10 Early Signs And Symptoms Of Pregnancy

Early pregnancy symptoms can be confusing because they often mimic symptoms many women experience around the time of their menstrual cycle, such as breast tenderness, cramping or even spotting.

But the most common early pregnancy symptom is a missed period, according to Shari Lawson, M.D., division director of general obstetrics and gynecology at Johns Hopkins Medicine in Baltimore. “If a woman has gone four or five days past their cycle, it’s usually an indication that she should go ahead and take a pregnancy test,” says Dr. Lawson.

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Other common early pregnancy symptoms include:

• Spotting: Defined as vaginal bleeding that’s lighter than your period—think a few drops of blood in your underwear, or blood that you only see when you wipe—around the time your period would typically arrive, or around week four of pregnancy
• Light cramping: Starts around weeks four to six
• Breast tenderness: Starts around weeks four to six
• Nausea: Starts around weeks four to six
• Fatigue: Starts around weeks four to six
• Frequent urination: Starts around weeks four to six
• Heartburn: Can occur at any time during pregnancy
• Mood swings: May occur during the first trimester and again toward the end of the third trimester

The severity of these symptoms vary, and while some people may experience only a few of them, others will experience none at all. Every person is different, but if you have any concerns about your symptoms (or lack thereof), talk to your doctor.

Spotting is not unheard of in early pregnancy. In a study of more than 4,500 women, 27% reported bleeding in their first trimester. While bleeding in early pregnancy can sometimes signal pregnancy loss, bleeding that was very light and only lasted one to two days was typically not associated with miscarriage, the study found.

Why it happens:  Sometimes, spotting happens right after fertilization, often referred to as “implantation bleeding.” “As the embryo makes its way down the uterus and implants, a small amount of bleeding can occur,” says Dr. Lawson.

Another benign reason for first-trimester spotting? Your cervix is more sensitive than usual. So a pelvic exam or sex can cause light bleeding.

What to do: Although it’s not unusual, any spotting in early pregnancy is worth a call to your doctor to rule out an ectopic pregnancy—which can be a potentially life-threatening condition. If the spotting is benign, typically you’ll be advised to keep track of it and call again if it gets heavier. In most cases, spotting doesn’t last long and goes away on its own.

Many women experience light or even severe cramping in the early stages of pregnancy. “Sometimes it can be really significant, and they’re confused because they’re having it without a period,” Lawson says.

Why it happens: There are a few theories on why cramping happens in early pregnancy, according to Dr. Lawson. One is the small amount of bleeding that occurs with implantation. “Blood is an irritant, and that can cause cramping,” she says.

Another theory has to do with the stretching of the uterus. “The uterus is a muscle, so it contracts during pregnancy,” she says. “Some women will associate that with cramping.”

What to do: If pregnancy cramps are really bothering you, try soaking in a warm bath, wrapping a hot water bottle in a towel and placing it near your abdomen or doing any kind of relaxation exercise. It’s important to make sure you’re well hydrated, too.
If none of these solutions work, know that Tylenol is generally considered safe to take during pregnancy, but always talk to your doctor before taking any medication while you’re pregnant.

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Beyond a missed period, Dr. Lawson says one of the most common, very early pregnancy signs is sore or tender breasts.

Why it happens: Blame hormones. “Breast tenderness happens because of higher levels of estrogen and progesterone in early pregnancy,” says Dr. Lawson. This tenderness is also a signal your body is starting to develop milk ducts, meaning it’s already preparing for lactation.

What to do: A supportive bra can make all the difference when you’re dealing with sore or heavy breasts, especially because breasts tend to enlarge throughout pregnancy. And the same goes for a sports bra—the one you wore for your pre-pregnancy workouts may not support you well enough now. If you’re dealing with discomfort at night, it’s okay to sleep in a bra.

Besides a good bra,  warm showers and cold compresses help, too.

Nausea is probably the most talked about early pregnancy symptom, and that’s because it’s very common: 70% of pregnant people experience what’s commonly referred to as “morning sickness” (although, for many, it lasts all day), and nausea or vomiting can be extreme in about 3% of pregnancies, according to the Cleveland Clinic.

Why it happens: When an at-home test tells you you’re pregnant, it’s because that little strip has detected the presence of the hormone human chorionic gonadotropin (HCG) in your urine. HCG levels continue to rise throughout the beginning of pregnancy—and unfortunately, high levels of HCG can lead to nausea.

“The higher your HCG levels, the more nausea you tend to have,” says Dr. Lawson. “We see higher levels of HCG in people with twins or triplets, which is why some women feel very sick with multiples, but we can also see high levels of HCG in a singleton pregnancy.”

Progesterone could also be to blame for nausea. “Progesterone levels cause relaxation of smooth muscles, which slows the transit of food through your stomach and can lead to nausea,” says Dr. Lawson.

What to do: Eat small, frequent meals throughout the day, says Rhonia Gordon, M.D., clinical assistant professor of obstetrics and gynecology at NYU Langone Health in New York City.

