The primary sign of pregnancy is missing a menstrual period or two or more consecutive periods, but many women experience other symptoms of pregnancy before they notice a missed period.

Missing a period does not always mean a woman is pregnant. Menstrual irregularities are common and can have a variety of causes, including taking birth control pills, conditions such as diabetes and polycystic ovary syndrome, eating disorders, excessive exercise, and certain medications. Women who miss a period should see their health care provider to find out whether they are pregnant or whether they have a specific health problem.

If you have missed one or more menstrual periods or have one or more of the early signs of pregnancy, you may wonder whether you are pregnant.

Home pregnancy tests, which are highly accurate and available without a prescription, can be the first way women determine if they are pregnant. If a home pregnancy test is positive, a woman should call her health care provider to schedule an appointment.

Home pregnancy tests measure the amount of human chorionic gonadotropin (hCG) in a woman's urine. Small amounts of this hormone are present even before the first missed period, and they increase as pregnancy continues.

NICHD research in the 1970s led to the development of the home pregnancy test. Researchers were studying the role of hCG in tracking the success of a cancer treatment. During this study, researchers discovered that high levels of hCG in the urine were associated with pregnancy. Manufacturers used this research to create home pregnancy tests that detect hCG levels in urine with up to 97% accuracy.

The primary sign of pregnancy is missing a menstrual period or two or more consecutive periods, but many women experience other symptoms of pregnancy before they miss a period.

Missing a period does not always mean a woman is pregnant. Menstrual irregularities are common and can have a variety of causes, including taking birth control pills, conditions such as diabetes and polycystic ovary syndrome, eating disorders, and certain medications. Women who miss a period should see their health care provider to find out whether they are pregnant or whether they have another health problem.

Pregnancy symptoms vary from woman to woman. A woman may experience every common symptom, just a few, or none at all. Some signs of early pregnancy include:

• Slight bleeding. One study shows as many as 25% of pregnant women experience slight bleeding or spotting that is lighter in color than normal menstrual blood. This typically occurs at the time of implantation of the fertilized egg (about 6 to 12 days after conception) but is common in the first 12 weeks of pregnancy.
• Tender, swollen breasts or nipples. Women may notice this symptom as early as 1 to 2 weeks after conception. Hormonal changes can make the breasts sore or even tingly. The breasts feel fuller or heavier as well.
• Fatigue. Many women feel more tired early in pregnancy because their bodies are producing more of a hormone called progesterone, which helps maintain the pregnancy and encourages the growth of milk-producing glands in the breasts. In addition, during pregnancy the body pumps more blood to carry nutrients to the fetus. Pregnant women may notice fatigue as early as 1 week after conception.
• Headaches. The sudden rise of hormones may trigger headaches early in pregnancy.
• Nausea and/or vomiting. This symptom can start anywhere from 2 to 8 weeks after conception and can continue throughout pregnancy. Commonly referred to as "morning sickness," it can actually occur at any time during the day.
• Food cravings or aversions. Sudden cravings or developing a dislike of favorite foods are both common throughout pregnancy. A food craving or aversion can last the entire pregnancy or vary throughout this period.
• Mood swings. Hormonal changes during pregnancy often cause sharp mood swings. These can occur as early as a few weeks after conception.
• Frequent urination. The need to empty the bladder more often is common throughout pregnancy. In the first few weeks of pregnancy, the body produces a hormone called human chorionic gonadotropin, which increases blood flow to the pelvic region, causing women to have to urinate more often.

Many of these symptoms can also be signs of other conditions, the result of changing birth control pills, or effects of stress, so they do not always mean that a woman is pregnant. Women should see their health care provider if they suspect they are pregnant.

Approximately 70% of women have morning sickness during their first trimester of pregnancy. Morning sickness usually starts at around 6 weeks of pregnancy and peaks at 9 weeks.

Most women start to feel better by 14 weeks of pregnancy; however, morning sickness can last throughout the pregnancy for some women.

Having a baby is an exciting time that often inspires women to make healthier lifestyle choices and, if needed, work toward a healthy body weight. Here you’ll find tips on how to improve your eating and physical activity habits while you’re pregnant and after your baby is born.

These tips can also be useful if you’re not pregnant but are thinking about having a baby! By making changes now, you can get used to new lifestyle habits. You’ll give your baby the best possible start on life and be a healthy example to your family for a lifetime.

