Pregnancy is a normal, healthy physiological occurrence that nevertheless places a strain on your body. There are several warning signs which could indicate significant complications.

1) Severe abdominal pain

2) Menstrual-like vaginal bleeding

In early pregnancy (the first 3 months), this may indicate a threatened miscarriage. Put on a pad, call us, and be sure to save any clots or tissue that you may pass.

In middle or late pregnancy, bleeding can be a sign of problems which can sometimes be quite serious. Call us right away.

As your due date approaches, you may have a bloody show. This may be pink, red or brown and mixed with mucus. This usually means that labor will start in the next few hours or days, and is no cause for alarm, so you don’t have to notify us. You may also have a little show after a vaginal examination. If the show is heavier than a period, or if there are any clots, call us right away.

3) Breaking of the bag of waters

If you think your bag of waters is broken or leaking at any time, please call us right away. The fluid is usually clear or pink-tinged, but can also be green or brown. You may feel a “pop” and a sudden gush from your vagina or you may notice a slow trickle or leak, especially when you stand up or move about.

If you think you may be leaking fluid, put on a pad. Sometimes it is hard to tell if the bag of waters has broken, or if you are wetting your pants! If this is the case, don’t be embarrassed to call.

Whether or not you are near your due date, the breakage or leakage of the bag of waters calls for immediate attention. It serves as a barrier between the sterile part of the uterus where the baby develops and the bacteria that are in the vagina. Once it is gone, the chance of infection increases, and we will want to watch you and your baby carefully.

4) Menstrual-like cramps that do not respond to the suggestions given for Braxton-Hicks contractions

If you have signs of labor more than 3 weeks before your due date, call us at once, because premature labor can often be stopped with bedrest and medication, allowing your baby to grow to maturity.

Premature labor can be upsetting. If you find you are having painless or uncomfortable contractions more than 5 times per hour, you need to do several things:

First, empty your bladder (a full bladder causes uterine irritability).

Second, drink 3-4 glasses of water or juice. Dehydration also causes uterine irritability.

Lastly, lie down on your left side and place your right hand on your abdomen. Lying on your left side allows maximum blood flow to your vital organs, including your uterus. Feel for contractions (your uterus will harden, then soften); if contractions continue to come more frequently than 5 times per hour over the next hour, call us. If you are within 3 weeks of your due date, please read the section on Labor.

The following warning signs may require an office visit to evaluate the symptoms; however, you can wait until office hours to call (unless symptoms are severe).

1) Vaginal spotting.

2) Prolonged nausea, vomiting or diarrhea.

3) Chills and fever over 101°F, not relieved by these suggestions.

4) Frequent, severe headaches.

5) Visual disturbances, especially blurring, dimness, spots, or double images.

6) A definite decrease in the amount of urine passed.

7) Swelling or puffiness of the face (especially around the eyes) or hands, or excessive continuous swelling of feet or ankles.

8) Pain or burning with urination.

9) Constant dull ache in back or side just below ribs (flank pain).

10) In the last 3 months of pregnancy, absence of fetal movement for a 12-hour period.