Tommy’s midwives are here to support you by telling you everything you need to know about week 4 of pregnancy: advice on common pregnancy symptoms, practical actions, such as the ‘booking’ appointment and what’s happening with your baby.
Before week 4
Congratulations on your exciting news! If your periods are usually regular, conception is likely to happen in the middle of weeks one to four. You are very unlikely to know you're pregnant at this stage.
It may sound odd but pregnancies are measured from the first day of your last period rather than the day you actually conceived your baby. This is because it's not always easy to be sure of the exact date you became pregnant.
“I spent the entire week my period was due running to the loo, just to double check I didn’t have my period. My boobs felt tender - but that can be a sign of PMT too. I took an early test in the end and couldn’t believe it when it showed positive.” Ayida, mum of one
Although a fertilised egg may have implanted in your womb just two weeks ago, if the first day of your last period was four weeks ago, you are officially four weeks pregnant! This may seem odd if you think you can definitely date the pregnancy more recently.
What does my baby look like?
The tiny person inside you is the size of a poppy seed. A little dot, measuring about 2mm.
The baby may be miniscule but big things are happening! The fertilised egg has snuggled into the side of your womb. It divides into layers of cells that will eventually become different parts of your baby’s body.
Your baby’s nervous system and heart are developing. Amazingly your tiny dot already has some of its own blood vessels and blood is starting to circulate. A string of these blood vessels connects you to your baby. This will eventually become the umbilical cord.
Right now, your poppy seed is known as an embryo. They get their energy and nourishment from a yolk sac (until the placenta takes over in a few weeks). Your baby is surrounded by amniotic fluid within the amniotic sac, providing a comfy cushion for them throughout your pregnancy.
Your symptoms - what happens in week 4
Early symptoms of pregnancy
Bleeding or spotting
You might notice some very light bleeding, or ‘spotting’, known as implantation bleeding. This can be caused by your little seed burrowing into the lining of your womb. It often happens around the time your period would have been due and is relatively common.
You may also have some period-like cramping in these early weeks.
If you notice any bleeding at any stage of your pregnancy, though, it's important to get it checked out by your doctor or midwife.
This week, a surge in progesterone can start to make your boobs feel tender, heavy and sore - a bit like how they might feel before your period.
Remarkably, these are pregnancy hormones already preparing your body to produce milk. This tenderness usually eases off by the end of the first trimester.
Things to do in week 4
Smoking and alcohol in pregnancy
It’s time to quit cigarettes and alcohol. Both can be harmful to your growing baby because the toxins pass through the placenta.
Here’s our guide to avoiding alcohol during pregnancy.
Find out more about the effects of smoking in pregnancy.
And if you’re still struggling to stop smoking, these ten steps towards quitting could help.
If you use street or recreational drugs, stop or ask your doctor for advice on stopping safely.
Sexually transmitted infections (STIs) such as chlamydia, gonorrhoea, syphilis and genital herpes can affect your baby's health during pregnancy or birth.
If you think you or your partner might have an STI, go for a check-up as soon as you can. Your doctor or midwife can tell you where you can find your nearest sexual health clinic.
Don't worry, nobody will judge you and it's important to be checked as soon as possible.
Continue (or start) taking these supplements
There are two vitamins that are very important in pregnancy and that you can take as supplements: Folic acid and vitamin D.
Folic acid is naturally present in leafy vegetables, fruits and berries, beans and wholegrain products - but keep taking folic acid supplements too, until at least week 12 because you can't get enough through food alone to build up the level of folic acid that your baby needs.
Folic acid helps in the formation of your baby's nervous system and reduces the risk of spina bifida, which is where the baby's spine doesn't close up properly.
You should take:
- 10 micrograms of vitamin D each day throughout your pregnancy and if you breastfeed
- 400 micrograms of folic acid each day – you should take this from before you are pregnant until you are 12 weeks pregnant
Find out more about important supplements in pregnancy.
