Problems During Pregnancy: Warning Signs to Know

Normal pregnancy symptoms vs warning signs

Problems in early pregnancy (first trimester)

Bleeding and miscarriage

Bleeding in the first 12 weeks is common: about 1 in 4 pregnancies has some. Many continue normally, but bleeding can be a sign of miscarriage, which ends roughly 1 in 8 to 1 in 10 known pregnancies, mostly from chromosomal problems the parents could not have prevented.

Ectopic pregnancy

An ectopic pregnancy implants outside the womb, usually in a fallopian tube. Warning signs, typically at 5 to 10 weeks, are one-sided lower belly pain, light bleeding, shoulder-tip pain, dizziness and fainting. A ruptured ectopic is a life-threatening emergency.

Severe vomiting

Hyperemesis gravidarum is severe, persistent vomiting with dehydration and weight loss, affecting around 1 in 100 pregnancies. It needs medical treatment, sometimes IV fluids.

Problems in the second and third trimesters

Preeclampsia

Preeclampsia is high blood pressure with signs of organ strain after 20 weeks. It can be silent, which is why blood pressure and urine are checked at every visit. Warning signs include severe headache, vision changes, upper belly pain under the ribs, nausea and sudden swelling. It can occur up to 6 weeks after birth.

Preterm labor and waters breaking early

Regular contractions, lower back ache, pelvic pressure, or fluid leaking before 37 weeks may signal preterm labor. Early assessment allows steroids for the baby's lungs and other treatment.

Bleeding in later pregnancy

Bleeding after 20 weeks can come from placenta previa (a low-lying placenta, usually painless) or placental abruption (the placenta separating, usually painful with a hard womb). Both need emergency assessment.

Reduced baby movements

After about 24 weeks, a reduction in your baby's usual movements can be an early sign that the baby is not getting enough oxygen or nutrients. Do not wait until the next day, and do not rely on home heartbeat monitors. Contact your maternity unit straight away.

Gestational diabetes

Gestational diabetes usually has no symptoms and is found by screening at 24 to 28 weeks. Excessive thirst and urination may occur.

Obstetric cholestasis

Intense itching, especially of the palms and soles at night, without a rash, can be intrahepatic cholestasis of pregnancy, a liver condition that needs blood tests and monitoring.

Blood clots

Pregnancy raises clot risk about fivefold. Calf pain and swelling, or chest pain and breathlessness, need urgent assessment.

Mental health in pregnancy

Depression and anxiety affect around 1 in 7 pregnant and postpartum people. Persistent low mood, worry that takes over, panic attacks, or intrusive thoughts deserve support. Treatment is safe and effective.

What to do if you notice a warning sign

1. Call your maternity unit, midwife or obstetrician using the number in your notes, or go to labor and delivery triage. Most hospitals have a 24-hour line.
2. Call 911 or your local emergency number for heavy bleeding, chest pain, breathing trouble, seizures, fainting or thoughts of self-harm.
3. Say you are pregnant and how many weeks, and describe the symptom clearly. If you have recently given birth, say so.
4. Bring your prenatal records if you go in.

See pregnancy complications for an explanation of the main conditions, how they are diagnosed and treated, and who is at higher risk.

Frequently asked questions

What are the danger signs in pregnancy?

Key danger signs are vaginal bleeding, severe belly pain, severe headache or vision changes, sudden swelling of the face or hands, fluid leaking, reduced baby movements, fever, chest pain or breathlessness, seizures and thoughts of self-harm. Contact your maternity team the same day, or emergency services for severe symptoms.

Is it normal to have cramps in early pregnancy?

Mild, period-like cramps without bleeding are common in early pregnancy as the womb grows. Cramps that are severe, one-sided or come with bleeding, dizziness or shoulder-tip pain need same-day assessment to rule out miscarriage or ectopic pregnancy.

When should I worry about a headache in pregnancy?

Worry if a headache is severe, does not go away with rest and acetaminophen, or comes with vision changes, upper belly pain or sudden swelling, especially after 20 weeks. These can be signs of preeclampsia and need urgent blood pressure and urine checks.

What should I do if my baby is moving less?

Contact your maternity unit straight away, at any time of day or night. Do not wait until the next day or try to check the heartbeat yourself with a home device. Reduced movements after 24 weeks should always be assessed.

Is swelling normal in pregnancy?

Mild swelling of the ankles and feet at the end of the day is common, especially in the third trimester. Sudden swelling of the face, hands or feet, or swelling in one leg with pain, is not normal and needs prompt assessment.