Early Signs of Pregnancy
If you were pregnant, you would probably want to know as soon as possible. If conception were to occur mid-cycle, at ovulation, it would be at least two weeks before you’d miss a period. Are there other early tell-tale signs of pregnancy? What are they and when do they appear?
In the movies, depicting nausea is an easy way to let audiences know a character has gotten pregnant. This may be a cliché, a common trope—but it’s true, nevertheless. As the body adapts itself to the new task of growing a child many changes take place and are reflected in various signs and symptoms, including nausea. Although every pregnancy is different, there are many potential common experiences.
So, what are the other signs of pregnancy and when do they usually appear? Let’s find out.
Is it stress or is it pregnancy?
If you suspect you are pregnant, the excitement and anxiety you are likely to feel can confuse the signs and symptoms your body presents, even if you aren’t pregnant.
Whether you have been longing for a child or it’s a less-than-ideal moment to get “knocked up”, stress makes it harder for us to tune in to our bodies and can intensify both real and perceived symptoms. No single sign, or even several together, automatically mean you are pregnant—not even missing a period.
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Tracking your cycle gives you information about any changes that might indicate a potential pregnancy or some health issue. However, today most people are swimming in information overload and for some of us hyperawareness of the monthly cycle can cause unnecessary anxiety—especially if your period is delayed, which does happen from time to time.
If you suspect you may be pregnant, buy a home pregnancy test and test yourself. These tests measure the amount of hCG, or human chorionic gonadotropin, in your urine. The body begins producing hCG as soon as the fertilized embryo embeds itself in the wall of the uterus, typically around day ten of pregnancy. The test package will say 10, 20, or 25 mIU/mL (milli-international units per milliliter). The smaller the number, the more sensitive the test.
Non-pregnant women typically have less than 5 mIU of hCG per mL, but once pregnancy has begun these numbers rise rapidly reaching around 75 mIU/mL within the first three weeks and 200,000 mIU/mL by the end of the first trimester, at which point levels decline slightly.
By now we are all used to home Covid tests, pregnancy tests are very similar. If anything, peeing on a stick is easier than putting a swab up your nose.
By the first day of your missed period there should be enough hCG in your urine for the test strip to indicate a positive result if you are pregnant. Testing at home is an easy and inexpensive way to help you prepare for different scenarios.
Every pregnancy is different
Every body is unique and every pregnancy is different. Some women report recognizing the signs of pregnancy immediately, while others discover how their bodies react as they go through the process. The signs of pregnancy can present very differently in different women and even in the same woman as she goes through different pregnancies.
It is impossible to predict the precise course of any given pregnancy because of the myriad of influencing factors. You may experience just a few of the classic symptoms or almost all of them. However, women carrying twins or other multiples do tend to experience strong symptoms from the beginning due to elevated levels of hCG.
How early can I tell?
Although some women describe having an immediate awareness of pregnancy from the moment of conception, this is most likely a trick of the brain. The earliest signs typically begin to appear about one week after conception—the moment when sperm and egg meet, unite their DNA, and the cells of the fertilized egg begin to divide.
Keep in mind that conception can occur during sex or at any time up to five days after intercourse! And once an egg has become fertilized, it still has to make its way through the fallopian tubes to implant itself into the lining of the uterus, or endometrium, where the embryo can develop safely. This is when the first signs typically begin to appear.
Spotting
When the fertilized egg implants itself into the uterine lining—approximately 6 to 8 days after conception—many women experience light spotting, otherwise known as implantation bleeding. Sometimes this light spotting can be mistaken for a period so by the time you notice you have missed a period you may already be in the second month of pregnancy.
One way to tell the difference is that period blood is bright red, especially in the first three days or so, but implantation bleeding tends to be brownish or pinkish in colour. It doesn’t help that implantation bleeding is often accompanied by cramping, although implantation cramps are also usually much milder than period cramps.
Each month the body creates a new uterine lining, so when pregnancy does occur, the endometrium is always in good shape—like putting fresh sheets on a bed. Period cramps occur when the uterus contracts to expel a month’s accumulation of blood-rich endometrium that is no longer necessary.
However, if conception has occurred the endometrium receives the fertilized egg and then acts as the interface between the mother and the developing embryo as her body supplies it with blood and nutrients.
Discharge
Increased vaginal discharge is another common sign of pregnancy. The body produces higher volumes of vaginal fluid in response to elevated hormone levels. This helps prevent an infection of any kind from disrupting what’s going on inside the uterus. You may notice increased levels of discharge early in the first trimester, and this is likely to continue as the pregnancy progresses.
Just like regular discharge, during pregnancy it should always be clear and have no distinct smell. If your vaginal discharge suddenly changes colour, contains blood spots, is accompanied by itching or some other unpleasant sensation, or has a strong or unusual odour, contact your doctor or OB/GYN right away.
Tiredness
Unusual tiredness is one of the earliest signs of pregnancy that can appear as early as one week after conception. During the first trimester this fatigue is caused mostly by changing hormone levels, especially the rather dramatic increase of progesterone.
