Early signs of pregnancy: how do you know if you're pregnant?

Maybe your period is late. Maybe your usual morning coffee suddenly smells wrong, or you fell asleep on the couch at half seven. Whatever made you search this, here is what the early signs of pregnancy actually look like, when a test will give you a reliable answer and what to do next, based on HSE guidance.

How soon do you start to feel pregnant?

It varies a lot. Some people feel different almost straight away, others notice nothing until the test is positive. For many, the first clue is simply that a period does not arrive.

It helps to know how pregnancy is counted. Your weeks of pregnancy are dated from the first day of your last period, not from the day you conceived. So the first two weeks happen before you are actually pregnant, and if your cycle is around 28 days, by the time your period is late you are already counted as about 4 weeks pregnant.

Morning sickness, one of the best known signs, usually starts between 4 and 7 weeks according to the HSE. That is why many people start to feel pregnant in the week or two after a missed period rather than before it.

What are 5 signs of pregnancy?

The five most common early signs are:

• A missed period. Often the first sign. Some people have a small bleed in early pregnancy, called spotting, so a light bleed does not always rule pregnancy out.
• Feeling sick or vomiting. Called morning sickness, but it can happen at any time of the day.
• Sore or swollen breasts. You may also notice darker nipples or more visible veins.
• Extreme tiredness. Not ordinary tired. The kind where the couch wins every evening.
• Needing to pee more often. Suddenly you know where every toilet in town is.

The HSE also lists a few others worth knowing:

• A stronger sense of smell, where cooking smells or smoke can make you feel sick
• Food cravings, or suddenly going off food and drink you usually like
• Changes to vaginal discharge, in colour, thickness or amount

None of these on their own proves anything. Tiredness, sore breasts and a late period can all happen for other reasons. The HSE is clear that taking a test is the best way to know.

Is spotting normal in early pregnancy?

Light bleeding, or spotting, is common. The HSE says it happens in about 1 in 2 pregnancies in the first 12 weeks. It is usually just a few drops, pink, red or brown, and tends to stop within a day or two. One cause is the fertilised egg attaching to the lining of the womb, known as implantation bleeding.

Even so, do not just wait and see. Contact your GP if you have light bleeding with no other symptoms. If the bleeding is heavy, you have severe tummy pain or you feel very unwell, contact your maternity unit or hospital straight away.

When should I take a pregnancy test?

Home pregnancy tests look for a hormone called hCG in your pee. Your body makes it once you are pregnant, and the level rises as the weeks go on. That is why timing matters so much.

The HSE says you are more likely to get an accurate result if you test on the day your period is due or any time after that. Some very sensitive tests can pick up a pregnancy as early as 8 to 10 days after conception, but the earlier you test, the more likely you are to get a false negative.

You can buy tests in pharmacies, supermarkets and many shops. Your GP or practice nurse can also do a test for you, though some practices may charge if you do not have a medical card, so it is worth asking when you ring.

How accurate are home pregnancy tests?

According to the HSE, a positive test is almost always correct. A negative test is less reliable. A false negative means the test says no when you are actually pregnant, and it usually happens because:

• You tested too early, before there was enough hCG to detect
• You read the result too soon. Results often take around 3 minutes, so follow the timing on the pack
• Your pee was very diluted, for example after drinking a lot of water
• The test was faulty

It can also go the other way. If you leave a test sitting for too long, an evaporation line can appear and look like a faint positive. Read it within the time the instructions give and not hours later.

If your test is negative but your period still has not come, repeat the test a few days later. If you are still unsure after a few negative tests, talk to your GP.

I have a positive test. What now?

Take a breath. Then book an appointment with your GP. They can confirm the pregnancy, help you work out your due date and register you for the Maternity and Infant Care Scheme, which makes pregnancy care free for anyone living in Ireland. You do not need a medical card.

The HSE also advises taking a 400 microgram folic acid supplement every day, ideally from before pregnancy and at least until 12 weeks. If you were not taking it already, mention it to your GP and pharmacist.

If you want a rough idea of dates before the appointment, our due date calculator works it out from the first day of your last period. Then you can follow along with 4 weeks pregnant and the weeks after. We have a full guide to what to do when you just found out you're pregnant in Ireland, covering the booking visit, public or private care and your rights at work.

When should I get help straight away?

Most early pregnancy symptoms are uncomfortable but normal. Some are not. Contact your GP, midwife or maternity unit straight away if you have:

• Bleeding from the vagina
• Pain in your tummy, especially low down and on one side
• Pain at the tip of your shoulder that does not go away
• Sickness so bad you cannot keep any fluids down for 24 hours
• Feeling dizzy or faint, or not having peed for more than 8 hours

Tummy pain on one side with bleeding can be a sign of an ectopic pregnancy, where the pregnancy grows outside the womb. The HSE says symptoms usually show up after week 6. Call 112 or 999 if you have sudden sharp tummy pain, if you feel faint or dizzy or if you look pale with cold clammy skin.

If you are not sure how urgent something is, HSE Live on 1800 700 700 can point you in the right direction.

What if I'm not sure how I feel about being pregnant?

That is completely normal, planned or not. If the pregnancy was unplanned or you are unsure what to do, the HSE's My Options service gives free, non-judgmental information and support on freephone 1800 828 010 or by webchat. Your GP is also a good place to talk it through.

And if it's good news you've been hoping for, congratulations. The Lullagram app has a free pregnancy section with a week-by-week guide and Irish dates worked out from your due date, if you'd like to follow along on your phone.

Frequently asked questions

What are the first signs of pregnancy?

A missed period is often the first sign. Others include feeling sick or vomiting at any time of the day, sore or swollen breasts, extreme tiredness, needing to pee more often, a stronger sense of smell, new food cravings or dislikes and changes to vaginal discharge.

How soon can I take a pregnancy test?

You are more likely to get an accurate result from the day of your missed period onwards. Some very sensitive tests can pick up pregnancy 8 to 10 days after conception, but the earlier you test, the more likely you are to get a false negative.

Can a home pregnancy test be wrong?

A positive result is almost always correct. A negative result can be wrong, usually because you tested too early, read it too soon, your pee was very diluted or the test was faulty. If you still have no period, repeat the test a few days later, and contact your GP if you are still unsure.

When does morning sickness start?

According to the HSE, morning sickness usually starts between 4 and 7 weeks of pregnancy and usually clears up by 16 to 20 weeks. It affects about 8 out of 10 pregnant women and can happen at any time of the day, not just the morning.

When should I see a GP if I think I'm pregnant?

Book your GP as soon as you get a positive test. They can confirm the pregnancy, help you work out your due date and register you for free maternity care. Contact your GP or maternity unit straight away if you have bleeding or tummy pain.