Urgent Maternal Warning Signs

If you have any of these symptoms during or after pregnancy, contact your health care provider and get help right away. If you can’t reach your provider, go to the emergency room.

Always remember to say that you’re pregnant or have been pregnant within the last year when getting help.

Symptoms

Headache that won’t go away or gets worse over time

Feels like the worst headache of your life
Lasts even after treatment with medication and fluid intake
Starts suddenly with severe pain – like a clap of thunder
Throbs and is on one side of your head above your ear
Comes with blurred vision or dizziness

A headache is especially worrisome if:

You don’t usually have headaches
It happens at or after 16 weeks of your pregnancy or in the first few weeks after giving birth
You have high blood pressure or swelling in other parts of your body

A lasting, severe headache may be a warning sign of other problems, such as:

Preeclampsia – a type of high blood pressure that happens during pregnancy
A migraine – women sometimes get their first migraine during pregnancy (migraines are severe headaches on one or both sides of your head that get worse with light, sound, or smells)
Rarely, a stroke or other brain problems (a stroke is a blood clot that stops blood and oxygen from going into your brain

Dizziness or fainting

You faint or pass out
You have dizziness and lightheadedness that’s ongoing, or comes and goes over many days
You experience a gap in time of which you have no memory

Feeling dizzy or faint is especially worrisome if:

It happens at or after 16 weeks of your pregnancy or in the first few weeks after you give birth
You also have:
- Headache
- Blurred vision
- Slurred speech
- Fast heartbeat, chest pain, or shortness of breath
- Vaginal bleeding

Feeling dizzy or faint may be a warning sign of other problems, such as:

Preeclampsia—a type of high blood pressure that happens during pregnancy
A stroke—a blood clot that stops blood and oxygen from going into your brain
A heart or lung problem
Too much bleeding, which can occur even if you don’t see blood
Problems with your blood sugar levels

Thoughts about hurting yourself or your baby

You may think about hurting yourself because you:
- Feel very sad, hopeless, or not good enough
- Don’t feel that you have control over your life
- Feel extremely worried all the time
You may think about hurting your baby and/or you may have scary thoughts that come when you don’t want or that are hard to get rid of.

If you feel out of touch with reality (you see or hear things that other people don’t), or if family/friends are worried about your safety or that you might hurt others, get help now.

Options for getting help now include:

Go to the local emergency room
Call 9-1-1
Call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for free and confidential emotional support

Thoughts of hurting yourself or your baby may be a warning sign of other problems, such as:

Depression – a serious mood disorder that affects how you feel, think, and handle daily activities
Anxiety – feelings of fear, worry, or panic

Feelings and thoughts about hurting yourself or your baby:

May be mild to completely unbearable
May come and go, or be with you constantly
Could feel like “I can’t do this anymore” or “I wish I could make this go away”

You’re not alone–call your care provider for help.

Changes in your vision

You see flashes of light or bright spots
You have blind spots or you can’t see at all for a short time
Your vision is blurry, you can’t focus, or you’re seeing double

Vision changes are especially worrisome if:

They happen at or after 16 weeks of your pregnancy or in the first few weeks after you give birth

Vision changes may be a warning sign of other problems, such as:

Preeclampsia – a type of high blood pressure that happens during or after pregnancy
Stroke – a blood clot that stops blood and oxygen from going into your brain

Fever

You have a temperature of 100.4°F (38°C) or higher

A fever is especially worrisome if you also have:

Diarrhea, nausea, or vomiting
Severe belly pain
Severe back pain
Trouble urinating or changes in your urination
Vaginal discharge that smells bad

A fever may be a warning sign of other problems, such as:

An infection somewhere in your body
- Appendix, gall bladder, or bowel infection
- Kidney infection
- Uterine infection
- Infection in your lungs, (pneumonia or the flu)

Trouble breathing

You feel short of breath suddenly or over time, as if you can’t breathe deeply enough to get enough air in your lungs
Your throat and/or chest feel tight
You have trouble breathing when you’re laying down flat, such as needing to prop your head up with pillows to sleep

