Falling while pregnant, particularly in the third trimester, is a common experience that often triggers immediate and intense worry. Studies suggest that approximately one-quarter of pregnant individuals will experience a fall at some point during their pregnancy. While the body has remarkable protective mechanisms for the baby, any fall involving blunt trauma to the abdomen warrants immediate attention. This guide offers clear, actionable steps for what to do and what symptoms to monitor to ensure the health and safety of both you and your baby.
Why Falls Are More Common in Late Pregnancy
The physiological changes that occur during the third trimester significantly challenge a person’s balance and stability. As the uterus expands, the body’s center of gravity shifts forward and upward, pulling the posture out of its familiar alignment. This necessary adaptation forces a pregnant person to lean backward, increasing the curvature of the lower spine, which can make maintaining balance more difficult.
Hormonal changes also contribute to instability, specifically the increase in the hormone relaxin. Relaxin serves the important function of loosening the ligaments and joints in the pelvis to prepare for birth. However, this joint laxity is not limited to the pelvis and can affect the stability of the hips and feet, leading to a wider, less secure gait and an increased risk of tripping. Other factors, such as fatigue, swelling in the feet and ankles, and episodes of low blood pressure (orthostatic hypotension) upon standing, further compound the risk of a stumble.
Assessing the Risk to Mother and Baby
The primary concern following blunt abdominal trauma in late pregnancy is a condition known as placental abruption. This serious complication occurs when the placenta separates, either partially or completely, from the inner wall of the uterus before delivery. The force from a fall creates a sudden shearing effect between the relatively elastic uterine wall and the less flexible placenta, causing it to tear away.
Placental abruption can severely compromise the baby’s oxygen and nutrient supply, potentially leading to fetal distress or, in rare severe cases, fetal hypoxia. Even a minor fall can trigger uterine contractions, which may lead to preterm labor if the uterus is irritable. Although the amniotic fluid and the thick, muscular uterine wall offer a degree of cushioning protection, a fall can also cause serious maternal injuries such as sprains, contusions, or bone fractures.
Immediate Steps Following a Fall
The moments immediately following a fall require a calm and systematic approach to minimize further injury and ensure safety. First, remain on the floor for a few moments and take slow, deep breaths to regain your composure and prevent a dizzy spell. Assess yourself for any immediate pain, bleeding, or fluid leakage before attempting to move.
When you are ready to get up, move slowly and carefully, perhaps rolling onto your hands and knees before pushing up with the help of a stable object. The single most important action after any fall in the third trimester is contacting your obstetric healthcare provider right away. This communication is necessary even if you feel perfectly fine and the fall seemed minor. Your provider will offer specific guidance and likely recommend monitoring, as some complications may not show symptoms right away.
Warning Signs That Require Emergency Care
Certain symptoms after a fall indicate a severe complication and require an immediate trip to the emergency room or calling emergency services:
- Any vaginal bleeding, even light spotting or brownish discharge.
- Leakage of fluid from the vagina, which could signal the rupture of membranes.
- Severe, persistent abdominal or back pain, especially if the uterus feels hard or tender (potential placental abruption or internal injury).
- Uterine contractions that are regular, increasing in intensity, or persistent (to rule out preterm labor).
- A change in the baby’s movement pattern, such as a noticeable decrease or a sudden, frantic increase in activity (a sign of fetal distress).
Preventing Falls During the Third Trimester
Reducing the risk of falls involves making several practical adjustments to daily routines and environments:
- Choose appropriate footwear with low heels and non-slip soles for better traction and stability.
- Avoid walking on slippery or uneven surfaces, particularly wet floors or icy sidewalks.
- When navigating stairs, always use the handrails and take your time to ensure secure footing on each step.
- Move slowly when transitioning from lying or sitting to standing to help mitigate dizziness caused by orthostatic hypotension.
- Avoid carrying heavy or bulky items that obstruct your view of the ground.