Early signs of pregnancy: what you notice first

Short answer: the first and most reliable sign is a missed period. On top of that many women notice tender breasts, tiredness, peeing more and nausea in the first weeks. The tricky part: many of those symptoms look like PMS. Only a pregnancy test gives certainty, and it is most reliable from the day your period was due.

The first signs at a glance

1. Your period does not come

With a regular cycle this is usually the first thing you notice. With an irregular cycle it is harder to see. Not sure when your period was due? Read when will I get my period.

2. Tender, swollen breasts

Your breasts can feel fuller, heavier or sore early on, and the area around your nipples can darken. It looks like breast tenderness before your period, but it carries on when your period does not come.

3. Tired, very tired

Especially in the first three months many women feel unusually tired, even after a good night. Your body is working hard and the hormone progesterone makes you sleepy.

4. Nausea

Nausea or vomiting starts for many women around four to six weeks of pregnancy, counted from the first day of your last period. It is called morning sickness, but it can happen at any time of day. Not everyone gets it.

5. Peeing more often

In the first weeks you often need the toilet more, because of hormones and more blood flow to your kidneys.

6. A strange taste and new cravings

A metallic taste in your mouth, suddenly disliking coffee or the smell of certain food, or craving something you normally do not eat.

7. A little bleeding or cramps

Around the time your period is due, some women lose a little blood or brown discharge. That can be implantation bleeding. Read implantation bleeding or period. Mild cramps, like before a period, also happen.

8. Mood swings, bloating

Also well known early symptoms, and also very similar to PMS.

Pregnant or PMS?

Tender breasts, tiredness, bloating, mood swings: they fit both. You cannot reliably tell the difference from symptoms alone. What does help:

• Timing. PMS symptoms usually fade once your period starts. In pregnancy the period does not come and the symptoms carry on.
• Nausea and a strange taste fit PMS less.
• Your own pattern. If you track your cycle, you see whether this is different from other months. See recognising PMS symptoms.

When to take a pregnancy test

A pregnancy test measures the hormone hCG in your urine. You only make it after the embryo has implanted, and the amount then rises quickly.

• Most tests are reliable from the first day your period was due.
• Do not know when that is? Test about three weeks after the sex that could have made you pregnant.
• Testing early? Use first morning urine. It is the most concentrated.
• Negative test and no period? Test again after a few days to a week. If you were too early, there may not be enough hCG yet.

A positive test is almost always right. A false negative is more common, usually because you tested too early.

Positive. Now what?

In the Netherlands you can contact a midwife directly, without a referral. Do it in the first weeks, then you plan the first check and the scan together. Elsewhere, contact your doctor or midwife. Not taking folic acid yet? Start straight away; the Dutch advice is 0.4 milligrams a day until ten weeks of pregnancy. On medication? Ask your doctor whether it can continue.

When to call straight away

Call your doctor, midwife or out of hours service straight away if you could be pregnant and:

• you have severe pain on one side of your lower belly;
• you have pain in the tip of your shoulder;
• you are bleeding heavily;
• you feel dizzy or faint.

That can point to an ectopic pregnancy or a miscarriage, and you want to be seen quickly. Also get in touch if you are vomiting so much that you cannot keep anything down.

Period still missing and the test is negative?

That happens more often than you think. Stress, illness, travel, weight loss, heavy exercise or just stopping the pill can move your cycle. Read missed period and not pregnant. If your period stays away for three months, see your doctor.

From cycle to pregnancy in one app

If you track your cycle, you see straight away that you are later than usual and you can test at the right moment. Once you are pregnant, PERIOD. baby follows your pregnancy week by week, in the same app and with the same data. It stays in the EU and is never sold. Still trying? Read how long it takes to get pregnant.

Sources: NHS, Signs and symptoms of pregnancy, Doing a pregnancy test and Ectopic pregnancy; Thuisarts.nl (Dutch College of General Practitioners), Pregnant; ACOG, Morning Sickness; RIVM, folic acid advice. This article is general information and not medical advice. In doubt? Call your doctor or midwife.

FAQ

What are the very first signs of pregnancy?

The most reliable sign is a missed period. On top of that many women notice tender breasts, tiredness, peeing more and nausea.

How soon after sex do you notice you are pregnant?

Most early symptoms start around the time of your missed period or in the weeks after. Nausea often starts around four to six weeks of pregnancy, counted from your last period.

When is a pregnancy test reliable?

From the first day your period was due. If you do not know when that is, test about three weeks after sex.

Can I be pregnant and still bleed?

Yes. A little bleeding around your expected period can be implantation bleeding. With heavy bleeding or pain, contact your doctor or midwife straight away.

Want to know when you can test, and then follow your pregnancy? Download PERIOD. on the App Store or on Google Play.