The most common early signs of pregnancy (tanda-tanda mengandung) are a missed period, feeling sick, unusual tiredness, sore breasts and needing to pee more often. According to the NHS, symptoms usually start around 4 to 6 weeks of pregnancy, which is around the time your period is due or a little after. Many early signs look like the days before a period, so the only reliable way to know is a pregnancy test, which works best from the first day of a missed period. This guide lists the early signs, explains implantation bleeding and discharge, tells you when to test and how accurate tests are, what to do after a positive result, and which symptoms need urgent medical help.
When do pregnancy signs start?
Doctors count pregnancy from the first day of your last period, not from the day you had sex. That means "4 weeks pregnant" is roughly when your next period is due, even though conception happened only about 2 weeks earlier.
- Pregnancy tests detect the hormone human chorionic gonadotrophin (hCG), which the NHS says starts to be produced around 6 days after fertilisation.
- Most early symptoms appear around 4 to 6 weeks of pregnancy.
- Every pregnancy is different, and some women notice very few symptoms at first.
This is why searches such as "tanda hamil 1 minggu" or "tanda-tanda orang hamil 3 hari" rarely have a clear answer: a few days after sex, the body has usually not yet started producing enough pregnancy hormone to cause noticeable symptoms. Symptoms at that stage are more likely to have another cause.
What are the early signs of pregnancy?
The NHS lists these early signs. You may have several, a few or none of them.
About discharge: the NHS says it is normal to have more discharge during pregnancy, and that healthy discharge is thin, clear or milky white and does not smell unpleasant. Call your doctor or midwife if it smells unpleasant, is green or yellow, or comes with itching, soreness or pain when you pee. Our guide to keputihan (vaginal discharge) explains what is normal.
Pregnancy or period coming?
Several early pregnancy signs, such as sore breasts, tiredness, mood changes and mild cramps, also happen in the days before a period. A few differences can help, but none of them is reliable on its own:
- Bleeding: implantation bleeding is usually much lighter than a normal period, with spotting or only a little blood.
- Timing: if your period is late, a pregnancy test will give you a clearer answer than symptoms.
- Other reasons for a late period: the NHS lists stress, sudden weight loss, being overweight, too much exercise, some hormonal contraception, breastfeeding, thyroid problems and polycystic ovary syndrome among the common causes. See our guide to PCOS symptoms if your periods are often irregular, and our guide to period lambat (late periods) for other causes.
When should you take a pregnancy test?
According to the NHS:
- most pregnancy tests can be used from the first day of a missed period;
- if you do not know when your period is due, test at least 21 days after unprotected sex;
- some very sensitive tests can be used before a missed period;
- you can test with urine collected at any time of day, not only in the morning;
- hormonal contraception such as the pill does not stop a pregnancy test from working.
How accurate are home tests? The NHS says a positive result is almost certainly correct, but a negative result is less reliable, especially if you test too early or do not follow the instructions. A US study that tracked hormone levels in women trying to conceive found that about 10% of pregnancies had not yet implanted by the first day of the missed period, so no test could detect them yet. One week after the missed period, the highest possible detection rose to about 97%.
If your test is negative but your period still has not come, wait a few days and test again. If the second test is negative and your period has still not arrived, see a doctor.
What to do after a positive test
- Start antenatal care early. Register at a klinik kesihatan or your chosen clinic as soon as possible, so your health and your baby's can be checked from the start. If you have a long-term condition or take regular medicine, see your doctor promptly.
- Take folic acid. The NHS recommends 400 micrograms of folic acid every day, ideally from 3 months before pregnancy, and for the first 12 weeks of pregnancy. Some women need a higher dose, for example if there is a family history of neural tube defects. Read more in our guide to folic acid for pregnancy.
- Stop alcohol and smoking, and ask for help if you need it.
- Avoid vitamin A supplements and liver. The NHS advises against cod liver oil and supplements containing vitamin A (retinol), and against liver and liver products, because too much vitamin A can harm the baby's development.
- Check your medicines and supplements. Do not stop prescribed medicine without talking to your doctor, and check any supplements or herbal products with a doctor or pharmacist. Some popular supplements are not recommended during pregnancy; for example, see our guide to ashwagandha in pregnancy.
- Look after your iron levels. Anaemia is common in pregnancy; your clinic will check your haemoglobin. See our guide to kurang darah (anaemia).
