When to call your midwife, your trusted-instinct guide

This is your quick-reference for one of the most important questions in pregnancy: when do I pick up the phone? You will never be a nuisance. Maternity units are open 24 hours a day, every day, and the people answering expect calls exactly like yours. If something does not feel right, that is reason enough to ring. You do not need to have all the words, and you do not need to be certain, that is our job, not yours.

Call your maternity unit straight away (do not wait until morning) if: your baby is moving less than usual, or their movements have changed or stopped; you have any vaginal bleeding; you have a sudden gush or trickle of fluid; you have a bad headache that will not go with paracetamol, or changes to your vision like flashing lights or blurring; you have sudden swelling of your face, hands or feet; you have pain just under your ribs; you feel feverish, shivery or generally very unwell; or you have strong, regular tummy tightenings before 37 weeks.

A word on swelling, because it is one many people second-guess. Some puffiness in the ankles and feet by the end of the day is normal in pregnancy. What we worry about is swelling that comes on suddenly, that affects your face and hands, or that arrives alongside a headache or vision changes, that combination can be a sign of pre-eclampsia and needs checking the same day, whatever your skin tone.

If you have brown or Black skin, please know that some warning signs are described in ways that were written with lighter skin in mind, which can leave you unsure. Swelling, for example, may be easier to feel than to see, rings, shoes or a watch suddenly feeling tight is a real and valid sign. If you feel pale or grey, look at the inside of your lower eyelid, your gums and your palms; if those usually-pink areas look unusually washed-out, mention it. Trust what your body is telling you even if a checklist does not seem to fit how you look.

Make an appointment to be seen soon (within a day or two) for things like: persistent itching, especially on your palms and soles, that is worse at night; ongoing heartburn that paracetamol-style measures are not touching; burning when you pass urine; or feeling low, anxious or not yourself for more than a couple of weeks. These are not emergencies, but they do deserve attention and a plan.

Here is the underlying rule that matters more than any list: you know your body and your baby better than anyone. If your instinct says something is wrong, ring, even if it is the third time this week, even at 3am, even if your last check was fine. A short phone call costs nothing and reassurance is part of good care. This is placeholder guidance for now and will be reviewed by our midwife, Dumebi, but the principle behind it will not change: when in doubt, get in touch.