Urgent warning signs during and after pregnancy

Most pregnancies and postpartum recoveries go well. But serious complications can happen at any point: during pregnancy, around the time of birth, and up to a year afterward.

Warning signs can be easy to dismiss as a normal part of pregnancy or recovery. This is especially true after birth, when you may be exhausted, sore, bleeding, or swollen, and focused on caring for your baby. With so much changing in your body and your life, it can be hard to tell what's normal and what isn't.

But recovering from birth doesn't mean you have to accept feeling seriously unwell. If something feels different, concerning, or simply not right, trust that feeling. You deserve to be heard, taken seriously, and given the care you need.

Urgent warning signs to know

Based on the CDC's Hear Her campaign, the following are urgent maternal warning signs during pregnancy and in the year after pregnancy. These symptoms can sometimes be signs of a serious or life-threatening complication.

• A headache that won't go away or gets worse over time
• Dizziness or fainting
• Changes in your vision, including blurry or double vision, flashes, or temporary loss of vision
• A fever of 100.4°F (38°C) or higher
• Extreme swelling of your hands or face
• Thoughts about harming yourself or your baby
• Trouble breathing
• Chest pain or a fast-beating or irregular heart
• Severe nausea or vomiting, especially when you cannot keep fluids down
• Severe belly or abdominal pain that doesn't go away
• Overwhelming tiredness or weakness that is unusual for you and makes it difficult to function
• Your baby's movement slowing or stopping during pregnancy
• Vaginal bleeding or fluid leaking during pregnancy
• Heavy vaginal bleeding or unusual or bad-smelling vaginal discharge after pregnancy
• Severe swelling, redness, or pain in a leg or arm, particularly on one side

The warning signs aren't limited to this list. If something feels wrong or you're worried about a symptom, contact your healthcare provider.

What if someone tells you that you're fine?

This is the part we don't talk about enough. You can recognize a warning sign and still have trouble getting someone else to take it seriously.

Maybe you've already called your provider and been told to rest. Maybe you went to the emergency department and were reassured. Maybe someone tells you that the symptom is "normal during pregnancy" or "just part of postpartum recovery."

Sometimes that reassurance is appropriate. But being told that nothing is wrong doesn't mean you have to ignore a symptom that is continuing, changing, or worrying you. Symptoms can change after you've been seen, and your healthcare team can only act on what they know.

You are allowed to ask questions.

You are allowed to say that something feels different from your usual.

And you are allowed to ask what you should watch for next.

Be specific about your symptoms

You don't have to convince anyone that something is seriously wrong. Instead, describe what you're experiencing as clearly as you can.

Include where you are in your pregnancy or postpartum recovery, what symptoms you're having, how long they've been going on, and any important health history or medications you take. For example:

"I am 32 weeks pregnant, and I've had a severe headache for six hours that hasn't improved with medication."

"I gave birth three weeks ago. I have shortness of breath that started today and is getting worse."

"I know some swelling can be normal during pregnancy, but this swelling is new and much worse than what I've experienced before."

Specific information gives your healthcare team something concrete to evaluate.

Questions to ask your provider when you're concerned

You shouldn't have to diagnose yourself. That's your provider's job. Your role is to describe what you're experiencing and ask for help figuring out what's going on.

But if you feel like your concerns are being brushed aside, asking a few questions can help nudge your provider in the right direction and make sure you're both on the same page. The CDC recommends asking questions like these:

• "Could this symptom be related to my pregnancy or recent pregnancy?"
• "What are the possible causes of this symptom?"
• "Is there anything serious that we should rule out?"
• "Are there tests or an exam that would help determine what's causing this?"
• "What symptoms should make me come back or seek emergency care?"
• "If this gets worse tonight, who should I call?"

If you have a specific concern, you can say:

"I'm concerned about this symptom and want to make sure we aren't missing something serious. Can you help me understand what could be causing it?"

What to do if you don't feel heard

If you have an urgent warning sign, don't let embarrassment, uncertainty, or fear of being dismissed keep you from getting care. You can:

• Ask to speak with another clinician.
• Ask the clinician to explain why they don't think the symptom is concerning.
• Ask what else could cause the symptom.
• Ask for a clear follow-up plan before you leave.
• Bring a partner, friend, family member, doula, or other support person when possible.
• Write down your symptoms, when they started, and whether they are getting better or worse.
• Seek care from another qualified healthcare professional or facility if you remain concerned.

How partners, family, and friends can help

Sometimes the person who is pregnant or recently gave birth is too tired, overwhelmed, sick, scared, or unsure to advocate for themselves. They may downplay how they feel, worry about overreacting, or be so focused on the baby that they put their own health last.

You may notice a change before they do. Pay attention if they seem more confused, withdrawn, anxious, or unwell than usual, if they mention a symptom more than once, or if they say anything about harming themselves or the baby.

• Listen and take them seriously. When they say something feels wrong, believe them. Don't assume a symptom is "just pregnancy" or "just postpartum."
• Make it easier to get help. Offer to make the call with them, look after the baby, or drive them to an appointment. Small practical steps can remove the barriers that keep someone from reaching out.
• Help them tell their story. Keep track of what symptoms they're having, when they started, and whether they're getting worse. At appointments, help describe what you've noticed and remind the care team that they are pregnant or gave birth within the last year.
• Speak up if something doesn't add up. If you feel their concerns are being dismissed, it's okay to ask questions or ask for a second look.

You can say:

"You don't seem like yourself. Do you want me to stay with you while you call?"

"You said you're worried about this. Let's make sure someone checks it out."

"I'll watch the baby. You focus on getting looked at."

One more thing: you are allowed to speak up

Pregnancy and postpartum care involves a lot of uncertainty. Your healthcare provider brings clinical expertise, but you're the one living in your body every day. Both perspectives matter.

Sometimes a symptom turns out to be nothing to worry about. Sometimes it's something minor that's easy to manage. And sometimes it's a sign that you need treatment. You don't have to know which one it is before you ask for help.

If something feels wrong, say so. Ask questions. Ask for an explanation. Ask what to watch for next. Your concerns deserve to be heard.

If you have an urgent warning sign, get medical care right away. If it feels like an emergency, call 911.

Sources: CDC Hear Her campaign; 988 Suicide & Crisis Lifeline; National Maternal Mental Health Hotline (HRSA).