- Topic Overview
- Health Tools
- Check Your Symptoms
- Home Treatment
- Preparing For Your Appointment
- Related Information
British Columbia Specific Information
Midwives are health professionals who have specialized midwifery education and training. In British Columbia, a registered midwife is a regulated health care professional whose services are covered by the Medical Services Plan (MSP). In order to practice, they must be registered by their provincial regulatory bodies: the College of Midwives of British Columbia (CMBC) and the Midwives Association of British Columbia. Midwives provide primary care for women from early pregnancy, throughout labour and birth and up to at least 6 weeks postpartum. They are qualified to prescribe many medicines and to order screening and diagnostic tests for women.
After the baby is born in the hospital, a newborn screening test is done for early detection and treatment of any problems. Babies born at home under the care of a midwife, have the test done as well. For more information about the newborn screening test, see HealthLinkBC File #67 Newborn Screening Test. Midwives deliver babies in both B.C. hospitals and in homes, but currently not in birthing centers.
If a complication arises during the pregnancy, labour, birth, or postpartum, a midwife will consult with a health care provider such as an obstetrician or pediatrician. Midwives provide advice about healthy food choices, breast-feeding support, family planning and birth control counselling, gynecological services, and preventive health screening. After delivery, some women experience symptoms of postpartum depression. For more information about postpartum depression, visit the Pacific Postpartum Support Society website.
For more information, or if you have any concerns about pregnancy, labour and baby care speak with your health care provider. You can also read Baby's Best Chance (PDF 10.97 MB), a parent’s handbook on pregnancy and baby care, or visit the Healthy Families BC website.
You may also contact HealthLink BC at 8-1-1 to speak with a registered nurse anytime of the day or night, any day of the year, or a pharmacist from 5:00 p.m. to 9:00 a.m.
Top of the page Check Your Symptoms
Most women are healthy during pregnancy and do not have serious health concerns. You may have minor physical symptoms throughout your pregnancy that are considered normal pregnancy changes. It is important for you to be aware of symptoms that may mean you have a more serious problem. Talk with your doctor about any concerns you have during your pregnancy so that your health problems can be checked quickly.
Many minor problems of pregnancy can be managed at home. Home treatment measures are usually all that is needed to relieve mild morning sickness or discomfort from heartburn or constipation. There are also home treatment measures for sleep problems, hip pain, hemorrhoids , or fatigue. If you develop a problem and your doctor has given you specific instructions to follow during your pregnancy, be sure to follow those instructions.
If you have a family history of diabetes, you may develop a type of diabetes that only occurs during pregnancy ( gestational diabetes ). Gestational diabetes is treated by watching what you eat, exercising, checking blood sugar levels, and possibly taking oral medicines or insulin shots to keep blood sugar levels within a target range. Women who have gestational diabetes are likely to have babies that weigh more than normal. If the mother's blood sugar is not controlled, this could cause serious problems for the baby before and during delivery.
You may also have other common problems, like a cold or the flu, while you are pregnant that are not caused by your pregnancy. You can use home treatment measures for these illnesses as well, but make sure to talk to your doctor if your symptoms become more serious, such as coughing up blood or not being able to drink enough fluids ( dehydrated ).
While most problems that occur during pregnancy are minor, you may develop more serious symptoms that you need to talk to your doctor about. Your symptoms may be related to:
- Miscarriage . Symptoms may include:
- Premature birth. Symptoms may include:
- Abnormal vaginal discharge or fluid leaking from your vagina.
- Belly, pelvic, or back (flank) pain. This pain may come and go regularly.
- Preterm labour, which happens when contractions begin before the 37th week of pregnancy.
- Infection. Symptoms may include:
- Changes in your blood pressure that may mean you have pre-eclampsia . This problem may cause:
- Depression . If you are tearful, sad, anxious, or have big mood swings, talk to your doctor. If you are depressed during your pregnancy, you may have a hard time bonding with your baby after delivery. Depression can be treated so that you and your baby will be able to bond.
During the days and weeks after delivery (postpartum period), you can expect that your body will change as it returns to its non-pregnant condition. As with pregnancy changes, postpartum changes are different for every woman. Some problems, such as high blood pressure, hemorrhoids, or diabetes, may continue after delivery. You may need to follow up with your doctor about these problems after delivery.
Check your symptoms to decide if and when you should see a doctor.
Health Tools help you make wise health decisions or take action to improve your health.
|Actionsets are designed to help people take an active role in managing a health condition.|
|Pregnancy: Dealing With Morning Sickness|
|Stress Management: Doing Guided Imagery to Relax|
Check Your Symptoms
Pain Severity, Adult or Child (Not Baby)
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Signs that you are in labour include:
- Regular contractions for at least 1 hour. This means about 4 or more contractions in 20 minutes, or about 8 or more in a single hour.
