Call The Midwife

Years ago, the saying was “Call the Midwife!” This message is just as significant now as it was then. As an expectant parent, you will get to know your bump and recognise when something doesn’t feel right. Here are some symptoms that shouldn’t be ignored and should be reported to your maternity unit straight away and not the next day.

This list is not exhaustive so please call your midwife if you have any other concerns.

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Call The Midwife

Ectopic Pregnancy

An ectopic pregnancy is when a fertilised egg implants itself outside of the womb, usually in one of the fallopian tubes.

The fallopian tubes are the tubes connecting the ovaries to the womb. If an egg gets stuck in them, it won’t develop into a baby and your health may be at risk if the pregnancy continues.

Unfortunately, it’s not possible to save the pregnancy. It usually has to be removed using medicine or an operation.

In the UK, around 1 in every 90 pregnancies is ectopic. This is around 11,000 pregnancies a year.

An ectopic pregnancy doesn’t always cause symptoms and may only be detected during a routine pregnancy scan.

If you do have symptoms, they tend to develop between the 4th and 12th week of pregnancy.

Symptoms can include a combination of:

  • a missed period and other signs of pregnancy
  • tummy pain low down on 1 side
  • vaginal bleeding or a brown watery discharge
  • pain in the tip of your shoulder
  • discomfort when peeing or pooing

But these symptoms aren’t necessarily a sign of a serious problem. They can sometimes be caused by other problems, such as a stomach bug.

Contact your GP or call NHS 111 if you have a combination of any of the above symptoms and you might be pregnant – even if you haven’t had a positive pregnancy test.

An ectopic pregnancy can be serious, so it’s important to get advice right away.

Your GP will ask about your symptoms and you’ll usually need to do a pregnancy test to determine if you could have an ectopic pregnancy. You may be referred to a specialist early pregnancy unit for further assessment, where an ultrasound scan and blood tests may be carried out to confirm the diagnosis.

Reduced Fetal Movements

A baby’s pattern of movement should not slow down towards the end of pregnancy. If your baby’s movements have reduced, slowed down or changed in any way, call your maternity unit straight away. Don’t wait until the next day. Your maternity team should ask you to come in for assessment.


You may have an infection if you experience pain whilst passing urine, pain in your abdomen or loin, blood in your urine, or a high temperature. Vomiting or diarrhoea can also be signs of an infection. Reduce your chance of infection:

  • Be strict about good hygiene – wash your hands before and after handling food, and going to the toilet and after sneezing and blowing your nose. Wear gloves whilst gardening or handling cat litter and avoid being around newborn lambs or pregnant ewes.
  • Have the seasonal flu jab – your midwife will offer you this free of charge and it’s safe at any stage of pregnancy.
  • Avoid people with infectious illnesses – such as diarrhoea or sickness, chickenpox or slapped cheek syndrome.
  • Know what foods to avoidin pregnancy.
  • Talk to your midwife about Group B Strep– let your midwife know if you’ve had a urine infection (cystitis) as this can sometimes be caused by Group B Strep. NHS guidelines recommend that women at risk are given antibiotics in labour.

Premature Labour

The main signs of labour starting are strong, regular contractions, and a ‘show’ (when the plug of mucus sealing your cervix comes away). Signs of premature labour may be more subtle, however. Other signs that you are going into labour can include your waters breaking, backache, vomiting or nausea, and diarrhoea.


Mild or severe itching especially affecting the hands and feet could be signs of a liver disorder called Intrahepatic Cholestasis of Pregnancy (ICP). Sometimes itching may occur anywhere on the body and other symptoms include jaundice (yellowing of the skin and whites of the eyes), dark urine and pale stools. Talk to your midwife if you have any form of itching. A simple blood test for ICP is available, so it’s straightforward to diagnose, and treatment is available.


Sudden swelling of the feet, ankles, face or hands can indicate pre-eclampsia and needs to be reported to your medical team straight away. Other symptoms of pre-eclampsia include persistent headaches (especially those that do not disappear with simple painkillers) and problems with vision (blurring, flashing lights or spots). Sudden swelling of one leg only is important too and should not be ignored as it can be a sign of a thrombosis (clot in the leg).

Also tell your midwife if you experience pain in your tummy, especially if it is just below the ribs in the middle of your abdomen.

Visual Problems

Floaters are a common problem but look out for flashing lights.


If you think you may have gestational diabetes because it runs in the family or you have any of the following symptoms, please speak to your midwife:

  • Increased thirst
  • Extreme tiredness
  • Unexplained weight loss
  • Blurred vision

Other Symptoms

Other symptoms not to ignore include:

  • Vaginal fluid loss or bleeding
  • Feeling faint and dizzy
  • Any abdominal pain, even if it eases whilst resting
  • Mother’s instinct that something isn’t right

Always have the number of your local maternity ward stored in your mobile phone so you can speak to them without delay if you have any questions or concerns.