Midwife’s Musings- When to ask for help

Whilst most pregnancies are ‘straight forward’ and many women won’t experience any of these problems, it is always good to be prepared, just incase. If you are pregnant or a new parent abroad, particularly if you are in a remote location, knowing when you need medical help can feel like a mine field. Our bodies are amazing, and often we have a gut instinct when something is not quite right. My first piece of advice is, trust this! Secondly, if in doubt, check it out. It is always better to reach out, to ask the question, even if it is for your maternity team to reassure you. We would much rather that you ask, than suffer in silence and sometimes smaller symptoms can add up to a big picture.

The other main point to highlight here, is making sure that you have a medical team you trust. As with the per Maternity care abroad, research different providers, and find one you trust. They may be local or they may be further away, but having someone you can ask, even via phone is vital! I don’t want to cause unnecessary worry but to quote the boys scouts, always be prepared. Hopefully you won’t need this at all but if you are living further away, it is good to think in advance about what you would do if you do need immediate help; which local clinics may be able to help with which services and whether you have medical insurance (e.g. could you be medivact/airlifted if you need assistance that is not available in your area).

Having said all of that, here are a few scenarios when you should ask for help. It is not an extensive list, but should give you a general idea. Promptly should be within but preferably before 24 hours. A helpful thing to be aware of is that for pregnant women and new babies, their immune systems are not as strong. Therefore, it is better to ask for help sooner rather than later as illnesses like malaria can become more serious, more quickly.

General

Promptly:

  • If you feel unwell in yourself. We sometimes have an innate sense that something is not right, even if we cant put our fingers on it. If you feel this, definitely trust your gut.
  • Fever. 
  • Itchy or fowl smelling discharge. 
  • Any symptoms that could be linked to tropical diseases e.g. malaria.
  • Any other concerns.

Immediately:

  • Pain or passing blood in your urine.
  • Seizures.
  • One of your legs swells more than the other, it may be red and painful. 

During pregnancy

Promptly:

  • Itchy all over and particularly on your palms or the soles of your feet. 
  • Pain or burning when passing urine or feeling like you need to pass small amounts of urine frequently.
  • Itchy or fowl smelling discharge.  
  • Any other concerns. 

Immediately:

  • Any bleeding or leaking of fluids (apart from normal discharge) from your vagina. If you think your waters might have broken you might hear a popping sensation, it could be a big ‘Hollywood’ gush or a little trickle which can make you wonder if you might be wetting yourself (pregnancy is glamorous hey!). 
  • Sudden or severe headache, your eyes may also feel funny or you see flashing lights, pain in your right side just under your rib cage or swelling in your face.
  • Severe or constant stomach pain.
  • Reduced movements- The baby’s movements are the best way to know that the baby is healthy. If the baby’s movements are less than usual, then it is important to have a check.
  • If you feel something hanging in your vagina (this could be the baby’s cord hanging down and you need help asap!).

During labour

If you are not birthing in a medical facility it is really important that you have a medically trained professional with you. They should know all the signs so I won’t go into these ones.

After the baby is born

All of these symptoms should be reported sooner rather than later. 24 hours may be too long, so it’s good to ask for help quickly if any of these occur.

Mum

  • Fowl smelling bleeding.
  • Very heavy bleeding with clots larger than the size of a 50p or large coin. 
  • If your wound or stitches smell funny, they look inflamed, you see pus or they seem to not be healing well. 
  • If your breasts become lumpy, swollen, red or painful. 
  • One of your legs swells more than the other, it may be red and painful. 
  • Seizures.
  • Fever.
  • Sudden or severe headache, your eyes may also feel funny or you see flashing lights, pain in your right side just under your rib cage or swelling in your face.
  • Any other concerns. 

Baby

  • If they are drowsy and do not wake.
  • If they are not feeding well. 
  • If they have a yellow tinge in their skin, eyes or gums.
  • Seizures. 
  • If they seem to not be increasing in weight. 
  • If they are not opening their bowels or passing urine properly. 
  • Any signs of infection around their belly button.
  • Any other concerns. 

As I say, this post is not at all meant to cause concern or worry, and hopefully these things won’t happen. For most families, pregnancies are ‘normal’, without these occurring, but it is always good to know what to do if any of these scenarios were to occur. As I’ve said above, having a maternity team you trust is key, and if in any doubt then please do reach out and ask. They would much rather that you got in touch so they can help you in anyway you need 🙂

Published by joannacharlottebrowngmailcom

A Brit with itchy feet and a wandering heart, currently dancing in Mbale, Uganda.

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