Summary of Tips for Pregnancy

• Talk to your health care professional about how much weight you should gain during your pregnancy, and regularly track your progress.
• Consume foods and beverages rich in folate, iron, calcium, and protein. Talk with your health care professional about prenatal supplements (vitamins you may take while pregnant).
• Eat breakfast every day.
• Eat foods high in fiber, and drink fluids (particularly water) to avoid constipation.
• Avoid alcohol, raw or undercooked fish, fish high in mercury, undercooked meat and poultry, and soft cheeses.
• Do moderate-intensity aerobic activity at least 150 minutes a week during your pregnancy. If you have health issues, talk to your health care professional before you begin.
• After pregnancy, slowly get back to your routine of regular, moderate-intensity physical activity.
• Gradually return to a healthy weight.

Why is gaining a healthy amount of weight during pregnancy important?

Gaining an appropriate amount of weight during pregnancy helps your baby grow to a healthy size. But gaining too much or too little weight may lead to serious health problems for you and your baby.

According to experts, gaining too much weight during pregnancy raises your chances for developing gestational diabetes (diabetes during pregnancy) and high blood pressure during pregnancy. It also increases your risk for type 2 diabetes and high blood pressure later in life. If you’re overweight or have obesity when you get pregnant, your chances for health problems may be even higher. You could also be more likely to have a cesarean section (C-section).

Gaining a healthy amount of weight helps you have an easier pregnancy and delivery. It may also help make it easier for you to get back to your normal weight after delivery. Research shows that recommended amounts of weight gain during pregnancy can also lower the chances that you or your child will have obesity and weight-related problems later in life.

How much weight should I gain during my pregnancy?

How much weight you should gain depends on your body mass index (BMI) before pregnancy. BMI is a measure of your weight in relation to your height. You can use a formula to calculate your BMI online.

The general weight-gain advice below is for women having only one baby.

It’s important to gain weight very slowly. The old myth that you’re “eating for two” is not true. During the first 3 months, your baby is only the size of a walnut and doesn’t need many extra calories. The following rate of weight gain is advised

• 1 to 4 pounds total in the first 3 months
• 2 to 4 pounds each month from 4 months until delivery

Talk to your health care professional about how much weight gain is appropriate for you. Work with him or her to set goals for your weight gain. Take into account your age, weight, and health. Track your weight at home or when you visit your health care professional.

Don’t try to lose weight if you’re pregnant. Your baby needs to be exposed to healthy foods and low-calorie beverages (particularly water) to grow properly. Some women may lose a small amount of weight at the start of pregnancy. Speak to your health care professional if this happens to you.

How much should I eat and drink?

Consuming healthy foods and low-calorie beverages, particularly water, and the appropriate number of calories may help you and your baby gain the proper amount of weight.

How much food and how many calories you need depends on things such as your weight before pregnancy, your age, and how quickly you gain weight. If you’re at a healthy weight, the Centers for Disease Control and Prevention (CDC) says you need no extra calories in your first trimester, about 340 extra calories a day in your second trimester, and about 450 extra calories a day in your third trimester. You also may not need extra calories during the final weeks of pregnancy.

Check with your health care professional about your weight gain. If you’re not gaining the weight you need, he or she may advise you to take in more calories. If you’re gaining too much weight, you may need to cut down on calories. Each woman’s needs are different. Your needs also depend on whether you were underweight, overweight, or had obesity before you became pregnant, or if you’re having more than one baby.

What kinds of foods and beverages should I consume?

A healthy eating plan for pregnancy includes nutrient-rich foods and beverages. The 2015–2020 Dietary Guidelines for Americans recommend these foods and beverages each day

• fruits and vegetables (provide vitamins and fiber)
• whole grains, such as oatmeal, whole-grain bread, and brown rice (provide fiber, B vitamins, and other needed nutrients)
• fat-free or low-fat milk and milk products or nondairy soy, almond, rice, or other drinks with added calcium and vitamin D
• protein from healthy sources, such as beans and peas, eggs, lean meats, seafood that is low in mercury (up to 12 ounces per week), and unsalted nuts and seeds, if you can tolerate them and aren’t allergic to them.

A healthy eating plan also limits salt, solid fats (such as butter, lard, and shortening), and sugar-sweetened drinks and foods.

Does your eating plan measure up? How can you improve your habits? Try consuming fruit like berries or a banana with hot or cold cereal for breakfast; a salad with beans or tofu or other non-meat protein for lunch; and a lean serving of meat, chicken, turkey, or fish and steamed vegetables for dinner. Think about new, healthful foods and beverages you can try. Write down your ideas and share them with your health care professional.

