Early pregnancy symptoms

There are various early signs and symptoms that can indicate you might be pregnant. These early symptoms of pregnancy differ from woman to woman, and from pregnancy to pregnancy. If you are pregnant, you may notice one or more of these early symptoms, but don't worry, you are unlikely to get them all at once. Also, there’s no need to worry if you don't experience any of them, that’s also perfectly possible. Whether you get any of these first symptoms, or none of them at all, the only way to find out for sure whether or not you are pregnant is to take a pregnancy test.

When do pregnancy symptoms usually start?

To understand more about pregnancy symptoms and when they happen, let’s talk about the timeline for a pregnancy:

• Day 1. This is the first day of your last menstrual period, i.e., before you even get pregnant! Although you are not yet pregnant, your doctor will date the start of your pregnancy from this day.
• Around day 12-16, your ovary releases an egg (ovulation). When you ovulate in your cycle can vary depending on your cycle length.
• Within 24 hours of ovulation. If you had sex in the days leading up to ovulation or on the day you ovulated without using contraception, the sperm can fertilise the egg, this is called conception.
• About 7 to 9 days after ovulation. The fertilized egg implants into the lining of the womb. You may have implantation bleeding (see below) around this time.
• Once implantation is complete, the pregnancy hormone starts to become detectable in your blood and urine, and you are now pregnant.

You won’t notice any pregnancy symptoms before conception (before you’ve released an egg) in the first two weeks. When it comes to early symptoms of pregnancy post-conception, some women report noticing symptoms at different times. For example, some notice pregnancy symptoms about a week after conception—when the fertilised egg implants into the uterine wall, causing implantation bleeding (light spotting) —others notice their first signs later, usually with a missed period.

Signs and symptoms of early pregnancy

Missed period

A missed period is often the first indicator you’re pregnant, that is if you have a regular menstrual cycle.

If your menstrual cycle has been fairly regular for years, and suddenly your period is late, then it’s a good idea to get a home pregnancy test to check whether you are pregnant or not. If the test is negative, and your period is late, then it’s possible there is another reason behind your missed period.

If your cycles aren't regular, you may notice other early pregnancy symptoms before you notice a missed period.

Implantation bleeding or Spotting

You may get some light bleeding or spotting around the time your period is due. This is known as implantation bleeding and happens when the fertilized egg implants in the lining of your womb when you’re pregnant. Although it tends to happen when you’d usually expect your period, it is likely to be shorter in duration, lighter in colour and you may or may not experience light cramping.

Although implantation bleeding doesn’t mean your pregnancy is at risk, if you notice any blood and are concerned, see a doctor as there is no way to know how much bleeding is safe if you’re pregnant.

Changes in your breasts

Your breasts might swell or even go up a cup size. They may also feel tender or highly sensitive, similar to the way your breasts sometimes feel just before your period. You can also see the veins on your breasts may become more noticeable, and your areola (nipples) may darken and enlarge.

Fatigue or Tiredness

If you find yourself feeling unusually tired during early pregnancy, you’re not alone. You are likely to feel unusually tired in the first few weeks of pregnancy. It’s one of the most common early symptoms of pregnancy. Although the exact cause of fatigue in very early pregnancy is unknown, it’s possible this could be due to the rising levels of hormones, like progesterone, in your body. The good news is this tiredness usually goes away in the second trimester, but it may return in the third trimester for some women.

Morning sickness

You could start feeling sick, and even vomit, this is a classical pregnancy symptom you may start to experience between the 2nd and the 8th week of pregnancy, but which usually passes by the 16th week. Although this is often called “morning sickness”, it can happen at any time of the day or night. Nausea affects approximately 70-80% of the pregnant population¹. However, it’s important to note that if you don’t get this symptom, it doesn’t mean you’re not pregnant.

Hyperemesis gravidarum

Though morning sickness is common, this more severe form affects around 1 to 3 in 100 pregnant women². Normally continuing well past the first trimester (12 to 13 weeks), hyperemesis gravidarum causes vomiting so often and severe that no food or liquid can be kept down. Usually, the condition can be treated and only in very rare cases will cause complications for the pregnancy, but please seek doctor’s advice if you are suffering from severe sickness.

