You've taken a tumble and are terrified that you may have hurt your baby. It's easy to panic if you fall during pregnancy. But your body is designed to protect your developing baby. An injury would have to be severe enough to seriously hurt you before it would directly harm your baby.

The walls of your uterus are thick, strong muscles that help keep your baby safe. The amniotic fluid also serves as a cushion. And during the early weeks of pregnancy, the uterus is tucked behind the pelvic bone, so there's even more protection. If you do fall, you can take comfort in knowing that your baby most likely won't be hurt.

In late pregnancy, a direct blow to the abdomen can give rise to placental abruption, in which the placenta separates from the wall of the uterus. This complication is very unlikely unless you've been injured. But if you break a bone, the possibility of this complication means that you must be evaluated.

■ Prevention and self-care for falls

When you're pregnant, your sense of balance is thrown off as your uterus grows. With this in mind, take a few extra precautions to avoid tripping or falling:

• Wear stable, flat shoes with soles that provide good traction. Put away your heels or pumps for the duration of your pregnancy.

• Avoid situations that require careful balance, such as climbing ladders or standing on stools.

• Take a little extra time when going up and down stairs, during tasks that require several changes of position or in situations that pose a risk of falling, such as walking on an icy sidewalk or wet surface.

■ When to seek medical help for falls

If you're worried about the welfare of your baby after a fall, see your health care provider for reassurance. Most practitioners want to hear about any spills you take after the 24th week of pregnancy because the possibility of placental abruption must be considered. Seek medical attention immediately if:

• Your fall results in pain, bleeding or a direct blow to the abdomen

• You're experiencing vaginal bleeding or leaking of amniotic fluid

• You feel severe pain or tenderness in your abdomen, uterus or pelvis

• You have uterine contractions — abdominal tightening that may or may not be painful

• You notice a decrease in fetal movement

In most cases, your baby will be fine. But your health care provider may want to monitor the fetal heart rate or do blood tests to make sure the placenta wasn't injured.

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