Pregnancy

Pregnancy begins after implantation and lasts about 40 weeks. Knowing what to expect can help protect your health and the baby’s health.

Pregnancy occurs when a sperm fertilizes an egg after it’s released from the ovary during ovulation. The fertilized egg then travels down into the uterus, where implantation occurs. A successful implantation results in pregnancy.

Many factors can affect a pregnancy. Women who receive an early pregnancy diagnosis and prenatal care are more likely to experience a healthy pregnancy and give birth to a healthy baby.

If you’d like to prevent pregnancy, there are effective forms of birth control to consider.

Symptoms of pregnancy

You may notice some signs and symptoms before you even take a pregnancy test. Others will appear weeks later, as your hormone levels change.

Missed period

A missed period is one of the earliest symptoms of pregnancy (and maybe the most classic one). However, a missed period doesn’t necessarily mean you’re pregnant, especially if your cycle tends to be irregular.

There are many health conditions other than pregnancy that can cause a late or missed period.

Headache

Headaches are common in early pregnancy. They’re usually caused by altered hormone levels and increased blood volume. Contact your doctor if your headaches don’t go away or are especially painful.

Spotting

Some women may experience light bleeding and spotting in early pregnancy. This bleeding is most often the result of implantation. Implantation usually occurs one to two weeks after fertilization.

Early pregnancy bleeding can also result from relatively minor conditions such as an infection or irritation. The latter often affects the surface of the cervix (which is very sensitive during pregnancy).

Bleeding can also sometimes signal a serious pregnancy complication, such as miscarriage, ectopic pregnancy, or placenta previa. Always contact your doctor if you’re concerned.

Weight gain

You can expect to gain between 1 and 4 pounds in your first few months of pregnancy. Weight gain becomes more noticeable toward the beginning of your second trimester.

Pregnancy-induced hypertension

High blood pressure, or hypertension, sometimes develops during pregnancy. A number of factors can increase your risk, including:

• being overweight or obese
• smoking
• having a prior history or a family history of pregnancy-induced hypertension

Heartburn

Hormones released during pregnancy can sometimes relax the valve between your stomach and esophagus. When stomach acid leaks out, this can result in heartburn.

Constipation

Hormone changes during early pregnancy can slow down your digestive system. As a result, you may become constipated.

Cramps

As the muscles in your uterus begin to stretch and expand, you may feel a pulling sensation that resembles menstrual cramps. If spotting or bleeding occurs alongside your cramps, it could signal a miscarriage or an ectopic pregnancy.

Back pain

Hormones and stress on the muscles are the biggest causes of back pain in early pregnancy. Later on, your increased weight and shifted center of gravity may add to your back pain. Around half of all pregnant women report back pain during their pregnancy.

Anemia

Pregnant women have an increased risk of anemia, which causes symptoms such as lightheadedness and dizziness.

The condition can lead to premature birth and low birth weight. Prenatal care usually involves screening for anemia.

Depression

Between 14 and 23 percent of all pregnant women develop depression during their pregnancy. The many biological and emotional changes you experience can be contributing causes.

Be sure to tell your doctor if you don’t feel like your usual self.

Insomnia

Insomnia is another common symptom of early pregnancy. Stress, physical discomfort, and hormonal changes can be contributing causes. A balanced diet, good sleep habits, and yoga stretches can all help you get a good night’s sleep.

Breast changes

Breast changes are one of the first noticeable signs of pregnancy. Even before you’re far enough along for a positive test, your breasts may begin to feel tender, swollen, and generally heavy or full. Your nipples may also become larger and more sensitive, and the areolae may darken.

Acne

Because of increased androgen hormones, many women experience acne in early pregnancy. These hormones can make your skin oilier, which can clog pores. Pregnancy acne is usually temporary and clears up after the baby is born.

Vomiting

Vomiting is a component of “morning sickness,” a common symptom that usually appears within the first four months. Morning sickness is often the first sign that you’re pregnant. Increased hormones during early pregnancy are the main cause.

