Pregnancy: When to Get Your Ass to the Doctor

A list of signs and symptoms that you should hustle your pregnant self to a medical professional for.

A while back I got an email from a reader who asked if it would be possible to write a quick list of the things you should really keep an eye out for when you’re pregnant – “like if you’re experiencing this, get thee to a trained professional.” 

Good idea! Except who could I ask that would actually tell us rather than hmmming and hawwing about how every experience is different crap? I know! Hilary from Pulling Curls! She’s a no-shit tell-it-like-it-is kind of gal.

So Hilary was kind enough to take a run at it so we have a general idea of what should be on our radar.  

– Amy

Sure, I see a lot of dumb reasons to come into labor and delivery.  I’ve even heard of someone coming in because their belly button lint fell out, but THAT, my friends, is a blog for another day.  Here are SOME reasons that we never question you for coming in.

1. If your baby isn’t moving.

Babies do fluctuate in how much they move, but if you feel like it’s lower than usual drink 2 ginormous glasses of water (ice water is best as the chilly stomach is next to the uterus that wakes the baby up), eat something, lay down and “feel”.  If within the next hour the wee one doesn’t perk-up. Come on in. The official kick count sheet says 10 movements should happen in 2 hours. You know your baby, if it’s way less and bells are going off in your head, come in. We’ll leave the light on for you. 🙂

2. A headache that won’t go away.

If you have a strong headache that’s not relieved by tylenol and LOTS of water (3-4large glasses of water, all at once) come in. It could just be the 20 hot dogs you ate last week, or it could be the beginnings of Preecclampsia (learn more about it here and here).  Call your doctor, see what they think and they are likely to want you to head on in.

3. Face swelling.

If all the sudden you wake up and your face is REALLY swollen, and it seems to have happened overnight (and can be confirmed by someone you live with – this isn’t just a case of personal fat face). This too can be a symptom of PIH (pregnancy-induced hypertension). Call your doctor. Hands and feet swelling can be a problem, but no reason to rush to your doctor.

4. Pee problems.

If you can’t pee, it really hurts (or burns) to pee, or you have a backache on your flank (that’s the fattier part of your back on the sides of your spine), call your doctor. It could be a urinary tract infection. They may want to see you in the office (or sometimes you can just drop off a urine sample) or possibly go to labor and delivery.

5. Severe vomiting.

If you really can’t keep anything down for a full day. Call your doctor. There are drugs they can try and I can’t TELL you how much better you’ll feel after some IV fluids. If you’ve got CRAZY morning sickness going on, try to get a baseline when your doctor feels like you should be seen. They used to just kind of ignore these people, but they’re getting better at managing it with drugs, steroids and IV fluids. Call your doctor.

6. If you’re less than 36 weeks, more than 6 contractions in an hour.

Call your doctor, see what they want you to do. We’d prefer labor doesn’t happen much before 36 weeks. Keep that baby cookin’. Also, if you’re feeling contractions drink 3 GIANT glasses of water. Most preterm labor is caused by dehydration.

7. You think your water broke.

I have a good blog post that gives you an idea of if it really did break. I’ll leave that there. BUT, water breaking is certainly a reason to come in and we have a test we can do to see if it was that or you peed. Which, in fact, happens way more than I’d care to share (and I totally get it – no one is making fun of you behind your back, it’s an every-day occurrence for us). Also, if you think something is in your vagina after you water breaks, take a feel up there. That’s a 911 moment if the cord has slipped out (more about that in the link above).

8.  You have a fever over 100.4 – call your doctor.

Having a fever when you’re pregnant isn’t the best for you or your baby. It’s not something to rush to labor and delivery for, but call your doctor. They’ll probably want to see you, or have you come in to L&D.

9. Bright red bleeding.

Not related to any vaginal activity {wink, wink, nudge, nudge}. You may get some spotting after sex or after your doctor checks you – and that’s fine.  But if you’re getting enough to cover a pad or clots, you need to come in.  Don’t pass go, don’t collect your 200 dollars, just go in.  We’re not as concerned about dark red as the mucus plug looks like that.  Also, if your doctor has told you that you have problems with your placenta (called previa) you need to come in NOW. No shower. NOW.

