CONTRACTIONS & CRAMPS
A Note About Contractions And Cramping:
Your uterus is a very important muscle that undergoes much change throughout your pregnancy, birth and postpartum recovery. It starts out approximately the size of a closed fist and can amazingly expand to house a baby up to 10 or more pounds! With all these dynamic changes there are some things you should know about your uterus that can be expected:
• 1ST TRIMESTER:
Some mild crampiness can be expected as your uterus begins to expand– as long as it is NOT accompanied by any vaginal bleeding or spotting.
• 2ND TRIMESTER:
Cramping CAN be a sign of preterm labor… refer to PRETERM LABOR WARNING SIGNS.
• 3RD TRIMESTER:
Expect some cramping and contractions as your body prepares for the upcoming birth of your baby. Ask yourself if the contractions are becoming regular and intensifying, or are they just brief episodes? Are the contractions associated with bloody show, increased mucus, or a ‘bowel clean out’? Have you had more than 6 contractions in an hour? If yes, it’s time to call and check in with your midwife for further discussion or evaluation.

PRETERM LABOR WARNINGS
Any of the following symptoms prior to 35 weeks of pregnancy:
• Contractions every 10 minutes or closer
• Backache
• Menstrual-like cramps that may be accompanied by diarrhea
• Fluid leaking from vagina
• Any vaginal bleeding
• Increase in vaginal discharge
• Increased pressure in pelvis or vagina
• Flu-like symptoms such as nausea, vomiting, or diarrhea

WARNING SIGNS
At any time during your pregnancy:
• Vaginal bleeding
• Gush of fluid or leaking fluid from vagina
• Contractions or cramping –see detailed note
• Decreased or absent fetal movement
• Severe abdominal pain
• Blurred vision or other visual changes (pregnancy can cause some mild vision changes over time, but sudden or continuous blurred vision, seeing spots, floaters or light flashes should be reported)
• Persistent or severe headaches
• Excessive swelling of face, hands or feet (some degree of swelling of hands and feet can be normal)
• Fainting
• Convulsions/seizures
• Burning or pain with urination
• Fever or chills in the absence of “normal” cold or flu-like symptoms
• Persistent dizziness
• Pain in upper right side of abdomen
• Excessive diarrhea- defined as liquid or watery bowel movements more than 3 times a day
• Prolonged vomiting- unable to keep food/liquids down

These warnings should be promptly reported to your midwife for further discussion or evaluation.
Please call and share with your midwife any of the symptoms that you are experiencing. If in doubt, don’t wait it out…time is important for preterm babies.