Early pregnancy signs: when to test, the first ultrasound and the heartbeat

In the first weeks of pregnancy the body changes quietly but quickly. Some people sense from the very first days that something is different, while others only notice once a test turns positive. Both are normal.

The most common early signs

Signs usually become clearer between weeks 4 and 8. They do not all have to appear together.

• A late period: For most people, the earliest and most reliable clue.
• Tiredness and sleepiness: Linked to a rise in the hormone progesterone.
• Nausea, vomiting or aversion to certain smells.
• Tender, swollen or fuller breasts.
• Needing to urinate more often.
• Mild groin twinges or very light spotting: Some people notice this around the time the embryo settles into the womb.
• Mood swings and changes in appetite.

Many of these signs resemble the days before a period, so no single sign counts as proof of pregnancy.

When should you test?

Home urine tests measure the pregnancy hormone hCG. The most reliable result usually comes after a missed period, ideally with first-morning urine. A test taken very early can be negative because the hormone may not have risen enough yet. If it is negative but your period has not arrived, you can repeat it a few days later. If it is positive, it helps to speak with a doctor or midwife and book a first visit. According to the Turkish Ministry of Health guideline, the first antenatal visit takes place within the first 14 weeks.

The first ultrasound and the heartbeat

The first ultrasound is usually done between weeks 6 and 10. It helps to confirm a few things:

• That the pregnancy is in the womb
• That the gestational sac and embryo are present
• The heartbeat, which for most people starts to be visible around week 6
• The gestational age, and with it the due date

On a very early scan the heartbeat may not be visible yet. That alone does not mean there is a problem; doctors often suggest a repeat scan a week or two later. Waiting is hard, so be kind to yourself in the meantime.

What can you do?

• Eat regularly; if you feel sick, try small, frequent meals, a dry snack and sips of water.
• Ask your doctor or midwife about folic acid and vitamin support; they will advise on the dose.
• Avoid smoking, alcohol, and raw or unpasteurised foods. If you are unsure about a food, you can check the Can I eat it? feature in the app.
• If you take medication regularly, do not stop it on your own; speak with your doctor.
• Rest. Tiredness is very common now and is not your fault.
• Jot down how you feel; it can take time to take it all in.

When to contact your doctor

• Bleeding heavy enough to soak a pad, or bleeding with clots
• Severe or sharp pain on one side of the belly, pain reaching the shoulder tip, dizziness or a feeling of fainting; in this case call 112 straight away
• Vomiting so constant that you cannot keep any fluid down
• High fever or marked burning when passing urine
• Symptoms suddenly disappearing together with cramps or bleeding

Light spotting is common and often harmless; it is still sensible to let your doctor know.

A short reminder

Some people have very strong symptoms in this phase and others feel almost nothing. Having few or many symptoms does not by itself say anything about your baby. Do not hesitate to ask your doctor or midwife your questions.

This article is for information only; your doctor's or midwife's advice for your own situation comes first.