28 weeks pregnant: baby is the size of an eggplant

Your baby this week

Your baby's eyes can open fully, and eyelashes have grown. Your baby sleeps and wakes in cycles, and has periods of active sleep in which the eyes move quickly. This is called REM sleep, and it is linked to dreaming in adults. The brain is growing deeper folds on its surface, which increases its capacity.

The lungs are producing more surfactant, and a baby born at this stage has a good chance of survival with specialist care. Fat is building up under the skin, and it will help your baby control body temperature after birth.

How it happens. Movement is part of development. When your baby kicks and stretches, the muscles, bones and joints get stronger, and the brain refines the connection to them. This is why healthy movement is a sign of wellbeing.

Your body this week

Your uterus is now about 8 cm above your belly button. You may notice it is harder to find a comfortable position, and to bend or move quickly. Your antenatal visits may also become more frequent. In some places, you are seen every two weeks from now.

Your energy may dip again, and you may feel more tired at the end of the day.

How to know your baby's normal pattern

Your baby's movements are one of the best ways to check that they are well. The NHS advice is:

• You should feel movements regularly from about 24 weeks. The type may change as your baby grows, from kicks to stretches and rolls.
• There is no set number. Every baby is different. What matters is what is normal for your baby.
• Movements should not slow down or stop in late pregnancy. This is a common myth. Your baby will keep moving right up to the birth, and through labour.
• Get to know your baby's pattern. Notice when your baby is usually active, and what a typical day feels like.

Some guidelines suggest a formal count. For example, Cleveland Clinic and ACOG describe lying on your side and counting until you have felt 10 movements, aiming for that within two hours. Both approaches aim to help you notice a change. If you find a count helpful, use it, but do not use it as a reason to delay calling if something feels different.

What to do if movement changes

Call your maternity unit or midwife straight away if:

• You feel your baby's movements have slowed, reduced or stopped.
• The pattern has changed in a way that worries you.
• You have not felt any movement by 24 weeks.

Do not wait until the next day, and do not wait to see if it settles. Call even if it is the middle of the night. Do not use a home Doppler, a phone app or a handheld monitor to check the heartbeat. They can give false reassurance and delay the checks that matter.

At the unit, the team will listen to the heartbeat, perhaps place a monitor on your belly for a while, and may arrange a scan. Most of the time, all is well. If you feel reduced movement again, call again, even if you have been checked before.

Rh-negative blood and the anti-D injection

If your blood group is Rh-negative, your body may make antibodies against Rh-positive blood cells if your baby is Rh-positive. This does not usually affect a first pregnancy, but it can affect later ones. Anti-D immunoglobulin, an injection, prevents this. In many countries it is offered at about 28 weeks, and some also give a second dose at 34 weeks, then after birth if the baby is Rh-positive. It is also given after bleeding, a fall or some procedures. Ask your provider what applies to you.