I’m pregnant and bleeding. Should I go to the hospital?

I am cramping really badly. How do I know if I need to go to the hospital?
Normal cramping early in pregnancy usually feels achy like menstrual cramps. If they become sharp and rhythmic and are combined with heavy bleeding, you should call (473-2021) or go to the hospital emergency room (Sentara Bayside if you are less than 18 weeks pregnant or Sentara Leigh if you are beyond 18 weeks). Throughout your pregnancy, you will continue to be achy with occasional sharp pains in the vagina, lower back and on each side of your abdomen. These pains are usually due to the stretching of the round ligaments, are very brief, irregular in occurrence and aggravated by change in position (like moving from lying to sitting). You also may notice contractions that occur at irregular intervals. All of these pains are normal and drinking plenty of water, applying heat, taking a warm bath and using proper body mechanics when you move your body or lift things can be soothing.

If you are less than 36 weeks and start having regular contractions every ten minutes (like clockwork!) for at least an hour, drink two glasses of water and lay on your side. If the contractions continue in this regular pattern without getting milder over the next hour, then call us. If you are more than 36 weeks pregnant, we will have discussed your own personal parameters of when to call for labor. Generally, if you are still able to talk during contractions or they are not at regular intervals (every 5 minutes or less), it’s not time yet. If you need help deciding what’s going on and you are worried what to do about it – call us!

I can’t feel my baby moving – at least not as much as (s)he used to!
Especially at the end of pregnancy, it is a common perception that the baby does not move as much as (s)he did just a couple of weeks ago. As long as your baby moves ten times a day after 28 weeks, there is adequate movement. These movements may not be as dramatic as they once were because the baby’s head is beginning to descend into the pelvis and your little fetus is running out of “womb” to move! If you really think your baby is not moving, drink two cold glasses of water and lie down on your left side. Your baby should move four times over the next hour. (If the baby moves four times in five minutes – you’re done!) If the baby doesn’t move four times in an hour, you can call us for more advice (473-2021) or go to Sentara Leigh Hospital Admitting for evaluation on the Labor & Delivery unit.

I have so much discharge coming out – is it my water breaking or do I have an infection?
During pregnancy your vaginal discharge will get quite heavy. It is usually clear to whitish in color, and requires no attention if there is no foul odor or itching. This leukorrhea, as it is called, is normal and is the result of complex changes in the body that occur during pregnancy. It may be heavy enough that you feel more comfortable wearing a panty-liner. Make sure you change the liner often or wear cotton underwear to avoid developing a yeast infection in this moist environment.

If you find that clear fluid is coming out so much that you feel like you are urinating and you are soaking and changing maxi pads, then your water may have broken! One gush followed by no fluid is not your water – the amniotic fluid keeps coming out until the baby is born and will certainly cause you to need reinforcements (like a towel or maxi pad). If your water has broken, check in through Admitting at Sentara Leigh Hospital, they will get you to Labor & Delivery and the nurses there will call us when you arrive. If you are not sure what to do - call us.

I think I just lost my mucus plug!
Congratulations!
Although much of the literature makes it seem like the mucus plug coming out is like releasing the cork to labor, it is not significant to us clinically. Please do not bring your mucus plug to us at the office, call on the emergency line or pack it in your purse for a trip to the hospital! This sign, by itself, does not mean that labor is imminent. In fact, the mucus plug may regenerate. (So, you may lose it again in another week or when you’re in the midst of hard labor!)

Is it okay to lift my arms up above my head or bend over while I’m pregnant?
You may safely continue to do these and all of the other activities you performed before you were pregnant. In fact, you may even want to take up prenatal yoga or exercise classes to improve your health and sense of well-being. The only unsafe activities are those that are affected by your increasingly wobbly center of balance combined with high speeds, like downhill skiing or mountain biking in the last trimester. You can even safely continue to work until the onset of labor unless you are among the minority of women who develop a medical condition during pregnancy that requires limitations, in which case we will advise you accordingly.

How bad is my stress level for my baby?
Although many women experience significant stress while they are pregnant, in most cases the fetus is blissfully ignorant to your emotional struggles! Of course, you want to try to manage stress as well as you can for your own sense of well-being and proper physiologic function. Usually, increasing exercise (like taking a daily walk), exposure to sunshine, pampering activities (alone or with supportive friends), a good cry or receptive ear can make you feel a lot better. If you have complex circumstances that require medication, referral to counseling or shelter services it is imperative to let us know.