Pregnancy brings many new sensations and symptoms, most of which are completely normal. However, some early pregnancy signs can indicate serious complications that require immediate medical attention. Knowing the difference between typical pregnancy discomforts and genuine warning signs could save your life and your baby’s life.
This comprehensive guide will help you understand which symptoms are normal, which warrant a call to your doctor, and which require emergency care. Remember: when in doubt, always contact your healthcare provider. It’s better to check and find out everything is fine than to ignore a potentially serious problem.
Understanding Normal Early Pregnancy Symptoms
Before we discuss warning signs, let’s review common normal symptoms in early pregnancy:
Typical First Trimester Symptoms (Usually Harmless)
- Mild cramping (similar to period cramps)
- Light spotting (implantation bleeding)
- Nausea and vomiting (morning sickness)
- Breast tenderness and swelling
- Fatigue and exhaustion
- Frequent urination
- Food aversions and cravings
- Mild headaches
- Constipation
- Bloating and gas
- Mood swings
- Light-headedness
- Increased vaginal discharge (clear or white)
These are generally normal, but severity matters! If any of these symptoms become extreme, contact your doctor.
Critical Warning Signs: Seek Immediate Medical Attention
1. Severe Abdominal or Pelvic Pain
Normal vs. Concerning
Normal:
- Mild cramping similar to period cramps
- Brief sharp pains (round ligament pain)
- Dull aching that comes and goes
- Cramping with position changes
CONCERNING:
- Sharp, intense pain on one side
- Severe cramping that doesn’t subside
- Pain accompanied by dizziness or fainting
- Pain that worsens over time
- Cramping with heavy bleeding
- Pain that doubles you over
Why It’s Serious
Ectopic Pregnancy:
- Fertilized egg implants outside uterus (usually fallopian tube)
- Can cause tube rupture
- Life-threatening if untreated
- Symptoms: One-sided sharp pain, shoulder pain, dizziness
Miscarriage:
- Severe cramping with heavy bleeding
- Tissue passing with blood
- Pain worse than period cramps
Ovarian Torsion:
- Ovary twists on itself
- Cuts off blood supply
- Causes sudden, severe one-sided pain
Other Causes:
- Appendicitis
- Ovarian cyst rupture
- Urinary tract infection
- Kidney stones
What To Do
Immediate ER if:
- Severe pain with fainting or dizziness
- Sharp, stabbing one-sided pain
- Pain with heavy bleeding
- Shoulder pain (can indicate internal bleeding)
- Can’t walk or stand due to pain
Call Doctor Same Day if:
- Moderate pain that persists
- Cramping worse than period cramps
- Pain with fever
- Increasing pain over hours
2. Heavy Vaginal Bleeding
Normal vs. Concerning
Normal:
- Light pink or brown spotting
- Spotting after sex (cervix is sensitive)
- Implantation bleeding (light, 1-2 days)
- Small amount of blood when wiping
CONCERNING:
- Bright red blood
- Soaking through a pad in an hour
- Passing blood clots
- Bleeding with tissue
- Bleeding with severe cramping
- Continuous bleeding for days
Why It’s Serious
Miscarriage:
- Affects 10-20% of known pregnancies
- Often occurs in first 12 weeks
- Symptoms: Heavy bleeding, severe cramping, tissue passing
Types of Miscarriage:
Threatened Miscarriage:
- Bleeding but pregnancy may continue
- Cervix remains closed
- Requires monitoring
Inevitable Miscarriage:
- Cervix opening
- Pregnancy cannot continue
- Heavy bleeding and cramping
Incomplete Miscarriage:
- Some tissue remains in uterus
- May require D&C procedure
- Continued bleeding and cramping
Molar Pregnancy:
