Welcoming The Final Trimester With The 28th Week Of Pregnancy

You are finally here and this has been quite a journey! The third and the final trimester is nothing short of a roller coaster ride but you can’t wait to experience all of it and deliver your baby as soon as possible. All the kicks and nudges are probably making you impatient to meet the tiny being inside your womb. Although 12 more weeks might sound far-fetched at this point but with new signs and symptoms keeping your occupied and the last minute preparations clouding your mind, you will hardly realize how time flies. You might as well be taken by surprise the morning your water breaks. Sounds exciting, doesn’t it? There is a lot to look forward to in this trimester and this article will help you introduce it with the 28th week of pregnancy.

Your Baby This Week

Measuring almost around two and a quarter pounds in weight and 15 inches in length, you could compare your baby to a large eggplant this week. A significant development marks the beginning of the third trimester, with your baby slowly settling down into a position for birth. Do not worry if your ultrasound shows that your baby is still in the breech position1, as opposed to the natural cephalic position favored for a vaginal. A lot of babies continue to be in the breech position till the last few days before delivery and turn right before your labor begins.

Your baby is at work whenever he is not sleeping and he is training hard in survival skills like hiccupping, coughing and sucking that will eventually help him to breathe effortlessly after birth. Yet another milestone this week is your baby being able to blink and open his eyes. He has eyelashes as well that will help to keep foreign objects away and keep his eyes safe after birth. With a rapid development of his eyesight, your baby will be able to see the light that shines through from outside the womb. However, your baby’s newly developed eyesight might still be sensitive to light so he might squint and turn away if bright lights are pointed at the baby bump.

Your baby’s body continues to lay down fat stores this week. If you have an ultrasound anytime soon, you might be able to notice that the lean structure is now filling out. The brain is also developing at a rapid pace, with more neurons being added to the already complex structure.

Your baby is also dreaming quite a lot these days. He might as well be having dreams about you and your spouse. Fetuses have different sleep cycles and just like a newborn, they also experience REM sleep2. Dreams occur especially in this stage of sleep.

Your Body This Week

Now that you are in the final trimester, your doctor would want to see you more frequently. Every two weeks is what most doctors suggest for a prenatal visit but if your pregnancy is complicated, you might need to visit more frequently.

It is not a very comfortable idea to realize that the golden period of pregnancy is over and all the ghosts of the first trimester will come haunting soon. New symptoms could keep you so tied up that eight hours of sleep might sound impossible. However, the assurance that you will be meeting your baby in 12 more weeks could at least help you to feel better when that nagging backache threatens to paralyze you forever.

If your baby is kicking, it is keeping you up. If he is not kicking, that is keeping you up. your swollen feet make you uncomfortable, you are getting leg cramps all the time, your back is giving you a hard time and reflux is back with a bang.

Is That Sciatica?

You hope with all your heart that it is not but are also aware that the third trimester is often accompanied by this pain. As your baby settles down in the cephalic presentation, it is likely that her head or your growing uterus rests on the sciatic nerve in the lower half of your spine. This can lead to sharp and shooting pains in the lower back and can also run down the back of your legs. You might also experience numbness or a tingling sensation in the same places. This pain is referred to as sciatica. Although this is a temporary pain that might reduce as and when your baby changes positions but it can also be quite intense, depending upon how severely compressed the nerve is. This pain will last till you deliver your baby.

While dealing with sciatica can be tough, practicing a few things could keep the pain under control. Lying down or sitting down for longer periods of time will only worsen the pain. It is recommended that you take frequent breaks and get moving. This will prevent the muscles surrounding the area from getting stiff. If moving around worsens the pain and lying down seems to help, you can try bed-rest for a while and see if the pain reduces. It is important to understand the triggers and do whatever helps with the pain.

A lot of women also try alternative therapies like acupressure, acupuncture, massages, chiropractic medicine, hydrotherapy, reflexology, etc. What might work for some might not work for others, hence it is important to ask your doctor about what method will suit you the best. Apart from these therapies, you could try hot and cold compresses, a heating pad, a warm bath etc to ease the sore back and muscles. As mentioned before, it is important to check the temperature of the water before you step in since your body might get overheated in certain circumstances.

Restless Leg Syndrome

Restless Leg Syndrome affects nearly 16% of every 600 pregnant women in the US and it is one of the most significant contributors to lack of sleep. Its symptoms include an uncontrolled urge to move one’s legs because sensations like crawling, itching and burning start disrupting sleep cycles. This does not occur only during pregnancy but could be enhanced because of the number of changes our body goes through during pregnancy.

