Warning signs

Some problems during pregnancy require immediate attention from a health professional for evaluation. You can also contact your birthing centre or your hospital’s obstetrics department directly.

Some of the warning signs listed in the red box are explained below.

Vaginal bleeding

Before 14 weeks of pregnancy

Pregnant women often experience bleeding at the beginning of their pregnancy.

Bleeding may be related to the changes in the body at the start of pregnancy, i.e., implantation of the embryo in the uterus. In such cases, bleeding is light and is no cause for concern. Often, the cause of the bleeding is unknown, it does not last, and the pregnancy proceeds normally.

However, half of all women who bleed early in their pregnancy have a miscarriage (see Miscarriage).

When to consult a health professional

You may have light bleeding after a gynecological exam because the cervix is more fragile during pregnancy. In this case, you don’t need to be evaluated.

In all other cases, if you experience bleeding during the first trimester, have a health professional evaluate the situation. Women whose blood is Rh negative, for example, may need to receive immunoglobulin (WinRho®) if they have bleeding.

Go directly to the emergency room if you have heavy bleeding (vaginal bleeding that soaks two regular sanitary pads or one maxi-pad per hour for two or three hours straight) or if bleeding is accompanied by weakness, dizziness, or severe abdominal pain.

An Info-Santé nurse (8-1-1) can advise you on what steps to take at any time.

After 14 weeks of pregnancy

It is not normal to have vaginal bleeding after the first trimester of pregnancy (i.e., the first 14 weeks). If you do, see a health professional right away for an evaluation.

The bleeding may come from the placenta, for example, or be a sign of a miscarriage or the start of labour. Bleeding does not always mean the pregnancy is at risk, but you should be evaluated to make sure everything is all right.

Note that you may experience light bleeding after a gynecological exam, because the cervix is more fragile during pregnancy. In this case, you don’t need to be evaluated.

Loss of consciousness (fainting)

Loss of consciousness (fainting) can be normal during pregnancy. But if you experience dizziness or fainting, it’s best to see a health professional.

Go directly to emergency if you lose consciousness and have other symptoms at the same time, such as bleeding, severe abdominal pain on one side, chest pain, shoulder pain, or palpitations.

Also see a health professional if you have suffered a blow to the head or belly.

Severe headaches, upper abdominal pain, or sudden changes in vision

Contact your health professional right away if you are experiencing any of the following symptoms:

• Severe headaches
• Upper abdominal pain
• A sudden change in vision
• A general feeling of being unwell

Also consult your health professional if you notice that your blood pressure is high (more than 140/90).

Fever

Fever is an increase in body temperature above the normal level. It is the body’s way of defending itself against infection.

An adult has a fever if their body temperature (taken orally) is 38°C or higher.

If you have a fever while you are pregnant, it could be dangerous for your pregnancy or indicate that you have an infection that needs to be treated.

When to consult a health professional

If you have a fever of 38 to 38.4°C and your overall condition is good, you can wait a while to see how the situation evolves. You can take acetaminophen to lower your temperature and relieve pain.

However, you should see a doctor or your prenatal care provider if

• Your fever of 38 to 38.4°C lasts more than 24 hours
• You have a fever of 38.5°C or higher
• You feel unwell or have any other concerns

If you think you have COVID-19, call Info-Santé (8-1-1).

You can contact an Info-Santé nurse for advice at any time by calling 8-1-1.

Lack of baby movement after 26 weeks

At around 20 weeks, your baby’s movements increase and are strong enough to be noticed. Some women feel movement a little sooner, others a little later. At the end of your pregnancy the baby’s movements may feel different, but they are still present.

Your baby is more active at certain times of day. You might not notice his movements if you are more active or distracted than usual. You also may not be able to feel all his movements, even if he is active. Remember the movements you saw on the ultrasound that you couldn’t feel.

After 26 weeks of pregnancy, if you can’t feel your baby move or he is moving less than usual, rest and see what happens. If you count fewer than six distinct movements over two hours, contact your birthing facility or health professional right away or go to the hospital to make sure your baby is all right.

If you are worried or unsure, you can also contact your hospital’s obstetrics department or your birthing centre.

Contractions before 37 weeks of pregnancy

Throughout your pregnancy, it is normal to feel contractions that are unrelated to labour. Known as Braxton Hicks contractions, they are irregular and may or may not be painful. They can be caused by sudden changes in your position, standing for long periods, or sexual activity.

You may also feel small “electric shocks” in your cervix or menstrual-like cramps that last a few seconds. If this happens, these are not contractions; they are usually reactions to the baby’s movements.

However, if you feel your uterus harden regularly and are experiencing pain, you may be having real contractions. Sometimes the pain of the first contractions is similar to menstrual cramping.

If you are experiencing regular or frequent contractions (more than seven in one day) before 37 weeks, you may be going into premature labour, especially if you also have more abundant vaginal discharge. Contact your health professional or hospital so they can determine what is happening. Premature labour can sometimes be stopped if it is caught early enough.

After 37 weeks, the same symptoms may indicate that labour is starting. In this case everything is perfectly normal because your baby is no longer considered premature (see The start of labour).

Telling the difference between contractions and other abdominal pain

Loss of amniotic fluid (breaking of the waters)

Most pregnant women have vaginal discharge during their pregnancy (see Physical changes). Sometimes, however, other fluids such as urine or amniotic fluid may be discharged.

The table Telling the difference between the types of discharge (below) can help you determine what type of discharge you are having.

Loss of amniotic fluid can indicate the start of labour.

If your waters break before 37 weeks, it can pose a risk for the baby. If you think you are losing amniotic fluid, or if you are unsure, call your midwife or your birthing facility or go to the hospital.

If your waters break at or after 37 weeks, you need to go to the hospital or birthing centre.

Telling the difference between the types of discharge

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Embryo: Name given during the first full 10 weeks of pregnancy to the human being developing in the mother’s abdomen.

Labour: Process by which the baby passes from the uterus to the outside world, primarily through contractions of the uterus.

Miscarriage: A spontaneous abortion, which can have a variety of causes (e.g., a deformity or disease).

Rhesus factor (Rh factor): One of the characteristics of blood. You are either Rh positive or Rh negative.

Ultrasound : An examination using an ultrasound device that can see the embryo or fetus in the mother’s womb.