Knowing the Early Signs and Symptoms of Pregnancy

Early signs of pregnancy
Illustration by Joshua Seong. © Verywell, 2018.

While many people assume that a missed period is the first sign of pregnancy, there are a number of other symptoms you can look for. From morning sickness to acne and sore breasts to mood swings, it's different for each person and with each pregnancy.

Common Pregnancy Symptoms

The only way to confirm whether or not you're pregnant is through a pregnancy test or ultrasound, but there are some common early signs. You may notice them as early as one week after conception or a few weeks after your last menstrual period. Some experience none at all while others have only temporary symptoms that are mistaken for their menstrual cycle.

The vast majority of women who do not show these usual signs still have a perfectly healthy pregnancy. If your lack of symptoms worries you, be sure to ask your healthcare provider if you're doing well and what you can expect.

You should also bring any and all questions you have to your next prenatal visit. Don't panic if you wonder if every little twinge is something wrong—that's normal. Your doctor will be able to analyze what's going on, reassure you that everything is okay, and find solutions if anything is off.

Missed or Strange Period

A missed period is probably one of the most reliable signs of pregnancy. However, pregnancy isn't always the reason for a missed period. This is why you are asked for the first day of your last normal menstrual period (LMP). That date will also help determine your due date if you are indeed pregnant.

Although some women will experience implantation bleeding around the time that their period is due, it is usually just spotting and lighter or shorter than their normal period. Although rare, a few women may continue to cycle throughout their pregnancy.

It may be harder to note a missed or strange period if you typically experience irregular cycles. In this case, a pregnancy test followed by a pelvic exam may be necessary. If your doctor rules out pregnancy as the cause for your missed period, she will take steps to rule out other possible causes.

Increased Basal Body Temperature

Basal body temperature (BBT) is your temperature as soon as you wake up and is influenced by hormones. An elevated BBT can be the first indication of pregnancy, even before your pregnancy test result is positive.

Some women continuously track their BBT for fertility purposes. It is a good indicator that a woman is pregnant if the temperature does not fall back down to or below the cover line temperatures on a BBT chart.

Morning Sickness

About half of pregnant women will experience morning sickness and it can vary greatly. Some women are sick only at night, some are sick all day, and other women feel ill on and off with a unique pattern. Vomiting may or may not be present.

The ill feeling occurs with the rapid rise of estrogen, which is produced by the fetus and placenta. Since a woman's sense of smell also becomes tuned, the odors from foods, fragrances, and smoke can trigger morning sickness. Most women begin to experience this between four and eight weeks of pregnancy, but it can occur as early as two weeks after conception.

Some women may have a severe form of morning sickness called hyperemesis gravidarum. This can lead to dehydration and other problems. Your doctor can help you find solutions.

Breast Soreness

Having sore breasts is usually one of the first physical signs of pregnancy and it often goes away during the second trimester. Once again, it's a symptom caused by hormones. As the breasts prepare for breastfeeding, estrogen and progesterone rise and cause the tenderness.

Frequent Urination

If you are going to the bathroom more than usual, that may be a sign that you're pregnant. Frequent urination is common fairly early on in the first trimester, and then again in the third trimester because of the growing uterus.

There isn't a lot that you can do about this except to know where all the bathrooms are. You'll also want to stay hydrated.

Fatigue

Not being able to keep your eyes open or needing a nap regularly is a pregnancy symptom as well. Fatigue sets in very early for some women, as their bodies undergo multiple changes in preparation for carrying a baby. Additionally, extra progesterone, which is a central nervous system depressant, contributes to the sleepiness.

If you find that you are really sleepy, try learning to power nap to get through the day.

Feeling Dizzy

Expanding blood volume and blood vessels may cause vertigo in pregnant women. You might feel dizzy on occasion, but this is usually only in the first trimester. If it becomes a concern or happens later in your pregnancy, it's certainly something to talk to your doctor about.

Cramping

Cramping may be something you associate with your impending period rather than an early pregnancy symptom. Some women experience early cramping in the uterus as it begins to stretch and changes occur.

Anything severe should be reported to your doctor immediately. The same is true if the cramping is accompanied by bleeding.

Acne

An increase in acne and other skin changes can also be a pregnancy symptom. Be careful what medications you use to treat it, though. Some medications like Accutane and those that are high in vitamin A can cause birth defects. It's best to talk to your doctor about how to battle bad skin while you're pregnant.

