Talk with the mother
Ask if she has any unusual pain in the belly, back, or legs
Healthy signs No pain in the belly, back, or legs. Or aches and pains that are
not dangerous, just uncomfortable, such as:
• mild, irregular cramps high in the belly, all over the belly, or inside the belly
(also called practice contractions, see page 150).
• sudden, sharp pains low in the front but to the side that last a few minutes
and then go away (see page 79).
• lower back pain that feels better with rest, massage, or exercise.
• sharp pain in the buttocks that runs down the leg and feels better with rest.
Wa r nin g s ig n s
If the mother has any of the following pains, there may be a problem.
• Cramps or belly pains in the first 6 months that get stronger or come
regularly may mean that a miscarriage is starting. (See page 91.)
• Pain in one leg that does not go away can be a sign of a blood clot in
the leg. (See page 273.)
• Constant pain in the lower belly that goes through the sides into the
back, or back pain that does not get better with rest, massage, or
exercise, especially if the mother also has a fever, may be caused by a bladder
or kidney infection. (See page 128.)
• Any belly pain with fever can be a sign of womb infection. (See page 179.)
• Constant belly pain in late pregnancy may mean the placenta is coming off
the womb wall. (See page 114.)
• Strong, constant belly or side pain in the first 3 months may mean that this is
a tubal pregnancy. (See below.)
Constant pain early in pregnancy (tubal pregnancy)
Constant pain in the belly during the first 3 months may be a sign that the
pregnancy is growing in the wrong place.
The baby usually grows in the womb, where it belongs. But in rare cases, it may
start to grow in the tube that leads from the ovary to the womb. This is called a
tubal pregnancy. Tubal pregnancy is very dangerous.
At first the tube stretches. But as the pregnancy grows, the mother may feel a
sore lump or pain on her side. Then, sometime before she is 3 months pregnant,
the tube breaks and bleeds. This bleeding usually stays inside the body where no
A pregnancy in
the tube will
make the tube
one can see it, but it can bleed
enough to kill the woman. If you
think that the pregnancy may be
growing in the tube, get medical
break and bleed.
help immediately! Watch for
signs of shock (see page 239).
A Book for Midwives (2010)