Frequent urination

About 6 to 8 weeks after conception, one of the early symptoms of pregnancy you may experience is the need to urinate more frequently. One reason for frequent urination is that the blood supply in your body increases, and your kidneys will filter this extra blood to remove waste, so you will end up urinating more.³ Another reason is that your uterus (the medical term for your womb) grows larger and presses on your bladder. At the end of the first trimester, your uterus rises up into your abdomen, which will take some of this pressure off your bladder⁴.

Mood swings

Your changing hormones may cause some mood swings in the early stages of pregnancy – you could even find yourself crying without really knowing why. It’s perfectly natural to feel emotional during early pregnancy. However, if you find that your feelings are too extreme or hard to deal with, or you are having long periods of sadness or anxiety make sure you contact a healthcare professional to get the help you need.⁵

Food cravings 

Craving pickles and ice cream? Food cravings tend to be one of the classical symptoms of pregnancy, and they often begin in the first trimester, and become stronger in the second. It’s possible that your hormonal changes can affect your senses of smell and taste, leading you to crave certain foods. Another theory is your body needs more of certain nutrients to help your baby grow and develop, so cravings are your body’s way of saying you need more of a certain food. Also, it’s possible that cravings have an emotional component, and they’re one way of seeking comfort.⁶

Changing tastes in food / drink aversions and sensitivity to smells

You may stop liking certain things such as tea, coffee or fatty food and might start to crave things you don't normally like. You might feel queasy when you smell certain things, too – like coffee, meat or alcohol. These changes in food preferences and enhanced sensitivity to certain smells are most likely to be caused by the changes in hormones going on in your body. Although food aversions tend to happen in early pregnancy, they can appear anytime while you’re pregnant.

Cramps

You may get cramps (like period cramps) in your abdomen in early pregnancy as your womb starts to expand. Your ligaments will also stretch as your bump grows, but pregnancy hormones can also cause constipation or trapped wind that also add to the cramping sensation. However, if you notice these cramps are severe, and you feel them on one side of the body, see a healthcare professional immediately to rule out an ectopic pregnancy or another complication.³

Other early pregnancy symptoms

You may also notice other, less common early pregnancy symptoms, which are often not exclusive to pregnancy.

Bloating

Bloating in early pregnancy is caused by hormonal changes during early pregnancy and may resemble that feeling you sometimes get just before your period arrives. When your pregnancy hormones change, these can relax your womb and digestive muscles, which can slow down your digestion, and this is why you may also be feeling a bit gassier than usual.³  

Backaches and headaches

Backaches and headaches are quite common in pregnant women. Backaches tend to happen in early pregnancy as the ligaments in your body begin to soften, which can put strain on the joints around your pelvis and lower back⁷. Headaches, on the other hand, may be due to changing hormone levels and increasing blood volume, although the exact reasons for headaches are still unclear. You might even get a headache due to fatigue or low blood sugar. Dehydration from morning sickness can also trigger a headache. 

Constipation

When you get pregnant, you might begin to feel constipated early on. As your body begins to increase production of hormones like progesterone. These hormonal changes can impact your digestive system, making it slow down, for example. Progesterone can relax your intestines, which can be a positive thing, as it gives your body more time to absorb more nutrients and water to support your growing foetus. The downside is that it also dries out your faeces, making it harder to pass and causes constipation.⁸ 

Nasal congestion

You may be surprised to learn that a stuffy nose can be sign of pregnancy. Again, we have all those changing hormone levels to thank for that⁹. Although congestion can appear early on in your pregnancy, it’s more likely you’ll get it during your third trimester, in the last six or so weeks. Nasal congestion during pregnancy is known as pregnancy rhinitis, and it can affect as many as 20%¹⁰ of pregnant people.

Vaginal discharge

You may notice more discharge than before when you are pregnant. Healthy discharge is nothing to worry about, if it’s odourless and you don’t notice any burning or itching sensations. However, a bad smell, discomfort, or discharge that is green or yellow could mean a vaginal infection, so you should talk to your doctor immediately if you notice it. 

