Pregnancy · Symptom Triage
Pregnancy Symptom Self-Check
When to call, when to wait, and when it's an emergency. Plain-language red-flag triage for common pregnancy symptoms.
Last reviewed 27 May 2026
Pregnancy symptom check
When to call, when to wait, when it’s an emergency
Tick what you’re experiencing
🚨 Always call your maternity unit straight away for:
- Reduced or absent fetal movements (after 24 wk) — this is THE single most important pregnancy red flag.
- Vaginal bleeding heavier than light spotting.
- Severe headache + visual changes (flashing lights, blurring) + swelling of face/hands — possible pre-eclampsia.
- Severe abdominal pain not relieved by rest.
- Sudden swelling, redness, or pain in one calf — possible DVT.
- Sudden breathlessness or chest pain — possible pulmonary embolism.
- Trickle / gush of clear fluid from vagina before 37 weeks — possible PPROM.
- Persistent itching of palms / soles, worse at night — possible cholestasis (ICP).
Self-care tips for common pregnancy discomforts
- Morning sickness — small frequent meals, ginger, vitamin B6 (10–25 mg), avoiding triggers. Paracetamol if needed. Severe vomiting → see hyperemesis pathway.
- Heartburn / reflux — smaller meals, prop up the head of the bed, avoid late-evening eating, antacids (Gaviscon) and PPIs (omeprazole) safe in pregnancy.
- Backache — pregnancy pillow between knees while sleeping on left side, supportive shoes, prenatal yoga / physio, paracetamol if needed. Avoid NSAIDs after 30 wk.
- Constipation — water + fibre + movement; pregnancy-safe laxatives (lactulose, Movicol).
- Fatigue — common 1st & 3rd trimester. Iron deficiency is a frequent contributor — check ferritin at booking.
- Round ligament pain — brief sharp pain with movement, 2nd trimester. Slow position changes, gentle exercise.
- Braxton-Hicks contractions — tightening without pattern or cervical change. Hydrate, rest. Painful or > 4/hour before 37 wk → call.
- Mild swelling (oedema) — feet/ankles, especially evenings. Elevate, compression stockings. Sudden swelling of face/hands or both legs differently → call.
- Pelvic girdle pain — physiotherapy referral, supportive belt, avoid one-leg-stand activities.
- Vaginal discharge — increased clear/white normal. Itchy, burning, foul-smelling, green/yellow — possible infection, get checked.
- Sleep disturbance — left-side sleeping after 28 wk (cuts late stillbirth risk vs supine), pillows, cool room.
- Headache — mild + settles with paracetamol = usually normal. Severe + visual disturbance + swelling = pre-eclampsia until proven otherwise.
Educational tool only — not medical advice. When in doubt, call your maternity team. Maternity units expect questions and never want you to wait when you’re worried.
What does this mean?
The hardest part of pregnancy is often knowing when something is normal pregnancy discomfort versus when to actually call. A few rules of thumb help. Reduced fetal movements after 24 weeks is the single most important red flag — never wait for movements to return. Maternity units expect these calls and would rather see you for nothing than miss something. The MBRRACE-UK reports repeatedly cite missed or delayed action on reduced movements as a stillbirth contributor. Severe headache + visual disturbance + swelling of face / hands is the pre-eclampsia triad and warrants emergency assessment regardless of how recently you were seen. Vaginal bleeding more than light spotting, severe abdominal pain, sudden breathlessness or chest pain, and swelling/pain in one calf all need same-day urgent review — these are the patterns of placental abruption, pulmonary embolism, and deep vein thrombosis. The first 12 weeks postpartum is the highest-risk window for clots; pregnancy itself raises that risk 4–5 fold over baseline. On the other side, many common discomforts — mild nausea, fatigue, heartburn, backache, Braxton-Hicks tightening, mild ankle swelling, round-ligament pain — respond to simple self-care and don’t need an appointment between routine visits. The compromise: call your midwife when in doubt. Maternity teams are explicit that they want you to call, and being “wrong” about an emergency is never the problem — missing one is.
When should I call my midwife in pregnancy?
The hardest part of pregnancy is often knowing when something is normal discomfort versus when to actually call. A few rules of thumb help. Maternity teams expect questionsand would rather see you for nothing than miss something.
Red flags — call your maternity unit straight away
- Reduced or absent fetal movements after 24 weeks — the single most important red flag.
- Vaginal bleeding heavier than light spotting.
- Severe headache + visual disturbance + sudden swelling of face/hands (possible pre-eclampsia).
- Severe abdominal pain not relieved by rest.
- Sudden swelling, redness, or pain in one calf (possible DVT).
- Sudden breathlessness or chest pain (possible PE).
- Trickle or gush of clear fluid from the vagina before 37 weeks (possible PPROM).
- Persistent itching of palms / soles, worse at night (possible cholestasis).
