SKIP AHEAD. . .
Let’s do a health class 101 recap: the profound union of a sperm and an egg, implanted into the lush conditions of the uterus, results in a successful pregnancy.
Whether you’ve been attempting to become pregnant with your partner, missed taking a pill while sexually active, or experienced a birth control complication (like a broken condom, failed withdrawal method, or miscalculating with FAM), symptoms of pregnancy can begin as early as 1-2 weeks after conception (1). Sperm doesn’t discriminate!
THE CATEGORIES OF PREGNANCY SYMPTOMS
With so many sensations, hormones, and messages flying around the body, it is hard to sometimes recognize that changes are occurring.
Here are three categories that can help navigate the early stages of pregnancy:
Presumptive signs — There is a possibility of pregnancy, or you could be coming down with the flu. Keep an eye on your body and for probable signs developing.
Probable signs — Most likely indicating pregnancy, again check in with your body and this might be a good time to take a pregnancy test or visit your doctor.
Positive signs — This is a confirmation of pregnancy by having a positive pregnancy test or the visualization of a fetus (via an ultrasound) done with your healthcare professional.
LET’S TALK ABOUT THE PROBABLE SIGNS OF PREGNANCY
Increased frequency of urination: As the uterus increases in size to accommodate a baby, it puts pressure on the bladder, which leads to a need to urinate more often (annoying, we know). This symptom is common towards the end of the first trimester (6).
Soft Cervix: Another probable symptom is Hegar’s sign or a soft cervix – caused by the softening in the consistency of the lower section of the uterus, which can typically be detected during a physical pelvic exam (2). It is possible to experience this symptom in conditions other than pregnancy such as leading up to a menstrual cycle.
Bloating: Similar to premenstrual fluctuations, fluid retention and bloating is a common symptom (2). This occurs due to increased levels of progesterone, which is essential as the body prepares for a healthy pregnancy. When you have a menstrual period and aren’t pregnant, the increasing progesterone levels fall along with premenstrual symptoms like bloating. If you are pregnant, these levels keep going up! Increased progesterone can also cause gas and burping. Why? Because progesterone causes smooth muscles to relax (this includes the digestive tract) causing everything to slow down to support fetal growth – things may start to feel sluggish! Drink lots of water and eat smaller meals high in fiber to try and overcome these discomforts.
Skin Changes: An onset of cystic acne can indicate a fluctuation of hormone levels and, as you’ve probably guessed, pregnancy can cause major shifts in your hormones (3). Each pregnant person’s reaction can be different, and for those who have experienced problems of acne and skin irritation before getting pregnant, these issues may actually rebalance, clearing up your skin. But that’s not all that hormonal changes can do to your skin when you’re pregnant! Skin pigmentation is also common, and dark patches may develop around the face (chloasma) and areas around the nipples, genitals, and thighs may darken (4). You may also encounter Chadwick’s sign as well (a bluish discoloration of the cervix, vagina, and labia in early pregnancy).
Mild Uterine Cramping: If you experience cramping during your menstrual cycle, this one is difficult to discern between PMS or pregnancy. 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 (9).
However, it’s important to note that these are probable signs, and not positive signs of pregnancy, meaning that they don’t mean that you’re absolutely pregnant. Every pregnant person’s experience can be different!
Other things happening in the body can also cause similar signs. A tumor can cause the uterus to grow (cue frequent urination), stomach viruses can cause abdominal discomfort, and any number of things can cause hormone shifts, which can, in turn, cause skin changes. To make sure that you are 100% pregnant, you’re going to have to see a medical professional (and more on that below).
But what if you’re experiencing other symptoms that have you thinking you’re pregnant?
If you haven’t experienced any of the above probable signs of pregnancy, it doesn’t mean that you can totally rule out being pregnant—after all, some of those signs can take 16 weeks to show up (2)! Let’s talk a bit about the presumptive signs of pregnancy, which means that you’re possibly pregnant. These symptoms can show up as early as 3 weeks after conception.
Some of the more common symptoms that tend to get uterus-havers suspicious are:
Missed period: Knowing the patterns of your menstrual cycle can help monitor any irregularities or missed periods. If a week or more has passed, this may be an indication you are pregnant. Due to our #1 pregnancy hormones Estrogen and Progesterone, the lining of the uterus becomes thick and nutritious – an ideal environment for a fertilized egg to land and grow. When there is no fertilized egg, we have a menstrual period or the shedding of the uterine wall.
Tender and swollen breasts/chest: Fluctuations in breast/chest size and sensitivity can occur as your hormones fly high in preparation for breast/chestfeeding – sensitivity can occur 1-2 weeks after conception. Estrogen stimulates the growth of the milk duct system, and progesterone controls the growth of the glandular buds (8). As pregnancy progresses, a combination of hormones such as Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) play a vital role in milk production. Your breasts/chest may continue to grow and change throughout pregnancy.
