Pregnancy
28 Weeks Pregnant
At 28 weeks pregnant, your baby is the size of an eggplant. Learn about third-trimester symptoms, fetal eye-opening, glucose testing, and kick counts.
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This article is for general information and is not a substitute for professional medical advice. Always consult your pediatrician or doctor about your child.
Sources: WHO, CDC, AAP and NHS guidance. Recommendations differ between countries — for local advice see the NHS or ACOG.
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At a Glance: Week 28
Welcome to the third trimester. At 28 weeks, you are about seven months pregnant and have roughly 12 weeks until your due date. Your baby is approximately the size of a large eggplant, measuring around 37.6 cm (14.8 inches) from head to heel and weighing roughly 1,000 grams (2.2 pounds). This week marks an important developmental milestone: your baby can now open and close their eyes, blink, and respond to light filtering through your abdomen. From a survival standpoint, the lungs and brain still need significant maturation, but babies born at 28 weeks have very high survival rates with neonatal intensive care — typically above 90 percent.
The third trimester brings new physical sensations, more frequent prenatal visits, and the start of practical preparation for birth. Most providers transition you from monthly to every-two-week appointments around this time.
Your Baby's Development This Week
Several major developments are unfolding inside the womb at week 28:
- Eyes: The eyelids, fused since the second trimester, have separated. Your baby can blink, open their eyes, and detect light. Eyelashes have formed. The retina is maturing and will continue developing for months after birth.
- Brain: The cerebral cortex is rapidly developing characteristic folds and grooves (gyri and sulci). Billions of neurons are forming connections, and the brain has tripled in weight since mid-pregnancy. REM sleep cycles, which support brain maturation, are now observable on imaging.
- Lungs: The lungs are producing surfactant, the substance that prevents tiny air sacs from collapsing. Surfactant production continues to increase through term, which is why each additional week in utero meaningfully reduces respiratory complications.
- Body fat: White adipose tissue is being laid down, smoothing out your baby's previously wrinkled skin. This fat is critical for temperature regulation after birth.
- Hearing: Your baby reliably responds to sound, including your voice, your partner's voice, music, and ambient noise. Heart rate often changes in response to familiar voices.
- Bone marrow: Bone marrow has fully taken over red blood cell production from the liver and spleen.
Your Body and Symptoms This Week
As you enter the third trimester, your body is working harder than ever. Your blood volume has increased by roughly 40 to 50 percent above your pre-pregnancy baseline. Your uterus now reaches several centimeters above your belly button. Common symptoms this week include:
- Shortness of breath as your uterus presses on your diaphragm
- Heartburn and indigestion from slowed digestion and stomach displacement
- Lower back pain as your center of gravity shifts and relaxin loosens ligaments
- Leg cramps, especially at night
- Braxton Hicks contractions — irregular, painless tightening that does not progress
- Mild swelling in the feet, ankles, and hands
- Difficulty sleeping from physical discomfort and frequent urination
- Vivid dreams, partly due to fragmented sleep and hormonal shifts
- Colostrum leakage from the breasts in some people
Nutrition: What to Eat and Avoid This Week
In the third trimester, your caloric needs increase by roughly 450 calories per day above your pre-pregnancy baseline (per ACOG). Focus on nutrient density rather than just calories. Key nutrients this week:
- Iron (27 mg/day): Critical in the third trimester as your blood volume peaks. Sources: lean red meat, lentils, fortified cereals, spinach. Pair plant iron with vitamin C for absorption.
- Calcium (1,000 mg/day): Supports your baby's rapidly mineralizing bones. Sources: dairy, fortified plant milks, leafy greens, tofu, sardines.
- Omega-3 DHA (200–300 mg/day): Crucial for brain and eye development. Sources: low-mercury fish (salmon, sardines), algae-based supplements.
- Protein (~71 g/day): Supports tissue growth in both you and your baby.
- Choline (450 mg/day): Supports brain development and is often under-consumed. Sources: eggs, lean meat, soybeans.
Foods to avoid: high-mercury fish (shark, swordfish, king mackerel, tilefish), raw or undercooked meat and seafood, unpasteurized dairy and juices, deli meats unless heated until steaming (listeria risk), raw sprouts, and alcohol. Caffeine should stay under 200 mg per day.
