Pregnancy Symptoms: The Good, the Bad, and the Ugly
Comprehensive pregnancy symptoms: A detailed guide from week one to delivery
A comprehensive introduction to the pregnancy journey
Pregnancy is an extraordinary experience in which a woman undergoes a unique physical and emotional transformation that lasts approximately 40 weeks. This journey, divided into three trimesters, is accompanied by a variety of symptoms, ranging from expected to unexpected. While most of these symptoms are considered normal and indicate a healthy pregnancy, understanding and managing them properly remains essential for the well-being of both mother and baby.
Important medical warning: The following content provides general educational and awareness information only. It is not a substitute for professional medical advice. You should always consult your obstetrician-gynecologist or other qualified healthcare provider for an individual assessment and appropriate medical guidance.
Part 1: Pregnancy Symptoms
The first third (weeks 1-12): The foundation stage
Basic hormonal changes:
During the first few weeks, the body produces large amounts of key pregnancy hormones:
Human chorionic gonadotropin (hCG): responsible for a positive pregnancy test
Progesterone: Maintains the uterine lining and relaxes muscles
Estrogen: Stimulates uterine growth and the growth of milk ducts
Detailed symptoms of the first trimester:
Menstrual cycle amenorrhea:
The first and most obvious sign
Some women may notice light "implantation bleeding" one to two weeks after fertilization.
Nausea and vomiting (morning sickness):
It affects 70-80% of pregnant women
It can happen at any time of day, not just in the morning.
It typically peaks between weeks 6 and 12
Tip: Eat small, frequent meals, avoid strong odors, and drink ginger.
Extreme fatigue:
As a result of elevated progesterone levels
Increase blood production by 30-50%
The body works harder to support the developing fetus.
Breast changes:
Increased sensitivity and pain
Darker halo
The appearance of small bumps around the nipple (Montgomery glands)
Increase in breast size by the sixth week
Frequent urination:
The growing uterus puts pressure on the bladder.
Increased blood volume leads to increased kidney filtration.
Mood swings:
As a result of rapid hormonal changes
Mixed feelings of joy and anxiety
Symptoms similar to premenstrual syndrome may appear
Aversion to food or intense craving for it:
50-90% of pregnant women experience intense cravings
Aversion to some of the aforementioned foods may be preferable.
Theory: A natural protective mechanism against toxins
Constipation:
The hormone progesterone slows down bowel movements.
Iron supplements may worsen the problem.
Second trimester (weeks 13-28): The boom phase
General improvement in symptoms:
It is often called the "honeymoon period" because:
Reduced levels of nausea
Return of energy and activity
Beginning to feel fetal movements
New and distinctive symptoms:
Pregnancy belly appearance:
The abdomen begins to protrude noticeably.
Normal weight gain: 0.5-1 kg per week
The first fetal movements (acceleration):
First movements between weeks 16 and 25
They resemble butterflies or gas bubbles
The intensity and frequency increase as the pregnancy progresses.
Sharp or aching pain in both sides of the abdomen
As a result of stretching of the ligaments supporting the uterus
This occurs when changing position or coughing.
Skin changes:
Linea nigra: A dark line from the navel to the pubic area
Melasma: Dark spots on the face (pregnancy mask)
Stretch marks on the breasts, abdomen, and thighs
Nasal congestion and bleeding gums:
Increased blood flow to the mucous membranes
Swelling of the nasal membranes (rhinitis of pregnancy)
Bleeding gums when brushing (pregnancy gingivitis)
Varicose veins:
Enlarged veins, especially in the legs
As a result of increased blood volume and uterine pressure
Normal vaginal discharge (leukorrhea):
thin, white, milky secretions
Increase due to increased blood flow and estrogen
Important: Distinguish it from abnormal secretions
Third trimester (weeks 29-40): Preparation phase
The body's preparations for childbirth:
shortness of breath:
The uterus presses on the diaphragm.
It improves slightly when the baby's head descends into the pelvis.
Heartburn and indigestion:
The uterus presses on the stomach.
The hormone progesterone relaxes the valve between the stomach and esophagus.
Tip: Eat small meals, avoid lying down after eating
hemorrhoids:
Varicose veins in the rectal area
As a result of increased pressure and constipation
Swelling of the ankles and feet (edema):
natural fluid retention
Prolonged standing increases in hot weather
Warning: Sudden swelling of the face or hands requires medical evaluation.
Back and pelvic pain:
Weight gain and change in center of gravity
The hormone relaxin loosens the ligaments in preparation for childbirth.
Irregular training contractions
It differs from true labor in its irregularity and disappearance with rest.
Constant fatigue:
Difficulty sleeping due to belly size
Frequent nighttime urination
Anxiety about childbirth and motherhood
Part Two: Symptoms According to Body Systems
Digestive system:
Cravings: A strong desire for specific foods
Food aversion: dislike of certain smells or foods.