Tell the GP you are pregnant
Once you know you’re pregnant, make an appointment to see your doctor or a midwife to get any advice you need and to be booked in for your pregnancy care appointments. pregnancy care appointments. If you make a GP appointment, they will set you up for midwife appointments or you can call the maternity unit in the local hospital and refer yourself that way.
However you book it, your first appointment with the midwife will not take place until after week 8, the ‘booking’ appointment. This can make it an anxious time but reading through these dos and donts of pregnancy may help.
This is an important time to talk about any health issues you have to make sure your pregnancy goes well. It is very important to tell your doctor about any medication you may be on, especially long-term medicines for conditions, such as asthma, epilepsy, mental health conditions, diabetes, hormone therapy, heart problems and so on. Your doctor can make sure you are on the safest medication for you and baby.
It is very important that you do not stop taking medication without talking to your GP or specialist
Find out what questions you'll be asked at the booking appointment.
If you have an existing mental health problem
If you have a pre-existing mental health condition and take medication, tell your doctor and the person who prescribed the medication that you’re pregnant as soon as possible.
They will talk to you about whether your medication is safe in pregnancy or whether you should consider a different treatment.
Find out more about your mental wellbeing in pregnancy.
What are my chances of miscarrying?
It’s a sad thing to think about, but up to one in five pregnancies will end in miscarriage in the first three months.
If you do have light bleeding, spotting or stomach pains, this doesn't mean you are going to miscarry. However, you should always speak to your doctor or midwife and ask for advice.
Find out the other symptoms you should contact your midwife about.
1. NHS Choices.You and your baby at 0–8 weeks pregnant, NHS Choices: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/pregnancy-weeks-4-5-6-7-8.aspx#close (Page last reviewed: 28/02/2017 Next review due: 28/02/2020)
2. NHS Choices. Vaginal bleeding in pregnancy http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vaginal-bleeding-pregnant.aspx (Page last reviewed: 26/01/2018 Next review due: 26/01/2021)
5. NHS Choices. Signs and symptoms of pregnancy http://www.nhs.uk/Conditions/pregnancy-and-baby/pages/signs-and-symptoms-pregnancy.aspx (Page last reviewed: 06/10/2016 ;Next review due: 06/10/2019)Hide details
ℹLast reviewed on June 22nd, 2018. Next review date June 22nd, 2021.
By Duke (not verified) on 11 Apr 2020 - 12:24
I tested positive to d home pregnancy test... ND at week 4 I HV my period again... Though it was only normal at day 1 and other days were just drops and little clots... Pls am I still pregnant?
By Jakyra Hedrick (not verified) on 4 Apr 2020 - 13:41
So I’m 3-4 weeks pregnant and I was spotting and I went to the doctor they said I was dehydrated and need to drink more water but I’m scared and I want to know could it be the uti pills
By Malebo (not verified) on 3 Apr 2020 - 13:39
I'm 4 weeks pregnant, I have cramps and pains on my legs arms, waist ,stomach and back pain and headaches.My stomach is making noise like when u r hungry I'm scared I may miscarry
By Eroubome joy (not verified) on 23 Mar 2020 - 15:19
My period is 3 day late
By Tasha (not verified) on 10 Mar 2020 - 01:13
Hi last period on 2/5/20 always 28 day cycle alway normal now tts 3/9/20 6 days past my expected period just see light pink spott
By Fiona ebi (not verified) on 2 Apr 2020 - 07:07
You might be pregnant dear, do a home pregnancy test to be sure.
By Stiffie (not verified) on 6 Apr 2020 - 05:08
Light pink spotting is usually what they call implantation bleeding: it means you’re fertilized egg is attaching itself to your womb!
By Dayana (not verified) on 24 Feb 2020 - 11:04
Kindly anybody share the exact symptoms on your nearest periods dates and early pregnancy symptoms...will it be same...I'm trying for a baby but I have all usual pre-menus symptoms ...
