Feel free to ask your midwife or doctor – or look at NHS Choices: www.nhs.uk
Common pregnancy symptoms. You may experience some symptoms during pregnancy. Most are normal and will not harm you or
your baby, but if they are severe or you are worried about them, speak to your midwife or doctor. You may feel some tiredness, sickness,
headaches or other mild aches and pains. Some women experience heartburn, constipation or haemorrhoids. There may also be some
swelling of your face, hands or ankles or you may develop varicose veins. Changes in mood and sex drive are also common. Sex is safe
unless you are advised otherwise by your health care team. Complications in pregnancy require additional visits for extra surveillance of
you and your baby’s well-being. Many conditions will only improve after the birth; therefore it may be necessary to induce your labour
or undertake a planned (elective) caesarean section.
Pregnancy sickness is common and for most women symptoms can be managed with changes to their diet and lifestyle. However, it
is not uncommon for pregnancy sickness to be severe and have a serious negative impact on the quality of your life and your ability to
eat and drink and function normally. If this happens, speak to your GP and request anti-sickness medication. These are safe to take at
any stage of pregnancy. It is important to treat pregnancy sickness at an early stage to prevent it from developing into the more serious
condition called hyperemesis gravidarum. If you are sick, wait at least 30 minutes before brushing your teeth or using a mouthwash. This
helps to protect your teeth from tooth decay. For further information visit www.pregnancysicknesssupport.org.uk
Abdominal pain. Mild pain in early pregnancy is not uncommon and you may have some discomfort due to your body stretching and
changing shape. If you experience severe pain, or pain with vaginal bleeding or need to pass urine more frequently - contact your midwife
or nearest maternity unit immediately for advice. Don’t wait until your next appointment.
Vaginal bleeding may come from anywhere in the birth canal, including the placenta (afterbirth). Occasionally, there can be an ‘abruption’,
where a part of the placenta separates from the uterus, which puts the baby at great risk. If the placenta is low lying, tightenings or
contractions may also cause bleeding. Any vaginal blood loss should be reported immediately to your midwife or nearest maternity
unit. You will be asked to go into hospital for tests, and advised to stay until the bleeding has stopped or the baby is born. If you have
rhesus negative blood, you will require an anti-D injection (page 6).
Abnormal vaginal discharge. It is normal to have increased vaginal discharge when you are pregnant. It should be clear or white and
not smell unpleasant. You need to seek medical advice if the discharge changes colour, smells or you feel sore or itchy.
Diabetes is a condition that causes a person's blood glucose (sugar) level to become too high. It may be pre-existing diabetes that is
present before pregnancy, or some women can develop diabetes during their pregnancy (gestational diabetes). High levels of glucose
can cross the placenta and cause the baby to grow large (macrosomia - page 14). If you have pre-existing or gestational diabetes during
your pregnancy, you will be looked after by a specialist team who will check you and your baby’s health and wellbeing closely. Keeping
your blood glucose levels as near normal as possible can help prevent problems/complications for you and your baby. Gestational diabetes
usually disappears after the birth, but can occur in another pregnancy. To reduce your future risks of diabetes: - be the right weight for
your height (normal BMI); eat healthily, cut down on sugar, fatty and fried foods and increase your physical activity (page 20).
High blood pressure. Your blood pressure will be checked frequently during pregnancy. A rise in blood pressure can be the first sign
of a condition known as pre-eclampsia or pregnancy induced hypertension. Contact your midwife or nearest maternity unit immediately
if you get: a severe headache/s, blurred vision or spots before your eyes, obvious swelling (oedema) especially affecting your hands and
face, severe pain below your ribs and or vomiting as these can be signs that your blood pressure has risen sharply. If there is protein in
your urine, you may have pre-eclampsia which in its severe form can cause blood clotting problems and fits. It can be linked to problems
for the baby such as growth restriction. Treatment may start with rest, but some women will need medication that lowers high blood
pressure. Occasionally, this may be a reason to deliver your baby early.
