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Nausea in early pregnancy

Regular nausea/vomiting before 12 weeks is commonly known as ‘morning sickness Vinculo 3’ (although the name is misleading, as it can happen at any time of the day) and is usually not serious.
If you find you are vomiting several times during the day and unable to keep food/drink down, you may need to be treated to help you cope with the symptoms and stay nourished and hydrated. You should see your GP or midwife to be checked. If you have severe and persistent vomiting usually starting very early in pregnancy (hyperemesis gravidarum), you should also see your doctor or midwife, as this needs to be treated.
Sometimes this nausea will last until later pregnancy.Read more about morning sickness. Vinculo 2

Nausea in late pregnancy

 If you start vomiting during the second half of your pregnancy, it may be a sign of pre-eclampsia Vinculo 1. This could especially be the case if you also have stomach pain, sudden, severe swelling in your face, hands and feet, vision problems and/or headache, or if your blood pressure has started to rise during your routine checks. Call your midwife immediately if you have these symptoms.

Vomiting accompanied by diarrhea could be a sign of food poisoning or a tummy bug. If you’re vomiting and have pain and a temperature it could mean you have a kidney infection. If you have these symptoms you should contact your doctor, midwife or hospital.

Read more about pre-eclampsia Vinculo 5

A slight increase in discharge/fluid during pregnancy is normal, especially when the weather is hot. You may find that it is a mild-smelling, milky fluid, which is fine.

Any other discharge/fluid needs to be checked out by a midwife or doctor. Look out for the following:
• Any sign of blood, which may be red (like if you cut your finger) or dark brown (if it is old blood). This is not normal and if it happens, you should contact your midwife.
• Discharge that is green/brown or yellow in color is itchy and/or has an offensive smell. This may be a sign of infection so you should contact your midwife.
• Leaking or gushing clear or pinkish liquid from your vagina before 37 weeks. This may mean that your waters have broken early (preterm prelabour rupture of membranes – PPROM). Once your waters have broken, the baby has less protection against infection. There’s also a possibility that you may need to prepare for a premature birth. Contact your midwife.
Leaking or gushing of clear or pinkish fluid after 37 weeks may mean that your waters have broken and that you may be about to go into labour. You should note down the time your waters broke, color, smell, amount and if baby is moving after your water broke. Call your midwife right away and provide this information.
If your waters are green or brown (or if there is blood) you need to be checked urgently, so call the maternity unit immediately.
Read more about premature birth.
Read more about waters breaking early (PPROM).
Read more about waters breaking after 37 weeks.

class 2Stomach bugs in pregnancy are common. It is very unlikely that your baby will be harmed from a bug lasting less than 48 hours. Your baby will be protected and take all the nutrients it needs from you.
Stomach bugs can be exhausting for you and you should look after yourself.
Here are a few simple rules to remember if you do have a stomach bug:
• If you do have diarrhoea and vomiting, don’t panic.
• Make sure you rest as much as possible.
• Drink plenty of water through the day specially coconut water.
• Eat small, light meals if you are hungry and it doesn’t make you feel sick. If you are not hungry, you do not have to eat for 24 hours so long as you drink plenty of fluid.
• Wash your hands before and after going to the toilet and after vomiting.
• If the diarrhoea does not go away within 48 hours, see your GP.
It is important to note that you must NOT take any medication to stop diarrhoea in pregnancy without consulting a medical professional or pharmacist first.
If you also have a fever, any stomach pain, you have very dark urine, or any blood in the stool you should see a medical professional as soon as possible.

If your temperature is above 99.5 degrees Fahrenheit, but with no other flu or cold symptoms, call your doctor. It could be a sign of a hidden infection. 

If your temperature is more than 102 degrees Fahrenheit, call the midwife, immediately as it is more likely you have an infection.

Swelling or puffiness (edema) of your hands and feet (including ankles) is common in late pregnancy.
If you have the common non-urgent type, it will probably be worse in the afternoon or evenings and will be present in both feet. It should also lessen when you lie down.   

If your swelling is severe or comes on suddenly, or particularly in your face as well as hands and feet, and comes with a headache or problems with your vision, you may have pre-eclampsia Vinculo 1. If you are experiencing these symptoms, you should call your midwife.

class 1Stomach bugs in pregnancy are common. It is very unlikely that your baby will be harmed from a bug lasting less than 48 hours. Your baby will be protected and take all the nutrients it needs from you.
Stomach bugs can be exhausting for you and you should look after yourself.
Here are a few simple rules to remember if you do have a stomach bug:
• If you do have diarrhoea and vomiting, don’t panic.
• Make sure you rest as much as possible.
• Drink plenty of water through the day specially coconut water.
• Eat small, light meals if you are hungry and it doesn’t make you feel sick. If you are not hungry, you do not have to eat for 24 hours so long as you drink plenty of fluid.
• Wash your hands before and after going to the toilet and after vomiting.
• If the diarrhoea does not go away within 48 hours, see your GP.
It is important to note that you must NOT take any medication to stop diarrhoea in pregnancy without consulting a medical professional or pharmacist first.
class 1If you also have a fever, any stomach pain, you have very dark urine, or any blood in the stool you should see a medical professional as soon as possible.

