What should you call your practitioner about and when? What's a possible emergency and what isn't?

As early on in your pregnancy as possible, it's a good idea to set up a protocol for emergencies with your practitioner. That way you'll know which symptoms are always a red flag that require immediate medical attention, which should be addressed sooner rather than later and which are totally normal — you don't need more to worry about as it is!

Here's some guidance to help you tell the difference, along with what to do next.

When to go to the doctor while pregnant

The following symptoms during pregnancy warrant an immediate call to your practitioner:

  • Heavy bleeding or bleeding with cramps or severe pain in the lower abdomen[1]
  • Severe lower abdominal pain — either in the center or on one or both sides — that doesn't subside, even if it isn't accompanied by bleeding
  • A sudden increase in thirst accompanied by reduced urination, or no urination at all for an entire day
  • Painful or burning urination accompanied by chills and fever over 101 degrees Fahrenheit and/or backache
  • Bloody diarrhea
  • Fever over 101 degrees Fahrenheit
  • Very sudden and severe swelling or puffiness of the hands, face and eyes, accompanied by headache, vision difficulties or sudden significant weight gain not related to overeating[2]
  • Vision disturbances like blurring, dimming and double vision that persist for more than a few minutes
  • A severe headache or a headache that lasts for more than two to three hours
  • Less than 10 movements within two hours after having a snack or some fruit juice when counting kicks after 28 weeks of pregnancy. Though an absence of activity doesn't necessarily mean something is wrong, it could be a red flag requiring evaluation right away.
  • Thoughts of harming yourself or the baby[3]

If you experience any one of the above symptoms:

  • Call your practitioner's office.
  • If he or she isn't available, leave a message detailing the symptoms.
  • If you don't get a call back within a few minutes, call again or call the nearest emergency room and tell the triage nurse what's going on.
  • If the nurse tells you to come in, head to the ER and leave word with your practitioner.
  • Call 911 if no one can take you to the ER.

Call the same day — or the next morning, if it's in the middle of the night — if you experience:

  • Blood in your urine
  • Swelling or puffiness in your hands, face or eyes
  • Painful or burning urination
  • Fainting or dizziness that's more than momentary
  • Chills and fever over 100 degrees F in the absence of cold or flu symptoms (start bringing down any fever over 100 degrees F promptly by taking acetaminophen — aka Tylenol)
  • Severe nausea and vomiting, vomiting more often than two or three times a day in the first trimester, or vomiting later in pregnancy when you didn't earlier
  • Itching all over, with or without dark urine, pale stools or jaundice (yellowing of the skin and whites of the eyes)
  • Frequent — i.e. more than three times a day — diarrhea, especially if there's mucus in the toilet

How to talk to your practitioner

When you talk to your practitioner or the triage nurse, be sure to mention any other symptoms you may be experiencing, no matter how unrelated they may seem to the immediate problem. Also be specific, mentioning when you first noticed each symptom, how frequently it recurs, what seems to relieve or exacerbate it and how severe it is.

Your practitioner may want you to call for different reasons or within parameters, so be sure to ask him or her what protocol you should follow if you experience any of these symptoms.

Keep in mind, too, that there might be some times when you have none of the symptoms listed here, but you feel not quite right. If a good night's sleep and some extra relaxation don't make you feel better, check in with your practitioner. If you ever are in doubt, just get checked out.

Chances are what you're feeling is par for the pregnancy course. But it's also possible that you've become anemic or are fighting an infection of some kind. Certain conditions — UTIs, for example — can do their dirty work without any clear-cut symptoms.