SKIP AHEAD. . .
What are the categories of pregnancy symptoms?
The possibility of being pregnant can mean different things to different people. Whether it’s the moment you’ve actively been trying for or one you’re hoping is not the case, we can all agree pregnancy is a big deal for the body. Supporting a fetus is a full team effort from start to finish, so the symptoms can show up early and sometimes in ways you wouldn’t expect. Sounds like a party!
Symptoms that point to pregnancy are divided into three categories (1):
Presumptive signs: It’s possible your pregnant, but don’t facetime your squad just yet. These can start as early as a few days after conception.
Probable signs: The chances you’re pregnant are high, so pee on a stick and call the midwife or doctor to confirm. These start a couple of weeks after conception.
Positive signs: You’re pregnant, pregnant. These signs are more definite and include seeing the fetus on an ultrasound. We can see these around the 8-week mark.
Let’s tackle the earliest signs: presumptive. These can be tricky because it could be a sign of early pregnancy OR be related to other factors like a hormonal cycle and stress—confusing, huh?
P.S. No matter what set of signs you’re experiencing, know that it’s fantastic that you’re listening to your body! It also never hurts to stop by a clinic or see your care provider to ease (or vindicate) your mind at any point in time.
Presumptive signs of pregnancy
Late or missed period: This is the most obvious sign of pregnancy and the one we tend to expect. When you’re about to start your menstrual period, pregnancy hormones estrogen and progesterone make the uterus nice and welcoming (thick and nutritious) for the potential fertilized egg (5). Usually, this egg doesn’t come and the uterine wall shreds, causing your period. But if an egg is fertilized, the wall has no need to shed and you miss your period (and potentially several more after).
However, a late or missed period could also be due to other internal and external factors like an irregular cycle, extreme stress, change in birth control, or changes in weight. It should be noted that a knowledge of your cycle will help you spot this sign. If you know what “normal” looks like for you, you’ll know when something is amiss (or missed altogether).
Fatigue: When you PMS, you can feel fatigued because your progesterone levels skyrocket, making you feel like hitting the snooze button about 10 more times (2). Usually, the progesterone levels come down when your period starts, but not if you have a fetus. Your body is producing more blood to carry nutrients to the embryo, and your blood pressure and blood sugar are probably also lower (2). Fatigue can also cause, or feel like, lightheadedness. However, as we mentioned before, this could be a PMS symptom or even something like a seasonal cold, the flu, heat exhaustion, or having long periods of disrupted/no so sleep.
Breast/chest tenderness or swelling: Another sign that can go two ways. Breast/chest tenderness can be a sign of PMS. However, even in the early stages of pregnancy, the milk ducts are getting prepped and ready for future lactation (breast/chestfeeding), so they grow and stretch making you feel sore or tender (3).
Frequent urination: When the uterus increases to make room for the fetus, the pressure it puts on the bladder can have you running in and out of the loo. This will continue throughout pregnancy as well (1). However, kidney/bladder stones, a UTI, some STDs/STIs, or even an increase in anxiety can be the cause (4). Definitely take a note of all your symptoms, because you may not be pregnant but something else could need checking out.
Food/Alcohol aversions: In the early stages of pregnancy, your hormones are on a rollercoaster and trying to adjust quickly. Like other presumptive signs, food (and even some odors) aversions can come on strong at first. The rapid increase in Human Chorionic Gonadotropin (HCG) to support the endometrial lining and maintain pregnancy can put you off your favorite salmon dish.
Nausea / stomach problems: Morning sickness (which can happen any time of day, go figure) can start about a month after conception. It should be noted that some people never feel nausea, and some feel it early on (1). So, you could be coming down with a stomach virus, the flu, food poisoning, etc. and not a fetus, but the absence of morning sickness shouldn’t be an indicator that you aren’t preggers. Estrogen and cortisol (the stress hormone) can make you feel ill on any given day. But, the rapid increase in Human Chorionic Gonadotropin (HCG) that we mentioned above can also be the culprit. Once the placenta takes hold to nourish the fetus, HCG levels lower and nausea symptoms should pass.
Probable signs of pregnancy
So you’re getting that feeling that maybe you’re a couple of weeks into your first trimester, what’s next? As time goes on, you can expect signs such as:
Bloating, minor weight gain, or softness of the stomach: Similar to fatigue, bloating and fluid retention can start as a PMS symptom that occurs when progesterone increases (1). However, if you have a fetus, the progesterone levels don’t lower, they increase to prep for the fetus.
Light spotting or bleeding: This can be a sign of early implantation. Vaginal bleeding is common in the first trimester in 20-40% of women and can be a combination of light, medium, or heavy flow with pain or painless (5). This can be confused with a period early on.
