Confirming Your Pregnancy

Woman in doctor's office 

Some women “know” they are pregnant from the moment of conception. For most women, though, the first sign of pregnancy is a missed period. For days, you may wonder if perhaps you got the dates wrong. A few more days go by, and the reality sets in that you might be pregnant. Should you wait a bit longer before buying a pregnancy test? Should you see a doctor right away?

It is imperative to take that pregnancy test as soon as possible after you have missed one period. Your baby’s most important organs and structures develop in the first few weeks of pregnancy. The earlier you confirm the pregnancy, the sooner you can take the steps to properly care for yourself, to ensure your baby’s health. If you are taking any medications or working with chemicals, some of them may be hazardous to your baby. The sooner you know that you are pregnant, the earlier you can avoid using these substances.

Home pregnancy tests

Pregnancy can be diagnosed using a home pregnancy test as early as two weeks after conception. This is around the time that you would normally expect your period. Shortly after you become pregnant, a hormone called human chorionic gonadotropin (hCG) starts to appear in your blood. The levels of hCG increase dramatically over the next few days, and get excreted in your urine. The presence of this hormone in your urine on a home pregnancy test means that you are pregnant.

There are a variety of home pregnancy tests available, and they are much more accurate than in the past. Most of these tests involve running a few drops of urine over a dipstick containing certain chemicals. Some pregnancy tests recommend that you retest three to five days later. This is because a negative result could just mean that you haven’t built up enough hCG yet to show up on the test. The chances of a false result are higher if your periods are irregular.

The advantages of using a home pregnancy test are that they offer you privacy and almost immediate results. The major drawback is that a false negative result would cause you to postpone seeing your health care provider. Even if the result is positive, you may still put off seeing your health care provider, thinking that the only reason for a medical visit is to diagnose the pregnancy. After using a home pregnancy test, always make sure to confirm the result at a medical visit.

Pregnancy tests at your medical visit

During your medical visit, you can have either a urine or blood test done to confirm the pregnancy. Like the home pregnancy test, the urine test at your health care provider’s office checks for the level of hCG in your urine. If you have the test done at your health care provider's office, you will receive the results within minutes. If you have it done at a laboratory, the lab will call the doctor’s office with the result shortly after. A blood test measures the exact level of hCG in your blood, and thus can be used to track the development of the pregnancy.

Signs and symptoms of pregnancy

In addition to missing your period, there are a few signs and symptoms of pregnancy in the first trimester:​

  • Fatigue: This is a frequent, tell-tale sign of early pregnancy.
  • Nausea or vomiting: Also called “morning sickness​,” nausea or vomiting may last throughout the first trimester of pregnancy. Usually the nausea occurs in the morning, but it can happen at any time of the day. The cause of morning sickness is unknown but it appears to be associated with the increased levels of the hCG hormone circulating in your body. Morning sickness usually goes away after the first trimester, although sometimes it can linger. If it is severe, there are medications that are safe for the baby that can be used to control the nausea and vomiting.
  • Frequent urination: As the uterus grows during the first trimester, it puts pressure on the bladder, causing you to urinate more often.
  • Breast changes: Your breasts may feel tender and heavy. They may increase in size. The brown or pink circles around your nipples, called the areola, may become darker and the little bumps in them may become more visible. You may notice a lacy map of blue veins appearing all over your breasts.

Other possible signs of pregnancy may include a metallic taste in your mouth, headaches, mood swings, and cravings or aversions to certain foods.

Don’t worry if you do not have all the signs and symptoms of pregnancy. In fact, you could have none of the signs and symptoms, and still be pregnant. Alternatively, you could have some or all of the signs and symptoms, and not be pregnant. The best way to determine if you are pregnant is to confirm the pregnancy with your health care provider. However, if you have confirmed the pregnancy and have symptoms that suddenly disappear, it may mean that your pregnancy is not progressing normally.

Dating the pregnancy

Pregnancy is dated from the first day of your last menstrual period, which is usually about two weeks before the date of conception. The average baby takes 266 days or 38 weeks to fully develop from conception to birth. Add two weeks to account for the time between your last menstrual period and the date of conception, and you come up with a grand total of 40 weeks. Therefore, you can estimate your baby’s date of birth by adding 40 weeks to the date of your last menstrual period. Most women give birth within two weeks before or after this date.

Ultrasound is the best way to determine the estimated date of delivery. The earlier an ultrasound is done, the more accurate the dating. Your estimated date of delivery is the one determined from your first ultrasound, and the date does not change if another ultrasound is done.

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Nicolette Caccia, MEd, MD, FRCSC

Rory Windrim, MB, MSc, FRCSC ​

9/11/2009


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