Hip pain

Hip pain is common during pregnancy and tends to increase in late pregnancy. It can have a variety of causes, including:

• pressure on your ligaments
• sciatica
• changes in your posture
• a heavier uterus

Diarrhea

Diarrhea and other digestive difficulties occur frequently during pregnancy. Hormone changes, a different diet, and added stress are all possible explanations. If diarrhea lasts more than a few days, contact your doctor to make sure you don’t become dehydrated.

Stress and pregnancy

While pregnancy is usually a happy time, it can also be a source of stress. A new baby means big changes to your body, your personal relationships, and even your finances. Don’t hesitate to ask your doctor for help if you begin to feel overwhelmed.

The bottom line

If you think you may be pregnant, you shouldn’t rely solely on these signs and symptoms for confirmation. Taking a home pregnancy test or seeing your doctor for lab testing can confirm a possible pregnancy.

Many of these signs and symptoms can also be caused by other health conditions, such as premenstrual syndrome (PMS). 

Pregnancy Symptoms: 10 Early Signs That You May Be Pregnant

Pregnancy week by week

Pregnancy weeks are grouped into three trimesters, each one with medical milestones for both you and the baby.

First trimester

A baby grows rapidly during the first trimester (weeks 1 to 12). The fetus begins developing their brain, spinal cord, and organs. The baby’s heart will also begin to beat.

During the first trimester, the probability of a miscarriage is relatively high. According to the American College of Obstetricians and Gynecologists (ACOG), it’s estimated that about 1 in 10 pregnancies end in miscarriage, and that about 85 percent of these occur in the first trimester.

Seek immediate help if you experience the symptoms of miscarriage.

Second trimester

During the second trimester of pregnancy (weeks 13 to 27), your healthcare provider will likely perform an anatomy scan ultrasound.

This test checks the fetus’s body for any developmental abnormalities. The test results can also reveal the sex of your baby, if you wish to find out before the baby is born.

You’ll probably begin to feel your baby move, kick, and punch inside of your uterus.

After 23 weeks, a baby in utero is considered “viable.” This means that it could survive living outside of your womb. Babies born this early often have serious medical issues. Your baby has a much better chance of being born healthy the longer you are able to carry the pregnancy.

Third trimester

During the third trimester (weeks 28 to 40), your weight gain will accelerate, and you may feel more tired.

Your baby can now sense light as well as open and close their eyes. Their bones are also formed.

As labor approaches, you may feel pelvic discomfort, and your feet may swell. Contractions that don’t lead to labor, known as Braxton-Hicks contractions, may start to occur in the weeks before you deliver.

Pregnancy and vaginal discharge

An increase in vaginal discharge is one of the earliest signs of pregnancy. Your production of discharge may increase as early as one to two weeks after conception, before you’ve even missed a period.

As your pregnancy progresses, you’ll continue to produce increasing amounts of discharge. The discharge will also tend to become thicker and occur more frequently. It’s usually heaviest at the end of your pregnancy.

During the final weeks of your pregnancy, your discharge may contain streaks of thick mucus and blood. This is called “the bloody show.” It can be an early sign of labor. You should let your doctor know if you have any bleeding.

Normal vaginal discharge, or leukorrhea, is thin and either clear or milky white. It’s also mild-smelling.

If your discharge is yellow, green, or gray with a strong, unpleasant odor, it’s considered abnormal. Abnormal discharge can be a sign of an infection or a problem with your pregnancy, especially if there’s redness, itching, or vulvar swelling.

If you think you have abnormal vaginal discharge, let your healthcare provider know immediately. 

Pregnancy and urinary tract infections (UTIs)

Urinary tract infections (UTIs) are one of the most common complications women experience during pregnancy. Bacteria can get inside a woman’s urethra, or urinary tract, and can move up into the bladder. The fetus puts added pressure on the bladder, which can cause the bacteria to be trapped, causing an infection.