By Anonymous (not verified) on 8 Feb 2020 - 01:01
I was suppose to get my period February 1st and it never came so decided to take a pregnancy test and it came back positive yay but 5 days after I realized I was spotting but it was only for a day. Is that normal or should I go get it checked out?
By Boatemaa patience (not verified) on 24 Feb 2020 - 12:50
I have my last period on the 1/23/2020 and on February 16 seen bleeding coming and stop by three days and feeling like I'm pregnant
By Mary (not verified) on 2 Mar 2020 - 01:06
I missed my period i checked it was positive but I have untreated infection can I insert antifungal drug instructed by my doctor
By Ang (not verified) on 16 Mar 2020 - 03:17
I'd recommend getting it checked out. On January 29th i started lightly spotting & feb 1st it got worse; Those 2 days were hospital visits with a blood test. The 29th the doctor wasnt able to tell yet/ the 1st he said sorry because it was noticeable in my blood that i had had a miscarriage. But thats ok....
sad but I guess I got pregnant immediately after and now Im waiting a few weeks until my first ultrasound to see the proper date! Super exciting. I almost didn't go in, thought I was spotting... checkups are important. & no you didn't do anything wrong if it were a miscarriage, apparently it is a common thing. I'm hopeful though im nervous & scared because it's happened, im glad it was early on.. I was probably just 2 weeks.
By Ann (not verified) on 4 Feb 2020 - 03:44
My last period was on 24 to 29 December, as at now I havnt seen my period I took a pregnancy test and its positive, this morning I saw some slimy discharge and then some light bleeding on my bed what could be the reason cux am worried
By Mc (not verified) on 3 Apr 2020 - 14:58
I have small bleeding in 6 week pregnancy,what is the course
By tolulopeabimbol... (not verified) on 16 Jan 2020 - 08:04
I am bleeding in my 4th week of pregnancy and am feeling pains what is about and what can I do
By Helen (not verified) on 12 Jan 2020 - 15:35
l had 3 miscarriage then ectopic pregnancy which my left tube was removed all like 3years ago, later tried to be pregnant but not coming,hsg test shows blockage of the right tube that remains so no major hope until now that l just felt my breast is painful, missed period and pregnancy test positive,but very worried so as not to experience what happened in the past
By Mpho (not verified) on 4 Apr 2020 - 20:31
Hi Helen,how is it going.
By Ks (not verified) on 20 Dec 2019 - 16:13
I have confirmed implantation bleeding by my midwife which is brown but it smells odd is this normal? Please help
By m (not verified) on 17 Jan 2020 - 10:44
when did you start this bleeding before/after your period was due?
By Stephanie (not verified) on 18 Dec 2019 - 11:29
Hi, I have just found out I’m 4-5 weeks pregnant, I was prescribed metformin 6 months ago to help with PCOS, but stopped taking it 2 months ago as I found it wasn’t helping me, however I was told to keep taking it even if I did conceive. My question is should I start taking it again now I am pregnant?
By Natalie (not verified) on 16 Dec 2019 - 14:54
I haven't had my periods since last month could I be pregnant
By Anonymous (not verified) on 20 Nov 2019 - 21:45
Hi On the 27th of September I went to the doctor to take my 1st depo provera short and the next day my period begin sinces then I haven't seen my period could I be pregnant?
By Julia (not verified) on 14 Nov 2019 - 15:17
Hi i did home pregnancy test and the result says i concived more than 3 weeks ago 5+weeks and my last period was on 14 September so i want to know when did i actually convinced?
