pregnancy

Is it normal to have spotting during pregnancy? 9 red flags you should never ever ignore.

This post mentions miscarriage and may be triggering for some readers.

So, I'm spotting... is that normal? Should I be worried if I have pelvic pain, orrr? What happens if I just don't feel right? 

You can read a thousand books and seek advice from all your pregnant friends, but pregnancy is a strange, scary and confusing time - and it can be difficult to know if what you're feeling is 'normal'. 

Sometimes you don't know whether you should be genuinely concerned or if you should troop on and just keep an eye on it. 

Watch: Questions about childbirth answered by mums and non-mums. Post continues below.


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The thing is though, you should *always* talk to your doctor if you have any concerns about your risk of complications during pregnancy. 

Because late night anxiety-induced Googling is never a fun time for anyone (let alone if you're pregnant) we pulled together some of the most common pregnancy issues in one place, and asked an expert what each one might mean.

Are you struggling with hair loss post-bub? Listen to Mamamia's podcast for your face, You Beauty, where we talk about why your hair is falling out after pregnancy. Post continues below. 

"Being pregnant, especially for the first time, can be an anxious time as lots of never before experienced changes happen to your body, and every twinge brings with it the thought of, 'is this significant?'" said Associate Professor Gino Pecoraro, President of the National Association of Specialist Obstetricians & Gynaecologists (NASOG). 

So, when should you be worried?

1. Chronic nausea and vomiting.

While we all know this is a common and well-known sign of pregnancy, sometimes severe nausea and vomiting can develop into a serious issue. 

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If you're throwing up multiple times a day, this means you're probably not able to keep down much food or liquids and this could ultimately influence the amount of nutrients your baby is getting. 

Chronic nausea and vomiting actually has a name - it's called hyperemesis gravidarum, and it could mean you'll require treatment in hospital.

Vomiting in the second half of your pregnancy? If this is accompanied by severe pain under your ribs or you're noticing signs of swelling in your face, hands and feet - this could point towards pre-eclampsia (see more on this condition under point 6, below.)

2. Flu-like symptoms.

Fact: Pregnancy makes your immune system weaker. As a result, you have a higher risk of getting sick. It's therefore really common for you to get catch a cold during your pregnancy, but there are a few things you should look out for if you think you have the flu.

Things like fever (we're talking 37.5 degrees up), bloody mucus, difficulty breathing, shortness of breath or severe vomiting are all signs you should head to the hospital for a check-up.  

3. Vaginal discharge.

Just as an FYI, a general clear or white-coloured discharge in your undies is normal and usually means everything is in working order.

Professor Pecoraro explained, "Placental hormones increase the amount of normal vaginal and cervical secretions and mucus, so many women may find they need to wear a panty liner during pregnancy." 

However, there are a few things to look out for.

If you notice thick, white discharge accompanied by itching or irritation, it could be a sign of thrush. If the discharge is smelly or has a yellow or green tint to it, this could mean you have a bacterial infection.

"These hormonal changes also make the cells lining the vagina accumulate a specific type of sugar called glycogen, which is also an excellent food source for bacteria and fungi making thrush in particular very common during pregnancy and almost universal during an Australian summer."

Eek! What does this mean?

Apparently iron deficiency is also very common in pregnancy and an independent risk factor for thrush, but it's nothing unusual. Professor Pecoraro said very few women will escape an entire pregnancy without at least one bout of a candidal infection.

"This usually presents with an increase in discharge or vaginal itch. If there is a change in either the nature or volume of vaginal discharge, it is well worth asking for a vaginal swab or even a speculum examination to check out exactly what is going on," he said.

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Anything out of the ordinary - like a large amount of fluid - call your doctor. "A large amount of vaginal fluid loss may actually be a sign of ruptured membranes, which needs a speculum examination by a doctor at the hospital to diagnose."

4. Feeling faint or dizzy.

Have you been eating and drinking enough? Dehydration and hunger is one of the major symptoms of dizziness and feeling faint. However, it could also mean your blood pressure is low - which is fairly common in the early stages of pregnancy. 

If you're concerned, make an appointment with your doctor for a check-up.

5. Persistant headaches.

If your headache is constant, or keeps coming back and if you're noticing swelling or blurred vision, this could mean you have pre-eclampsia.

If this happens, you're most likely in the second half of your pregnancy. However, you might also experience these symptoms after the baby is born.

6. Pains in your stomach.

What kind of pain should ring alarm bells?

According to Professor Pecoraro, pain that is not relieved by simple measures like taking paracetamol or a warm shower, lasts longer than 30 minutes or is increasing in intensity rather than lessening, is usually the type that requires review and should not be ignored.

"As a general rule, pain, especially severe pain, is your body’s way of telling you that something is not quite right and if in doubt, it is always safest to go and be checked out by your obstetrician to make sure that both you and your baby are alright," said Professor Pecoraro.

The type of pain you're experiencing will also depend on different conditions and where in the pregnancy you are. 

Here are the conditions that may cause stomach pain and the relevant symptoms that go with them:

Threatened miscarriage, or miscarriage.

If you are experiencing a central, dull, crampy pain early in your pregnancy and you're also seeing bleeding, Professor Pecoraro said, "It may mean a threatened or inevitable miscarriage, as the uterus starts to contract and expel the uterine contents and the pregnancy."

However, it's important to remember that if you're experiencing these kinds of symptoms, it don't always point to miscarriage.

"In some situations, it is only threatened and while obviously emotionally distressing, it does not always lead to a miscarriage and can occur on multiple occasions."

Ectopic pregnancy.

For those who may experience a sudden sharp pain (which can also be associated with shoulder pain - it's not known why this occurs), Professor Pecoraro said this could mean you have something called an ectopic pregnancy.

