Pregnancy symptoms you should never ignore

Even if you’ve read lots about pregnancy and spoken to other mums about your pregnancy symptoms, there will still be times when you wonder if what you’re feeling is normal or not. Certain pregnancy symptoms should set off a few alarm bells though. If you experience any of them you should call your midwife, doctor, or your maternity unit straight away. Add the number of your maternity unit to your phone contacts so you can speak to a midwife without delay if you need to.

Be especially aware of unusual symptoms if you’re Black or have Asian ethnicity as in the UK you’re more likely than White mums to develop some pregnancy complications. Sadly, you’re also more likely to suffer serious outcomes. Remember though that while your risk is greater, it’s still low (MBRRACE-UK 2021).

Experts say there are complex reasons for this. For example, research shows that you’re less likely to feel that your concerns are taken seriously by health professionals. This means it’s really important to make sure you know the health complications to watch out for during pregnancy and to get help straight away. We’ve listed the conditions that you’re more likely to develop if you’re Black or have Asian ethnicity. You'll also find their symptoms detailed further down (MBRRACE-UK 2021).

• ectopic pregnancy
• miscarriage
• pre-eclampsia
• premature labour
• fibroids
• placental abruption
• gestational diabetes

I have a pain in my middle

Severe or sharp pain in your middle or upper tummy, with or without nausea or vomiting, could mean one of several things. You could have:

• severe indigestion
• heartburn
• a stomach bug
• food poisoning
  (NICE 2017)

If you’re in the second half of your pregnancy, pain in your middle, usually just under your ribs, could indicate severe pre-eclampsia (August and Sibai 2019, NICE 2019a). This is a serious condition for which you'll need immediate medical help.

Pre-eclampsia comes with other symptoms too, which are explored more in our pre-eclampsia content and also detailed under the relevant headings in this article.

I have a pain in my lower belly

Severe pain on either side or both sides of your lower belly needs investigating, to be sure it’s nothing serious. You could have pulled or stretched a ligament (Aguilera 2018, NHS 2018a), which is common in pregnancy.

Conditions that may cause stomach pain, and need to be checked urgently, include:

• Ectopic pregnancy. Symptoms typically appear between four weeks and 12 weeks of pregnancy (NHS 2018a, RCOG 2016a).
• Miscarriage. Cramping pains and bleeding before 24 weeks of pregnancy (NHS 2018a, RCOG 2016b).
• Pre-eclampsia. It typically starts after 20 weeks or just after the baby is born (NHS 2018a).
• Premature labour. If you're less than 37 weeks pregnant and you’re having regular abdominal cramps or tightenings, call your midwife straightaway (NHS 2018a, NICE 2015a).
• Fibroids. These may cause abdominal pain at any point during pregnancy (NHS 2018b, Todd 2018a).
• Placental abruption. This is a serious condition when the placenta separates from the lining of your womb (uterus). It is most likely to happen in late pregnancy and means your baby may have to be delivered urgently (NHS 2018c, Gaufberg 2015).

I have a fever

If you have a fever and your temperature is above 37.5 degrees C, but with no cold symptoms, call your doctor the same day (Tommy's 2018).

If your temperature is more than 39 degrees C, call your local maternity unit straight away (Todd 2018b). You probably have an infection which may need treating urgently with antibiotics. If your temperature rises higher than 39 degrees C for a long time it may be harmful to your baby (Dreier et al 2014).

My vision is blurred and I see flashing spots

Call your doctor or midwife if, in the second half of your pregnancy, your eyesight is affected by:

• double vision
• blurring
• dimming
• flashing spots or lights before your eyes

These may be symptoms of pre-eclampsia (August and Sibai 2019, NICE 2019a).

My hands and feet are swollen

Swelling or puffiness (oedema) in your hands, face and eyes is common in late pregnancy (NHS 2018d). In most cases, it’s not a cause for concern (NHS 2018d). But if your swelling comes on suddenly, or has become more severe, and you have a headache or problems with your vision, you may have pre-eclampsia (NHS 2018d, NICE 2019a). If you notice any of these symptoms, call your doctor or midwife straight away.