Movement and Exercise
The ACOG recommends at least 150 minutes per week of moderate-intensity activity throughout pregnancy unless your provider has restricted exercise. At 28 weeks, low-impact options are best:
- Walking at a conversational pace
- Swimming and water aerobics (the buoyancy relieves joint pressure)
- Prenatal yoga (avoid deep twists and supine poses)
- Stationary cycling
- Pelvic floor exercises (Kegels) and gentle prenatal Pilates
Avoid: contact sports, activities with fall risk (skiing, horseback riding), scuba diving, hot yoga, and lying flat on your back for extended periods. Stop exercising and call your provider if you experience vaginal bleeding, regular painful contractions, fluid leakage, dizziness, chest pain, calf pain or swelling, or decreased fetal movement.
Mental and Emotional Wellbeing
The third trimester often brings a shift in emotional landscape. Excitement about meeting your baby can coexist with anxiety about birth, financial pressures, or how your relationship and career will change. Sleep disruption from physical discomfort can amplify mood changes. None of this means anything is wrong with you.
Strategies that genuinely help:
- Talk openly with your partner about hopes and fears for birth and early parenthood
- Limit doomscrolling about birth complications — fear-based content rarely informs, often inflames
- Consider a prenatal mental health screening if you have a history of depression or anxiety
- Use a pregnancy support pillow to improve sleep position
- Practice short daily relaxation: 5 minutes of slow breathing, a walk outside, or guided meditation
If you experience persistent sadness, intrusive thoughts, panic attacks, or feel disconnected from your pregnancy, contact your provider. Perinatal mood disorders are common and treatable.
Common Concerns and When to Call Your Doctor
After 28 weeks, fetal movement monitoring becomes especially important. Call your provider promptly for:
- Decreased fetal movement — fewer than 10 movements in 2 hours during your baby's normally active period
- Vaginal bleeding of any amount
- Leaking fluid from the vagina (could indicate ruptured membranes)
- Regular, painful contractions before 37 weeks (signs of preterm labor)
- Severe, persistent headache not relieved by acetaminophen
- Vision changes: blurriness, spots, flashing lights
- Sudden swelling of the face, hands, or around the eyes
- Severe upper-right abdominal pain
- Intense itching on palms or soles (possible cholestasis)
- Fever above 38°C (100.4°F)
Tests and Appointments This Week
Week 28 is a milestone for prenatal testing. You can expect:
- Glucose tolerance test (GTT): Screens for gestational diabetes, typically done between 24 and 28 weeks.
- Complete blood count (CBC): Checks for anemia, which is common in the third trimester.
- Rh antibody screen: If you are Rh-negative, you will likely receive a RhoGAM injection.
- Tdap vaccine: The CDC recommends Tdap between 27 and 36 weeks of every pregnancy to protect your newborn against pertussis (whooping cough) through passive antibody transfer.
- Visit frequency: Most providers move you from monthly to every-two-week appointments starting around 28 weeks.
- Fundal height: Your provider will measure your uterus to confirm growth is on track.
Tips for Week 28
- Start daily kick counts. Choose a consistent time when your baby is usually active and track movements.
- Sleep on your left side with a pillow between your knees and behind your back — this optimizes blood flow to your baby.
- Schedule a hospital tour and pre-register if your facility allows it.
- Sign up for a childbirth class — most run 4 to 8 weeks, so now is the right time.
- Hydrate consistently. Aim for 2.3 liters (10 cups) of fluids daily to support blood volume and reduce swelling and Braxton Hicks.
Preparing for What's Next
The next 12 weeks will move faster than you expect. Start a low-pressure weekly checklist:
- Research and interview pediatricians (most want to meet you before delivery)
- Begin drafting a birth preferences document — flexibility matters more than rigidity
- Install the infant car seat early and have it inspected by a certified Child Passenger Safety Technician
- Wash and organize newborn clothing, blankets, and burp cloths
- Start gathering hospital bag essentials (you do not need to have it packed for several more weeks)
- Confirm parental leave plans with your employer
Frequently Asked Questions About Week 28
Is it normal to feel out of breath at 28 weeks pregnant?
