28 weeks pregnant: the third trimester, anti-D and your RSV vaccine

How is my baby developing at 28 weeks?

Your baby can now open and close their eyes and blink, and they have regular cycles of sleeping and waking. Their brain is developing quickly and they’re laying down fat under their skin, which will help them control their temperature after birth. Their lungs are still maturing, which is one reason every extra week in the womb matters.

You’ll probably feel lots of movement now: kicks, rolls and the rhythmic jolts of hiccups.

What happens at the 28-week appointment?

This is a routine appointment with your midwife, for everyone. They will:

• check your blood pressure and urine
• measure the size of your bump to check your baby’s growth
• listen to your baby’s heartbeat and ask about their movements
• take a blood test to check for anaemia (low iron) and your blood group
• give you an anti-D injection if your blood is rhesus negative and your baby could be at risk of rhesus disease
• talk to you about labour, birth and the checks your baby will have after they’re born

If you were offered a glucose tolerance test for gestational diabetes, it’s usually done between 24 and 28 weeks.

Should I have the RSV vaccine?

RSV is a common virus that can cause serious breathing problems in young babies. The NHS offers the RSV vaccine from 28 weeks, and having it as soon as possible from 28 weeks gives your baby the best protection in their first months. If you missed it, you can still have it at any time until you go into labour. Ask your midwife or GP surgery.

If you haven’t had your whooping cough vaccine yet, try to have it before 32 weeks.

Your baby’s movements: what’s normal?

From now on, it’s important to know your baby’s normal pattern of movements. There’s no “right” number of kicks. What matters is what’s normal for your baby.

If you think the movements have slowed down, stopped or changed, contact your midwife or maternity unit straight away, at any time of day or night. Don’t wait until the next day, and don’t use a home heartbeat monitor (Doppler) to reassure yourself. Even if you can hear a heartbeat, it doesn’t mean your baby is well.

Sleeping on your side

From 28 weeks, the NHS advises going to sleep on your side, either left or right. Going to sleep on your back in the third trimester is linked to a higher risk of stillbirth. A pillow behind your back can help you stay put. If you wake up on your back, don’t panic; just roll back onto your side.

How might I feel at 28 weeks pregnant?

• Tiredness returning as your bump grows.
• Heartburn and indigestion, as your womb pushes up on your stomach.
• Swollen ankles and feet, especially at the end of the day. Sudden swelling of your face, hands or feet, a severe headache or problems with your vision can be signs of pre-eclampsia. Call your maternity unit or NHS 111 straight away.
• Braxton Hicks contractions, painless tightenings of your bump.

What should I be doing this week?

• Start thinking about your hospital bag. The NHS suggests having it packed at least 3 weeks before your due date. Our hospital bag checklist covers what to take.
• Check your travel plans. Many airlines ask for a letter from your midwife or GP after 28 weeks.
• Think about antenatal classes, if you haven’t booked any. NHS classes fill up quickly in some areas.

What’s coming next?

If this is your first baby you’ll see your midwife at 31 weeks, and everyone has an appointment at 34 weeks. At 36 weeks your midwife will check your baby’s position. Read our 36 weeks pregnant guide for what to expect.