Labor, Delivery, And Postpartum Period: When To Call A Doctor

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When to Call a Doctor

You or someone else should call 911 or other emergency services immediately if you think you may need emergency care. For example, call if you:

• Have a seizure.
• Pass out (lose consciousness).
• Have severe vaginal bleeding.
• Have severe pain in your belly or pelvis.
• Have had fluid gushing or leaking from your vagina (the amniotic sac has ruptured) AND you know or think the umbilical cord is bulging into your vagina (cord prolapse). This is quite rare, but if it happens, immediately get down on your knees, dropping your head and upper body lower than your buttocks to decrease pressure on the cord until help arrives. Cord prolapse can cut off the baby's blood supply.

Call your health professional now or go to your hospital's labor and delivery unit immediately if you:

• Have any vaginal bleeding.
• Have signs of preeclampsia, such as:
  • Severe headache that does not go away with acetaminophen (such as Tylenol).
  • New visual problems (such as dimness or blurring).
  • Sudden swelling of your face, hands, or feet.
• Have belly pain or cramping.
• Have a fever of or higher.
• Have had regular contractions for an hour. This means about 4 or more in 20 minutes, or about 8 or more within 1 hour, even after you have had a glass of water and are resting.
• Have a sudden release of fluid from your vagina. It is possible to mistake a leak of amniotic fluid for a problem with bladder control.
• Have low back pain or pelvic pressure that does not go away.
• Have noticed that your baby has stopped moving or is moving much less than normal.

If you are between 20 and 37 weeks pregnant, call your health professional immediately or go to the hospital now if you have:

• Concern that the baby has stopped moving or is moving much less than normal. See kick counts for information on how to check your baby's activity.
• Any vaginal bleeding.
• Uterine tenderness, unexplained fever, or weakness (possible symptoms of infection).
• Loss of a large amount of fluid from your vagina [a cup (240 mL) or more].

Some of these symptoms could mean you are having preterm labor.

Call your health professional right away if you have:

• Regular contractions for an hour. This means about 4 or more in 20 minutes, or about 8 or more within 1 hour, even after you have had a glass of water and are resting.
• Unexplained low back pain or pelvic pressure.
• Intestinal cramping with or without diarrhea.

For more information, see the topic Preterm Labor.

After 37 weeks of pregnancy, call your health professional immediately or go the hospital if you have:

• Concern that the baby has stopped moving or is moving much less than normal. See kick counts for information on how to check your baby's activity.
• Any vaginal bleeding.
• Regular contractions (about 4 or more in 20 minutes, or about 8 or more within 1 hour).
• A sudden release of fluid from the vagina.

At any time during pregnancy, call your health professional if you have new steady or heavy discharge from the vagina along with symptoms of itching, burning, or odor.

After delivery

After you have delivered, call 911 if:

• You have sudden, severe pain in your belly.
• You pass out (lose consciousness).

After you have delivered, call your health professional now or seek medical care right away if:

• You have severe vaginal bleeding. You are passing blood clots and soaking through a new sanitary pad each hour for 2 or more hours.
• Your vaginal bleeding seems to be getting heavier or is still bright red 4 days after delivery or you pass blood clots larger than the size of a golf ball.
• You feel dizzy or lightheaded, or you feel as if you may faint..
• You are vomiting or you cannot keep fluids down.
• You have a fever.
• You have new or more belly pain.
• You pass tissue (not just blood).
• You have a severe headache, visual problems, or sudden swelling of your face, hands, or feet.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You are not getting better after 2 to 3 days.
• You have vaginal discharge that smells bad.
• You have signs of postpartum depression, such as:
  • Feelings of despair or hopelessness for more than a few days.
  • Troubling or dangerous thoughts or hallucinations.
• Your breasts are painful or red and you have a fever, which are symptoms of both breast engorgement and mastitis. For more information, see the topics Breast Engorgement and Mastitis While Breast-Feeding.

Last updated:	December 05, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Sarah Marshall, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC