Week 28
Welcome to the third trimester. Your baby is about 36.6 cm (14.4 in) from crown to heel and weighs about 875 g (1 lb 15 oz), close to 1 kg. Babies vary, and growth from here is quick. The brain is getting bigger and more folded, and fat keeps building up under the skin.
You may feel heavier, more tired and more aware of your baby's strong movements. This week's focus is safety and knowing your baby: what to do if movements change, the warning signs of pre-eclampsia, and why your fingers and rings may feel tight. It is also a good week to begin a birth plan, a simple way to think through what matters to you.
Day 190 · 27 weeks 0 days
The third trimester starts today
At 27 weeks, you have reached the final stretch. The third trimester runs from now until your baby is born, usually somewhere around 37 to 42 weeks. That's roughly 13 weeks to go, give or take.
This trimester is mostly about growth. Your baby will more than triple in weight, adding fat, maturing the lungs and building the brain connections needed for life outside. Babies born from now on have a good chance of doing well with specialist care, and the odds improve with every week. For you, the coming months often bring a return of tiredness, more trips to the bathroom, aches in the back and hips, and trouble getting comfortable at night. Your care provider will see you more often and keep a close eye on your blood pressure, your baby's growth and your baby's movements. There's a lot to look forward to and some planning to do: choosing your baby's doctor, thinking about feeding, writing a birth plan, and later, packing your bag. Most of it can be done in small steps.
Try this: Take a photo of your bump today, and plan to take one each month until the birth.
Day 191 · 27 weeks 1 day
If your baby's movements slow down or change, call the same day In week 26 you began learning your baby's pattern of movement. Now it matters even more. A baby who is moving less than usual, or whose movements have changed or stopped, may not be getting enough oxygen through the placenta. Checking quickly can make a real difference. Babies do not move less as they run out of room. The type of movement may change, from jabs to rolls and pushes, but you should keep feeling your baby regularly right up to and during labour.
If you think movements have slowed or changed, don't wait to see whether they pick up, and don't spend time trying to get your baby moving with food or cold drinks first. Trust your sense that something is different. Call your care provider if your baby is moving less than usual, has changed their pattern, or you feel no movement at all. Call straight away, day or night, and don't wait until the next day or your next appointment. If you can't reach them, go to your birth unit or hospital.
Please don't use a home heartbeat monitor (doppler) to reassure yourself. Hearing a heartbeat doesn't tell you the baby is well, and it can delay getting checked. You will never be a nuisance for calling about movements.
Try this: Save your care provider's or birth unit's phone number in your phone now, under a name you'll find quickly.
Day 192 · 27 weeks 2 days
Know the warning signs of pre-eclampsia
Pre-eclampsia is a condition of pregnancy that causes high blood pressure and can affect the kidneys, liver, brain and placenta. It affects roughly 2 to 8 in every 100 pregnancies, usually after 20 weeks and most often in the third trimester. It can also start in the days after birth.
Often there are no symptoms at first, which is why your blood pressure is checked at every visit and your urine is tested for protein. Some people are at higher risk: a first pregnancy, previous pre-eclampsia, high blood pressure or kidney disease before pregnancy, diabetes, carrying twins, or a body mass index over 30. Your care provider may suggest steps to lower your risk.
Symptoms to know, because they can come on fast:
a bad headache that doesn't go away with rest or simple painkillers blurred vision, flashing lights or spots in front of your eyes pain just below the ribs, especially on the right side sudden swelling of the face, hands or feet
vomiting or feeling very unwell
Get help right away if you have any of these. Contact your care provider or birth unit immediately, or call your local emergency number. Pre-eclampsia can be managed well when it is found early. Try this: Read this list aloud to your partner or a support person so that someone else knows the signs too.
Day 193 · 27 weeks 3 days
Your baby's brain is folding and growing fast
In the third trimester, your baby's brain changes shape. Until now, its surface was fairly smooth. Over the coming weeks it develops the deep grooves and folds you picture when you imagine a brain. Folding lets a lot more brain fit inside a small skull, and the brain will roughly triple in weight between now and birth.
