Symptoms of Pregnancy

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Listen to Your Body

How can you be sure you’re pregnant? If you are unusually tuned in to your body, you might begin to suspect you’re pregnant as soon as the first few days after conception or even earlier. When Jillian and her husband, John, were planning to conceive their second child, she kept track of her temperature every morning. Based on the figures on her chart, averaged over a period of several months, she chose a day that seemed right for making the big attempt, and she and her husband made love on that day.

"A few hours later,” Jillian told me, “I felt twinges in my left side.” She knew this meant she was ovulating. She turned to John and said, “Let’s start thinking of boys’ names. I believe we’ve just made a baby.”

Jillian became aware of tenderness and fullness in her breasts, and when her period didn’t arrive within two weeks, she came to see me. I was able to confirm her pregnancy by means of an internal examination and a pregnancy test. Their son was born less than nine months later.

While few women can pinpoint their children’s conception with Jillian’s accuracy, many notice signs of pregnancy within days of their expected period. If you’ve been trying to conceive a child, you’re more likely to interpret these signs correctly. Otherwise, it’s easy to confuse the tender breasts, tiredness, and moody feelings with premenstrual tension. In fact, it’s not unusual for your fatigue and feelings of malaise to be so strong that you think you’re ill.

Stacey had been using birth control when she became pregnant. “It was one of the less dependable methods of birth control,” she relates, “but still, it simply didn’t occur to me that I could be pregnant. So when I suddenly started feeling nauseated and sleepy all day, I called in sick and took to my bed, determined to ride out this flu or whatever it could be. When I missed my period, I finally put two and two together.” Luckily, Stacey and her husband had been planning to have a child in the not-too-distant future anyway, so they adjusted quickly.

One study found that of 28 women, none of whom had any actual medical evidence that they were pregnant, nearly half suspected they were pregnant before they missed a period, and 44 percent were convinced they were pregnant before a common pregnancy test would have indicated so. On the other hand, some women with vague symptoms think they’re pregnant when they aren’t. It’s uncommon to experience actual symptoms of pregnancy prior to implantation.

Occasionally, a woman who has irregular periods won’t suspect—or won’t believe—she is pregnant for months after conception. Her symptoms may be so minor and she may be so preoccupied with other things that she doesn’t realize what’s happening to her body until she starts showing in the second trimester or until she actually feels the baby kick. Unfortunately, these women may have missed the chance to give their babies the healthiest possible start by beginning prenatal care early.

Missing your menstrual period is the most clear-cut sign of pregnancy. But even this is not definitive, as once in a while stress alone will keep your period from appearing at its usual time.

While you will not get a regular period if you are pregnant, a few women who become pregnant do experience some vaginal bleeding, called implantation bleeding, at 27 to 35 days after the first day of the last menstrual period. In the week after conception, the fertilized egg with its surrounding cells travels through the fallopian tube, enters the uterine cavity, and then burrows into the uterine lining and implants itself, which is what causes the slight bleeding. This should be a slight spotting or staining of a pink or brown color rather than deep red. Some women feel cramping along with implantation (with or without bleeding), which sometimes continues for several weeks. Check with your doctor to make sure that’s what you’re experiencing.

Changes in the breasts are among the earliest signs of pregnancy. As you approach menstruation, your breasts normally become fuller and more tender because of the increase in your estrogen and progesterone levels. With conception, these female hormones continue to increase, and in the following days and weeks, the breasts become fuller and sometimes feel tingly. Increased nipple sensitivity may also occur. The surface veins of the breasts become more visible, and the areola, the brown area around the nipple, darkens.

Beating a Path to the Bathroom:

Even before you miss a period, you’ll find yourself trekking again and again to the bathroom to relieve the pressure on your bladder. You may get up at night to urinate, even though that’s not your typical pattern. As the uterus grows larger, it pushes on the bladder. As it becomes larger still, it lifts out of the pelvis, and the pressure on the bladder subsides. Toward the end of your pregnancy, as the baby’s head pushes back down into the pelvis, you will feel the pressure again, along with a need to urinate more frequently. But don’t cut down on your fluid intake at this time. Nutritionally, an adequate fluid intake is important for you and your developing fetus.

Sleep and More Sleep:

Fatigue, even utter exhaustion, is another very early sign that you’re sharing your body with a fetus. Due to high levels of progesterone newly circulating in their bloodstreams, some women, like Stacey above, are sure they have come down with the flu or some other illness within days of conceiving. The only way to cope with your greatly increased need for rest is to sleep as much as you can and reduce your activity level as much as you need to. Don’t try to push yourself; you’ll have more stamina later. Nap when you can, even if you have to do it after work. It may be the only way you’ll get through the evening without passing out.

Newly pregnant patients often ask me if their extreme fatigue might be the result of iron-deficiency anemia or a lack of certain vitamins. Although some women are anemic, and certainly pregnancy can accentuate that condition, the major reason for tiredness early in a pregnancy is not anemia or a vitamin deficiency, but rather the hormonal effects of pregnancy itself.

