What are warning signs at 28 weeks pregnant?

Severe headache that won't go away with acetaminophen — preeclampsia.; Vision changes — blurred vision, light flashes, vision loss.; Severe right-upper-quadrant pain — HELLP syndrome.; Sudden swelling of face, hands, or feet.; Reduced fetal movement — fewer than 10 kicks in 2 hours.; Vaginal bleeding, fluid leakage, or persistent contractions.; Severe shortness of breath at rest or chest pain.; Fever over 100.4°F.; Seizure — eclampsia, life-threatening.;

Third trimester · Pregnancy week by week

Week 28 of pregnancy

Q: How big is the baby at 28 weeks?

size of an eggplant. The fetus is now nearly 1 kg (2.2 lbs). Eyes can blink and detect light. Brain develops rapidly. Lungs are immature but functional with NICU support if born now (~85% survival rate). REM and non-REM sleep cycles are established.

Baby is the size of an eggplant. About 14.80 inches, 1000g.

Welcome to the third trimester — the highest-mortality window for Black women. Per CDC PMSS, more than half of pregnancy-related deaths occur in the third trimester or postpartum period. Self-advocacy now is decisive. Source

What's happening with the baby

The fetus is now nearly 1 kg (2.2 lbs). Eyes can blink and detect light. Brain develops rapidly. Lungs are immature but functional with NICU support if born now (~85% survival rate). REM and non-REM sleep cycles are established.

What's happening for you

Bump is heavy. Many women feel breathless with mild exertion. Sleep is increasingly difficult. Heartburn is common. Some women experience increased anxiety or pregnancy-related insomnia.

Common (normal) symptoms this week

Heartburn, breathlessness with exertion, sleep disturbance, frequent urination, increased Braxton Hicks, swelling of feet by end of day, occasional leg cramps.

Call your OB or 911 if

Severe headache that won't go away with acetaminophen — preeclampsia.
Vision changes — blurred vision, light flashes, vision loss.
Severe right-upper-quadrant pain — HELLP syndrome.
Sudden swelling of face, hands, or feet.
Reduced fetal movement — fewer than 10 kicks in 2 hours.
Vaginal bleeding, fluid leakage, or persistent contractions.
Severe shortness of breath at rest or chest pain.
Fever over 100.4°F.
Seizure — eclampsia, life-threatening.

Why this week matters for Black families

The third trimester carries the highest Black-maternal-mortality risk in the U.S. obstetric data. Preeclampsia, HELLP syndrome, and preterm labor are most common here. The CDC Pregnancy Mortality Surveillance System repeatedly cites delayed recognition of severe symptoms in Black women as a contributor to preventable deaths. This is the window where you advocate hardest. If the OB's office tells you a symptom 'sounds like normal pregnancy,' ask: 'Can you document in the chart that I reported this and that you decided not to evaluate it further?' That sentence alone reverses outcomes in documented case reviews.

What to do this week

Begin every-other-week OB visits. Get the Tdap vaccine (between 27–36 weeks; protects newborn from pertussis). Get the RSV vaccine if recommended. Confirm GBS test plan for week 35–37. Begin counting fetal kicks daily — if fewer than 10 in 2 hours, call OB.

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References

CDC Pregnancy Mortality Surveillance System.
CDC Tdap in Pregnancy Recommendation.

Last medically reviewed: April 25, 2026.

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