How Do I Know if I’m Pregnant?

Everything You Need to Know About Late Periods, Pregnancy Tests and Telltale Signs

The only way to absolutely confirm the life-changing fact that you're pregnant is by getting a positive result on a pregnancy test. If you're actively trying to get pregnant, you've likely been anticipating the moment for some time, be it many months or only a few days. No matter how you came to this point of potential impending parenthood, the time between possible conception and the arrival of your period, or lack thereof, is one of profound emotional upheaval. The average "two-week wait" for the point when a pregnancy test promises accurate results may sound brief, but it can feel like an eon of uncertainty. Consider it the first of countless tests of patience that await you on your journey into motherhood.

A Timeline of Very Early Pregnancy

Woman holding positive pregnancy test

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Understanding what is going on inside your body will help you determine when to take a pregnancy test and also detect other subtle signs of very early pregnancy. Know that ovulation occurs, on average, 11 to 21 days after the first day of your most recent period. Fertilization happens a few days after ovulation, then the fertilized egg travels through the Fallopian tube into the uterus, where it implants in the uterine lining. Upon implantation, hCG, the "pregnancy hormone" detected by pregnancy tests is produced. Implantation takes place, on average, between six and 12 days after ovulation, but it takes at least several more days, and up to several weeks, before hCG levels are high enough to be detected on a home pregnancy test. This timeline results in pregnancy being accurately detectable around a week after you expect your next period to begin.

At-Home Pregnancy Tests

Home pregnancy tests are considered 99 percent accurate, but they give accurate results only when used correctly and when you've waited long enough after potential conception for your hormone levels to reach a detectable point. The sensitivity of tests varies by brand, with some claiming to give accurate results up to five days before you miss your period. Most claim accuracy from the first day of your missed period, with the most accurate results occurring when testing around one week after that date. Whatever brand you use, follow the instructions closely.

Positive Pregnancy Test: If the results of a pregnancy test are positive, even if the positive result indicator is barely detectable, then you are pregnant. Some women like to take a second (or third, or fourth…) test to confirm, but it's not necessary. False positives are very rare.

Negative Pregnancy Test: A negative pregnancy test result isn't quite as straightforward as a positive one. Before writing off the possibility of pregnancy, consider whether your period could not really be late, or not as late as you thought, as well as the possibility of later-than-average ovulation. If it's possible that you're testing too early, wait a few days and test again, and continue until you either get your period or the test becomes positive. (Continued and confusing negative results in the absence of your period warrant a call to your doctor.)

Subtle Early Signs

Woman holding positive pregnancy test

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During the two-week wait, or any time between suspecting pregnancy and taking a test, it's easy to become hyper-aware of your body and wonder whether every sensation is a sign. The following symptoms are associated with early pregnancy and might offer clues that you're about nine months away from becoming a mother:

  • Nausea. The notorious morning sickness usually doesn't start until at least six weeks into pregnancy, but can come sooner.
  • Breast changes. Tender, heavy feeling and/or enlarged breasts are early pregnancy signs, as are darker areolas.
  • Fatigue. Extreme tiredness is caused by increased levels of progesterone, among other factors, during early pregnancy.
  • Uterine cramps. Some women feel cramping in the uterus around the time of implantation. It feels similar to menstrual cramps, and the two are easily confused.
  • Spotting. Implantation sometimes causes light spotting, which can be confused with the start of your period.
  • Digestive issues. Progesterone slows down digestion, which can cause constipation, gas and bloating during early pregnancy.
  • Other signs. Other symptoms associated with early pregnancy include food aversions or cravings, sensitivity to smells, shortness of breath, frequent urination, headaches, back pain, mood swings and dizziness.

When to Call Your Doctor

You should call your family doctor or an OB/GYN to make your first prenatal appointment soon after getting a positive pregnancy test. Inform her of the date of the first day of your last period, which is needed to date your pregnancy. Don't be surprised if the doctor doesn't want you to come in until you're six to eight weeks into your pregnancy. She may want to see you sooner, however, if you're anticipating a high-risk pregnancy, are experiencing any unusual or troubling symptoms such as pain or bleeding, or don't know the date of your last period.

While waiting to see your doctor, start routine prenatal self-care. This means taking prenatal vitamins, cutting out alcohol, avoiding certain foods and checking with your doctor before taking medications. Write down all the questions you have for your doctor.