Varicose veins

Varicose veins—enlarged veins that usually show up on the legs—tend to appear in the third trimester, but they can also appear early on in your pregnancy due to the higher levels of the hormone progesterone, which relaxes the walls of your blood vessels and also decreases valve function¹¹. You also have more blood in your body when you are pregnant.¹² All of these factors together can make it more difficult for blood to flow from going from your legs to your heart.¹³

Bacterial vaginosis

Bacterial vaginosis is an inflammation of the vagina secondary to an infection, and it can appear with an itching or burning sensation, unpleasant odour in some cases, or a different or an abnormal amount of discharge. In pregnant women, changes in hormone levels (particularly estrogen) may affect the normal balance of bacteria and yeast in the vagina, leading to infections inflammation.¹⁴ Some forms of bacterial vaginosis can cause problems during pregnancy, so see a healthcare professional if you notice it.¹⁵

Tingling and numbness in your hands

Tingling and numbness in your hands, is common in pregnancy. It’s caused by the median nerve being compressed due to an increase in tissue fluids while you’re pregnant. Although it is usually mild and symptoms usually tend to resolve once you give birth, we recommend you talk to a healthcare professional if you notice this symptom.¹⁶ 

Itchy skin

You may have itchy skin during pregnancy, which is thought to be caused by increased levels of hormones or increased blood supply to the skin.¹⁷ As your pregnancy progresses, you may also notice increased itching as your skin stretches.¹⁸ Although some mild itching is nothing to worry about, it’s worth getting it checked out by your doctor or healthcare provider, as itching can be a symptom of a liver disorder, like intrahepatic cholestasis of pregnancy (ICP), and may require special care.

Heartburn and indigestion

The hormone progesterone is on the rise over the course of your pregnancy, and it can relax the muscle between the oesophagus and the stomach. If you’re getting more indigestion, then switch to smaller, more frequent meals, and avoid eating before bed. Also, make a note of any food triggers—like spicy foods or fatty foods—and avoid them if you can. If you find that doesn’t help, see your doctor to find a safe way to handle it. 

Haemorrhoids

Haemorrhoids affect 30 to 40% of pregnant women¹⁹. They are itchy and painful varicose veins in or around the anus, and you don’t have to be pregnant to get them. Although it’s more common in the later stages of your pregnancy, you can also get haemorrhoids due to changes in your hormones that can slow your digestion down and cause constipation. 

Can early signs of pregnancy be mistaken for PMS?

If you are waiting for your period to arrive, you may even notice a few early pregnancy symptoms like tender breasts, fatigue, mood swings, and strong chocolate cravings, but are you pregnant or is it just PMS?

Although there is some overlap between early symptoms of pregnancy and PMS, if you suspect you may be pregnant and don’t want to wait for the day of your expected period, you can take an early detection pregnancy test.

What does your stomach feel like when you’re pregnant in the beginning?

You might notice some light cramping around implantation. Hormonal changes in early pregnancy may make you feel a little bloated or constipated, too, but at this stage of your pregnancy, you wouldn’t feel any movement due to the fetus, as it would just be an embryo. You will only start to feel any movement from the baby in the second trimester from weeks 16 to 24.

Could you have early pregnancy symptoms and not be pregnant?

Some of the above pregnancy symptoms are not exclusive to pregnancy, e.g., bloating, congestion, or even just feeling fatigued. There are a few symptoms that overlap with PMS, but what if you have many of the above symptoms, and the pregnancy test is still negative? It could be that you took your pregnancy test too soon before your expected period, or that you drank too much water before taking the test, so your urine was diluted. Or it could be that you did not test with the first urine of the day, if you were testing early (before your period was expected). If that’s the case, wait a few days and then test again. If you’ve missed your period, and suspect pregnancy but your result is not pregnant, see your doctor.

When should you see a doctor about a new pregnancy? 

Frequently asked questions

Answers from our Experts

Dr. Julie Oliver is an accredited GP with Special Interest (GPwSI) in Gynaecology working within North Durham CCG