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Pregnancy Symptoms: The First Signs You Should Never Ignore

By Natasha Burton ; Updated June 20, 2018

At some point in most women’s lives — whether they experience pregnancy symptoms or not — they’ll ask themselves the question, “Am I pregnant?” Discovering whether or not you’ve conceived is not so much about guesswork as it is understanding the early signs of pregnancy and following expert advice so you can definitively know if you are, indeed, pregnant.

Some women are excited to start a family and hope to get that so-called “big, fat positive.” Others may experience an unplanned pregnancy. No matter your feelings about pregnancy, getting answers about what is going on in your body is important for your peace of mind and for your potential future child. That’s why it’s so crucial to know exactly which pregnancy symptoms to look for — and what they might mean if you’re not actually pregnant.

Here’s what you need to know about these common signs that you’re pregnant and what to do if you experience them.

The Most Common First Signs of Pregnancy

If you think you may be pregnant, there are a few first signs of pregnancy that you can look out for. Lynn L. Simpson, M.D., chief of obstetrics at Columbia University Medical Center, says that the most common sign you’re pregnant is a missed period. A period is typically considered late if you haven’t started menstruating five days after your period is scheduled to start, according to Summit Medical Group. Other early signs of pregnancy are nausea, fatigue and breast tenderness, Dr. Simpson says, noting that these are the most common.

Another sign of pregnancy is bleeding, which can sometimes be mistaken for a period. “Light bleeding in early pregnancy affects about a quarter of all women,” Dr. Simpson says. “Spotting can be associated with implantation of the embryo into the wall of the uterus, but this bleeding is usually small in amount and duration.” If the bleeding you experience doesn’t look like your normal period, it may instead be an early sign of pregnancy.

Alternatively, if the bleeding is especially heavy, it could be an early miscarriage, she says, explaining that studies show that about 15 percent of all first-trimester pregnancies don’t make it to term. For this reason, she advises getting expert help if this symptom occurs. “All pregnant women with bleeding and cramping early in pregnancy should see their doctor for evaluation and advice,” she says.

The Early Signs of Pregnancy Explained

As much as science has taught us about the human body, we still do not fully understand the root cause of all of the pregnancy symptoms. “Experts believe that many are related to the hormonal changes that are taking place soon after conception,” Simpson says.

Once pregnancy occurs, chemical changes begin in the body to support and grow the fetus into a baby. But the way these signs of pregnancy manifest varies, and some women don’t have any symptoms at all, except for a missed period.

“All of these symptoms — feeling tired or nauseous and having increased breast tenderness — can show up during the first trimester; exact timing is really variable from woman to woman,” says Mary Jane Minkin, M.D., clinical professor of obstetrics at Yale. “And the other important thing to remember is that you don’t have to have any of these pregnancy symptoms.”

Simpson agrees. “Doctors often associate these symptoms with a ‘healthy’ pregnancy that is producing appropriate level of hormones,” she says. “However, women can respond differently to these hormonal changes, and a lack of signs and symptoms does not necessarily indicate a problem with the pregnancy.”

Other Common Pregnancy Symptoms

Additional signs and pregnancy symptoms include increased fatigue, moodiness, nausea, vomiting, aversion to certain smells and foods and lightheadedness. “The pregnancy hormone, or human chorionic gonadotropin (hCG), may be responsible for some of these symptoms like nausea and vomiting, while increases in estrogen and progesterone may be responsible for others like dizziness and breast tenderness,” Dr. Simpson says. While “morning sickness” is a common term associated with pregnancy, some women actually are nauseous all day long.

On the flip side of experiencing pregnancy symptoms like not wanting to eat and certain food aversions, you may actually feel hungrier than ever and crave certain foods or strange food combinations (hence the age-old pickles-and-ice-cream stereotype people tend to employ when talking about the weird things pregnant women suddenly want to eat).

But there are still more pregnancy symptoms women may face, including constipation, headaches, lightheadedness and heartburn. Basically, anything out of the ordinary you experience while pregnant can potentially be associated with your body’s focus on growing your child. Even nasal congestion is a pregnancy symptom: Changes in hormones and blood production may cause mucous membrane dryness, making your nose feel stuffy.

Some women also report a boost in libido, in part due to a pregnancy side effect known as Chadwick’s Sign: Added blood flow to the vaginal area may turn one’s nether regions a purple or bluish tinge and, combined with the influx of estrogen in the body, could spark a marked increase in desire.

