Pregnancy: What Are The Symptoms To Watch Out For?

There are many symptoms that can indicate pregnancy.

Discover all our advice to know if you are pregnant.

What are the symptoms of pregnancy?

Pregnancy is the term used when a woman has a fetus growing inside her, mostly in the womb.

Pregnancy in humans lasts about 40 weeks, or just over 9 months, from the last period of menstruation until the child is born.

Signs of Pregnancy: Am I Pregnant?

The first signs of pregnancy are:

• the absence of one or more cycles of menstruation;
• breasts that are harder, larger, or more painful to the touch. More rounded, darker nipples. Montgomery tubercles (small glands present on the areola) are more numerous or larger;
• nausea or vomiting (usually appears after a few weeks of pregnancy).

As the pregnancy progresses, other symptoms may appear, internally, externally, and mentally.

Internally

• Headaches ;
• excess saliva, especially when it comes to a first pregnancy;
• a metallic taste in the mouth;
• heartburn or gastroesophageal reflux disease;
• gum sensitivity;
• frequent urges to urinate. The growing uterus presses on the bladder;
• brownish bleeding. When the egg settles on the uterine wall (implantation), small bleeding may appear. If the bleeding is very red and accompanied by clots, contact your doctor;
• white, painless, and odorless vaginal discharge which may be abundant;
• constipation. Sometimes present from the start of pregnancy, constipation is usually more bothersome in the second half of pregnancy, when the uterus compresses the organs;
• abdominal pain reminiscent of menstrual cramps;
• vaginitis (fungal infection);
• nasal congestion;
• numbness or pain in the hands, especially during the 3rd trimester and at night;
• hemorrhoids;
• weight loss in early pregnancy;
• back pain, especially during the last months of pregnancy.

In external appearance

• A breakout of acne;
• fluid retention or edema (swelling), in the ankles, legs, or face;
• the appearance of varicose veins (damaged veins in which the blood circulates poorly). They usually form around the 7th month and are manifested by a feeling of heaviness or itching;
• the appearance of the mask of pregnancy (chloasma), dark spots on the face, mainly the forehead, nose, cheekbones, and chin, following exposure to the sun;
• the appearance of a brown line from the navel to the pubis, as the belly grows.

At the psychic level

• Fatigue, especially during the first trimester of pregnancy;
• cravings or an aversion to certain foods. A loss of appetite, or on other days, a difficult-to-control appetite;
• sensitivity to certain smells;
• mood swings, irritability, hypersensitivity;
• dizziness. The increase in blood volume and the more active work of the heart can cause dizziness. These can also be hypoglycaemic or even caused by a drop in blood pressure;
• sleep problems;
• stress, caused by the arrival of the future baby.

weight gain during pregnancy

During pregnancy, weight gain follows an upward curve, but weight gain is not the same depending on the trimester of pregnancy.

In the first trimester, weight gain is weak. Some women may even lose weight at the very beginning when they have nausea or vomiting.

In the second trimester, weight gain accelerates. This is the period of cravings or sudden cravings (which are sometimes disgusting). To avoid excessive weight gain, it is best to split meals (four or five small meals) and avoid excessive sugary foods. By the sixth month, a pregnant woman should have gained at least 6 kilos.

In the third trimester, the pregnant woman gains about 1 to 1.5 kilos per month on average. This is equivalent to a total weight gain at the end of pregnancy of 9 to 12 kilos.

Diagnosis of pregnancy

Pregnancy tests are sold in pharmacies. The result is reliable, just a few days after a late period. A doctor can also perform a pregnancy test.

Pregnancy test

The pregnancy test measures the hormone chorionic gonadotropin also called HCG or beta-HCG. This hormone is secreted by the cells of the future placenta as soon as the embryo is installed in the uterine wall. It is detectable around 8 days after fertilization and throughout pregnancy. Its quantity is maximum in the body between the 7th and 12th week of pregnancy, then falls.

