Pregnancy guide

Nausea and vomiting are extremely common in the first trimester, affecting up to 80% of pregnant women. It is caused by rising hCG and oestrogen levels and usually improves after week 12–14.

What to do: Eat small, frequent meals and avoid an empty stomach. Plain crackers, ginger tea, and cold foods can help. Rest when you can and avoid strong smells that trigger nausea.

When to escalate: See your midwife or GP if you cannot keep any food or fluids down, are losing weight, or feel very dehydrated.

Hyperemesis gravidarum (HG) is severe, persistent nausea and vomiting that goes well beyond typical morning sickness. It can cause dehydration, weight loss, and nutritional deficiencies if untreated.

What to do: Contact your midwife or GP as soon as possible — do not wait. HG often requires anti-nausea medication and IV fluids in hospital. If you cannot keep any fluids down, go to your nearest emergency department.

When to escalate: Go to hospital if you cannot keep down any fluids for 24 hours, feel very dizzy or faint, have dark urine, or are losing significant weight.

A burning sensation in the chest or throat is very common in pregnancy, especially from the second trimester onwards. Progesterone relaxes the valve between the stomach and oesophagus, allowing acid to rise.

What to do: Eat smaller meals, avoid lying down straight after eating, and limit spicy, fatty, and acidic foods. Sleeping with your head slightly elevated can help. Antacids safe in pregnancy (e.g. Gaviscon) can be used — ask your pharmacist.

When to escalate: See your GP if heartburn is severe, doesn't respond to antacids, or is accompanied by difficulty swallowing.

Progesterone slows digestion, and iron supplements (common in pregnancy) can worsen constipation. It is one of the most common digestive complaints during pregnancy.

What to do: Increase fibre intake (fruit, vegetables, wholegrains), drink plenty of water, and stay active. If dietary changes aren't enough, ask your GP about pregnancy-safe laxatives.

When to escalate: See your GP if constipation is severe, accompanied by bleeding, or lasts more than a week without improvement.

Strong aversions to certain foods or smells — particularly meat, eggs, or strong flavours — are very common in the first trimester and are thought to be a protective mechanism triggered by hormonal changes.

What to do: Eat whatever you can tolerate. Cold foods often smell less strongly than hot ones. Focus on getting adequate nutrition from foods you can manage.

When to escalate: See your midwife if aversions are so severe that you cannot maintain adequate nutrition.

Producing significantly more saliva than usual, sometimes to the point of needing to spit frequently. It often accompanies nausea and is more common in the first trimester.

What to do: Chew sugar-free gum, brush teeth frequently, and stay hydrated. The symptom usually improves as nausea eases.

When to escalate: Mention to your midwife at your next appointment if it is persistent and affecting your daily life.

Sharp, stabbing, or aching pain on one or both sides of the lower abdomen or groin, usually in the second trimester. It is caused by stretching of the ligaments that support the growing uterus.

What to do: Change positions slowly, avoid sudden movements, and rest. A warm (not hot) heat pack on the area can help. Gentle prenatal exercise may reduce frequency.

When to escalate: See your midwife if the pain is severe, persistent (not brief and sharp), accompanied by fever, or on one side only with urinary symptoms.

Back pain affects more than half of all pregnant women. Your growing uterus shifts your centre of gravity and stretches abdominal muscles, placing extra strain on the back.

What to do: Maintain good posture, wear supportive footwear, use a pregnancy pillow at night, and avoid standing for long periods. Prenatal yoga and swimming are gentle options. A physio referral can help.

When to escalate: See your midwife if back pain is severe, radiates down your legs, is accompanied by fever, or you have difficulty walking or controlling your bladder.

Pelvic girdle pain (PGP), sometimes called symphysis pubis dysfunction (SPD), is pain in the pelvic joints and surrounding area. It can range from mild discomfort to severe pain that limits mobility.

What to do: Keep your knees together when getting in and out of a car or bed. A physiotherapist specialising in pregnancy can provide exercises and a support belt. Avoid activities that worsen pain.

When to escalate: Tell your midwife at your next visit, or sooner if the pain is severe and limiting your movement.

Irregular, painless tightenings of the uterus that can begin as early as the second trimester. They are the uterus 'practising' for labour and are not a sign of preterm labour.

What to do: Change position or activity — they usually ease when you move around or rest. Staying hydrated can reduce their frequency. A warm bath can help with discomfort.

When to escalate: Call your midwife if contractions become regular (e.g. every 10 minutes or more often), are painful, or are accompanied by bleeding, discharge, or pressure in the pelvis before 37 weeks.

Sudden, painful muscle spasms in the calf or foot, most commonly at night. They become more common in the second and third trimester and may be related to changes in circulation and mineral levels.

What to do: Stretch the affected muscle by flexing your foot upward. Regular calf stretches before bed, staying hydrated, and gentle walking may help prevent them.

