at the guidance from Royal College of Obstetricians and Gynaecologists on coronavirus and pregnancy.

Nosebleeds

Nosebleeds are common in pregnancy due to hormonal changes, and they can even strike when you're asleep.

Here's what you can do:

  • sit or stand up – do not lie down
  • pinch your nose just above your nostrils for 10 to 15 minutes
  • lean forward and breathe through your mouth
  • put an icepack (or a bag of frozen peas wrapped in a tea towel) at the top of your nose

Get more tips for stopping nosebleeds.

3rd trimester pregnancy symptoms (at 28 weeks)

You may start getting new symptoms now, such as nosebleeds and indigestion.

Your signs of pregnancy could also include:

You may also experience symptoms from earlier weeks, such as:

Read Tommy's guide to common pregnancy symptoms.

What does my baby look like?

Your baby, or foetus, is around 37.6cm long from head to heel. That's approximately the size of an aubergine.

Your baby's heart rate is changing all the time. Around week 5 or 6, when a baby's heart is first detectable, it is around 110 beats per minute (bpm). Then it goes up to around 170 bpm in week 9 and 10.

Now, it's slowed down to around 140 bpm and it will be around 130 bpm at birth.

That's still a lot faster than your heart rate, which will be around 80 to 85bpm. This is partly because babies' hearts are so small that they cannot pump much blood, but they can make up for this by going faster. It also helps to keep them warm.

Your baby's heart can be heard through a stethoscope. Someone else might be able to hear it by putting an ear to your pregnant belly – give it a go, but it's tricky finding the right spot.

Composite. One side shows a foetus attached to the placenta by the umbilical cord. The foetus is recognisable as a baby. Other side shows a person holding an aubergine in 2 hands.
Your baby is about the size of an aubergine.

Action stations

It's time to work out where your baby will sleep, and it's best to do this sooner, rather than later, before you start running out of energy.

Your baby will spend a lot of time in a cot, so make sure it's safe. If you're buying a new cot, look for the British Standard mark BS EN 716-1.

Read more about what you need for your baby.

This week you could also...

Talk to your work

You have maternity rights. You can ask for a risk assessment of your work place to ensure that you're working in a safe environment.

You should not be lifting heavy things and you may need extra breaks and somewhere to sit.

You can also attend antenatal appointments during paid work time.

Start doing pelvic floor exercises

It's a good time to tone up your pelvic floor muscles. Gentle exercises can help to prevent leakage when you laugh, sneeze or cough.

Get the muscles going by pretending that you're having a pee and then stopping midflow.

Visit Tommy's for more information on pelvic floor exercises.

Antenatal classes

Ask your midwife or doctor about online antenatal classes – they may be able to recommend one. The charity Tommy's has lots of useful information on antenatal classes and preparing you for birth.

Ask your partner if they would like to take part in the antenatal classes. Even if you've had children before, antenatal classes are still worth going to as you can meet other parents-to-be.

The NCT offers online antenatal classes with small groups of people that live locally to you.

Smoking, drinking and caffeine in pregnancy

Do your best to stop smoking and give up alcohol, and go easy on the tea, coffee and anything else with caffeine.

Ask your midwife or GP for support.

Vitamins in pregnancy

To keep bones and muscles healthy, we need vitamin D.

From late March/early April to the end of September, most people make enough vitamin D from sunlight on their skin. However, between October and early March, you should consider taking a daily vitamin D supplement because we cannot make enough from sunlight.

Some people should take a vitamin D supplement all year round, find out if this applies to you on the NHS website.

You just need 10 micrograms daily (it's the same for grown-ups and kids). Check if you're entitled to free vitamins.

Exercising in pregnancy

It's recommended that you do 150 minutes of exercise a week while pregnant.

You could start off with just 10 minutes of daily exercise – perhaps take a brisk walk outside. Check out Sport England's #StayInWorkOut online exercises (scroll to the pregnancy section).

Listen to your body and do what feels right for you.

Healthy eating

There's no need to eat for 2.

Now you're in the 3rd trimester, you may need an extra 200 calories a day, but that's not much. It's about the same as 2 slices of wholemeal toast with margarine.

You just need to eat a healthy balanced diet, with a variety of different foods every day, including plenty of fruit and veg. Have a look at our guide to healthy eating in pregnancy.

You may be able to get free milk, fruit and veg through the Healthy Start scheme.

Emotional and mental wellbeing

How are you today?

If you're feeling anxious or low, talk to your doctor or midwife, who can point you in the right direction to get all the support that you need. You could also discuss your worries with your partner, friends and family.

You may be worried about your relationship, or money, or having somewhere permanent to live.

Don't keep it to yourself – it's important that you ask for help if you need it.

Contraception

Getting pregnant again is probably the last thing on your mind right now. However, now is a good time to start planning what type of contraception you would like to use after your baby is born.

Getting pregnant again could happen sooner than you realise, and too short a gap between babies is known to cause problems.

Talk to your GP or midwife to help you decide.

Talk to your midwife about newborn screening

You will be offered newborn screening tests for your baby soon after they are born.

These screening tests are recommended by the NHS because they can make sure your baby is given appropriate treatment if needed.

Your decisions about whether or not you want these screening tests will be respected, and healthcare professionals will support you.

Ask your midwife or doctor for more information about newborn screening.

More in week-by-week

Week 29

Are you feeling excited? Or nervous? Or maybe you're a bit of both. Being pregnant stirs up all kinds of emotions.

Week 30

Week 27

More in week-by-week guide to pregnancy

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