Claire Dawson
Pregnancy is a delicate time, and it's important to know when to seek medical attention. While it's normal to experience some discomfort during pregnancy, certain symptoms may indicate a more serious issue that requires immediate medical attention. Pregnant women should be aware of the common pregnancy-related concerns and when to visit a hospital or emergency department (ED). This includes recognizing symptoms such as vaginal bleeding, abdominal pain, nausea, vomiting, contractions, and other warning signs that may require urgent care or a hospital visit. Knowing when and where to seek medical attention during pregnancy can save time, money, and potential health complications for both mother and child.
| Characteristics | Values |
|---|---|
| When to visit a hospital | If you have a health care emergency during pregnancy, time is of the essence. |
| If you have a history of complications such as preeclampsia, pre-term labor, pre-term birth, or heavy bleeding, it is best to rest and stay close to the provider who knows you best. | |
| If you experience abdominal pain, nausea or vomiting, constipation, vaginal bleeding or leakage, contractions, and painful or frequent urination, these could indicate pregnancy-related concerns. | |
| If you are experiencing a life-threatening emergency, call 911. | |
| If you have a fever, it is recommended to get tested for COVID-19 first. If negative, you can be seen at urgent care or the emergency department. | |
| If you are in your last trimester, it is best to avoid travel, especially flying. | |
| If you are in active labor, go to the hospital. |
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What You'll Learn
When to go to the emergency room
Pregnancy is a delicate time, and it is understandable that any symptom or issue may cause concern. However, it is important to know when to seek emergency care and when to opt for urgent care or a visit to your OB/GYN.
Firstly, it is recommended that you identify hospitals along your route and at your destination, especially if you have a history of complications. This will save time and reduce stress if you need to seek medical care while travelling.
Now, here are some situations that warrant a trip to the emergency room:
- If you are experiencing a life-threatening emergency, call 911 or visit the nearest emergency room. This includes symptoms such as severe bleeding, severe abdominal pain, severe nausea or vomiting, fast or irregular heartbeat, severe constipation, confusion, drowsiness, dehydration, and high fevers. These symptoms may indicate a health emergency such as preeclampsia, miscarriage, or even a heart attack or stroke.
- If you are in active labour, with contractions occurring every five to ten minutes for one hour, especially if this is not your first baby, head to the hospital.
- If your water breaks or you are leaking fluids, contact your prenatal care provider immediately and follow their guidance.
- If you experience any vaginal bleeding, notify your doctor. Heavy bleeding could indicate a serious complication such as a miscarriage, ectopic pregnancy, or placental abruption. Light spotting can be normal, but regular bleeding can lead to issues like anemia if left untreated.
- If you are feeling dizzy or faint during pregnancy, it could be a sign of preeclampsia or an issue with your blood sugar levels. Fainting during pregnancy has been linked to an increased risk of preterm births and heart problems in babies.
- If you have a fever, especially over 100 degrees Fahrenheit, and it is accompanied by other symptoms such as cramping, nausea, abdominal pain, or spotting, go to the emergency room. Studies suggest a sustained fever during pregnancy may increase the chance of miscarriage.
Remember, if you are unsure or concerned about your health or that of your baby, always seek medical advice promptly.
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Vaginal bleeding
Some possible causes of vaginal bleeding during pregnancy include a sensitive cervix, infection, or miscarriage. Bleeding can also be caused by implantation, which is when the fertilized egg implants in the wall of the uterus. Hormonal changes can also lead to spotting, as the extra hormones required for pregnancy can cause the cervical lining to bleed more easily. Ectopic pregnancy, when the fertilized egg develops outside the uterus, can be life-threatening and requires immediate medical attention. Molar pregnancy, a rare condition where a tumor forms instead of a fetus, is another potential cause of vaginal bleeding. Placenta previa, a condition where the placenta obstructs the cervical outlet to the vagina, is also a serious condition that requires immediate medical attention.
While light bleeding or spotting during pregnancy can be a normal symptom, it is always recommended to contact a healthcare provider to rule out any potential complications. They may advise rest and monitor you and your baby to ensure a healthy pregnancy. Your doctor may recommend a vaginal or pelvic examination, an ultrasound scan, or blood tests to determine the cause of the bleeding.
If you experience heavy vaginal bleeding, it may be necessary to go to the hospital or undergo a surgical procedure. If something other than blood is passing, contact your healthcare provider immediately.
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Severe nausea or vomiting
Nausea and vomiting during pregnancy, often known as morning sickness, is very common in early pregnancy. Morning sickness is extremely common during pregnancy, with about 70% to 80% of women experiencing it. It can affect you at any time of the day or night, or you may feel sick all day long. Morning sickness is unpleasant, and can significantly affect your daily life, but it usually clears up by weeks 16 to 20 of your pregnancy and does not put your baby at any increased risk.
