Week 5
For many people, this is the week it becomes real: a missed period and a positive test. By gestational age you are 4 weeks pregnant, though the embryo is only about two to three weeks old. It is about 1 to 2 mm long (less than a tenth of an inch), roughly the size of a poppy seed, and babies vary. It is forming three layers of cells that will build every organ. Toward the end of the week, the first fold of the nervous system appears and the cells that will form the heart gather.
You may feel tired, tender, or nothing much at all. Emotions can run in every direction. The practical focus this week is finding a care provider and booking your first visit, while keeping up folic acid and the healthy changes from earlier weeks.
Day 29 · 4 weeks 0 days
A missed period, and a new way of counting
If your cycle is about 28 days, your period would have started today. For many people, this is the day the test turns positive. If yours has, you are 4 weeks pregnant.
That number can be surprising. You may have conceived only two weeks ago, and it can feel odd to be told you are a month along. As you read in week 1, pregnancy is counted from the first day of your last period, not from conception. So the embryo is about two weeks old, but the pregnancy is 4 weeks by the standard count. Every care provider, ultrasound report, and app uses this same system.
Now is a good time to work out your estimated due date, using the method from week 1, and to find where you are in this book. If your cycles are longer than 28 days, you may be a little less far along than the calendar suggests, and an early ultrasound may adjust the date later.
If your period is late but your test is negative, wait a few days and test again. Stress, illness, travel, and changes in weight or exercise can all delay a period.
Try this: Write down today's date, your test result, and the first day of your last period together in one place, ready for your first appointment.
Day 30 · 4 weeks 1 day
Every feeling about this news is allowed
A positive test can bring joy, shock, fear, relief, doubt, or all of them within an hour. There is no right way to feel. Even a longed-for pregnancy can bring a wave of worry, and an unexpected one can bring surprising happiness.
If the pregnancy was not planned, you may need time to think about what you want. You have options, and a care provider can talk them through with you confidentially and without pressure. Making a decision that is right for you is a valid part of this time.
If you have had a loss before, or went through fertility treatment, the early weeks can feel fragile. Many people hold back from feeling excited until a scan or a milestone. That is a natural way to protect yourself, not a lack of love.
Some people feel a sense of unreality for weeks. With no bump and few symptoms, it can be hard to believe. That also passes.
Pregnancy can affect mental health, and existing anxiety or depression can flare. Call your care provider if you feel low, hopeless, or anxious most of the day for more than two weeks, or if worry is stopping you from eating, sleeping, or getting through the day. Get help right away if you have thoughts of harming yourself.
Try this: Take five minutes to write down how you feel right now, honestly and without judging it. You may find it meaningful to read later.
Day 31 · 4 weeks 2 days
Three layers of cells will build your whole baby
This week the embryo goes through one of the most important changes of its life, called gastrulation. The flat disc of cells, which had two layers, reorganizes into three. Cells move inward along a groove called the primitive streak, which also marks out the embryo's head and tail ends and its left and right sides.
Each of the three layers has its own future.
The outer layer, the ectoderm, will become the brain, spinal cord, and nerves, along with the skin, hair, nails, and the enamel of the teeth. The middle layer, the mesoderm, will form the heart and blood vessels, muscles, bones, kidneys, and reproductive organs.
The inner layer, the endoderm, will form the lining of the gut and lungs, along with the liver, pancreas, and thyroid.
This is a sensitive stage. Organs are being laid out for the first time, which is why alcohol, smoking, certain medicines, and high fever matter so much in these weeks. If you get a fever, it is reasonable to bring it down with acetaminophen used as directed on the package, and to let your care provider know if it is high or does not settle.
Try this: Check that your folic acid is part of your daily routine. The neural tube, which grows from the outer layer, begins forming in the next few days.
Day 32 · 4 weeks 3 days
Choosing who will care for you in pregnancy
Once you know you are pregnant, the next step is to find a care provider. Depending on where you live, this might be a midwife, a family doctor, an obstetrician, or a team that shares your care. Some places have you register with a midwife or clinic directly. Others need a referral from a family doctor.
