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When to call the doctor or midwife

Tiernan McKay is a freelance writer based in Denver, Colorado. Her writing has appeared in magazines such as Alive!, Occupational Health and Safety, Restaurants and Institutions, Tampa Bay and Arizona Woman. Right now, she is either ridi...

The third trimester

OK, ladies. It’s your third trimester (finally!) and the light at the end of the tunnel is beginning to glow. You know better than anyone that it’s a long road from “I’m pregnant” to “It’s a girl/boy!” Along the way, you may have called your doctor or midwife on more than one occasion because of a strange or uncomfortable pregnancy symptom. As you prepare to give birth, it may be harder to determine whether a particular symptom is normal or a sign of a pregnancy complication. Here are a few tips to help you decide when to call the doctor or midwife.

Dr Rallie McAllister, MPregnant woman itchingPH, coauthor of The Mommy MD Guide to Pregnancy and Birth, shares some of her top reasons to make the call.

1Excessive itching

Itching seems to come with the territory when you're pregnant, but there's a limit to the scratchy madness. Sometimes a simple antihistamine can take care of the problem, but persistent and excessive itching could be cause for concern. "This is often caused by a condition called cholestasis, in which bile acids can build up in the liver and spill over into the maternal bloodstream," says Dr McAllister. "Cholestasis generally happens in the last trimester, when hormones are at their peak. The itching is often on the hands or feet, but some women itch all over."

2Depression

Surprisingly, one in 10 pregnant women suffers from major depression. If you are overwhelmed with sadness, can't sleep or eat, or are plagued by negative thoughts, make the call. "Moms-to-be with depression have more cases of placental abruption and pre-eclampsia," says Dr McAllister. "Babies born to depressed mothers might have lower birth weights or are more likely to be born prematurely."

3Swelling

Pre-eclampsia is a potentially dangerous condition that can affect both mother and child. Swelling can be a sign of this condition, so if you notice that your feet, hands or face are swollen, call your doctor or midwife. "It's especially important to call if the swelling is accompanied by other symptoms of pre-eclampsia such as blurred vision, says Dr McAllister. Other possible signs include headaches, nausea, sudden weight gain and protein in your urine.

4Your water breaks

It's not uncommon for pregnant women to have slight bladder-control issues, which could lead to an occasional leak of urine. But if you find that your underwear is wet or feel a gush that is not urine, the liquid could be amniotic fluid. "If you think that your water has broken, call your doctor or midwife right away," says Dr McAllister. He or she can help you determine whether the liquid is amniotic fluid and instruct you on your next steps.

More tips for the third trimester

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