Trouble breathing is especially worrisome if:

You have high blood pressure or swelling in other parts of your body
It happens suddenly, sometimes after you’ve had swelling in one of your thighs, lower legs, or arms
It happens at or after 16-20 weeks of your pregnancy or in the first few weeks after you give birth (vaginally or by c-section)
You also have chest or back pain, headache, swelling, changes in your vision, dizziness, a fast heartbeat, or skipped heartbeats

Trouble breathing may be a warning sign of other problems, such as:

Preeclampsia – a type of high blood pressure that happens during pregnancy
Pulmonary embolism – when your blood carries a blood clot or other substance to your lungs, making it harder for you to breathe
Infection in the lungs
A heart problem that’s getting worse

Chest pain or fast-beating heart

You have chest pain, such as:
- A feeling of tightness or pressure in the center of your chest
- Pain that travels to your back, neck, or arm
You have a change in your heartbeat, such as:
- A fast heartbeat or a pounding in your chest
- An irregular heart rate or skipped heartbeats
You feel dizzy, faint, or disoriented
You have trouble catching your breath (talking and breathing are difficult)

These symptoms can happen at any time and anywhere or may be triggered by a specific event.

These symptoms are especially worrisome if:

Your symptoms start suddenly
You also have:
- Swelling in your arm or leg
- Trouble breathing
- Dizziness or a headache

Chest pain or a fast beating heart may be warning signs of other problems, such as:

Heart attack—when part of your heart dies because it doesn’t get enough oxygen
A blood clot that has traveled to your lungs
A tearing of the large blood vessels that come out from your heart
Some other blockage of normal blood flow in your chest

Severe belly pain that doesn't go away

You have a sharp, stabbing, or cramp-like belly pain that doesn’t go away
Your belly pain starts suddenly and is severe, or gets worse over time
You have severe chest, shoulder, or back pain

Severe belly pain is especially worrisome if you also have:

Back pain
Heartburn so bad it hurts in your chest
Pain in the upper part of your belly
Vaginal bleeding

Severe belly pain may be a warning sign of other problems, such as:

A placental abruption – when your placenta separates from the wall of your uterus before birth
Preeclampsia – a type of high blood pressure that happens during pregnancy
HELLP Syndrome – a condition of pregnancy that affects your blood and liver

Severe nausea and throwing up (not like morning sickness)

You feel severely sick to your stomach (nauseous) beyond the normal queasy feeling and throwing up that many moms have in early pregnancy
You are unable to drink for more than 8 hours or eat for more than 24 hours
You throw up and can’t keep water or other fluids in your stomach
You have:
- A dry mouth
- Headaches
- Confusion
- Fever
- Dizziness or lightheadedness

Feeling severely sick to your stomach or throwing up is especially worrisome if:

You continue to feel sick to your stomach and throw up throughout your pregnancy

Feeling severely sick to your stomach and throwing up may be a warning sign of other problems, such as:

A viral infection
Problems with your liver or pancreas
Food poisoning, which may lead to dehydration

Vaginal bleeding or fluid leaking DURING pregnancy

You have any bleeding from your vagina that is more than spotting – like a period
You have fluid leaking out of your vagina
You have vaginal discharge that smells bad

Vaginal discharge during pregnancy is more worrisome if you also have:

Cramping or pain in your back or belly
Fluid leaking that is bloody or greenish
A feeling of wooziness or light-headedness

Vaginal discharge during pregnancy may be a warning sign of other problems, such as:

An infection
A placental abruption – when your placenta separates from the wall of your uterus before birth
Breaking of your water

Some vaginal discharge is normal during pregnancy.

It’s normal to have small amounts of fluid leaking out of your vagina while you’re pregnant, such as:

An increase in a whitish fluid
Spotting of blood at the start of your pregnancy, after sexual intercourse, or after a vaginal exam
Small amounts of urine (pee)
Pink- or brown-tinged mucous during early labor (your mucous plug)

Pay attention to the changes in your discharge and call your doctor if you have questions.

