As your body changes while growing a baby, you may experience twinges or feel surprising sensations. Most symptoms are perfectly normal and mean your body is doing precisely what it’s supposed to do. But sometimes, symptoms should be accompanied by a call to your OB or midwife – be it during or after hours.
Your provider, who will get to know you quite well during your pregnancy, will advise on next steps and make sure that you and your baby stay healthy and safe.
Dr. Louise Carroll, an obstetrician and gynecologist at Rochester Regional Health’s Rochester General Hospital reviews the warning signs to watch for and when to call your provider.
Symptoms to watch
Your body is busy every second of your pregnancy. It’s changing in a million ways; some that you can see, and some you cannot. It’s important to remind yourself to relax – most pregnancies go smoothly.
Complications do occur for some women, and it’s a good idea to know what those complications may look and feel like. These warning signs or symptoms should not be ignored, and you should call your provider if you experience them. And, remember – we are your team throughout your pregnancy. If you have concerns or questions, you can always call and talk through them!
Abdominal pain
If sharp cramps on one side of your stomach occur in early pregnancy before you’ve had an ultrasound, your OB will want to rule out an ectopic pregnancy, which is when a pregnancy has implanted in your fallopian tube instead of your uterus.
Abdominal pain is typical later in your pregnancy, too. It is common to experience gas and pain that is associated with normal uterus growth, and your ligaments stretching. But pain that persists, gets worse, or includes bleeding may be cause for concern. If you are experiencing intense, recurring pain, call your provider.
When to watch for abdominal pain: during the first trimester and the final weeks of your pregnancy
Early contractions
Early contractions can be a sign of preterm labor. If you start feeling them when you’re 24 to 36 weeks pregnant, please call your provider. They may be Braxton Hicks contractions (which are harmless and normal), but your OB or midwife will be able to advise.
When to watch for early contractions: between weeks 24 and 36 of your pregnancy
Extreme vomiting
Morning sickness is a normal and expected symptom of pregnancy. But, if you are unable to keep liquids down and are not urinating, you should call your provider immediately. Extreme vomiting can lead to severe dehydration, which is not good for your baby or you.
If you are struggling to keep food down, if you think you have food poisoning, or if you have a high fever, you should also let your provider know immediately. In some cases, you may need to go to the hospital for IV fluids. Your OB or midwife will let you know what is best for you and your health.
When to watch for extreme vomiting: between weeks 4 and 20 of your pregnancy
Fever
Your baby’s growth and development depend on your body maintaining a healthy, steady temperature. A disruption in temperature can cause miscarriage. If you experience a fever over 101 degrees Fahrenheit, call your OB or midwife immediately.
When to watch your temperature: in the first trimester
Itching
Mild itching while pregnant is normal, but severe itchiness can be a sign of something else called cholestasis of pregnancy. Cholestasis is a typically harmless liver ailment that needs to be monitored by your doctor. It can lead to preterm birth in extreme, untreated cases, so be sure to call your provider if your itchiness is severe and persistent.
When to watch for itching: during the third trimester
Lack of fetal movement
Each pregnancy is different and each baby will move differently – in frequency, type of movement, and position in the uterus. The ideas of counting 10 movements in 2 hours, and drinking juice or cold water to induce movement are myths. Instead, simply note how long it takes for your baby to move 10 times. Note how strong those movements are and the time of day it is occurring, and whether your baby responds to sounds or gentle pokes.
Once you are aware of a consistent amount of time for those movements, keep that timeframe in mind. Avoid using a home Doppler for reassurance. If that frequency changes or you do not feel any movement for 90 minutes, contact your OB provider.
When to watch your baby’s movement: during your third trimester
Leg pain
Pregnancy–specifically your hormonal changes–puts you at a much higher risk for blood clots, especially deep vein thrombosis (DVT). The pressure of your growing uterus can also impede circulation, causing blood to pool in your legs and your feet.
Women who are predisposed to clotting, and those who are older or overweight are at a higher risk for DVT. If you are put on bed rest during your pregnancy, your provider may recommend compression socks or heparin to promote circulation. Staying active and well-hydrated may help prevent clots.