Each type of care has its strengths. Midwives specialize in normal pregnancy and birth and often offer longer appointments and continuity, with the same small team throughout. Obstetricians are specialists in pregnancy complications and surgery, and are the usual choice if you have significant health conditions or a higher-risk pregnancy. Family doctors in some areas provide pregnancy care and know your history well. Your care can also change later if your needs change.
Questions worth asking include:
Where can I give birth with this provider: hospital, birth centre, or home?
Who covers when you are not available?
How do I reach someone urgently, day or night?
What are the waiting times for a first appointment?
In some areas, midwives and clinics fill up quickly, so it helps to start looking early.
Try this: Make a list of the care options available near you today, and make your first phone call or online registration if you can.
Day 33 · 4 weeks 4 days
Booking your first appointment
When you contact a care provider, you will usually be offered a first full visit sometime between about 8 and 12 weeks. For most healthy pregnancies, nothing more is needed before then.
Some people should be seen sooner. Contact your care provider early, and say why, if you have diabetes, epilepsy, high blood pressure, a thyroid condition, or another ongoing illness; if you take regular medicines; if you have had an ectopic pregnancy, repeated losses, or a complicated previous pregnancy; or if you conceived with fertility treatment.
When you call or register, have a few basics ready: the first day of your last period, any health card or insurance details your area uses, and a number where you can easily be reached. Ask what to do if you have bleeding or pain before your visit, and whether there is an early pregnancy clinic or after-hours line. Next week you will read what to gather for the visit itself.
If you have a partner or support person, ask whether they can come along. Call your care provider if you have heavy bleeding, worsening pain, or are unable to keep fluids down at any point before your first visit. You do not need to wait for the appointment.
Try this: As soon as your first visit is booked, put it in your calendar with a reminder a few days before.
Day 34 · 4 weeks 5 days
Early loss is common, and it is not your fault
Pregnancy loss in the first weeks is common. Roughly 10 to 20 out of every 100 known pregnancies end in miscarriage, most of them in the first trimester, and many more end so early that they are never noticed. Most happen because of chance chromosome differences in the embryo, which mean it cannot develop.
Very early losses, around the time of a missed period, are sometimes called chemical pregnancies. A test is positive, and then a period arrives, often a little late and heavier than usual. Emotionally, it can be a real loss, and it is fine to grieve it.
Loss is not caused by exercise, sex, work, lifting, stress, a fall, or an argument. It is not caused by a cup of coffee or a glass of wine before you knew. Nothing you did or did not do in these early days is likely to have made the difference.
Bleeding in early pregnancy does not always mean a loss. Many people bleed and go on to have healthy babies.
Call your care provider if you have bleeding or cramping in early pregnancy. Get help right away if you have heavy bleeding soaking a pad an hour, severe pain, pain on one side, shoulder tip pain, or you feel faint. Try this: If this topic worries you, put your care provider's phone number and your local emergency number in your phone today, so you never have to search for them.
Day 35 · 4 weeks 6 days
Support works best when it starts early
The first weeks of pregnancy are often invisible to the outside world. There is no bump, and many people have not told anyone yet. Yet this can be one of the hardest stretches physically, with tiredness, tender breasts, and, for many, nausea soon to come. Support at home makes a real difference.
Partners and support persons sometimes feel unsure of their role so early. The answer is simple: share the load and stay curious. Take on more of the cooking, cleaning, and errands, especially in the evenings when energy runs out. Learn about what is happening this week. Ask how the pregnant person is feeling, and listen without trying to fix everything. Partners have their own feelings too: excitement, worry about money or change, fear of loss. Those deserve space, and talking about them openly helps both of you.
Healthy changes are easier together. If you drink or smoke, stopping alongside your partner, or at least never around them, helps more than you might think. Second-hand smoke is a real risk to the pregnancy. By the end of this week, the embryo's neural tube is starting to fold, and next week brings more changes to follow together.
For your partner: Pick one household job to take over fully for the next few weeks, and offer to come to the first appointment.