Leg pain is a sign of early pregnancy

Early pregnancy is a time of incredible change, both mentally and physically. Especially if it's your first pregnancy, you're bound to question every change, feeling or symptom and wonder, "Is this normal?" We spoke with Dr. Iffath Hoskins of NYU Langone Health for more information on early pregnancy symptoms.

Meet the Expert

Dr. Iffath Hoskins is a clinical professor in the Department of Obstetrics and Gynecology at NYU Langone Health.

Spotting

Seeing blood in any form while pregnant can be quite alarming, but, Dr. Hoskins says, approximately 20% of pregnant women experience spotting, cramping, and bleeding in the first trimester, and half of them go on to have normal outcomes. A cause for concern would be if spotting is dark red, and associated with cramps and pain, or if it continues for days, such as a week or so. Under these circumstances, seek medical care. Hoskins adds that most likely, spotting can be due to the implantation of pregnancy into the uterine wall.

Pelvic Pain

Similar to spotting, nearly 20% of pregnant women may experience cramps and pelvic pain, but also half will go on to have normal outcomes. Hoskins explains that pelvic pain "can also be due to fibroids (an effect of pregnancy hormones), and may be due to the uterus 'growing out of the pelvis' and thus putting the supporting ligaments on stretch or pull."

Dr. Hoskins advises that if the pain is severe (whatever you perceive that to mean), persistent (over more than a couple of hours), or associated with bleeding or leaking of fluid, to seek medical care because it could potentially be a miscarriage.

Vomiting

Good ole' morning sickness, right? Most likely. Hoskins says, "It is very common to have nausea and vomiting in early pregnancy. This is due to the surge in pregnancy hormones. In general, this will subside by the third month." However, if the problem causes severe weight loss (think 4 to 5 pounds over a week), and/or if you experience fainting, seek medical care.

Exhaustion

Being sleepy can also be chalked up to the pregnancy hormone, however, if you become bedridden and can't perform normal day to day activities, it's important to see your doctor.

Muscle Aches

Pregnancy can be tough, especially early on as your body is rapidly adjusting to its new state. If you're experiencing muscle aches, Hoskins says that this may be more a sensation of fatigue. It could also be due to the pregnancy hormone, progesterone, causing your muscles to feel "relaxed and flaccid." If ever your muscle aches are accompanied by fever, again, seek medical care.

Sore Breasts

Lots of women recall that this was one of the first signs of pregnancy. "This is due to pregnancy hormones affecting breast tissue (muscle and glands) as preparation for later breastfeeding," explains Hoskins. If you experience specific areas of heat, redness, or pain, especially if associated with a fever, seek medical care.

Headaches

Throbbing headaches can also be attributed to the pregnancy hormone. For some relief, try some simple remedies including increasing your fluids intake and resting in a dark and quiet area. Hoskins advises you should seek medical care if your headache is accompanied by vision changes, balance issues, changes in consciousness, seizure, etc.

Mood Swings

Again, thanks to the pregnancy hormone, you might be experiencing swift changes in mood. For some relief, you might try acupuncture, meditation, or any other non-medicinal aids to elevate your mood. If the mood swings are ever associated with insomnia, suicidal ideation, panic, or anxiety, be sure to seek prompt medical attention.

Other Symptoms

Dr. Hoskins adds that sometimes patients might feel winded. Again, due to the hormones, your breathing and air in your lungs are now affected so that maximum oxygen goes to the growing baby. If you can't breathe or feel that you might pass out, seek care. Feeling flushed is another common symptom some patients report, and this is attributed to an increase in blood flow to supply for your baby's needs, as well as "the baby's growth and development generating heat within the mother," explains Hoskins. If ever this is accompanied by a high fever, shaking or chills, be sure to see your doctor.

*Note: These comments all address the early stages of pregnancy. Most of the above-mentioned symptoms in later pregnancy would have different connotations.

As your body changes while growing a baby, you may experience twinges or feel surprising sensations. Most symptoms are perfectly normal and mean your body is doing precisely what it’s supposed to do. But sometimes, symptoms should be accompanied by a call to your OB or midwife – be it during or after hours.

