Congratulations! You've made it to the third trimester of pregnancy!

By week 28, the average weight gain is 17-24 pounds (around 22.5 pounds if you carry twins). Don't worry if your weight gain is a little more or less than this. Weight is carried and gained differently for every person. 

By week 28, most of your symptoms are directly related to the amount of space your little one now occupies inside of you. Here are some things you may experience this week.

Outie belly button: If you had an “innie” belly button before pregnancy it is possible that it has turned into an “outie” with your expanding middle!

Larger feet: hormones causing your ligaments to relax are not limited to your abdomen. Some individuals have reported noticing their shoe-size increase with pregnancy. This may be a temporary change, or your new normal. Either way- time to go shoe shopping!

Stretch marks, itchy or dry skin, and/or unwanted hair growth: as your baby continues to grow and your body grows to accommodate, your skin may experience stretching, leaving marks and causing discomfort. You may also notice hair growing in places it didn’t grow previously, or growing more aggressively than it did before. You can utilize lotions and creams to soothe irritated skin; but stretch marks are largely genetic and not something you should feel guilty for not “preventing”.  Unwanted hair growth can be shaved or plucked. Waxing may not be advisable during pregnancy and should be explored as an option with caution. 

Swelling, or edema, in your ankles and/or feet: some swelling is normal and expected during pregnancy, especially if you are on your feet all day, but it’s best to keep an eye on any sudden changes. Talk to your healthcare provider if you are experiencing swelling, as this could be a warning sign of a dangerous complication called preeclampsia. 

Sweating: increased perspiration can be a result of hormonal changes, or the additional weight and pressure on your body as you carry your growing baby. Stay hydrated to replace any fluids lost. 

Heartburn: as your baby continues to grow and press on internal organs, your digestive system is likely to feel the impact of cramped quarters. This, paired with continuing hormone fluctuations can result in heartburn or indigestion. Talk to your medical care provider about options for relief if you’re feeling too uncomfortable.

Braxton Hicks: also referred to as “practice contractions” Braxton Hicks are your body’s way of preparing for giving birth. They are generally painless, or uncomfortable at most– like subtle period cramps. If you are experiencing severe pain, or the cramping does not stop– seek medical attention.

Tingling, numbness, or pain in your hands and wrists: possible warning signs for carpal tunnel syndrome, keep an eye on any numbness or pain in your hands and wrists and be sure your doctor is aware so they can rule out any concerns.

Bleeding and/or swollen gums: increased blood volume can make ruptures in sensitive places like the nasal membranes and gum line more likely. Dental health is critical during pregnancy, so you should continue to brush and floss– but take care to do so gently!

Frequent nighttime wakings: between getting up to use the bathroom, leg cramps, shortness of breath, and even heartburn– you may be struggling to get a decent amount of sleep during the night. 

Backaches and/or leg cramps: aches and pains are an uncomfortable, albeit normal, part of pregnancy. Stay hydrated and talk to your doctor about safe pain relief options that may offer some comfort.

Crazy dreams: the stress of anticipating your baby’s arrival and the poor sleep of the third trimester can result in interrupted sleep. While the cause of the more vivid dreams in pregnancy is unknown it may have something to do with that interrupted sleep. Not sleeping as deeply may allow you to remember your dreams more easily. 

If you plan on using a birth plan, no matter what you're planning, you should write it out. A written birth plan, or a written statement of your and your partner's preferences for labor and delivery, may be a good idea. And bringing a copy of this plan to the hospital with you is an even better idea. It's a simple way to inform anyone you may come in contact with of your preferences for this birth. The best birth plan is one page or less, bullet points, and easy to understand.
Here are some question your birth plan might address:

• Do you want to listen to music? Did you bring any music?
• Do you want access to a tub or shower?
• Do you want pain medications? Of the opioid (narcotic) medications more commonly used for labor pain relief - fentanyl, Nubain (nalbuphine), morphine, and Stadol (butorphanol) - do you have a preference?
• Do you want an episiotomy?
• Do you want a routine IV, a heparin/saline lock, or nothing at all?
• Is there a position in which you would prefer to give birth?
• Think about the baby too, do you want eye ointment, vitamin k shot, vaccines, bath, or bottle?

Those who choose to compose a birth plan may feel an enormous release of stress and anxiety surrounding the big day. So, set aside some time to discuss your personal labor and delivery wishes with your partner and to go over the many options available together.

Take a side profile pregnancy picture and write in your pregnancy journal this week.

How will you wear your baby? Have you taken a good look at the various slings, wraps, hybrids, and structured carriers available? Baby-wearing is a practice that has been common throughout history and provides many benefits for babies and parents. Even the partners who once refused anything other than a front or back-carrying, structured version are opening up to newer styles of baby-wearing products, because baby-wearing is a great way to soothe a fussy newborn. The closeness and gentle motion often replicate the closeness of the womb - a familiar, warm, and safe association.