There are sure warning signs in pregnancy that need immediate medical attention.

1. Bleeding

First trimester bleeding (0-3 months)

Bleeding during the first three months could be an indication of an ectopic pregnancy. Ectopic means the foetus is developing somewhere outside the uterus, for example, in the Fallopian tube. It is a medical emergency.

First – the second trimester bleeding (0-6 months)

Heavy bleeding with cramping can be a sign of a miscarriage during this time.

Last trimester bleeding (6-9 months)

• Bleeding during the 3rd trimester may indicate Abruptio placenta – which means the placenta tore loose from the uterine wall.
• It is a medical emergency.
• Bleeding during pregnancy is thus always a serious matter.
• Call an ambulance or go to the hospital if it occurs immediately.

2. Severe nausea and vomiting

Nausea and vomiting are common in the first trimester of pregnancy. If you experience severe nausea and vomiting that leaves you dehydrated and malnourished, you should see your doctor for a prescription medicine to stop nausea. It can harm the baby if you are underweight.

3. Active baby becomes quiet

An active baby in the womb is a healthy baby. It is a reason for concern if your baby suddenly quiets down and moves very seldom or not at all. A baby should move or kick about ten times every two hours. Please see your doctor if you are concerned about your baby not moving enough. They have the equipment to monitor the baby’s well-being.

4. Contractions early in the third trimester

There are two types of contractions. The first are called Braxton-Hicks contractions. They are just painless contractions of the uterus, that is, practice contractions. They do not increase in intensity. It can be called false labour.

• The actual labour contractions are painful. They increase in intensity and are rhythmic.
• When they are ten minutes apart, you are in labour.
• This needs medical attention if you are not yet full-time in your pregnancy.
• A baby’s lungs are not fully developed by 36 weeks, and premature birth could be a problem.

5. Water breaks

The baby grows in the uterus in a protective, water-filled bag. This bag (thin membranes) is called the amniotic sac and is filled with amniotic fluid.

Membrane rupture can happen subtly with amniotic fluid trickling out of your vagina or with a sudden burst and gush of water down your legs.

If this happens, you might go into spontaneous labour, and you should get to a hospital as soon as you can.

Trickling amniotic fluid doesn’t necessarily start labour, but it means it becomes less and less fluid for the baby to move around in. There is also a good chance of infection because the sac that protects the baby is punctured.

6. Pre-eclampsia

A persistent severe headache, abdominal pain, visual disturbances and swelling can be an indication that you have developed pre-eclampsia.

It is a syndrome that develops after the 20th week of pregnancy.

It means your body has a ‘not happy’ reaction to the pregnancy. It is a severe condition that needs to be monitored by medical practitioners.

Early signs of this syndrome are rising blood pressure and the presence of excess protein in your urine.

HIV & Pregnancy

Can two HIV-positive parents have an HIV-negative child?

Yes, they can. Although HIV can pass from an HIV-infected mother to her child during pregnancy, at the time of birth, or when breastfeeding the infant, medical treatment of both the mother and her infant can minimize the chances of that happening. HIV infection in both the mother and the father does not appear to affect the likelihood of having an HIV-infected baby.

HIV-infected women ideally should start antiretroviral therapy (ART) before pregnancy, both for their health and to reduce the risk of HIV transmission during pregnancy. To treat their disease, they should start or continue to receive it during pregnancy. Women who are not being treated with ART before pregnancy should receive it during pregnancy. The goal is to lower the mother’s HIV viral load (the concentration of HIV in her blood) as much as possible to prevent infection of the fetus. The lower the mother’s viral load during pregnancy and birth, the lower the risk of infecting her baby. A baby’s chances of being born with HIV are less than 2 in 100 when the mother has a viral load so low that it’s undetectable.

After delivery, the infant should receive ART for six weeks. In addition, the mother should preferably breastfeed her baby for at least the first six months while taking ARVs daily.

For their peace of mind, HIV-infected couples wanting to have children should receive counselling, if possible, before deciding on conception. During counselling sessions, they should ask about the likelihood that they will survive long enough to parent effectively. They should learn how to deal with the possibility that their infant may become HIV-infected.  And they should know how to cope if members of their family or community judge and stigmatize their child.

It is essential to be tested for HIV before you plan to fall pregnant.

For more information on the prevention of HIV from mother to child: http://www.avert.org/fact-sheet-hiv-pregnancy.htm