- Abnormal tissue growth instead of baby
- Causes severe nausea, rapid uterus growth
- Requires immediate treatment
Subchorionic Hematoma:
- Blood accumulation between uterus and placenta
- Can cause bleeding
- Often resolves on its own
- Requires monitoring
What To Do
Immediate ER if:
- Soaking through pads every hour
- Passing large clots (bigger than quarter)
- Bleeding with severe pain
- Bleeding with dizziness or fainting
- Bright red bleeding with tissue
Call Doctor Immediately if:
- Any amount of red blood
- Bleeding after sex
- Bleeding with cramping
- Pink or brown discharge continues for days
- Any bleeding concerns you
What to Track:
- Amount (light, moderate, heavy)
- Color (pink, brown, bright red)
- Clots or tissue
- Associated pain
- When it started
- Save any tissue that passes (doctor may want to examine)
3. Severe Nausea and Vomiting (Hyperemesis Gravidarum)
Normal vs. Concerning
Normal Morning Sickness:
- Nausea throughout day
- Vomiting 1-2 times daily
- Can eat and drink between episodes
- Doesn’t prevent daily activities
- Improves by 12-14 weeks
CONCERNING (Hyperemesis Gravidarum):
- Vomiting multiple times daily
- Can’t keep any food or liquids down
- Losing weight (5% or more)
- Dark urine (dehydration)
- Dizziness when standing
- Rapid heartbeat
- Confusion or weakness
- Vomiting blood
Why It’s Serious
Dehydration:
- Leads to electrolyte imbalance
- Can harm mother and baby
- Causes kidney problems
- May require hospitalization
Malnutrition:
- Baby can’t get needed nutrients
- Mother’s health declines
- Weight loss dangerous in pregnancy
Ketosis:
- Body breaks down fat for energy
- Can harm baby’s development
- Requires medical treatment
What To Do
Immediate ER if:
- Can’t keep down liquids for 24 hours
- Vomiting blood
- Severe dizziness or fainting
- Dark urine or no urination
- Confusion or severe weakness
Call Doctor Same Day if:
- Vomiting more than 3-4 times daily
- Losing weight
- Can’t eat or drink
- Urine is dark yellow
- Normal remedies don’t help
Treatment Options:
- IV fluids
- Anti-nausea medications (safe for pregnancy)
- Vitamin B6 and doxylamine
- Hospitalization if severe
- Home health care for IV fluids
4. High Fever (100.4°F or Higher)
Why It’s Serious
Risk to Baby:
- High fever in first trimester linked to birth defects
- Can affect neural tube development
- May increase miscarriage risk
- Indicates infection
Possible Causes:
- Urinary tract infection (UTI)
- Kidney infection
- Flu or COVID-19
- Listeria (food-borne illness)
- Appendicitis
- Other bacterial/viral infections
What To Do
Call Doctor Immediately if:
- Temperature 100.4°F or higher
- Fever with chills
- Fever with back pain (kidney infection)
- Fever with painful urination
- Fever with severe headache
- Fever that doesn’t respond to Tylenol
Safe Fever Treatment:
- Acetaminophen (Tylenol) – safe in pregnancy
- Cool compress
- Lukewarm bath
- Stay hydrated
- Rest
DO NOT use:
- Ibuprofen (Advil, Motrin)
- Aspirin
- Naproxen
5. Sudden Severe Headache
Normal vs. Concerning
Normal Pregnancy Headaches:
- Mild to moderate intensity
- Respond to rest and Tylenol
- Gradual onset
- No visual changes
- No other symptoms
CONCERNING:
- Sudden, severe headache (worst of your life)
- Throbbing pain that won’t go away
- Headache with vision changes
- Headache with swelling
- Migraine worse than usual
- Headache with dizziness
Why It’s Serious
Preeclampsia (even in early pregnancy):
- High blood pressure disorder
- Can develop before 20 weeks (rare but possible)
- Symptoms: Severe headache, vision changes, upper abdominal pain, sudden swelling
Other Serious Causes:
- Blood clot in brain
- Stroke (rare but possible)
- Meningitis
- Brain hemorrhage
What To Do
Immediate ER if:
- Sudden, severe headache
- Headache with vision changes (spots, flashing lights, blurriness)
- Headache with slurred speech
- Headache with numbness or weakness
- Headache with seizure
- Worst headache of your life
Call Doctor Same Day if:
- Persistent headache not relieved by Tylenol
- Headache with swelling
- Headache with upper abdominal pain
- Frequent severe headaches
6. Vision Changes
Concerning Symptoms
- Blurred vision
- Seeing spots or flashing lights
- Double vision
- Temporary vision loss
- Seeing auras (shimmering lights)
- Tunnel vision
- Sudden floaters
Why It’s Serious
Preeclampsia:
- Can cause vision changes
- Requires immediate treatment
- Can progress to eclampsia (seizures)
Gestational Diabetes:
- Can affect vision
- Requires blood sugar management
Other Causes:
- Migraine with aura
- Retinal detachment
- High blood pressure
- Blood clots
What To Do
Immediate ER if:
- Sudden vision loss
- Vision changes with headache
- Vision changes with swelling
- Persistent vision problems
Call Doctor Same Day if:
- Blurred vision
- New floaters
- Any vision changes concern you
7. Persistent Dizziness or Fainting
Normal vs. Concerning
Normal:
- Light-headedness when standing quickly
- Brief dizziness that passes
- Feeling slightly dizzy when hungry
CONCERNING:
- Fainting or passing out
- Severe dizziness that doesn’t improve
- Dizziness with chest pain
- Dizziness with vaginal bleeding
- Room spinning (vertigo)
- Dizziness with rapid heartbeat
Why It’s Serious
Ectopic Pregnancy:
- Internal bleeding causes dizziness
- Can lead to shock and collapse
- Life-threatening emergency
Severe Dehydration:
- From vomiting or not drinking enough
- Drops blood pressure
- Reduces blood flow to baby
Anemia:
- Low iron levels common in pregnancy
- Causes dizziness and fatigue
- Reduces oxygen to baby
Low Blood Pressure:
- Normal in pregnancy but can be excessive
- Reduces blood flow to baby
- May indicate other problems
What To Do
Immediate ER if:
- Fainting or passing out
- Dizziness with vaginal bleeding
- Dizziness with severe abdominal pain
- Dizziness with chest pain
- Can’t stand without fainting
Call Doctor Same Day if:
- Frequent dizziness
- Severe light-headedness
- Dizziness that doesn’t improve with eating/drinking
- Dizziness with rapid heartbeat
Prevention:
- Stand up slowly
- Eat small, frequent meals
- Stay hydrated
- Avoid hot environments
- Lie on left side
8. Decreased or No Fetal Movement (After Quickening)
When You Should Feel Movement
- First pregnancy: 18-25 weeks
- Subsequent pregnancies: 16-18 weeks
- Regular patterns establish by 28 weeks
Concerning Signs
- Not feeling baby move all day
- Sudden decrease in normal movement
- No movement after eating or drinking cold water
- No movement after lying on left side
- Pattern significantly different from normal
Why It’s Serious
Potential Issues:
- Fetal distress
- Umbilical cord problems
- Placental problems
- Low amniotic fluid
- Baby needs monitoring
What To Do
If After 28 Weeks:
Immediate ER if:
- No movement for several hours (after 28 weeks)
- Sudden decrease from normal pattern
- Can’t get baby to move with usual tricks
Try This First (after 20 weeks):
- Lie on your left side
- Drink cold water or juice
- Eat a snack
- Poke belly gently
- Count movements for an hour (should feel 10)
- If still no movement, call doctor immediately
Note: Before 20 weeks, movement is sporadic and hard to track. Don’t panic if you don’t feel daily movement before this point.