The pregnancy test comes in the form of a stick or card. The device contains antibodies that react in the presence of the pregnancy hormone, indicating a blue line or a small cross depending on the state “pregnant” or “not pregnant”.

Diet during pregnancy

During pregnancy, women experience major physical changes that increase their nutrient and energy needs. By eating well, the pregnant woman, in addition to improving her health, contributes to the growth and development of the baby, as well as to the smooth running of her pregnancy.

Some tips :

• it is normal to eat a little more than usual, especially from the 2nd trimester (15 weeks and more);
• eat regularly (3 meals a day and snacks if necessary), to avoid low energy;
• vary your diet by including lots of vegetables and fruits, whole grains;
• cook meat, poultry, and fish well to avoid the risk of contamination;
• regularly consume foods rich in calcium, necessary for the formation of bones and teeth, such as dairy products, soy drinks, and canned fish. Foods containing vitamin D help absorb calcium; these are milk, fortified soy beverages, and fatty fish;
• regularly consume foods rich in iron, necessary for the growth of the baby and the placenta, for example, red meats, poultry, legumes, and nuts.

Vitamin and mineral supplements

Food is by far the best source of nutrients, even during pregnancy. Vitamin and mineral supplements will never replace a nutritious and varied diet. Pregnant women should not consume regular multivitamins. Multivitamins formulated specifically for pregnant women, especially those containing iron and folic acid, may be recommended by your doctor.

folic acid

Folic acid (or vitamin B9) is one of the essential B vitamins for baby growth, especially during the first four weeks of pregnancy.

Folic acid supplements help reduce the risk of the baby having a defect of the neural tube (a part of the embryo that gives rise to the brain and spinal cord), such as spina bifida (a malformation of birth of the spine), or other congenital malformations. Supplements usually contain 0.4 to 1 mg of folic acid.

It is recommended to start taking folic acid supplements 3 months before pregnancy and to continue taking them throughout pregnancy.

Caffeine, alcohol, tobacco, drugs

Caffeine

According to Health Canada, pregnant and breastfeeding women should consume no more than 300 mg of caffeine per day. Two epidemiological studies have highlighted the increased risks of miscarriage and of delivering a low birth weight baby in pregnant women who consume more than 3 cups of coffee per day. 

On the other hand, other data indicate that, despite what was once believed, coffee consumption is not associated with the risk of fetal death or congenital malformation.

Alcohol

The idea is not to consume any alcohol during pregnancy. The consumption of a large quantity of alcohol on the same occasion and the regular consumption of alcohol is particularly harmful to the baby, including in early pregnancy. 

The alcohol consumed passes directly from the blood of the mother to the blood of the baby through the placenta. It is not known exactly what the effects of occasional consumption of a small amount of alcohol are.

Alcohol can have several adverse effects on pregnancy, such as causing miscarriage, stillbirth, and premature delivery, and increasing the risk of the baby suffering from growth retardation and birth defects.

Fetal Alcohol Syndrome is one of “Fetal Alcohol Spectrum Disorders” (or FASD). The severity of the disorder depends on several factors, such as the amount of alcohol consumed and the concentration of alcohol in the mother’s blood.

Children with fetal alcohol syndrome have:

• below normal height and weight;
• facial malformations;
• brain damage.

Tobacco

Smoking harms the development of the fetus and can have consequences on the course of pregnancy. This is also the case for exposure to indirect second-hand smoke. Indeed, smoking:

• increases the risk of placental abruption, premature rupture of membranes, and premature delivery;
• can slow the growth of the fetus and thus reduce the weight of the baby at birth;
• increases the risk of having a baby who is stillborn or who dies in the days following delivery;
• increases the risk of sudden infant death syndrome (unexplainable, sudden death of an apparently healthy infant under one year of age).

Pregnancy is a great time to quit smoking. Although it is best to quit smoking before becoming pregnant, research shows that quitting smoking as late as 32 weeks gestation can still be beneficial.

