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Pregnancy is one of the interesting processes that could happen to a woman’s body. While there are expected milestones for the next nine months, the experience may vary for each expectant mom. In fact, each pregnancy may bring a different set of experiences for a woman.

If this is your first time, these changes can be uncomfortable, while some ladies might even miss the very first signs of pregnancy entirely. However, there is something to be said about knowing if you are pregnant the earliest time possible. It allows you and your baby to receive the right diet, the right care, and proper monitoring.

So, if you are trying to get pregnant or if you are reeling from certain changes happening to your body, these are the initial signs of pregnancy to watch out for even before you get to a pregnancy test.

Light Spotting

Also referred to as implantation bleeding, light spotting occurs when a 6-12 day-old fertilized egg attaches itself to the interior lining of the uterus.This may be mistaken as menstrual bleeding since some occurs a few days before the next menstruation cycle, but it is not as heavy.

Spotting can be determined as something that is present only when wiping, while bleeding refers to the kind of flow you experience during menstruation.To determine if it is indeed implantation bleeding, you should take into consideration other accompanying signs such as, light or faint cramping, headaches, breast tenderness, mood swings, nausea, or  lower backaches.

Key differences between implantation bleeding and menstrual bleeding include the following

    • Color: Women are familiar with the color of their period as it ranges from bright to dark red. Implantation bleeding, on the other hand, is typically light pink to dark brown in color.
    • Clotting: Some amount of clotting is present during with menstrual bleeding, but implantation bleeding doesn’t come with any at all.
    • Amount: It is normal for women to soak pads and tampons during their period, but it is different with implantation bleeding. The word “bleeding” is actually misleading because implantation bleeding is actually very light, almost like a stain rather than a full flow.
  • Length of Time: Typically, a woman’s period can range from 3-7 days, while those on birth control tend to bleed for a shorter time. Implantation bleeding can last for a few hours to less than three days, and it doesn’t require any treatment.

Light spotting isn’t as cumbersome as other early signs of pregnancy. It does not require any medical intervention, however, it is important that you closely observe it.

Mild Cramping

What is tricky about interpreting this symptom is that it can be confused with ovulation cramps and menstrual cramping. The mild cramping sensation you feel when ovulating occurs when the follicle – a sac in your ovary that carries the eggs – ruptures and releases an egg. This is called “mittleschmerz,” which is a German word that means “middle” and “pain.” It often occurs mid cycle, or two weeks prior to your period, although most women don’t feel it at all. Meanwhile, menstrual cramps strike 24-48 hours before your period and goes away once menstruation starts. The pain can be range from mild to severe depending on the level of prostaglandins – a hormone-like substance that causes uterine muscle contractions.

Implantation cramps, on the other hand, are more mild and intermittent, occuring on and off for one to three days. This happens as the embryo implants itself into the lining of the uterus. It takes about a week for the fertilized egg to burrow its way into the thick, rich lining which causes the mild pain. This typically occurs about a week before you would expect your period (for those with a normal 28-30 day cycle), which is why some women confuse it with ovulation or menstrual cramps.

To relieve the discomfort you can do the the following:

    • Try sitting, lying down, or changing positions.
    • Try to do relaxation exercises.
    • Soak in a warm bath.
  • Place a warm water bottle wrapped in a towel on the area.


Feeling tired or exhausted is a common early sign of pregnancy. Some women may feel fatigued for the first 12 weeks or throughout the pregnancy, while others may hardly feel tired at all. You can get 10-12 hours of sleep but still wake up feeling lethargic. This can be frustrating especially when you can’t seem to get things done.

Hormonal changes are the likely cause of fatigue. Increased progesterone levels are responsible for making you feel sleepy. In addition, your blood sugar levels and blood pressure also lowers to provide blood flow to the baby.

As the second trimester rolls around, there is a good chance that your energy level will increase making you feel like your old self. Most call this stage “the happy trimester” and would take advantage of it to finish important tasks before energy levels are likely to decrease again during the third trimester. However, don’t be alarmed if you still feel fatigued during the second trimester.

So, if you notice your afternoon energy drop to be out of the ordinary, this could be your body’s way of telling you that a baby could be on board.

To cope with the constant feeling of tiredness, you just need to make sure that you adjust your schedule to allow yourself to get ample rest. Avoid drinking fluids several hours before bedtime to minimise on the number of times you have to get up at night to use the bathroom. It also helps that you choose a healthy, balanced diet because your level of nutrition can go a long way in supporting your energy levels. Make sure that you get enough calories, protein, and iron.

Nausea (with or without vomiting)

Along with constantly feeling tired, you may also experience light-headedness or dizziness. Commonly known as “morning sickness,” this occurs during the first week after conception as blood vessels dilate and your blood pressure drops. Not every woman will experience nausea the entire duration of the first trimester. However, in some cases, it can start earlier and can last longer too.