Nausea and Food Aversions: Morning sickness can begin one month after conception (2). Nausea and vomiting can begin earlier, as can aversions to certain foods or increased cravings for some interesting taste combinations. Odors can become a problem too. Human Chorionic Gonadotropin (HCG) increases rapidly at the onset of pregnancy to support the endometrial lining and maintain pregnancy. Once the placenta takes hold to nourish the fetus, HCG levels lower and nausea symptoms should pass. Hormones such as Estrogen and Cortisol (“the” stress hormone) can also impact nausea symptoms.
Mood changes: Fluctuations in mood due to hormonal changes, fatigue and the overwhelming reality that you are bringing a child into this world, can impact your emotional state. Dumping a whole bunch of hormones into your body as pregnancy develops can also impact your neurotransmitters, which are chemical messengers in the brain – this can impact mood and how you are feeling. Being mindful that this is a normal symptom of pregnancy can help you move through this emotional space.
Other presumptive signs of pregnancy include back pain, poor sleep, spotting, heartburn, nasal congestion, shortness of breath, lightheadedness, spider veins, reddening of the palms. As you can imagine, a TON of other things can cause any of these symptoms (nasal congestion? really??), so if you think that you’re pregnant you can either wait and see if any of the probable signs show up, or you can take a pregnancy test. Speaking of which…
A note about pregnancy tests: As you might know, a pregnancy test measures the levels of a hormone called Human Chorionic Gonadotropin (HCG) in your urine. HCG is released when a fertilized egg attaches to the lining of the uterus. A pregnancy test is considered 99% reliable and is less accurate if it is past the expiry date (5). If you receive a negative result and still suspect you are pregnant, re-test in a few days as levels of HCG gradually increase during pregnancy. A blood test can also indicate positive levels of HCG in your system and this is done with your health care provider.
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.
If you think you are pregnant
You have taken a pregnancy test and the result is positive.
Before you rush to the doctor, tell your best friends, or sit down with your partner or inseminating person—STOP! Take a full breath and connect with the body that you are in. How does this news make you feel? Did you plan this pregnancy and if not, what are the emotional reactions that you are experiencing? Excitement, joy, anger, fear, guilt, confusion are all valid responses to have. Being clear with how you feel is an important step to assist you in having open and informative conversations with others.
The next step is to make an appointment with an OB/GYN, Family Doctor or Midwife. At your first prenatal appointment, which you can attend on your own or with your partner, family member, or friend, your health care provider will take you through a series of tests to ensure the health of you and the baby. They will also be able to give you an indication of how far along you are in your pregnancy.
These tests may include:
- A pap smear
- Blood work to measure hormone levels, iron, and blood glucose levels
- A pregnancy test, ultrasound, blood pressure, and weight measurements
- A breast exam
- STI/STD screening including swabs for chlamydia and gonorrhea
- Blood tests for syphilis, HIV, and Hep C
It is helpful to ask why these tests are being done and if you feel uncomfortable about the procedures, make sure to voice your concern!
Your medical professional may also provide you with some options and discuss what your needs are during this time. Also, remember that you have choices: continue with the pregnancy and raise the newborn, continue with the pregnancy and develop an adoption plan for an alternate parent(s) to care for the newborn, or develop a plan to terminate the pregnancy. Figure out what is right for you and discuss it with your healthcare provider. You can never ask too many questions!
Pregnancy may not be in the cards right now, may evoke fear and vulnerability, or may be powerful and uplifting. Be honest with your feelings and if you are pregnant, start developing a plan for how you are going to proceed through this transformative stage of your life.
Written By: Emily Nam, an artist, birth worker, and writer in New York City. You can find her at communitybirthing.com.
Medically Reviewed By: Danielle LeBlanc, BScN, RN
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. American College of Obstetricians and Gynecologists. “PDF.” Washington, DC, July 2016.
2. 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.
3. 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.
4. 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.
5. 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.
6. Staff, Familydoctor.org Editorial. “Changes in Your Body During Pregnancy: First Trimester.” familydoctor.org. American Academy of Family Physicians, March 19, 2018. https://familydoctor.org/changes-in-your-body-during-pregnancy-first-trimester/.
7. ACOG Committee on Practice Bulletins—Gynecology, Sarah Prager, MD, Vanessa K. Dalton, MD, MPH, and Rebecca H. Allen, MD, MPH. “Early Pregnancy Loss.” Accessed September 10, 2019. https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Early-Pregnancy-Loss?IsMobileSet=false.
8. Hopkins Medicine Staff. “Normal Breast Development and Changes.” Johns Hopkins Medicine. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. Accessed September 10, 2019. https://www.hopkinsmedicine.org/health/conditions-and-diseases/normal-breast-development-and-changes.
9. “Braxton Hicks Contractions: Causes and Treatment.” American Pregnancy Association. American Pregnancy Association, July 15, 2019. https://americanpregnancy.org/labor-and-birth/braxton-hicks/.