10. Supremely Itchy

I’m not talking mosquito bites, or stretch marks on your belly. I’m talking REALLY itchy, sometimes (but not always) accompanied by a rash. Of course, that COULD just be a rash. I’d take a dose of benedryl and see if that goes away. If the crazy itchiness continues, I’d make an appointment with your doctor. It can be cholestasis (when bile isn’t moving properly) and it isn’t something to mess around with and it’s something your doctor will want to keep an eye on.

11. Your mommy bells and whistles are going off.

Ladies, it’s time to start listening to your mommy gut. I’d figure out a way to articulate what’s wrong (most often it’s that the baby isn’t moving). But listen to those bells and whistles. Start now, you need them.

[Editor’s note: keep in my handy venn diagram of Medical Visits: Get Used to Feeling Like an Ass in mind for this stuff and don’t sweat it.]

12.  Anything your medical practitioner told you to come in for.

They know you, they know your history, they know your ultrasound and they know your baby.  If they said “come in for __________” don’t hem and haw over it.  Just go.

This list is by no means comprehensive, but it was what I came up with on the top of my 14 years as a labor nurse head.  As an aside, try to figure out where you should show up at your hospital.  Some have you go right to the ER, and some, after a certain number of weeks, send you to labor and delivery.  At my hospital that’s not connected to the main hospital, so there is a delay in us seeing you if you go to the ER (because we have to come get you).  So, double check that and get on in there!

Unlike me, Hilary is a nurse who has worked in various medical fields for the past 14 years, however, none of the information on this blog should be substituted for the care of a physician. You’re smart. You get it. Call your doctor if something seems weird.

More from Hilary

Induction: why and how to get labour going

My first son was nine days overdue – he was over 10lbs...
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  • Hi! I’d also add SEVERE SEVERE heartburn/chest pain discomfort paired with extreme malaise that doesn’t go away with any kinds of heartburn meds. Turns out I had a severe form of preeclampsia called HELLP syndrome that affects the liver and causes it to swell causing you to feel heartburn like discomfort. I also had nausea and nosebleeds as well as a result of it affecting my blood platelet count. Scary stuff!

  • I completely agree that if your intuition tells you something is wrong, at least call your doctor ASAP! At 37 weeks my hands went suddenly numb and I was bone chillingly freezing for an hour. I didn’t eat much for 24 hours, threw up twice and baby didn’t move much for 4 hours. My doctor had me go to the ER. They didn’t figure out what caused any of it, but better safe than sorry! I think it was a weird sign of early labor because baby girl arrived 4 days later.

  • Very good list. I wish they would have more straightforward lists like this at the doctor’s office and would be more prevalent in Google searches (which can scare the crap out of you and are not advised at 3 am). I had 2 scares from this list including inability to pee at 20 weeks (baby was blocking my urethra and I had retained nearly 2 liters of urine and needed a catheter for 3 days) and contactions for 8 hours at 32 weeks (for which I was admitted and required a shot to stop the contractions). 2 others on this list (bleeding and lack of movement) occurred in friends for which they had to deliver immediately.

  • I had several bouts of bleeding throughout my pregnancy and needed to stay in hospital for 6 weeks before baby arrived. I had vasa previa which can be very dangerous for mother and baby. When in doubt get checked out!

  • I get a lot of contractions all the time: six an hour, eight an hour… sometimes five-minute long ones… but that’s how I was in my previous pregnancy, too. Seems I may just have an "irritable uterus." I do make sure to drink water, empty my bladder, and rest when I’m having a lot. And it actually helps! Not like with my first pregnancy! (That time it seemed to start with an invisible infection, so yes, definitely glad I went in. But they were never effective, thank goodness, but also never went away by drinking water, grrr.)

    Of course, I’m also one of the many cholestasis/ICP moms who’s found this post, and turns out that’s ALSO associated with preterm labor, so who knows. Definitely something I’m keeping my eye on, and my doctor encourages me to call if I’m ever worried at all. (So, uh, yeah, not contradicting any of your points — very good advice! And you’re the one with lots of medical expertise and experience! All I know is my own body.)