These may be symptoms of a migraine or they could be symptoms of pre-eclampsia, Vinculo 1 which is a condition that normally occurs after 20 weeks of pregnancy with raised blood pressure. You might also have other symptoms such as a bad headaches, stomach pain, nausea and vomiting. Pre-eclampsia is potentially dangerous for you and for the baby.
Call your midwife immediately.
Read more about pre-eclampsia Vinculo 4

Mild headaches can be caused by hormones and are common in pregnancy. You may also suffer from migraine in pregnancy. Paracetamol tablets taken according to the guidelines are safe for you and your baby.

If you are past 20 weeks and have a bad headache that lasts for more than two or three hours (particularly if not relieved by Acetaminophen), it could be an indication of high blood pressure, which is a symptom of pre-eclampsia Vinculo 3. If your headache is accompanied by vision problems and bad swelling on your hands, feet, face or stomach, call your midwife immediately. 

If your headache is accompanied by pain while urinating or blood in the urine, you may have a urinary tract infection and need to be treated.

Bleeding in early pregnancy (before 24 weeks)
Spotting or light bleeding without pain is not uncommon before 12 weeks and is often not serious, but you should contact your doctor immediately to be checked.

If it is accompanied by a severe pain in one side of your stomach or pain in your shoulder tip, diarrhoea or bowel pain, it may be a sign of an ectopic pregnancy and needs to be checked urgently by your maternity unit.  

Bleeding combined with back or stomach pain may be a sign of miscarriage. Call your doctor immediately.

Read more about ectopic pregnancy
Read more about miscarriage

Bleeding in late pregnancy (after 24 weeks)
Some women may experience a light bleed later on in their pregnancy. This is may not be from inside the womb, but from the cervix, for example. Postcoital (after sexual intercourse) bleeding can occur due to this. This may settle and doesn’t necessarily mean there is a problem, but you should always let your midwife or doctor know of any bleeding.
There are two more serious causes of bleeding in late pregnancy:
• placenta praevia (a low-lying placenta). You may experience sudden, painless bleeding that can be light to heavy.  Most women who have placenta praevia will already know their placenta is low from their ultrasound scans, although most women with a low placenta do not go on to have placenta praevia.
• placental abruption (abruptio placentae). Bleeding with discomfort or pain could mean you have had a placental abruption, which happens when the placenta starts to separate from the wall of your uterus. It is likely to be accompanied by cramps and tenderness when you press your stomach.
Contact your midwife, doctor or maternity unit immediately if you are bleeding in late pregnancy.

Fetal movements can be anything from a flutter, kick, swish or roll. These can be felt as early as 18 weeks of pregnancy (or even sooner in later pregnancies), but many women don’t feel them until later.

When should I start feeling the baby start moving in.
You may be able to feel the baby move as early as 18 weeks into your pregnancy. If it is your second or third baby, you may feel the movement even earlier. However, baby movements before 28 weeks can be changeable and not have a regular pattern.
This could be because of the baby’s position in the womb or the position of the placenta. It is also likely to be due to the fact the baby is small at this time, and therefore has smaller movements. If you have been on your feet or busy all day, you are also less likely to feel the baby’s movements than when you are resting.
What happens to fetal movements in later pregnancy?
Babies should continue to move normally throughout pregnancy and you should even continue to feel them while you are in labor. As babies get big the movements feel different but they should still follow their usual pattern right up to the end. It is not true that babies ‘slow down’ as labor approaches, but they have less space to move in.
During your pregnancy you should try to be aware of your baby’s movement patterns. If the movements slow down or change it could be a sign that your baby is unwell and you should contact your midwife immediately.
Do I need to count the kicks?
There isn’t enough evidence to say that counting kicks throughout pregnancy helps. It is more important to be aware of the pattern of movements throughout the pregnancy and to seek help if they slow down.
What should I do if I’m not sure whether fetal movements have slowed down?
If you are unsure whether movements are have slowed or changed, you should lie on your left side and focus on the baby’s movements for two hours.
If you do not feel ten or more movements in two hours, you should contact your midwife inmediatly.
What happens if my baby’s movements have slowed down?

