Pregnancy tests are very sensitive so it is common to find out that you are pregnant before you develop any signs or symptoms of pregnancy. However, as your pregnancy continues you may experience these early symptoms and signs of pregnancy.
Signs and symptoms of early pregnancy
The signs of early pregnancy vary tremendously between women. Some women hardly have any symptoms, whereas others have very severe symptoms. It is impossible to predict which women will have more severe symptoms. However, in general, if you are expecting twins or triplets then it is likely that your symptoms will be more severe.
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Extreme tiredness is often the most common sign of an early pregnancy. Although it is common to become more tired in the later stages of pregnancy, this extreme tiredness and lack of energy (lethargy) usually last for the first twelve weeks (first trimester). The symptoms usually then improve.
You may notice that you need to pass urine more frequently than you used to. This is actually due to the effect of the beta-hCG hormone which makes your kidneys work harder to produce more urine. This is different to the reason you will need to pass urine more often in the later stages of pregnancy, which is due to the baby's head pressing on your bladder.
Note: if you experience any burning, stinging or a high temperature (fever) with these urinary symptoms, contact your doctor or midwife. Urine infections are common when you are pregnant. Your doctor or midwife will arrange to test your urine for an infection.
Constipation and bloating
Constipation is more common in the early stages of pregnancy. This is due to the chemical (hormone) progesterone making your bowel more relaxed and sluggish. It is important to have a healthy diet throughout your pregnancy. If you do become constipated then you should eat more foods with lots of fibre in them, like wholemeal bread, fruit and vegetables. Make sure you are drinking enough fluids, especially water.
Another very early sign of pregnancy is breast tenderness. You may find that just the water from your shower on your breasts makes them feel uncomfortable and very tender. You may also find that you wake in the night when you roll on to your front because your breasts are tender. Your breasts may tingle at times or even have stabbing pains in them. You may also notice that you may have swollen breasts or breasts become bigger over the first few weeks of pregnancy. As your pregnancy develops it is common to notice some veins under the surface of your skin over your breasts. This is entirely normal.
After a few weeks you may notice that the coloured skin around your nipples (the areolae) becomes darker.
Morning sickness and dizziness (nausea)
Although most women think that feeling sick is the first sign of being pregnant, it is more common to develop other symptoms first. Feeling sick usually starts around the sixth week of your pregnancy. It is more common to experience feeling sick only in the mornings. However, you may find that this feeling continues throughout the afternoons and even into the evenings.
This can, however, vary between pregnancies in the same woman as well as between different women. You may find that you are being sick (vomiting) as well as feeling sick. The amount, frequency and time of the day really do vary between women and can also be different (worse or better) in later pregnancies.
This sickness is commonly referred to as morning sickness. It is more common to experience feeling sick only in the mornings. However, you may find that this feeling continues throughout the afternoons and even into the evenings.
Food cravings and aversions
You may find that you crave certain foods during your pregnancy or even go off some foods (food aversion). Some women experience a metallic taste in their mouth.
You are likely to have a heightened sense of smell during your early pregnancy. This may make any feelings of sickness that you have worse.
Mood swings and irritability
The changes in hormone levels in early pregnancy may make you have more mood swings and feel irritable than usual.
Spotting and missed period
Although this has always been the most obvious sign of pregnancy, many women now find out they are pregnant before they miss their first period.
Many women may have a small amount of bleeding (spotting) at the time of their missed period. This is sometimes called an 'implantation bleed'. It happens when the fertilised egg attaches and fixes itself (implants itself) in the wall of your womb (uterus). It is harmless.
However, if you have any spotting or heavy bleeding when you are pregnant then you should let your doctor or midwife know. In some cases further tests (for example, a scan) are necessary. This is because bleeding can sometimes be a sign of a miscarriage.
Less commonly it can be the first symptom of an ectopic pregnancy. 'Ectopic' refers to a pregnancy which occurs outside the womb.
Indigestion (dyspepsia) is common in pregnancy and is often due to acid reflux from the stomach into the gullet (oesophagus). See also the leaflet called Indigestion and Acid Reflux in Pregnancy.
It is common to have cramps that feel lime menstrual cramps.
Cramps in the legs are also common in pregnancy. They occur in late pregnancy and are usually worse at night. Massaging the affected leg and elevation of the foot of the bed may help. Always see a midwife or doctor if you are concerned, particularly as leg pain and swelling may be caused by a deep vein thrombosis.
Raised body temperature
It is normal to have a body temperature that is slightly above your normal body temperature (basal body temperature) when you're pregnant. However an abnormally high or low body temperature could also be a sign of an illness, especially if you feel generally unwell or have any other symptoms. It's also very important to avoid overheating during hot weather or when you exercise.