By Midwife @Tommys on 19 Nov 2019 - 12:17
If you use our pregnancy calculator, in the link below, you can enter your last period date and your average length of cycle, it will then calculate your due date, how many weeks you are currently and will then help you to work backwards to work out roughly when you conceived. Tommy's Midwife https://www.tommys.org/pregnancy-information/im-pregnant/use-our-pregnancy-calculator-find-out-your-due-date
By Tumi (not verified) on 24 Oct 2019 - 10:38
Hi there plz help I'm Tumi 28 last years October i had a miscarriage i was 3 months pregnant and didn't go for womb scrub now I'm pregnant again..im scared what is might happen to my baby
By Nosiphowe (not verified) on 14 Oct 2019 - 18:34
I have been having unprotected sex for the past 2 months .then this month I missed my periods due date by 5 days then on the 6th day I experienced heavy bleeding the. The blood got lighter and clotting .could be possible that I was experiencing a miscarrage
By Oke adewumi (not verified) on 30 Jan 2020 - 21:30
By Faheedat (not verified) on 1 Mar 2020 - 13:02
By Florence Susan scott (not verified) on 1 Oct 2019 - 20:28
I really need to know been having some pains in my abdomen
And I have Missed my period for one month
Do you think it a sign of pregnancy
By J Salmond (not verified) on 15 Nov 2019 - 20:24
Please see a GP. Sounds like you are pregnant. Good luck xx
By Grace (not verified) on 22 Sep 2019 - 13:11
Hi. I just want to know if i had sex on august 24 and was pregnant when I had my OB check up on September 20, how many weeks is my baby?
By Natalie (not verified) on 2 Aug 2019 - 13:14
Hi I've recently had a very light bleed that lasted 2 days but only when I wiped then I started with bad headache and light headed lower tummy cramps some lake yellowish or white discharge tired but I'm not due on till between 14th and 17th August could this be a sigh of pregnancy or is it to early thanks you for reading be happy for some one to comment as I don't no what's happening with my body and symptoms
By Lucy (not verified) on 25 Jul 2019 - 16:34
Hi..i was suppose to have my period on the 7th till 10 july 2019..but now its the 25th i still ddnt get my periods..am i pregnant?
By Zain (not verified) on 25 Aug 2019 - 19:12
Hi, you can have a pregnancy test at ur home. If u r not having the period this month, you have a chance of becoming pregnant. Don't think too much and have a check up at home or hospital. Thank you
By Caz (not verified) on 23 Jul 2019 - 16:14
I had a miscarriage in 2018 and I've now found out that I'm pregnant again- I went to see a private consultant to have a internal scan as I was bleeding a lot and I was scared I was losing the baby. All is well I'm 5/6 weeks so really happy. The consultant put me on progesterone pessaries for 4 weeks to stop the bleeding, I'm concerned as I've read that it mask/delay a miscarriage- I don't know what to do .
By adeela (not verified) on 31 Jul 2019 - 01:59
I just want to tell you relax
What's going on will not change if you stressed
I've had two miscarriages then a healthy baby and then again two miscarriages in Oct 2018 and Jan 2019
Now I just did HPT and it's positive
Hoping for the best
I'm having abdominal cramps
Going to visit a gynecologist soon
By Louise (not verified) on 17 Aug 2019 - 20:58
Hi I found out I was pregnant on 8th August which test said 2-3 weeks and I was bleeding was at d hospital and scan showed sac but nothing in it as doctor said I was too early or may be losing I wanted to ask was any one had same and had ok results pleas I am now 4 weeks and still bleeding heavy thank you .
By Danielle (not verified) on 8 Sep 2019 - 19:48
I read your post and i found out i am four weeks and for 5 days now everytime i pee i either spot or blood drips in the toilet. I went to the er yesterday and they said they baby was fine however we are on miscarriage watch. It kills me because no doctors give me any answers and dont want a miscarriage.. i want to be excited but so worried if something is wrong. How long does implantation bleeding last???
By Aarohi (not verified) on 8 Jul 2019 - 05:06
Hello I had period one month ago. After that I feel nausea and vomiting and feel like a pregency. On this month I had bleeding on the same day of period. Is it pregency or miscarriage
By Kim (not verified) on 7 Jul 2019 - 18:49
Hi I've just found out I'm pregnant after having 4 miscarriages in the last 2 years I've been to see the RMC and they cant find a reason for it but ive had 3 pregnancies that resulted in preterm birth with my ex, I was talked into sterilisation after my 3rd and had it reversed privately 2 years ago and now I'm terrified this pregnancy is going to end in miscarriage too. What can I do?