Excessive salivation (ptyalism): especially with severe nausea
Change in sense of taste: metallic taste in the mouth
The musculoskeletal system:
Pubic pain: a result of stretching of the pubic symphysis
Carpal tunnel syndrome: numbness and pain in the hands
Rib pain: a result of fetal kicks and expansion of the rib cage.
The nervous system:
Pregnancy forgetfulness: difficulty concentrating and remembering
Dizziness: Low blood pressure or low blood sugar
Numbness in the extremities: a result of fluid retention
Urinary system:
Urinary incontinence: leakage when sneezing or laughing
Urinary tract infections: more common during pregnancy
Part Three: Symptom Management and Healthy Lifestyle
Balanced nutrition:
Essential nutrients:
Folic acid: 400-800 micrograms daily
Iron: 27 mg daily
Calcium: 1000 mg daily
Vitamin D: 600 IU daily
Healthy foods:
High-quality protein (meat, chicken, fish, legumes)
Whole grains
Colorful fruits and vegetables
Low-fat dairy products
Foods to avoid:
High mercury fish
undercooked meat
unpasteurized soft cheeses
Excessive caffeine (less than 200 mg per day)
Safe physical activity:
Recommended exercises:
Daily walk 30 minutes
Swimming and water exercises
Yoga and meditation
Pelvic floor (Kegel) exercises
Exercises to avoid:
Contact sports
Activities with a high risk of falling
underwater diving
Exercise in hot, humid weather
Psychological and emotional care:
Mental health support:
Joining pregnancy support groups
Practicing relaxation techniques
Talking about feelings and fears
Preparing for childbirth:
Childbirth preparation courses
Birth plan
Visit the hospital or maternity center
Part Four: Symptoms that require immediate medical intervention
Danger signs at any stage of pregnancy:
Vaginal bleeding:
Mild with pain: Consultation within 24 hours
Heavy as a menstrual flow: immediate emergency
Accompanied by tissue: Immediate emergency
Liquid leakage:
sudden flow of liquid
Continuous leakage of drops
Watery and transparent color (may be amniotic fluid)
Decreased or stopped fetal movement:
Fewer than 10 movements in two hours after week 28
A noticeable change in movement pattern
Counting method: Lie on your left side, count the movements
Signs of preeclampsia:
Severe headache that does not respond to painkillers
Visual disturbances (spots, lights, blurring)
Pain in the upper abdomen or below the ribs
Sudden swelling of the face and hands
Sudden weight gain (>1 kg per week)
Signs of infection:
Fever above 38 degrees Celsius
goosebumps and trembling
Pain or burning when urinating
Foul-smelling vaginal discharge
Regular contractions:
Before week 37 (sign of premature birth)
Every 10 minutes or less
It increases in strength and frequency over time.
When to go to the emergency room:
Heavy vaginal bleeding
severe chest pain or difficulty breathing
Fainting or severe dizziness
abdominal injury
Thoughts of harming oneself or others
Part Five: Medical Follow-up and Examinations
Visit schedule:
Until week 28: Visit every 4 weeks
Weeks 28-36: Visit every two weeks
Week 36 - Birth: Weekly Visit
Basic tests for each trimester:
The first third:
Comprehensive blood tests
Urine test
First ultrasound waves
Examination of the nuchal translucency (if present)
The second third:
Blood sugar test between weeks 24-28
Detailed ultrasound
Birth defect screening (quadrilateral screening)
The third third:
Group B Streptococcal swab (week 36)
Examination of fetal position
Cervical assessment
Part Six: Psychological and Practical Preparation for Childbirth
Hospital bag:
Mother's essentials:
Identity and insurance documents
Comfortable clothes for childbirth and stay-at-home
personal hygiene products
nursing pillow
Baby essentials:
Going-out clothes
diapers
blankets
car seat
Birth plan:
Pain relief preferences
People who are wanted to attend
Preferences in case of medical intervention
Breastfeeding plans
Part Seven: Scientific Sources and Reliable References
To ensure you receive accurate and up-to-date information, we recommend referring to:
Global organizations:
World Health Organization (WHO)
Global guidelines for pregnancy care
Nutrition during pregnancy
Educational brochures for prenatal care
Maternal and child health support programs
Multilingual awareness materials
Specialized medical associations:
American College of Obstetricians and Gynecologists (ACOG)
Clinical Guidelines
Answers to frequently asked questions
Monthly tips
The Royal College of Obstetricians and Gynaecologists (RCOG)
Clinical practice guidelines
Patient information leaflets
International Federation of Gynecology and Obstetrics (FIGO)
Scientific announcements and positions
Care Quality Improvement Programs
Research and knowledge centers:
Centers for Disease Control and Prevention (CDC)
Pregnancy health statistics and monitoring
Vaccination recommendations during pregnancy
National Institutes of Health (NIH)
Recent research and studies
Information about clinical trials
Mayo Clinic
Medically reviewed articles
Interactive tools and metrics
Local authorities:
Ministry of Health in your country
National Care Programs
Accredited health centers
Local medical associations
Certified doctors in your area
Local support programs
Additional reliable sources:
American Pregnancy Association
Nemours Foundation
"What to Expect" website
Academy of Breastfeeding Medicine
Tip for verifying information:
Make sure of the publication date of the information (it must be recent, within 3 years).
