Warning Signs
Go to your nearest ER immediately if you have:
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a seizure. Call 911 for an ambulance.
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severe pain in your pelvis or abdomen, shoulder, back or chest.
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blurry vision or a blind spot, pain just under your ribcage, or a severe or continuous headache (different from headaches you usually have, e.g. not affected by medication).
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regular contractions (at least 6 per hour) before 37 weeks. They may feel painful, like menstrual cramps, a backache, tightening or vaginal pressure. Do not wait to see if the contractions will slow or stop.
Call your midwife immediately (day or night) if you have: Note: if you cannot reach your midwife, go to the ER.
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vaginal bleeding beyond a very small amount of spotting following intercourse or a vaginal exam. Although spotting is quite common, you still need to be checked.
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swelling of your hands and face.
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a gush of fluid from your vagina before 37 weeks.
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reduced or no movement from baby.
Call your midwife as soon as possible during daylight hours if you have:
Note: feel free to email at night, as you may get a faster reply, but call in the morning if you haven’t heard by then.
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severe nausea and vomiting, especially when accompanied with abdominal pain.
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signs of infection such as ‘flu-like symptoms, vaginal discharge with an unpleasant odor or that causes itchiness or pain, pain on urination or a need to go more frequently, diarrhea, a rash or a fever.
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changes in your vaginal discharge.
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severe mid-back pain that does not go away.
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blisters in or around your vagina in your first trimester, and this is your first time having them.
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intense itchiness, with or without a rash.
Both pregnancy and the postpartum period are usually safe and healthy times in a person’s life, but there are possible complications that you should be aware of, and you should know what to do if you see signs or symptoms of them. The most important thing to do is to stay calm. The information below tells you whether you should then go to the ER, contact your midwife immediately (day or night), or whether you should contact your midwife during daylight hours.
Pregnancy
Postpartum
Go to your nearest ER immediately if:
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baby has flaring nostrils, chest retractions, or grunting with breathing, or is breathing more than 80 times a minute when resting or fewer than 30 times a minute. Your baby may be struggling to breathe. Call 911 for an ambulance.
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baby has a pulse less than 100 or over 180 beats per minute when resting.
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baby's underarm temperature is less than 96°F or over 100°F when clothing is appropriate.
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baby has a blue tinge to the skin including lips, but not just hands and/or feet, nor just around the mouth when crying.
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baby has very pale skin or the skin looks gray or mottled.
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baby has a seizure (the eyes move randomly or roll or eyelids flutter, baby drools, makes unusual bicycling movements, or thrashes in an odd-looking way).
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baby seems floppy.
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your bleeding increases to the point that you are worried or are soaking through a towel in an hour. Do not wait an hour if bleeding is heavy!
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you have a seizure. Call 911 for an ambulance.
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you have blurry vision or a blind spot, pain just under your ribcage, or a severe or continuous headache (different from headaches you usually have, e.g. not affected by medication).
Call your midwife immediately (day or night) if:
If you cannot reach your midwife, go to the ER.
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baby has signs of jaundice (yellowing of the whites of the eyes or skin). This can be normal, but call if the jaundice is either:
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within 24 hours of birth,
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from the head down to the belly button,
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if the jaundice appears fast. That is, either:
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from no jaundice to jaundice down to the nipple line in 24 hours,
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from jaundice of the head only to jaundice down to the bottom of ribs in 24 hours.
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baby's skin briefly stays raised when pinched and let go, or dented when pressed and let go.
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baby is bleeding (beyond a few drops around the umbilical cord or a circumcision).
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baby develops a swelling on the head that wasn’t there at birth.
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baby won’t wake up when roused.
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baby isn’t feeding at all (either isn’t sucking, isn’t swallowing, or there isn’t let-down after milk is ‘in’).
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baby seems jittery or cries inconsolably or with a weak or high-pitched cry.
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baby produces no wet diapers within 24 hours of birth.
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baby produces no dirty diapers within 24 hours of birth.
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you have swelling of your hands and face.
Call your midwife as soon as possible during daylight hours if:
Feel free to email at night, as you may get a faster reply, but call in the morning if you haven’t heard by then.
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baby's pulse is less than 120 or over 160 beats per minute when resting.
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baby's underarm temperature is less than 97.7°F or over 99°F when clothing is appropriate.
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baby sleeps more than 6 solid hours.
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baby produces no wet or no dirty diapers in a day, poop is small and firm or you suspect diarrhea.
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baby's poop does not transition to brown-green by day 3 or yellow/green by day 5.
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baby vomits an entire feed or ‘projectile’ vomits.
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severe nausea and vomiting, especially when accompanied with abdominal pain.
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signs of infection such as ‘flu-like symptoms, vaginal discharge with an unpleasant odor or that causes itchiness or pain, pain on urination or a need to go more frequently, diarrhea, a rash or a fever.