Urgent Maternal Warning Signs

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 another part 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.)

Additional Resources

• National Library of Medicine Medline Plus – High Blood Pressure in Pregnancy 
• National Heart, Lung, and Blood Institute — Pregnancy and High Blood Pressure
• Preeclampsia Foundation – Signs & Symptoms
• March of Dimes – Preeclampsia
• National Heart, Lung, and Blood Institute — What is Venous Thromboembolism? 
• CDC – Venous Thromboembolism (Blood Clots) and Pregnancy
• March of Dimes – Blood Clots and Pregnancy
• March of Dimes – Migraine Headaches During Pregnancy 

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

Additional Resources

• Preeclampsia Foundation – Signs & Symptoms
• March of Dimes – Blood Clots and Pregnancy
• National Heart, Lung, and Blood Institute — Pregnancy and Your Heart Health Fact Sheet
• National Heart, Lung, and Blood Institute — Pregnancy and Cardiomyopathy
• National Library of Medicine Medline Plus – Peripartum Cardiomyopathy
• March of Dimes – Bleeding and Spotting from the Vagina During Pregnancy
• March of Dimes – Postpartum Hemorrhage
• CDC – Diabetes During Pregnancy
• March of Dimes – Gestational Diabetes
• March of Dimes – Preexisting Diabetes
   

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.

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.

Additional Resources

• 988 Suicide & Crisis Lifeline. If you are in suicidal crisis, please call or text 988 or visit the 988 Suicide & Crisis Lifeline. If you are hard of hearing, you can chat with a Lifeline counselor 24/7 by online chat – Lifeline Chat : Lifeline (988lifeline.org) or, for TTY Users: Use your preferred relay service or dial 711 then 988.
• Health Resources and Services Administration (HRSA) National Maternal Mental Health Hotline. Call or text 1-833-943-5746 (1-833-9-HELP4MOMS). TTY users can use a preferred relay service or dial 711 and then 1-833-943-5746.
• National Institute of Child Health and Human Development – Mom’s Mental Health Matters
• Office on Women’s Health – Postpartum Depression
• March of Dimes – Depression During Pregnancy

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

Additional Resources

• Preeclampsia Foundation – Signs & Symptoms
• March of Dimes – Blood Clots and Pregnancy

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)

Additional Resources

• Sepsis Alliance – Pregnancy & Childbirth 
• Merck Manual — Infections of the Uterus After Pregnancy 
• CDC – Pregnancy and Flu
• CDC – COVID-19 – Pregnant and Recently Pregnant Women

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

Additional Resources

• March of Dimes – Preeclampsia
• CDC – Venous Thromboembolism (Blood Clots) and Pregnancy
• National Library of Medicine Medline Plus – Pulmonary Embolism
• National Heart, Lung, and Blood Institute — Pregnancy and Your Heart Health Fact Sheet
• National Heart, Lung, and Blood Institute — Pregnancy and Cardiomyopathy
• National Library of Medicine Medline Plus – Peripartum Cardiomyopathy
• CDC – COVID-19 – Pregnant and Recently Pregnant Women

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 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

Additional Resources

• National Heart, Lung, and Blood Institute — Heart Attacks in Women
• CDC – Venous Thromboembolism (Blood Clots) and Pregnancy
• National Library of Medicine Medline Plus – Pulmonary Embolism
• National Heart, Lung, and Blood Institute — Pregnancy and Your Hearth Health Fact Sheet
• March of Dimes – Blood Clots and Pregnancy

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

Additional Resources

• March of Dimes – Placental Abruption
• National Library of Medicine Medline Plus – Placenta Abruptio
• National Library of Medicine Medline Plus – High Blood Pressure in Pregnancy 
• Preeclampsia Foundation – What is HELLP Syndrome?
• March of Dimes – HELLP Syndrome
   

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

Additional Resources

• National Library of Medicine Medline Plus – hyperemesis gravidarum
• March of Dimes – Intrahepatic Cholestasis of Pregnancy 
• March of Dimes – Food Poisoning During Pregnancy
   

BABY’S MOVEMENT STOPPING OR SLOWING DURING PREGNANCY

• 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

Additional Resources

• Count the Kicks
• National Health Services (UK) and St. Thomas’ Hospital (Tommy’s)– Reduced Fetal Movement Informational Leaflet (PDF)
• Merck Manual — Infections of the Uterus After Pregnancy 
• March of Dimes – Oligohydramnios
• Mayo Clinic – Low Amniotic Fluid

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. 

Additional Resources

• Merck Manual — Infections of the Uterus After Pregnancy 
• March of Dimes – Placental Abruption
• National Library of Medicine Medline Plus – Placenta Abruptio
• March of Dimes – Bleeding and Spotting from the Vagina During Pregnancy

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.

Additional Resources

• March of Dimes – Postpartum Hemorrhage
• Sepsis Alliance – Pregnancy & Childbirth 
• Merck Manual — Infections of the Uterus After Pregnancy 
   

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

Additional Resources

• National Heart, Lung, and Blood Institute — What is Venous Thromboembolism? 
• CDC – Venous Thromboembolism (Blood Clots) and Pregnancy
• March of Dimes – Blood Clots and Pregnancy
• National Library of Medicine Medline Plus – Pulmonary Embolism

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

Additional Resources

• National Library of Medicine Medline Plus – High Blood Pressure in Pregnancy 
• National Heart, Lung, and Blood Institute — Pregnancy and High Blood Pressure
• Preeclampsia Foundation – Signs & Symptoms
• March of Dimes – Preeclampsia
• National Institute for Child Health and Human Development (NICHD) – Preeclampsia and Eclampsia
• National Heart, Lung, and Blood Institute — Pregnancy and Your Heart Health Fact Sheet

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

Additional Resources

• National Heart, Lung, and Blood Institute — Pregnancy and Cardiomyopathy
• National Library of Medicine Medline Plus – Peripartum Cardiomyopathy
• National Heart, Lung, and Blood Institute — Pregnancy and Your Heart Health Fact Sheet
• March of Dimes – Anemia
• Office on Women’s Health – Iron Deficiency Anemia
• CDC – Diabetes During Pregnancy
• March of Dimes – Gestational Diabetes
• March of Dimes – Preexisting Diabetes
• NICHD – Mom’s Mental Health Matters
• Office on Women’s Health – Postpartum Depression
• Health Resources and Services Administration (HRSA) National Maternal Mental Health Hotline Call or text 1-833-943-5746 (1-833-9-HELP4MOMS). TTY users can use a preferred relay service or dial 711 and then 1-833-943-5746.