Pregnancy Trimester 3
Pregnancy 28 Weeks
Pregnancy makes huge demands on all aspects of you: body mind and soul. Pregnancy also brings with it some health challenges – that you can help to minimize – for your own sake and for the sake of your baby. Some of these challenges are not something you can control, and when faced with them, it is important that you have a Doctor/Obstetrian/Midwife who you trust – so that when you are advised to follow a particular course of action – you know that it is in your best interests, which means it is also best for your baby.
Making sure you and your baby are healthy: Your Doctor/Obstetrician/Midwife will be looking out for the following conditions:
• Gestational Diabetes
• Group B Strep
• Pre-eclampsia – a disease that only occurs in pregnancy, and first pregnancies are more at risk. Each of these conditions is discussed below:
Apart from your usual blood pressure, Urine sample, checking for swelling of hands and feet, and weight checks – you Doctor/Obstetrician/Midwife – would want to know if you are at risk of developing “Gestational Diabetes” – as this can affect your baby, particularly your baby’s growth, and therefore – your recommended birth choice.
1. Testing for Gestational Diabetes
There are different ways to do the testing, but all of them involve taking a sample of blood, then you drink a particular amount of glucose, and then after a certain period of time – you have another blood test. Sometimes it is necessary for you to not have anything to eat or drink before taking the test, but your Doctor/Obstetrician/Midwife will let you know what to do.
If your have developed Gestational Diabetes, you will be educated on how to control it with your diet, and very occasionally an expecting Mother may need to take insulin. Again you would be educated about this, and would be taught how to test your blood glucose level.
Your Doctor/Obstetrician/Midwife also wants to be sure that your baby is growing at the expected rate – as often this is a reflection of how well the placenta (afterbirth) is providing for your baby. With Gestational Diabetes, often the baby is much larger in size, and may need to be delivered by Caesarian Section. Even though your baby may be large, their organs, eg lungs, are still immature and they may need help with breathing.
2. Testing for Group B Streptococcus (GBS)
You will also be tested for Group B Streptococcus (GBS) which is a bacteria that can be extremely harmful to your newborn baby. This bacteria can live in your vagina – so a vaginal swab will be taken. If you do have this bacteria – you may be given antibiotics (Penicillin) during delivery. Group B Strep can cause very serious breathing difficulties for your baby – which may not be apparent immediately at birth – so your baby is closely watched for any signs of distress. These can include tachycardia (rapid heart beat), tachypnoea (rapid breathing), abnormal temperature either high or low, signs that your baby is struggling to breathe – which include using extra muscles when breathing and making a grunting sound/ or nasal flaring.
3. Testing for Anaemia
Routine blood tests are usually taken again, particularly looking for anaemia – your iron supplements show help keep your iron levels acceptable and occasionally – iron injections may be needed.
Some expecting Mothers will accept the offer for a further Ultrasound.
4. Pre-eclampsia or Pregnancy induced Hypertension (PIH)
As these can effect up to 8% of pregnancies – the majority of which are first time pregnancies (about 85%) – it is worth knowing what to look out for. It is very important that you go to all your scheduled prenatal/antenatal visits – because mostly an expecting Mother feels absolutely fine – and is not aware that she is developing a condition that can be very serious for both her and her baby. Because modern day care of this disease is so good – it is very rare for this to end up with catastrophic consequences.
Expecting Mothers who are more at risk include teenage Moms, or Moms over 40, plus those with existing kidney or blood pressure problems.
What signs should an expecting Mother look out for?
Unfortunately – swelling of the hands and feet – may be the only thing you notice. Headaches and visual disturbances only happen once the condition is very advanced and needs immediate Medical attention.
Your regular antenatal check ups would have been showing that you have
• Protein in your Urine (wee)
• Blood pressure going up
• Your hands and feet becoming more oedematous (swelling up)
Some Doctor/Obstetrians recommend the supervised use of low dose aspirin to help prevent Pre-eclampsia occurring
Pre-eclampsia can progress to Eclampsia where the expecting Mother starts to have seizures (fitting) and may go into a coma. Another rare condition known as HELLP syndrome can occur which has similar symptoms to Pre-eclampsia, but which includes blood and liver changes – which are only picked up on blood testing.