This is a good time to begin communicating with your husband about how to divide the household responsibilities, unless he already handles most of them. You can’t possibly do it all now, and you shouldn’t have to try. Think of this low-energy period as practice for once the baby is born. You’ll need plenty of help with housecleaning, cooking, and so on then, too.

Morning, Noon, and Night Sickness:

Morning sickness isn’t necessarily limited to mornings. You’ll probably feel at least slightly nauseated at other times during the day. At least half of all pregnant women are nauseated enough to throw up. Beginning a few days following conception, queasiness is probably related to the increased level in your bloodstream of the hormone human chorionic gonadotropin (HCG). Here is some comfort: a few studies have shown that women who experience vomiting during early pregnancy have a lowered risk of miscarrying. You might also be relieved to know that this particular distress usually tapers off by the end of the first trimester. Actually, most women feel quite exhilarated during the middle of their pregnancies, so you have something positive to look forward to very soon.

Here are the traditional suggestions for coping:

* If you tend to feel nauseated first thing in the morning, rise slowly. Leave some crackers by your bed so you can eat one or two before getting up.
* If an empty stomach makes you nauseous during the day, eat several small meals.
* If you become sensitive to certain tastes and odors, you may feel better if you avoid fried, greasy, strong-smelling, or spicy foods, or any other food that makes your stomach turn.
* Some women find that sucking on fruit-juice Popsicles helps, while others are comforted by hot, clear liquids, such as broth or tea.
* If keeping your prenatal vitamins down is a problem, take them after your largest meal or at night.
* There may be a pattern to your sickness; if you can figure it out, you may be able to avoid much of your discomfort. Some women find that lying down for 15 minutes after each meal helps.
* Taking extra vitamin B6 has been found to help many women with nausea. Ask your doctor if you should try it.

With patients who vomit a great deal in early pregnancy, doctors worry much more about dehydration than about a lack of nutrients, since dehydration can be harmful to your baby. Make a point of drinking a lot of liquids, particularly if your nausea causes you to vomit. Your baby only accounts for about an ounce of the first trimester weight gain, so you don’t need a lot of food. But your blood volume is increasing greatly, making additional fluids a necessity.

Testing, Testing: Are You Pregnant?

Testing for pregnancy used to take a few days. Even today, you’ll still hear people announce, “The rabbit died.” What exactly does that mean? To determine whether conception has taken place, tests of the woman’s urine measure the level of the hormone HCG, produced by the placenta shortly after implantation. In 1927, the researchers who discovered this hormone found they could inject some of a woman’s urine into a rabbit and then, days later, kill the animal and examine it for ovarian changes.

Now pregnancy tests can be performed directly on your blood or urine, either by your doctor or by you at home. When the level of HCG reaches a certain level—it begins low and rises quite rapidly during the beginning of pregnancy—it can be detected around the time of your missed period.

More sensitive blood tests can detect pregnancy as early as six days after conception. False negatives are common, however. As your HCG level rises, this more sensitive blood test will turn positive, but the less sensitive urine test will remain negative for several more days. About two weeks after conception, your HCG level will rise to the point where both tests will read positive.

The usual pregnancy test is a qualitative test, which means that it’s either positive or negative. It either identifies the presence of HCG hormone or it doesn’t. A quantitative test, on the other hand, not only tells us that HCG is present but also tells us how much is present. This test can’t tell you, however, exactly how many weeks pregnant you are. If you’re having a problem during early pregnancy, such as unusual bleeding, quantitative testing can either reassure you that your pregnancy is normal or alert you to the fact that all may not be well. By taking a number of measurements several days apart, we can determine whether the level of hormone is rising or not.

Emma came to see me because she was worried about her spotting. In the old days, all I could have done was suggest she wait and see what happens. Now, by measuring how much HCG was present in her bloodstream over a period of days—and it was a good rising level, I might add—I was able to tell her that her pregnancy was progressing normally. The test can also help detect an ectopic pregnancy before other clinical signs become obvious, by disclosing too low a level of HCG.

How accurate are the tests? Although the manufacturers of the newer methods, including home urine tests, claim an accuracy rate of 97 percent, studies indicate the accuracy range is from 60 to 90 percent. Misinterpretation of the results is possible, of course, since what you’re looking at is a change of color on a dipstick or filter pad. Also, keep in mind that it’s possible to be pregnant and have a test show negative, which is usually due to levels of hormone too low to register. In a normal pregnancy, if you wait a few days or a week longer, the test will usually turn positive.

False positive tests, in which the results say you’re pregnant and you turn out not to be, are possible but rare. With current tests, if you wait until you have missed a menstrual period by a few days, the test will be positive if you’re pregnant. If it isn’t, and you feel OK, just repeat the test in about a week. If you have spotting or lower abdominal pain, it’s wise not to rely only on a home test. In this case, see your doctor to rule out a problem like an ectopic pregnancy.