9. Painful or Burning Urination
Symptoms of Urinary Tract Infection (UTI)
- Burning when urinating
- Frequent urge to pee with little output
- Cloudy or foul-smelling urine
- Blood in urine
- Lower abdominal pressure
- Low back pain
Why It’s Serious
Kidney Infection Risk:
- Untreated UTIs can spread to kidneys
- Causes high fever and severe back pain
- Can trigger preterm labor
- May harm baby
Increased Risk in Pregnancy:
- Hormones relax urinary tract
- Uterus presses on bladder
- UTIs more common and dangerous
- Can lead to serious complications
What To Do
Immediate ER if:
- Fever with urinary symptoms
- Severe back pain (especially one-sided)
- Nausea and vomiting with UTI symptoms
- Blood in urine with pain
Call Doctor Same Day if:
- Burning when urinating
- Frequent urination with pain
- Cloudy or smelly urine
- Pelvic pressure with urinary symptoms
Treatment:
- Antibiotics (safe for pregnancy)
- Drink plenty of water
- Urinate frequently
- Cranberry juice may help prevent (not treat)
Prevention:
- Wipe front to back
- Urinate after sex
- Stay hydrated
- Don’t hold urine
- Wear cotton underwear
10. Sudden Swelling (Especially Face and Hands)
Normal vs. Concerning
Normal:
- Gradual swelling in feet and ankles
- Swelling that improves with rest
- Mild puffiness in hands
- Swelling worse at end of day
CONCERNING:
- Sudden swelling in face
- Rapid hand swelling (can’t remove rings)
- Swelling in one leg only
- Swelling with headache
- Swelling with vision changes
- Severe puffiness that doesn’t improve
Why It’s Serious
Preeclampsia:
- High blood pressure with organ damage
- Can develop suddenly
- Dangerous for mother and baby
- Symptoms: Sudden swelling, severe headache, vision changes, upper abdominal pain
Blood Clot (DVT):
- Swelling in one leg only
- Warmth, redness, pain
- Can travel to lungs (life-threatening)
Other Causes:
- Kidney problems
- Heart problems
- Severe fluid retention
What To Do
Immediate ER if:
- Sudden facial swelling
- Swelling with severe headache
- Swelling with vision changes
- One-sided leg swelling with pain
- Swelling with upper abdominal pain
Call Doctor Same Day if:
- Rapid increase in swelling
- Hand swelling that prevents ring removal
- Swelling that doesn’t improve with rest
- Swelling with weight gain (more than 5 lbs in a week)
11. Fluid Leaking from Vagina (Before 37 Weeks)
Normal Discharge vs. Amniotic Fluid
Normal Discharge:
- Thick, white, or clear
- No odor or mild smell
- Increases throughout pregnancy
- Doesn’t continuously leak
Amniotic Fluid:
- Watery, thin consistency
- Clear or pale yellow
- Continuous trickle or gush
- Slight sweet or no odor
- Soaks underwear or pad
- May have vernix (white flakes)
Why It’s Serious
Preterm Premature Rupture of Membranes (PPROM):
- Water breaks before 37 weeks
- High risk of infection
- May lead to preterm labor
- Baby may need to be delivered
Risks:
- Infection (chorioamnionitis)
- Umbilical cord compression
- Placental abruption
- Preterm birth
What To Do
Immediate Call to Doctor if:
- Gush of fluid from vagina
- Continuous trickle soaking pad
- Suspect water broke (any amount)
- Fluid leaking with contractions
What Doctor Will Do:
- Test fluid to confirm amniotic fluid
- Check for infection
- Monitor baby
- Decide on delivery vs. monitoring
- May give steroids for baby’s lungs
- Antibiotics to prevent infection
DO NOT:
- Insert anything into vagina
- Have sex
- Take a bath (shower only)
- Wait to call if you suspect water broke
12. Severe Upper Abdominal Pain
Location Matters
Right Upper Abdomen:
- Below ribs on right side
- May radiate to back
- May be HELLP syndrome (variant of preeclampsia)
Epigastric Pain:
- Upper middle abdomen
- Below breastbone
- May be preeclampsia
Why It’s Serious
HELLP Syndrome:
- Hemolysis, Elevated Liver enzymes, Low Platelets
- Variant of severe preeclampsia
- Can cause liver rupture
- Life-threatening
- Symptoms: Right upper abdominal pain, nausea, vomiting, headache
