When to see a Midwife

Pregnancy is a normal physiological process our body goes through as a woman, however there are times where complications may occur and it is important to be aware of these potential symptoms and when you need to see a Midwife.

The symptoms discussed below do not mean there is a necessarily a problem, but it is important to get these checked out anyway.

When you first have contact with your Midwife, they will provide you with their contact details and also the contact details of your local hospital maternity triage assessment unit which is open 24 hours a day, 7 days a week if you have any concerns or questions.

The first symptom we are going to discuss is discharge in pregnancy. Experiencing a larger amount of vaginal discharge in pregnancy is quite common and normal due to the hormonal changes we as women experiencing and to prevent infections travelling from the vagina into the uterus. Discharge that is healthy is usually thin in consistency, clear or milky in colour and should not have an offensive smell.

An increase or change in your vaginal discharge including an offensive smell, or discharge that is green, brown or yellow in colour can be a sign of an infection. Also these symptoms may be accompanied by irritation around your vagina or pain when you wee, which all require the attention of a Midwife or Doctor so any potential infection can be treated quickly.

Secondly, bleeding in pregnancy can require you to seek medical advice and attention from a Midwife. During the first 12 weeks of pregnancy, it can be common for women to experience light bleeding that isn’t accompanied by any pain. There are a number of reasons for this, one which can be known as implantation bleeding, which is where the fertilised egg attaches itself to an area of the uterus. Another reason may be due to cervical changes as a result of an increased blood supply travelling to this area, creating a softer cervix. It is not as common, however, bleeding can be caused by infection.

For reassurance and advice, if your bleeding becomes heavy, is accompanied by pain, and/or you feel generally unwell, contact a Midwife, Doctor or the early pregnancy unit immediately. It is important to remember that most women who experience bleeding before 12 weeks, do end up having a successful pregnancy.

If you experience any bleeding after 12 weeks, at any point, contact triage or a and e immediately as this is not common at all.

There are three common causes of bleeding after 12 weeks which include a bleed inside the uterus, which can cause bleeding after sex. It commonly settles and doesn’t often come with problems, however you should immediately seek medical attention.

A low lying placenta and placental abruption are more serious cases of bleeding in later pregnancy which need immediate medical attention of these occur, and you made need emergency treatment, so suggest calling 999. Placental abruption occurs with extreme stomach pain also whereas a low lying placenta is not accompanied by any pain.

This leads us onto the symptom of stomach pain in pregnancy. Stomach pains in pregnancy can be worrying for us as expectant mothers, however this is in fact a common symptom in pregnancy. During the first 12 weeks especially, stomach pain can be more common due to a number of bodily changes including ligaments of the uterus expanding, hormonal changes causing constipation or trapped wind. This usually presents as mild period pain or cramps and should pass with positional changes and time.

If you do however experience severe abdominal pain in early pregnancy localised to one side of the lower stomach, this could be a sign of an ectopic pregnancy. An ectopic pregnancy, is where a fertilised egg begins to grow in a different place, often the fallopian tubes, as opposed to the uterine lining. There are additional symptoms that are a sign of an ectopic pregnancy including bleeding, pain in the tip of your shoulder blade, brown discharge, feeling faint or dizzy, and discomfort when going to the toilet.

Also towards the end of pregnancy you may feel discomfort and tightening of the abdomen, as the body is preparing itself for birth through Braxton hicks contractions. They should be irregular, short lived and not painful just uncomfortable.  Whilst it is common at this point of pregnancy, do not hesitate to contact your Midwife for reassurance or if you have pains that do not go away, you experience a small trickle or gush of clear/pinkish fluid from the vagina, unusual back ache, pressure in the lower pelvis as prior to 37 weeks you may be experiencing premature labour therefore, seek immediate advice.

Thirdly, we are going to discuss swollen hands and feet developing in pregnancy. It is common for this to occur in pregnancy as our body’s create and hold more water. This occurs even more so if the weather is warmer or if you are on your feet a lot during the day. Normal swelling usually worsens as the day progresses, during the latter stages of pregnancy, is a gradual process, improves when you lie town and put your feet up.

However, swollen hands and feet can be a sign of a pregnancy condition called pre eclampsia if accompanied by an extremely bad headache, a headache that wont go away with medication, visual disturbances including flashing lights, severe pain above your bump and under your ribs, nauseating, being sick and unwell. This condition usually causes problems with the kidney and/or liver and can be presented as high blood pressure and protein in the urine. Pre eclampsia needs to be treated urgently, as it can lead to further complications and seizures.

This leads us on to migraines in pregnancy, which come with symptoms of throbbing, pulsating pains, nauseating feelings, and visual disturbances of flashing lights. It is important to discuss this with your Midwife as the medication your normally take made need adapting to be safe during pregnancy. If you have never had migraines before, this is when you should seek advice, as above this could be a sign of pre eclampsia.

A further symptom that is important to seek medical advice if you are experiencing is a high temperature of over 37.5 degrees. A high temperature could be a result of a number of problems, often an infection can be hidden, which can be harmful to yourself and your baby. However, alongside a high temperature, symptoms of lower pelvic pain, back pain, loin pain, uncontrollable urge to pass urine, frequent urination, cloudy/unpleasant/ fishy smell or blood in your urine, feeling sick and vomiting could be a sign of a urinary tract infection. This is not an emergency but needs to be treatment sooner rather than later to prevent the infection spreading to the kidneys and also this can lead to premature labour.

This leads onto sickness and vomiting within pregnancy. Within the first 12 weeks, a common symptom of pregnancy is morning sickness which is experienced by around 70% of pregnant women. If you cannot keep any fluids down at all, or if you are being sick multiple times per day and there is no improvement within 48 hours, then it is important to seek medical advice, as you may be experiencing hyperemesis gravidarum which can cause severe dehydration and sometimes hospitalisation is required. Stomach bugs in pregnancy on the other hand, are likely not to harm your baby if they last less than 48 hours and it is important not to panic if you have diarrhoea and vomiting, make sure you rest as much as possible and keep hydrated.

Lastly, between 16 and 24 weeks of pregnancy you should begin to feel your baby move and by 24 weeks your baby should establish their own pattern that you will come to learn. At no point during your pregnancy should your movements reduce or change, therefore if this does occur it is important to call the maternity triage immediately as your baby’s movements indicate their wellbeing. Most of the time everything is okay, but it is important for your concerns to be checked out as soon as possible.

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