For more about healthy eating, see the MyPlate Daily Checklist. It can help you make an eating plan for each trimester (3 months) of your pregnancy.

What if I’m a vegetarian?

A vegetarian eating plan during pregnancy can be healthy. Consider the quality of your eating plan and talk to your health care professional to make sure you’re getting enough calcium, iron, protein, vitamin B12, vitamin D, and other needed nutrients. Your health care professional may also tell you to take vitamins and minerals that will help you meet your needs.

Do I have any special nutrition needs now that I’m pregnant?

Yes. During pregnancy, you need more vitamins and minerals such as folate, iron, and calcium.

Getting the appropriate amount of folate is very important. Folate, a B vitamin also known as folic acid, may help prevent birth defects. Before pregnancy, you need 400 mcg per day from supplements or fortified foods, in addition to the folate you get naturally from foods and beverages. During pregnancy, you need 600 mcg. While breastfeeding, you need 500 mcg of folate per day. Foods high in folate include orange juice, strawberries, spinach, broccoli, beans, fortified breads, and fortified low-sugar breakfast cereals. These foods may even provide 100% of the daily value of folic acid per serving.

Most health care professionals tell women who are pregnant to take a prenatal vitamin every day and consume healthy foods, snacks, and beverages. Ask your doctor about what you should take.

What other new habits may help my weight gain?

Pregnancy can create some new food, beverage, and eating concerns. Meet the needs of your body and be more comfortable with these tips. Check with your health care professional with any concerns.

• Eat breakfast every day. If you feel sick to your stomach in the morning, try dry whole-wheat toast or whole-grain crackers when you first wake up. Eat them even before you get out of bed. Eat the rest of your breakfast (fruit, oatmeal, hot or cold cereal, or other foods) later in the morning.
• Eat high-fiber foods. Eating high-fiber foods, drinking water, and getting daily physical activity may help prevent constipation. Try to eat whole-grain cereals, brown rice, vegetables, fruits, and beans.
• If you have heartburn, eat small meals spread throughout the day. Try to eat slowly and avoid spicy and fatty foods (such as hot peppers or fried chicken). Have drinks between meals instead of with meals. Don’t lie down soon after eating.

What foods and drinks should I avoid?

Certain foods and drinks can harm your baby if you have them while you’re pregnant. Here’s a list of items you should avoid.

• Alcohol. Do not drink alcohol, such as wine, beer, or hard liquor.
• Caffeine. Enjoy decaf coffee or tea, drinks not sweetened with sugar, or water with a dash of juice. Avoid diet drinks, and limit drinks with caffeine to less than 200 mg per day—the amount in about 12 ounces of coffee.
• Fish that may have high levels of mercury (a substance that can build up in fish and harm an unborn baby). Limit white (albacore) tuna to 6 ounces per week. Do not eat king mackerel, marlin, orange roughy, shark, swordfish, or tilefish. To get the helpful nutrients in fish and shellfish, you may eat up to 12 ounces of seafood per week, choosing from many safe seafood choices (PDF, 387.44 KB), such as cod, salmon, and shrimp.
• Foods that may cause illness in you or your baby (from viruses, parasites, or bacteria such as Listeria or E. coli). Avoid soft cheeses made from unpasteurized or raw milk; raw cookie dough; undercooked meats, eggs, and seafood; and deli salads. Take care in choosing and preparing lunch meats, egg dishes, and meat spreads. See more food safety guidelines during pregnancy.
• Anything that is not food. Some pregnant women may crave something that is not food, such as laundry starch, clay, ashes, or paint chips. This may mean that you’re not getting the right amount of a nutrient. Talk to your health care professional if you crave something that isn’t food. He or she can help you get the right amount of nutrients.

Should I be physically active during my pregnancy?

Almost all women can and should be physically active during pregnancy. According to current physical activity guidelines (PDF, 14.4 MB) , regular physical activity may

• help you and your baby gain the appropriate amounts of weight
• reduce backaches, leg cramps, and bloating
• reduce your risk for gestational diabetes (diabetes during pregnancy)
• reduce your risk for postpartum depression

There's also some evidence that physical activity may reduce the risk of problems during pregnancy such as preeclampsia (high blood pressure during pregnancy), reduce the length of labor and postpartum recovery, and reduce the risk of having a cesarean section (or C-section).