When to escalate: See your GP if cramps are frequent and severe, or if you notice persistent swelling, redness, or warmth in one leg (which could indicate a clot).

Headaches are common in early pregnancy due to hormonal changes, increased blood volume, dehydration, and low blood sugar. They often improve after the first trimester.

What to do: Rest in a quiet, dark room. Stay hydrated and maintain regular meal times. Paracetamol at the recommended dose is safe in pregnancy — avoid ibuprofen and aspirin unless advised by your GP.

When to escalate: See your midwife or GP promptly if headaches are severe, sudden, or 'thunderclap', accompanied by visual disturbances, swelling of the face or hands, or upper abdominal pain — these can be signs of pre-eclampsia.

Light spotting or pink/brown discharge that can occur around the time of your expected period, when the fertilised egg implants in the uterine lining. It is brief and much lighter than a period.

What to do: No action needed. Use a panty liner if helpful. Note the timing and colour.

When to escalate: See your GP or midwife if spotting is heavy, bright red, or accompanied by pain.

An increase in clear or white, mild-smelling vaginal discharge (leucorrhoea) is normal throughout pregnancy. It helps protect the birth canal from infection.

What to do: Wear breathable cotton underwear and change when needed. Avoid douching or scented products in the vaginal area.

When to escalate: See your midwife if discharge becomes yellow, green, grey, frothy, strongly smelling, or is accompanied by itching or burning — these can indicate infection.

The mucus plug seals the cervix during pregnancy. Losing it — often appearing as a thick, jelly-like discharge that may be clear, pink, or blood-tinged — can happen weeks before or right at the start of labour.

What to do: Note the timing and appearance. If you are 37 weeks or beyond, this is normal and labour may begin soon or in a few weeks.

When to escalate: Contact your midwife promptly if you lose your mucus plug before 37 weeks, or if it is accompanied by regular contractions, heavy bleeding, or fluid gushing.

Bright red vaginal bleeding at any point in pregnancy requires immediate assessment. In early pregnancy it can indicate miscarriage or ectopic pregnancy; later in pregnancy it can indicate placenta praevia or placental abruption.

What to do: Go to your nearest emergency department or call 000. Do not drive yourself if bleeding is heavy.

When to escalate: Any bright red bleeding requires immediate care. Do not delay.

A dark vertical line that appears down the centre of the abdomen during pregnancy, usually from the navel to the pubic bone. It is caused by increased melanin production and is harmless.

What to do: No treatment needed. It typically fades within a few months after birth.

When to escalate: No escalation needed — this is a normal skin change.

Pink, red, or purple streaks on the skin of the abdomen, breasts, thighs, or buttocks, caused by rapid skin stretching. They are extremely common and largely determined by genetics.

What to do: Keeping skin moisturised may reduce discomfort. They usually fade to silver after birth.

When to escalate: No escalation needed.

Brown or grey-brown patches on the face, often on the cheeks, forehead, and upper lip. Also called the 'mask of pregnancy', it is caused by increased melanin production triggered by hormones.

What to do: Wear SPF 30+ sunscreen daily and a wide-brimmed hat — sun exposure worsens melasma. It often fades after birth.

When to escalate: No escalation needed. Mention to your GP if patches are very dark or spreading after birth.

Mild itching, especially over the abdomen as skin stretches, is common and usually harmless. The skin becomes dry and taut as it expands.

What to do: Use fragrance-free moisturisers and gentle soaps. Cool showers can help. Avoid scratching as it can damage skin.

When to escalate: See your midwife if itching is intense, does not respond to moisturiser, or is worst on your palms and soles — particularly at night. This could indicate obstetric cholestasis.

Intense itching on the palms of the hands and soles of the feet, often worse at night, can be a sign of intrahepatic cholestasis of pregnancy (ICP). This is a liver condition that can pose serious risks to the baby.

What to do: Contact your midwife or go to hospital today — do not wait for your next routine appointment. ICP requires blood tests and monitoring.

When to escalate: Any intense palm or sole itching, especially at night, requires same-day assessment.

Rapid shifts in mood — feeling happy one moment and tearful or irritable the next — are common throughout pregnancy, particularly in the first trimester, due to hormonal changes and physical discomfort.

What to do: Be gentle with yourself. Rest when you can, maintain connection with your support network, and share how you're feeling with your partner or a trusted person.

When to escalate: See your midwife if mood swings feel overwhelming, persistent, or are affecting your daily life or relationships.

Worry and anxiety about your baby's health, birth, or parenthood is very common. Some anxiety is a normal response to a major life change.

What to do: Talk to your partner or a trusted person about your worries. Mindfulness, gentle exercise, and attending antenatal classes can help. Avoid excessive searching of symptoms online.

When to escalate: See your midwife or GP if anxiety is persistent, severe, stopping you from functioning day-to-day, or accompanied by panic attacks or intrusive thoughts.

