28 Weeks Pregnant
What’s happening this week
Your baby…
- probably weighs around 1.1kg
- now two thirds of her birth size
- skin changing from being quite transparent to opaque
- is beginning to ‘fill out’ as weight gain speeds up
- definite sleep and wake times
- the folds and grooves of the brain continue to develop
- hair continues to grow.
You…
- may notice swollen ankles – put your feet up when you can!
- could find yourself getting short of breath as your uterus pushes up towards your rib cage.
Pain relief choices in labour
Wondering which sort of pain relief you might choose, and wondering what to put down on your birth plan? Our chart will help you decide by looking at the pros and cons of each method.
| Type of pain relief | What is it? How is it used? | Pros | Cons |
|---|---|---|---|
| TENS | A small machine with pads that stick onto your back and stimulate your nerves with small, safe amounts of electric current. You can turn the machine up and down as needed. Best used from very early labour | Useful for backache during labour You are in control Can be used at home before going to the maternity unit Has no adverse effects on you or your baby | You may need more pain relief than TENS can provide May not help with the pain for some women, but some women do find it helpful You need to hire one as not many hospitals have them |
| Pethidine | Pethidine is often given intravenously (via a drip) as well as into the muscle (IM) - thigh or bottom, either singly or together with IM dose. It takes about 5 - 20 minutes to be effective and lasts for two to four hours | May enable you to rest if labour is long and difficult Some women find it helps 'distance' them from the pain If you are feeling anxious, it may relax you and help contractions be more effective | May make you feel dizzy or sick but an antiemetic (anti-sickness) medication is usually given at the same time to combat this |
| Gas and Air (Entonox) | You breathe gas in through a mouth-piece or mask Take several good deep breaths at the very beginning of each contraction You hold the mask or mouthpiece and take as much or as little as you need | You are in control The oxygen is good for your baby The gas doesn't linger in your system Only affects alertness temporarily as it's quickly breathed in and out | It's only a mild form of pain relief May make you feel slightly sick You may not like the feeling of light-headedness it gives |
| Epidural/Spinal | This injection into your lower back numbs your body from the waist down so you don't feel the contractions. It takes 20 minutes to set up and another 5 - 20 minutes for the anaesthetic to work | It can mean you feel no pain during labour Most effective form of pain relief in labour | May have a patchy effect can increase the length of the labour May cause sudden fall in blood pressure May cause headache after delivery May lead to short-term backache You are more likely to need an assisted deliver (forceps or ventouse)/caesarean |
Alternative Therapies
Some mothers find hypnotherapy or acupuncture can be effective for pain relief. Aromatherapy can also be useful. Discuss the availability of these options with your LMC.
If you’re a single parent
If you’re a mother-to-be on your own, you may start to feel particularly lonely around now. Other women have partners to help and support them, you don’t. But that doesn’t mean you have to be alone – friends and family can become even more important to you now – don’t be too proud to ask for their help, they may be glad of the chance to be there for you when you most need it.
More blood tests
Your blood will probably be tested again this week for the level of haemoglobin – this is to check that you have enough iron in your bloodstream and aren’t becoming anaemic. You may be prescribed iron tablets if you are not already taking them, and, if you’ve been feeling tired, they may give you your energy back.
A test for gestational diabetes is often offered at this time too. Your LMC will discuss this with you.
Low-lying placenta?
If you’ve been told earlier in pregnancy that your placenta is low-lying, a scan this week may show that it is now higher up in the uterus. There is still time for the lower segment to stretch and in turn, the placenta may still move. If it’s still lying low, perhaps covering or partially covering the cervix – the opening of your uterus that will gradually open to let the baby out – then you will be scanned at intervals to assess the placenta’s position and see if it has moved.
Childbirth classes
You will soon be starting your childbirth education classes. Parents Centres also run a number of programmes to help you through those early months of parenthood see www.parentscentre.org.nz.