Always get advice for any vaginal bleeding, whether it is a small amount, large amount, dark or bright blood. If you experience a large amount of bleeding, call an ambulance on 000 immediately.
Pregnancy
When to call the hospital
When to call the hospital
Many women are unsure whether they should contact the hospital or their doctor when certain problems arise or when they are in early labour and feel they need to come into hospital.
The best general advice we have is that if you are worried about anything; please contact your doctor or hospital, however minor you may think it is. If you feel unwell, there is something not quite right or there is something bothering you, then you need to speak to someone. It is better to find out it is a false alarm than ignoring problems that could be harmful to you or your baby.
Serious problems
We advise you to contact your hospital or obstetrician immediately if you notice any of these things, but also if you experience anything particular to your individual circumstances, that is not mentioned here, that you feel warrants assistance or advice:
Fluid loss from your vagina could mean your waters have broken. They may break at the beginning of labour or before the start of labour (preterm premature rupture of membranes). The water may be clear, pink, green or brown in colour. Please call your obstetrician or hospital and your midwives; you will need to be admitted to hospital if the membranes have ruptured.
What should you do if you think your baby is not moving as normal?
If you feel that your baby's pattern of movement has changed, or you become aware that the baby is moving less than normal during the day than at night, you should make an appointment with your obstetrician or midwife as soon as possible to be assessed.
Please call the hospital if:
- At any time you are concerned about your baby’s movements, or there is a change in the type or pattern of movements
- The baby moves less and less and over the course of a few days, or the type or pattern of movements is very different
- You have not felt your baby move at all during the course of a day (do not wait until the next day to call)
We would always rather that you call to discuss your concerns and, if necessary, come in for a reassuring check, and not sit at home and worry.
Contact your hospital or obstetrician if you experience pain that is not helped by paracetamol (e.g. Panadol) or that lasts more than a couple of hours, especially if the abdominal pain is accompanied by pre-eclampsia or high blood pressure.
Contact your hospital or obstetrician if you experience headaches that won't go away, flashes of light, blurred vision or spots before your eyes.
Contact your hospital or obstetrician if you experience swelling in your face, eyes, hands or persistent swelling of your feet.
Contact your hospital or obstetrician if you have a fever or high temperature.
Contact your hospital or obstetrician if you have a fainting spell or feeling dizzy. Have someone call an ambulance immediately if you have an epileptic seizure.
Contact your hospital or obstetrician if you experience vomiting that won't stop.
Contact your hospital or obstetrician if your skin or the whites of your eyes turn yellow.
Contact your hospital or obstetrician if you experience severe itching which starts on the hands and soles of the feet, then spreads to the trunk and is ongoing.
Contact your hospital or obstetrician if you experience urinary burning or stinging.
Contact your hospital or obstetrician if you experience a painful, hot and swollen calf, or you have pain behind your knee.
Call an ambulance immediately if this persists or is severe and unrelieved by any prescribed medications, such as asthma puffers.
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Contacting the hospital when you think you are in labour
It can be difficult to tell when labour is established and this will be different for every woman and every pregnancy. Labour can start days or even weeks before your estimated due date (term is anytime from 37 weeks onwards). It can begin in many ways – contractions, a “show” or the waters may break, and these things can occur in any order or together!
Sometimes if it is not truly established, it can stop and start again later. Other signs include loose bowel motions, feeling like you want to vomit and low back pain. The midwives in the Delivery Suite/Birth Suite of your hospital are available 24 hours a day every day of the year and can advise you about your concerns. Always seek their advice prior to leaving for the hospital. If you are unsure about anything, you can telephone the hospital at any time.
There are two types of contractions: Braxton-Hicks contractions and labour contractions. Braxton-Hicks contractions feel like tightenings of your uterus and they increase in frequency towards the end of pregnancy. Their job is to prepare your uterus for labour and birth. They can be painful, but are usually irregular, do not get progressively stronger either on their own or by walking, and often go away with relaxation techniques such as lying down or taking a warm bath. Braxton-Hicks contractions do not open the neck of the womb.
Labour contractions, on the other hand, become progressively stronger, closer together and more painful. They do not go away with relaxation techniques. In the early stages, labour contractions cause the neck of the womb (cervix) to become soft and start to open. Most women can manage comfortably at home during this early stage. Early labour can sometimes but not always be accompanied by a mucousy ‘show’ of blood. It may be seen in the toilet or on underwear as a small amount of pinkish mucous. The ‘show’ on its own though does not necessarily indicate labour has begun as it may still be several hours or days before real labour begins. It is important to know the difference between a show and a fresh bleed (as described in the section about vaginal bleeding).
At any time your waters break, with or without contractions, you should call the hospital for advice. It will be important to distinguish between a show (mucousy and/or pink) or a bladder leak or whether the waters have broken. When the waters break it can be a slow trickle or a large gush. Place a pad on so you can note the colour and amount of fluid. It may appear clear, straw coloured, blood stained or green. If you feel or see any part of the baby such as the cord (cord prolapse) coming out of your vagina when the waters break please either lie on your left side with a pillow under your left hip or adopt a knees to chest position with your face down and bottom up on the floor and have someone call an ambulance on 000 immediately. Do not try to push the cord back into your vagina but keep yourself as calm as possible and stay warm and covered until help arrives.
As labour progresses, if you cannot manage your pain, you should contact the hospital. The midwife will ask you about where you feel your contractions, how often the contractions come and how long they last. This will help the midwife to know how much your labour has progressed. Depending on what is happening, the midwife may reassure you that it is okay to stay at home or s/he may ask you to come into hospital so that you and your baby can be checked. Usually, you will be seen by a midwife and then admitted. S/he will then contact your obstetrician. If you are not in labour or if the labour is not yet established, you may be advised to go home. If the waters have broken and labour has not commenced, your obstetrician may decide to keep you in and induce (start) labour because there is a risk of infection the longer the membranes remain ruptured. If you feel you are about to give birth call an ambulance immediately.
Learning link
The Labour and Birth section in this series has more information on early labour.