If you are unsure whether movements are have slowed or changed, you should lie on your left side and focus on the baby’s movements for two hours.
If you do not feel ten or more movements in two hours, you should contact your midwife immediately.
Less than 24 weeks pregnant
If by 24 weeks you have never felt your baby move, you should contact your midwife, who will check your baby’s heartbeat. You may have an ultrasound scan and you may be referred to a specialist fetal medicine center (perinatologist) to check your baby’s health.
Between 24 and 28 weeks pregnant
You should contact your midwife immediately. Do not wait until the next day or next appointment.
You will have a full prenatal check-up. If anything is unusual you may have an ultrasound scan to check on your baby.
Over 28 weeks
You will have a full prenatal check-up, your baby’s heart rate will be monitored to reassure you about your baby’s wellbeing.
An ultrasound scan may be arranged if:
• Your womb is smaller than expected
• you have a high risk pregnancy
• the heart rate is normal but you still feel that your baby’s movements are slower or less.
If the movements have slowed down does it mean my b
Fewer movements could mean that your baby is unwell, but usually these checks reveal that all is well. Most women who have experienced one episode of fewer movements have a straightforward pregnancy and healthy baby.

Some itching around the stomach is normal as your skin is stretching around your growing baby.
If you notice that you have severe itching, particularly on the palms of your hands or the soles of your feet, the itching is worse at night and there is no rash with it you should see your midwife and be tested for a liver condition called obstetric cholestasis.

Nausea in early pregnancy

Regular nausea/vomiting before 12 weeks is commonly known asclass 1 ‘morning sickness Vinculo 1’ (although the name is misleading, as it can happen at any time of the day) and is usually not serious.
If you find you are vomiting several times during the day and unable to keep food/drink down, you may need to be treated to help you cope with the symptoms and stay nourished and hydrated. You should see your GP or midwife to be checked. If you have severe and persistent vomiting usually starting very early in pregnancy (hyperemesis gravidarum), you should also see your doctor or midwife, as this needs to be treated.
Sometimes this nausea will last until later pregnancy.Read more about morning sickness. Vinculo 1

Nausea in late pregnancy

class 1 If you start vomiting during the second half of your pregnancy, it may be a sign of pre-eclampsia Vinculo 2. This could especially be the case if you also have stomach pain, sudden, severe swelling in your face, hands and feet, vision problems and/or headache, or if your blood pressure has started to rise during your routine checks. Call your midwife immediately if you have these symptoms.

Vomiting accompanied by diarrhea could be a sign of food poisoning or a tummy bug. If you’re vomiting and have pain and a temperature it could mean you have a kidney infection. If you have these symptoms you should contact your doctor, midwife or hospital.

Read more about pre-eclampsia Vinculo 1

If you find that you have a painful or burning sensation when you urinate, you are likely to have a urinary tract infection (UTI).
Pregnant women can be especially prone to UTI’s due to the changes that occur in the body throughout the pregnancy, this is one of the reasons why your midwife and you will screen the urine sample that you are asked to take to every prenatal appointment.
Other signs to look out for are:
• pelvic discomfort
• lower stomach/abdominal or back pain
• loin pain
• frequent or uncontrollable urge to urinate
• cloudy, foul-smelling (fishy) or bloody urine
• a raised temperature
• nausea and vomiting.
If you get a UTI in pregnancy, you will need treatment with diet changes, herbal supplements, and immune support that are safe to use in pregnancy. If the UTI is severe or not responding to the treatment, You should contact your midwife to do urine testing and culture to identify the bacteria to ensure that you are put on the correct antibiotic (will refer you to a doctor)
This is not an emergency, but it should be treated as soon as possible.

Your midwife should start measuring your growing baby at prenatal appointments.
The measurements are taken with a non-elastic centimeter tape measure from the top of your bump to the top of your pubic bone. It may be written down as ‘fundal height’ (FH) or symphysis-fundal height (SFH). These measurements should be taken at each prenatal visit (on average every 2-4 weeks).
The measurement should be within 3cm of the number of weeks you are pregnant. When you’re 30 weeks pregnant, for example, your measurement should be somewhere between 27cm and 33cm. This will vary depending on your height and weight in early pregnancy, how many children you’ve had and your ethnicity.
Your baby’s growth is recorded in your notes either as a measurement or plotted on a chart through your pregnancy. This chart can show the midwives if there is a steady incline, no growth or decline in the growth.
If you are concerned that your bump isn’t getting any bigger, call your midwife and ask for an extra prenatal appointment to be measured. If your measurements are outside of the normal range, or if you still feel worried that your bump is too small, your midwife should recommend an ultrasound scan called a growth scan.
This will give a more accurate measurement. If the scan is normal, the measurement doesn’t matter.

If you feel your bump isn’t getting any bigger and your baby’s movements have slowed down, talk to your midwife and immediately get checked. These are the symptoms of a condition called intrauterine growth restriction (IUGR/FGR). It means the baby is not growing properly in the womb. Your midwife should refer you to the hospital for a scan and extra monitoring.
Read more about intrauterine growth restriction, also known as fetal growth restriction (IUGR/FGR)

If you feel that something is wrong, or if you are worried about the baby, call your midwife or doctor to talk about it. It’s important to listen to your own instinct and the midwife will be happy to discuss your worries. 

Do not rely on advice from family members, friends or even the internet.