When to Seek Help in Pregnancy

A straightforward guide to knowing when a pregnancy symptom needs checking.

Pregnancy comes with a rather impressive collection of new sensations. Some are exciting. Some are weird. Some are uncomfortable. And some make you think: "Is this normal, or should I be calling someone?" The answer isn't always obvious.

This guide isn't designed to make you worry about every twinge. Quite the opposite. It's here to help you understand which symptoms are commonly part of pregnancy, which ones are worth getting checked and when you should seek urgent help. Because you don't need to be able to diagnose yourself. You just need to know when to ask.

First Things First: trust Your Instincts

There is a lot of pressure in pregnancy to know what is "normal". But pregnancy isn't identical for everyone. Something that is completely ordinary for one person might need investigating in another, depending on your stage of pregnancy, medical history and individual circumstances. If something doesn't feel right, you are allowed to ask for advice even if you aren't sure whether it's important. You are not expected to sit at home trying to work out whether your headache is a headache or The Headache That Means Something™. Your maternity team would much rather you contacted them if you're worried.

Symptoms That Need Checking

There are some symptoms during pregnancy that should prompt you to contact your maternity team, GP, NHS 111 or another appropriate healthcare service.

These include:

vaginal bleeding
severe or persistent abdominal pain
a severe headache
changes to your vision
sudden swelling, particularly of your face, hands or feet
a high temperature or feeling very unwell
significant or persistent vomiting
sudden or severe breathlessness
chest pain
fluid leaking from your vagina
a change in your baby's usual movements
symptoms of labour before 37 weeks
anything else that feels concerning to you

The right place to seek help depends on what is happening and how many weeks pregnant you are. Let's look at some of the more important ones in a little more detail.

Vaginal Bleeding

Bleeding during pregnancy isn't always a sign that something is wrong, but any bleeding in pregnancy is worth getting advice about.

The amount, colour, timing and whether you have pain alongside it can all be relevant. Light spotting can have several causes, particularly in early pregnancy, but bleeding can also sometimes be associated with complications that need assessment.

Get urgent help if bleeding is accompanied by:

severe abdominal pain
shoulder pain
dizziness or fainting
feeling very unwell
heavy bleeding that is soaking through a pad quickly

These symptoms can require immediate assessment. If you are bleeding and are unsure what to do, contact your maternity service or NHS 111. If you have severe pain, heavy bleeding, feel faint or lose consciousness, call 999.

Your Baby's Movements

Once you start feeling your baby move, getting to know their usual pattern is one of the most useful things you can do. Most people first feel their baby move somewhere between 16 and 24 weeks, although this varies. If this is your first baby, you may not notice movements until after 20 weeks. There isn't a magic number of movements your baby should make each day. Instead, you're looking for your baby's usual pattern.

Contact your midwife or maternity unit immediately if:

your baby is moving less than usual
you cannot feel your baby moving
you notice a change in their usual pattern of movements

Do not wait until the next day. And don't rely on a home Doppler to reassure yourself. Hearing a heartbeat does not tell you that your baby is well. This is one of those occasions where it really is better to make the phone call. Even if it's the middle of the night.

Severe Headache or Changes to your Vision

Headaches can be common during pregnancy. A severe or unusual headache, however, needs checking, particularly after 20 weeks.

Contact your maternity team, GP or NHS 111 urgently if you have:

a severe headache
blurred vision
flashing lights or spots in your vision
pain just below your ribs
vomiting alongside a severe headache
sudden swelling of your face, hands, feet or ankles

These can be symptoms of pre-eclampsia, which is why they shouldn't simply be put down to being tired or hormonal.

Sudden Swelling

Some swelling during pregnancy is common, particularly in your feet, ankles and fingers. But a sudden increase in swelling, particularly of your face or hands, needs checking. This can sometimes be associated with pre-eclampsia. Sudden swelling in one leg, particularly if it is painful, warm or red, can also be a sign of a blood clot and needs medical assessment.

Fever or Feeling very Unwell

Pregnancy doesn't make you immune to ordinary illnesses, and a cough, cold or stomach bug doesn't automatically mean something is wrong with your pregnancy. But a high temperature, feeling significantly unwell or symptoms that are worsening rather than improving are reasons to seek medical advice. If you are worried about how unwell you feel, don't wait for your next routine appointment.

Severe Vomiting

Nausea and vomiting are extremely common in pregnancy. But there is a difference between: "I feel sick all day and toast is currently my only friend" and "I cannot keep food or fluids down and I'm becoming unwell."

