One of the strangest mysteries of pregnancy involves asking the question: Is this normal or abnormal? For example, a headache can be nothing, or it can be a sign of a serious condition. Also, you’re supposed to gain weight when pregnant, but a sudden, large increase on the scale can be a red flag. You may have moments when you wonder, “Should I call my provider?”

pregnant woman calling her provider - When to Call Your Provider in the First, Second, and Third Trimesters of Pregnancy After Loss

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The answer: It depends. Some symptoms by themselves are not problems unless they become severe, while a few signs might occur in combination with others. As a loss parent, worrying about your health and your baby’s safety can be enough to make you feel crazy. Here’s a breakdown of when to call your provider in the first, second, and third trimesters.

High Fever

While the body’s average temperature ranges from 97-99°F, the medical definition of a fever is a temperature above 100.4°F, or 38°C. The same is true during pregnancy, so if you get a thermometer reading higher than that number, it’s important to call your provider immediately.

A fever is the body’s way of fighting an infection. Reasons for a fever during pregnancy could be the common cold, the flu, or COVID-19, which are all caused by viruses. Bacterial infections, such as listeriosis, strep throat, and urinary tract infections, can be treated with antibiotics[1]“Causes and consequences of fever during pregnancy: A retrospective study in a gynaecological emergency department,” C. Egloff, et. al, Journal of Gynecology Obstetrics and … Continue reading. If you develop a fever, your provider will most likely recommend taking acetaminophen. A fever can develop at any time during pregnancy, but research shows a high fever in the first trimester carries the most risk for birth defects[2]“Maternal Fever During Early Pregnancy May Be Linked to Birth Defects,” Centers for Disease Control and Prevention (CDC), November 1, 2020, … Continue reading.

Severe and Persistent Vomiting

Nausea is one of the most common discomforts during the first trimester. However, if you’re vomiting several times a day or your vomiting is accompanied by fever or pain, tell your provider. You could be suffering from hyperemesis gravidarum (HG), the most severe form of nausea, which happens to about three percent of pregnant people. This condition may be diagnosed when a person has lost 5 percent of their pre-pregnancy weight and has other problems related to dehydration. Folks with HG often need treatment, sometimes in a hospital, to stop the vomiting and restore fluids[3]“Morning Sickness: Nausea and Vomiting of Pregnancy,” The American College of Obstetricians and Gynecologists, May 2020, … Continue reading. In addition, if you experience severe vomiting at any time during pregnancy, including in the second or third trimester, call your provider.

Heavy Vaginal Bleeding

While light bleeding or spotting can be normal, especially in the first trimester, a large amount of bright red blood is a reason to contact your provider. Heavy bleeding can be a sign of threatened miscarriage, and bleeding in the second trimester or third trimester before 37 weeks could indicate a problem with the placenta and/or preterm labor[4]“Bleeding During Pregnancy,” The American College of Obstetricians and Gynecologists, May 2021, https://www.acog.org/womens-health/faqs/bleeding-during-pregnancy.

Abdominal Pain

Severe cramping in the lower abdomen sometimes accompanies bleeding and is also a warning sign of a problem. Stabbing pain on one side can be a symptom of ectopic pregnancy, which is a serious, potentially life-threatening situation when a pregnancy develops outside the uterus, usually in a fallopian tube. Later in pregnancy, pain in the upper right abdomen can be a warning sign of preeclampsia, appendicitis, or gallstones[5]“Stomach Pain in Pregnancy,” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/abdominal-pain-during-pregnancy/.

Severe Headaches

Headaches can start in early pregnancy and often are the result of hormonal shifts. They might persist throughout the prenatal period and can be the result of dehydration, stress, caffeine withdrawal, or sinus trouble. Generally, if a headache continues for more than two or three hours, you should call your provider. In addition, if a headache is accompanied by visual disturbances or sudden, dramatic swelling, reach out to your care team immediately[6]“Headaches in Pregnancy,” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/headaches-and-pregnancy/.

Visual Disturbances

Much like headaches, hormonal changes can cause occasional blurry vision or dry eyes. But if you see spots or auras, notice flashes, or experience double vision, definitely let your provider know. These types of visual disturbances can indicate serious problems like gestational diabetes or preeclampsia[7]“The eye and visual system in pregnancy, what to expect? An in-depth review,” Khawla Abu Samra, Samra, Khawla Abu. “The eye and visual system in pregnancy, what to expect? An in-depth … Continue reading. Both conditions are usually manageable, but they need to be closely monitored to ensure your and your baby’s well-being.

Swelling

Some swelling, especially in the third trimester, is normal[8]“Swelling During Pregnancy,” American Pregnancy Association, https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/swelling-during-pregnancy/. However, call your provider if you experience extreme or sudden swelling in your hands, feet, or legs, whether it’s symmetrical or asymmetrical. Any swelling in the face or around the eyes is also concerning. If you have abnormal swelling, your provider should evaluate you for preeclampsia, a blood clot, and heart problems[9]“Swelling in the Third Trimester: What’s Normal, When to Worry, What to Do,” Cara Terreri, LCCE, CD(DONA), Lamaze International, March 16, 2018, … Continue reading.

Rapid Weight Gain

Quick, sudden weight gain is something to be monitored by your healthcare professional. It can be a symptom of preeclampsia, which is often accompanied by swelling and headaches. Rapid weight gain can also lead to or be a result of gestational diabetes[10]“Pregnancy and birth: Weight gain in pregnancy,” InformedHealth.org, March 22, 2018, https://www.ncbi.nlm.nih.gov/books/NBK279575/.

Regular Contractions Before 37 Weeks

If you’ve not yet reached 37 weeks and you feel contractions that come every 10 minutes or more often, and they do not subside when you change position, call your practitioner. These are different from Braxton Hicks contractions, which are irregular and will go away when you shift your body. Contractions often occur in tandem with backache, belly cramps, pelvic pressure, changes in vaginal discharge, or an amniotic fluid leak[11]“Signs and Symptoms of Preterm Labor,” March of Dimes, December 2020, https://www.marchofdimes.org/complications/signs-and-symptoms-of-preterm-labor.aspx.

Change in Fetal Movement

If you’re tracking baby’s movement in the second and third trimester, you should note any changes in fetal movement. Most providers recommend tracking your baby’s movements every day starting around 28 weeks. As you track your baby’s movements, you want to know your baby’s normal, not worry about reaching a certain number of kicks in a particular time period. Keep track of the daily pattern, strength, and frequency of your baby’s movements. If you notice a change in your baby’s movement patterns, frequency, or strength call your provider right away[12]“Why Do Baby’s Movements Matter?” Still Aware, https://stillaware.org/yourpregnancy/free-information. 

Takeaways

A good takeaway is — if you’re worried, it’s OK to call your practitioner’s office. Depending on your past losses, certain symptoms might feel more concerning. You will never regret alerting your care team to a potential problem, especially if it helps ensure your baby’s well-being.

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