Your body must make many changes to adapt to supporting a new life and from now until the birth a significant proportion of your resources will go to the baby—you will feel tired. Make sure you get plenty of sleep in a restful environment, eat foods rich in protein, and watch for signs of iron deficiency.
Changing breasts
Tender, swollen breasts are another well-known sign of pregnancy. Before they were just decorative, now they are preparing to make the milk that will nourish your newborn. As the volume of blood in your body increases, you may notice the veins in your breasts becoming larger and more visible.
The sensitive skin of the areolas will darken and expand as pregnancy hormones cause your body to produce more pigment, and you may notice small bumps around the areolas as well. They have always been there but become more noticeable during pregnancy. They lubricate and protect the area and may be the source of the scent that helps babies find the nipple and latch on.
Your nipples will also probably change shape and become more prominent and as your breasts grow the skin will feel sensitive, perhaps sore or itchy, and you may get stretch marks if they grow quickly. You will probably go up a cup size or two. If you have flat or inverted nipples, don’t worry. There are a number of tips and tricks that can help.
When and how these changes take place depends on the person, but extra sensitivity is especially common in the first and last weeks of pregnancy.
Morning sickness
While for some that notorious nausea can begin as early as week two after conception, morning sickness typically begins around week six and sometimes also manifests as motion sickness, for example when riding an elevator, taking the train, or driving.
Nausea is a common symptom of a variety of health issues from migraines to blood sugar fluctuations to hangovers, so how can you know if that queasy feeling is being caused by a new baby or due to something else? It’s not that simple. All the early signs of pregnancy, including nausea, can also be caused by other things, including the normal hormonal fluctuations of the menstrual cycle and PMS.
Olfactory perception
Food cravings usually are at their strongest in the second trimester, but you may notice that you experience certain smells, flavours, and textures differently starting from week five or even earlier.
Changes in your sense of smell are often, but not always, related to nausea. You may develop an aversion to smells in your environment you never paid much attention to before, and certain foods you once enjoyed might suddenly seem very strong or even repugnant. (Unfortunately, a distorted sense of smell, or dysgeusia, is also one of the main symptoms of Covid.)
This heightened sense of smell may also explain the metallic taste some women experience early in their pregnancies.
Urination
Pregnant women typically start feeling the need to pee more often throughout the day around week six, and this only increases over the course of the pregnancy. The bladder sits just under the uterus. As the uterus grows to make room for the developing baby, the bladder is flattened and compressed leaving less space for urine to collect. Although this can be uncomfortable, things generally return to normal quite quickly once the baby is born.
Salivation
Temporary hypersalivation can be an early sign of pregnancy in some women. This is most common in the first trimester, but in some cases persists into the second or even third trimester and can contribute to nausea, sleeplessness, food cravings and aversions, and other difficulties. The mechanism that causes hypersalivation is still unknown, but in the case of pregnancy the condition usually resolves itself once the baby is born if not sooner.
Bloating and constipation
The “pregnancy hormone” progesterone is essential for maintaining a supportive environment for the developing foetus. Among other effects, progesterone can slow the process of digestion in the stomach and intestines. This gives your body more time to process nutrients and pass them on to the little one but often results in bloating and/or constipation as well.
These symptoms can start as early as week three, but most commonly appears around week twelve and remains throughout pregnancy. To keep discomfort to a minimum, stay active, drink plenty of water, and eat nutritious whole foods that contain fibre. Eating smaller meals more frequently can also make things easier.
Mood swings
Hormonal mood swings usually appear in the second half of the first trimester—weeks six to ten. The neurotransmitters that regulate emotion are sensitive to progesterone and oestrogen.
Of course, stress can affect mood and behaviour at any time. Pregnancy takes an enormous toll on the body. Any expectant mother will need support from her family and friends as she prepares to bring a new life into the world.
If you are predisposed toward depression or any other mental health issue, be extra kind to yourself during this time, and seek counselling if necessary. We all deserve to feel happy and healthy.
Pain
Progesterone prepares the body for childbirth by relaxing the joints and ligaments, but this sometimes can strain the body in other ways. Back pain, especially lower back pain can start from approximately week eight in response to the changes in your body.
Headaches are also a frequent occurrence early on. If you are predisposed to having headaches or migraines, your changing hormone levels and the up to 50% increase in blood volume that come with pregnancy can cause additional headaches. Headaches as a symptom of pregnancy usually begin around week nine and are often related to other symptoms such as nausea, fatigue, and general stress in your everyday life.
Elevated temperature
If you regularly track your basal body temperature (BBT), your body’s natural resting temperature—typically 97–97.5° F (36.2–36.6° C) for women—you will notice it goes up slightly during ovulation—usually to 97.6–98.6° F (36.7–37° C)—and then returns to the baseline. If you become pregnant, BBT remains elevated for 2–3 weeks after fertilization.
Test to be sure
Any of the issues mentioned in this article may or may not be a sign of pregnancy. If you have had unprotected sex—including period sex and your partner “pulling out” before ejaculation—taking a pregnancy test is a must. Start with a home test and then see your doctor for a serum blood test to confirm.
If you don’t feel comfortable buying a pregnancy test at the pharmacy, you can easily order one online. Tests are also often available at your local community health centre or Planned Parenthood office.
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