Mild Uterine Cramping: Another PMS symptom gone rogue! This form of cramping can be hard to discern especially if you’re usually someone who cramps before/during your “normal” menstrual cycle. Discomfort during the early stages of pregnancy can be due to the uterus expanding to accommodate the growing fetus, causing ligaments and muscles that support it to stretch. Braxton-hicks contractions (painless uterine contractions) are also a symptom of pregnancy and can start as early as 16 weeks (6).
Skin Changes: We all know how temperamental skin can be. A big exam or even a glance at greasy french fries can cause a pimple or breakout. It’s no surprise major hormonal shifts from pregnancy would do the same. An onset of cystic acne can indicate fluctuation in hormone levels (7). However, if you’ve experienced problems of acne and skin irritation before getting pregnant, these issues may actually rebalance and clear the skin. Cue that stellar glow!
Also, cue possible skin pigmentation and possible dark patches around the face (chloasma) and areas around the nipples, genitals, and thighs (8). You may also encounter Chadwick’s sign as well (a bluish discoloration of the cervix, vagina, and labia in early pregnancy).
What are positive signs of pregnancy?
- Fetal heartbeat
- Visualization of fetus through ultrasound
- Positive pregnancy test
If you think you are pregnant...
You’ve read the signs and it’s looking likely. What’s next?
Take a pregnancy test
Let’s start by confirming the pregnancy with an at-home test (or skip to seeing your care provider). Pregnancy tests measure the levels of that HGC hormone (the one that can cause nausea) in your urine. When a fertilized egg attaches to the uterine lining, HCG is released and can show up in your urine. Though pregnancy tests are 99% accurate (less if expired so check those dates!), doing a retest or two never hurts.
Allbodies resident badass, Danielle LeBlanc BScN RN, also notes that it’s important to know that urine pregnancy tests are qualitative, not quantitive – meaning they can only tell us whether or not beta HCG is present, but not how much. This becomes an issue when people are trying to rule out pregnancies shortly after abortions or miscarriages because it can take weeks before beta HCG levels reach zero/undetectable.
See your care provider
If the urine test comes back negative but you believe you could be pregnant, you can retest a few days later with another (not expired) at-home test. However, you may also want to call your midwife, gynecologist, or another care provider for a blood test that can indicate positive levels of HCG in your system at lower levels (9). You may even want to see your provider if the pregnancy test is positive, cause they can perform an ultrasound which can tell with complete certainty whether or not you’re pregnant.
If you don’t have a regular care provider, clinics like those provided by Planned Parenthood offer affordable services to the communities they serve. Not insured or underinsured? They have your back, and your health is the top priority.
Take a breath and ask for help if needed
Wow, that was a lot! Take a full breath and take a moment to connect with your body and answer some questions. Are you showing any signs of pregnancy? What are your next steps going to be? How are you feeling and is this what you were expecting? There are so many resources out there no matter what you choose and where you are. Head over to allbodies’ “find help” center to get access to professionals specializing in talk therapy, pregnancy support, and much more.
Contributed by: Gretchen Decker and Teri Bradford
Medically reviewed by: Danielle LeBlanc, BScN RN (she/hers)
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
1.Mayo Staff Clinic. “Symptoms of Pregnancy: What Happens First.” Mayo Clinic. Mayo Foundation for Medical Education and Research, May 11, 2019. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of- pregnancy/art-20043853.
2. “Fatigue During Pregnancy.” American Pregnancy Association, July 16, 2019. https://americanpregnancy.org/your-pregnancy/fatigue-during-pregnancy/.
3. “Breast Changes During Pregnancy.” American Pregnancy Association, July 15, 2019. https://americanpregnancy.org/pregnancy-health/breast-changes-during-pregnancy/.
4. PhD, Catharine Paddock. “Frequent Urination: Causes, Symptoms, and Treatment.” Medical News Today. MediLexicon International, November 16, 2018. https://www.medicalnewstoday.com/articles/70782.php.
5. “Pregnancy Symptoms – Early Signs of Pregnancy.” American Pregnancy Association, August 30, 2019. https://americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/.
6. “Braxton Hicks Contractions: Causes and Treatment.” American Pregnancy Association. American Pregnancy Association, July 15, 2019. https://americanpregnancy.org/labor-and-birth/braxton-hicks/.
7. U.S. Department of Health and Human Services. “Acne: MedlinePlus Medical Encyclopedia.” MedlinePlus. U.S. National Library of Medicine, September 3, 2019. https://medlineplus.gov/ency/article/000873.htm.
8. Mayo Clinic Staff. “Skin Changes during Pregnancy: What Can You Expect?” Mayo Clinic. Mayo Foundation for Medical Education and Research, May 11, 2018. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/skin-changes-during-pregnancy/faq-20416440.
9. Parenthood, Planned. “When to Take a Pregnancy Test: Options, Cost and Accuracy.” Planned Parenthood. Planned Parenthood Federation of America Inc. Accessed September 10, 2019. https://www.plannedparenthood.org/learn/pregnancy/pregnancy-tests.