The complications of pregnancy: identifying warning signs

Updated August 2023 | 5 min read
Expert contributor Andrea Fallon, midwife
Words by Fran Molloy

You’ll experience lots of changes to your body during pregnancy. Here are some signs when there may be complications with your pregnancy.

With all the changes happening to your body throughout pregnancy, it can be hard to know what’s normal and what requires medical attention.

Midwife Andrea Fallon outlines some of the most common issues you may experience during pregnancy and some of the indications that suggest it’s time to check in with your midwife or doctor.

Bleeding

About one in four women will experience spotting in the early weeks of pregnancy. Spotting is a small amount of blood that wouldn’t use up a sanitary pad. The Royal Women's Hospital recommends that women contact a health professional if they experience any bleeding during any stage of their pregnancy. It can be helpful to note down the kind of bleeding you’re experiencing, in particular the colour, amount of bleeding, pain and if you notice blood clots.

Bleeding, stomach pain and discomfort when going to the bathroom can be symptoms of an ectopic pregnancy. An ectopic pregnancy is when a fertilised egg implants itself outside of the womb. You can speak with your GP, obstetrician or midwife if you experience these symptoms for further advice and help.

Morning sickness

Despite the name, morning sickness might not only happen in the morning: nausea and vomiting can strike at any time of day during pregnancy. Though some women manage to get through their pregnancy without being ill, up to 80% of pregnant women are affected by nausea and vomiting.

The symptoms usually fade after the first trimester, but a small percentage of women struggle with nausea and vomiting throughout their pregnancy.

An even smaller number – about one in 1,000 – suffer from severe morning sickness, known as hyperemesis gravidarum, with symptoms including repeated vomiting, weight loss and dehydration.

"While some nausea and vomiting is normal in pregnancy, persistent vomiting where fluid is unable to be kept down warrants a visit to the doctor for medication, and in some cases hospitalisation is required," says Andrea.

Mood swings or prenatal depression?

Pregnancy can sometimes feel like an emotional roller-coaster. In a single day, it’s not unusual to swing from happy to sad, calm to irritable, or controlled to tearful.

Be watchful for long periods of feeling low. Around one in 10 Australian women experience depression during pregnancy, and it’s important to get help early. Speak to your healthcare team if you’re concerned.

If you need to talk to someone, contact Beyond Blue on 1300 224 636. Alternatively, contact the national Perinatal Anxiety & Depression helpline from 9am to 7.30pm AEST/AEDT on 1300 726 306.

If you need professional support, we've partnered with PSYCH2U to offer HCF members faster and easier access to mental health support. PSYCH2U mental wellbeing services are unique to HCF, offering eligible HCF members^* access to a free telehealth HealthyMinds Check-in with a PSYCH2U psychologist.

Itching and cholestasis

Itching can be a concerning pregnancy symptom, says Andrea.

"Constant and intense itching, especially on the palms of the hands and soles of the feet, can be a sign of cholestasis of pregnancy."

This is a liver condition triggered by pregnancy hormones, which should be monitored by a health professional. It can lead to the baby being born early or having lung problems. It’s rare for this to lead to further problems for the mum.

If your stomach area is itchy, it’s usually caused by your skin stretching. Speak to your healthcare team if the itching is excessive or unbearable.

Aches, pains and discomfort

The big changes that happen during pregnancy can trigger headaches, back, leg or abdominal pain, particularly during the later months.

While headaches can be common, "Severe or persistent headaches, particularly after 20 weeks, do need to be checked out as they could be a sign of pre-eclampsia or high blood pressure," says Andrea. Also seek medical help for blurred vision, which is another symptom of pre-eclampsia.

Pelvic pain

Pain around your pelvis, known as symphysis pubis dysfunction (SPD), is a common complaint that affects about 20% of pregnant women.

SPD, sometimes called pelvic girdle pain, can limit your movement, making it hard to climb stairs and get in and out of cars. Physiotherapy, massage and equipment like pelvic support belts can help, so talk to your GP, obstetrician or midwife if you’re struggling.

Severe or sudden pain, however, can indicate a more serious situation, such as premature labour, and should be discussed with your healthcare team.

Lack of baby movement

From 16 to 18 weeks, you should start to feel infrequent 'flutters' in your uterus as your baby moves around.

"If your baby is moving less than usual for a time or if no movement is felt by 24 weeks, then follow up with a doctor," says Andrea.

Frequent urination and gestational diabetes

Many women need to go to the toilet frequently during pregnancy because of hormonal changes and their growing baby putting pressure on their bladder.

But it’s worth mentioning to your doctor, because it’s one of the symptoms of gestational diabetes, which leads to higher than normal levels of sugar in the blood, which can be unhealthy for both you and the baby.

Many women with gestational diabetes don’t have symptoms, so it’s important to keep up to date with health appointments. The oral glucose tolerance test is usually done between weeks 24 and 28 of pregnancy, or earlier if you’re at greater risk, and will identify if you have gestational diabetes. Your healthcare team will help you manage your condition throughout your pregnancy and labour.

Swelling

This is a tricky one to spot, because in late pregnancy – particularly in hot weather – swollen ankles are normal, particularly by the end of the day.

However, "excessive swelling of hands, face or feet first thing in the morning and any extreme swelling [particularly at the start of the day] can be a sign of pre-eclampsia and should be investigated," says Andrea.

Managing pregnancy with complications

While it’s important to treat pregnancy as a normal part of life, it does come with some risks. The best way to reduce your risk is to keep up with your prenatal visits to your midwife, GP or obstetrician.

Complications of pregnancy only affect a small percentage of women. About 8% of women experience pregnancy with complications that can harm you and the baby.

Complications can be treatable or manageable during your pregnancy. It’s important to go to your regular appointments and communicate with your healthcare team to manage any pregnancy-related risk.

In a healthy pregnancy, you should have at least one check-up before 12 weeks and at least 10 check-ups before you reach full term. Make sure you don’t miss your appointments so that any pregnancy warning signs can be spotted long before they might cause harm.