I have a headache that won’t go away

If your headache doesn’t stop or is recurring, and you have visual disturbances and sudden swelling in your body, you may have pre-eclampsia (August and Sibai 2019, NICE 2019a). If pre-eclampsia occurs, it is usually in the second half of your pregnancy or soon after your baby is born (August and Sibai 2019, NICE 2019a).

My leg feels tender and swollen

Pain, tenderness or swelling in your leg could be a sign of a clot or deep vein thrombosis (DVT) (NICE 2018a, RCOG 2015). This is more common in the left leg during pregnancy than the right (Malhotra and Weinberger 2018). Other signs of DVT include red or discoloured patchy skin. The area may feel warm and veins may look larger than normal (NICE 2018a).

I have vaginal bleeding

Spotting or very light bleeding with or without pain is common in early pregnancy (Norwitz and Park 2019). Light bleeding in very early pregnancy usually resolves itself and is unlikely to harm your baby (NHS 2018e, Norwitz and Park 2019).

Even so, always check with your doctor or midwife if you bleed at any stage during your pregnancy (NHS 2018e, RCOG 2011a). It may indicate a serious complication if it is:

• Bleeding that’s different from your normal period, so lighter in flow or darker in colour than usual. This, with severe, persistent, one-sided pain in your tummy, may be a sign of an ectopic pregnancy (NHS 2018e, RCOG 2016a).
• Heavy bleeding, combined with persistent back pain or abdominal pain. This may be a sign of miscarriage (NHS 2018e, NICE 2019b).
• Sudden, painless bleeding. This may happen if you have a low-lying placenta (placenta praevia) (NHS 2018e, RCOG 2018), which will have been seen at your 20-week scan (RCOG 2018).
• Sudden light to heavy bleeding in later pregnancy could mean you have placental abruption (Ananth and Kinzler 2019, RCOG 2011a). This is when the placenta starts to separate from the wall of your womb. Depending on the position and extent of the separation, it can cause either a small amount of bleeding or a gush, as well as pain and tenderness (Ananth and Kinzler 2019, Gaufberg 2015).
• Heavy bleeding, or the mucus plug coming away (bloody show) may mean you’re going into premature labour, if you’re less than 37 weeks pregnant (NICE 2015a, RCOG 2011a).

Bleeding in the last trimester may be less of a concern if it only happens after sex or you're past 37 weeks and it's part of the mucus plug coming away. However, you must call your midwife straightaway if the bleeding is sudden, bright red or heavy (NHS 2018e, RCOG 2011a).

Find out more about bleeding in the later stages of pregnancy.

I’m leaking fluid from my vagina

If you are leaking fluid from your vagina before 37 weeks it may mean that your waters have broken early. Contact your maternity unit so that a doctor or midwife can check on your baby’s health (RCOG 2019). You may need treatment if there are signs of an infection (RCOG 2019).

Once your waters have broken, your baby has less protection against infection. Or you could already have an infection that has made your waters break (RCOG 2019). You may need to prepare for a premature birth (RCOG 2019). You’ll have a specialist team on hand in the hospital to make sure you and your baby get the right care.

When your waters break after 37 weeks, you’re likely to go into labour within the next day or so (NICE 2014). Call your midwife or maternity unit to tell them what’s happened. You’ll probably be asked to go to hospital to be checked over, and to discuss what’s best to do if your labour doesn’t start within 24 hours (NICE 2014).

It's normal to have plenty of clear or milky white vaginal discharge during pregnancy and a show as the mucus plug comes away towards the end of your pregnancy (NHS 2018f). However, thick, white discharge with itching or irritation around your vagina could be a sign of thrush (NHS 2018f). While discharge that becomes smelly or a green or yellow colour could indicate an infection (NHS 2018f), such as bacterial vaginosis.

I’m suddenly really thirsty

If you’re suddenly thirsty, and your wee is dark yellow, it could be a sign of dehydration (BDA 2017, RCOG 2016c). You need to drink more fluid when you’re pregnant.

If you’re thirsty and weeing a lot more than usual it could be a sign of gestational diabetes, although this often doesn’t cause symptoms (NHS 2019a).

Gestational diabetes can increase the risk of complications for you and your baby (NHS 2019a, NICE 2015b), so tell your doctor or midwife.