Symptoms of a UTI usually include pain and burning or frequent urination. You may also experience:

• cloudy or blood-tinged urine
• pelvic pain
• lower back pain
• fever
• nausea and vomiting

Nearly 18 percent of pregnant women develop a UTI. You can help prevent these infections by emptying your bladder frequently, especially before and after sex. Drink plenty of water to stay hydrated. Avoid using douches and harsh soaps in the genital area.

Contact your healthcare provider if you have symptoms of a UTI. Infections during pregnancy can be dangerous because they increase the risk of premature labor.

When caught early, most UTIs can be treated with antibiotics that are effective against bacteria but still safe for use during pregnancy.

Pregnancy prevention

Women who have male sexual partners should consider birth control if they’re not interested in becoming pregnant.

Some methods of pregnancy prevention work better for certain individuals. Talk to your doctor about birth control that’s right for you. A few of the most common birth control methods are discussed below:

Birth control method	Effectiveness rate
Intrauterine devices (IUDs)	Over 99 percent
The pill	99 percent with perfect use; around 91 percent with typical use
Male condom	98 percent with perfect use; around 82 percentTrusted SourceTrusted Source with typical use
Female condom (or internal condom)	95 percent effective with perfect use; around 79 percent with typical use
Morning-after pill	Up to 95 percent (taken within one day of sexual contact); 75 to 89 percent (taken within three days)
Natural family planning (NFP)	75 percent when used on its own

Intrauterine devices (IUDs)

Intrauterine devices (IUDs) work by mostly by stopping fertilization. They’re currently the most effective form of birth control. The downside is that they don’t prevent sexually transmitted diseases (STDs).

The pill and other hormonal birth control methods

Birth control pills, patches and the vaginal ring work by controlling the hormone levels in a woman’s body. They’re available by prescription.

Actions that can reduce the effectiveness of these methods include forgetting to use them as prescribed. Effectiveness rates that mention “typical use” account for these types of human errors.

Other forms of hormonal birth control include the patch and the vaginal ring. They’re also available by prescription, and their effectiveness rates are similar to those of the pill.

Condoms and other barrier methods

Condoms, diaphragms, and sponges are convenient and inexpensive forms of birth control that can be bought without a prescription.

They’re most effective when used correctly every time you have sexual intercourse. If you’re relying on these barrier methods to avoid getting pregnant, also consider using an additional method of contraception such as spermicide or a birth control pill.

Other barrier methods include diaphragms and sponges. They can be bought without a prescription.

Emergency contraception

Several morning-after pills are available, both over the counter and by prescription. These pills aren’t intended as regular forms of birth control. Instead, they can act as a backup if you have unprotected sex or forget to use your regular form of birth control.

They must be used within 120 hours (five days) of sexual contact to be effective. Some pills are most effective when taken within 72 hours (three days).

Natural family planning (NFP)

Natural family planning (NFP), or fertility awareness, is the birth control method with the highest failure rate. With NFP, a woman tracks her menstrual cycle so that she can predict when she’ll ovulate. She’ll then avoid intercourse during her fertile window.

Accidental pregnancies can occur because there are many variables affecting a woman’s cycle from month to month.

The bottom line

Condoms are the only birth control method that both prevent pregnancy and protect against STDs. Discover the safest condoms on the market here.

Pregnancy or PMS

The symptoms of early pregnancy can often mimic those of premenstrual syndrome (PMS). It may be difficult for a woman to know if she’s pregnant or simply experiencing the onset of another menstrual period.

It’s important for a woman to know as soon as possible if she’s pregnant so that she can get proper prenatal care. She may also want to make certain lifestyle changes, such as abstaining from alcohol, taking prenatal vitamins, and optimizing her diet.

Taking a pregnancy test is the best, and easiest, way to determine if it’s PMS or early pregnancy. You can take a home test or visit your healthcare provider.

Some common symptoms of both PMS and early pregnancy include:

• breast pain
• bleeding
• mood changes
• fatigue
• food sensitivities
• cramping

Early pregnancy and PMS are often difficult to tell apart. Learn to distinguish between the two with the help of this Venn diagram.

