Week 28 of Pregnancy: Beginning of the Third Trimester. The Baby’s Vital Week

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Motherhood

You have reached the third trimester of pregnancy. At this stage, the baby continues to grow and mature rapidly. The brain develops at an accelerated rate, the lungs begin to prepare for breathing, and movements are stronger and more defined. On the maternal level, you may notice increased fatigue, difficulty breathing, and some changes in sleep due to the size of the abdomen. This is a good time to start childbirth preparation classes and ensure you maintain a healthy lifestyle to face this final phase of pregnancy with well-being.

Symptoms

Fatigue and tiredness – Weight gain and hormonal changes can make you feel more exhausted.
Difficulty breathing – As the uterus grows, it puts pressure on the diaphragm and lungs, which can make you feel more short of breath.
More intense baby movements – Kicks and stretches are more noticeable and can be felt with greater force.
Heartburn and reflux – Pressure from the uterus on the stomach can cause digestive discomfort, especially after eating.
Swelling and fluid retention – It is common to notice swelling in the feet, ankles, and hands due to slower blood circulation.
Back and pelvic pain – The baby’s weight and changes in posture can cause discomfort in the lower back and pelvis.
Leg cramps – These are common at this stage due to nerve compression and altered blood circulation.
Increased Braxton Hicks contractions – These irregular contractions may be felt more frequently as the body prepares for labor.
Difficulty sleeping – The size of the abdomen and discomfort can make finding a comfortable sleeping position more difficult.
Increased appetite – The baby continues to grow and you may feel hungrier, so it is important to maintain a balanced diet.

Baby’s size

The baby measures approximately 37-38 cm from head to toe and weighs around 1.1 kg, similar to a large eggplant.

Brain growth: The brain continues to develop rapidly, with more folds and grooves, improving learning and perception capacity.
Eye opening: The baby can now open and close the eyes, reacting to light and darkness. Eyelashes are fully formed.
Lung development: Although not yet fully mature, the lungs are beginning to produce surfactant, an essential substance for breathing outside the uterus.
Greater fat accumulation: The skin begins to look less wrinkled thanks to increased subcutaneous fat, which will help regulate temperature after birth.
Sleep and activity cycles: The baby alternates between more defined periods of sleep and wakefulness. The baby may even dream and respond to external sounds with movements or changes in heart rate.
Immune system in formation: The baby receives antibodies from the mother through the placenta, strengthening defenses for after birth.

What Should You Do?

Third trimester medical checkup – It is time to have a prenatal consultation to evaluate the health of the baby and mother. The glucose test may also be performed to rule out gestational diabetes.
Whooping cough vaccine administration – This is recommended at this stage to protect the baby after birth, as antibodies pass through the placenta.
Monitor the baby’s movements – Counting kicks and movements helps identify well-being. It is recommended to feel at least 10 movements in 2 hours.
Take care of posture and rest – Sleeping on your side, preferably on the left side, improves circulation and oxygen flow to the baby.
Maintain a balanced diet – Consume proteins, calcium, iron, and omega-3 to support the baby’s development.
Stay properly hydrated – Drinking enough water helps reduce swelling and improves blood circulation.
Perform moderate exercise – Walking, swimming, or doing prenatal yoga helps relieve physical discomfort and improve overall well-being.
Prepare the birth plan – This is a good time to learn about birth options, enroll in preparation classes, and define preferences for delivery.
Pay attention to warning signs – You should see a doctor if there is sudden swelling, severe abdominal pain, bleeding, or a decrease in the baby’s movements.
Begin organizing for the baby’s arrival – Choose the hospital, prepare the hospital bag, and plan the baby’s space at home.

Nutrition in week 28 of pregnancy

Proteins – These are essential for the baby’s muscle and cellular development. Include lean meats, chicken, fish, eggs, dairy, legumes, and nuts.

Iron – Prevents anemia and supports red blood cell production. It is found in red meats, spinach, lentils, and fortified cereals. It is advisable to combine it with vitamin C (citrus fruits, strawberries, peppers) to improve absorption.

Calcium – Helps in the formation of the baby’s bones and teeth. It is found in dairy products, almonds, broccoli, and tofu.