If you are desperate need of sleep and these symptoms have been giving you restless nights, understand and identify the triggers. The symptoms usually show up when you have been sitting for longer periods of time or right before falling asleep. They could also occur when you have been sitting in a car for a really long time and you haven’t stretched in between. While these symptoms mostly occur in the lower part of your limbs, they could also be experienced in the thighs, arms and hands, depending upon the severity of the situation.

RLS could leave you exhausted, especially if the symptoms have a tendency of occurring at night. You will notice that you feel relieved as soon as you move but they are back to haunt you as soon as the movement stops. What causes these symptoms and how could you possibly deal with them?

There could be a number of reasons for RLS to occur during pregnancy. Although research shows no proven reason for it to occur yet reasons like iron and folate deficiency, sudden hormonal changes and changes in the circulatory system could be attributed to this symptom.

Not many ways are known to ease the discomfort of RLS but there are a few measures that can be adopted to keep the uneasiness away:

  • You can stretch and move around often, especially if you have desk jobs that involve sitting down for longer periods of time.
  • Getting prenatal massages have been known to help pregnant women with RLS.
  • You could consult your doctor regarding the dosage of your prenatal supplements. He might recommend a higher dose if the deficiency still continues.
  • Relaxation techniques, hot and cold compresses, gentle stretching of limbs etc can also help keep the pain at bay at bedtime.

What to Do When Dizziness Returns?

If you are back to feeling dizzy or light-headed in this trimester, you have all the reasons to feel so. It is not for nothing that the third trimester is seen as a follow-up of what the first trimester had been like. Your pregnancy is advancing and your body is adapting to the changes every single day. There is a growing demand on your circulatory system to carry more blood and oxygen to the uterus so that your growing fetus can use it to support the rapid development. Your respiratory system is pushed upwards because of the crowding of your stomach cavity and your blood sugar could also drop, causing you to feel faint and dizzy.

Since you might be feeling all hot and sweaty, wearing slightly restrictive clothing could also cause your body temperature to rise. This, in turn, causes you to feel light-headed. You cannot really do much about the circulation of blood and the pressing down of the uterus but what you could do is to alter lifestyle choices.

Wearing loose and un restrictive clothing helps with keeping your body at normal temperature. Drinking plenty of fluids also avoids overheating. Even if you feel like urinating frequently, avoid giving into the temptation of cutting down fluids. All it takes is one trip to the washroom, which is way better than having to visit the doctor for treating a urine infection.

Should I Start Thinking About Preeclampsia?

you are in the third trimester, have high blood pressure or have been obese, to begin with, you should be concerned about the signs and symptoms of preeclampsia and should also be aware of the means by which you could avoid it. Research shows that 5% of pregnant women in the US are affected by preeclampsia after completing 20 weeks of pregnancy. This is quite an alarming rate, considering the effects it has on the mother and the baby. Two of the most significant symptoms of preeclampsia are the presence of protein in urine and an elevated blood pressure. While the latter may not always indicate preeclampsia, the former is almost always a precursor of the disorder.

Mild cases of preeclampsia might occur just around the due date but most women who have such cases often deliver healthy full term babies without any complication. However, in severe cases, even the slightest hint should be reported to the doctor immediately.

Preeclampsia can affect a number of organs and could also be fatal for both mother and baby. The symptoms of preeclampsia fade away after delivering the baby. While reading about the symptoms, there are a few significant ones that should never be ignored. Listed below are the red flags that you should speak to your doctor about as soon as possible:

  • Elevated blood pressure
  • Sudden swelling or puffing of hands, feet, ankles, face.
  • Accelerated weight gain which amounts to 5 pounds a week.
  • Changes in vision; sensitivity to light, blurred vision, seeing double objects, squinting in bright lights, loss of vision etc.
  • A headache that refuses to go.
  • Unexplained bouts of nausea and vomiting.
  • Sore or painful abdomen.

What is slightly inconvenient regarding the diagnosis of preeclampsia is how it could go unnoticed, especially in the early stages of pregnancy. This is because most of the symptoms like nausea, headache, pain in abdomen etc could seem to be normal first trimester symptoms. However, if there is a history of preeclampsia, preterm babies, high blood pressure, gestational diabetes or miscarriages in the family, it is quintessential that both you and the doctor keep an eye on the symptoms. It could actually be a normal headache but if ruled out on time, it will save complications in the future. This is all the more reason to not miss any of your prenatal appointments.

Could I Be Prone To Preeclampsia? 

Yes, there are certain factors that could put you at a potential risk for preeclampsia. There is also a tendency for preeclampsia to show up in first-timers. In fact, it is a vicious cycle because if you have had preeclampsia before, there is a higher probability for you to have it in the next pregnancy.