Pregnancy diet

A healthy pregnancy diet should be much the same as your typical healthy diet, only with 340 to 450 additional calories per day. Aim for a healthy mix of foods, including:

• complex carbohydrates
• protein
• vegetables and fruits
• grains and legumes
• healthy fats

If you already eat a healthy diet, you’ll only need to make slight changes. Fluids, fiber, and iron-rich foods are especially important during pregnancy.

Vitamins and minerals

Pregnant women require larger amounts of some vitamins and minerals than women who aren’t pregnant. Folic acid and zinc are just two examples.

Once you find out you’re pregnant, you may wish to increase your vitamin and mineral intake with the help of supplements. Be sure to read nutrition labels and seek your doctor’s advice before using any supplements or over-the-counter (OTC) medications.

Although rare, taking supplements could result in vitamin toxicity or overdose. However, a complete prenatal vitamin will probably contain a good mix of the nutrients that you need for a healthy pregnancy.

The bottom line

Taking care of yourself is one of the best ways to take care of your growing baby. Discover the 18 vitamins and minerals that lay the foundation for an optimal pregnancy diet.

Pregnancy and exercise

Exercise is essential to keeping you fit, relaxed, and ready for labor. Yoga stretches in particular will help you stay limber. It’s important not to overdo your stretches, however, as you could risk injury.

Other good exercises for pregnancy are gentle Pilates, walking, and swimming.

You may need to modify your current fitness routine to accommodate your changing body and lower energy levels. Work with your healthcare provider or a personal trainer to ensure that you aren’t overexerting yourself. Get more ideas for staying fit in your first trimester.

Pregnancy massage

Practicing relaxation techniques can help relieve some of the stress and anxiety you may feel throughout your pregnancy.

If you’re searching for ways to stay calm, consider trying a prenatal massage. A prenatal massage is good for relieving mild tension. It may also help ease your body and muscle aches.

Massages are generally safe at any time during your pregnancy. Some facilities avoid performing them in the first trimester because the risk of miscarriage is highest during this period.

Getting your doctor’s approval before you get a massage is a good idea, especially if you’ve had pain in your calves or other parts of your legs.

Essential oils

Using essential oils during pregnancy is controversial. Some healthcare professionals say that certain oils can be safe and helpful for relaxing and alleviating pain during pregnancy and labor. However, they also warn against using the oils in the first trimester.

According to the nonprofit National Association for Holistic Aromatherapy, the main point of contention is whether oils used during pregnancy can harm the growing baby if they cross over into the placenta.

More research is needed about using essential oils during pregnancy and labor. If you plan to use them, seek guidance from your healthcare provider.

The bottom line

Prenatal massage can be a soothing and tranquil part of your pregnancy routine, with or without the essential oils. See how it compares to other types of massage here.

When to seek medical care

Most women in their 20s or early 30s have a good chance of a problem-free pregnancy. Teens and women over the age of 35 are at a higher risk for health complications.

Underlying conditions

Underlying health conditions such as high blood pressure, diabetes, or cardiovascular disease will increase your risk of pregnancy complications. Other examples include:

• cancer
• kidney disease
• epilepsy

If you have one of these conditions, ensure that it’s properly monitored and treated throughout your pregnancy. Otherwise, it can lead to miscarriage, poor fetal growth, and birth defects.

Other risk factors

Other factors that can affect an otherwise healthy pregnancy include:

• multiple-birth pregnancies, such as twins or triplets
• infections, including STDs
• being overweight or obese
• anemia

Pregnancy complications

Pregnancy complications can involve the baby’s health, the mother’s health, or both. They can occur during pregnancy or delivery.

Common pregnancy complications include:

• high blood pressure
• gestational diabetes
• preeclampsia
• preterm labor
• miscarriage

Addressing them early can minimize the harms done to the mother or the baby. Know your options when it comes to treating pregnancy complications.

Pregnancy and labor

Sometime after your fourth month of pregnancy, you may begin to experience Braxton-Hicks contractions, or false labor. They’re completely normal and serve to prepare your uterus for the job ahead of real labor.