However, in some cases, morning sickness can become more severe, developing into hyperemesis gravidarum (HG). This is a severe form of pregnancy sickness that can be serious. It is characterised by excessive nausea and vomiting, causing you to be sick many times a day and be unable to keep food or drink down. This can lead to weight loss and dehydration, which can impact your health and that of your baby. HG can make you feel very unwell, and if left untreated, can cause rare complications like fetal growth restriction, malnutrition, and oesophageal tears, among other things.
If you are experiencing severe nausea and vomiting, you should contact your midwife, doctor, or hospital as soon as possible. You may need to be admitted to the hospital to receive treatment and protect the health of you and your baby. Treatment can include intravenous fluids (IVs), which are given directly into a vein through a drip, to restore hydration. Anti-nausea medications can also help relieve vomiting, and in very severe cases, nutrients may be administered through IVs. If you continue to lose weight, a feeding tube may be recommended to ensure that you and your baby are getting enough nutrients.
There are also some steps you can take to help manage severe nausea and vomiting. It is important to try to stay hydrated, and it is recommended that pregnant women drink 8 to 12 glasses of water per day, although you should talk to your doctor about the amount that’s right for you. Eating small, frequent meals of plain, bland, and high-carbohydrate foods that are low in fat, such as bread, rice, crackers, pasta, and potatoes, may also help. Eating cold or dry foods rather than hot meals can also be beneficial if the smell of hot meals makes you feel sick.
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Pre-existing conditions
Pregnancy can be a complex and challenging time for those with pre-existing medical conditions. Pre-existing maternal risk factors can increase the likelihood of hospitalisation during pregnancy. It is recommended that pregnant women with pre-existing conditions consult with a high-risk pregnancy physician (also called a maternal-fetal medicine specialist) to create an individualised care plan to monitor their condition and take necessary precautions.
Some common pre-existing conditions that may require specialised care during pregnancy include preeclampsia, gestational hypertension, diabetes, and mental health conditions. Preeclampsia, a pregnancy complication characterised by high blood pressure, often requires hospitalisation for close monitoring of both mother and baby. Gestational hypertension, which is more common during a first pregnancy or a twin pregnancy, can also lead to preeclampsia and may require hospitalisation and bed rest.
Pregnant women with diabetes need to carefully manage their condition as it can have serious consequences for both mother and baby if left uncontrolled. Diabetes is when the body does not produce enough insulin or cannot effectively use the insulin produced, leading to a build-up of glucose in the blood. Pre-existing diabetes is referred to as pre-gestational diabetes during pregnancy.
Mental health conditions during pregnancy, such as depression, psychosis, post-traumatic stress disorder, and others, can impact both antenatal and postnatal periods. Monitoring and support from mental health specialists during and after pregnancy are crucial for positive maternal and child outcomes.
Other pre-existing conditions that may require attention during pregnancy include epilepsy, infections such as toxoplasmosis (which can be prevented by practising good hygiene when handling raw meat and cat litter), and hepatitis B. Overall, pregnant women with pre-existing conditions should seek specialised care to ensure the best outcomes for themselves and their babies.
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Signs of labour
While the early signs of labour may vary from person to person, there are a few common symptoms to watch out for. As the due date approaches, it is important to be vigilant and look out for these signs, as labour can progress quickly.
One of the most common signs of early labour is the start of contractions. These contractions are different from Braxton Hicks contractions, which feel like uncomfortable cramps. True contractions occur consistently every few minutes, becoming more painful and with shorter intervals. As labour progresses, contractions become stronger and more frequent, occurring about three minutes apart.
Another sign of labour is the breaking of the amniotic sac, also known as the "water breaking". This can happen during labour or before it starts. If the fluid is green or brown, it could indicate that the baby has passed meconium, their first stool, which can be dangerous if ingested during birth.
During early labour, the cervix softens, thins out, and starts to dilate in preparation for birth. This can result in the discharge of a mucus plug, also called a "bloody show". This discharge is pink-tinged, stringy, and gelatinous, and may pass out in one blob or several pieces.
Other signs of labour include nausea, backache, and increased urination as the baby descends into the pelvis.
If you experience any of these signs, it is important to contact your healthcare provider for guidance and instructions. For first-time mothers, healthcare providers typically recommend going to the hospital once contractions are three to four minutes apart for two hours. If you have given birth before, labour may progress more quickly, and providers suggest going to the hospital once contractions occur every five minutes for one hour.
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Frequently asked questions
These symptoms could indicate pregnancy-related concerns, but not always. It is recommended to first visit your OB/GYN's office or call your prenatal care provider. If your OB/GYN office is closed and you've developed severe symptoms, the emergency room is the safest place to be seen.
False labor is fairly common and can be pretty convincing. If you think you're in early labor, try to relax and allow your body to progress naturally at home. You should be on your way to the hospital or birthing center when you're in active labor, especially if you've been pregnant or given birth before.
Minimal spotting does not require a visit to the hospital right away, but it's worth a phone call to your OB/GYN. If you're bleeding and also feeling pain, consider being seen by their OB triage unit. If your doctor is concerned about something more serious like preterm labor or a placental disorder, you may be admitted to the hospital for observation.
