How do you know whether that sudden ache is normal or warrants a 2 a.m. call to your doctor or midwife? Here's a rundown of symptoms that should set off your warning bells. But even if you don't see your symptom on this list, it's better to err on the side of caution and make that call than to agonize for hours, wondering whether you've pulled a ligament or gone into preterm labor.
Note that some of these symptoms may be more or less urgent depending on your particular situation or health history and on how far along you are in your pregnancy. Ask your practitioner to review with you which signs warrant an urgent call at various points in your pregnancy.
• Your baby is moving or kicking less than usual (once he begins moving regularly). Ask your caregiver if you should monitor your baby's activity by doing daily "kick counts." She can give you specific instructions on how to count and when to call.
• Severe or persistent abdominal pain or tenderness.
• Vaginal bleeding or spotting.
• An increase in vaginal discharge or a change in the type of discharge — that is, if it becomes watery, mucousy, or bloody (even if it's only pink or blood-tinged). Note: After 37 weeks, an increase in mucus discharge is normal and may indicate that you'll be going into labor soon.
• Pelvic pressure (a feeling that your baby is pushing down), lower back pain (especially if it's a new problem for you), menstrual-like cramping or abdominal pain, or more than four contractions in an hour (even if they don't hurt) before 37 weeks.
• Painful or burning urination, or little or no urination.
• Severe or persistent vomiting, or any vomiting accompanied by pain or fever.
• Chills or fever of 100 degrees Fahrenheit or higher.
• Visual disturbances such as double vision, blurring, dimming, flashing lights, or "floaters" (spots in your field of vision).
• Persistent or severe headache, or any headache accompanied by blurred vision, slurred speech, or numbness.
• Any swelling in your face or puffiness around your eyes, anything more than a little swelling in your hands, severe and sudden swelling of your feet or ankles, or a rapid weight gain (more than 4 pounds in a week).
• A persistent or severe leg cramp or calf pain that doesn't ease up when you flex your ankle and point your toes toward your nose or when you walk around, or one leg being significantly more swollen than the other.
• Trauma to the abdomen.
• Fainting, frequent dizziness, a rapid heartbeat, or heart palpitations.
• Difficulty breathing, coughing up blood, or chest pain.
• Severe constipation accompanied by abdominal pain or severe diarrhea that lasts more than 24 hours.
• Persistent intense itching of your torso, arms, legs, palms, or soles, or a feeling of itchiness all over your body.
• Any health problem that you'd ordinarily call your practitioner about even if it's not pregnancy related (like worsening asthma or a cold that gets worse rather than better). Just call a little sooner than you would normally.
If you're not sure whether a symptom is serious, you don't feel like yourself, or you're uneasy, trust your instincts and call your healthcare provider. Your practitioner expects such calls. If there's a problem, you'll get help right away. If nothing's wrong, you'll be reassured.
Your body is changing so rapidly that it's hard to know whether what you're experiencing is "normal." Do yourself and your baby a favor and get any unusual symptoms checked out.
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