Risks and Danger Signs during Pregnancy

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HealthWiki > Where Women Have No Doctor > Chapter 6: Pregnancy and Birth > Risks and Danger Signs during Pregnancy

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In this chapter:

 

In this chapter:

Problems that make pregnancy more risky

A woman who is likely to have a dangerous birth should plan to have her baby in a health center or hospital.

Someone with any of the following problems should plan to go to a health center or hospital for birth, and should try to get regular prenatal care during pregnancy.

• Anemia makes someone more likely to bleed heavily (hemorrhage) during birth, become ill after birth, or even die.
• Diabetes can cause very serious problems during pregnancy. The pregnant person is more likely to develop pre-eclampsia and the baby may become very ill and die after birth.
• High blood pressure can lead to severe headaches, seizures, and even death.
• Being older and having had many babies make someone more likely to have a difficult labor and heavy bleeding after birth.
• Someone under the age of 17 is more likely to have eclampsia (seizures), a long, difficult labor, a baby born too early (premature), or a blocked birth, which may damage the bladder, vagina, and womb. These can even cause death.
• Someone who had problems with a past pregnancy—such as seizures, birth by operation, heavy bleeding, a too-early or too-small baby, or a baby born dead—is more likely to have problems in another pregnancy or birth.
• Someone with a disability, such as a loss of feeling in the body or difficulty walking, can have problems during both pregnancy and birth.
• Someone with HIV risks spreading HIV to their baby, but can take medicines to prevent this.

Feeling very weak or tired (anemia)

If you feel very weak or tired, you could be anemic. Being very anemic in pregnancy means you are much more likely to have heavy bleeding after the baby is born.

What to do:

• Eat foods rich in iron—meat, fish, chicken, eggs, beans, peas, and leafy green vegetables.
• Take 325 mg of ferrous sulfate (iron) by mouth 2 times a day, and 400 mcg of folic acid by mouth once a day, until the baby is born. If you take iron tablets with fruits like oranges, mangoes, or papayas, your body uses the iron better.

Pain in the lower belly (abdomen)

tubal pregnancy

1. Pain in the first 3 months may be caused by a pregnancy that is growing outside the womb in the tube (a tubal pregnancy). As the tube stretches, it causes pain. If the pregnancy grows large enough, the tube will burst and bleed. This is very dangerous. You will bleed inside your abdomen and may die.

   Signs of tubal pregnancy (ectopic pregnancy):

   Strong pain in the abdomen does not always mean something is wrong with a pregnancy. For information about other possible causes, see Chapter 21.

   • missed menstrual period, and
   • pain in the lower abdomen on one side, or
   • slight bleeding from the vagina, or
   • feeling dizzy, weak, or faint

   What to do:

   Go to the nearest hospital.

2. Strong pain that comes and goes (cramping) in the first 6 months could mean you are losing the pregnancy (having a miscarriage).

TRANSPORT!

3. Strong, constant pain in late pregnancy. This could mean the afterbirth (placenta) is coming off the wall of the womb. This is very dangerous. You could die if you do not get help. Go to the nearest hospital.
4. Pain that comes and goes in the 7th or 8th month could mean you are going into labor too early.

Bleeding from the vagina

1. Bleeding early in pregnancy. Light bleeding from the vagina for a few days during the first 3 months of pregnancy can be normal. But pain with light bleeding could be a pregnancy in the tube, which is very dangerous. If the bleeding gets heavier than your usual menstrual period, you are probably losing the pregnancy (having a miscarriage).
2. Bleeding later in pregnancy. Bleeding after the first 3 months can mean there is a problem with the afterbirth (placenta). Both you and the baby are in danger.

What to do:

• Go to the nearest hospital.
• On the way, lie down with your feet up.
• Do not put anything in your vagina.

TRANSPORT!

See Where There Is No Doctor for more information about malaria.

Fever

Fever over 38°C (100.4°F) with shivering, body aches and headache can be caused by malaria. For uncomplicated malaria during the first 3 months of pregnancy, take 600 mg of quinine and 300 mg of clindamycin, both by mouth 3 times a day for 7 days. At any time during pregnancy you can use the artemisinin combination therapy (ACT) recommended for your area instead.

High blood pressure, a sign of pre-eclampsia

Blood pressure of 140/90 or higher can mean you have a serious problem called pre-eclampsia (toxemia). Pre-eclampsia can lead to seizures, and both you and the baby can die.

What to do:

• Check your blood pressure and for protein in the urine. Go to a health center or hospital if necessary.
• If you are at risk for pre-eclampsia you can take a low-dose aspirin (81 mg) daily to help prevent it.
• Rest as often as possible, lying down on your left side.
• Plan to have the birth in a health center or hospital

TRANSPORT!

IMPORTANT! Someone with high blood pressure and any signs of preeclampsia needs medical help fast. If already having seizures, see information about what to do.

If the baby's head is down, the birth is more likely to go well.

Baby in the wrong position when labor starts

If the baby’s head is not down, toward the womb opening, when labor starts, the birth can be more difficult or even dangerous. If you do not already know how, you can learn how to check the baby’s position.

Lie on the floor with pillows under the hips. Try to get the hips higher than the head.

During the last month of pregnancy, it may be possible to change the baby’s position by lying in this position for 10 minutes, 2 times a day:

Do this exercise every day with an empty stomach, until the baby changes to a headdown position and then stop. The baby’s position should be checked each week.

TRANSPORT!

• If labor starts and the baby is still sideways, go to a health center or hospital where the baby’s position can be changed, or where you can have an operation. Without medical help, you and your baby will almost certainly die.
• If labor starts and the baby is still buttocks first, see information about what to do.

IMPORTANT! DO NOT try to change baby’s position by hand yourself unless you have been trained to do it and have done it before successfully. You can tear the womb and harm both the pregnant person and the baby.

This page was updated:13 Nov 2023