By Pregantwith#7 (not verified) on 31 Jul 2019 - 21:36
Hi, A girlfriend of mine kept getting pregnant and then losing the baby 5 months or further into her pregnancies, no one could figure it out for years. Finally they did some testing and found that there is a hormone in her body that detects pregnancy as toxic and it attacks the baby which was causing her to miscarry. She is now 8 months pregnant and doing great! She has to get a shot every once in a while that tricks that specific hormone into thinking her pregnancy is not toxic. I think you should talk to your doctor about it and see if they can test you for it. My girlfriend lost too many babies all at different stages and if they would have tested her after the first time, this would have not kept on going.
By RIRI (not verified) on 4 Jul 2019 - 05:09
Hello, Me and my boyfriend been ttc for some time now and I was supposed to get my period on the 30th of June but it's July 4th now . I don't wanna get too hyped up in case its just my period. He did have cancer wen he was 16 and he is 22 now so i wonder if that could be an issue. Idk really about the symptoms Im having. I've been feeling tired lately
More than usual . Even during the day I wnna just take a nap. I never felt like this before . Even on my period. My other symptom I feel is bloated. Even though my period is still not here I feel bloated. And also tender boobs. I just wondering if I could be pregnant. Or should I wait to take a pregnancy test. Is it too early still ?
By Jenn (not verified) on 25 Jun 2019 - 01:22
Based off my periods would put me at 4 weeks but our local health department put 6 weeks. Had a ttansvaginal ultrasound last week but said there is no baby in the uterus. My HCG is 295. I have had light bleeding. I have had 3 natural healthy births never miscarried.. is this normal to not detect an embryo? Took blood today and tomorrow again.. just worried.
By Camila (not verified) on 24 Jun 2019 - 10:20
I had my last periods on the 26 to 30th of may 2019.Am now worried cx am 2 days late for me periods. Can I be pregnant?
By grace (not verified) on 6 Jul 2019 - 07:21
I had my last period on 30 may could it be possible to get pregnant
By Nicole (not verified) on 18 Jun 2019 - 05:00
Last period was on the 22 of May. Was trying for a baby on June 3-6th. It’s been two weeks from the 3rd. Pregnancy test are saying no... my period supposed come in 2 days. Was it to early to test? Could the test be wrong since it was to early or?
By Holly (not verified) on 20 Jun 2019 - 03:31
Yes it could be too early yet, though some pregnancy tests can show up as early as 5 days of a missed period. I know mine was 1 day late I tested and I’m happy to find out I’m pregnant!!!! I tried to test one to two weeks earlier and nothing happened it was negative then. If your period is couple days late I would retry again to take pregnancy test if still negative you should go to your doctor to get checked out or you can wait few days and see what happens.
By Sandra (not verified) on 18 Jun 2019 - 04:27
Hi there I had embryo transfer on 6th of June and on 28th I did test which came back positive. Week before test I was feeling tired,hungry from early morning and on test day my boobs was hurting,my mood was swinging and belly was bloated. But 2 days later all symptoms disappeared. Now only nipples sensitive and nothing else I would feel. Should I be worried? My scan is due on 16th of July.
By KJ (not verified) on 24 Jun 2019 - 07:54
The same exact thing happened to me. I was relieved I didn’t feel as miserable the past two days, but it did make me concerned. My doctor says this is normal. Try not to stress try to think positive.
By N (not verified) on 16 Jun 2019 - 20:14
hi,I had my last period on the 13 may 2019..my cycle is normally 31 days and I never miss..as of today my period haven't came as yet..I have slight breast pain and cramps but that's normal , I usually have those ..I took a pregnancy test this morning and it came negative.. I'm a bit worried because last 2 year I had a molor pregnancy and I'm wondering if that would happen to me again..with my molor I didn't get any symptoms at all besides the missed period,now I'm scared thinking it would happen again..plz help me ..thanks