Severe pregnancy sickness can lead to dehydration and weight loss and may require medical treatment. If you are struggling to keep fluids down, are becoming dehydrated, are losing weight or are unable to manage normal daily activities because of vomiting, speak to your midwife or GP. You do not have to simply endure severe pregnancy sickness.

Breathlessness and Chest Pain

Feeling a little more breathless during pregnancy can be normal, particularly as your baby grows. But sudden or severe breathlessness is not something to ignore.

Seek urgent medical advice if breathlessness:

comes on suddenly
happens while you are resting or lying down
is accompanied by chest pain
is accompanied by dizziness or fainting

If you have severe chest pain or severe difficulty breathing, call 999.

Fluid Leaking from your Vagina

Towards the end of pregnancy, it can become increasingly difficult to know whether that damp patch is: urine, discharge, or your waters.

And honestly, sometimes it isn't obvious. If you think your waters may have broken, contact your midwife or maternity unit for advice.

Amniotic fluid is usually clear or pale. If the fluid is coloured, smells unpleasant or there is blood, tell your maternity team immediately.

Use a period pad rather than a tampon so that the fluid can be assessed if necessary.

Signs of Labour Before 37 Weeks

If you are less than 37 weeks pregnant and think you may be in labour, contact your maternity unit urgently.

Possible signs include:

regular contractions or tightenings
period-like pain
backache
pressure in your pelvis
a change in vaginal discharge
fluid leaking from your vagina
a "show"

It's much better to be assessed and find out that everything is fine than to ignore possible signs of preterm labour.

What about Contractions after 37 weeks?

As you get closer to your due date, you may experience Braxton Hicks contractions, period-like pains and other signs that your body is preparing for labour. When labour begins, contractions usually become progressively stronger, longer and more regular.

If you think you're in labour, contact your midwife or maternity unit for guidance. Your local maternity service will be able to tell you when they would like you to come in. This can vary depending on your individual circumstances and where you plan to give birth.

Who Should you Contact?

This is where things can get confusing because there isn't one universal number for every pregnancy concern. Your local maternity service should tell you who to contact and when. As a general guide, the NHS advises:

Early pregnancy

If you're in the first 12 weeks and haven't yet had your first midwife appointment, you may contact your GP surgery or local Early Pregnancy Unit (EPU) depending on the situation.

From around 12–19 weeks

Your midwife or Early Pregnancy Unit may be the appropriate point of contact.

From around 20 weeks

Your midwife or maternity unit will usually be your main point of contact for urgent pregnancy concerns. The exact arrangements vary between NHS trusts, so save the relevant number from your maternity notes or local maternity service.

Outside normal hours

If you aren't sure what to do or cannot access your usual healthcare service, NHS 111 can help direct you.

Emergencies

If you think you are experiencing a life-threatening emergency, call 999. You do not need to work out whether your symptoms meet some imaginary pregnancy emergency threshold before calling. If you think you need emergency help, call.

What if I'm Simply Worried?

This might be the most important section on this page. You don't need to have a specific symptom to deserve support. Maybe something feels different. Maybe you've had a previous difficult experience and you're feeling particularly anxious. Maybe you've been told something at an appointment that you don't understand. Maybe you just have a gut feeling that something isn't right.

You can ask. Your maternity team can assess you and help you understand what is happening. And if everything is fine? Brilliant. You've had some reassurance and can go home. That's not a wasted phone call

A Useful Rule of Thumb

You don't need to memorise every warning sign in pregnancy. Instead, remember three things:

1. Know what's normal for you.

Your body and your baby's movements will have their own patterns.

2. Don't ignore a significant change.

Particularly changes in your baby's movements, bleeding, severe pain, severe headache, vision changes or feeling suddenly very unwell.

3. If you're worried, ask.

You don't need to diagnose yourself before contacting your maternity team. Your job isn't to know what's wrong. Their job is to help you work that out.

A Final Word

Pregnancy information can sometimes feel like a very long list of things to worry about. That's not what this page is for. The vast majority of pregnancies progress without serious complications. Knowing the warning signs isn't about expecting something to go wrong. It's about having enough information to recognise when something does need attention.

So learn your baby's usual movements. Save your maternity unit's number. Know where your local maternity assessment service is. And trust yourself enough to pick up the phone when something doesn't feel right. You don't need to be certain. You just need to ask.

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