- A sudden release of fluid from the vagina.
"Bloody show" is blood-tinged mucus that will pass out of the vagina as the cervix begins to open (dilate) and thin (efface). On its own, however, this is not a definite sign that you are in labour.
Fever Estimates, 12 and Older
If you're not sure if a fever is high, moderate, or mild, think about these issues:
With a high fever:
- You feel very hot.
- It is likely one of the highest fevers you've ever had. High fevers are not that common, especially in adults.
With a moderate fever:
- You feel warm or hot.
- You know you have a fever.
With a mild fever:
- You may feel a little warm.
- You think you might have a fever, but you're not sure.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Difficulty Breathing Severity, Adult or Older Child
Severe trouble breathing means:
- You cannot talk at all.
- You have to work very hard to breathe.
- You feel like you can't get enough air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means:
- It's hard to talk in full sentences.
- It's hard to breathe with activity.
Mild trouble breathing means:
- You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Fever Ranges, 12 and Older
Temperature varies a little depending on how you measure it. For adults and children age 12 and older, these are the ranges for high, moderate, and mild, according to how you took the temperature.
Oral (by mouth) temperature
- High: 40°C (104°F) and higher
- Moderate: 38°C (100.4°F) to 39.9°C (103.9°F)
- Mild: 37.9°C (100.3°F) and lower
Ear or rectal temperature
- High: 40.6°C (105°F) and higher
- Moderate: 38.6°C (101.4°F) to 40.5°C (104.9°F)
- Mild: 38.5°C (101.3°F) and lower
Armpit (axillary) temperature
- High: 39.5°C (103°F) and higher
- Moderate: 37.4°C (99.4°F) to 39.4°C (102.9°F)
- Mild: 37.3°C (99.3°F) and lower
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Vaginal Bleeding, Severity
Severe vaginal bleeding means you are passing clots of blood and soaking through your usual pads or tampons each hour for 2 or more hours. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered severe. If you are pregnant: You may have a gush of blood or pass a clot, but if the bleeding stops, it is not considered severe.
Moderate bleeding means that you are soaking more than 1 pad or tampon in 3 hours.
Mild bleeding means that you are soaking less than 1 pad or tampon in more than 3 hours.
Minimal vaginal bleeding means "spotting" or a few drops of blood.
Preterm Labour Symptoms
Symptoms of preterm labour may include:
- Mild or menstrual-like cramps, with or without diarrhea.
- A feeling of pressure in your pelvis or lower belly.
- A steady, dull ache in your lower back, pelvis, lower belly, or thighs.
- Changes in your vaginal discharge.
- Regular contractions for an hour. This means about 4 or more contractions in 20 minutes, or about 8 or more in 1 hour, even after you have had a glass of water and are resting.
You can get dehydrated when you lose a lot of fluids because of problems like vomiting or fever.
Symptoms of dehydration can range from mild to severe. For example:
- You may feel tired and edgy (mild dehydration), or you may feel weak, not alert, and not able to think clearly (severe dehydration).
- You may pass less urine than usual (mild dehydration), or you may not be passing urine at all (severe dehydration).
Impaired Immune System, Adult
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Bladder Infection Symptoms
Symptoms of a bladder infection may include:
- Pain or burning when you urinate.
- A frequent urge to urinate without being able to pass much urine.
- Blood in the urine.
Kidney Infection Symptoms
Symptoms of a kidney infection may include:
- Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.
- Fever or chills.
- Pain or burning when you urinate.
- A frequent urge to urinate without being able to pass much urine.
- Belly pain.
Vaginal Infection Symptoms
Symptoms of a vaginal infection may include:
- Vaginal itching.
- Vaginal discharge that is not normal for you.
- Red, irritated skin in the vaginal area.
- Pain when you urinate.
- Pain or bleeding when you have sex.
Shock Symptoms, Adult or Older Child
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Symptoms of shock (most of which will be present) include:
- Passing out.
- Feeling very dizzy or light-headed, like you may pass out.
- Feeling very weak or having trouble standing.
- Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.
Dehydration Severity, Adult or Older Child
Severe dehydration means:
- Your mouth and eyes may be extremely dry.
- You may pass little or no urine for 12 or more hours.
- You may not feel alert or be able to think clearly.
- You may be too weak or dizzy to stand.
- You may pass out.
Moderate dehydration means:
- You may be a lot more thirsty than usual.
- Your mouth and eyes may be drier than usual.
- You may pass little or no urine for 8 or more hours.
- You may feel dizzy when you stand or sit up.
Mild dehydration means:
- You may be more thirsty than usual.
- You may pass less urine than usual.
