Guide for Pregnant Women
When To Be Concerned...

Nausea (morning sickness) is common in the first trimester of pregnancy, however frequent vomiting is of concern, especially if it lasts for more than 24 hours. Other symptoms that are not normal in pregnancy are abdominal pain, fever, yellowing of the skin or the whites of the eyes and change in bowel habit.

There may be some pressure or mild discomfort in the lower abdomen as the uterus grows out of the pelvis and displaces the bowels and puts pressure on the bladder. The need to empty the bladder frequently is also common. It is not normal to have severe or sharp pain or cramping in the abdomen.

It is NOT normal to have vaginal bleeding in pregnancy. Vaginal bleeding is not always associated with serious problems, but it should always be reported. If a woman has a blood type that is negative (Rh negative), she may need to receive a medication if vaginal bleeding has occurred, to prevent Rh disease from affecting this and future pregnancies.

Fetal movements should be felt daily, usually after 24 weeks. Fetal movement counts are a useful way to track the movements of the baby. Feeling no fetal movements for a 12 hour period is not normal, nor is a decrease in movements from a previously established pattern. Movements may be less noticeable as pregnancy approaches the due date, but any change in pattern should be reported.

Contractions occur irregularly throughout pregnancy and are called Braxton-Hicks contractions. Regular contractions can mean that labor is starting. If regular contractions occur prior to 37 weeks, this should be reported. A good measure of contractions is to count how many occur in a one – hour period. If five or more contractions have occurred in one hour, this should be reported. Useful things to do if it seems contractions are occurring regularly are: empty the bladder, drink a large glass of water, lie on the side and monitor carefully for tightenings or contractions.

At 37 weeks and beyond, it is common to wait until contractions are occurring at five minute intervals for an hour to minimize the possibility of false labor. However, circumstances such as history of fast labor, rupture of the amniotic membranes, previous cesarean delivery, breech position, distance from the hospital and many others may influence how long a woman should wait before coming to the hospital. It is always safer to call if there is any question about how long to wait.  

If a sudden leak of fluid occurs from the vagina, it may mean that the water from the sac around the baby has broken (amniotic membrane rupture). Sometimes the leak is not a sudden gush but a slow and constant drainage of fluid. It is usually more watery fluid than the normal increase in vaginal discharge that occurs commonly. Either of these situations should be reported. A simple test can be done to tell whether the amniotic fluid is leaking or not.

Over the counter medication: it is best to minimize the amount of medication that is taken during pregnancy unless specifically prescribed. Please report any alternative therapies, herbal and other supplements that are taken for any reason in pregnancy.

Acetaminophen (i.e. Tylenol) is generally considered safe for treatment of mild headaches, aches, fever and other conditions requiring anti-inflammatory action. Aspirin, ibuprofen (Advil), naprosyn (Alleve) and other medications known as NSAID’s are not used in pregnancy.

Mild heartburn can be treated with Tums, Rolaids, Mylanta or Maalox, although the symptoms should be reported.

Mild constipation can be treated with increase in fruit, vegetables and other fiber-containing foods in the diet. Stool softeners such as Colace taken twice a day along with increased fluid intake can help maintain regularity.

Swelling of the feet and ankles is common in pregnancy. If it is severe or sudden in onset, if swelling occurs in the face, hands or in other non-dependant parts of the body, this should be reported.