Liver Problems:
- Acute fatty liver of pregnancy (rare)
- Liver dysfunction
- Requires immediate delivery
Gallbladder Issues:
- Gallstones common in pregnancy
- Can cause severe pain
- May require treatment
What To Do
Immediate ER if:
- Severe upper abdominal pain
- Pain with headache
- Pain with nausea/vomiting
- Pain with vision changes
- Right shoulder pain (can indicate liver bleeding)
Call Doctor Immediately if:
- Persistent upper abdominal pain
- Pain that worsens
- Pain with other symptoms
13. Severe Itching (Especially Hands and Feet)
Normal vs. Concerning
Normal:
- Mild itching on belly (stretching skin)
- Itching relieved by moisturizer
- Occasional itching
CONCERNING:
- Intense itching on palms and soles
- Itching that keeps you awake
- Itching all over body
- Itching worse at night
- No rash (or rash from scratching only)
Why It’s Serious
Intrahepatic Cholestasis of Pregnancy (ICP):
- Liver disorder
- Bile acids build up in blood
- Can harm baby
- Increased risk of stillbirth
- Usually occurs in 3rd trimester but can be earlier
Symptoms:
- Intense itching (especially hands/feet)
- No rash
- Dark urine
- Pale stools
- Jaundice (yellowing skin/eyes)
What To Do
Call Doctor Soon if:
- Severe itching, especially palms and soles
- Itching that doesn’t respond to moisturizer
- Itching keeps you awake
- Dark urine with itching
Testing:
- Blood test for bile acids
- Liver function tests
Treatment:
- Medication to reduce itching
- Monitoring baby closely
- May require early delivery
14. Chest Pain or Difficulty Breathing
When It’s an Emergency
Immediate ER if:
- Severe chest pain
- Can’t catch your breath
- Chest pain radiating to arm, jaw, or back
- Rapid heartbeat with chest pain
- Blue lips or fingertips
- Chest pain with coughing up blood
Why It’s Serious
Pulmonary Embolism:
- Blood clot in lung
- Life-threatening
- Pregnancy increases risk
- Symptoms: Sudden shortness of breath, chest pain, rapid heartbeat
Heart Problems:
- Peripartum cardiomyopathy
- Heart attack (rare but possible)
- Arrhythmias
Severe Asthma Attack:
- Dangerous for mother and baby
- Requires emergency treatment
Normal vs. Concerning
Normal:
- Slight breathlessness with exertion
- Feeling “out of breath” after stairs
- Need to breathe deeper
CONCERNING:
- Can’t catch breath at rest
- Chest pain
- Wheezing
- Rapid heartbeat over 100 bpm
- Feeling like you’re suffocating
When to Call Your Doctor vs. Going to ER
Call Your Doctor’s Office
During office hours for:
- Persistent mild symptoms
- Questions about normal vs. concerning symptoms
- Symptoms that worry you but aren’t emergencies
- Scheduled appointment concerns
Call Your Doctor’s After-Hours Line
For:
- Moderate bleeding
- Severe morning sickness
- Fever
- UTI symptoms
- Moderate pain
- Any symptom you’re unsure about
Go Directly to Emergency Room
For:
- Heavy bleeding
- Severe abdominal pain
- Signs of ectopic pregnancy
- Water breaking before 37 weeks
- Severe headache with vision changes
- Fainting
- Chest pain or difficulty breathing
- Severe allergic reaction
- High fever with severe symptoms
- Any life-threatening symptom
When in doubt, call! Your healthcare provider would rather you check than ignore a serious problem.
Risk Factors for Pregnancy Complications
You may be at higher risk if you have:
Medical Conditions:
- High blood pressure
- Diabetes
- Thyroid disorders
- Autoimmune diseases
- Heart disease
- Kidney disease
- Blood clotting disorders
Previous Pregnancy Issues:
- Previous miscarriage
- Previous ectopic pregnancy
- Previous preeclampsia
- Previous preterm birth
- Previous stillbirth
Lifestyle Factors:
- Maternal age over 35
- Maternal age under 17
- Obesity
- Underweight
- Smoking
- Alcohol use
- Drug use
Current Pregnancy:
- Multiples (twins, triplets)
- IVF pregnancy
- Pregnancy complications already diagnosed
If you have risk factors, discuss closer monitoring with your healthcare provider.
