The 28-week prenatal appointment marks the official start of the third trimester of pregnancy. At this stage, your healthcare provider shifts focus toward monitoring your health and the baby’s growth more frequently. Organizing your questions beforehand allows you to address specific concerns and gather the necessary medical and logistical information for the final months.
Understanding Third Trimester Screening and Procedures
One of the primary focuses of this visit is the screening for gestational diabetes, which is typically performed between 24 and 28 weeks. You should ask about the specific procedure for the one-hour Glucose Tolerance Test (GTT), including whether you need to fast beforehand and what the next steps are if the screening results are elevated. The test involves drinking a sugary solution followed by a blood draw exactly one hour later to measure how your body processes sugar.
This appointment often includes a second round of routine blood work to check for conditions like anemia, which is common as blood volume increases significantly during pregnancy. If your blood type is Rh-negative, you will also receive an injection of Rhogam, an immune globulin. You should ask your provider to explain how this injection works to prevent your body from creating antibodies that could affect a future Rh-positive baby.
The Tdap vaccine, which protects against tetanus, diphtheria, and pertussis (whooping cough), is also routinely recommended during this window. Inquire about the best timing for this booster and whether other family members or caregivers should also receive the vaccine to maximize protection for the newborn.
Tracking Fetal Movement and Growth
The 28-week visit is the time to ask for formal instructions on fetal movement counting, often called “kick counts,” which becomes an important daily responsibility. You should clarify the exact technique recommended by your provider, such as the common goal of noting ten distinct movements—kicks, rolls, or swishes—within a two-hour period. Ask what time of day is best for you to perform these counts and what specific changes in the baby’s pattern should prompt an immediate call to the office.
During the physical examination, your provider will typically measure your fundal height, which is the distance from your pubic bone to the top of your uterus. This measurement helps determine if the baby’s growth is on track for the gestational age. You should ask what the current measurement is and what the expected range is for 28 weeks.
Inquire about the baby’s current position, though it is usually still early for concern about a breech presentation. Knowing the position now can prepare you for future discussions if the baby remains head-up later in the third trimester.
Managing Maternal Symptoms and Warning Signs
As you enter the third trimester, new physical symptoms often arise, making it important to discuss safe management strategies. Ask about approved remedies for common discomforts like persistent heartburn, which is caused by hormonal relaxation of the esophageal sphincter, and increased swelling in the feet and ankles. You can also discuss effective ways to manage back pain and improve sleep quality, which is often disturbed by the growing abdomen.
Crucially, you must ask for a clear list of warning signs that necessitate contacting the provider immediately, rather than waiting for the next appointment. This list should include signs of preeclampsia, such as a severe, persistent headache that Tylenol does not resolve or changes in vision like seeing spots. You should also be aware of the signs of preterm labor, including regular, painful contractions that do not stop with rest and hydration.
Clarifying other urgent issues is also important, such as a sudden gush or trickle of fluid that might indicate your water has broken, or any vaginal bleeding. Discussing safe exercise modifications and whether any work or travel restrictions are recommended for the coming weeks will help you navigate the end of your pregnancy safely.
Planning Ahead for Labor and Delivery
With the due date in sight, this appointment is an excellent time to begin discussing the logistics of the delivery itself. Ask your provider when they prefer to review and finalize your birth plan document, which outlines your preferences for pain management and the birth environment. Getting this conversation started now allows time to incorporate their clinical perspective and the hospital’s policies into your wishes.
Inquire about the process for hospital registration and whether virtual or in-person maternity unit tours are available for scheduling. These logistical steps often have waitlists, and coordinating them around 28 weeks helps prevent last-minute stress. Ask about the recommended timeline for completing any remaining childbirth education classes, ensuring you finish them well before the baby’s expected arrival.
Ask about the schedule for your future prenatal visits, as the frequency typically increases from monthly to every two weeks starting around 30 to 32 weeks. Understanding the upcoming schedule helps you plan for the final, intensive phase of prenatal monitoring.