Ahhhhh, pregnancy! You’ve either waited a long time to experience it, or no time at all. It may be smooth and fairly uneventful, or you may encounter some bumps along the way such as morning sickness, vivid dreams, and fatigue. These are relatively harmless pregnancy symptoms and generally don’t require medical attention, however; there are a few pregnancy symptoms that you should never ignore. 

Vaginal Bleeding

Vaginal bleeding during the first trimester occurs in about 20-30% of pregnancies, and it is not always a sign of a medical condition (implantation bleeding, for example). However, vaginal bleeding in the second or third trimester of pregnancy can pose a threat to the pregnant individual, and/or fetus, and may be be a medical emergency. It should not be ignored.

It is important that you contact your provider ASAP if you have any bleeding in the second half of pregnancy. The bleeding may be caused by:

  • Placental abruption—when the placenta detaches from the wall of the uterus prematurely (1% of pregnancies will experience this)
  • Placenta previa—confirmed via ultrasound, when the placenta lies low and partially or fully covers the cervix (1 in 200 pregnancies will experience this) 
  • Preterm labor— vaginal bleeding mixed with mucus or not, before 37 weeks

Abdominal Cramping

Some cramping in early pregnancy can be normal and is usually related to the uterus expanding, and the muscles that support it (round ligaments) being stretched. Other things that may cause cramping are gas, constipation, and intercourse. 

If you have cramping in addition to bleeding, contact your provider immediately. Cramping should also not be ignored if you have high blood pressures along with protein in your urine (your provider should be checking your urine for this) as this could be preeclampsia. UTIs are also a cause for abdominal cramping and may require antibiotics or other treatment. 

Leaking Fluid

If you suspect you may be leaking fluid, you should contact your provider and note COAT!

C: Color— what color was the fluid? Was it clear or did it have a yellow or green tinge to it? Was there anything floating in it?

O: Odor—did it smell slightly sweet, or like nothing? Did it smell like urine/ammonia?

A: Amount— was it a small gush? A trickle? A large gush? Put a pad on!

T: Time— what time did you first notice the fluid? How long has it been happening?

Discuss with your provider what you should do if you are leaking fluid or if your water breaks. Many area providers will instruct you to come into the hospital right away, regardless of how many weeks you are, but especially if you are less than 37 weeks pregnant. 

Severe Swelling

Some swelling in pregnancy is normal. It usually occurs in the third trimester while standing or being active for a long period of time, during the summer months, or while in excessive heat. Some things you can do to help relieve normal swelling are:

  • Rest and lay down
  • Elevate your feet
  • Avoid sitting or standing for long periods of time
  • Avoid crossing your legs when sitting
  • Drink plenty of water
  • Wear compression socks or tights
  • Limit the amount of time you spend in the heat
  • Add potassium to your diet
  • Exercise 

When swelling is outside the range of normal or is accompanied by these other symptoms, you should contact your provider immediately:

  • Swelling in your face, puffiness around your eyes
  • Extreme or sudden swelling in your hands/feet/ankles
  • Swelling along with a headache that won’t go away, vision changes, sudden nausea, sudden weight gain, shortness of breath, or stomach/shoulder/back pain
  • Swelling in one leg more-so than the other 

Persistent Itchy Skin

As your pregnancy advances and your baby and belly grow, your skin may itch due to being stretched. This mild, sometimes annoying, itching is usually nothing to worry about and a good quality lotion usually does the trick! But if it becomes severe, you should contact your provider immediately. 

Obstetric cholestasis is a serious liver disorder that affects a small number of pregnancies (less than 1%), typically sometime during the last three months of pregnancy. Some of the symptoms include:

  • Itchiness without a rash (usually on the palms of the hand and soles of the feet) that is non-stop, unbearable, and can be worse at night
  • Dark urine
  • Jaundice 
  • Pale bowel movements

As you can see, these pregnancy related conditions are pretty uncommon but they require medical attention. Remember to discuss any concerns with your provider so they can determine if something is within the range of normal or if something outside the range of normal and needs treatment. Your doula can help you formulate questions to ask as well as help you process information should you develop any of these more complicated medical conditions during pregnancy. 

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