Drugs

Using street drugs or second-hand smoke is never safe, especially during pregnancy. In general, taking drugs during pregnancy can have serious consequences for the development of the baby, and can cause the death of the fetus or premature birth.

Possible infections during pregnancy

Listeriosis

Listeriosis is an infectious disease caused by a bacterium (Listeria monocytogenes) present in the environment, which can sometimes contaminate certain already cooked foods, fruits and vegetables, milk, raw meat, and seafood.

If this infection often goes unnoticed in healthy subjects, it can have serious consequences in pregnant women, since it can cross the placental barrier and thus reach the fetus. The bacterium survives and grows well in the cold. Pregnant women are advised not to consume:

• unheated smoked sausages (hot dogs);
• uncured deli meats;
• refrigerated pâtés and meat spreads;
• chilled raw or smoked fish and seafood;
• milk or dairy products (yogurt, cheese) made from unpasteurized milk.

toxoplasmosis

Toxoplasmosis is a disease caused by a parasite. It is usually transmitted to humans by pets, especially cats, or by ingesting undercooked meat. It is a mild disease for human beings, but it can be dangerous for the developing fetus.

Many women are already immune to this parasite because they have already been in contact with the disease. A blood test is necessary to detect the presence of antibodies.

As a precaution:

• wear gloves when handling cat litter or gardening (the disease is transmitted through animal feces);
• wash fruits and vegetables thoroughly;
• avoid raw or undercooked meat.

Dental health during pregnancy

Pregnancy-related hormonal changes make the gums more sensitive, that is, they may be swollen or may bleed more easily. It is therefore important to have good dental hygiene.

Usually, bleeding gums decrease during pregnancy. Cavities, abscesses, or any other urgent problem can be treated without problem, with or without local anesthesia.

If an X-ray is needed, be sure to mention that you are pregnant so that the baby is protected.

Pregnancy follow-up

Control visits

Regular visits to a health professional make it possible to check that the pregnancy is going well and to detect any abnormalities that may arise.

The first visit for a pregnancy follow-up generally takes place between 8 and 12 weeks of pregnancy. Thereafter, the frequency of visits is one visit every 4 to 6 weeks, then more frequent visits as the due date approach.

At each appointment, the healthcare professional will check in on the pregnant woman:

• his weight ;
• his blood pressure;
• the height of her uterus;
• the baby’s heartbeat (although it doesn’t start to be heard until around 10 to 12 weeks, the baby’s heart started beating 21 or 22 days after fertilization).

Blood tests and urine tests will be carried out during pregnancy to check in the woman:

• the presence of anemia (iron deficiency);
• the presence of an infectious disease that could be transmitted to the baby;
• glycemia (blood sugar level), to detect gestational diabetes;
• blood type and rhesus (or Rh) factor. (If the woman is Rh negative, certain precautions will have to be taken. The woman is given anti-Rh immunoglobulin (also called WinRho®) at 28 weeks and sometimes after delivery. This treatment will prevent the development of anti-Rh antibodies. -Rh that could harm the current pregnancy or a future pregnancy);
• the presence of rubella antibodies;
• the presence of a urinary tract infection, even if there are no symptoms.

Ultrasound

Generally, during a normal pregnancy, a first ultrasound is performed between 18 and 20 weeks of pregnancy. This examination is safe for the fetus and allows:

• to observe the development of the baby;
• to more accurately determine the age of pregnancy;
• determine the location of the placenta;
• to observe the majority of the organs (heart, liver, kidneys, stomach, bladder, brain, etc.) and the baby’s limbs;
• to check how many babies there are;
• sometimes to know the sex of the baby.

Prenatal screening for trisomy 21

Trisomy 21, also called Down syndrome, is the most common chromosomal abnormality. It affects one in 800 babies and has the effect of limiting the intellectual development of those who are affected. There is currently no treatment for this disease.

