WHEN SHOULD I WORRY ABOUT...

8 Common Pregnancy Concerns & When to See Your OB-GYN About Them

May 16, 2022 - Katie McCallum

Your body changes significantly when you're pregnant, leading to some fairly uncomfortable — and sometimes alarming — symptoms and issues.

"With so many new changes in your body, it's normal to be concerned about the symptoms you may experience while pregnant," says Dr. Lexanne Mauney, an OB-GYN at Houston Methodist. "It's important to know which of these are a normal part of pregnancy and which warrant medical attention."

Dr. Mauney is here to explain when it's time to worry about eight common pregnancy complaints and concerns.

1. Back pain

"There are many reasons for experiencing back pain while pregnant," says Dr. Mauney. "Your larger belly throws off your center of gravity. Your abdominal muscles become stretched and weakened. Your pelvic floor isn't as strong. All of these can affect your posture and lead to pain in your lower back."

To help ease pregnancy back pain, Dr. Mauney recommends:

  • Wearing supportive shoes
  • Wearing supportive garments, such as a belly band
  • Doing pelvic floor exercises
  • Going to a pre-natal yoga or Pilates class
  • Taking over-the-counter pain relievers, such as acetaminophen
  • Soaking in a warm bath
  • Getting a massage

"Almost all of my patients ask if they can get a massage during pregnancy, and I always say yes," adds Dr. Mauney.

Back pain during pregnancy can be concerning in some cases, though — especially if it's pain that comes and goes in waves during the third trimester.

"This is when we worry that the pain could actually be preterm contractions," warns Dr. Mauney. "If you have pain that lasts about a minute and goes away, but then it comes back again — and this cycle repeats every five minutes or so for longer than an hour — I recommend that you be evaluated."

And — anytime during pregnancy — back pain that's accompanied by fever and/or a burning sensation while urinating may indicate you have a urinary tract infection.

"Women are more prone to get to getting UTIs," says Dr. Mauney. "In pregnant women, those UTIs are then more prone to ascend up the urinary system and into the kidneys."

That's especially problematic because if a UTI progresses to the kidneys it can increase the risk of complications later in the pregnancy.

"It's important to seek treatment for a urinary tract infection as soon as symptoms are first noticed," adds Dr. Mauney.

2. Belly pain

Similar to back pain, belly pain during pregnancy is almost always related to the changes happening in your body.

"Your muscles and ligaments have to move to make space for your baby, and this isn't comfortable," explains Dr. Mauney. "Belly pain is usually due to what we call round ligament pain, which is pain that starts on the side of the belly and moves down toward the groin area."

The tips to ease belly pain are the same as the ones for relieving back pain.

And, here again, belly pain that comes and goes in waves could be a reason to alert your doctor.

"A constant pain or pressure in the belly isn't as worrisome as a tightening and then releasing that's happening over and over again in a pattern," says. Dr. Mauney. "Similar to waves of back pain, this could be a sign of preterm contractions — and it's important to seek evaluation."

3. Swelling in your feet

"Feet swelling during pregnancy is incredibly common, but the vast majority of the time it's just part of a normal pregnancy," says Dr. Mauney. "Your weight is increased. Your blood volume is increased. Your blood vessels are dilated. These changes can cause blood to pool in your legs, leading to swollen ankles and feet."

To reduce this swelling, elevation and movement are key.

"I always say that laying is better than sitting and walking is better than just standing," recommends Dr. Mauney.

When standing still, she recommends putting one foot up on a stool, alternating to your other foot every few minutes.

"We do worry about feet swelling more in women who are at risk for pre-eclampsia, which is high blood pressure that develops during pregnancy," warns Dr. Mauney.

This is also called gestational hypertension.

Your OB-GYN might be worried about pre-ecamplsia if you:

  • Developed it during a previous pregnancy
  • Have gestational or pre-gestational diabetes
  • Are 35+ or younger than 18 years of age
  • Were diagnosed with high blood pressure prior to pregnancy
  • Have an autoimmune, renal or vascular condition
  • Are obese

"In these cases, I usually recommend that you have a blood pressure cuff on hand so you can take your blood pressure," recommends Dr. Mauney. "It's also important to check for other pre-eclampsia symptoms, such as headaches and vision changes."

If your feet seem unsually swollen and your blood pressure is high or you notice one of these other signs of pre-eclampsia, it's a good idea to get evaluated by your OB-GYN.

