9 pregnancy warning signs to watch out for

No matter what trimester you’re in, there are a host of physical symptoms—cramping, fatigue, headaches and more—that go along with being pregnant, and it’s easy to find yourself wondering if these symptoms are normal or if they’re warning signs of something more serious going on (either with you or your developing baby). 

While there’s no “always” or “never” when it comes to whether these symptoms are something to be concerned about, it is helpful to know if what you’re experiencing is something you’re going to want to contact your medical provider about, and what these symptoms could be a warning sign of, exactly. We spoke to experts to learn what pregnancy warning signs to be concerned about, and why. 

When in doubt, of course, it’s always a good idea to reach out to your care team, as they know your medical history and any individual concerns. “Every pregnancy is unique, and it’s always better to err on the side of caution,” says Meleen Chuang, MD, clinical associate professor in the department of obstetrics and gynecology at Family Health Centers at NYU Langone. “If you have any concerns or questions, it’s best to reach out to your doctor or midwife for guidance and reassurance.”

Pregnancy warning signs to know

While this isn’t an exhaustive list of every possible pregnancy complication—nor is it the case that any of these symptoms are always or even often a sign of something being wrong—these are some of the more common symptoms that can also indicate a cause for concern. Again, if you are experiencing any of these symptoms, call your care provider to get their advice on next steps.

Vaginal bleeding

Let’s start here: this is the rare symptom that should almost always be treated as a pregnancy warning sign. If you are bleeding, call your doctor. True, bleeding in pregnancy can sometimes be totally normal. 

“Early on in the pregnancy, it can be normal to experience spotting that’s known as implantation bleeding,” explains Lisha Coster, CNM, the director of the midwifery program at Open Door Family Medical Center in Ossining, New York. “However, in some cases there could be spotting or bleeding due to a more serious condition.” 

If you see blood, especially if it is accompanied by any other symptoms like cramping or lightheadedness, call your doc. “If you experience any vaginal bleeding, heavy or light, it is essential to contact your doctor,” says Dr. Chuang. Especially later in pregnancy, “it could be a sign of various conditions that require medical attention, such as placenta abruption, where the placenta separates from the uterus prematurely and can cause the baby to lose blood.” 

Extreme abdominal cramping

Some abdominal cramping during pregnancy is very normal—it might be round ligament pain, gas pain or Braxton-Hicks contractions. “Round ligament pain is usually a dull ache or sharp pain on either side of your belly, most noticeable when you cough or sneeze,” says Coster. But “persistent or severe abdominal pain or cramping could be indicative of a problem and should be reported to your doctor,” says Dr. Chuang. Some of the more serious outcomes that severe abdominal cramping can be a sign of include an ectopic pregnancy, a placental abruption, pregnancy loss, preeclampsia, or a urinary tract infection. If your pain is extreme and/or unrelenting, call your doctor.

Intense vomiting

Non-stop vomiting early in pregnancy (up until about 16 weeks or so) is most likely hyperemesis gravidarum, a pregnancy condition that occurs in about 1% to 3% of pregnancies. “Hyperemesis requires medical attention,” says Coster—because the vomiting is so severe, it can cause other symptoms like weight loss, inability to hydrate or keep food down, or electrolyte imbalances. 

“These are reasons to be concerned,” says Dr. Chuang—so call your provider ASAP. If you begin vomiting uncontrollably in your third trimester, “this is also a concern, as there are conditions that are very serious that can start out as nausea/vomiting,” she says, including preeclampsia. 

If you begin vomiting later in pregnancy (when you weren’t before, or had stopped and then started again), this can also be a sign of a viral illness, so be sure to get appropriate care for that, too.

Sudden swelling or puffiness

Another pregnancy warning sign of preeclampsia: “if you notice sudden and excessive swelling in your face, hands or legs,” says Dr. Chuang. Preeclampsia, a condition marked by elevated blood pressure and protein in the urine, requires immediate medical attention, and the swelling may be one of the earliest signs of it. Yes, some swelling, particularly in your ankles, is a normal pregnancy symptom, but pay special attention to any new, rapid-onset swelling in the areas Dr. Chuang mentions, and call your doctor as soon as you notice it.  

Persistent headaches after 20 weeks

Headaches in pregnancy are very typical (and are often a sign of dehydration, says Dr. Chuang). But if you have a gnarly headache after 20 weeks, call your doc, she says. It could be another sign of preeclampsia, especially if the headaches are accompanied by “blurry vision, or visual disturbances such as floaters or seeing spots.” 

Frequently feeling dizzy

This is another pregnancy warning sign where the frequency is really important: occasional dizzy spells may happen in pregnancy because of changes in your blood volume, or low blood sugar. “However, if this feeling of dizziness persists; if you feel faint or actually do faint; or if your dizziness is combined with other symptoms like blurred vision, vaginal bleeding, headaches, or pain in your abdomen; consult your healthcare provider so that a cause can be identified and treated,” says Dr. Chuang. Some of those causes can include an ectopic pregnancy, a low-lying placenta, or placenta abruption.

A decrease in movement from the baby

Once you’re in your third trimester (28 weeks), you’ll want to begin keeping general track of your baby’s movements. “Feeling for fetal movement is recording the time it takes to feel 10 fetal movements—preferably after a meal or at a time when the baby is more active,” says Dr. Chuang. If you notice it’s taking considerably longer than usual to get to 10 kicks—in medical terms this is known as “decreased fetal movement”—call your doctor. “It’s important to ensure everything is alright, so call your provider or go to the hospital,” says Dr. Chuang. Decreased fetal movement could be a fluke, but it could be something else like low amniotic fluid or another issue that requires attention.

Painful urination

Needing to pee a lot when you’re pregnant is normal, but if that pee hurts, you may have a UTI. “If you have painful urination, an urge to pee and only a few drops come out, or a burning sensation with urination, that can all be a sign of a urinary tract infection,” says Dr. Chuang. Other symptoms of a UTI can include fever, chills, or blood-tinged urine, says Coster. “Call your doctor because they will be able to diagnose your symptoms and treat the bacterial infection to avoid complications,” Dr. Chuang says.

Widespread itchiness, especially on your palms and feet 

If you feel whole-body itchiness in your third trimester, particularly if it’s on the palms of your hands and soles of your feet, call your doctor as soon as it starts. “This is a sign of cholestasis of pregnancy,” says Dr. Chuang. “This is a liver condition in late pregnancy that causes severe itching.” When your liver is operating at reduced functionality, she explains, bile acid can build up. “When the level of bile acid is too high, it can cause severe itching.” Cholestasis is extremely dangerous for the baby, and it can get severe really quickly, so stay on high alert for this.