A screening test assesses whether the probability (or risk) that the baby has trisomy 21 is low or high. This test consists of a blood sample, then the analysis of the nuchal translucency (the space between the skin of the neck and the spine of the fetus) during an ultrasound between 11 and 13 weeks of pregnancy. This test is safe for the foetus.

Amniocentesis is the most common prenatal diagnostic technique. It makes it possible to determine with certainty whether the fetus has trisomy 21 or not. This test can be done when 14 weeks of pregnancy have been completed. 

Amniocentesis is done by removing amniotic fluid from the pregnant woman’s uterus with a thin needle inserted into her abdomen. However, amniocentesis carries certain risks of complications, which can go as far as the loss of the foetus. This is why it is mainly offered to women who present a high risk according to screening tests.

What are the possible complications during pregnancy?

Discover the complete list, as well as indications on when to consult a doctor, for the safety of your child and yours.

Possible complications of pregnancy symptoms

• Miscarriage (natural termination of pregnancy before 20 weeks of pregnancy). It occurs in 15 to 20% of pregnant women;
• gestational diabetes is an intolerance to glucose that manifests during pregnancy, most often during the 2nd or 3rd trimester;
• ectopic pregnancy (EGU) or ectopic pregnancy occurs when the fertilized egg implants outside the uterus, typically in one of the fallopian tubes (tubal pregnancy), more rarely in the ovary (ovarian pregnancy ), or in the peritoneal cavity (abdominal pregnancy);
• iron deficiency anemia (due to iron deficiency) is common in pregnant women, particularly those with multiple and closely spaced pregnancies;
• Preeclampsia or pregnancy hypertension results from high blood pressure and excess protein in the urine. It can develop gradually or appear suddenly after about 20 weeks of pregnancy. The only way to cure it is to give birth to the child;
• preterm labor occurs before the 37th week of pregnancy. The causes are multiple and very often unknown.

When to consult your doctor?

• Loss of fluid or blood from the vagina;
• sudden or extreme swelling of your face or fingers;
• severe or persistent headaches;
• persistent nausea and vomiting;
• dizziness;
• blurry or blurred vision;
• abdominal pain or cramps;
• fever or chills;
• a change in the baby’s movements;
• a burning sensation when urinating;
• illness or infection that persists;
• if you are a victim of abuse or mistreatment;
• any other concerns.

During pregnancy, prescription and over-the-counter medications, herbal products, topical creams, inhalers, vitamins, and supplements can cross the placenta and enter the baby’s bloodstream.

It is therefore advisable to consult a doctor before taking any type of medicine.

Medicines during pregnancy

If you are already taking medication for chronic disease (asthma, diabetes…) or any particular condition, your doctor will tell you what to do during your pregnancy.

In general, it is preferable to favor alternative methods for common ailments.

In case of a cold

Acetaminophen (Tylenol) or paracetamol (Doliprane, Efferalgan) is safe. Blow your nose regularly, and use a saline solution to clean your nose.

Cold medicines often have vasoconstrictor effects (which decrease the diameter of blood vessels) and are not recommended for pregnant women.

Nasal sprays containing azelastine (antihistamine) are not recommended, those containing ephedrine or phenylephrine should be used for a short time, without exceeding the dosages.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and acetylsalicylic acid (Aspirin) should be avoided during the last four months of pregnancy.

In case of a cough

If necessary (disabling, tiring dry cough, etc.) and with the agreement of a doctor, antitussives with mild opiates (containing codeine or dextromethorphan) can be taken without exceeding the prescribed doses.

Be careful, however, not to take it a few days before delivery because of a risk of a sedative effect on the child.

In the case of constipation

Favor a diet rich in fiber, drink a lot, and move regularly.

Pharmaceutical products based on bran or mucilage (plant substance that swells when hydrated), such as Metamucil or Prodiem®, as well as lubricating laxatives based on paraffin oil, can be used for a few days.

Avoid mannitol (Manicol®) and pentaerythritol (Auxytrans®, Hydrafuca®). Beware of laxative herbal teas, some can promote uterine contractions.

