Week 28: Welcome to the Third Trimester!
You've entered the home stretch! Your baby can blink, cough, and has more developed sleep-wake cycles. Visits to your OB will increase to every 2 weeks.
Medically reviewed by Samantha L. Fox, RN, BSN, MSN
Nursing Informaticist · United States Navy Nurse Corps · Last reviewed
Your baby is the size of a...
🍆 Eggplant!
👶 Baby Development
- ✓Baby can blink and has eyelashes
- ✓Can cough and make sucking motions
- ✓REM sleep is now occurring — baby dreams!
- ✓Body fat continues to increase
- ✓Brain is forming folds and grooves (increasing surface area)
- ✓Baby may move into head-down position soon
💊 Common Symptoms
- •More frequent prenatal visits (every 2 weeks now)
- •Difficulty breathing as baby presses on diaphragm
- •Sciatica and back pain intensifying
- •Trouble finding comfortable positions
- •Increased urination as baby presses on bladder
- •Braxton Hicks contractions more noticeable
🩺Clinical Context — From a Nurse's View
Welcome to the third trimester. Visits typically shift to every two weeks now and every week after 36. RhoGAM goes in this week if you're Rh-negative. Formal kick counts start: pick a time when the baby is usually active (often after a meal), lie on your side, and time how long it takes to feel 10 movements. Most babies do 10 in under 30 minutes. ACOG (2021) considers 10 in 2 hours adequate; longer than that warrants a non-stress test. Decreased movement is the single most important thing you'll be watching for from now until delivery — call about it without hesitation. Heartburn intensifies as the uterus pushes the stomach upward; sleeping propped on pillows and TUMS or famotidine (safe in pregnancy) help. Lying flat on your back can compress the inferior vena cava, drop your blood pressure, and reduce placental flow. If you wake up dizzy on your back, just roll onto a side. Don't lose sleep over it.
Written by Samantha L. Fox, RN, BSN, MSN — Emergency Department nurse, US Navy Nurse Corps officer.
🚨 When to Call (or Go to the ER)
- !Decreased fetal movement / fewer than 10 movements in 2 hours during a count — call
- !Severe headache, vision changes, RUQ pain, swelling — call (preeclampsia)
- !Regular contractions, fluid leak, bleeding — call
✅ Normal — Even If It Feels Worrying
- ✓More frequent Braxton Hicks
- ✓Sciatica or pelvic pain
- ✓Difficulty bending and sleeping
- ✓Increased urination day and night
✅ To-Do This Week
- Start prenatal visits every 2 weeks
- Pack your hospital bag — it's never too early!
- Finalize your birth plan
- Install the car seat and have it inspected
- Take a tour of the labor and delivery unit
- Start counting kicks daily (10 kicks in 2 hours)
🩺 Questions for Your Doctor
- ?How often should I come in for check-ups now?
- ?Is the baby in the right position?
- ?Do I need any additional tests this trimester?
- ?What are the signs of preeclampsia?
- ?Should I prepare for any specific complications?
- ?When should I go to the hospital during labor?
📚 References
- [1]ACOG Practice Bulletin No. 229: Antepartum Fetal Surveillance. Obstet Gynecol. 2021;137(6):e116-e127.
- [2]ACOG Practice Bulletin No. 222: Gestational Hypertension and Preeclampsia. Obstet Gynecol. 2020;135(6):e237-e260.
- [3]ACOG Committee Opinion No. 718: Update on Immunization and Pregnancy: Tetanus, Diphtheria, and Pertussis Vaccination. Obstet Gynecol. 2017;130(3):e153-e157.
Editorial review: Samantha L. Fox, RN, BSN, MSN. Last reviewed: see footer.
Your baby is the size of a...