Depression during pregnancy (antenatal depression) is as common as postnatal depression but less talked about. Symptoms include persistent low mood, loss of interest, hopelessness, and difficulty bonding with the pregnancy.

What to do: Contact your midwife or GP — you don't have to manage this alone. Counselling, support programs, and medication options safe in pregnancy are available.

When to escalate: Seek help now if you are experiencing thoughts of harming yourself. In Australia, call Lifeline on 13 11 14 or go to your nearest emergency department.

Difficulty sleeping is extremely common in pregnancy, caused by physical discomfort, frequent urination, heartburn, leg cramps, anxiety, and hormonal changes.

What to do: Use a pregnancy pillow for support, establish a calming bedtime routine, avoid screens before sleep, and nap during the day if needed. Sleeping on your left side improves circulation to the baby.

When to escalate: See your GP if insomnia is severe, persistent, and significantly affecting your wellbeing.

Feeling mildly breathless, especially with activity, is common throughout pregnancy. In early pregnancy, progesterone causes you to breathe more deeply. In later pregnancy, the growing uterus presses on the diaphragm.

What to do: Slow down when you feel breathless and rest. Good posture and sleeping slightly propped up can help.

When to escalate: See your midwife or GP promptly if breathlessness is sudden, severe, at rest, accompanied by chest pain, palpitations, cough, or leg swelling.

Awareness of your heartbeat — fluttering, pounding, or skipping sensations — is common in pregnancy. Blood volume increases by up to 50%, causing the heart to work harder.

What to do: Rest when palpitations occur. Avoid caffeine, which can worsen them. Practise slow, deep breathing.

When to escalate: See your midwife or GP if palpitations are frequent, prolonged, accompanied by chest pain or pressure, dizziness, shortness of breath, or fainting.

Feeling lightheaded or dizzy is common, especially when standing up quickly. Blood vessels relax in pregnancy and blood pressure often drops slightly in the second trimester.

What to do: Rise slowly from sitting or lying positions. Stay hydrated and eat regularly to maintain blood sugar. Avoid standing for long periods without moving.

When to escalate: See your midwife if dizziness is frequent, severe, or accompanied by fainting, blurred vision, headache, or chest pain.

Briefly losing consciousness can occur in pregnancy due to low blood pressure, low blood sugar, overheating, or anaemia. While often not dangerous in itself, it can cause injury from falling.

What to do: Lie down with legs elevated if you feel faint. Avoid hot environments and long periods of standing. Eat regular meals.

When to escalate: Tell your midwife at your next appointment, or contact them sooner if fainting is recurrent. Go to hospital if fainting is accompanied by chest pain, palpitations, or if you injure yourself falling.

Mild swelling of the feet, ankles, and lower legs is very common, especially in the third trimester. It is caused by increased fluid retention and pressure on the veins from the growing uterus.

What to do: Elevate your feet when resting, avoid standing for long periods, stay active with gentle walking, and wear comfortable supportive footwear. Compression stockings can help.

When to escalate: See your midwife if swelling is sudden, severe, affects the face or hands, is accompanied by headache or visual changes, or is worse in one leg only.

Tingling, numbness, or pain in the hands and fingers, particularly at night or after repetitive hand movements. Fluid retention in pregnancy can compress the median nerve in the wrist.

What to do: Wear a wrist splint at night (available at pharmacies). Avoid repetitive hand movements where possible. Elevating hands when resting may help.

When to escalate: See your GP if symptoms are severe, affecting your ability to use your hands, or not improving with a splint.

Sudden or severe swelling of the face, hands, or feet — especially with headache, visual disturbances, or upper abdominal pain — can be a warning sign of pre-eclampsia, a serious pregnancy complication.

What to do: Go to hospital or call 000 immediately. Do not wait to see if it improves.

When to escalate: This requires immediate assessment. Do not delay.

Rhythmic, repetitive jerking movements felt in the belly are usually baby hiccups — a normal part of fetal development as the baby practises breathing movements.

What to do: No action needed. Hiccups are a reassuring sign that your baby is active and developing well.

When to escalate: No escalation needed for hiccups.

Most women feel their baby move for the first time between 16–25 weeks. First-time mothers often feel movement later (closer to 20–25 weeks) than those who have been pregnant before.

What to do: This is normal before 20 weeks. Your next ultrasound will confirm the baby is moving well.

When to escalate: Mention to your midwife if you have passed 25 weeks and have not felt any movements.

After 28 weeks, you should be aware of your baby's normal pattern of movement. A noticeable reduction or absence of movement compared to your baby's usual pattern requires immediate assessment.

What to do: Do not wait until the next day or your next appointment. Go to your maternity unit or call your midwife now. There is no such thing as too many calls about reduced movement.

When to escalate: Contact your midwife or go to hospital immediately if you notice reduced or absent movement after 28 weeks.