Braxton-Hicks contractions don’t occur at regular intervals, and they don’t increase in intensity. If you experience regular contractions before week 37, it could be preterm labor. If this occurs, call your healthcare provider for help.

Early labor

Labor contractions are generally classified as early labor contractions and active labor contractions. Early labor contractions last between 30 and 45 seconds. They may be far apart at first, but by the end of early labor, contractions will be about five minutes apart.

Your water might break early during labor, or your doctor may break it for you later on during your labor. When the cervix begins to open, you’ll see a blood-tinged discharge coating your mucous plug.

Active labor

In active labor, the cervix dilates, and the contractions get closer together and become more intense.

If you’re in active labor, you should call your healthcare provider and head to your birth setting. If you’re unsure whether it’s active labor, it’s still a good idea to call and check in.

Labor pain

Pain will be at its height during active labor. Have a discussion with your doctor about your preferred method of dealing with pain.

You may choose drug-free measures such as meditation, yoga, or listening to music.

If you choose to manage your pain with drugs, your doctor will need to know whether to use analgesics or anesthetics.

Analgesics, such as meperidine (Demerol), dull the pain but allow you to retain some feeling. Anesthetics, such as an epidural, prevent certain muscle movement and completely block the pain.

The bottom line

Whether you’re planning for a vaginal or a cesarean delivery, you may feel nervous as your due date approaches. Know what to expect with this guide to the different stages of labor.

Prognosis

You’re likely to move through each week of your pregnancy without too much trouble. Pregnancy brings with it many changes to your body, but those changes don’t always have a serious impact on your health.

However, certain lifestyle choices can either help or actively harm your baby’s development.

Some actions that can keep you and your baby healthy include:

• taking a multivitamin
• getting sufficient sleep
• practicing safe sex
• getting a flu shot
• visiting your dentist

Some things you’ll want to avoid include:

• smoking
• drinking alcohol
• eating raw meat, deli meat, or unpasteurized dairy products
• sitting in a hot tub or sauna
• gaining too much weight

Medications

It can be hard to determine which medications you can take during pregnancy and which ones you should avoid. You’ll have to weigh the benefits to your health against potential risks to the developing baby.

Ask your healthcare provider about any drugs you may take, even OTC ones for minor ailments such as headaches.

According to the Food and Drug Administration (FDA)Trusted SourceTrusted Source, each year 50 percent of pregnant women in the United States report taking at least one medication.

In the 1970s, the FDA created a letter systemTrusted SourceTrusted Source to categorize drugs and their perceived risk to pregnant women. However, they began to phase out this letter system (and use updated drug labeling) in 2015. Their new rules for drug labelingTrusted SourceTrusted Source only apply to prescription drugs.

The service MotherToBaby also provides up-to-date information on the safety of specific drugs.

The bottom line

Learning or relearning all the rules of pregnancy can be overwhelming, especially if you’re having your first child. Feel more prepared with this handy list of pregnancy do’s and don’ts.

The takeaway

Under the Affordable Care Act (ACA), all health insurance plans in the United States are required to offer some level of prenatal care.

Once your pregnancy’s been confirmed, call your insurance provider to get an idea of what’s covered by your specific plan. If you don’t have health insurance when you find out you’re pregnant, speak to your doctor about steps you can take to get coverage.

The timing of your first prenatal visit may depend on your overall health. Most women may have their first visit during week 8 of pregnancy. Women whose pregnancies are considered high-risk, such as those who are over 35 or have chronic conditions, may be asked to see their doctors earlier.

There are many ways to mentally and physically prepare for labor. Many hospitals offer birthing classes prior to delivery so that women may better understand the signs and stages of labor.

In your third trimester, you may want to prepare a hospital bag of toiletries, sleepwear, and other everyday essentials. This bag would be ready to take with you when labor begins. During the third trimester, you and your doctor should also discuss your labor and delivery plan in detail.

Knowing when to go to the birth setting, who’ll be assisting in the birth, and what role your doctor will play in the process can contribute to greater peace of mind as you enter those final weeks.