What to expect when you're expecting (54 page)

Bloody diarrhea.

Call the same day (or the next morning, if it’s the middle of the night) if you experience:

Blood in your urine.

Swelling or puffiness of your hands, face, eyes.

Sudden excessive weight gain not related to overeating.

Painful or burning urination.

Fainting or dizziness.

Chills and fever over 100°F in the absence of cold or flu symptoms (start bringing down any fever over 100°F promptly by taking acetaminophen, or Tylenol).

Severe nausea and vomiting; vomiting more often than two or three times a day in the first trimester; vomiting later in pregnancy when you didn’t earlier.

Itching all over, with or without dark urine, pale stools, or jaundice (yellowing of skin and whites of the eye).

Frequent (more than three times a day) diarrhea, especially if it’s mucousy (if it’s bloody, call right away).

Your practitioner may want you to call for different reasons or within different parameters, so be sure to ask him or her what protocol you should follow if you experience any of these symptoms.

Keep in mind, too, that there might be some times when you have none of the symptoms listed here, but you feel unusually exhausted, achy, not quite right. If a good night’s sleep and some extra relaxation don’t team up to make you feel better in a day or two, check with your practitioner. Chances are what you’re feeling is normal—par for the pregnancy course. But it is also possible that you’ve become anemic or you’re fighting an infection of some kind. Certain conditions—UTI, for example—can do their dirty work without causing any clear-cut symptoms. So when in doubt, check it out.

Infection of the vagina or cervix.
An inflamed or irritated cervix or vagina might cause some spotting (though the spotting should disappear once you’re treated for the infection).

Subchorionic bleed.
Subchorionic bleeding occurs when there is an accumulation of blood under the chorion (the outer fetal membrane, next to the placenta) or between the uterus and the placenta itself. It can cause light to heavy spotting but doesn’t always (sometimes it is only detected during a routine ultrasound). Most subchorionic bleeds resolve on their own and do not end up being a problem for the pregnancy (see
page 545
for more).

Spotting is as variable in a normal pregnancy as it is common. Some women spot on and off for their entire pregnancies. Other women spot for just a day or two—and others for several weeks. Some women notice mucousy brown or pink spotting; others see small amounts of bright red blood. But happily, most women who experience any kind of spotting continue to have com
pletely normal and healthy pregnancies and end up delivering perfectly healthy babies. Which means that there’s probably nothing for you to worry about (though, realistically, that doesn’t mean you’ll stop worrying).

For extra reassurance, put in a call to your practitioner (no need to call immediately or during non–office hours unless you’re noticing spotting accompanied by cramping or bright red, soak-through-a-pad bleeding), who will likely order an ultrasound. If you’re past the sixth week, you’ll probably be able to see your baby’s heartbeat during the ultrasound, which will reassure you that your pregnancy is progressing along just fine, even with the spotting.

What if the spotting progresses to heavier bleeding similar to a period? Though such a scenario is more cause for concern (especially if it’s accompanied by cramps or pain in your lower abdomen) and does warrant an immediate call to your practitioner, it’s not a sign that you’re inevitably miscarrying. Some women bleed—even heavily—for unknown reasons throughout their pregnancies and still deliver healthy babies at term.

If it does end up that you’re having a miscarriage, see
page 536
.

No Worries

Some expectant moms (and you know who you are) will always find something to worry about—especially in the first trimester and particularly in first pregnancies. Topping the list of most common concerns, understandably, is a fear of miscarriage.

Fortunately, most expectant worriers end up worrying unnecessarily. Most pregnancies continue uneventfully, and happily, to term. Just about every normal pregnancy includes some cramps, some abdominal aches, or some spotting—and many include all three. While any of these symptoms can be understandably unnerving (and when it comes to a stain on your underwear, downright scary), more often than not, they’re completely innocuous—and not a sign that your pregnancy is in trouble. Though you should report them to your practitioner at your next visit (or sooner if you need some professional reassurance), the following are no cause for concern. So don’t worry if you have: