How do you know if you are pregnant?

If your periods are normally regular, the most common reason for missing a period is being pregnant. A period which is much lighter than normal or that is unusual in any way may also be a sign of pregnancy. If your cycle is irregular, it is more difficult to know if you have missed a period.

If you are trying for a baby, missing a period may come as a welcome experience. If you aren’t, it is important to consider whether you have had unprotected intercourse since your last period or whether there was any situation where your contraceptive may have failed, e.g. broken condoms, or diarrhoea/vomiting if on the pill.

If you feel there is any chance you might be pregnant, you can take a home pregnancy test yourself, or make an appointment with your General Practitioner (GP).

Early signs of pregnancy

Aside from a missed period, there are several other common early signs of pregnancy. Nausea, commonly called “morning sickness” is relatively common in the first trimester (first 12 weeks of pregnancy) and can start very early into your pregnancy. As the name suggests, it often occurs in the mornings, usually improving as the day goes on but can occur at any time of the day. As well as feeling nauseous, you may also experience vomiting, which can occasionally be severe. In this instance you should see your GP, or receive immediate medical attention if your symptoms warrant it.

Tiredness and general fatigue can also be signs of pregnancy. Tiredness can be caused by a number of conditions (some medical, some not) but is often present and noticeable during the early stages of pregnancy. Another early sign of pregnancy is breast tenderness. This is caused by an increase in certain hormones, making the breasts more tender than usual. Some women do experience some breast tenderness ordinarily with their periods, but this usually settles as their period ends.

Taking a pregnancy test

If you think you might be pregnant, or you are just not sure, a pregnancy test would be the most helpful thing to do in the first instance. Pregnancy test kits are available from pharmacies and are relatively inexpensive. Alternatively, you could have a pregnancy test carried out at your GP surgery, although you may need to book an appointment. Some Family Planning Clinics, and some Sexual Health Clinics (GUM clinics) also provide pregnancy testing without charge.

The pregnancy tests available from the pharmacies are very similar to those used at the doctors’ surgery. The test is performed on a urine sample passed at any time during the day and can be done at any point from the first day after your period was due. This test takes just a few moments to provide a result, and will come with instructions to help you interpret the results.

These tests are approximately 97% accurate when performed correctly, however the tests are more accurate with positive results, than negative results. Therefore, if you think you may be pregnant, but have a negative test result, it would be advisable to repeat the test, or see your GP because the negative result may be incorrect. Your GP can then take a full history from you and perform another test (blood test) to assess more accurately whether you are pregnant or not. However, it takes longer to receive results following a blood test as the sample must be sent to a laboratory for processing. Both the urine and blood tests detect the presence of a hormone called human chorionic gonadotropin (hCG) which is produced by the embryo within a few days of pregnancy.

General information for early pregnancy

In early pregnancy it’s best to lead a healthy diet and lifestyle and to avoid anything which may affect the baby in the first few weeks of development. This is discussed in more detail in separate articles, but general guidance includes:

• avoid caffeine, alcohol, smoking and e-cigarettes (if you have difficulty with this, inform your GP or midwife who can refer you to services to provide support and guidance)
• drink plenty of water or water-based drinks
• continue to exercise, but avoid excessively long and strenuous exercise
• swimming is good exercise during pregnancy, however you should avoid Jacuzzis, hot tubs, saunas and steam rooms because of the risk of overheating, dehydration and fainting. There are also some skin infections which can be picked up in hot tubs and Jacuzzis if the water cleansing process is not adequate
• avoid all medication bought over the counter until discussed with your doctor. If you need a painkiller, paracetamol, taken within the recommended dosage, is accepted as suitable for short term use during pregnancy
• if you are taking long term medication prescribed by your doctor, you should make an appointment with your doctor to discuss this and continue until you have spoken to your GP
• try to have a healthy, well-balanced diet. Specific dietary items to avoid (and those to consume more of) is discussed in detail in separate articles, however there are some general foods to avoid;
  • pate
  • soft cheese with white or mound rind
  • blue cheese
  • raw eggs
  • raw or undercooked meat, including salami, uncooked chorizo, pepperoni
  • liver
  • unpasteurised milk
  • fish: avoid marlin, shark and swordfish; limit tuna

What to do next

If you have received a positive result from a pregnancy test, think you may be pregnant, or are just unsure, you should make an appointment to see your GP. This is the first step in your antenatal care (care of you during pregnancy). The GP does not need to repeat a pregnancy test if you have had a positive result from a test bought at the pharmacy, but will do a test if you have not already done one or if there is any doubt about whether you are pregnant.

During the first visit, your GP will discuss your pregnancy and answer any questions or concerns you may have.  Your general health is very important for the healthy development of the baby and your doctor will look at any illnesses, both past and current, as well as medications and advise you about these for your pregnancy.

Your GP will then arrange your first, or “booking” appointment, with the midwife who will look after you during pregnancy. Your care will be “midwife-led” which means the midwife leads and coordinates your care during pregnancy but will liaise with your GP and obstetricians as required. However, your GP will still be responsible for your general health throughout this period and you should still make an appointment with them for anything non pregnancy-related.

If you have certain pre-existing conditions such as diabetes or epilepsy you may be referred directly to an obstetrician or specialist clinic that looks after pregnant patients with these conditions to optimise your care and ensure you remain fit and well during the pregnancy.

Main Points

• Early signs of pregnancy include a missed period, nausea, vomiting, and tiredness
• A light period or one which is unusual in any way can also be a sign of pregnancy
• If you think you may be pregnant or are in any way unsure, you should make an appointment to see your GP
• Over the counter pregnancy test kits, based on urine sampling, are similar to those used in a GP’s surgery and are around 97% accurate
• If you get a negative result and are still unsure whether you might be pregnant, you should take another test as the kits are more accurate for positive results.
• A healthy diet and lifestyle are important for your general health and the early development of your baby
• If you are pregnant, your GP will arrange for you to have an appointment with a midwife who will co-ordinate your care throughout pregnancy
• Your GP will continue to be responsible for your general health and if you have any problems or concerns you should book an appointment with them as you would normally do