“If your stomach is empty, you may build up more gastric acid, which can trigger nausea,” she says. “You can also try cutting back on foods that are acidic and start incorporating natural supplements like ginger. You can put it in a smoothie or in yogurt, or you can make ginger tea or buy ginger candies, which are typically sold at health food stores.”

If nausea and vomiting are impacting your day-to-day life to the point where it’s difficult to function, talk to your doctor—they may be able to prescribe you a pregnancy-safe, anti-nausea medication.

Fatigue in pregnancy varies. While some feel only a little more tired than usual, others feel like all they want to do is sleep. “Some women report feeling really run down,” says Dr. Lawson.

Why it happens: If you’re feeling exhausted in early pregnancy, you can blame the hormone progesterone. It rises quite a bit in the first trimester, which can make many people feel tired. Your body is also working really hard: It’s developing a placenta, a fetus is starting to grow and blood volume in the body is increasing, all of which can result in fatigue.

What to do: Dr. Gordon suggests adjusting your lifestyle, making sure to eat frequently and move regularly, even if that just means going for a walk. Do your best to get enough rest at night, and if your schedule allows for it, take naps.

While that constant “I need to pee” feeling is famous for happening at the end of pregnancy when the belly puts pressure on the bladder, it’s an early pregnancy symptom, too, according to Dr. Lawson.

Why it happens: The combination of rising HCG levels and high levels of progesterone can make you need to urinate more. And while it’s early for your baby to put pressure on your bladder, your uterus is growing and expanding—and that can send you running to the bathroom more often than usual.

What to do: Avoid beverages with caffeine (caffeine is a diuretic, meaning it can make you need to urinate more often than you would normally), and if the amount of times you have to get up at night is disrupting your sleep, do your best to stop drinking fluids two to three hours before bedtime.

While every woman is different, most of these uncomfortable early pregnancy symptoms will resolve themselves by the beginning of your second trimester, if not earlier. And if you’re ever concerned about the severity of any early pregnancy symptoms, always reach out to your doctor.

Indigestion and heartburn are common pregnancy symptoms. It may present as a burning sensation or pain in the chest, feeling full and bloated, burping, bringing up food and feeling sick or vomiting.

Why it happens: Heartburn during pregnancy can occur due to hormonal changes and a growing baby pressing on the stomach. Symptoms often present soon after eating or drinking, and are most common after the 27th week of pregnancy.

What to do: Simple lifestyle changes can help prevent heartburn during pregnancy or make it less severe, including following a healthy diet, eating smaller meals more often, not eating within three hours of going to bed and avoiding caffeine, rich foods, spicy foods and fatty foods. If symptoms persist, you may want to talk to your doctor about taking antacids.

Why it happens: Mood swings are common during the early weeks of pregnancy due to changes in hormones. You’re more likely to have marked mood swings in pregnancy if you experience PMS symptoms during your periods. The mood swings of early pregnancy can also return toward the end of the third trimester.

What to do: Mood swings are expected during pregnancy, but if you have symptoms including sleep problems, changes to your eating habits or mood swings that last longer than two weeks, contact your health care provider. And don’t be afraid to ask for support from a partner or loved ones.

Why it happens: People who are pregnant can also experience hot flashes (a sudden feeling of warmth in the upper body, often the face, neck or chest) both during and after pregnancy. The cause of hot flashes is not very well understood, but is thought to be the result of hormonal changes. Generally feeling warmer during pregnancy can also be a symptom, triggered by hormones and increased blood supply to the skin.

What to do: If your temperature is higher and you think you may be pregnant, take a pregnancy test. If you have concerns about your body temperature, contact your health care provider.

Why it happens: If a pregnant person has high blood pressure before becoming pregnant or before 20 weeks of pregnancy, it’s considered chronic hypertension. People who have chronic hypertension are also at risk for preeclampsia in the second or third trimesters of pregnancy.

Preeclampsia is when a pregnant person with previously normal blood pressure develops high blood pressure and has protein in their urine, along with other symptoms. Pregnant people with chronic hypertension can also develop preeclampsia.

Those at particular risk of higher blood pressure during pregnancy include people who are having their first baby, those who have a mom or sister who had high blood pressure during pregnancy, are carrying multiples, are older than 40, are Black, were overweight before they became pregnant or who had high blood pressure before they were pregnant.

What to do: If a pregnant person has high blood pressure before becoming pregnant, it’s important that they speak with their health care provider so they can get proper treatment and control their blood pressure throughout pregnancy. If blood pressure is not under control, complications for the mother can include preeclampsia, stroke and placental abruption. For the baby, the risks are preterm birth and low birth weight.

While every person is different, most of these uncomfortable early pregnancy symptoms will resolve themselves by the beginning of your second trimester, if not earlier. And if you’re ever concerned about the severity of any early pregnancy symptoms, always reach out to your doctor.