Where There Is No Doctor 2011 249
Danger Signs in Pregnancy
1. Bleeding: If a woman begins to bleed during pregnancy, even a little, this is
a danger sign. She could be having a miscarriage (losing the baby, p. 281) or the
baby could be developing outside the womb (ectopic pregnancy, see p. 280). The
woman should lie quietly and send for a health worker.
Bleeding late in pregnancy (after 6 months) may mean the placenta (afterbirth) is
blocking the birth opening (placenta previa). Without expert help, the woman could
quickly bleed to death. Do not do a vaginal exam or put anything inside her vagina.
Try to get her to a hospital at once.
2. Severe anemia: The woman is weak, tired, and has pale or transparent skin
(see The Signs of Anemia, p. 124). If not treated, she might die from blood loss at
childbirth. If anemia is severe, a good diet is not enough to correct the condition
in time. See a health worker and get pills of iron salts (see p. 392). If possible, she
should have her baby in a hospital, in case extra blood is needed.
3. High blood pressure or other signs of pre-eclampsia: Blood pressure
of 140/90 or greater can be a sign of a serious problem called pre-eclampsia
(toxemia). A lot of protein in the urine, sudden weight gain, and swelling are other
important signs. Pre-eclampsia can lead to seizures (convulsions, fits) and even
death.
If a woman has high blood pressure, ask her to lie down and rest more often. Help
her get plenty of good foods and to eat a lot of protein (p. 110). She should avoid
salty packaged foods and snacks. Re-check her blood pressure in a few days.
If you cannot check for high blood pressure or protein in the urine, watch for
these other signs of pre-eclampsia:
• Swollen face, or swelling all over in the morning upon awakening
• Headaches
• Dizziness
• Blurred vision
• Pain high in the belly
If her blood pressure keeps going up (to 160/110 or higher) or if she shows
any of these signs — get medical help fast! If she is already having seizures,
see p. 178.
HIV and Pregnancy
If the mother has HIV, HIV can spread to her baby while it is still in her womb or
during birth. Medicines can help prevent the baby from getting HIV. Talk to a health
worker who has experience working with people who have HIV, and see p. 398 for
more information.