Common Pregnancy Concerns by Trimester — When to Call

Pregnancy brings many new symptoms. Knowing which are normal, which need same-day evaluation, and which are emergencies makes the journey calmer. This page sorts the most common concerns by trimester with a clear “when to call” guide.

First trimester, common normal symptoms

Nausea/vomiting, fatigue, breast tenderness, bloating, mild headaches, mild cramping, mood swings, increased urinary frequency. These are typical and rarely concerning. Manage with practical strategies (small meals, ginger, rest, hydration). Persist with daily life.

First trimester, call same day

Heavy bleeding (more than spotting), severe one-sided pelvic pain (possible ectopic), inability to keep down fluids over 24 hours, signs of urinary infection (burning, frequency, fever), severe abdominal pain, fainting episodes. Same-day urgent assessment.

First trimester, emergency

Heavy bleeding with severe pain (suspected ectopic rupture or miscarriage); shoulder tip pain (ectopic); severe persistent vomiting with dehydration; high fever; signs of sepsis. Emergency department immediately.

Second trimester, common normal symptoms

Round ligament pain (sharp groin pulls with movement), increasing weight gain, mild back ache, mild constipation, occasional Braxton-Hicks contractions, mild varicose veins, nasal congestion. Energy returns. Most women feel best in this period.

Second trimester, call same day

Vaginal bleeding; severe headache; visual changes (spots, blurriness); persistent severe abdominal pain; reduced or absent fetal movement after 24 weeks; signs of preterm labour (regular contractions); fluid leak from vagina; high fever; severe nausea returning.

Third trimester, common normal symptoms

Increased fatigue, sleep difficulties, heartburn, swelling of feet/ankles, vivid dreams, frequent Braxton-Hicks, increased urinary frequency, lightning crotch pain, breast leaking colostrum. Most are normal late-pregnancy experiences.

Third trimester, call same day

Reduced fetal movement (apply “10 movements in 2 hours” test); severe headache or visual changes (possible preeclampsia); upper right abdominal pain (HELLP); persistent severe swelling; fluid leak (possible PROM); regular contractions before 37 weeks; vaginal bleeding; severe itching of hands/feet (intrahepatic cholestasis).

When to go to hospital directly

Regular contractions (5 minutes apart for 1 hour at term); rupture of membranes; vaginal bleeding more than spotting; severe headache with visual changes; severe abdominal pain; no fetal movement for several hours after appropriate stimulation; seizure; severe shortness of breath. Do not delay.