It is normal to put on 10-16 kg in weight during your pregnancy. The weight gain is mainly due to your baby growing, but your body also stores more fat during pregnancy. Too much or too little weight gain during pregnancy can lead to health problems for you or your unborn baby. You should see your midwife or doctor if you have any concerns. It is essential that you eat a healthy diet during your pregnancy.
Pregnancy glow or acne (skin changes)
Pregnancy often causes skin changes due to rising hormone levels. Pregnancy may promote healthier skin, hair and nails, and pregnancy is often associated with a healthy glow. But pregnancy can also cause skin problems such as acne, unwanted hair growth, hair thinning, skin pigmentation, spider veins and stretch marks.
Pregnancy can cause nasal congestion, which is sometimes called pregnancy rhinitis. The lining of your nose may also swell, causing further nasal obstruction.
Increased heart rate
An increased heart rate is common during pregnancy. During the first few months of pregnancy (first trimester), it is normal for your heartbeat to increase by around 15 or 20 beats per minute.
When do early signs of pregnancy start?
If you have a regular monthly menstrual cycle, the earliest and most reliable sign of pregnancy is a missed period. The time of your first missed period is usually about 2 weeks after conception, which is when the sperm fertilizes the egg.
Early pregnancy symptoms, such as morning sickness, usually start when you’re about 4-6 weeks pregnant. The number of weeks of your pregnancy is usually taken from the first day of your last menstrual period.
Early Pregnancy Q&A
How long does it take to get symptoms of pregnancy? What can cause the same symptoms of pregnancy? What are the different stages of pregnancy? All your questions answered.
Can you feel pregnant before you miss your period?
Although a missed period is often the first sign of pregnancy, other symptoms may occur before the missed period. These include:
- A small amount of bleeding (spotting).
- vaginal discharge: The discharge is usually thin, clear or milky white, and doesn't have an unpleasant smell.
- Cramping, which may feel similar to menstrual cramps.
- Breast changes: your breasts tend to feel full and become sore, swollen, tingly, and tender. The area around the nipple (areola) may get darker.
- Morning sickness.
- Food cravings or aversions.
- Raised body temperature can be an early signifier of pregnancy as well.
- Feeling very tired.
- Mood swings.
- An urge to urinate more often.
- Dizziness and fainting may be caused when blood pressure and blood sugar levels fall.
Can you experience pregnancy symptoms and not be pregnant?
It's not uncommon to experience pregnancy symptoms without being pregnant. Similar symptoms may occur before a period (premenstrual), at the time of ovulation, or as a side effect of medicines used in fertility treatments.
The symptoms may also occur if you want to be pregnant so badly that you focus on any change so much that you convince yourself you are pregnant, even though you're not.
How do I know I am pregnant?
If you're experiencing early signs of pregnancy then the next thing to do is a home pregnancy test to confirm it. These are are available from chemists and supermarkets and are very sensitive. They test for the presence of a hormone called beta human chorionic gonadotrophin (beta-hCG) in your urine. Beta-hCG is produced by your body when an egg (which has been fertilised by a sperm) attaches and fixes itself (implants itself) into the wall of your womb (uterus).
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Different makes of pregnancy tests vary in how sensitive they are. The more sensitive ones can become positive only a few days after conception. However, a negative test does not mean that you are not pregnant; it may just mean that the levels of this hormone are not high enough to be detected by the test.
As pregnancy tests vary in how you use them, it is important to read the instructions carefully before you do the test.
If your first pregnancy test is negative but you think you may be pregnant then you should repeat the pregnancy test one week later. If you have a positive pregnancy test, this does not need to be repeated by a doctor or a midwife.
What should I do when I find out that I am pregnant?
Once your pregnancy has been confirmed by a pregnancy test then you should contact your doctor's surgery. They will arrange for you to see your doctor or midwife. Usually you will be seen by a midwife at around twelve weeks of your pregnancy. They will see you at your surgery, at a children's centre or at home. It is rare nowadays to have to go to a hospital to see a midwife.
It is important to have a healthy lifestyle during your pregnancy. This includes healthy eating and taking folic acid and vitamin D supplements.
Further reading and references
Antenatal care for uncomplicated pregnancies; NICE Clinical Guideline (March 2008 - updated February 2019)
Antenatal care - uncomplicated pregnancy; NICE CKS, February 2019 (UK access only)
Al-Memar M, Vaulet T, Fourie H, et al; Early-pregnancy events and subsequent antenatal, delivery and neonatal outcomes: prospective cohort study. Ultrasound Obstet Gynecol. 2019 Oct54(4):530-537. doi: 10.1002/uog.20262.