Pregnancy can be tough, both mentally and physically. Not only is your body changing in a million different ways, but every little twinge can put you in a panic, making you worry that something is wrong. Relax, say the experts. "Women need to remind themselves that the vast majority of pregnancies go smoothly," says Bruce Flamm, M.D., an ob-gyn in Riverside, California.
Still, pregnancy problems can, and do, happen. That's why it's important for every expecting mom to know which warning signs she should look out for. These symptoms require an immediate phone call to your doctor.
Most cases of morning sickness are annoying, but not harmful. But if you're throwing up so much that you can't keep liquids down or if you're not urinating, you need to let the doctor know. "This can lead to severe dehydration, which isn't good for you or your baby," says Isabel Blumberg, M.D., an ob-gyn in New York City. It can also be a sign that you're suffering from hyperemesis gravidarum, a type of extreme morning sickness that can last throughout your entire pregnancy. Also call if you haven't been able to keep food down for two days straight, if you think you have food poisoning, or if the vomiting is accompanied by a high fever. In these cases, you may need to go to the hospital for IV fluids.
If you're less than 12 weeks pregnant, you're feeling sharp cramps on one side of your stomach, and you've yet to have an ultrasound, your doctor will want to rule out an ectopic pregnancy (one in which the egg has implanted itself in the fallopian tube rather than in the uterus). Later on in your pregnancy, call if the pain is intense or recurrent, since it could be anything from contractions to appendicitis.
If you're near the end of your pregnancy, this discharge probably means your water has broken, so head to the hospital. But if you suddenly experience a gush of fluids anytime before 37 weeks, call your doctor pronto. It might be a sign that your amniotic sac has ruptured and you're going into preterm labor. Still, don't assume the worst. "Many women think their water has broken too early, when the baby may have just kicked their bladder hard and they lost some urine," says Dr. Flamm.
Contractions are another potential sign of preterm labor. So if you suddenly feel them when you're between 24 to 36 weeks pregnant, pick up the phone. While they could just be harmless Braxton-Hicks contractions, talk to your doctor to make sure.
Any time you have vaginal bleeding, you should talk to your doctor. "In your second or third trimester, it could mean you have a tear in your placenta or another problem that should be diagnosed by ultrasound," says Dr. Flamm. "But don't panic, most bleeding during pregnancy doesn't lead to long-term problems." If you're in your first 12 weeks, keep in mind that many women spot during the first trimester, so bleeding probably doesn't mean you're having a miscarriage.
If you get a bad headache in your first trimester or regularly suffer from migraines, it's probably no big deal. Ditto if you have some swelling in your ankles as your pregnancy progresses that just means you're retaining fluid. But, if you suddenly get a splitting headache in your second or third trimester, or if your hands and face swell like crazy and won't go down, you could be suffering from preeclampsia (pregnancy-induced high blood pressure) and need to see your doctor immediately. Another possible sign of preeclampsia to tell your doctor about: Your vision suddenly becomes blurry.
If you haven't felt much in the way of kicking for about an hour, no need to call right away. Instead, drink a glass of fruit juice (the sugar in juice will make your baby's blood-sugar levels jump, increasing the chances that he'll start kicking), then lie on your left side in a quiet room for half an hour. "If you don't count three to four movements within that time frame, give your doctor a call," says Dr. Blumberg. "Usually it's nothing, the baby was just being especially still, but your doctor will probably want you to have a stress test or an ultrasound to make sure there aren't any problems."
Originally published in the June 2007 issue of Parents magazine.