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Get down on your knees, bend forward, and put your head on the floor so your buttocks are higher than your head. Stay in this position until help arrives.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Swelling During Pregnancy (Severe)
During pregnancy, swelling that may be a sign of a more serious problem may include:
- Weight gain of 0.9 kg (2 lb) or more during a 24-hour period.
- New and increasing swelling, especially in your face, hands, or feet.
- Swelling in your feet that does not improve even after you lie on your side for several hours.
Pregnancy affects almost every part of a woman's daily life. If you develop problems and your doctor has given you specific instructions to follow during your pregnancy, be sure to follow those instructions.
During your pregnancy, you may have questions about many of the following common concerns:
For many women, the hardest part of early pregnancy is morning sickness . You may be able to use home treatment to help your nausea or vomiting.
- If nausea is worse when you first wake up, eat a small snack (such as crackers) before you get out of bed. Rest a few minutes after eating the snack, then get out of bed slowly.
- Eat regularly. Do not skip meals or go for long periods without eating. An empty stomach can make nausea worse. Eat several small meals every day instead of three large meals.
- Drink enough fluids every day. Do not become dehydrated . Sports drinks, such as Gatorade or Powerade, may help if you have ongoing vomiting. Ginger tea may help your nausea as well.
- Eat more protein, such as dairy products.
- Do not eat foods high in fat.
- Do not take iron supplements, which can make nausea worse.
- Try to stay away from smells that trigger morning sickness. Citrus juice, milk, coffee, and caffeinated tea may make nausea worse.
- Get lots of rest. Morning sickness may be worse when you are tired.
Feeling tired (fatigue)
Most women have some fatigue during pregnancy, especially during the first and third trimesters . During the first trimester, your body makes higher levels of the hormone progesterone , which may make you feel more tired. You may feel more energy during most of your second trimester. Later in pregnancy, your growing baby and loss of sleep because you cannot find a comfortable position can lower your energy level.
To help with fatigue during pregnancy:
- Eat regularly. Do not skip meals or go for long periods without eating. Choose healthy foods.
- Exercise regularly. Get outside, take walks, or keep your blood moving with your favourite workout. If you do not have your usual energy, do not overdo it.
- Try to take rest breaks often during the day.
- Do only as much as you need to, and do not take on extra activities or responsibilities.
Sleep problems are common during pregnancy. These tips may help you get a good night's sleep.
- Keep a regular sleep schedule.
- Keep your naps as short as possible.
- Use your bed only for sleep.
- Limit your caffeine, such as coffee, tea, cola drinks, and chocolate.
- Try relaxation methods, such as meditation or guided imagery. For more information, see the topic Stress Management.
- Limit what you drink after 6 p.m. so you do not have to get up to the bathroom during the night.
- Use extra pillows to raise your head or to help you find a comfortable position.
Using medicine to help relieve discomfort or fever
You may also have other common problems, like a cold, mild headache, backache, mild fever, or the flu, while you are pregnant that are not caused by your pregnancy. These minor symptoms generally do not cause problems or hurt your baby. In general, doctors say it is usually safe to take acetaminophen (Tylenol) for fever and pain.
Acetaminophen dosage: The usual dose is 650 mg. Take every 4 hours, as needed, up to 4 times in a 24-hour period. Do not take more than 4,000 mg in a 24-hour period.
Be sure to follow these non-prescription medicine precautions.
- Use, but do not exceed, the maximum recommended doses.
- Carefully read and follow all labels on the medicine bottle and box.
- Do not use other non-prescription medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs) , until you have talked with your doctor.
Check with your doctor before you take any other types of medicines.
Heartburn and gastroesophageal reflux disease (GERD)
Most pregnant women have symptoms of gastroesophageal reflux disease (GERD), especially heartburn, at some time during pregnancy. These symptoms are common but do not usually cause problems or hurt your baby. Most of the time symptoms of heartburn get better once the baby is born.
You can make changes to your lifestyle to help relieve your symptoms of GERD. Here are some things to try:
- Change your eating habits.
- It's best to eat several small meals instead of two or three large meals.
- After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.
- Chocolate and mint can make GERD worse. They relax the valve between the esophagus and the stomach.
- Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
- Do not smoke or chew tobacco.
- If you have GERD symptoms at night, raise the head of your bed 15 cm (6 in.) to 20 cm (8 in.) by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
- Use non-prescription antacids for heartburn symptoms. Do not use antacids that have sodium bicarbonate (such as baking soda) during pregnancy because they can cause fluid buildup. It is okay to use antacids that have calcium carbonate (such as Tums).
Constipation and hemorrhoids
Constipation and hemorrhoids are common during pregnancy. To prevent or ease these symptoms:
- Eat a high-fibre diet with lots of fruits, vegetables, and whole grains.
