Most pregnancies go well. A small number turn dangerous quickly, and almost all of those give a warning first. These are the warnings. Going early costs a taxi fare. Going late can cost the mother, the baby, or both.
Go to a facility now, at any hour
- Any bleeding, at any stage, however little.
- A fit or convulsion. This is eclampsia until proven otherwise.
- A severe headache, blurred vision, or seeing flashing lights.
- The face or the hands swelling, especially with a headache. Swollen feet alone at the end of the day is usual; a swollen face is not.
- The baby has stopped moving, or is moving much less than usual.
- Water breaking before nine months.
- Severe stomach pain that does not come and go.
- Fever. Malaria in pregnancy turns severe faster than it does otherwise.
- Hard breathing, or fainting.
- Painful, burning urine. A urine infection in pregnancy can start labour early.
The four that kill most often here
Bleeding, high blood pressure that becomes eclampsia, infection, and obstructed labour. Every one of them is survivable when it is reached in time, and every one of them is far more dangerous at home than in a facility. That is the whole argument for going early.
Why the antenatal visits matter more than they seem
Most of the visit is a blood pressure cuff, a urine strip, a blood test and a tape measure. None of it feels dramatic, and all of it is looking for exactly the things above before they announce themselves. High blood pressure in pregnancy has no symptoms until the day it becomes an emergency.
Prepare the journey before you need it
- Decide now which facility you will go to, and how you will get there at two in the morning.
- Keep the money for that journey separate.
- Agree with somebody that they will go with you, and tell them these signs.
- Keep your antenatal card where anybody in the house can find it.
What not to do
- Do not wait for morning, for market day, or for money to come.
- Do not treat a fever at home with tablets and see how it goes.
- Do not let anyone tell you bleeding is normal because it is only a little.
