When to call your midwife: the signs not to sit on

Funmi sat on the edge of the bed at eleven at night, phone in hand. Her headache had not shifted all evening and the lights looked strangely sparkly. 'I don't want to bother anyone,' she told her sister. Her sister took the phone and dialled the maternity unit. Funmi's blood pressure was high, and she was cared for quickly and well. Later her midwife said the words every pregnant woman needs to hear: 'This is exactly why we are here.'

Most aches and twinges in pregnancy are normal. A few signs are not, and they need a call straight away, day or night. Keep this list somewhere you can find it, and save your maternity unit's number in your phone today.

Call an ambulance or go to emergency care if

• You have heavy bleeding from the vagina.
• You have chest pain, difficulty breathing or you collapse.
• You have a fit (seizure).
• You feel severely unwell and something feels very wrong.

Call your midwife or maternity unit straight away if

• Any bleeding from the vagina, at any stage of pregnancy.
• Your baby is moving less, or the pattern of movements has changed. Do not wait until the next day, and do not use a home heartbeat monitor to reassure yourself.
• Severe or constant tummy pain, or pain that does not ease with rest.
• A severe headache, especially with blurred vision, flashing lights, or sudden swelling of your face, hands or feet. These can be signs of pre-eclampsia.
• Pain just below your ribs, often on the right side.
• Fluid leaking from your vagina, whether a gush or a trickle.
• A high temperature, shivering, or feeling hot and unwell.
• Regular tightenings or period-like pains before 37 weeks.
• Intense itching, particularly on the palms of your hands and soles of your feet.
• Vomiting so much you cannot keep fluids down, or you are passing very little urine.
• A burning or stinging feeling when you pass urine, or pain in your back or side with a temperature.

Call today, or ask for an urgent appointment, if

• Unusual vaginal discharge, itching or soreness.
• Calf pain or swelling in one leg, especially if it is red or warm. If you are short of breath as well, treat it as an emergency.
• A persistent cough, a rash, or contact with someone who has chickenpox or measles if you are not sure you are immune.
• A fall, a car accident or a blow to your tummy, even if you feel fine.

Your mind matters too

Call your midwife, doctor or a crisis line, or go to emergency care, if you have thoughts of harming yourself or feel you cannot keep yourself safe. Speak up too if low mood, panic or worry is stopping you from eating, sleeping or coping. This is not a lack of faith. It is a health need, and help is available.

Why women wait, and why you do not have to

Many of us hold back because we do not want to make a fuss, we are afraid of being seen as dramatic, or we called last week too. Hear this clearly: midwives would far rather see you and send you home reassured than have you sit at home with a sign that needs care. You are never wasting their time. If you call and feel brushed off but still feel something is wrong, it is fine to say so and ask to be seen.

Getting ready, just in case

1. Save your maternity unit or labour ward number and your midwife's number in your phone under a clear name.
2. Write the number on a card in your bag, in case your phone dies.
3. Keep your pregnancy notes with you when you go out.
4. Tell your husband, partner, a friend or a neighbour where your notes are and who to call.
5. Think about how you would get to the hospital at night.

When you call

Say how many weeks pregnant you are, what you have noticed and when it started. If you have a temperature or have been bleeding, say roughly how much. Have a pen ready for their advice.

A very present help

“God is our refuge and strength, a very present help in trouble” (Psalm 46:1). Calling for help is not the opposite of trusting God. Very often, the midwife on the end of the line, the sister who dials for you and the doctor on the ward are the very help He sends.

A prayer for courage to ask

Lord, when something feels wrong, give me the courage to pick up the phone without shame. Make the people who answer kind and wise. Keep me and my baby safe tonight, and help me rest in Your care. Amen.