Tommy's PregnancyHub

28 weeks pregnant: baby's development, itchy skin and your next midwife appointment

Your baby weighs about 1kg now and is roughly the size of an aubergine.

Your baby’s development this week 

Skin creases can now be seen on your baby’s hands, which will also have perfectly formed fingernails.

Your baby will be having periods of sleep and periods of activity, which you’ll probably be aware of because of their movements. You may have noticed that these movements are settling into a regular pattern.

There is no set number of normal movements you should be feeling. But DO NOT WAIT until the next day to seek advice if you are worried about your baby’s movements.

Contact your midwife or maternity unit immediately if you think your baby’s movements have slowed down, stopped or changed. 

Find out more about your baby's movements.

Your pregnancy symptoms in week 28

Itching skin

Itching is common in pregnancy. Usually, this is due to hormones and your tummy skin stretching.

However, itching can be a symptom of a liver condition called intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis (OC).

The main symptom is itching, usually without a rash. This may be more noticeable on the hands and feet, but can be all over the body and worse at night.

Tell your midwife or doctor if you are itching, even if you think it’s mild. They can help you manage your symptoms or do some tests to find out more.

Are you feeling dizzy? Or are you suffering from indigestion, cramps or headaches?

Here’s our guide to 10 common pregnancy complaints (and how to avoid them).

Restless legs syndrome

Do you get an uncontrollable urge to move your legs? Or perhaps a crawling, tingling sensation? This could be restless legs syndrome. It’s quite common in pregnancy, especially as you go into the third trimester. It usually happens when you’re resting or in bed.

Restless legs syndrome caused by pregnancy will go away once your baby is born. 

Find out more about restless legs syndrome.

Feeling uncomfortable

Use pillows as best you can to get comfortable. Try one supporting your bump, another for your back and then one between your legs.

Pillows will also help you go to sleep on your side, which is the safest sleeping position for your baby in late pregnancy.

Sleep problems

Here are some tips to help you drift off.

What to do in week 28

Next midwife appointment

You may have a routine antenatal appointment at 28 weeks. You’ll be offered a blood test to screen for anaemia and any antibodies in the blood. You may be prescribed iron tablets if your iron levels are low.

All women are offered blood tests as part of their antenatal checks and tests. This is to see whether your blood is RhD negative or positive. 

This is because you may need treatment to prevent rhesus disease. Rhesus disease only happens when the mother has rhesus negative blood (RhD negative) and the baby in her womb has rhesus positive blood (RhD positive).

Being rhesus negative is not a problem in your first pregnancy. But if you have more babies, there is a risk of rhesus disease. This doesn't harm the mother, but it can cause the baby to become anaemic and develop newborn jaundice

Rhesus disease is uncommon these days because it can usually be prevented using injections of a medication called anti-D immunoglobulin, if needed. You will be offered this at certain points during pregnancy or after birth.

Swim time

As well as being good for your circulation, swimming in pregnancy improves your muscle tone and increases your endurance (great for preparing for labour). It may also give you more energy and help you sleep better.

As your bump grows, the feeling of weightlessness in the water can be lovely and relaxing.

“Swim swim swim! I swam 60 lengths, 2 or 3 times a week in my first pregnancy and had a wonderful natural birth, which I think my fitness had a large part to play in.”
Sara

Birth plan

If you haven’t written your birth plan yet, you may want to start thinking about doing it.

Think about the different kinds of pain relief and which, if any, you may like to consider when you’re in labour.

Did you know that depending on where you live and your health, you could decide to give birth in hospital, in a midwife-led birth centre or at home? Read more about where you can give birth.

We also have a pregnancy and post-birth wellbeing plan, which is similar to a birth plan for your mental health. It can help you think ahead to make sure that you are supported after the birth. You can complete the wellbeing tool at any point during your pregnancy. 

1.  Regan, Lesley (2019) Your pregnancy week by week, Penguin Random House, London

2.  NHS. Itching and intrahepatic cholestasis of pregnancy. https://www.nhs.uk/pregnancy/related-conditions/complications/itching-and-intrahepatic-cholestasis/ (Page last reviewed: 02 August 2019 Next review due: 02 August 2022)

3.  Clinical Knowledge Syndrome. (2020) Restless legs syndrome https://cks.nice.org.uk/topics/restless-legs-syndrome/

4.  Heazell AEP, Li M, Budd J, Thompson JMD, Stacey T, Cronin RS, Martin B, Roberts D, Mitchell EA, McCowan LME. Association between maternal sleep practices and late stillbirth – findings from a stillbirth case-control study. BJOG2017; https://doi.org/10.1111/1471-0528.14967.

5.  NHS. Rhesus disease. https://www.nhs.uk/conditions/rhesus-disease/ (Page last reviewed: 16 November 2021 Next review due: 16 November 2024)

6.  NHS. Exercise in pregnancy. https://www.nhs.uk/pregnancy/keeping-well/exercise/ (Page last reviewed: 20 January 2020 Next review due: 20 January 2023)

Review dates
Reviewed: 11 July 2022 | Next review: 11 July 2025