Yes. As your uterus expands upward, it pushes against your diaphragm, reducing lung capacity. Progesterone also stimulates faster breathing. Mild breathlessness during activity or even at rest is common and normal in the third trimester. However, sudden severe shortness of breath, chest pain, or breathlessness at rest accompanied by a racing heart should be evaluated immediately, as these can signal preeclampsia, anemia, or a pulmonary issue.
How often should I feel my baby move at 28 weeks?
By 28 weeks, you should feel consistent daily movement. Most providers recommend starting formal kick counts: pick a time when your baby is usually active, lie on your left side, and time how long it takes to feel 10 distinct movements. Ten movements within 2 hours is reassuring. If you notice a significant decrease in your baby's normal pattern, call your provider the same day — do not wait until your next appointment.
What is the glucose tolerance test and do I need it at 28 weeks?
The glucose tolerance test (GTT) screens for gestational diabetes and is typically performed between 24 and 28 weeks. You drink a sweet glucose solution, then have your blood drawn after 1 hour. If that screen is abnormal, a longer 3-hour test confirms the diagnosis. Gestational diabetes affects roughly 6 to 9 percent of pregnancies and is highly manageable when identified early. The ACOG recommends universal screening for all pregnant people.
Why am I so itchy at 28 weeks pregnant?
Mild itching, especially on the belly as skin stretches, is very common. Dry skin and stretching pruritus typically respond to fragrance-free moisturizer and lukewarm showers. However, intense itching on the palms of your hands or soles of your feet, especially without a rash, can be a sign of intrahepatic cholestasis of pregnancy (ICP). ICP requires prompt evaluation because it can affect your baby's safety. Always report severe or palm-and-sole itching to your provider.
Can my baby see or hear at 28 weeks?
Yes to both. By 28 weeks, your baby's eyelids have unfused and they can open and close their eyes. They can detect light filtering through your abdominal wall. Their auditory system is also functional. They recognize the rhythm of your voice, your heartbeat, and familiar sounds. Studies show babies prefer their mother's voice and music heard repeatedly during pregnancy after birth, suggesting genuine prenatal learning.
When should I worry about swelling at 28 weeks?
Mild swelling in feet and ankles, especially at the end of the day or in warm weather, is normal and caused by increased blood volume and pressure on pelvic veins. Sudden or severe swelling in your face, around your eyes, or in your hands — especially with headache, vision changes, or upper abdominal pain — can be a warning sign of preeclampsia and warrants immediate evaluation. Call your provider promptly if you notice this pattern.
Is it safe to exercise at 28 weeks pregnant?
For most uncomplicated pregnancies, yes. The ACOG recommends at least 150 minutes of moderate-intensity activity weekly throughout pregnancy. Walking, swimming, prenatal yoga, and stationary cycling are excellent choices at 28 weeks. Avoid contact sports, activities with fall risk, scuba diving, and exercising flat on your back for extended periods (which can compress the vena cava). Always stop and call your provider if you experience contractions, dizziness, bleeding, or fluid leakage.
Why is my heartburn worse at 28 weeks?
Progesterone relaxes the valve between your stomach and esophagus, while your growing uterus presses upward on your stomach. This combination makes heartburn more frequent and intense in the third trimester. Eating smaller meals more often, avoiding spicy or fatty foods, not lying down for 1 to 2 hours after eating, and elevating the head of your bed can help. Most antacids containing calcium carbonate are considered safe in pregnancy, but check with your provider before starting any medication.
Do I need a Rh immune globulin (RhoGAM) shot at 28 weeks?
If you are Rh-negative and your baby's father is Rh-positive or unknown, your provider will likely give you a dose of Rh immune globulin around 28 weeks. This prevents your immune system from producing antibodies that could harm Rh-positive babies in current or future pregnancies. A second dose is typically given within 72 hours after delivery if the baby is confirmed Rh-positive. This routine intervention has dramatically reduced cases of hemolytic disease of the newborn.
What should I be doing to prepare for the third trimester at 28 weeks?
Week 28 is a good time to start tangible preparations. Consider touring your birth facility, beginning childbirth education classes, choosing a pediatrician, drafting a birth plan, installing the infant car seat (you can have a certified technician inspect it), and starting to gather essentials for your hospital bag. You do not need to finish everything now, but starting small tasks each week makes the final weeks far less overwhelming.
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