If you were physically active before you became pregnant, you may not need to change your exercise habits. Talk with your health care professional about how to change your workouts during pregnancy.

Being physically active can be hard if you don’t have childcare for your other children, haven’t exercised before, or don’t know what to do. Keep reading for tips about how you can work around these hurdles and be physically active.

How much and what type of physical activity do I need?

According to current guidelines (PDF, 14.4 MB) , most women need the same amount of physical activity as they did before becoming pregnant. Aim for at least 150 minutes a week of moderate-intensity aerobic activity. Aerobic activities—also called endurance or cardio activities—use large muscle groups (back, chest, and legs) to increase your heart rate and breathing. Brisk walking is a form of aerobic activity.

How can you tell if you’re doing moderate-intensity aerobic activity? Take the “talk test” to find out. If you’re breathing hard but can still have a conversation easily—but you can’t sing—that’s moderate intensity.

If you can only say a few words before pausing for a breath, that’s called vigorous-intensity activity. If you were in the habit of doing vigorous-intensity aerobic activity or were physically active before your pregnancy, then it’s likely okay for you to continue these activities during your pregnancy.

You can talk to your health care professional about whether to or how to adjust your physical activity while you’re pregnant. If you have health issues such as obesity, high blood pressure, diabetes, or anemia (too few healthy red blood cells), ask your health care professional about a level of activity that’s safe for you and your unborn baby.

How can I stay active while pregnant?

Even if you haven’t been active before, you can be active during your pregnancy. Here are some tips.

• Go for a walk where you live, in a local park, or in a shopping mall with a family member or friend. If you already have children, take them with you and make it a family outing.
• Get up and move around at least once an hour if you sit most of the day. When watching TV or sitting at your computer, get up and move around. Even a simple activity like walking in place can help.
• Make a plan to be active while pregnant. List the activities you’d like to do, such as walking or taking a prenatal yoga class. Think of the days and times you could do each activity on your list, such as first thing in the morning, during your lunch break from work, after dinner, or on Saturday afternoon. Look at your calendar or phone or other device to find the days and times that work best and commit to those plans.

How can I stay safe while being active?

For your health and safety, and for your baby’s, you should not do certain physical activities while pregnant. Some of these are listed below. Talk to your health care professional about other physical activities you should not do.

Safety do’s and don’ts

Follow these safety tips while being active.

How can I stay healthy after my baby is born?

After you deliver your baby, your health may be better if you try to return to a healthy weight slowly. Not losing your “baby weight” may lead to overweight or obesity later in life. Slowly returning to a healthy weight may lower your chances of diabetes, heart disease, and other weight-related problems.

Healthy eating, regular physical activity, adequate sleep, and other healthy habits after your baby is born may help you return to a healthy weight and give you energy.

After your baby is born

• Consume foods and beverages to meet your calorie needs.
• Regular physical activity will continue to benefit your overall health. Moderate-intensity physical activity will increase your fitness and can improve your mood.

Also, physical activity does not appear to have bad effects on how much breast milk is produced, what the breast milk contains, or how much the baby grows.

How may breastfeeding help?

Breastfeeding may or may not make it easier for you to lose weight because your body uses extra calories to produce milk. Even if breastfeeding does not help you lose weight, it’s linked to many other benefits for mother and child.

For mothers who breastfeed, experts advise feeding their babies only breast milk for the first 6 months—no other foods or drinks during this time. Experts suggest that those women continue breastfeeding at least until their baby reaches 12 months.

Calorie needs when you’re breastfeeding depend on how much body fat you have and how active you are. Talk with your health care professional about your calorie needs while you are breastfeeding.

Benefits of breastfeeding. Breastfeeding your baby

• likely gives him or her an appropriate mix of vitamins, minerals, and other important nutrients in a liquid (breast milk) that is easy to digest
• helps boost his or her immune system
• helps protect your baby from common problems, like ear infections and diarrhea

What else may help?

Pregnancy and the time after you deliver your baby can be wonderful, exciting, emotional, stressful, and tiring—all at once. These feelings may cause you to overeat, not get enough calories, or lose your drive and energy. Being good to yourself may help you cope with your feelings and follow healthy lifestyle habits.

Here are some ideas that may help.

• Sleep when the baby sleeps.
• Ask someone you trust to watch your baby while you nap, bathe, read, go for a walk, or go grocery shopping.
• Explore groups that you and your newborn can join, such as “new moms” groups.
• Don’t feel like you need to do it all on your own. Seek help from friends, family members, or local support groups.