In case of nausea and vomiting

Diclectin® (doxylamine succinate-pyridoxine hydrochloride) is a prescription drug that is safe in pregnancy as it has been shown not to harm babies. It contains a certain amount of vitamin B6 (pyridoxine). Several studies have also confirmed the effectiveness of vitamin B6 in reducing nausea and vomiting in pregnant women at the start of pregnancy.

Like prescription drugs, herbal products contain chemicals that can affect the health of the woman or baby.

The dosage and duration of taking these products must therefore be respected, particularly in pregnant women.

(See article from 2004: Pregnant women and natural products: caution is essential, on Passeport Santé).

Medicinal plants and pregnancy: what to do?

Safe natural products

Raspberry leaf tea is known to prevent complications during pregnancy and ease childbirth. In addition, grass is said to contain several vitamins and minerals. So far, studies have not been able to show any real beneficial effect, but it would be safe to consume during pregnancy.

Oxerutins are plant substances from the bioflavonoid family. Two clinical trials with 150 pregnant women indicate that oxerutins can relieve symptoms of hemorrhoids associated with pregnancy. 

In Europe, there are several pharmaceutical preparations based on oxerutins (troxerutin in particular) intended for the treatment of hemorrhoids (tablets, capsules, or drinkable solutions). These products are generally not sold in North America.

To be used in limited quantities

Ginger

According to the authors of a meta-analysis8, covering more than 1000 subjects, ginger can be useful in relieving pregnancy nausea in pregnant women. Several organizations, such as the Association of American Family Physicians, American College of Obstetricians and Gynecologists, Commission E, and WHO consider ginger to be an effective non-drug treatment for pregnancy nausea.

It is generally recommended to stick to the equivalent of 2g of dried ginger or 10g of fresh ginger per day, in divided doses.

Mint

Like tea, mint herbal tea decreases the absorption of iron in the body. As pregnant or breastfeeding women have higher iron needs, mint tea should preferably be consumed at least one hour before or after a meal and in moderation. Mint should not be consumed in the first trimester of pregnancy unless medically indicated.

Although peppermint is often recommended to pregnant women to counter the nausea of ​​pregnancy, the safety of peppermint essential oil has not been well established in this regard.

Green tea, consumed in large quantities, may reduce the absorption of folate (folic acid) in the body. Pregnant women are advised to consume it in moderation to minimize the risk of fetal malformations.

Avoid, as their safety has not been established

Chamomile

Since chamomile is traditionally known for its effectiveness in inducing menstruation, pregnant women are advised to avoid it.

Echinacea

Studies show that the consumption of echinacea would not be linked to complications of pregnancy and birth. On the other hand, some authors recommend avoiding echinacea in pregnancy, due to the lack of complete toxicological data. Some tests conducted on pregnant mice indicate a risk to the fetus during the first trimester.

Many other herbal medicines, such as evening primrose oil, ginkgo, and St. John’s wort, have not been studied enough to recommend during pregnancy.

Avoid, may be harmful to the health of pregnant women

Aloe

Although aloe latex is known to be effective and safe for treating occasional constipation, it is a stimulant laxative and therefore not recommended for pregnant women.

Eucalyptus Radiata essential oil (E. radiata) is not recommended during the first three months of pregnancy.

Licorice

An excess of glycyrrhizin (the active compound responsible for the benefits of licorice), during pregnancy, could lead to premature ^labor.

St. Christopher’s Grass

Using John Dory grass (false pigamon or blue cohosh) to stimulate labor can be dangerous.

Other medicinal plants

According to the Canadian Society of Obstetrics and Gynecology, several other herbal medicines should not be taken during pregnancy because they pose some level of risk to the health of the fetus or the woman.

For example, burdock, ginseng, chaste berry, valerian, and many others are to be avoided. Check the labels before consuming an over-the-counter natural product and make sure the product has a DIN (Drug Identification Number). If necessary, consult the pharmacist.

Image Credit: Photo by Amina Filkins from pexels.com