The physical and emotional changes of pregnancy can feel overwhelming, making it difficult to discern a normal symptom from a medical concern. This guide clarifies which symptoms require immediate emergency action, which necessitate an urgent call to your doctor or midwife, and which can safely wait until your next scheduled appointment. Healthcare providers prefer to be contacted if there is any doubt about a symptom, as they are best equipped to assess the situation and provide guidance for the safety of both you and your baby.
Immediate Emergency Signals
Certain symptoms represent a medical emergency requiring immediate action, such as calling 911 or going directly to the nearest hospital emergency department. The sudden onset of severe, unrelenting pain in the abdomen or chest should prompt immediate care, as this may signal conditions like placental abruption or a pulmonary embolism. Placental abruption involves the placenta separating from the inner wall of the uterus before delivery, which can result in heavy internal bleeding.
Heavy vaginal bleeding that soaks through one or more sanitary pads within an hour signals an emergency. This level of blood loss can be life-threatening and may indicate a major hemorrhage or other serious complication. Sudden loss of consciousness, a seizure, or signs of a stroke, such as facial drooping or slurred speech, are also clear indicators for immediate emergency services.
A sudden, severe gush of fluid from the vagina, particularly before 37 weeks of gestation, should be treated as an emergency, as it could signal the rupture of membranes. While some fluid leakage can be normal, a large, sudden release requires immediate assessment to check for infection risk and fetal well-being.
Urgent Warning Signs Requiring a Provider Call
A number of symptoms require contacting your obstetrician, midwife, or the maternal triage unit right away, even after business hours, for professional assessment. One of the most time-sensitive concerns is a noticeable decrease or sudden change in fetal movement, particularly after 28 weeks of gestation. A significant reduction in the baby’s usual pattern needs immediate investigation.
Decreased fetal movement can be an early sign of fetal compromise and should not be delayed by trying to stimulate the baby with food or drink before calling your provider. Your care team will likely recommend an immediate assessment, which may include a fetal heart rate check and an ultrasound. A persistent, severe headache that does not improve with rest or over-the-counter medication is another urgent sign, especially if it occurs after 20 weeks.
This type of headache, particularly when combined with visual changes like blurred vision or flashing lights, can be a symptom of preeclampsia. Preeclampsia is a serious condition characterized by high blood pressure. Sudden swelling of the face, hands, or eyes, along with a rapid weight gain of more than three to five pounds in one week, is also a highly concerning sign of potential preeclampsia.
A persistent fever of 100.4°F (38°C) or higher requires an urgent call, as it may indicate an infection that could affect the pregnancy. Infections like pyelonephritis, a kidney infection, often present with fever, back pain, and painful urination, requiring prompt antibiotic treatment. Severe nausea and vomiting that prevents the ability to keep any fluids down for more than 12 hours can lead to dehydration and may signal hyperemesis gravidarum.
Painful urination, burning, or blood in the urine, combined with flank or back pain, may signal a urinary tract infection (UTI) that has progressed to the kidneys. Early pregnancy cramping, especially if accompanied by light spotting, requires professional evaluation to rule out concerns like ectopic pregnancy or miscarriage. Sharp, stabbing, or cramp-like belly pain that does not resolve should always be assessed.
Symptoms That Can Wait Until Business Hours
Many common and uncomfortable pregnancy symptoms are not considered urgent and can be discussed during your next routine prenatal visit. Mild to moderate heartburn or acid reflux is a frequent complaint caused by pressure from the growing uterus. This discomfort is typically manageable with dietary changes or over-the-counter antacids and does not require an after-hours call.
Minor swelling of the ankles and feet is a normal occurrence in pregnancy due to increased blood volume and fluid retention. This mild edema is generally not a concern unless it appears suddenly or involves the face and hands, which could signal preeclampsia. Similarly, mild, occasional lower back pain is common as the body’s posture shifts and ligaments soften, and this can be addressed with gentle stretching or heat therapy.
Constipation and the development of hemorrhoids are frequent due to the slowing of the digestive system by pregnancy hormones. These issues are managed through increased fiber and fluid intake and are not an emergency. Very light, brownish spotting that occurs immediately after intercourse or a pelvic examination is often due to the highly sensitive cervix and can typically wait for discussion at your regular appointment.
Questions regarding the safety of common over-the-counter medications, concerns about insomnia, or general fatigue are best suited for discussion during scheduled office hours. These symptoms do not represent an immediate threat to the health of the pregnant person or the fetus. Your provider can offer tailored advice for managing these issues during your next visit.