These conditions continue to worsen – until the pregnancy is over, so it may be necessary to deliver your baby early, usually by Caesarian Section so that your body does not have to cope with the increased stress of labour.
Carpal tunnel syndrome Pregnancy
Carpal tunnel syndrome in pregnancy is fairly common. As the hands and fingers swell in pregnancy – the carpal tunnel which is the area where the nerves and tendons to the fingers run through – also becomes swollen. Because of the pressure on the nerves and tendons, you get a feeling of pins and needles into the hand – but not the little finger. With carpal tunnel syndrome in pregnancy – it is usually worse during the night – when lack of hand movement makes the fluid accumulate and the wrist and joints swell.
Try sleeping with your hand/s raised on a pillow. Some expecting Mothers may need a wrist splint. Obviously, once the pregnancy is over – the carpal tunnel syndrome disappears.
Possible effects on You and lots of baby preparing activities going on:
• You are wearing a good supportive bra for those growing boobs!!
• Because the uterus is so high up – you could be having some pregnancy heartburn
• It is also possible to become a bit short of breath – but make sure that you tell your Doctor/Obstetrian/Midwife – particularly if you have had pain in your legs or chest – as very rarely – you can develop clots during pregnancy.
• Because of the increased levels of Progesterone – your smooth muscle in your blood vessels are more relaxed and you could be experiencing varicose veins, and of course pregnancy constipation! – make sure you are eating lots of whole foods with fibre and drinking plenty of pure water.
• Making time each day – even if only 10 minutes – to look after yourself – check out our “Looking after yourself is looking after your baby”
• Research your preferred birth option, writing your birthing plan. Remember, aim for the stars, but realise that unforseen events may happen, so be open to the fact that you may have to change.
• You are busy “baby preparing” – getting things ready for that incredible day when your baby comes home – check out our newborn baby checklist which is also your hospital checklist
Apart from knowing what to expect when your baby arrives (you and your Partner can watch our online dvds – to prepare you for the Sacred Journey of your Baby’s birth, and also learn practical skills so that you will quickly become on expert on how to care for your baby safely.
• Baby preparing includes: buying or organising to hire – an infant safety seat/baby capsule – so that you can transport your baby safely – this is a mandatory requirement in most countries. Make sure this is fitted by a licensed Organisation
• A Moses basket/bassinette or crib for when baby is first born. Investing in an Arm’s reach Co-sleeper is a great idea – this safely attaches to the parent’s bed, and makes night feedings much easier. The co-sleeper, especially if you buy the larger “Universal” size – will suit your baby until approximately one year of age or more – depending on their size
• Sling/baby pouch – this will be one of the most important items you buy. Keeping your baby close to your body (or your Partner’s body) – baby wearing as it is sometimes called – helps reassure your baby that your are close and you are easily able to respond to your baby’s cues. You need to make sure that the position your baby lies in – is good for your baby’s development – and that your spine is protected through even weight distribution. Check out our recommendations
• A stroller or pram – much as it would be fantastic to carry your baby on your body all the time – when your baby is a little older – we are fortunate enough to be able to have the choice of an amazing array of strollers/prams to choose from. Choose one that is going to fit in with your lifestyle
• Baby change table – for diapering baby
• Baby bath
• Diaper bag – nappy bag
• Night light
• Organise a very comfortable chair for sitting when feeding your baby
A list of the other smaller items is available at our newborn baby checklist
By 28 weeks of pregnancy – your baby is viable and if born at this stage, with modern Neonatal Intensive Care – would stand a good chance of uncomplicated survival. The chances of uncomplicated survival increases usually with every week your baby stays in the womb, unless the placenta is not feeding your baby adequately – and then your Doctor/Obstetrician may wish to deliver you early.
Your baby statistics: weight approx 2 ½lbs or 1.1kg, is about 10 inches from top of head to rump (25cm).
Your baby is increasingly aware of all the sounds and movements around him/her – and knows how you feel by the hormones that are flowing in your blood.
What is your baby’s name check out our baby names list – if you need some help