Am I pregnant?

Many women don't suspect they're pregnant until they've missed a period, but there may
be other indications, sometimes even before that missed period, too.

• Sickness and/or feelings of nausea

• A strange, 'metallic' taste in your mouth
• Breast tenderness, tingling and enlargement
• The small bumps - 'Montgomery's tubercules' - on your nipples becoming more
obvious
• Stomach pains
• Tiredness
• Constipation
• Needing to urinate more often
• Going off certain things, such as coffee and fatty foods
• Increased vaginal discharge
• Some women experience very light bleeding (called 'spotting') that they mistake
for their period

When should I do a test?

Home pregnancy tests can be used on the first day of your missed period, and some very
sensitive tests can be used sooner than this.

The tests work by detecting the hormone human chorionic gonadotrophin (hCG) in your
urine. A chemical in the stick changes colour when it comes into contact with this
hormone, so the usual way of testing is to urinate on the end of the stick and watch for the
result in the window of the stick.

Pregnancy tests are very accurate as long as you use them properly. It's possible to have a
false negative, when the test says you aren't pregnant but you are. If your period still
doesn't arrive, repeat the test or check with your GP.

You can buy home pregnancy tests online, in the supermarket or at your local chemist.
Some GPs, family planning clinics and young people's services (such as Brook Centres)
offer free tests, as do some pharmacies, the British Pregnancy Advisory Service and
Marie Stopes International clinics.

When is my baby due?

The length of your pregnancy is dated from the first day of your last period, even though
you actually conceive two weeks or so after this date (depending on the length of your
cycle). Your baby is likely to be born two weeks either side of the due date.
Check your due date and what's happening within your body week by week with our
pregnancy calendar. All you need to know is the first day of your last period.

Most women see their GP to arrange antenatal care, but you can book directly with a
community midwife if you prefer. Call your doctor’s surgery, or your primary care trust,
to find out how to do this.

Does a GP need to confirm my pregnancy?

If you've had a positive home test, you just need to tell your doctor. They're unlikely to
test you again. You may be offered a 'dating' scan, even if you're sure of your dates. This
is an ultrasound scan done in early pregnancy to find out the size of your uterus and the
embryo, to help determine how many weeks pregnant you are.

Your most fertile time

You can work out the 'best' time to conceive by counting 14 days back from when your
next period would be expected. Or, you can take your temperature every day before you
get up in the morning.

An ovulation predictor kit uses urine testing sticks (similar to the ones in pregnancy
tests), which detect a rise in hormones just before ovulation. These are available from
chemists.

Sperm: the facts

A man typically produces something like 200 million to 500 million sperm per
ejaculation, but normally only one fertilises the egg. The sperm are contained in semen,
which nourishes and activates the sperm and which is made in the seminal vesicles and
the prostate gland. The sperm head fuses with the membrane of the egg, letting the head's
content penetrate the egg.

Sperm counts done by laboratories will literally count the number of sperm in a sample,
but should also look at the shape, and motility of the sperm, and whether they are fully
mature and capable of fertilisation.

Blastocyst
A blastocyst is an embryo that has developed to the stage where it has two different cell
types and a central fluid-filled cavity. The surface cells, called the trophectoderm, will
become the placenta, and the inner cells, called the inner cell mass, will become the fetus
itself. Blastocyst formation in the human usually occurs on the fifth day after fertilisation.

Tender breasts
Breasts start to react to the fertilisation of the egg because of hormones, before your first
period is missed. Your body assumes you're going to be breastfeeding.

Unlike other mammals, human females have breasts even when they are not pregnant or
lactating, because of fat - and pregnancy means some of the fat is replaced with what you
need to breastfeed. After breastfeeding ceases, it can take a little while for the fat to
return, and for the breasts to regain their previous size and shape.

Drugs
There's a great deal of caution, understandably, about the use of drugs and medications
during pregnancy - but that is not to say that all drugs and medicines 'go through' to the
baby. Some don't but others do cross the placenta although it's known from long
experience or research that some don't present a problem.

