Pregnancy Symptoms Not to Ignore

Call now if you have any of these

Do not read the rest of the page first. These are the symptoms the NHS and HSE list as needing contact straight away, at any hour.

• Any change in your baby's movements — fewer, weaker, or a different pattern. The NHS: "A change in your baby's movements can sometimes be a sign of a problem, so it's important to get help if you notice any change."
• Sudden swelling in your face, hands, legs or feet. The NHS says a sudden increase "can be a sign of pre-eclampsia or a type of blood clot called deep vein thrombosis (DVT) and needs to be checked immediately".
• A severe headache, particularly with blurred vision, upper tummy pain, nausea or swelling (HSE).
• Sudden vision problems — blurring or flashing lights. The NHS: "This needs to be checked immediately."
• Breathlessness that comes on suddenly, breathlessness when lying down, or breathlessness with chest pain or dizziness.
• Severe or persistent pain just below the ribs, particularly on the right.
• A high temperature — feeling hotter than usual, shivering, or a thermometer reading of 38C or above.
• Vaginal bleeding, at any stage and any colour.
• Fluid leaking from your vagina, or any change in the smell or colour of your discharge.
• Itchy skin without a rash, especially palms and soles. The NHS names the reason: it "can sometimes be a sign of a liver condition called intrahepatic cholestasis of pregnancy (ICP) that may need treatment".
• One calf that is red, swollen and hot (HSE).
• Severe vomiting that stops you keeping fluids down.
• Stomach pain that is severe, or does not settle after resting for 30 to 60 minutes, or that comes with bleeding, tightenings, back pain, unusual discharge, or pain when you pee (NHS).
• Feeling emotionally distressed or in mental health crisis. The HSE lists this alongside the physical red flags, and so should everyone.

The NHS adds the instruction that people most often override: "Do not wait until the next day — call immediately, even if it's the middle of the night."

Who to call, at which stage

The right number changes as pregnancy goes on. The NHS sets it out as:

• First 12 weeks, before your first midwife appointment: your GP surgery or an early pregnancy unit (EPU).
• 12 to 19 weeks: your midwife or an EPU.
• 20 weeks or more: your midwife or maternity unit.

Early pregnancy units are specialist services, usually in hospitals, for problems like spotting, light bleeding or mild tummy pain in early pregnancy. Under 20 weeks you may be able to contact one yourself, particularly after a previous miscarriage or ectopic pregnancy, though some need a referral. Find the number on your local NHS trust website, in your maternity notes, or by asking your midwife.

Two numbers apply throughout. The NHS: "Always call 999 if you think it's a life-threatening emergency, no matter what stage of pregnancy you are." And call 111 if you are not sure what to do, or need help when your GP and maternity services are closed. Outside the UK, use your local emergency number — 999 in Ireland, 911 in the US and Canada, 000 in Australia, 111 in New Zealand.

Save the numbers now, in your phone, before you need them at 2am.

Why these particular symptoms

Most of the list clusters around a small number of conditions that are treatable when caught and dangerous when missed.

Pre-eclampsia

Several of the red flags belong to one condition. The NHS lists the pre-eclampsia cluster as a sudden increase in swelling of the face, hands or feet, a very bad headache, vision problems such as blurring or flashing lights, severe pain just below the ribs, heartburn that does not go away with antacids, feeling very unwell, and nausea or vomiting. It usually starts after 20 weeks or just after birth.

The reason it needs a same-day response rather than a next-appointment mention is that the early stage often has no symptoms at all — it is picked up by blood pressure and urine checks. By the time you feel it, it is worth acting on immediately. NICE's antenatal guideline instructs clinicians to refer blood pressure of 160/110 mmHg or higher to secondary care to be seen the same day.

Reduced movements

NICE tells maternity services to advise you "to contact maternity services at any time of day or night if she has any concerns about her baby's movements or she notices reduced fetal movements after 24+0 weeks". There is no threshold to meet and no kick count to complete first. A change is the trigger.

Pain that is not ordinary pain

The NHS's own line is that pain is "probably nothing to worry about if the pain is mild and goes away when you change position, have a rest, do a poo or pass wind". The corollary is the useful part: pain that does not do that, or that is severe, or that arrives with bleeding, tightenings or urinary symptoms, gets checked.

The rule that covers everything not on the list

The NHS ends its own red-flag page with a sentence that is more important than any individual item: "These are not all the symptoms and problems that can happen in pregnancy. If you have any other symptoms or you're worried about your health or your baby's health, get help." The HSE puts it more bluntly: "Always trust your instincts. It's best to be safe."

You are not expected to work out whether a symptom qualifies. That is the job of the person who answers the phone. Nobody in a maternity unit thinks you called too soon.

The short version

Reduced movements, sudden swelling, severe headache, vision changes, breathlessness at rest, pain under the ribs, fever, bleeding, leaking fluid, itching without a rash and severe unrelenting pain all mean phone, tonight, not tomorrow. Know which number applies at your stage, and use 999 for anything that feels life-threatening.