What Are the Early Signs of Pregnancy?

Week-by-week guide to first trimester symptoms - what is normal, what is concerning, and when to book your first appointment in Singapore.

Week-by-Week First Trimester Timeline

The first trimester runs from week 1 to week 13. Most symptoms are driven by rapidly rising hCG and progesterone levels. Not every woman gets every symptom - some women feel almost nothing, while others feel very unwell.

Wk 1-3
Conception and implantation happen. No symptoms yet. hCG levels too low to detect on most tests.
Wk 4-5
Missed period. Light spotting (implantation bleeding) in 25-30% of women. Breast tenderness begins. A home pregnancy test turns positive.
Wk 5-6
Nausea begins for most women. Fatigue can be extreme. Frequent urination starts as kidneys work harder. Food aversions emerge.
Wk 7-9
Nausea and vomiting peak. Smell sensitivity at its worst. Bloating and mild cramping are common. Mood swings due to hormonal changes.
Wk 10-12
Nausea usually starts to ease. Energy levels slowly return. First trimester scan (NT scan) done around week 11-13. Heartbeat visible on ultrasound.
Wk 13
End of first trimester. Most women feel much better. Miscarriage risk drops significantly. Safe to share your pregnancy news.

Common Early Pregnancy Symptoms Explained

Symptom When It Starts Why It Happens What Helps
Missed period Week 4-5 Progesterone prevents uterine lining from shedding Take a home test; book GP or gynae
Breast tenderness Week 3-6 Oestrogen and progesterone increase breast tissue Soft, supportive bra; avoid tight clothing
Fatigue Week 4-6 Progesterone is sedating; body working hard on placenta Rest when possible; short naps; go to bed earlier
Nausea and vomiting Week 5-6 Rising hCG levels; stomach empties more slowly Small frequent meals; ginger; Vitamin B6
Frequent urination Week 4-6 hCG stimulates kidneys; uterus begins pressing on bladder Stay hydrated; do not restrict fluids
Light spotting (implantation) Week 3-4 Embryo burrowing into uterine lining causes minor bleeding Pink or brown; lighter than period; should stop in 1-2 days
Food aversions Week 5-8 Heightened smell sensitivity; evolutionary protective response Eat whatever you can tolerate; aversions ease in T2
Bloating and mild cramps Week 4-6 Progesterone slows digestion; uterus expanding Normal if mild; heating pad on low; gentle walking

Singapore context: Food aversions to hawker food are extremely common - satay, laksa, and durian smells are among the most reported triggers. Many mums find plain rice, toast, and watermelon are easier to manage in the first trimester.

What Is Normal vs What Needs Medical Attention

Symptom Normal - Monitor Seek Help Immediately
Vaginal bleeding Light pink or brown spotting for 1-2 days Bright red bleeding, heavy flow, tissue passing
Cramping Mild, period-like cramps on and off Severe one-sided pain (may indicate ectopic pregnancy)
Nausea Daily nausea, occasional vomiting Cannot keep any fluid down for 24 hours; signs of dehydration
Abdominal pain Stretching or round ligament sensation Sharp, constant one-sided pain with shoulder tip pain
Discharge Clear or white, mild odour increase Green, yellow, or foul-smelling discharge with irritation

Ectopic pregnancy warning: Severe one-sided abdominal pain, shoulder tip pain, and dizziness in early pregnancy requires immediate emergency care. This is a life-threatening condition. Go to A&E immediately - do not wait for a GP appointment.

Taking a Pregnancy Test and Booking Your First Appointment

Home pregnancy tests in Singapore are widely available at Guardian, Watsons, Cold Storage, and even NTUC FairPrice. Most brands are reliable from the first day of a missed period.

Digital Tests (e.g., Clearblue)

  • - Show "Pregnant" or "Not Pregnant" - no ambiguity
  • - Available from S$15-25 per test
  • - Can detect from 5 days before missed period (lower accuracy)
  • - Best used on first morning urine

Strip Tests (e.g., Careone)

  • - Two lines = positive (even faint lines count)
  • - Much cheaper: S$1-5 each at Watsons or online
  • - Just as accurate from missed period date
  • - Good for those who test frequently during TTC

When to Book Your First Appointment

Once you have a positive test, book an appointment with your GP or gynae within 1-2 weeks. Your first visit is usually at week 6-8, when a heartbeat can be confirmed on ultrasound. If you plan to use a polyclinic for shared care, your GP will refer you. If going private, call the clinic directly.

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