Week 28

What’s happening this week

You…

• may have antenatal visits once a fortnight from now on
• may have more blood tests this week
• may notice swollen ankles – put your feet up when you can!
• may have an itchy abdomen – always check itchiness with your LMC, it could be a sign of something more serious
• could find yourself getting short of breath as your uterus pushes up towards your rib cage.





Your baby…

• is beginning to ‘fill out’ as weight gain speeds up
• probably weighs around 21/2 lbs (1.1 kg)
• has times of sleep and times of waking
• is still busy tossing and turning..





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
Gas and air (Entonox)	You breathe gas through a mouthpiece or mask Take several good deep breathes at the beginning of each contraction You may 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 sick You may not like the feeling of light-headedness it gives
Pethadine	This is given by injection, usually into your bottom or thigh. It takes about 20 minutes to be effective and lasts for two to four hour	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 You may dislike feeling 'detached' from what's happenong May make your baby tired and slow to respond Affects your digestive system, which may be a problem if you need anaesthetic
TENS	A small machine with pads that stick onto your back and stimulate your nerves with smal, 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
Epidural	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 to 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 labour May cause a sudden fall in blood pressure May cause headache after delivery




Alternative Therapies

Some mothers find hypnotherapy or accupuncture 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.




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.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 may need to make plans with your doctors to have your baby by caesarean.

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