4. Headaches

Due to hormonal changes, it's common to develop headaches during pregnancy.

"To relieve headaches, I recommend acetaminophen (1,000 mg up to three times a day) and small amounts of caffeine (no more than 200 mg per day)," says Dr. Mauney.

Pregnancy can also affect the headaches or migraines you may have been prone to prior to pregnancy. In some cases, they get worse. But in at least one-third of cases, women with pre-existing headaches and migraines actually see improved symptoms during pregnancy.

At any rate, headaches during pregnancy become worrisome when they're new and unexplained.

"If you have a new headache in your third trimester that you've never had before, it could be an early warning sign of pre-eclampsia," says Dr. Mauney. "So, it's important to mention this to your OB-GYN."

5. Light bleeding or spotting

In the first trimester, it's not unusual for a woman to experience some light bleeding — bleeding that's lighter than a period. Dr. Mauney says this happens in about 10%-30% of pregnancies.

"This can be due to what we call implantation bleeding, where we see some spotting here or there after implantation," explains Dr. Mauney. "It can also happen after a specific event, like the pap smear we perform at your initial appointment, or after you have intercourse."

If you have an established pregnancy and a confirmed heartbeat via ultrasound, spotting during pregnancy might be alarming — but it's not a reason to panic. Take note if the bleeding worsens, but know that light bleeding is likely explained by one of the reasons previously noted.

If bleeding is heavy, however, it could signal a miscarriage.

"If you have heavy bleeding — which is bleeding like a period — and think you may be miscarrying, schedule an evaluation with your OB-GYN," says Dr. Mauney. "Unless you are at risk for hemorrhaging — for instance, you're saturating through more than two heavy pads in an hour — or if you are bleeding heavily and have dizziness and shortness of breath, there's no reason for you to go to the ER, even if you suspect you're miscarrying."

If you're very newly pregnant and aren't sure if the egg has implanted in the uterus yet, bleeding becomes more immediately concerning.

"If we haven't established an intrauterine pregnancy on ultrasound and you're bleeding and there's pain, it's important to go to the ER," Dr. Mauney warns. "This is when we start to worry about an ectopic pregnancy, which is a medical emergency."

Light bleeding is also very common toward the last few weeks of pregnancy.

"As the cervix starts to change and prepare for delivery, it's not uncommon for blood vessels in the area to pop and bleed," explains Dr. Mauney. "This can result in light bleeding."

But, if you're bleeding more than a period toward the end of pregnancy, it's a reason to seek care at the ER — especially if your OB-GYN has told you that you have an increased risk of bleeding-related complications, such as having a low-lying placenta.

6. Constipation

As a result of the hormonal changes that occur, constipation is also very common during pregnancy.

"If you're experiencing constipation, stool softeners are safe to take," adds Dr. Mauney. "A softened stool is easier to pass."

You can also help prevent constipation during pregnancy by making sure you're drinking plenty of water and eating good sources of fiber, which include whole grains, fruits and vegetables.

7. Acid reflux

It's incredibly common for women who are pregnant to experience acid reflux, whose most common symptom is heartburn. Other symptoms include burping or belching, feeling bloated or full, food coming back up your throat and even vomiting.

"If you experience heartburn during pregnancy, it's totally fine to take antacids," says Dr. Mauney. "Just be sure to follow the dosage guidelines on the bottle.

There are also plenty of home remedies for easing — or even preventing — heartburn that you can try, including knowing and avoiding the most common triggers of it.

8. Decreased fetal movement

As your baby starts to move, it becomes a way to engage with his or her health. So should you be worried if it seems like your baby is moving less?

"When we talk about fetal movement, I always say that the quality of movement can go down, but the quantity of movement should stay the same," says Dr. Mauney.

As your baby gets bigger, he or she runs out of room to move around in your womb. Therefore, it's normal for his or her movement to feel less pronounced as you reach your third trimester.

But, Dr. Mauney stresses that you should still be feeling the same frequency of movement throughout the day.

"If you notice your baby is moving less frequently than he or she normally does, go straight to your Labor & Delivery unit's ER," Dr. Mauney warns. "Happy babies move. Decreased fetal movement could be a sign that your baby is in distress and an immediate evaluation is essential to check on the wellbeing of your baby."

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