- Women's Health
What to Expect in the 4th Week of Pregnancy
Detecting a Pregnancy
A Positive Pregnancy Test
The fourth week of pregnancy is usually the time a new mother suspects she may be pregnant. This is the week a menstrual cycle will be due, and missed, if there is a pregnancy. For women who have been trying to conceive, the missed cycle will be a very welcome sign! Most pregnancy tests will generate an accurate result on the first day of a missed period.
Now that a new pregnancy has been confirmed, what are the next steps? A woman should:
- Call her doctor (obstetrician/gynecologist or general practitioner, depending on the medical system).
- Start taking prenatal vitamins, if she hasn't already been taking them.
- Avoid alcohol and other environmental toxins.
The Developing Gastrula
How the Baby is Developing
When doctors state a woman is "four weeks pregnant," they are indicating the time since the woman's last menstrual cycle. The developing embryo is only 2 weeks old from the time of conception.
The baby is approximately the size of a poppy seed, and has developed two distinct layers. The epiblast is a disc shaped layer, which is also called the "inner cell mass." This layer will form the embryo. The hypoblast will form the yolk sac, which will nourish the developing baby until the placenta is functional.
In a short period of time, an important process called gastrulation will occur (at around 5 weeks of pregnancy). The epiblast will completely reorganize itself into a three-layered structure. This early stage of embryogenesis is critical for proper organ development in the baby - from now until approximately 10 weeks of pregnancy, all of the baby's organs will be formed. Environmental toxins are at their most dangerous during these early weeks of pregnancy.
Pregnancy: Weeks 1-4
How he Mother Will Feel at Four Weeks
Some women will feel no symptoms of pregnancy at this stage, while others will begin to feel the common signs of early pregnancy:
- Sore breasts
- Frequent urination
There are other symptoms of early pregnancy that are more vague. Many women will get headaches during this time. Constipation or diarrhea may also make an appearance, which can make the woman uncomfortable. Acne may increase and appear on the face, arms, and back. Veins may become prominent and look like a "road map" on a woman's chest. Irritability and emotional swings are also common.
Headaches in Early Pregnancy
Common Concerns: Cramping and Spotting
Some women will experience "pinches and pulls" in the uterus. This is often normal: the uterus is already beginning to grow and there may be some small pinching pains every once in a while. In addition, up to 1/3 of women will experience spotting during early pregnancy. This is sometimes caused by the release of "old blood" from implantation, though all spotting should be reported to the woman's physician immediately.
About 1/2 of all women who have spotting in early pregnancy will experience a miscarriage, though the other half will deliver healthy babies. Spotting that turns into frank bleeding, often accompanied by cramps, is generally a sign of an impending miscarriage. Spotting brown blood is less worrisome, but should still be reported. A "viability" ultrasound may be performed as the pregnancy progresses to determine if there is a heart beat at around 6 weeks of pregnancy. Beta hCG numbers may be obtained through a blood test - the hCG numbers should double every 48-72 hours. A drop in beta hCG levels indicates an impending miscarriage, while hCG levels that rise at the appropriate rate indicate the pregnancy is continuing.
Nature Made Prenatal Vitamins
Nature Made vitamins receive high reviews among pregnant moms, as they have the necessary nutrients without any fillers. This vitamin does not contain DHA, so a separate DHA supplement will be necessary if desired.
Types of Prenatal Vitamins
Prenatal vitamins may be obtained over-the-counter or by prescription. There are many different formulations available - the most important nutrient to consider at an early stage of pregnancy is the amount of folic acid in the vitamin. A prenatal vitamin should contain at least 400 mcg of folic acid: this will help prevent neural tube defects in the developing baby. Many formulations contain 800 mcg to further ensure a sufficient supply of this vital nutrient. Women who have had a prior pregnancy with a neural tube defect should consult their doctor immediately, as a very high level of folic acid may be recommended to prevent future occurrences.
Many prenatal vitamins are now formulated as soft gel tablets. Chewable, liquid, and standard tablet forms are also available. Read the ingredient label carefully to ensure there are no additional herbs included in the recipe, as herbal concoctions are not recommended in early pregnancy (discuss any herb usage with a doctor prior to pregnancy, as some herbs are toxic to a developing embryo).
Docosahexaenoic Acid, or DHA, is often added to prenatal vitamins. This fatty acid is known to assist with brain and eye development. Some vitamin packages come with a separate DHA capsule, which must be swallowed in addition to the prenatal vitamin. Some prenatals are formulated with the DHA incorporated into the main vitamin pill.
In early pregnancy, it may be difficult to stomach the vitamins. If nausea is a problem, try taking the vitamins in the evening. Taking two Flintstones chewable vitamins is another option: these vitamins have the equivalent nutrients to a prenatal vitamin, and are more palatable and tolerable for some women.
Prenatal Vitamin Checklist
400 mcg (minimum)
Prevents neural tube defects
Prevents anemia in the mother
Necessary for DNA repair and immune system function
Helps to build baby's bones and teeth
Necessary for bone development
Antioxidant; also used to form collagen
Riboflavin (Vitamin B2)
Helps with growth, skin, and energy production
Thiamine (Vitamin B1)
Brain development, muscle development
Brain and nervous system development
First Appointment Poll
When does your doctor's office see pregnant women for the first time?
What to Expect at the Doctor's Office
Many doctor's offices will have a newly pregnant woman come in to fill out paperwork and to set the date for the first appointment. Some doctors may schedule an appointment early in the pregnancy, though many doctors may not see a woman for a physical and first ultrasound until she is 8-10 weeks pregnant. In some offices, only one ultrasound may be ordered at approximately 18-20 weeks of pregnancy.
Women who have had prior miscarriages, are spotting, or are otherwise concerned about their pregnancy should let the office staff know up front, particularly if the doctor's office in question does not see women until they are at the end of their first trimester. A viability scan may be ordered at 6-7 weeks gestation to monitor the pregnancy and detect the embryo's heart rate.