Labor, Delivery, And Postpartum Period: When To Call A Doctor

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When to Call a Doctor

Call 911 or other emergency services immediately if you:

• Have had fluid gushing or leaking from your vagina (the amniotic sac has ruptured) AND you know or think the umbilical cord is bulging into your vagina (cord prolapse). If this happens, immediately get down on your knees, dropping your head and upper body lower than your buttocks to decrease pressure on the cord until help arrives. Cord prolapse can cut off the baby's blood supply.
• Have severe abdominal pain.

Call your health professional immediately if you:

• Have any vaginal bleeding.
• Have signs of preeclampsia, such as:
  • Sudden swelling of your face or hands.
  • Visual problems (such as dimness or blurring).
  • Severe headache.
• Have pain, cramping, or fever with bleeding from the vagina.
• Pass some tissue from the uterus.
• Have a fever of or higher.
• Have pelvic pain that doesn't get better or go away.
• Vomit more than 3 times per day, especially if you also have fever or pain.
• Have pain when you urinate.
• Have an increase or gush of fluid from your vagina or have vaginal bleeding or spotting. It is possible to mistake a leak of amniotic fluid for a problem with bladder control.
• Have painful or frequent urination or urine that is cloudy, foul-smelling, or bloody.

If you are between 20 and 37 weeks pregnant, call your health professional immediately or go to the hospital if you have:

• Concern that the baby has stopped moving or is moving much less than normal. See fetal movement counting for information on how to check your baby's activity.
• Any vaginal bleeding.
• Uterine tenderness, unexplained fever, or weakness (possible symptoms of infection).
• Loss of a large amount of fluid from your vagina [a cup (240 mL) or more].

Some of these symptoms could mean you are having preterm labor.

Call your health professional right away if you have:

• Regular contractions (with or without pain) less than 15 minutes apart that continue for more than 2 hours after changing your position and drinking fluids.
• Unexplained low back pain or pelvic pressure.
• Intestinal cramping with or without diarrhea.

For more information, see the topic Preterm Labor.

After 37 weeks of pregnancy, call your health professional immediately or go the hospital if you have:

• Concern that the baby has stopped moving or is moving much less than normal. See fetal movement counting for information on how to check your baby's activity.
• Any vaginal bleeding.
• Regular contractions (5 to 6 minutes apart, lasting at least 45 seconds each).
• A sudden release of fluid from the vagina.

At any time during pregnancy, call your health professional if you have new steady or heavy discharge from the vagina along with symptoms of itching, burning, or odor.

After delivery

After you have delivered, call your health professional if:

• You use a new sanitary pad for vaginal bleeding every hour for 4 or 5 hours.
• Your vaginal bleeding seems to be getting heavier or is still bright red 4 days after delivery or you pass blood clots larger than the size of a golf ball.
• You feel dizzy.
• You have signs of postpartum depression, such as:
  • Feelings of despair or hopelessness for more than a few days.
  • Troubling or dangerous thoughts or hallucinations.
• Your vaginal discharge smells bad or fishy.
• Your abdomen feels tender.
• Your breasts are painful or red and you have a fever, which are symptoms of both breast engorgement and mastitis. For more information, see the topics Breast Engorgement and Mastitis While Breast-Feeding.

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Last updated:	December 19, 2005
Author:	Lila Havens
Reviewed By:	Kathleen Romito, MD - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Michele Cronen