I feel a burning sensation when I wee

You may have a urinary tract infection (UTI) if you:

• feel a painful or burning sensation when weeing
• have a frequent urge to wee, even if you’ve only just been, and may be wetting yourself when you get the urge
• pass cloudy, bloody or smelly wee
• have a fever, pain in your abdomen, back or sides, and shivers
  (NICE 2019c)

If you have any of these symptoms, see your doctor, as she can give you antibiotics to treat your UTI (NICE 2019c).

I’m constantly vomiting

Vomiting more than a couple of times a day could dehydrate and weaken you, although it’s unlikely to hurt your baby. You need to speak to your midwife or GP about severe and persistent vomiting (hyperemesis gravidarum), especially if you can’t keep down any food or drink. You may need treatment, possibly in hospital (NICE 2018b, RCOG 2016c).

If you’re vomiting during the second half of your pregnancy, you may also have severe pain just below the ribs, and sudden swelling in your face, hands or feet. These symptoms may be a sign of pre-eclampsia (NHS 2018g, NICE 2018b).

Vomiting and diarrhoea could be a sign of food poisoning or a tummy bug (NICE 2019d).

If you’re vomiting, feverish and have pain in your side, lower back or around your genitals, it could mean you have a kidney infection. If you have these symptoms you should contact your doctor (NHS 2018h, NICE 2018b).

I feel faint and dizzy

Fainting or feeling light-headed may be a sign that you haven’t eaten enough that day. But it could also mean that you have low blood pressure, which is common in early pregnancy (Marks 2019, Stöppler 2016). That’s because the pregnancy hormone progesterone relaxes the walls of your blood vessels (Stöppler 2016).

Many women feel dizzy during pregnancy, but if you faint you should see your doctor afterwards to make sure all is well.

My baby’s movements have changed

If you are between 24 and 28 weeks and you’ve noticed that your baby’s pattern of movements have changed, contact your midwife or hospital, as it may mean they're in distress. If you’re over 28 weeks, do this immediately, day or night (RCOG 2012a). Read more about your baby’s movements, including when to seek help if you haven’t felt your baby move yet.

I itch all over

If you have severe itching all over, particularly at night, you may have obstetric cholestasis (OC) (NICE 2015c, RCOG 2012b). OC is a condition of the liver. You may develop jaundice with OC, which can make your wee dark and your poo paler than usual (NICE 2015c, RCOG 2012b).

If you have mild itching, try not to worry too much. Some itching is normal and may be caused by pregnancy hormones (NHS 2019b). Or it may be caused by your skin stretching to accommodate your growing baby (NHS 2019b).

However, it’s best to have intense itching checked out. This is especially the case if the itching is worse at night and centres on the soles of your feet and the palms of your hands (NHS 2019b, RCOG 2012b).

I fell and hit my belly

Falls or blows aren’t always dangerous, but always call your doctor or midwife straight away to explain what happened (Kilpatrick 2019, Krywko and Kiel 2017).

If you had a light fall and didn't bump yourself hard, such as a slight slip on the stairs, you probably don’t need to worry (Krywko and Kiel 2017, Nall 2016). Your baby is well cushioned by your womb and amniotic fluid.

However, blows to your abdomen may result in complications, such as bleeding (Kilpatrick 2019, NHS 2018c, RCOG 2011a) .

If you've bumped your head or chest in a fall or you think you might have sprained or fractured something, this also needs checking out (Nall 2016).

If you notice contractions, leaking fluid, changes in your baby's pattern of movements or any bleeding, call your doctor or midwife right away, or go to your nearest accident and emergency department (A&E) (Kilpatrick 2019, Sakamoto et al 2019).

I just don’t feel right

If you’re not sure about a symptom, don’t feel like yourself, or simply feel uneasy, trust your instincts and call your doctor or midwife (Todd 2018b). If there’s a problem, you’ll get help right away. If nothing’s wrong, you’ll go home reassured.

Your doctor or midwife expects to get calls like these, and will be happy to give you advice. Your body is changing so rapidly that it’s sometimes difficult to know if what you’re experiencing is normal, or if it’s something to worry about.

Discover how to cope with these other pregnancy aches and pains:

• swelling
• heartburn
• pelvic pain