    • I haven’t seen a lot of preterm labor with chole — mostly just miserable women. And babies at risk. 🙂

      • I read somewhere that there is an associated risk (though it isn’t as direct or important as the risk of stillbirth at the end, of course!) — but I know for myself, for my last pregnancy, it didn’t LOOK like preterm labor and chole — I had that infection and a ton of preterm contractions before I ever developed cholestasis symptoms. I’ve also read that bile acid levels can go up weeks before the itch starts, so who knows. Maybe a connection, maybe not? Probably more connected to the bacterial infection, though even in this pregnancy, without that, I still have a lot of BH contractions, and long ones… Maybe I’m just "lucky" and I get an irritable uterus PLUS chole, yaaay… 🙂

        (Oh, here it is! "Spontaneous pre-term delivery… in 20-40% of cases." Not sure what studies that’s based on.)

  • Cholestasis doesn’t present a rash. I have had it my mom had it. And it can cause stillbirth. Its scary and miserabke unless treated. Check out

    Thanks for spreading awareness

  • About #10 some times is not even and itch it can be like a burning sensation that won’t go away and it can start anywhere, not just at the Palm of your hands or bottom of your feet, my didn’t start there….

  • The section about cholestasis is incorrect. You do not get a rash with cholestasis. It starts with itching on the palms of the hands and the bottom of the feet. I got it at 28 weeks and was induced at 35 weeks it was horrible. Thankfully I was managed and me and my twins are fine.

  • Hi! I just wanted to touch on number 10… choleatasis actually usually does NOT have a rash. is A GREAT foundation that I’m part of working to spread awareness of cholestasis of pregnancy. PUPPS is the condition that frequently has a rash.. some women with cholestasis get little bumps from itching though. I love that you have at least heard of cholestasis. It’s a very scary thing and I had it twice requiring my babes to be born at 34 and 35 weeks.

    Thanks so much!

    Sadie Lane

    • Ok, now I’m not the doctor but they SAY that the women who have this horrible rash have cholestasis. I have also see Pupp’s, although if they show up with a rash like that we usually check liver enzymes and bile salts (I think — again, I don’t give orders and the reality is this is something your doctor should see in the office, not me in L&D) to make sure it’s not cholestasis. It is scary, I remember being shocked by how scary it was the first time I had a patient with it and read up on it. 🙂

  • All great information. I think #11 is a key one. Even if it’s your first pregnancy, and every one is giving you advice, listen to your gut. If you still don’t feel something is right, go see your Doctor. It’s always better to be safe than sorry.

  • I did not realize that most preterm labor is caused by dehydration! That is a very valuable piece of information, thank you!

  • Great list and all important things. I had blood in my wee when I was about 6 months pregnant and was so scared. I never actually found out the reason but going to the doctors meant they tested me and sent me for scans to rule out anything dangerous x

  • I went to the ER last night for severe flank pain and not peeing enough. I was admitted to L&D for severe dehydration and kidney stones. Not fun!

    • I had 3 kidney stones with my last pregnancy (I actually think I had them with the other 2, but thought they were UTI’s). NO FUN. Hydration is what keeps them away. Drink like a river! 🙂

  • 6….does this count Braxton hicks? I am 21 weeks. I haven’t stopped and counted mine and most are barely noticeable but it seems like I have them a lot. Especially when I am very active, cleaning etc. I don’t lift anything heavy.

    • Hey Railee, this is Hilary — the writer of the post. 🙂 6 is any contractions, even braxton hicks. It sounds like maybe you could use some nifedipine. There is a test called Fetal Fibronectin that your doctor can do to see if you’re in preterm labor. I mean, often those type of contractions are NOT a big deal, but sometimes they are. I’d call and make an appt in their office. 🙂 Hilary from 🙂

  • Great post! Really like your blog! I agree with Jessica that this is nice and down to earth!
    If it’s okay, I would like to invite you to check out my new website. I have been writing ans researching breast pumps to help other moms make the best choice. Check it out 🙂 Anna

  • I would add blurry vision to that list. It’s another sign of preeclampsia and that’s no joke.

    I love no nonsense posts about pregnancy. Most stuff is either really alarmist or full of the aforementioned hemming and hawing. This is nice and down to earth. Thank you.

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