If you have a chronic condition, you may need to continue taking medication, anyway.
Speak to your doctor, or the specialist looking after you, and discuss possible alternatives,
where necessary. NHS Medicines Information (MI) Service is a speciality within the
NHS Pharmacy service, and your doctor or midwife can access it on your behalf.

Community midwives
In the UK, midwives normally work in hospital, or in 'the community' which simply
means 'not in hospital'. All midwives, wherever they work, are qualified to give antenatal
care, care during labour and birth, and postnatal care. They are trained to care for normal
pregnancy and birth, and to see when a situation may need a medical input from a doctor.

Most healthy women never actually see a doctor all the way through their pregnancy and
birth - and their care is solely with the midwife. Community midwives are usually the
health professionals involved with home births.

Heart rate
During a normal pregnancy, the heart rate of the foetus starts off at about 110 beats a
minute, and then gradually gets faster. It's usual for a foetus to have a faster heartbeat
earlier in the pregnancy, but by the end of your full-term pregnancy the normal heartbeat
is 110 to 160 beats a minute.

On your notes, the midwife will mark FHH, or FHRH, which means foetal heart heard, or
foetal heart rate heard. It's an essential sign of the health of your baby, and it is checked at
every antenatal visit.

Ectopic
Ectopic literally means 'out of place' and although the fallopian tube is the most usual site
for a non-uterine pregnancy, in very rare instances the fertilised egg can embed in the
ovary or elsewhere in the pelvis.

The pregnancy always ends early and unsuccessfully in one way or another, either by a
miscarriage, or surgical removal. If you have pain, or unexplained bleeding, you need to
see your doctor. Left untreated, ectopic pregnancy can cause a life-threatening
haemorrhage, and/or a ruptured fallopian tube.

Fertility after an ectopic pregnancy in the fallopian tube may be reduced, as this tube's
functioning is likely to be affected. If you've experienced an ectopic pregnancy ask to be
tested for chlamydia. Chlamydia is a sexually transmitted disease (STD) with few
symptoms, which has been shown to cause ectopic pregnancy in some cases. It can be
easily treated. Read our article about ectopic pregnancies and miscarriages for more
information.

Alcohol and pregnancy

Heavy drinking that continues throughout pregnancy can lead to foetal alcohol syndrome,
which can permanently damage your baby's physical and mental development.

There is some evidence that binge drinking leads to a higher risk of miscarriage. But if
you drank alcohol, even to the point of drunkenness, before you knew you were pregnant,
don't torture yourself. The majority of babies are born healthy, and that includes the
babies of mothers who 'indulged' in early pregnancy.

Average weight gain

It's not just your baby that contributes to your weight by the end of pregnancy. Your
breasts gain about half a pound each, you lay down maybe eight pounds of fat elsewhere,
and the placenta weighs over a pound.

The uterus gains more than two pounds in weight, and to that you need to add the
amniotic fluid which weighs another two pounds; you also have extra blood and lymph
circulating in your body, totalling an extra eight pounds.

Generally, women gain anything between 22-28 lbs during pregnancy, but it's linked to
your weight, health and metabolism pre-pregnancy. As long as you're eating healthily,
don't worry about your weight and check with your midwife or doctor if you have any
concerns.

Nuchal pad of skin

This is the fold of skin at the back of the neck. In some hospitals, mums-to-be are offered
a nuchal fold scan at 11 to 13 weeks. An increased nuchal fold, which is a collection of
fluid at the back of the neck, is associated with Down's syndrome.

Hormone levels
Hormones are chemicals produced by the body and which circulate in the blood. They
stimulate various organs of the body into some form of action - and that action may
include making other hormones which travel to other parts of the body.

Hormones to support your pregnancy are made from the start of conception in the ovary,
and from the 10th to the 14th week, the placenta gradually takes over this production.
The main hormone is progesterone, which sustains the pregnancy. The amount produced
increases as your pregnancy progresses. At the end of pregnancy, labour begins under the
stimulus of oxytocin, produced by the pituitary gland underneath the brain.