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Common Concerns During Pregnancy

Pregnancy brings a lot of changes, many of which will be new to you. Fortunately, most pregnancies and births are normal and progress without problems or complications. Nevertheless, the hormonal influences and physical changes that occur in your body while growing a baby can be quite surprising.

In general, most symptoms are a result of a normally developing pregnancy and can be discussed with the midwife at your next regularly scheduled prenatal appointment. However, there are times when it may be necessary to contact your midwife between appointment dates. We have developed the guidelines below to assist you in deciding when to call your midwife.

Common Concerns

Remember, unless you are experiencing a life­‐threatening emergency you should ALWAYS call the midwife before coming to the office or going to the hospital to be evaluated. Call the office at (864) 797-7350 to contact the midwife on call or to schedule an appointment according to the guidelines below.

VAGINAL BLEEDING

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Slight spotting that goes away within a day

Next regularly scheduled appointment

Any spotting or bleeding that lasts more than a day

Call office for next available appointment

Moderate or heavy bleeding (like a regular period)

Immediately

Bleeding with pain, fever, or chills

Immediately

ABDOMINAL PAIN

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Occasional pulling, twinging, pinching or sharp stabbing sensation on one or both sides of abdomen or over pubic bone, worse with walking, prolonged standing, sitting or sudden position changes.

Next regularly scheduled appointment

Severe pelvic or abdominal pain that is unrelieved by Tylenol, heat pack, warm bath, massage or accompanied by nausea, vomiting, diarrhea.

Immediately

BACK PAIN

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Achy low back pain, sometimes radiates down back of hips and one or both sides of legs. Occasionally sharp or stabbing. Worsens with prolonged sitting, standing, or walking. Usually relieved with pelvic rocking exercises, hip stretches, warm bath, heating pad or Tylenol.

Next regularly scheduled appointment

Severe, continuous pain, may radiate to one or both sides of front of abdomen. Not affected by movement, exercises, warm bath or position changes.

Immediately

Pelvic pain with bleeding or fever.

Immediately

HEADACHE

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Occasional mild headache relieved with Tylenol and rest.

Next regularly scheduled appointment

Headache unrelieved by Tylenol, rest, hydration or antihistamines.

Same day

Severe or persistent headache, especially if accompanied by visual changes (spots before eyes, light sensitivity, etc.).

Immediately

COLD/COUGH/STUFFY NOSE

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

With fever greater than 100.8 for longer than 48 hours

Same day

Without fever, but symptoms lasting longer than 7 days and not improving

Call office for next available appointment

SORE THROAT

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Chronic (longer than 1 week) without fever or other symptoms

Next regularly scheduled appointment

With fever greater than 100.8 and lasting longer than 48 hours

Same day

With red rash that feels like sandpaper

Same day

NAUSEA AND VOMITING

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Constant nausea, occasional vomiting

Next regularly scheduled appointment

Vomiting 1-3 times per day with persistent nausea

Call office for next available appointment

Vomiting several times per day and unable to hold down any food or fluids for more than 8 hours

Immediately

Vomiting with pain or fever

Immediately

HEARTBURN

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Occasional mild heartburn relieved by dietary changes, antacids such as Tums, Mylanta, Ginger, Papaya enzyme, etc.

Next regularly scheduled appointment

Severe or persistent despite above measures

Immediately

SWELLING

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Mild-moderate swelling of feet, ankles

Next regularly scheduled appointment

Sudden (over the course of several hours, overnight) severe swelling of feet extending to lower legs; noted in hands or face

Immediately

VAGINAL DISCHARGE

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Milky white, creamy or pale yellow without irritation or odor

Next regularly scheduled appointment

Any discharge with foul odor or irritation

Call office for next available appointment

Steady gush or leaking of watery fluid that requires use of a pad to contain it or prevent it from trickling down your leg

Immediately

Stringy thick mucus - less than 36 weeks

Call office for next available appointment

Stringy thick mucus -36 weeks or more

Next regularly scheduled appointment

URINARY SYMPTOMS

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Frequency - Urinating several times per hour

Same day

Pain with urination without chills, fever or headache

Same day

Pain with urination accompanied by chills, fever or headache

Immediately

FEVER

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Greater than 102° or accompanied by chills

Immediately

Greater than 100.8° for greater than 24 hours

Same day

Less than 100.8° for more than 48 hours

Call office for next available appointment

VISION CHANGES

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

"Sparkles", dizziness, light-headedness or wooziness, usually with prolonged sitting or standing or sudden movement from sitting to standing position or while in warm shower or bath. Lasts momentarily, resolves on its own.

Next regularly scheduled appointment

Persistent blurring, dim vision or gray shadow in your vision, double vision, loss of peripheral vision (tunnel vision), "floaters".

Immediately

BABY NOT MOVING OR DECREASED MOVING

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

After 24 weeks gestation

Immediately

CONTRACTIONS (Less than 37 Weeks)

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Any contractions accompanied by heavy vaginal bleeding - i.e. soaking full-size pads every hour or heavy period accompanied by clots

Immediately

More than 6 per hour

Immediately

Less than 6 per hour

Next regularly scheduled appointment

CONTRACTIONS (More than 37 Weeks)

CONCERN

WHEN TO REPORT/WHEN TO BE SEEN

Any contractions accompanied by heavy vaginal bleeding - i.e. soaking full-size pads every hour or heavy period accompanied by clots

Immediately

5 minutes apart or less for more than 1 hour, each one lasting 50-60 seconds and strong and painful enough that you are unable to walk or talk through them (i.e. unable to remain on the phone to talk with someone during a contraction).

Immediately