At 28 weeks pregnant with twins, your babies are growing and you’re probably experiencing a number of late pregnancy symptoms. Pregnancy symptoms at this time include Braxton Hicks contractions, varicose veins and spider veins, constipation, hemorrhoids, weight gain, and heartburn. Your babies’ movements may start to feel a little different since they have less room to move around as your pregnancy progresses. Fetal development at this stage includes brain change and development, the formation of sleep cycles and startle reflexes, smoother skin, and surfactant production in the lungs.
At 28 weeks pregnant with twins, you are in the third and final trimester of pregnancy! You may be feeling uncomfortable and possibly have some new symptoms as your belly grows with your growing babies. Twin development this week is very important as you head into the final trimester of pregnancy.
At 28 weeks pregnant, symptoms include Braxton Hicks contractions, varicose veins and spider veins, constipation, hemorrhoids, weight gain, back and body aches, and heartburn. You should still be feeling your babies move, although it may feel a bit different, since they have less space now. Here are some of the other symptoms you can expect:
In the third trimester, you might be feeling some Braxton Hicks contractions, also known as false labor. Braxton Hicks feel like contractions but are irregular and don’t actually mean you’re in labor. They might feel like cramps or a tightening sensation in your uterus. If you feel contractions, take a break and rest, put your feet up, or take a bath and stay hydrated if you can. If they slow down or stop, it’s very likely Braxton Hicks. You’re more likely to feel Braxton Hicks when active, dehydrated, or when it’s hot.
You may have tiny red veins at the top of your skin – called spider veins, or spider angiomas – on your face, neck, and arms. This is caused by hormones like estrogen, and the redness will probably fade after you deliver your babies.
You could get varicose veins, or veins that become swollen and blue, on your legs. This is caused by decreased blood flow to your legs because of the weight of your uterus. Varicose veins typically improve after delivery. You can prevent the intensity of varicose veins by getting up and moving around if you sit or stand in one place for a long time, not sitting with your legs crossed for too long and putting your feet up when you can. Exercise, elevating your legs, avoiding tight clothes, and wearing support hose can all help with the discomfort.
Hemorrhoids are swollen blood vessels on the rectum and anus that can be painful and uncomfortable. They can be caused by constipation and straining to have a bowel movement, or simply by the weight of the uterus on your pelvis. Trying your best to prevent constipation, but doing things like eating high fiber foods, drinking plenty of water, walking, and exercising – can prevent hemorrhoids or at least prevent them from getting worse. If you do have hemorrhoids, you can talk to your doctor to learn other ways to get relief.
You should be able to continue feeling your babies move, although their movement might not feel as strong since they don’t have as much room as they did before. Your provider may suggest keeping a daily count of how often your babies move and advise you to call them if you haven’t felt movement in two hours or so.
In the third trimester of pregnancy, you may be gaining over one pound a week. The general recommendation is to gain anywhere between 35-54 pounds total during a twin pregnancy, but this recommendation varies based on your pre-pregnancy weight. Your provider can help walk you through healthy habits and suggestions for achieving healthy weight gain for your pregnancy specifically and may refer you to a dietician.
Maintaining a healthy diet is important so that you get all the nutrients you need to help with healthy weight gain and your babies’ growth and development.
You will most likely feel back pain and body aches once you hit the third trimester of pregnancy (if you haven’t experienced it already!). This is because of your growing belly and the strain it puts on your back, and the fact that your spine is likely curved with your growing belly. Back and joint pain can also be due to rising levels of progesterone that continues until delivery, which can also loosen up your joints.
Heartburn is caused by slowed digestion and a relaxed esophageal sphincter due to an increase in progesterone. As your uterus expands in the third trimester, it may push against your stomach and make heartburn worse.
At this point in your pregnancy, your twins are continuing to grow, although twin fetal growth starts to slow at this time in comparison to a single pregnancy since they have less room in your uterus. Your babies will start to open and close their eyes during this time, their brain will continue to develop, their sleep cycles and their startle reflexes are continuing to take shape, among many other things.
Your uterus is continually expanding as your babies grow and this week is no different. Because your uterus is taking up so much space, it could be crowding all of your other organs, too, like your bladder.
This week, your twin’s eyelids open for the first time since they were formed, so they can now open and close their eyelids and react to light. At this point in pregnancy, your babies spend a lot of time in the REM (rapid eye movement) sleep cycle, which is a more wakeful state of sleep.
Your babies have now developed the startle, or moro, reflex. When they hear a loud noise, or after birth if they feel a falling sensation, they will automatically respond with the startle reflex. Usually the startle reflex causes them to throw their head back while their arms and legs fly out then come back in, and is part of the reason why newborn babies are more content in a swaddle.
Your babies’ skin is no longer transparent, although it is still very delicate. It smoother and less wrinkled as fat develops underneath.
Surfactant is a substance that keeps the lungs inflated. Once surfactant has developed, your babies have a much greater chance of surviving outside of the womb if they were to be born early.
Surfactant production makes this week very important, as it is a key component to a baby being able to breathe and survive outside of the womb. This makes 28 weeks another milestone of viability. If your babies were born at 28 weeks, they would still need a lot of medical care and have to spend some time in the NICU, but they’d have a better chance of survival than in past weeks.