It is important that all pregnant women are aware when it is necessary to go to the hospital for evaluation. While some of these features are more relevant to later in the pregnancy, it is helpful for expectant mothers to be aware of them. If you are >20 weeks pregnant, you should go.
It can be difficult for first time mothers to know when they are in true labour, and to differentiate between true labour and ‘early labour’ or Braxton Hicks contractions.
Prenatal classes often teach the 5-1-1 rule to provide expectant mothers. This rule helps women identify true labour. The “5” stands for contractions that are less than 5 minutes apart, with the measured interval being from the beginning of one contraction, to the beginning of the next. The first “1” stands for duration of contractions. Contractions from true labour generally last one full minute. The next “1” stands for 1 hour, meaning that the repeat contractions will continue for at least an hour.
True contractions typically take your breath away, and make it difficult for you to talk through a contraction.
Be aware that the 5-1-1 rule is a simple rule provided to help patients and may not be applicable to all patients (ex those with prior births or a history of rapid labour). If you are not certain, it would be encouraged to go to hospital to get checked out.
Bleeding from the vagina can be common in pregnancy. At times however, it can be a concerning sign. If you have bright red bleeding from the vagina that fills a pad, it would strongly be recommended to proceed to the hospital. Bright red bleeding would be far more concerning than dark red blood. Sometimes small amounts of bleeding can happen after the doctor or nurse checks your cervix, or after being intimate with your partner. This is normal and you can be assured.
Water Breaking, (also known as Rupture of Membranes)
We can all relate to the experience of watching a movie, where a pregnant woman’s water breaks and her garments become soaked with amniotic fluid. It can certainly happen this way in real life as well. When your water breaks in this way, it is fortunately quite obvious. It is important to go to the hospital immediately for assessment so that the medical team can confirm the time your membranes ruptured, and to come up with a plan on how to manage your pregnancy. This is particularly true for woman who are group B strep positive.
Your water breaking may be less obvious however. There are some women who experience a small trickle of clear fluid several times over the course of a day. This too is your water breaking and it can fool many patients. It is important again, to wear a pad if you suspect this, and to proceed to the hospital. The medical team can test you by performing a speculum vaginal examination to look and test for fluid.
We advise patients to wear a pad when they feel their water breaking, as the fluid in the pad can be tested for confirmation.
Not all amniotic fluid is clear however. On occasion, amniotic fluid can be yellow, green, or brown. This happens when the baby has a bowel movement in the womb. The fluid would generally run like water, which is different than vaginal discharge which is stickier.
Decreased Fetal Movements
One of the earliest signs of an unwell baby is a baby that moves less than expected. Fetal kick counting is a simple, non-invasive method that all mothers can utilize during the prenatal period. Mothers are asked to count their baby’s individual movements for up to 2 hours.
It is important that you find a relaxed and quiet setting in order to truly focus on counting. It is asked that mothers get into a comfortable position, either lying on one side, or sitting. One or both hands should be placed on the abdomen, and each individual movement is counted.
Mothers should feel at least 6 movements within a 2-hour period. If you feel 5 or less movements, you should go to the hospital for evaluation. You may stop counting upon reaching 6 movements. Please note that this is a practice intended for pregnant women around 26 weeks and beyond.
It is recommended that fetal kick counting is performed once daily, particularly in those women who have other medical conditions such as high blood pressure and diabetes, or in women who carry extra weight.
After Hours Medical Concerns
When your doctor’s office is closed, and you have an after-hours medical concern or are worried about your pregnancy, you should proceed to the hospital. Examples would include trauma to the tummy, or severe headache. After 20 weeks, we advise women to skip the Emergency Department, and proceed to the Women’s Specialty Unit. If you have been registered to deliver at the Rockyview General Hospital, this would be on the 6th floor of the main building. The Women’s Speciality Unit has nurses readily available to assess you and your baby by using a monitor.