Urgent but not emergency — call your team today
- Fever ≥ 38 °C.
- Persistent vomiting unable to keep fluids down for 24 hours.
- Repeated dizziness, fainting, or palpitations.
- Burning when urinating + lower back pain + fever (possible pyelonephritis).
Common discomforts — usually self-care
- Mild morning sickness — small frequent meals, ginger, vitamin B6.
- Heartburn — smaller meals, raise head of bed, Gaviscon or omeprazole.
- Backache — pregnancy pillow, supportive shoes, gentle exercise, paracetamol.
- Constipation — water, fibre, movement, pregnancy-safe laxatives.
- Fatigue — check ferritin at booking; common 1st & 3rd trimester.
- Mild ankle swelling — elevate, compression stockings.
- Round ligament pain — slow position changes, gentle exercise.
Why “reduced movements” is the single biggest red flag
After 24 weeks, you should be aware of your baby’s pattern of movement. Reduced movements are a recognised sign of fetal compromise and the MBRRACE-UK confidential enquiry repeatedly cites missed or delayed action as a stillbirth contributor. Don’t drink cold water, eat sugar, or push on your bump first — none of these reliably stimulate a quiet fetus and they only delay assessment. Call your maternity unit. The line is open 24 hours.
Sources
- RCOG patient information leaflets (variety).
- NHS Pregnancy — symptoms to call about.
- MBRRACE-UK Confidential Enquiries into Maternal Deaths.
- Tommy’s — pregnancy symptom guidance.
- ACOG Patient FAQ on common pregnancy symptoms.
Frequently asked questions
When should I worry about reduced fetal movements?
Always call your maternity unit straight away — without waiting to see if movements come back, without waiting for the next appointment, regardless of what time it is. After 24 weeks, reduced or absent movements are THE most important pregnancy red flag. Maternity units expect these calls and would much rather see you for nothing than miss something. Don't drink cold water, eat sugar, or push on your bump first — none of that reliably stimulates a quiet fetus and it just delays assessment.
What are signs of pre-eclampsia?
Severe or persistent headache that doesn't settle with paracetamol; visual disturbance (flashing lights, blurring, spots); sudden swelling of face, hands, or feet; severe upper-right abdominal pain; sudden weight gain; high blood pressure (≥ 140/90). Pre-eclampsia usually develops after 20 weeks. Any combination of these warrants same-day assessment. The triad of headache + visual disturbance + sudden swelling is the classic presentation.
Is it normal to have cramping in pregnancy?
Mild cramping or pulling sensations are common — round ligament pain (sharp brief pain with movement, 2nd trimester), Braxton-Hicks tightening (third trimester, no pattern, no cervical change), and constipation discomfort all happen. SEVERE constant abdominal pain, especially with bleeding, is NOT normal and warrants urgent review. Pain + reduced movements + bleeding = same-day emergency assessment.
When is back pain in pregnancy a concern?
Mild backache is common from the 2nd trimester onwards. Concerning back pain: severe + radiating to the leg + numbness or weakness in the legs (possible cauda equina — emergency); flank pain + fever + burning urination (pyelonephritis); central abdominal pain radiating to the back (could be placental abruption); back pain with tightening contractions before 37 weeks (possible preterm labour).
Can I take paracetamol in pregnancy?
Yes — paracetamol is the first-line pain relief throughout pregnancy. Take the lowest effective dose for the shortest period. Avoid NSAIDs (ibuprofen, naproxen) after 30 weeks (closes the ductus arteriosus). Codeine occasionally but not regularly. Always check any other medications with your pharmacist or GP.
What should I do about morning sickness?
Small frequent meals, dry crackers in the morning, ginger biscuits or tea, vitamin B6 (10–25 mg three times daily), avoiding food triggers. If symptoms are severe — unable to keep fluids down for 24 hours, weight loss > 5%, ketones in urine, dizziness — this could be hyperemesis gravidarum and needs medical review (see our hyperemesis-protocol calculator).
When should I go to maternity triage vs A&E?
Maternity triage / labour ward for pregnancy-specific concerns (reduced movements, bleeding, fluid loss, contractions, labour symptoms). A&E / emergency for severe sudden problems (chest pain, breathlessness, severe one-sided calf pain, collapse, severe head injury). When in doubt, call your maternity unit first — they'll direct you. Phone numbers are usually on your hand-held maternity notes.
How does this relate to other calculators on BumpBites?
Companion: /calculators/kick-counter for fetal movement tracking; /calculators/preeclampsia-diagnosis for the diagnostic criteria; /calculators/hyperemesis-protocol if severe vomiting; /calculators/icp-cholestasis if itching of palms/soles; /calculators/maternal-sepsis for infection signs; /calculators/trimester-symptom-quiz for the related trimester-by-trimester guide.