Thrombosis (clotting in the blood). Your body naturally has more clotting factors during pregnancy which helps prevent losing too much
blood during labour and birth. However, this means that all pregnant women are at a slightly increased risk of developing blood clots during
pregnancy and the first weeks after the birth. The risk is higher if you are over 35, have a BMI >30, smoke, or have a family history of
thrombosis. Contact your midwife or nearest maternity unit immediately if you have any pain or swelling in your leg, pain in your chest or
cough up blood.
Intrahepatic cholestasis in pregnancy (ICP) also known as obstetric cholestasis, is a liver condition in pregnancy that causes itching
on the hands and feet, but may occur anywhere on your body and is usually worse at night. It affects 1 in 140 women in the UK every
year. Having this condition may increase your risk of having a stillbirth, so you will receive closer monitoring of you and your baby’s health
during your pregnancy. If you have itching, blood tests will be offered to check if you have ICP. Treatment includes medication, regular
blood tests and having your baby at or around 37-38 weeks. After the birth, the itching should disappear quite quickly. A blood test to
check your liver function will be carried out before you are discharged from hospital after the birth and repeated about 6-12 weeks later.
Prematurity. Labour may start prematurely (before 37 weeks), for a variety of reasons. If you are planned to give birth in a birth
centre/midwifery unit or at home, you will be advised to transfer your care to a maternity unit with a neonatal unit/special care baby
facility. If labour starts before 34 weeks, most maternity units have a policy of trying to stop labour for at least 1-2 days, whilst offering
you steroid injections that help the baby’s lungs to mature. However, once labour is well established it is difficult to stop. Babies born
earlier than 34 weeks may need extra help with breathing, feeding and keeping warm.
Breech. If your baby is presenting bottom or feet first this is called a breech position (page 14). If your baby is breech at 36 weeks, your
health care team will discuss the following options with you: trying to turn your baby (ECV = external cephalic version); planned (elective)
caesarean section or a planned vaginal breech birth.
Multiple pregnancies. Twins, triplets or other multiple pregnancies need closer monitoring which includes frequent tests and scans,
under the care of a specialist healthcare team. You will be advised to have your babies in a consultant led maternity unit that has a neonatal
unit. Your healthcare team will discuss your options on how best to deliver your babies. It will depend on how your pregnancy progresses,
the position that your babies are lying and whether you have had a previous caesarean section.
Infections .Your immune system changes when you are pregnant and you are at a higher risk of developing an infection. It is very important
that if you are unwell and are experiencing any of the following symptoms, please seek immediate medical advice as treatment may be
required: - high temperature of 38C or higher, fever and chills, foul smelling vaginal discharge, painful red blisters/sores around the
vagina/bottom or thighs, pain or frequently passing urine, abdominal pain, rash, diarrhoea and vomiting, sore throat or respiratory infection.
Avoid unprotected sexual contact if your partner has genital herpes and avoid oral sex from a partner with a cold sore. Wash your hands
if you touch the sores. Wherever possible, keep away from people with an infection e.g. diarrhoea and sickness, cold/flu, any rash illness.
Group B Streptococcus (GBS) is a common bacterium carried by some women and rarely causes symptoms or harm. It can be detected
by testing a urine sample or a vaginal or rectal swab. In some pregnancies, it can be passed on to the baby around the time of birth, which
can lead to serious illness in the baby. The national recommendation is to offer antibiotics to women as soon as labour starts if: -
• GBS has been detected during the current pregnancy. • you have previously had a baby who developed a GBS infection. • you have a
high temperature (38
C or over) in labour. • you go into labour prematurely. • GBS was detected in a previous pregnancy and your baby
was not affected, you should be offered antibiotics in labour or be offered a test to screen for GBS late in pregnancy. If the test is positive
you will be offered antibiotics in labour.