What are the main symptoms of pregnancy?

CONSULTANT GYNAECOLOGIST

Mireia Galian

IVI London

From morning sickness to heartburn, from feeling exhausted to constantly having to run to the loo; the symptoms of pregnancy can seem like a long list of tribulations that have to be borne as the price you pay for the main event. However, not all of the symptoms are present all of the time and not everyone has them all. Those that do occur tend to follow a fairly well-established and predictable timeline, from early pregnancy symptoms that you could experience even before it’s official, to those that you can expect in the second and third trimesters as your pregnancy progresses through its natural stages.

Naturally enough, whether you’re longing to confirm that you have conceived, or are concerned to know that you’re not pregnant, you’re bound to be wondering how early you can get pregnancy symptoms and at what point you can really be sure.

How early can you get pregnancy symptoms?

The most reliable and obvious of the early pregnancy symptoms, especially for the majority of women who have a regular menstrual cycle, is a missed period. But there’s a lot going on in your body before this happens. If you take a home pregnancy test which is sensitive enough, it can spot elevated levels of the human chorionic gonadotropin (hCG) hormone even before you miss a period, and a blood test in a doctor’s office can also give an early result. Other early symptoms that are possible either around or just before a missed period include:

• Morning sickness: the feeling of nausea, with or without vomiting, is known as morning sickness but in fact it can happen at any time of day. Symptoms usually start at around four to six weeks, but since the first week is calculated from the first day of your last period, this could be before your first missed period.
• Food and smell aversions: these are just as common as the well-known cravings for unusual foods. You could notice an aversion to particular foods that are normally favourites such as coffee, tea or fatty foods, or have the sensation of a strange metallic taste in your mouth.
• Sore or enlarged breasts: for some women, this is part of the normal monthly menstrual cycle, but for others a feeling of swollen or sore breasts, particularly sore nipples, can be an early sign of pregnancy.

Pregnancy symptoms during the first trimester

Apart from early pregnancy symptoms which you may be on the lookout for at the beginning, there are pregnancy symptoms which you will probably experience during the first three months, usually after your pregnancy has been confirmed. These can include:

• Feeling tired: during the first 12 weeks, the hormonal changes taking place in your body can easily make you feel tired, even exhausted, for no obvious reason. The sudden change in the hormone balance can also make you feel unusually emotional or upset.
• Needing to go to the loo more frequently: increased urination occurs at a surprisingly early stage, well before the growing uterus is large enough to put pressure on your bladder. This can start at around four weeks and continue for the whole of the first trimester. It comes as a result of increased blood flow to the pelvic area and your kidneys, which increases their efficiency. You can expect a respite of a few months before the problem returns, this time caused by the expanded uterus causing pressure, at around 35 weeks.
• The increased blood flow also means your heart will be pumping harder and faster. Around week eight to 10, arrhythmia and palpitations are quite common. Unless you have an underlying heart problem, these are nothing to worry about.

Second trimester pregnancy symptoms

The next three months are often reckoned to be the most enjoyable time of pregnancy. The growing baby is still not so large that you feel uncomfortable or that daily tasks are becoming a bit of an ordeal, and most of the early pregnancy symptoms have faded or disappeared altogether. You will probably feel less tired and more up to facing the challenge of preparing for what happens after the birth. Now is a good time to start planning the details! There will, of course, be major changes in your body, including:

• A growing belly and enlarged breasts;
• The possibility of nasal or dental problems as a result of changing hormone levels and increased blood flow;
• Skin changes such as dark spots which result from increased melanin in your skin. It’s a good idea to be particularly careful about sun protection while you are pregnant.

The last three months of pregnancy

You will already have been delighted by the movements of your baby before now, but during the last three months these could become tiresome, particularly at night. Your increasing bulk may be making you feel uncomfortable and looking forward to the end of the pregnancy so you can move on to the next stage. In the meantime, some of your symptoms may include:

• Backache, heartburn, shortness of breath due to the restrictions on space for your lungs to expand, and sometimes the development of spider veins, varicose veins or haemorrhoids.
• A return of the frequent urination that you left behind at the end of the first trimester.
• Braxton Hicks contractions: mild contractions which you will probably experience just as a feeling of tightness in your stomach. These tend to become more frequent and stronger as your due date approaches.

And if you’re not pregnant after all?

If the early symptoms of pregnancy are what you were hoping for and it is still not happening, don’t lose heart. The NHS advises that you keep trying for a year (or six months if you are over 35) before seeking help. If the time is right for you, do browse our website to gen up on which tests, treatments and services may be suitable for your particular circumstances. Or just get in touch with us at IVI. It’s easy to use our online contact form to ask for more information, or simply give us a call on 0800 52 00 161.