Your provider, who will get to know you quite well during your pregnancy, will advise on next steps and make sure that you and your baby stay healthy and safe.

Dr. Louise Carroll, an obstetrician and gynecologist at Rochester Regional Health’s Rochester General Hospital reviews the warning signs to watch for and when to call your provider.

Symptoms to watch

Your body is busy every second of your pregnancy. It’s changing in a million ways; some that you can see, and some you cannot. It’s important to remind yourself to relax – most pregnancies go smoothly.

Complications do occur for some women, and it’s a good idea to know what those complications may look and feel like. These warning signs or symptoms should not be ignored, and you should call your provider if you experience them. And, remember – we are your team throughout your pregnancy. If you have concerns or questions, you can always call and talk through them!

Abdominal pain

If sharp cramps on one side of your stomach occur in early pregnancy before you’ve had an ultrasound, your OB will want to rule out an ectopic pregnancy, which is when a pregnancy has implanted in your fallopian tube instead of your uterus.

Abdominal pain is typical later in your pregnancy, too. It is common to experience gas and pain that is associated with normal uterus growth, and your ligaments stretching. But pain that persists, gets worse, or includes bleeding may be cause for concern. If you are experiencing intense, recurring pain, call your provider.

When to watch for abdominal pain: during the first trimester and the final weeks of your pregnancy

Early contractions

Early contractions can be a sign of preterm labor. If you start feeling them when you’re 24 to 36 weeks pregnant, please call your provider. They may be Braxton Hicks contractions (which are harmless and normal), but your OB or midwife will be able to advise.

When to watch for early contractions: between weeks 24 and 36 of your pregnancy

Extreme vomiting

Morning sickness is a normal and expected symptom of pregnancy. But, if you are unable to keep liquids down and are not urinating, you should call your provider immediately. Extreme vomiting can lead to severe dehydration, which is not good for your baby or you.

If you are struggling to keep food down, if you think you have food poisoning, or if you have a high fever, you should also let your provider know immediately. In some cases, you may need to go to the hospital for IV fluids. Your OB or midwife will let you know what is best for you and your health.

When to watch for extreme vomiting: between weeks 4 and 20 of your pregnancy

Fever

Your baby’s growth and development depend on your body maintaining a healthy, steady temperature. A disruption in temperature can cause miscarriage. If you experience a fever over 101 degrees Fahrenheit, call your OB or midwife immediately.

When to watch your temperature: in the first trimester

Itching

Mild itching while pregnant is normal, but severe itchiness can be a sign of something else called cholestasis of pregnancy. Cholestasis is a typically harmless liver ailment that needs to be monitored by your doctor. It can lead to preterm birth in extreme, untreated cases, so be sure to call your provider if your itchiness is severe and persistent.

When to watch for itching: during the third trimester

Lack of fetal movement

Your provider may recommend checking on your growing baby a few times a day, later in your pregnancy, looking for 10 movements within 1 hour. If you don’t feel any movement, you can drink a glass of fruit juice to get the baby moving, and then lie on your left side in a quiet room for 30 minutes. If two hours pass without 10 movements, give your provider a call. It’s often just that your baby is being especially still, but your provider may recommend an ultrasound or stress test, depending on what they know about you and your pregnancy.

When to watch your baby’s movement: during your third trimester

Leg pain

Pregnancy–specifically your hormonal changes–puts you at a much higher risk for blood clots, especially deep vein thrombosis (DVT). The pressure of your growing uterus can also impede circulation, causing blood to pool in your legs and your feet.

Women who are predisposed to clotting, and those who are older or overweight are at a higher risk for DVT. If you are put on bed rest during your pregnancy, your provider may recommend compression socks or heparin to promote circulation. Staying active and well-hydrated may help prevent clots.

Leg cramps and swelling are common throughout pregnancy, but DVT often only affects one leg, and makes that leg red, painfully swollen, and warm to the touch. If you experience shortness of breath, chest pain, or a rapid heart rate, please call 911.