Folic acid – Reduces the risk of birth defects. It is obtained from leafy green vegetables, citrus fruits, beans, and whole grains.

Omega-3 – Contributes to the baby’s brain and visual development. It is present in fatty fish such as salmon, chia, flaxseed, and walnuts.

Fiber – Prevents constipation, a common symptom at this stage. It is found in fruits, vegetables, whole grains, and legumes.

Hydration – Drinking at least 2 liters of water per day helps reduce swelling and prevent urinary infections.

Practical tips
Eat small, frequent meals to avoid heartburn.
Avoid ultra-processed foods high in sodium or refined sugars.
Reduce caffeine and avoid alcohol.
Control salt intake to avoid fluid retention.

Recommended exercises
Walking
Swimming
Prenatal yoga
Kegel exercises (to strengthen the pelvic floor)
Gentle stretching

Precautions
Avoid high-impact exercises or those involving risk of falls.
Do not make sudden movements or lift excessive weight.
Stay well hydrated and avoid overheating.
Consult with your doctor before starting any routine.

Exercise in week 28 of pregnancy

Improves blood circulation – Reduces swelling in legs and feet, preventing fluid retention.

Relieves back pain – Strengthens muscles and reduces pressure on the spine.

Reduces the risk of gestational diabetes – Helps control blood sugar levels.

Prevents excessive weight gain – Maintains a healthy weight and facilitates postpartum recovery.

Improves endurance and preparation for childbirth – Strengthens the pelvic and abdominal area, facilitating labor.

Emotional and mental benefits
Reduces stress and anxiety – Stimulates endorphin production, improving mood.

Promotes sleep – Helps combat insomnia and improve sleep quality.

Increases energy and reduces fatigue – Improves oxygenation and metabolism.

Things You Should NOT Do:

Excessive physical exertion
Do not lift heavy objects.
Avoid high-impact exercises or those with risk of falls, such as running, jumping, or contact sports.
Do not stand for long periods without rest.

Sleeping in an inappropriate position
Avoid sleeping on your back, as it can compress the vena cava and reduce blood flow to the baby. The ideal position is to sleep on your side, preferably on the left side.

Unhealthy diet
Do not consume ultra-processed foods rich in saturated fats, sugars, and sodium.
Avoid excess caffeine, as it can affect the baby’s heart rate.
Do not consume fish with high mercury content (swordfish, bluefin tuna, shark).
Avoid alcohol and tobacco, as they can cause complications in fetal development.

Neglecting hydration
Do not reduce water intake, as it can increase the risk of urinary infections and constipation.

Situations of extreme stress or anxiety
Avoid work overload or activities that generate significant emotional tension.
Do not ignore signs of fatigue or exhaustion; it is important to rest when the body asks for it.

Self-medicating
Do not take medications, supplements, or natural remedies without medical approval. Some can affect the baby’s development.

Frequently Asked Questions

Is it normal to feel more contractions at this stage?

Yes, Braxton Hicks contractions may become more frequent. They are painless and prepare the uterus for labor, but if they become regular or painful, it is important to consult your doctor.

How can I relieve swelling in my feet and legs?

To reduce swelling, it is advisable to elevate your legs, wear comfortable clothing, drink enough water, and avoid standing or sitting for long periods without moving.

How much weight should I have gained by this week?

Weight gain varies, but in general, a woman with a normal body mass index (BMI) should have gained between 7 and 10 kg by this week. However, every pregnancy is different and it is important to follow medical recommendations.

Is it normal to feel less energy or fatigue in this trimester?

Yes, fatigue may return due to the baby's growth and the body's increased energy demand. Getting enough rest and maintaining a balanced diet helps maintain energy.

Can I still have sex?

In most cases, yes. If the pregnancy is healthy and the doctor has not indicated restrictions, sexual relations can be maintained. However, if there is bleeding, placenta previa, or other risks, it is important to consult the specialist.

Should I start counting the baby's movements?

Yes, this is a good time to monitor fetal movements. It is recommended to notice if the baby moves at least 10 times in two hours. If there is a significant decrease in movements, it is important to notify the doctor.

How can I prepare for childbirth at this stage?

This is a good time to enroll in childbirth preparation classes, learn about birth options, practice breathing exercises, and strengthen the pelvic floor with Kegel exercises.