Pregnancy symptoms you should never ignore

Even if you’ve read lots about pregnancy and spoken to others about your pregnancy symptoms, there will still be times when you wonder if what you’re feeling is normal or not.

Whether you’re 12 weeks or 37 weeks pregnant, some symptoms are the same. Treatment will likely depend on how far along you are. If you’re 37 weeks pregnant, symptoms not to ignore will be different from the ones that are a worry if you’re only 12 weeks along.

The following pregnancy symptoms should set off some alarm bells. If you have any of them you should call your midwife, OB-GYN, or family doctor straight away.

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 (Crafter and Brewster 2014)
• a stomach bug or appendicitis
• food poisoning

If you’re in the second half of your pregnancy, pain in your middle could mean pre-eclampsia (NICE 2019b). In this case you’ll need urgent medical checks.

I have a pain in my lower belly

Severe pain on either side, or both sides, of your lower belly needs checking to be sure it’s nothing serious. It’s likely to be nothing to worry about. You could have pulled or stretched a ligament (Crafter and Brewster 2014), which is common in pregnancy. Or, it could be a kidney infection or a urinary tract infection (UTI), which you can be treated for.

Less likely things it may be a sign of include:

• an ectopic pregnancy (RCOG 2016)
• miscarriage (Crafter and Brewster 2014)
• premature labour (Crafter and Brewster 2014)
• a fibroid breaking down and bleeding into itself (Crafter and Brewster 2014)
• placental abruption, which is when the placenta comes away from the lining of your womb (uterus) (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 or midwife the same day.

If your temperature is more than 39 degrees C, call your doctor or midwife straight away. You might well have an infection. They may prescribe antibiotics and rest. If your temperature rises above 39 degrees C for a long time it can be harmful to your baby (Dreier et al 2014).

My vision is blurred and I can 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 visual problems may be a sign of pre-eclampsia (NICE 2019b).

My hands and feet are swollen

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

I have a severe headache that won’t go away

If a bad headache lasts for more than two or three hours, and you have visual disturbances and severe swelling in your body, you may have pre-eclampsia (NICE 2019b). If pre-eclampsia occurs, it is usually in the second half of your pregnancy, or soon after your baby is born.

I have vaginal bleeding

Spotting or very light bleeding, without pain, is common in early pregnancy (AHS 2021). It often resolves itself and is not likely to harm your baby.

Even so, always check with your doctor or midwife if you spot or bleed at any stage during your pregnancy (NHS 2021b). It may suggest 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 (RCOG 2016).
• Heavy bleeding, combined with back pain or abdominal pain that does not go away. This may be a sign of miscarriage (NICE 2019).
• Sudden, painless bleeding. This may happen if you have a low-lying placenta (placenta previa) (NICE 2019b), which will have been seen at your 20-week scan.
• Fresh or dark bleeding, with or without clots, in later pregnancy could mean you have placental abruption (Gaufberg 2015). This is when the placenta starts to part from the wall of your uterus. Depending on the position and extent of the separation, it can cause either a small amount of bleeding or a gush, as well as some pain (Gaufberg 2015). You should call your doctor or midwife right away if this happens.
• Heavy bleeding may mean you’re going into premature labour if you’re less than 37 weeks pregnant (RCOG 2011a).

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 doctor or midwife (SOGC ndB) as this is an emergency.

You may need treatment if there are signs of an infection (RCOG 2019). Once your waters have broken, your baby is less protected against infection. Or you could already have an infection that has made your waters break. You may need to prepare for a premature birth (RCOG 2019). If you have a midwife, there are certain situations that trigger a transfer of care to a physician. It’s vital to make sure you and your baby get the right level of care.

When your waters break after 37 weeks you’re likely to go into labour within a day or so (NICE 2022). Call your midwife or OB-GYN to tell them what’s happened. You’ll probably be asked to go to hospital to be checked over, and to discuss the options if your labour does not start within 24 hours (AOM 2020).

I’m really thirsty

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

If you’re thirsty and peeing a lot more than usual, it could be a sign of gestational diabetes, although this often does not cause symptoms (NHS 2022).

Gestational diabetes can increase the risk of complications for you and your baby (NICE 2015). So, tell your doctor or midwife if your thirst levels increase all of a sudden.

I feel burning when I pee

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

• feel a painful or burning sensation when you pee
• have a frequent urge to pee, even if you’ve only just been, and may wet yourself when you get the urge
• pass cloudy, bloody, or smelly pee
• have nausea, tiredness, and cold sweats
• have a pain in your lower abdomen, or feel achy all over

If you have any of these symptoms then see your doctor or midwife. They can give you antibiotics to treat your UTI (Government of BC 2020).

I’m constantly vomiting

Vomiting more than a couple of times a day could dehydrate and weaken you, although it is unlikely to hurt your baby. You need to speak to your midwife or GP about severe and vomiting (hyperemesis gravidarum), especially if you cannot keep any food or drink down. You may need hospital treatment (Campbell et al 2016).

If you’re vomiting during the second half of your pregnancy, and you have severe pain just below the ribs and sudden severe swelling in your face, hands or feet, this may be a sign of pre-eclampsia (NICE 2019b).

Vomiting and diarrhea could be because of food poisoning or a stomach bug (NICE 2022).

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 or midwife (NHS 2021a).

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). That’s because the pregnancy hormone progesterone relaxes the walls of your blood vessels.

Many pregnant people feel dizzy, but if you faint you should contact your doctor or midwife afterwards, to make sure all is well (SOGC ndC).

My baby’s movements have slowed down

If you have noticed that your baby is moving about less than usual, contact your midwife or doctor, as it may mean they’re in distress. If you’re over 28 weeks, do this straight away (SOGC ndA). Read more about your baby’s movements, including when to seek help.

I itch all over

If you have severe itching all over, particularly at night, you may have obstetric cholestasis (OC) (Hobson et al 2022). Now more commonly known as intrahepatic cholestasis of pregnancy, it is a condition of the liver. You may get jaundice with it, which can make your urine dark and your poo paler than it tends to be (RCOG 2022).

If you have mild itching, try not to worry too much. Some itching is normal as your skin stretches to make space for your growing baby (Crafter and Brewster 2014).

It’s best to get intense itching checked out, though. 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 (Hobson et al 2022).

I fell and hit my belly

Falls or blows are not always a danger to the baby (Siddiqi et al 2022) but call your doctor or midwife on the same day and explain what happened.

If you slipped on the stairs and bruised your tailbone, there is no need to worry. Your baby is well cushioned by your uterus and amniotic fluid.

But blows to your abdomen are more likely to result in complications (Sakamoto et al 2019), as are injuries to your bones, tendons, or ligaments.

If you notice the injury has led to contractions, leaking fluid or any bleeding, call your doctor or midwife right away, or go to your nearest emergency department.

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. If there’s a problem, you’ll get help right away. If nothing’s wrong, you’ll go home feeling less worried.

Your doctor or midwife expects to get calls like these and they will be happy to give you advice. Your body is changing so fast that it can be tough to know if what you’re feeling is normal, or if it’s something to worry about.