When You Really Need To Call Your Provider

One of the first things I learned as a Labor and Delivery Nurse was to cut to the chase. When I was meeting a new patient for the first time in L&D I was taught to ask 1. Are you feeling your baby move? 2. Do you think your bag of waters broke? 3. Are you having any vaginal bleeding? 4. Are you having regular contractions? If any of the answers were yes, the patient required immediate evaluation and I knew I had to move quickly. These questions address some of the most serious concerns regarding pregnancy and birth. There are always questions and or concerns that will come up throughout your pregnancy but these four topics are what you must call about. Your provider can then help you figure out over the phone if your concern will require further evaluation immediately or if it can wait.

1. Is your baby moving?

If you are 28 weeks pregnant or more and you have gone 2 hours or more without feeling your baby move you will want to next sit down to count your baby’s kicks. Babies have sleep cycles which means for 2 hours at a time your baby may simply be asleep, but after this stretch of sleep you should feel movement begin again as your baby wakes up. Your baby can hear you chewing and swallowing, so as you sit down to count kicks try drinking and/or eating to wake the baby. You should feel approximately 6 distinct kicks in an hour or 10 in 2 hours. If your baby wakes up, great! If not you should call your provider.

2. Are you leaking fluid or having vaginal bleeding?

A broken bag of water or vaginal bleeding should not be ignored. If you bag of waters has broken your baby’s protective sterile environment has been compromised. Our world is a germ filled place and the broken bag of waters now allows for bacteria from the vagina to enter the uterus and possibly infect the amniotic sac. You water breaking could be a trickle or a gush but if you are concerned at all that your waters are broken please avoid anything in the vagina (aka intercourse!) to prevent infection. Your broken bag of water may be accompanied by contractions or not but either way you should make your provider aware of this change. Vaginal bleeding could be a benign sign of cervical dilation, but it could also be a placental concern. Your placenta is how your baby receives what it needs to live. If the placenta is compromised then your baby’s health may be compromised as well.

3. Are you having regular contractions?

Lastly, regular contractions suggest you may be going into labor! This could be good or bad news depending where you are in your pregnancy. Many times throughout pregnancy women will feel braxton hicks contractions that come and go in an irregular pattern and only involve parts of their uterus. If you are feeling tightening of your entire uterus (touch your baby bump… that whole thing is your uterus!) in a regular pattern that does not go away with hydration and rest give your provider a call. A regular pattern is rhythmic and  evenly spaced tightening and relaxing of the uterine muscle. If the tightening persists for at last 1 hours make the call! Your provider may encourage you to stay at home but they will want to know what you are experiencing and will be able to give you some suggestions.

If you are uncertain what is going on with your baby or your body it is always better to err on the side of caution and call your provider. Let these criteria, however, give you some basic framework for what to be on the lookout for and when to be concerned.