Health & Pregnancy

First Trimester Problems: When to Call Your Doctor

You're expecting! It's an emotional and exciting time, especially if it's your first baby. You're going to notice a lot of changes in your body. Many of them are perfectly normal. And most women have healthy pregnancies.

Still, there are some symptoms you'll need to pay more attention to during your early months. For example, nausea, a little bleeding, and vaginal discharge aren't unusual, but they could also mean there's a problem. Should you call your doctor? Probably.

You might be tempted to dismiss these signs if you don't realize they're clues to avoid bigger troubles. Knowing what to watch for helps you take care of yourself and the little one growing inside you. Any time you're concerned about what's going on or how you're feeling, it's OK to talk to your doctor.

1. Vaginal Bleeding

What it may mean: "Some spotting is normal, but heavy bleeding could be a sign of miscarriage or ectopic pregnancy," says Natali Aziz, MD. She is a maternal-fetal medicine specialist at Lucile Packard Children's Hospital in Palo Alto, Calif. "The brighter red the bleeding, the more significant it is." 

"If you have bleeding and bad cramping similar to period cramps, this can be a sign of threatened miscarriage," says Manju Monga, MD. She is a maternal-fetal medicine specialist at Baylor College of Medicine in Houston. "If this is coupled with sharp, lower abdominal pain, it may be a sign of ectopic pregnancy," a serious complication that occurs when the fertilized egg implants outside the uterus, usually in the fallopian tubes.

What to do: "Call your doctor," Monga says. "Your doctor will likely do an ultrasound, an exam, and some blood work based on your symptoms." Though most spotting or light bleeding may not be a serious problem, "you don’t want to ignore it if it is associated with cramping, heavy bleeding, or abdominal pain."

2. Excessive Nausea and Vomiting

It's normal to have some nausea and vomiting during your first trimester. Most pregnant women go through that.

But if it's severe or makes you dehydrated, that's something to heed. If you can’t keep any water or fluids down for more than 12 hours, call your doctor.

What it may mean: “Vomiting that interferes with your day-to-day activities can lead to weight loss, dizziness, dehydration, and an imbalance of electrolytes,” Aziz says.

What to do:  Tell your doctor. “You may need hospitalization to treat the dehydration, and many medications are available to control nausea," Aziz says.

Bottom line: "Nausea and vomiting are normal occurrences during pregnancy, but the extremes can cause problems," says ob-gyn Stanley M. Berry, MD, of William Beaumont Hospital in Royal Oak, Mich. "The majority of women who have nausea and vomiting in their first trimester will go on to have normal, healthy pregnancies."