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An ectopic pregnancy is "a pregnancy in the fallopian tube which can rupture and lead to life-threatening haemorrhage, needing emergency surgery to save the mother’s life." 

Symptoms of an ectopic pregnancy usually develop between the fourth and 12th weeks of pregnancy. If you have one or a combination of these symptoms, immediately seek medical assistance. 

Round ligament spasm.

Later on in pregnancy, Professor Pecoraro said it is common for women to experience pain associated with spasm of the round ligament (a muscular tube that supports the rapidly growing uterus). However, he said this is not anything major to worry about.

"It goes into spasm and this can cause quite marked pain, going into the top part of the vagina and down the legs. It can usually be relieved by hot packs, massage and rest," said Professor Pecoraro.

So... is this a cause for concern?

"While very common and uncomfortable, it is not serious nor anything to be worried about."

Fibroids.

Professor Pecoraro said women with fibroids (which are benign tumours of the muscle of the uterus) can sometimes experience bleeds, which can cause pain. 

"Although uncomfortable, they generally resolve with simple painkillers and rest although on rare occasions can cause a woman to go into labour and so require follow-up with an obstetrician," he said.

Preterm labour.

For dull and crampy pain that comes and goes "usually with monotonous regularity," Professor Pecoraro said this "may be a sign of preterm labour if it is before term (greater than 37 completed weeks) or just labour if it is later than this time." 

However, depending where you are in your pregnancy, this could also mean you're experiencing Braxton-Hicks or 'false labour' contractions.  

"Braxton Hicks contractions usually start in the third trimester and are the body’s so-called 'practice' contractions to get the uterus toned up and ready for the big event," explained Professor Pecoraro. 

What does this feel like? Is it super painful?

"Although usually described in pregnancy books as painless, many women describe them as painful, especially after the first pregnancy."

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Uterine abruption.

"Any intense hard and painful uterus, with or without vaginal bleeding, may be a sign of uterine abruption which is when the placenta lifts off the wall of the uterus and the space fills with blood," Professor Pecoraro.

Okay. What does this mean?

"This is an obstetric emergency and can threaten the life of both mother and baby. An ambulance needs to be called, and the woman transferred to hospital immediately."

Pre-eclampsia.

When you're not pregnant, pain in the top part of the abdomen (underneath the breastbone) is usually caused by heartburn or gallstones, however when you're pregnant this is a different story and it could mean something else.

While it could still indicate some of these conditions, it may also be a sign of something called pre-eclampsia, "the serious pregnancy condition associated with high blood pressure, kidney, liver and placenta failure," said Professor Pecoraro.

If you notice any of these symptoms, it's obviously best to check in with your midwife or doctor to make sure everything is okay.

Urinary tract infections.

Getting a UTI during pregnancy is very common (due to changes in the urinary tract). However, that doesn't necessarily mean it's not a cause for concern.

Professor Pecoraro said UTI's "may be completely asymptomatic until the infection travels up to the kidneys, when women may suddenly become very unwell and have high fevers with severe back and groin pain."

Appendicitis.

Appendicitis during pregnancy is not rare, and it's associated with increased reproductive risk.

However, it isn't exactly an easy condition to diagnose during pregnancy. "The uterus may push the appendix out of its usual position, making the pain appear higher than it usually does in a non-pregnant woman."

7. Spotting or bleeding.

Is it normal to experience any amount of bleeding throughout pregnancy?

While it sounds really scary, spotting during pregnancy is actually quite common, especially around the 12 week mark. However, it's important to keep in mind that different types of bleeding during different stages of your pregnancy can mean very different things. 

With spotting (light bleeding) you'll occasionally see a few drops of blood in your undies - but usually not enough to fill a whole liner. 

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Light bleeding during the early part of your pregnancy will usually go away, but it's always best to check in with a doctor or midwife to make sure everything is okay.

If you're experiencing light bleeding along with a severe pain in your tummy, this may be a sign of an ectopic pregnancy (a pregnancy that develops outside of the uterus).

Light bleeding, followed by a heavy flow of blood later in the pregnancy can point towards placental abruption (the condition we talked about earlier).

If you're noticing a heavy flow of blood, this may mean something different. Heavy bleeding, combined with back pain or abdominal pain could indicate a miscarriage. Heavy bleeding might also mean you're going into premature labour if you're less than 37 weeks pregnant.  

Sudden, painless bleeding can point towards a low-lying placenta (but you'll probably already know this because of your 20 week scan).

Again, if you're experiencing bleeding, check in with someone to make sure you're in the clear.

8. Falling and hitting your bump.

If you're walking down the street and trying to juggle all of the things (plus more), miss the sidewalk and fall flat on your bump, it can be painful, concerning and really freaking scary.

More often than not, it's nothing to stress about - your baby is surrounded by a whole heap of protective layers such as amniotic fluid, tough membranes, a muscular uterus and your abdominal cavity. However, if you fall quite hard or hit at a certain angle, it's possible you might experience some complications such as bleeding. 

Even if it's a light fall, it's best to be safe and contact the doctor immediately to confirm everything is okay in there.

9. Your baby isn't moving.

You'll usually start to feel your baby move between 16 and 24 weeks of pregnancy. However, it's important to remember that each pregnancy is different. For example, first time mums will tend to feel movement later, whereas mums who have given birth before will feel it earlier.

If you notice that your baby’s pattern of movements has changed or slowed down or have not felt your baby move by 24 weeks, it's really important to contact your midwife or hospital as soon as possible. They'll be able to check your baby's heartbeat and movements, and let you know if your baby is in distress. 

If this has raised any issues for you or if you would like to speak with someone, please contact the Sands Australia 24 hour support line on 1300 072 637. 

Feature image: Getty.

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