Later in pregnancy, as the body prepares for birth, you’ll also experience further changes to your breasts: Your nipples may darken, the veins in your chest may become more pronounced due to increased blood flow and your breasts may leak fluid called colostrum, which is the nutrient-dense precursor to your milk.

As your baby continues growing, there are even more pregnancy symptoms, some of which are less-than-fun to experience. You’ll likely feel more discomfort than before, according to the American Pregnancy Association (APA), including hip and sciatic nerve pain, leg cramps, needing to urinate frequently (as your baby pushes on your bladder) and trouble sleeping.

Am I Pregnant? Here’s How to Know

The best way to tell if you’re really pregnant is not to question or mull over your early pregnancy symptoms but to get definitive answers. “The First Response home pregnancy test kit will tell you the soonest,” Dr. Minkin says. “The sensitivity of that test can show you that you are pregnant six days before the first day of your missed period.” She explains that this test, like other early-detection tests, is especially helpful because it will give you the answers you need the soonest.

And the sooner you know, the sooner you’ll start doing what’s best for your body and for your baby, ensuring a healthy pregnancy for both of you. “Scientific studies have confirmed that the best reinforcement strategy of healthy behavior is a positive pregnancy test,” she says.

Once you get a positive on your at-home test, she adds, you can call your OB-GYN to schedule a confirmatory blood test, if you want to make extra sure.

How Do I Know If It’s Not Pregnancy?

Sometimes the early signs of pregnancy happen in your body, but you’re not actually pregnant. This can happen for a number of reasons. First, you might think you’ve missed your period and that this is a pregnancy symptom. However, because not every woman tracks her cycle and/or has a regular cycle, you may not know when your period is scheduled to start. Risk factors like stress, smoking and obesity can also cause late or irregular periods, a recent study shows, which further complicate the issue.

Sometimes a late period combined with spotting may make you think you’re pregnant when you’re not. “Occasionally, delayed menses due to stress, physical activity or polycystic ovarian syndrome can also be mistaken as bleeding in early pregnancy,” Dr. Simpson says. She advises taking a pregnancy test to confirm if you’re really pregnant or not.

Because many of the symptoms of premenstrual syndrome are the same as pregnancy, it’s easy to mistake PMS for being pregnant. “There are many other causes for most of the symptoms,” Dr. Minkin says. “Women who have PMS regularly complain of sore breasts before their periods. And, for example, a stressed woman may be drinking more coffee — and caffeine can also lead to sore breasts.”

She adds that the first signs of pregnancy, such as fatigue and nausea, are very nonspecific complaints. “You can just be working too hard,” she explains. “So the easiest thing to do if you are heading towards your period and you are experiencing these symptoms is to take a home pregnancy test so you can know for sure. And then you can take one variable out of the conversation.”

What Can I Do Now to Ensure a Healthy Pregnancy?

Once you’ve detected pregnancy symptoms and confirmed that you are pregnant with a pregnancy test, it’s time to schedule an appointment with your OB-GYN. Seeing your doctor as soon as you can will help ensure that you and your baby are well taken care of from the get-go.

Eating a well-balanced diet and maintaining an exercise regimen are also important parts of staying healthy during pregnancy. (Notably, a 2018 Norwegian study found that continuing to exercise during pregnancy could potentially reduce the risk of having an unplanned C-section.) But be sure to talk with your doctor about which exercises to avoid while pregnant. According to the Society of Obstetricians and Gynaecologists of Canada and the Canadian Society for Exercise Physiology, activities like hot yoga are not advised because they can overheat your body. (Similarly, you should also avoid situations like sitting in a hot tub or sauna.) You should also steer clear of alcohol while pregnant, as the effects of fetal alcohol syndrome are not reversible, the Mayo Clinic reports.

Even though the common pregnancy symptom nausea may make you feel like you don’t want to eat anything, you should also be sure to take a prenatal vitamin each day or a daily vitamin that contains folate. According to the Centers for Disease Control and Prevention (CDC), this B vitamin — also known as folic acid — is proven to help prevent common birth defects like spina bifida, which affects normal spine and spinal cord developmen,t and anencephaly, which keeps the brain and the skull from fully forming. Certain foods are also high in folic acid and can give you an extra vitamin boost.

Finally, do whatever you can to get enough rest. Energy levels can significantly decrease during pregnancy (you are growing another human being, after all), so taking breaks when you need to is important. “The most common pregnancy symptom complaint I hear is fatigue, and my standard line is: ‘Some people talk about eating for two, but I think more about sleeping for two,’” Dr. Minkin says.

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