Check the content writer's qualifications
Look for consistent information from multiple sources.
Use websites ending in .gov or .edu for official information.
Conclusion: The journey of pregnancy, between challenges and joy
Pregnancy is a multifaceted journey that combines physical and emotional challenges with the anticipated joy of welcoming a new family member. Remember that:
Open communication with the healthcare team is the foundation of good care.
Trusting your intuition is important - you know your body's changes best.
Cognitive readiness reduces anxiety and increases confidence
Asking for help is a sign of strength, not weakness.
Every pregnancy is unique - comparing your experience with others may not be helpful.
We wish you a healthy and safe pregnancy, an easy delivery, and a happy start with your new baby.
Final disclaimer:
This article is intended as a general guide and does not cover all individual cases. All medical decisions should be made under the direct supervision of a qualified healthcare professional who can assess your individual situation and make appropriate decisions based on your complete medical history and physical examination.
Date prepared: [Today's date]
Date of medical review: [Review date]
Main sources: Review of WHO guidelines 2023, American College of Obstetricians and Gynecologists 2024, and Saudi Ministry of Health 2024.
Here is a curated list of **authoritative English-language sources** organized by category to support the comprehensive pregnancy symptoms article. All links lead to current, evidence-based resources from globally recognized health organizations (prioritizing .gov, .edu, and official medical association sites):
1. Global Health Organizations**
World Health Organization (WHO)
- [WHO Recommendations on Antenatal Care for a Positive Pregnancy Experience (2016/2021 updates)](https://www.who.int/publications/i/item/9789241549912)
*Comprehensive guidelines covering nutrition, maternal assessment, and symptom management*
- [WHO Antenatal Care Nutritional Interventions Update (2021)](https://www.who.int/publications/b/59023)
*Evidence-based recommendations on iron, folic acid, calcium, and multiple micronutrients*
- [WHO Multiple Micronutrient Supplements During Pregnancy](https://www.who.int/publications/i/item/9789240007789)
*Latest guidance on prenatal supplementation*
UNICEF
- [UNICEF Antenatal Care Resources](https://data.unicef.org/topic/maternal-health/antenatal-care/)
*Global standards for pregnancy care and monitoring*
2. U.S. Medical Associations**
American College of Obstetricians and Gynecologists (ACOG)
- [ACOG Patient FAQ: Nausea and Vomiting of Pregnancy](https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy)
*Evidence-based management of first-trimester symptoms*
- [ACOG Practice Bulletin No. 189: Nausea and Vomiting of Pregnancy (2018)](https://journals.lww.com/greenjournal/fulltext/2018/01000/acog_practice_bulletin_no__189__nausea_and.39.aspx)
*Clinical guidelines for severe symptoms*
- [ACOG Patient FAQ: Preterm Labor and Birth](https://www.acog.org/womens-health/faqs/preterm-labor-and-birth)
*Warning signs and management*
- [ACOG Committee Opinion: Prevention of Group B Streptococcal Disease (2020)](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/02/prevention-of-group-b-streptococcal-early-onset-disease-in-newborns)
*Screening at 36–37 weeks*
- [ACOG Patient FAQ: Preeclampsia and High Blood Pressure](https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy)
*Warning signs and management*
- [ACOG Infographic: Preeclampsia Warning Signs](https://www.acog.org/womens-health/infographics/preeclampsia-and-pregnancy)
*Visual guide to urgent symptoms*
Exercise Guidelines
- [ACOG Committee Opinion No. 804: Physical Activity and Exercise During Pregnancy (2020)](https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period)
*Evidence-based recommendations for safe exercise*
3. U.S. Government Health Agencies
Centers for Disease Control and Prevention (CDC)
- [CDC Hear Her: Urgent Maternal Warning Signs](https://www.cdc.gov/hearher/maternal-warning-signs/index.html)
*Official list of symptoms requiring immediate care (updated 2024)*
- [CDC Folic Acid Recommendations](https://www.cdc.gov/folic-acid/about/intake-and-sources.html)
*400 mcg daily recommendation*
- [CDC Group B Strep Screening Guidelines](https://www.cdc.gov/group-b-strep/testing/index.html)
*Screening at 36–37 weeks*
National Institutes of Health (NIH)
