Normal or not during pregnancy? When to relax, when to call the doctor

Many pregnancy symptoms may seem alarming. Some are red flags while others are normal. Here’s how to tell the difference.

Some lucky people sail through pregnancy feeling absolutely amazing. But for many that’s not the case. It’s normal to experience symptoms during your nine months. Just as you get used to your tender breasts, you might begin to feel queasy. Later on, you might notice you have heartburn or find that it’s hard to sleep. Those discomforts are common and are usually not a concern.

Sometimes, though, you might have symptoms that feel alarming or even painful. Is it normal to be short of breath? What about spotting or cramping? The answer is, it depends. What’s common in early pregnancy might be a red flag during the third trimester, or vice versa.

You know your body better than anyone, says ob-gyn Iris E. Dori, M.D. “Go with your gut. If you don’t feel right or even if you aren’t sure and need to be reassured, it’s always better to call than not to call.”

Read on to find out which symptoms are probably fine, and which ones need your provider’s immediate attention. And when in doubt, always get in touch with your doctor.

Symptom: Bleeding

Light bleeding from your vagina very early in pregnancy is common. It usually means the fertilized egg is attaching itself to the uterus, says Dr. Dori. This happens in the first or second week after conception. The cervix also bleeds more easily during pregnancy. You might see blood after you have sex, according to the American College of Obstetricians and Gynecologists (ACOG).

Call your doctor if: The bleeding is period-like or heavier, or you have any type of vaginal bleeding in the second or third trimester, says Dr. Dori.

Symptom: Lower belly pain or pelvic cramping

Your uterus is a muscle, and it needs to stretch to accommodate your fetus. So, you may feel some cramping or even pain in your lower abs. It usually goes away if you shift positions.

Call your doctor if: You feel pressure or pain in the pelvic area later in pregnancy. This could be a sign of early labor, according to ACOG. If the pain is sharp, stabbing, or severe, seek immediate help.

Symptom: Shortness of breath

You might feel winded during every trimester. Early on, it’s your pregnancy hormones affecting the lungs. As you get bigger, there’s less room in your diaphragm for you to breathe deeply, says Dr. Dori. Don’t worry: Your baby is getting plenty of oxygen in the womb, according to the March of Dimes.

Call your doctor if: Your shortness of breath gets worse or affects your ability to do things, says Dr. Dori. Also call if you have a cough or chest pain along with shortness of breath.

Symptom: Leg cramp

Leg cramps can be painful. They usually come on in the middle of the night after you flex your foot, says Dr. Dori. The cramp usually goes away after you massage or stretch your leg. Leg cramps are often due to a calcium deficiency, so getting ample calcium can help.

Call your doctor if: The pain gets worse, your leg is red and hot, or if one leg is bigger than the other. Those could be signs of a blood clot deep in the leg vein, says Dr. Dori.

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Symptom: Swollen feet and ankles

Some swelling is normal. Pregnancy hormones plus a lot of extra fluid in your body can make your legs, feet, and ankles swell as your pregnancy progresses. “At nighttime, try to elevate or get off your feet when you can,” suggests Dr. Dori. That should reduce the swelling.

Call your doctor if: Many women have swollen feet—that alone is not necessarily a problem. But if your feet are swollen plus your hands and face, that’s worth a call. “If your feet are still swollen or your shoes no longer fit you or your rings no longer fit you, tell your provider,” says Dr. Dori. These can be signs that your blood pressure is higher than normal, according to the National Library of Medicine.

Symptom: Nausea and vomiting

Queasiness and even vomiting in your first trimester or even into the second trimester is common. For a few women, it can last throughout pregnancy, says ACOG. It’s known as morning sickness, even though it can happen any time of day.

Call your doctor if: You are unable to keep anything down over a prolonged period of time. That means you can’t drink any liquids for more than eight hours, or you can’t eat any food for more than 24 hours, according to the Centers for Disease Control and Prevention. You might have hyperemesis gravidarum. That refers to persistent nausea and vomiting during pregnancy.

Symptom: Headache

Hormones can cause throbbing headaches during pregnancy. So can stress and tension. Talk to your provider about which pain relievers are safe to take.

Call your doctor if: The headache is extremely painful or won’t go away no matter how much you rest. A severe headache could be a sign of preeclampsia, according to the Mayo Clinic.

The bottom line: When in doubt, call your provider. “That’s why we’re there — to help guide you through a potentially physically and emotionally challenging time in your life,” says Dr. Dori. “And make it as pleasant and wonderful as it should be.”