- Drink plenty of fluids, especially water.
- Talk to your doctor about trying a stool softener.
- Do not strain (push hard) during a bowel movement.
- Get more exercise every day.
Back, pelvic, and hip discomfort
Many women have back, pelvic, or hip discomfort during pregnancy. As the size and weight of your belly increases, strain is placed on your back. Pelvic and hip discomfort is a normal sign that your pelvic area is getting ready for childbirth. To help with your discomfort, follow these tips:
- Try not to stand for long periods of time.
- Stand with a straight back. Do not stand with your belly forward and your shoulders back.
- Rest one foot on a small box, brick, or stool when standing.
- Try heat, such as a hot water bottle or a heating pad set on low, to painful areas when resting. Do not fall asleep with a heating pad in place. Place a cloth between your skin and the heating pad.
- Sit with a back support or pillow against your lower back. If you must sit for a long time, get up and move around every hour.
- Wear a prenatal belt or girdle around your hips but under your belly to support your hips.
- Sleep on a firm mattress (plywood under a mattress helps). Lie on your side, with a pillow between your knees.
- Do not lift anything heavy. Lift with your legs by rising from a squat, keeping your waist and back straight.
- Do not stretch to reach something on a high shelf or across a table.
- Try acetaminophen, such as Tylenol. Talk to your doctor if your discomfort does not get better with acetaminophen. Do not use more than the recommended dosage.
Fetal movement counting
After 18 to 20 weeks, you will notice that your baby moves and kicks more at certain times of the day. For example, when you are active, you may feel less kicking than when you are resting quietly. At your prenatal visits, your doctor may ask you whether the baby is active.
Kick counts. In the last trimester of your pregnancy, your doctor may ask you to keep track of the baby's movement every day. This is often called a "kick count." A common way to do a kick count is to see how much time it takes to feel 10 movements. Ten movements (such as kicks, flutters, or rolls) in 1 hour or less are considered normal. But do not panic if you do not feel 10 movements. Less activity may simply mean the baby is sleeping.
If an hour goes by and you have not recorded 10 movements, have something to eat or drink and count for another hour. If you do not record 10 movements in the 2-hour period, call your doctor right away.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Abnormal or increased bleeding.
- Weakness or light-headedness.
- Pain in your belly.
- Swelling in your face, hands, or feet.
- A severe headache.
- Vomiting that gets worse or continues even with home treatment measures.
- Urinary problems.
- Heartburn that continues even with home treatment measures.
- Symptoms that become more severe or occur more often.
It is important to make healthy lifestyle choices to lower your chance for serious problems during pregnancy. Learn about healthy lifestyle choices before, during, and after your pregnancy.
- Have a healthy pregnancy. Eat well, exercise regularly, get plenty of rest, avoid hot weather temperatures, and do not do activities that could lead to a fall or belly injury.
- Pay attention to your nutrition and weight gain during pregnancy. Be sure to get the right amounts of folic acid , iron, and calcium . Try for slow, gradual weight gain.
- Limit your use of caffeine.
- Eat a nutritious diet. Get enough protein , vitamin B12 , vitamin D , and zinc. These nutrients are vital to your baby's growth, development, and weight gain.
- Exercise safely during pregnancy. Try to get 30 minutes of exercise on most, if not all, days of the week.
- Do pelvic floor (Kegel) exercises to prevent urine control problems (incontinence) after childbirth.
- Discuss immunizations with your doctor.
Things to avoid when you are pregnant
- Alcohol and illegal drugs
- Smoking or using tobacco
- Misuse of medicines
- Hot tubs and saunas
- Uncooked food and other poisons. This includes raw meat, poultry, or seafood; unwashed fruits or vegetables; and cat feces or outdoor soil that cats commonly use.
- Unusual cravings, such as pica , when a woman craves things that are not food.
- Fish that may have mercury. This includes shark, swordfish, king mackerel, tilefish, more than 0.2 kg (6 oz) of white albacore tuna a week, or fish caught in local waters that have not tested as safe.
- Hazardous chemicals, certain cosmetic products, or radiation
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- When was your last menstrual period or what is your due date?
- What are your main symptoms?
- How long have you had your symptoms?
- Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
- What activities make your symptoms better or worse?
- Do you think that activities related to your job or hobbies caused your symptoms?
- Do you do sports activities?
- What home treatment measures have you tried? Did they help?
- What prescription or non-prescription medicines have you taken or used? Did they help?
- Do you have any health risks?
|Adapted By||HealthLink BC|
|Adaptation reviewed by||HealthLink BC|
Adaptation Date: 2/18/2014
Adapted By: HealthLink BC
Adaptation reviewed by: HealthLink BC
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