Billions of nerve cells are making connections, and many are getting a fatty coating, called myelin, that lets signals travel faster. Your baby is responding more to sound, touch and light, and their movements are becoming more coordinated.
Your baby is also storing more fat under the skin. Until now, the skin looked thin and somewhat wrinkled. Fat smooths it out and will help your baby keep warm after birth.
Brain growth needs good nutrition. Omega-3 fats, especially DHA, play a role. Two servings a week of fish that are low in mercury, such as salmon, trout, sardines or herring, are a good source. If you don't eat fish, ask whether your prenatal vitamin includes DHA or whether you should take a separate supplement.
Try this: Plan one meal this week built around fish that's low in mercury, or check your prenatal vitamin label for DHA.
Day 194 · 27 weeks 4 days
A birth plan is a starting point, not a script
A birth plan is a short note that tells the people caring for you what matters to you during labour and after the birth. It is a good tool for thinking things through, talking with your care provider, and making sure your support person knows your wishes.
The most useful birth plans are short, one page if possible, and written as preferences rather than demands. Birth can go in unexpected directions. A plan that says "if this happens, I'd prefer that" helps you feel involved in decisions even when things change.
Start by asking yourself a few questions. Where do you plan to give birth? Who do you want with you? What helps you feel calm: music, low light, moving around, a bath or shower? How do you feel about pain relief, which you'll read about in more detail later in the book? What would you like in the first hour after birth, such as holding your baby skin to skin? You don't need answers to all of these yet. Over the next few weeks, you can fill in your plan as you learn more, and bring it to an appointment to talk over.
Try this: Write three things that matter most to you about the birth, in any order, on one page.
Day 195 · 27 weeks 5 days
Tiredness often returns in the third trimester
If the energy of the middle months is starting to fade, that is very common. Your body is carrying more weight, your heart is pumping more blood, and your sleep may be broken by bathroom trips, kicks and heartburn. Many people feel nearly as tired as they did in the first trimester. Pacing helps. Plan the most demanding tasks for the part of the day when you feel best. Sit when you can, and take short breaks. If you work, ask whether you can adjust hours, take more breaks, or have a chair or a footrest. Simple meals and help with chores make a difference. A short daily walk often improves energy rather than draining it. A 20- minute rest on your side in the afternoon can help too.
Tiredness can sometimes be a sign of anemia, which becomes more common late in pregnancy. Call your care provider if you are exhausted all the time, short of breath with little effort, pale, dizzy, or have a racing heartbeat. They may check your iron levels.
Try this: Choose one task you can drop, delegate or simplify this week, and let it go.
Day 196 · 27 weeks 6 days
Swollen fingers and tight rings are common now
You read about tingling hands and carpal tunnel syndrome in week 25. The same extra fluid that presses on the nerve at your wrist can also make your fingers puffy, especially at the end of a warm day or first thing in the morning. Many people find their rings suddenly feel tight.
It is worth acting before a ring gets stuck. Take rings off while they still slide over the knuckle, and keep them somewhere safe or wear them on a chain until after the birth. If a ring is already tight, raise your hand above your heart for a few minutes, then try a little soap and a gentle twisting pull. If it will not come off, or your finger becomes painful, pale or blue, a clinic or emergency department can cut it off safely.
To ease puffiness, raise your hands on a pillow when you rest, open and close your fists several times, and keep drinking water. Swelling that builds slowly and eases with rest is usually harmless.
Call your care provider if the swelling is in one hand only, or you have numbness or weakness that does not ease. Get help right away if you have sudden swelling of your face and hands with a bad headache or vision changes, which can be a sign of pre-eclampsia.
For your partner: Learn the pre-eclampsia warning signs from day 192, and take over tasks that are hard on sore hands, like opening jars and carrying heavy bags.