Another reason behind this is the presence of a certain pregnancy hormone which is produced soon after the fertilized eggs attach to the uterine lining. Women with this hormone in their system experience severe nausea and vomiting (hyperemesis gravidarum), which would require medical intervention.

Estrogen is also another hormone that increases during early pregnancy which could cause nausea. Stress and fatigue brought by the string of changes pregnancy does to the body can also contribute to queasiness.

To prevent or manage nausea during pregnancy you can try the following home or natural remedies:

    • Eat smaller meals more frequently throughout the day instead of three big meals.
    • Avoid foods or smells that can trigger your nausea.
    • Stash soda crackers by your bed and eat a couple before getting up. Allow some time for it to be digested before slowly getting up.
    • Suck on hard candy.

Shortness of Breath

Feeling like you are short of breath is a common symptom of pregnancy. It can begin before any upward displacement of the diaphragm due to a growing uterus. During the first trimester, increased levels of progesterone causes the lungs to increase its demand for oxygen. There is an increase in lung capacity which increases oxygen-carrying capacity to provide nourishment for the growing fetus but your respiratory rate (breathing cycles per minute) only changes slightly. This will make you feel like you are short of breath.

To relieve shortness of breath, give your lungs as much breathing room as possible. You can do this by standing up straight, sitting up tall, and sleeping propped up on pillows to expand the space in your abdominal cavity. It also helps to slow down when you feel that your heart and lungs are working harder.

Tender or Swollen Breasts

Changes to the breasts can start as early as one to two weeks after conception. In fact, this is one of the top three things women complain about in early pregnancy. The formidable duo – estrogen and progesterone – are the main culprits behind breast tenderness. In addition to that, the fat layers in your breasts thicken, you grow more milk glands, and blood flow increases. These changes may give your cup size a favorable boost, however it doesn’t always leave you with a pleasant experience. But, more importantly, it also serves a purpose of preparing your breasts for breastfeeding in a few months.

To take care of tender or swollen breasts, it helps that you wear a supportive bra. A full-coverage bra can offer adequate support in lifting the breasts and relieving the pressure. You must also avoid underwire bras because it has the potential of digging into the skin. Furthermore, a cold compress or a warm shower can help relieve some tenderness. Warm water, in particular, can help ease the tension and relax the muscles around your chest.

Frequent Urination

A lot of women complain of having to spend a seemingly endless loop to the loo. This heightens during the first two to three weeks of your pregnancy. The reason behind this is because the blood flow to a pregnant woman’s kidneys increase by up to 30-60%. This makes the kidneys produce up to 25% more urine soon after she conceives.

Frequent urination can also be attributed to hormonal changes. Once the embryo is implanted into the uterus, your body produces the pregnancy hormone hCG. This triggers a woman to urinate frequently. Furthermore, the spike in progesterone levels can also result in this sensation.

Unfortunately, your urge to pee often will not only be an early sign of pregnancy. As the uterus expands to accommodate the growing baby, it presses down on your bladder, urethra and pelvic floor muscles. This means that your bladder can no longer expand to the same level of fullness as before, therefore it has to be emptied more often.

To reduce the hassle of having to go to the bathroom several times, especially during sleeping hours, avoid drinking too much water a few hours before bedtime.

Besides the usual missed period to signal that something is up, these signs should compel you to take that pregnancy test. Once you have confirmed it, your pregnancy calendar should now be lined with regular prenatal visits. The earlier you know, the earlier you can get professional help and regular monitoring. We hope that this knowledge will help you prepare for what is to come if you are still planning for a baby or if you are already experiencing some of these signs now.

Proper pregnancy planning and having the needed resources along with emotional support is essential during early pregnancy. For all your concerns, from pre-conception health screening to pre-natal visits, and everything in between, book a consultation with Dr. Pamela Tan today.

Dr. Pamela Tan, gynecologist and obstetrician based in Singapore, consults at Thompson Medical Center.

Dr Pamela Tan
About Dr Pamela Tan

Dr Pamela Tan is a board certified obstetrician and gynecologist in Singapore. She finished her undergraduate studies at the National University of Singapore and earned her post-graduate degree at the Royal College of Obstetricians and Gynaecologists in the UK. She is an accredited specialist by the Specialist Accreditation Board (Ministry of Health), and a fellow of the Academy of Medicine, Singapore. She subspecialises in colposcopy and is certified to perform Level 3 minimally invasive keyhole surgeries such as laparoscopic hysterectomy, myomectomy and cystectomy. Dr Pam also supports the natural birthing method and she strives to provide a personalised care and treatment for each patient.