When to watch for leg pain: throughout your pregnancy

Severe headache

Many people suffer from occasional headaches, including pregnant women. But, if your headache is persistent or severe, you should call your doctor.

Severe headaches may be accompanied by dizziness, fainting, or blurred vision. Sit somewhere comfortable, if you’re feeling faint, and have someone stay with you while you talk to your OB or midwife about next steps. Severe headaches during your second or third trimester may be a sign of preeclampsia.

Other signs of preeclampsia include:

• Abdominal pain, especially on the right side
• Blurred vision
• Excessive swelling of face, feet, or hands
• Flu-like achiness, but with no runny nose or sore throat
• Abnormally rapid weight gain

When to watch for headaches and preeclampsia: after you’ve reached 20 weeks

Vaginal bleeding

Vaginal bleeding is common while pregnant, especially during the first trimester. Nearly 25% of women have spotting or heavier bleeding in their first 13 weeks (give or take a few).

If you are experiencing cramping and bleeding during your first trimester, it may be a sign of miscarriage. It’s also possible that your egg is implanting in the lining of your uterus, or that you’re experiencing cervical polyps or cervical bleeding. Be sure to call your provider’s office and give them as much information as you can so they can recommend next steps.

Bleeding during pregnancy is cause for concern during the second and third trimesters, as well. Sometimes, it’s caused by a placenta tear or another problem that can be diagnosed by an ultrasound. If you notice bleeding — beyond spotting — at any time during your pregnancy, call your doctor immediately.

When to watch for bleeding: anytime throughout your pregnancy

Watery discharge

When you’re nearing the end of your pregnancy, discharge can mean that your water has broken. If you suddenly experience a gush of fluids or an increase in discharge before 37 weeks, please call your OB or midwife immediately. This can be a sign that your amniotic sac has ruptured, but it isn’t always cause for concern. Your provider will ask you questions and learn more before they advise next steps.

When to watch for increased discharge: between weeks 24 to 36 of pregnancy

What to say when you call

It’s possible you will encounter your provider’s answering service if you call after hours. They triage calls and will get you in touch with your provider if next steps are necessary. Be prepared to tell them your name, your due date, the symptoms you’re experiencing and for how long you’ve been experiencing them, and the name of your doctor or midwife.

Other symptoms to monitor

You’ll be seeing your OB or midwife often throughout your pregnancy. The following symptoms are common, but should be mentioned when they ask you how you are doing. Of course, if they concern you at any time, you are welcome to reach out and raise your concerns with your provider.

Confusion and forgetfulness

You may find yourself extra forgetful during your third trimester, which is completely normal. Utilizing stress-relief techniques and asking your support network for help can go a long way in easing any lingering anxiety.

Constipation

Constipation is a common pregnancy complaint, and is typically caused by the slowing down of your intestinal muscles and your baby pressing down on your rectum. Additionally, the iron found in prenatal vitamins or iron supplements can cause you to become constipated.

If you’re experiencing constipation, drink more fluids, increase your fiber intake, and exercise if you can. If your constipation persists, bring it up at your next prenatal appointment.

Fatigue

Your body is very busy growing a baby, and being more tired than normal is quite common. Energy levels will change throughout your pregnancy, and it’s very important to rest when you need it. You may not be able to do everything you could pre-pregnancy, and that is to be expected.

Mood swings

Changes in sleep patterns and eating habits can affect your emotional state. Sometimes a pregnant woman’s feelings can change rapidly, running the gamut of happy to sad within a matter of minutes. Just remember that any fears or concerns are perfectly normal and valid, and sharing those with your support network can help.

Nightmares or vivid dreams

Vivid or scary nightmares are common during your pregnancy. Pregnant women report an increase in random, but very life-like dreams, caused by changing hormones. Typically, this increase in dreams and nightmares subside once pregnancy is over.

If you have questions or concerns during your pregnancy, ask your provider! We are here to help you have the safest, healthiest pregnancy possible, and are honored by your decision to partner with us. If you chose to do your own research, please remember to use reputable, scientific journals and trusted sources.