How to Advocate for Yourself
Trust Your Instincts
- You know your body better than anyone
- If something feels wrong, speak up
- Don’t worry about “bothering” your doctor
- It’s their job to address your concerns
Be Prepared When Calling
Have This Information Ready:
- How many weeks pregnant you are
- Your symptoms (when started, severity, changes)
- Your temperature (if relevant)
- Amount of bleeding (if any)
- Pain level (1-10 scale)
- What makes symptoms better or worse
- Your medical history
- Current medications
Don’t Downplay Symptoms
- Be honest about severity
- Don’t minimize your concerns
- Describe symptoms accurately
- Mention if symptoms are worsening
Ask Questions
- “Should I come in to be checked?”
- “What symptoms should I watch for?”
- “When should I call back?”
- “What could this mean?”
- “Is there anything I should do at home?”
Get a Second Opinion
- If you feel dismissed, seek another opinion
- Switch providers if you’re not comfortable
- Trust your gut about your care
Keeping Track: Symptom Journal
Consider tracking:
- Date and time of symptoms
- Type of symptom
- Severity (1-10)
- Duration
- What you were doing when it started
- What makes it better or worse
- Associated symptoms
- Photos (of bleeding, swelling, rashes)
This helps your doctor:
- Understand patterns
- Make accurate diagnoses
- Track progression
- Determine urgency
Prevention and Self-Care
Reduce Risks
Do:
- Attend all prenatal appointments
- Take prenatal vitamins daily
- Stay hydrated (8-10 glasses water daily)
- Eat nutritious meals
- Get adequate rest
- Exercise moderately (with doctor approval)
- Manage stress
- Avoid alcohol, smoking, drugs
- Limit caffeine (under 200mg daily)
Avoid:
- Raw or undercooked meat
- Unpasteurized dairy
- High-mercury fish
- Deli meats and hot dogs (unless heated)
- Raw eggs
- Soft cheeses (brie, feta, blue cheese)
- Excessive vitamin A
- Cat litter (toxoplasmosis risk)
- Contact with people who are sick
Know Your Baseline
- Track your normal symptoms
- Know your blood pressure
- Understand your risk factors
- Recognize what’s normal for you
- Notice changes from your baseline
Reassurance: Most Pregnancies Are Healthy
While this guide covers many serious complications, remember:
- Most pregnancies proceed normally
- Most symptoms are typical pregnancy changes
- Your body is designed for this
- Modern medicine can treat most complications
- Being informed helps you recognize problems early
- Early intervention saves lives
The goal isn’t to worry constantly—it’s to be informed so you can act quickly if needed.
Final Thoughts
Early pregnancy is a time of immense change, excitement, and sometimes anxiety. While most symptoms are normal parts of your body adapting to pregnancy, some warning signs require immediate attention.
Key Takeaways:
✓ Trust your instincts – if something feels wrong, call your doctor ✓ Severe symptoms require immediate care – don’t wait ✓ Document your symptoms – helps with accurate diagnosis ✓ Know your risk factors – allows for appropriate monitoring ✓ Don’t fear “bothering” your doctor – they prefer cautious patients ✓ Most pregnancies are healthy – don’t stress constantly ✓ Early intervention is key – many complications are treatable if caught early ✓ You are your best advocate – speak up for yourself and your baby
Emergency Numbers to Keep Handy
- Your OB/GYN office number
- After-hours answering service
- Nearest emergency room
- Poison control: 1-800-222-1222
- Pregnancy helpline: Various organizations offer 24/7 support
Remember: This guide provides educational information about warning signs in early pregnancy. It is not a substitute for professional medical advice. Always consult with your healthcare provider about your specific symptoms and situation. When in doubt, make the call. Your health and your baby’s health are worth it.
You’re doing an amazing job growing your baby. Stay informed, stay vigilant, and don’t hesitate to seek help when you need it. You’ve got this, mama!