Headaches

Headaches are rather common in pregnancy due to hormonal changes. This may be a pregnancy symptom, but it is not necessarily a sign. There are many things that could cause the headaches, including stress.

This symptom can occur at any point in pregnancy but is most common during the first trimester. If the pain is too much to handle, talk to your doctor about which medications (including over-the-counter pain relievers) are safe for your baby.

Vaginal Discharge

Vaginal discharge, without itching or burning, may be a sign of pregnancy and can occur in the very beginning. The cervix is building a mucous plug to block the opening of the cervix and help protect your baby from infections. During this transition, you might notice a slight increase in vaginal secretions.

Vaginal discharge shouldn't smell, burn, or itch. These would be signs of infection that would require proper medical treatment.

Cravings

Strange pregnancy cravings are something you hear a lot about. In reality, you may have cravings or aversions to certain foods, particularly stronger smelling or unhealthier ones, early on and throughout your pregnancy.

Bloating and an Enlarging Belly

Early pregnancy is not when pregnant women begin to show, but some women report an enlarging belly as a pregnancy symptom. This is typically caused by bloating as opposed to the baby.

Weight gain in the first trimester is generally not very big—usually only a pound or two. In fact, you may even lose weight from a combination of not feeling well, food aversions, and a better diet as you make lifestyle changes.

Mood Swings

Once again, hormones are to blame for varying feelings and moods. Don't be surprised or upset if you're suddenly bursting into tears or experiencing intense emotions.

Constipation

Progesterone in the body impacts multiple processes, including food digestion. Increased levels of this hormone cause slower digestion and, in turn, constipation.

If you experience this symptom after you've confirmed your pregnancy, exercise and increased fiber can help. Also, once you begin to take prenatal vitamins, the iron in them can exacerbate constipation. You may have to try a few in order to find one that works well for you.

Pregnant vs. PMS

Many women confuse the symptoms of pregnancy with premenstrual syndrome (PMS). It is even more likely that the changes are so slight that you completely miss them. Feeling a bit bloated? That's easy to pass off as normal since many women experience this around the time of their period. The same goes for things like a backache and cramping.

The only way to confirm your pregnancy is to take a pregnancy test or make an appointment with your doctor. Doing this will also alleviate any worries you have.

If you are pregnant, keep in mind that most of these symptoms are normal. They're typically only an issue when they are so severe that they interfere with your daily life or health or if you have pregnancy symptoms that completely disappear, seemingly overnight.

When to Take a Pregnancy Test

If you suspect that you're pregnant, take a pregnancy test. These urine tests measure the level of human chorionic gonadotropin, or hCG, a hormone secreted when you're pregnant. The amount of hormone each test can detect varies widely. Every woman also secretes a little more or less of the hormone, so the tests are not completely accurate.

The better tests on the market will measure 25 to 50 mIU/mL (milli-international units per milliliter) of hCG. This is usually the amount found in urine between the fourth and fifth weeks of gestation. The levels of hCG in your urine will be different from those in your blood.

First-morning urine will always contain the highest concentration of hCG. However, most tests do not require that you use first-morning urine. You can better your chances of having enough hCG in your urine by waiting four hours after you last urinated to take the test. This allows the hCG to build up.

A negative result that is later revealed to be wrong is usually because the test was performed too early. A false positive, on the other hand, may indicate a very early miscarriage. Talk to your practitioner if you have questions about your pregnancy tests. You can also call the toll-free number provided by the test manufacturer.

Blood tests are the most accurate and can be performed seven to 10 days post-ovulation. They may also be used to help predict the health of a pregnancy at various points. You'll need to visit your doctor to get one.

When to Call the Doctor or Midwife

If you have questions, it's important that you call your doctor or midwife. Even if you don't have an appointment, they can address your concerns and make sure everything is okay. They understand that you have a lot of questions and are willing to give you the answers, but you have to call. Many practitioners have someone available who just answers patients' questions all day long.

It's not unusual for the answers to lead to more questions. It is appropriate to ask clarifying questions—do not feel like you are taking up too much of your doctor's time. They are there to help.

A Word From Verywell

Remember, pregnancy symptoms can start very early in pregnancy, but some take a while to develop. It can also be perfectly normal not to feel anything. If you think you might be pregnant, take a pregnancy test. If you're pregnant, or unsure of your results, check in with your doctor or midwife.

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