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When to call the doctor or midwife

During pregnancy, a woman’s experience varies greatly from week to week. Even before you bust out the maternity clothes, the first trimester can be particularly challenging. During this time, a call to the doctor is advised when a symptom could be a sign of possible pregnancy complications. Rallie McAllister, MD, MPH, coauthor of The Mommy MD Guide to Pregnancy and Birth, shares some of her top reasons to make the call.

First trimester headache


A pregnant woman’s emotions can be up and down, but the rollercoaster ride has a limit. “More than 70 percent of pregnant women experience mood swings,” says McAllister. “However, if you feel depressed for more than two weeks, call your doctor or midwife.”


While some spotting can be normal, bleeding in the first trimester can signal a serious problem. “[Bleeding] can be a sign of an ectopic pregnancy,” says McAllister. “Other symptoms include cramps, tenderness in the lower abdomen, shoulder pain, nausea and lower back pain.”


We’ve all heard the killer morning sickness stories, but sometimes vomiting can be a red flag. “Call your doctor or midwife if you have lost more than two pounds, vomit bright red or black blood, vomit more than four times in one day, or can’t keep fluids down for more than a day,” advises McAllister. “Less than 1 percent of pregnant women develop a condition called hyperemesis gravidarum — nausea and vomiting that is so severe the mom-to-be isn’t able to consume enough nutrients and calories.”


Irregular bowel movements often come with the territory during pregnancy, but there is normal constipation and abnormal constipation. “If you have severe constipation, or if it’s accompanied by abdominal pain or alternates with diarrhea, or if you pass mucus or blood, call your doctor or midwife immediately,” says McAllister.


Garden-variety headaches come and go, and are often harmless. “But if you have a migraine or a headache that feels unlike any that you’ve ever felt before, call your doctor or midwife,” says McAllister. “Also call if your headache is sudden, explosive, occurs after you’ve fallen or hit your head, or if it’s accompanied by fever or a stiff neck, vision changes or slurred speech, or nasal congestion, dental pain or pain underneath your eyes.”

Stay tuned for “When to Call the Doctor During the Second Trimester.”

More on the first trimester:

  • First trimester fetal development
  • 10 Foods pregnant women should avoid
  • 5 Ways to boost your immune system during pregnancy

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