Vaginal bleeding or fluid leaking AFTER pregnancy

You have heavy bleeding – soaking through one or more pads in an hour
You pass clots bigger than an egg or you pass tissue
You have vaginal discharge that smells bad

Vaginal bleeding, fluid leaking, or spotting after pregnancy may be a warning sign of other problems, such as:

Hemorrhage – too much bleeding
Retained placenta – when all of part of your placenta remains in your uterus after birth
An infection
An unhealed vaginal repair site

Some vaginal leaking is normal after pregnancy. It’s normal to have bleeding and cramping while your uterus heals and returns to its pre-pregnancy size in the 6 weeks after birth.

Bleeding should slow and stop over time:

The first day after you give birth, bleeding may be more than or the same as your period
In the first 1-2 days, you may pass a few small clots (no bigger than an egg), especially after you stand up
In the first 2-3 days, bleeding should be the as a period or heavy period, with cramping that feels like a period
Over the next 5-6 weeks, bleeding should be less every day and will turn into browning, pinkish, then whitish discharge.

6 weeks after giving birth, your uterus has usually healed and returned to its normal size.

Swelling, redness, or pain of your leg

Anytime during pregnancy or up to 6 weeks after birth

You have swelling, pain, or tenderness in your leg – usually your calf or in one leg:
- It may or may not hurt when you touch it
- It may hurt when you flex your foot to stand or walk
- The painful area can also be red, swollen, and warm to the touch
You have pain, tenderness or swelling in your arm, usually on just one side of your body

These symptoms are especially worrisome if:

The swollen side of your body looks redder in color than the other
You can feel a difference in temperature between the two sides of your body

Swelling, pain, or redness may be a warning sign of other problems, such as:

A clot in your vein (deep vein thrombosis), which may travel to other parts of your body and cause other problems:
- In your lungs, a pulmonary embolism that makes it harder for you to breathe (shortness of breath)
- In your brain, a stroke – the stopping of blood and oxygen to your brain

Baby's movements stopping or slowing

You feel that your baby has stopped moving or your baby is moving less than before.

There is no specific number of movements that is considered normal, a change in your baby’s movement is what is important.

Your provider may teach you about kick counts — a way to measure your baby’s movement over time – to help you identify when to get help.

A slowing of stoppage in movements may be a warning sign of other problems, such as:

An infection in your uterus
Not enough amniotic fluid
Fetal distress

Extreme swelling of your hands or face

Swelling in your hands makes it hard to bend your fingers or wear rings
Swelling in your face makes it hard to open your eyes all the way—they feel and look puffy
Your lips and mouth feel swollen or you have a loss of feeling

This swelling is not like the usual slight swelling that most moms have during pregnancy, especially during the last few months of pregnancy.

Swelling of your hands or face is especially worrisome if:

It happens quickly and includes your hands and wrists

Swelling of your hands or face may be a warning sign of other problems, such as:

Preeclampsia—a type of high blood pressure that happens during pregnancy

Overwhelming tiredness

You are suddenly very tired and weak, not like chronic fatigue
You don’t have enough energy to go about your day
No matter how much you sleep, you don’t feel refreshed
You feel so tired that you don’t get up to take care of your baby
You feel sad after having your baby

Overwhelming tiredness is especially worrisome if:

You’re so tired that you can’t do daily activities or take care of your baby
They last longer than 8 months after birth. Symptoms should improve within a couple of weeks.

Overwhelming tiredness may be a warning sign of other problems, such as:

Heart disease
Anemia—a low number of red blood cells
Diabetes—a lifelong illness that involves blood sugar and insulin
Depression—feeling so sad during the weeks and months after having a baby that you can’t do daily activities and have less interest in your baby

This list is not meant to cover every symptom you might have. If you feel like something just isn’t right, or you aren’t sure if it’s serious, it’s always best to tell your care provider and get the help you need.

For Providers

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Additional Resources

Recognize Postpartum Warning Signs Poster for Non-Obstetrical Clinical Staff

Recognize Postpartum Warning Signs Poster for Non-Obstetrical Clinical Staff (Spanish)