Pregnancy Calendar: 28 Weeks Pregnant

How big is baby? Baby weighs about 2.25 pounds (1 kg) and total length is just under 15 inches (37 cm). Baby will continue to add more fat to his or her frame over the next several weeks.

What’s new this week? If you have not already, take time this week to review your health and medical insurance and look into possible life insurance policies.

What’s next? While you have visited your doctor several times throughout this pregnancy already, the third trimester brings on many new questions and concerns. Make sure you are talking through everything with your medical care team.

Have you gotten your medical or healthcare insurance ironed out for baby’s arrival? If not, now is the time to do it. And at your next prenatal doctor visit, bring a list of questions to ensure you prepared for your third trimester and for labor and delivery. Check out the list below to help guide your conversation.

What’s happening with my baby?

This week your baby’s brain is the star. Had you been able to see his or her brain prior to this point, it would have appeared smooth. This week, the grooves you associate with a human brain begin to form. Baby is also adding brain tissue to the important organ.

Less dramatic but far cuter—baby’s eyebrows and eyelashes have formed, and hair on the head continues to grow longer.

Finally, baby continues to add fat, smoothing out the skin and creating a more “human” appearance. Baby’s weight has actually doubled in just the last four weeks!

How big is my belly?

At this stage, your uterus has expanded to nearly 4 inches (8 cm) above your bellybutton. Normal weight gain thus far would be considered between 17 and 24 pounds (7.7 to 10.8 kg).

Falling During Pregnancy

While frightening, a fall during pregnancy is not likely to harm your baby. Your body is built to protect baby: He or she is surrounded by amniotic fluid inside the strong walls of your uterus, which is behind layers of skin, fat, muscle and other tissues. Early on, your uterus is located behind your pelvic bone, which creates another layer of protection.

Any injury would have to be powerful enough to seriously injure you to affect baby. However, a fall later in pregnancy could potentially cause preterm labor. If you experience any of the below conditions or symptoms, head to the ER:

A direct hit to the abdomen that causes pain
Vaginal bleeding or leaking amniotic fluid
Uterine contractions
Decreased fetal movement

If you fall, your baby is likely fine. But call your physician if you have any concerns. Better to be safe than sorry.

All About the Placenta

Think of your baby’s umbilical cord and placenta as his or her lifeline. Without it, baby cannot grow, let alone survive. The placenta serves several major functions.

First, the placenta moves oxygen to your baby and carbon dioxide away from him or her. It also brings nutrition to baby and removes waste. The placenta is also responsible for producing the human chorionic gonadotropin (HCG) hormone, which is how pregnancy is detected early on. The organ also produces estrogen and progesterone starting around the seventh week of pregnancy.

The placenta establishes contact with the mother’s bloodstream without your blood mixing with your baby’s by forming cells that grow through the walls of maternal blood vessels. This separation is important in case mom and baby have different Rh factors.

The placenta grows quickly, from about .75 ounces (20 g) at 10 weeks to 6 ounces (170 g) at 20 weeks gestation. A placenta at full term can weigh upward of 1.5 pounds (650 g) and measure 6 to 8 inches (15 to 20 cm) wide and an inch (2.5 cm) thick! Villi, or projections from the base of the uterus, attach themselves to the wall of the uterus and absorb nutrients and oxygen from mom’s blood
stream. Waste is removed in the opposite manner, through the umbilical cord, through the villi and into the mother’s bloodstream.

If you are carrying multiples, you may have a placenta for each baby, or there may be one placenta with two or more umbilical cords.

Tip: Ignore the temptation to rely on prepackaged “diet meals,” like Jenny Craig, during pregnancy. These meals do not provide enough calories to sustain both you and baby. Pregnancy is not the time to lose weight or go on a diet.

Medical and Health Insurance

Currently, under the Affordable Care Act, maternity coverage (including pregnancy, labor, delivery and newborn baby care) is required to be covered by all health insurance plans offered to individuals, families and small groups. However, this can change with new policy reform, so keep up-to-date on healthcare news and double check with your insurance provider.

Under your plan, you will have access to:

Outpatient services, including prenatal care visits and some screenings, lab tests and medications
Inpatient services, including hospitalizations and physician fees
Care for your newborn baby
Lactation counseling and breast pump rental

Open enrollment for health insurance usually runs in November and December each year (check here for specific dates). You can also enroll or change your insurance plan after baby’s birth. (Pregnancy does not qualify for eligibility outside open enrollment, but giving birth does).

Most insurance plans will keep track of your medical costs throughout pregnancy and send you one bill post delivery. If your pregnancy stretches over two calendar years, ask if you will need to pay your deductible for both years.

Health and medical insurance can be confusing, so never hesitate to pick up the phone and ask questions. Even after you get your bill, if something doesn’t seem right, investigate. Care that should have been covered could have been coded wrong in the system. Make sure you understand what to expect and when—financial surprises are never a good way to kick off your baby’s new life.

Questions to Ask: Third Trimester

While you may begin to feel like a pro at being pregnant, the third trimester (not to mention the idea of nearing labor) conjures up many more questions and concerns. Here is a list of questions to address with your medical care team at your next check up:

What changes will occur during the third trimester?
Will there be further testing for baby or me?
Is my weight gain on track?
Is it safe to have sex during the third trimester?
What signs of labor should I be looking for?
When should I head to the hospital?
What if my water breaks?
What should I expect during labor and delivery?
What are my options for pain relief?
Who will deliver my baby?
What is the likelihood I will need a Cesarean delivery?
What happens if baby is overdue?
What support is available if I choose to breastfeed my baby?

You should also ask any questions regarding your specific situation. Your doctor will want you to be as comfortable as possible before heading into the big day.