Coping with morning sickness
Nausea and vomiting are very common in early pregnancy. The NHS says morning sickness usually clears up by weeks 16 to 20 and does not put the baby at increased risk. Things that may help:
- get plenty of rest, because tiredness can make nausea worse;
- avoid foods or smells that make you feel sick;
- eat something plain, like dry toast or a plain biscuit, in the morning;
- eat small, frequent meals of plain, high-carbohydrate, low-fat foods, such as bread, rice and crackers;
- eat cold foods if the smell of hot meals makes you feel sick;
- sip water little and often;
- try foods or drinks containing ginger, which has some evidence for reducing nausea (check with a pharmacist before taking ginger supplements).
If self-help does not work, a doctor can prescribe anti-sickness medicine that is safe in pregnancy.
Warning signs: when to get help
Ectopic pregnancy (mengandung luar rahim) happens when a fertilised egg implants outside the womb, usually in a fallopian tube. In the UK it affects around 1 in 90 pregnancies. Symptoms usually develop between weeks 4 and 12 and can include:
- a missed period and other signs of pregnancy;
- tummy pain low down on one side;
- vaginal bleeding or a brown watery discharge;
- pain in the tip of the shoulder;
- discomfort when peeing or pooing.
Get medical advice straight away if you have a combination of these symptoms and might be pregnant, even with a negative test. Call 999 or go to the nearest emergency department if you have sudden, sharp, intense tummy pain, feel very dizzy or faint, feel sick, or look very pale, as these can mean a rupture.
Also contact a doctor if you are pregnant and:
- have any vaginal bleeding;
- cannot keep food or fluids down for 24 hours, have very dark urine or have not peed for more than 8 hours;
- feel very weak, dizzy or faint when standing up;
- have tummy pain, a high temperature, or vomit blood.
Frequently asked questions (FAQ)
What are the early signs of pregnancy (tanda-tanda mengandung)?
The most common early signs are a missed period, light spotting around the time your period is due (implantation bleeding), feeling or being sick, feeling very tired, sore or larger breasts, needing to pee more often, constipation, more vaginal discharge, a metallic taste, sensitivity to smells, food cravings or dislikes, and mood changes. Not everyone has all of them.
How early do pregnancy symptoms start?
According to the NHS, symptoms usually start when you are around 4 to 6 weeks pregnant. Pregnancy is counted from the first day of your last period, so 4 weeks pregnant is around the time your next period is due.
Can I have pregnancy symptoms 1 week or 3 days after sex?
It is unlikely. Pregnancy tests detect the hormone hCG, which only starts to be produced around 6 days after fertilisation, and most symptoms appear around the time of a missed period or later. Symptoms a few days after sex are more likely to have another cause, so wait and take a test at the right time.
When should I take a pregnancy test?
Most pregnancy tests work from the first day of a missed period. If you do not know when your period is due, test at least 21 days after unprotected sex. A positive result is almost certainly correct, but a negative result is less reliable, so if your period still has not come, test again a few days later.
Is more vaginal discharge (keputihan) a sign of pregnancy?
It can be. More vaginal discharge without soreness or irritation is a common early sign, and the NHS says it is normal to have more discharge during pregnancy. Healthy discharge is thin, clear or milky white and does not smell unpleasant. See a doctor if it smells, is green or yellow, or causes itching or pain.
What should I do after a positive pregnancy test?
Start antenatal care as soon as possible, take 400 micrograms of folic acid every day until 12 weeks of pregnancy, stop alcohol and smoking, and check any medicines or supplements with a doctor or pharmacist. Avoid supplements containing vitamin A and avoid liver.
What are the signs of an ectopic pregnancy (mengandung luar rahim)?
An ectopic pregnancy can cause a missed period with pain low down on one side of the tummy, vaginal bleeding or brown watery discharge, pain in the tip of the shoulder, and discomfort when peeing or pooing. Get medical advice straight away. Go to an emergency department if you have sudden severe tummy pain, feel very dizzy or faint, or look very pale.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor, midwife or pharmacist. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Signs and symptoms that might mean you're pregnant — NHS
- Doing a pregnancy test — NHS
- Stopped or missed periods — NHS
- What to do when you find out you're pregnant — NHS
- Vitamins and supplements in pregnancy — NHS
- Vaginal discharge in pregnancy — NHS
- Vomiting and morning sickness — NHS
- Ectopic pregnancy — NHS
- Wilcox AJ, et al. Natural limits of pregnancy testing in relation to the expected menstrual period. JAMA. 2001;286(14):1759-1761.
