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Pregnancy makes you more aware of your body. It also brings a long list of changes, so it's not always easy to know when to call your healthcare provider. Here's a look at some of the common complications women may experience - and what to do if they happen to you.

Vaginal Bleeding

Vaginal bleeding during pregnancy is always a concern. If you have bleeding or spotting, stop whatever you're doing and talk to your healthcare provider immediately.

One quarter of pregnant women will have some spotting or light vaginal bleeding. Vaginal bleeding during pregnancy is more common among women who have been pregnant before than in women who are pregnant for the first time. A small amount of bleeding in the first trimester doesn't mean you're having a miscarriage, but vaginal bleeding in the second or third trimester may be serious.  When you call your healthcare provider, let them know the following:

• What colour is the blood? pink, brown or red?
• Are there any clots in the blood?
• When did it start?
• What were you doing when it started?
• How much is there? For example, is it spotting the size of a quarter, or soaking your underwear?
• Did it happen after intercourse or a vaginal examination?
• Are you having cramps, pain, or any other symptoms?

Gestational diabetes

Gestational diabetes can develop during pregnancy when hormones change the way your body uses insulin. Sometimes, a pregnant woman has been living with diabetes without knowing it. Symptoms of diabetes may include:

• Increased thirst.
• Increased urination.
• Increased hunger.
• Blurred vision.

Pregnancy causes most women to urinate more often and to feel hungrier, so having these symptoms does not always mean that a woman has diabetes.

Regular exercise and a healthy diet can help keep your blood sugar level within a target range and prevent gestational diabetes. However, some women will need insulin injections. Talk with your healthcare provider if you have these symptoms so that they can help you manage gestational diabetes, in consultation with a registered dietitian or diabetes educator.

Gestational diabetes usually goes away after birth. If you have had gestational diabetes, it is important to follow up with your health care provider after birth because it can increase your risk of getting diabetes in the future.

Premature Rupture of Membranes

When your water breaks, it typically means you're about to go into labour. When your membranes break or leak before you are in labour or before your due date, the condition is called Premature Rupture of Membranes (PROM). PROM can occur at any time during pregnancy.

If your membranes break or leak:

• contact your healthcare provider
• note the colour and amount of the fluid
• use a sanitary pad
• do not take baths, put in a tampon, or have sex

The type of treatment you need will depend on your stage of pregnancy, how much fluid was lost, and whether you develop an infection.

Placenta previa

Placenta previa is where the placenta is either partially or completely blocking the cervix. Doctors aren't sure what causes placenta previa, and some women do not have any symptoms. But there are a few warning signs and you may notice one or more symptoms such as:

• Sudden, painless vaginal bleeding that is light to heavy (the blood is often bright red).
• Symptoms of early labour, such as regular contractions and aches or pains in your lower back or belly. 
• Call your healthcare provider or go to the nearest emergency room right away if you have:
• Heavy vaginal bleeding during the first trimester.
• Any vaginal bleeding in the second or third trimesters.

If you have a placenta previa at the time of birth, a caesarean delivery will be recommended.

High Blood Pressure/Pregnancy InducedHypertension and HELLP Syndrome

About 7 in 100 pregnant women will develop high blood pressure. If it is not treated, it can harm both you and your baby. Signs of high blood pressure in pregnancy:

• swelling in your hands and face
• rapid weight gain
• unusual headaches that don’t go away
• blurred vision
• spots or stars in front of your eyes
• pain in the upper right side of your abdomen

If you have any of these symptoms, immediately contact your health care provider or call HealthLink BC at 8-1-1.

Pain in your abdomen can be a sign of a liver disorder called HELLP syndrome, a type of severe pre-eclampsia. HELLP is rare but very serious. If you think you are experiencing symptoms of HELLP syndrome, you should seek emergency medical treatment.

Breech position

By about 32 to 36 weeks, most babies will move into the head down birth position where the largest part of the baby is born first. In the breech position, the baby's buttocks or legs are facing down, as shown in the diagram below.

If your baby is in the breech position, your doctor or midwife may speak with you about external cephalic version (ECV). ECV is when the healthcare provider manipulates the outside of your belly with his or her hands to try to turn the baby to a head down position. If ECV does not work, talk to your healthcare provider about the possibility of a breech vaginal delivery.
Most of the time a planned caesarean delivery (C-section) will be required.

Resources and Links:

HealthLink BC: Breech Position and Breech Birth
HealthLink BC: External Cephalic Version (ECV) for Breech Position
HealthLink BC: Placenta Previa
HealthLink BC: Low Lying Placenta
HealthLink BC: Preterm Premature Rupture of Membranes
HealthLink BC: Vaginal Bleeding in Pregnancy
HealthLink BC: Gestation Diabetes
HealthLink BC: HELLP Syndrome and Pre-Eclampsia
HealthLink BC: High Blood Pressure During Pregnancy