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Learn the signs worth sharing with your healthcare provider

By Joelle Klein

With so many changes happening to your body during pregnancy, it can be hard to know which symptoms are normal and which aren’t. Some might need immediate attention, others are nothing to worry about, and still more need to be watched. Most symptoms vary in severity; if you’re ever unsure, a quick call to your healthcare provider is always warranted and should be well received, no matter what the time of day. 

“Every ob/gyn office should have someone on-call 24/7,” says ob/gyn Michelle Sang, MD, so talk to your provider at your next visit about what to do if you have a question after hours. Then keep this list handy to help you sort out your symptoms:

Call your healthcare provider right away IF:

• What looks like water is leaking from your vagina and the leaking is ongoing, especially in your second or third trimester. “It could be amniotic fluid,” says Sang.
• You notice bleeding that’s bright red and heavy, similar to a period.
• You have sudden or severe swelling of the hands and/or face, which could be a sign of preeclampsia, a serious blood pressure disorder in pregnancy.
• You have headaches in your third trimester that don’t improve by taking Tylenol or trying other remedies, and are associated with swelling of the hands and face, nausea, upper abdominal pain and visual disturbances (blurred vision, or seeing spots or “floaters”).
• You can’t keep fluids down, have lost weight, or aren’t peeing or making tears due to excessive vomiting and nausea. “Fluids are more important than solid food,” warns Sang.
• You have thoughts of suicide or of harming yourself or your baby.
• Your baby is moving less than usual. Not sure? Learn how to count kicks and record them here. 
• You have chest pain. Although it could be heartburn or sore muscles, it could also be a lung infection or a blood clot in your lung. You’re a greater risk of a blood clot when you’re pregnant.

Call that day or the next morning IF:

• You notice brown discharge or red spotting on your underwear. “Spotting, especially after intercourse, is common but should still be reported,” explains Sang.
• You experience cramping that doesn’t improve with rest or is accompanied by nausea and vomiting. 
• You experience burning sensation, discomfort or pain with urination. It’s most likely a urinary tract infection (UTI), which is common during pregnancy. “A UTI puts you at risk for kidney problems or preterm labor and so it must be treated right away,” says midwife Paula Giblin, MS, CNM.
• You have more than one episode of blurry vision or see floaters. “Corneal swelling in pregnancy is common and may cause changes in visual acuity that go away postpartum,” explains Sang. But consistent blurry vision or more severe vision changes may be signs of preeclampsia.  
• You have calf pain and swelling. Swelling in your legs is common, especially as you get closer to giving birth. But if there’s tenderness or redness, or one leg is more swollen than the other, there’s a chance it could be a blood clot. (These are very rare, affecting less than 1% of pregnant women, but need prompt treatment.) 
• You have a temperature over 100.4° F. Most likely it’s just a cold and won’t require medical attention. “If you feel a cold coming on, or a sore throat along with your fever, chances are you have a cold and should treat it as such,” says Giblin. You can take Tylenol if you have a fever.

Wait a day or two to call your healthcare provider, and only when symptoms persist or worsen, IF:

• You have a headache. Headaches are common in the first half of pregnancy due to rising estrogen levels. It’s best to use Tylenol or a little caffeine and rest to treat them.
• You have minor cramping. “Most often it is round ligament discomfort or growing pains,” says Sang. 
• You have mild nausea or occasional vomiting. Morning sickness doesn’t happen just in the morning and can last into the second trimester — and sometimes even throughout all trimesters.
• Your vision changes slightly or your eyes become dry and irritated. These symptoms can be a result of that temporary corneal swelling, a normal pregnancy side effect. If you have contacts, try wearing your glasses instead. 
• You feel dizzy. Pregnancy hormones, low blood pressure, low blood sugar, or changes in circulation related to posture are most likely the culprit. If you experience dizziness that won’t go away, accompanied by other symptoms such as bleeding or severe headaches, call your provider right away.

Pay attention to symptoms you can’t ignore; they’re likely your body trying to tell you something. You can track your symptoms in the I’m Expecting app (for Android and iOS) using the Pregnancy Diary, which you can find by hitting the plus button on the Home screen.

Published on November 18, 2015.

Joelle Klein is a Denver-based health and lifestyle writer and mother of two.