Some of the reasons that make you more prone to it are:

  • If you are 40 years or older.
  • If you were obese to begin with.
  • If this is a twin or multiple pregnancy.
  • If there is a family history of preeclampsia (this includes close relatives like aunts, mother, sisters etc)
  • If you have or have had blood-clotting disorders.
  • If you suffer from chronic hypertension.

Can Preeclampsia Be Avoided?

While preeclampsia is crippling a number of pregnancies, there is hardly much to do to keep it at bay. There is ongoing research in this area to find out means in which this can be avoided but nothing conclusive has been reached yet.

There is a practice among gynecologists to recommend low dosage of aspirin during pregnancy to keep preeclampsia at bay, especially for those who are at a high-risk already. However, it is advised to never take aspirin during pregnancy unless specified by the doctor.

Proper prenatal care, not missing prenatal appointments, keeping blood pressure and urine samples monitored at regular intervals and awareness is what doctors suggest pregnant women to do. Alerting the doctor as soon as you find one or more of the red flags is of prime importance.

How Can You Keep Yourself Busy This Week?

If you work outside home, you are already racing against time to finish off pending projects and train the new employees at work so that they can handle things efficiently when you are on maternity leave. There could be never-ending paperwork and formalities to be signed and updated, especially if you have been in the company for long. Distributing your work is what helps the most and your newbies will know what to do.

Whether you work outside home or not, you will need to keep yourself updated with respect to changes that are expected during pregnancy. The following are some of the things that you should always remember:

  • If you have RH factor and RH antibody is not found in your blood, you will need to be given two Rhogam3, once this week and the other after you deliver.
  • Your doctor should ideally discuss the fetal movement chart with you.
  • You will also be guided by your doctor or your midwife about counting kicks.
  • You need to decide on the kind of childbirth class you would like to attend along with your partner.
  • By now, you must be aware of the need to breastfeed your baby. If you are not, this is the time to know the multiple benefits of breastfeeding4.

How Should You Keep Yourself Prepared? 

Although your due date seems far-fetched and you feel that you have enough time to prepare yourself for the delivery, nothing is too soon as long as it is concerned with a baby. You might want to keep yourself mentally, financially and physically prepared for an early labor. What you need to do primarily is prepare yourself for the visit to the hospital.

It is important to keep your partner’s phone number handy so that you can reach him if you feel the early signs of labor. By 28 weeks, you will be able to distinguish between Braxton Hicks contractions and real labor. Not only will the contractions seem closer but also more intense. Your waters might leak or break, which is yet another reason to rush to the ER and get in touch with your doctor right away.

You might also want to map out the route to the hospital yourself, just in case your partner is not available at that moment. You can also keep your neighbors informed if your pregnancy is complicated and you need help reaching the hospital.

Always remember to keep your fuel tank filled because the last thing you would want is to rush to a pit stop while you are in labor.

Along with preparing your external situations, begin preparing yourself mentally for labor. If you are yet to enroll in a childbirth class, do so as soon as possible. A childbirth class will help you keep a note of the red flags in the third trimester and what could possibly be signs of premature labor.

Apart from the unusual signs and symptoms, a childbirth class will also prepare you for real labor. Breathing techniques, what food to eat, how to keep the anxiety away, how to ensure you are helping the labor progress, how not to fall prey to unnecessary medical intervention, when to know that a C-section is a must, how to deal with the pain and a lot other things are clarified in a positive light in these classes.

If you have a birth plan in place and are aiming for a natural birth at home, make sure you have a midwife appointed well ahead in time. She should be available at least 4-6 weeks prior to your due date because if your baby plans to arrive early, she should be able to make time for you.

How Can You Help Your Pregnant Spouse?

There will be a lot of decision making activities this week. Ensure that you are well-prepared for it. Since you are an integral part of the plans, you will need to have your suggestions because it is unfair to expect your pregnant wife to come to a conclusion when she is herself dealing with anxiety and apprehension regarding the birth.

You could talk to her about her fears and try your best to allay most of them by assuring her of your involvement and your contribution to the birth and after. You should always keep your phone handy so that you don’t miss messages from your spouse. Keep the refrigerator stocked up and take over the kitchen responsibilities, if you haven’t already.

The third trimester would require you to be more than a spouse and if you have been preparing yourself to be a father, there is nothing that you can’t do to help make the next 12 weeks happy and comfortable for your spouse.

References:

  1. https://en.wikipedia.org/wiki/Presentation_(obstetrics)
  2. REM sleep
  3. Rhogam
  4. https://en.wikipedia.org/wiki/Breast_milk