- [NICHD: About Pregnancy](https://www.nichd.nih.gov/health/topics/factsheets/pregnancy)
*Comprehensive overview of normal symptoms and warning signs*
- [NIH Office of Dietary Supplements: Pregnancy Fact Sheet](https://ods.od.nih.gov/factsheets/Pregnancy-HealthProfessional/)
*Evidence-based nutrient requirements (updated April 2025)*
- [MedlinePlus: Pregnancy Health Topics](https://medlineplus.gov/pregnancy.html)
*NIH-curated patient resources (.gov site)*
Office on Women's Health (HHS)
- [Stages of Pregnancy](https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy)
*Trimester-by-trimester symptom guide (updated 2024)*
4. Reputable Medical Institutions
Mayo Clinic
- [First Trimester Pregnancy: What to Expect](https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047208)
*Detailed symptom descriptions with medical review*
- [Second Trimester Pregnancy: What to Expect](https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047732)
*Symptom relief and fetal development*
- [Third Trimester Pregnancy: What to Expect](https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20047209)
*Late-pregnancy symptoms and preparation*
- [Symptoms of Pregnancy: Early Signs](https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853)
*Early symptom recognition*
Cleveland Clinic
- [Kick Counts (Fetal Movement Monitoring)](https://my.clevelandclinic.org/health/articles/23497-kick-counts)
*ACOG-aligned guidance on counting movements after 28 weeks*
- [Preterm Labor Symptoms](https://my.clevelandclinic.org/health/diseases/4498-premature-labor)
*Warning signs requiring immediate care*
5. UK National Health Service (NHS)
- [NHS Week-by-Week Pregnancy Guide](https://www.nhs.uk/best-start-in-life/pregnancy/week-by-week-guide-to-pregnancy/)
*Trimester-specific symptoms with UK clinical standards*
- [NHS Pregnancy Signs and Symptoms](https://www.nhs.uk/pregnancy/keeping-well/common-pregnancy-complaints/)
*Management of common ailments (constipation, heartburn, swelling)*
- [RCOG Patient Information Leaflets](https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/)
*Royal College of Obstetricians and Gynaecologists evidence-based resources*
6. Specialized Patient Education Resources
March of Dimes
- [Pregnancy Complications](https://www.marchofdimes.org/complications)
*Warning signs of preeclampsia, preterm labor, and other complications*
- [Foods to Avoid During Pregnancy](https://www.marchofdimes.org/pregnancy/foods-to-avoid-during-pregnancy)
*Evidence-based dietary safety guidelines*
American Pregnancy Association
- [Early Signs of Pregnancy](https://americanpregnancy.org/pregnancy-symptoms/early-signs-of-pregnancy/)
*Comprehensive symptom list with medical review*
- [Counting Baby Kicks](https://americanpregnancy.org/healthy-pregnancy/while-pregnant/counting-baby-kicks/)
*Fetal movement monitoring guidance*
7. Nutrition-Specific Guidelines
- [CDC Folic Acid Clinical Overview](https://www.cdc.gov/folic-acid/hcp/clinical-overview/index.html)
*400 mcg recommendation for all women of reproductive age*
- [WHO Iron and Folic Acid Supplementation](https://www.who.int/tools/elena/interventions/daily-iron-pregnancy)
*30–60 mg elemental iron daily recommendation*
- [ACOG FAQ: Healthy Eating During Pregnancy](https://www.acog.org/womens-health/faqs/healthy-eating)
*Balanced diet recommendations and supplement guidance*
8. Critical Warning Signs Resources**
- [CDC Hear Her Warning Signs Poster (PDF)](https://www.cdc.gov/hearher/resources/download-share/docs/pdf/Warning-Signs-Poster-LTR-English.pdf)
*Official printable guide for urgent symptoms*
- [Preeclampsia Foundation: Signs & Symptoms](https://www.preeclampsia.org/signs-and-symptoms)
*Patient-focused warning sign recognition*
- [ACOG: When to Call Your Doctor During Pregnancy](https://www.acog.org/womens-health/faqs/when-to-call-your-doctor-during-pregnancy)
*Symptom severity assessment guide*
Verification Tips for Credible Sources
✅ Prioritize URLs ending in **.gov** (U.S. government), **.nhs.uk** (UK National Health Service), or official medical association domains (**acog.org**, **rcog.org.uk**)
✅ Check publication dates—prefer resources updated within the last **3 years** (2022–2025)
✅ Cross-reference information across ≥2 authoritative sources
✅ Avoid commercial sites (.com) without medical oversight unless from recognized health organizations (e.g., Mayo Clinic, Cleveland Clinic)
*Note: Always consult a qualified healthcare provider for personal medical advice. These resources provide general educational information only.*