About Due Dates:

Once you’ve confirmed your pregnancy, your next question is bound to be, “When am I due?” Your estimated date of confinement (EDC), or due date, can be estimated from your last menstrual period. Thus, keeping a menstrual calendar is very important. If your periods are regular and approximately 28 days apart, take the first day of your last menstrual period (LMP), and add seven days to arrive at the day of the month your baby is due. Now subtract three months from the month of your LMP (use 1 for January, 2 for February, and so on). For example, if your LMP was October 15, you would determine your due date of July 22 as follows:

15 days + 7 days = 22 (the 22nd day of the month);

10 - 3 months = 7 (July).

If your periods tend to be irregular or your last period was abnormal, your due date may not be accurately calculated using the above rule.

Keep in mind that a due date is just an educated guess, a range during which the chances are good that you will deliver. Most women will deliver within two weeks before or after their due date. In the previous example, a due date of July 22 actually means that your doctor expects you to deliver sometime between July 8 and August 8. Inaccuracy can also result if you get pregnant right after stopping the birth-control pill or while you’re still breast-feeding, since your ovulation may have been delayed enough to throw the calculations off. In these instances, your doctor will examine you and use ultrasound tests to help determine your due date; even so, it’s impossible to predict exactly when labor will begin.

Herbs for Nausea:
Ginger

Ginger is well-known as being very effective for alleviating nausea that arises from the stomach. Ginger also acts to improve digestion.

Hyperemesis gravidarum

Hyperemesis gravidarum is a severe form of nausea associated with pregnancy. Women with hyperemesis gravidarum should consult their doctor before pursuing any course of treatment.

Ginger can reduce vomiting in hyperemesis gravidarum (a severe form of nausea associated with pregnancy).
Fischer-Rasmussen W, Kjaer SK, et al. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol 1990; 38:19-24.

Many people take 250 mg of ginger capsules, tablets, or as a tea four times per day to reduce nausea.
Fischer-Rasmussen W, Kjaer SK, Dahl C, Asping U. Ginger treatment of hyperemesis gravidarum. Eur J Obstet Gynecol Reproductive Biol 1990;38:19-24.

Although ginger capsules can be used, many people prefer to open them and use the powder to brew a tea.

Ginger should only be used for short periods of time, and the amount taken daily should not exceed 1 gram per day.

Red raspberry

Red raspberry is helpful during the entire pregnancy. It can be used as capsules, liquid extract or tea.

Some people recommend a few drops of peppermint oil on the tongue for morning sickness.

Liver Support

Experience has shown that improving liver function often improves morning sickness. Different levels of liver function may explain why some individuals develop morning sickness while others do not. The liver is responsible for detoxifying hormones and thus plays a role in maintaining good hormone balance.

Bitter herbs including dandelion stimulate liver function.

See Liver Function Support

The liver is the organ of fat metabolism and detoxification of fat-soluble toxins. Its capacities are challenged by the consumption of excess fat.

Avoid saturated fat

Consuming the equivalent of 1 cheeseburger or 3 cups of milk more than tripled the risk of developing morning sickness.
Signorello LB, Harlow BL, Wang SP, Erick MA. Saturated fat intake and the risk of severe hyperemesis gravidarum. Am J Epidemiol 1996;143 (11 Suppl):S25 [abstr# 97].

Vitamins
Vitamin B6

Vitamin B6 is helpful for nausea.  Vitamin B6, at an intake of 10-25 mg taken 3 times per day may relieve morning sickness.
Sahakian V, Rouse D, Sipes S, et al. Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized, double-blind placebo-controlled study. Obstet Gynecol 1991;78:33-6.
Vutyavanich T, Wongtra-ngan S, Ruangsri R-a. Pyridoxine for nausea and vomiting of pregnancy: a randomized, double blind, placebo-controlled trial. Am J Obstet Gynecol 1995;173:881-4.

Some suggest a dose of 50 mg every 4 hours. During pregnancy, this large dosage should not be continued for more than 7 days at a time.

Vitamin C with vitamin K - “Remarkable!”

Women who took 5 mg of vitamin K with 25 mg of vitamin C per day reported the complete disappearance of morning sickness within 3 days.
Merkel RL. The use of menadione bisulfite and ascorbic acid in the treatment of nausea and vomiting of pregnancy. Am J Obstet Gynecol 1952;64:416-8.

This amount of vitamin C is very small compared to a typical nutritional supplement providing 500-1,000 mg of vitamin C per dose.

Minerals
Magnesium

Magnesium is required by muscles to relax after contracting. Magnesium can help relax the stomach spasms that may accompany morning sickness.

RELATED STORIES:
Signs & Symptoms of Early Pregnancy   Ectopic pregnancy   A pregnancy breakthrough   Couple should see doctor after 2 years trying for baby   Infertility Medications (Drugs)   Unexplained Infertility   Male Infertility   Infertility   Fertility & Natural Progesterone

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