Leg cramps and swelling are common throughout pregnancy, but DVT often only affects one leg, and makes that leg red, painfully swollen, and warm to the touch. If you experience shortness of breath, chest pain, or a rapid heart rate, please call 911.
When to watch for leg pain: throughout your pregnancy
Severe headache
Many people suffer from occasional headaches, including pregnant women. But, if your headache is persistent or severe, you should call your doctor.
Severe headaches may be accompanied by dizziness, fainting, or blurred vision. Sit somewhere comfortable, if you’re feeling faint, and have someone stay with you while you talk to your OB or midwife about next steps. Severe headaches during your second or third trimester may be a sign of preeclampsia.
Other signs of preeclampsia include:
- Abdominal pain, especially on the right side
- Blurred vision
- Excessive swelling of face, feet, or hands
- Flu-like achiness, but with no runny nose or sore throat
- Abnormally rapid weight gain
When to watch for headaches and preeclampsia: after you’ve reached 20 weeks
Vaginal bleeding
Vaginal bleeding is common while pregnant, especially during the first trimester. Nearly 25% of women have spotting or heavier bleeding in their first 13 weeks (give or take a few).
If you are experiencing cramping and bleeding during your first trimester, it may be a sign of miscarriage. It’s also possible that your egg is implanting in the lining of your uterus, or that you’re experiencing cervical polyps or cervical bleeding. Be sure to call your provider’s office and give them as much information as you can so they can recommend next steps.
Bleeding during pregnancy is cause for concern during the second and third trimesters, as well. Sometimes, it’s caused by a placenta tear or another problem that can be diagnosed by an ultrasound. If you notice bleeding — beyond spotting — at any time during your pregnancy, call your doctor immediately.
When to watch for bleeding: anytime throughout your pregnancy
Watery discharge
When you’re nearing the end of your pregnancy, discharge can mean that your water has broken. If you suddenly experience a gush of fluids or an increase in discharge before 37 weeks, please call your OB or midwife immediately. This can be a sign that your amniotic sac has ruptured, but it isn’t always cause for concern. Your provider will ask you questions and learn more before they advise next steps.
When to watch for increased discharge: between weeks 24 to 36 of pregnancy
What to say when you call
It’s possible you will encounter your provider’s answering service if you call after hours. They triage calls and will get you in touch with your provider if next steps are necessary. Be prepared to tell them your name, your due date, the symptoms you’re experiencing and for how long you’ve been experiencing them, and the name of your doctor or midwife.
Other symptoms to monitor
You’ll be seeing your OB or midwife often throughout your pregnancy. The following symptoms are common, but should be mentioned when your provide asks you how you are doing. Of course, if these concerns worry you at any time, you are welcome to reach out and raise your concerns with your provider.
Confusion and forgetfulness
You may find yourself extra forgetful during your third trimester, which is completely normal. Utilizing stress-relief techniques and asking your support network for help can go a long way in easing any lingering anxiety.
Constipation
Constipation is a common pregnancy complaint, and is typically caused by the slowing down of your intestinal muscles and your baby pressing down on your rectum. Additionally, the iron found in prenatal vitamins or iron supplements can cause you to become constipated.
If you’re experiencing constipation, drink more fluids, increase your fiber intake, and exercise if you can. If your constipation persists, bring it up at your next prenatal appointment.
Fatigue
Your body is very busy growing a baby, and being more tired than normal is quite common. Energy levels will change throughout your pregnancy, and it’s very important to rest when you need it. You may not be able to do everything you could pre-pregnancy, and that is to be expected.
Mood swings
Changes in sleep patterns and eating habits can affect your emotional state. Sometimes a pregnant woman’s feelings can change rapidly, running the gamut of happy to sad within a matter of minutes. Just remember that any fears or concerns are perfectly normal and valid, and sharing those with your support network can help.
Nightmares or vivid dreams
Vivid or scary nightmares are common during your pregnancy. Pregnant women report an increase in random, but very life-like dreams, caused by changing hormones. Typically, this increase in dreams and nightmares subside once pregnancy is over.
If you have questions or concerns during your pregnancy, ask your provider! We are here to help you have the safest, healthiest pregnancy possible, and are honored by your decision to partner with us. If you chose to do your own research, please remember to use reputable, scientific journals and trusted sources.