Hesperian Health Guides

Learning the danger signs

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HealthWiki > Health Actions for Women > Chapter 8: Healthy Pregnancies and Safe Births > Learning the danger signs

More women’s lives would be saved if everyone knew the signs that mean a woman’s life could be in danger during pregnancy, birth, or the first 2 weeks after giving birth. Learning the danger signs is an important part of being prepared for emergencies.

Danger signs during pregnancy

Help a woman go to a health center or hospital quickly if she has:
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Bleeding from the vagina. Early in pregnancy, this can be a sign of miscarriage (loss of the pregnancy) or, later in pregnancy, of the placenta separating from the womb.

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Severe pain in the first 3 months, with or without bleeding. This can be caused by a pregnancy developing outside the womb. This can kill the woman.
Signs of infection (fever, chills, a bad smell from the vagina). Infection of the womb is very dangerous. It must be treated or the woman can die.
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Swollen face and hands, severe headaches, or dizziness. These problems, along with high blood pressure, are signs of pre-eclampsia. Eclampsia can kill the woman.
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Convulsions or "fits" (eclampsia). A pregnant woman with convulsions or who is unconscious needs medical help right away to save her life.

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In Oaxaca, Mexico, everyone listens to the radio, so a safe motherhood group made a series of short dramas. Each drama is about a different danger sign of pregnancy, and each time the woman’s family or neighbors take her to the hospital and save her life. The dramas end with tips about how to have a healthy pregnancy.

Danger signs during labor and birth

A woman with danger signs during labor needs to get to a hospital in less than 2 hours or the woman or baby could die. Some danger signs are:

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Heavy bleeding. A sudden gush of blood or a steady flow of blood is very dangerous. Two family members should go with the woman to give blood in case it is needed.
Severe, constant pain in the belly, different from labor contractions. This can mean the placenta (afterbirth) is separating from the womb, which can kill the mother or baby.
Severe headache and convulsions. These are signs of eclampsia. The woman needs medical help right away.
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Very long labor. Strong labor longer than 1 day or 1 night (12 hours), or pushing for more than 2 hours with no signs that the baby will be born soon are signs of obstructed labor that can kill both the mother and the baby.
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An arm or leg comes out first. This means the baby is lying in the wrong position for birth.
Waters break, but labor does not start. To prevent infection, birth should happen within 24 hours after waters break. Seek medical help if labor has not started 12 hours after a woman’s water breaks.
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Waters are green or brown. This means the baby passed stool in the womb. The baby may have trouble breathing or get an infection because of stool getting into his or her mouth.

Danger signs after giving birth

Danger signs may appear anytime during the first 2 weeks after a woman gives birth. These include:

Heavy bleeding or a constant flow of blood. This can be caused by tears in the vagina or the womb, but the most common cause of dangerous bleeding after a birth is "retained" or "stubborn" placenta. This happens when the placenta (afterbirth), or even a small piece of the placenta, stays inside the womb.

Signs of infection (fever, chills, a bad smell from the vagina). Infection of the womb is very dangerous. It must be treated or the woman may not be able to have any more children or she may die.

Dizziness, weakness, nausea, fainting. It is normal for a woman to be very tired after giving birth, but if she feels dizzy or sick, she may be bleeding inside (this is called internal bleeding).

Severe headaches and convulsions (eclampsia) can also happen after giving birth. Get medical help right away.

a midwife and 2 other women speaking while a man holds a pregnant woman in his arms.
I cannot stop the bleeding. Let’s go to the hospital.
I’ll wake my brother so he can drive us.
I’ll watch the baby.
ActivityA guessing game with skits: It’s an emergency!

This game is a fun way for a group of people to learn the danger signs for emergencies during pregnancy, birth, and the 2 weeks after the baby is born.

To prepare:
Assign each person a danger sign and ask them to prepare a short skit (play) to act out this danger sign, explaining that the rest of the group will watch the skits and try to guess which danger signs are acted out. Encourage people to use or make props (such as a glove stuffed with cotton to show swollen hands, red paint or marker to show blood, or a bundle of cloth as a newborn baby). Each person can ask another person to join in the skit.

To play:
Each person performs a short skit while the rest of the group watches. Once the skit is completed, ask the rest of the group to call out their guesses for which danger sign is being depicted with the skit. If the group wants more information they can call out questions and the person who performed the skit can answer "yes" or "no" to the questions. Once the group has correctly guessed the danger sign, have everyone applaud and thank the actors.

Continue playing until everyone has performed a skit.

a man holding a stuffed glove, as described above, while 2 people in a group ask him questions.
Is your face swollen too?
Is it pre- eclampsia?