First Month Pregnancy - 1 month pregnant

In short: The first month covers weeks 1–4. Fertilisation takes place, the embryo implants in the lining of the uterus, the cell layers that will form the brain, organs and bones begin, and limb buds appear in week 4. The mother may notice slight bleeding, tiredness, breast tenderness and frequent urination. See the doctor to confirm the pregnancy is inside the uterus, start folic acid at once, and avoid smoking and too much caffeine.

• 1 month pregnant (Weeks 1-4)

1 Week Pregnancy

Because pregnancy is counted from the first day of your last period, during week 1 you are actually having your period and are not yet pregnant. Around two weeks later you ovulate; of the millions of sperm released, only a few hundred reach the fallopian tube, where one meets the egg and fertilization occurs.

• This zygote is producing early pregnancy protein which is an immunosuppressant which prevents rejection of the embryo by your body.
• You won’t have nausea or vomiting yet. If you chart your temperature, a raised basal body temperature lasting more than 16–18 days after ovulation can suggest pregnancy, but a home pregnancy test from the day your period is due is far more reliable.

The headings below (2, 3 and 4 weeks) count weeks after conception, not from the first day of your last period. In clinic dating, conception is about week 2, and implantation, spotting and a positive test are about weeks 3–4.

2 Weeks Pregnancy

• You may see some vaginal spotting as the zygote implants into the uterine wall.
• After implantation, the early embryo is a small disc lying between two fluid-filled spaces: the amniotic cavity and the yolk sac.
• The yolk sac is responsible for nourishment of the embryo until the placenta is well formed in order to continue nourishment of the embryo but this will occur after another 8 weeks.
• The umbilical cord will start to form and function partly.
• The mother will start to feel more tired; her breast will become engorged and may experience frequent urination.
• At this time your body will start to produce beta human chorionic .gonadotrophin (B-HCG) which will induce estrogen and progesterone production.
• Avoid alcohol and tobacco completely, keep caffeine below 200 mg a day (about two cups of instant coffee), try to reduce stress and get enough sleep.
• Have appointment with your doctor to confirm pregnancy.

3 Weeks Pregnancy

• By this time your baby is like a poppy seed in size surrounded by an amniotic sac and fluid which protects your baby. Your baby is composed of three germ layers: ectoderm, endoderm mesoderm which will form the nervous system, brain, stomach, inner organs, bones of your baby.
• A vaginal ultrasound can usually show the pregnancy sac inside the womb from about 5 weeks after the first day of your last period; before that, not seeing a sac is normal.
• Your baby looks like a tiny pear inside the sac, where the rounded part will become the head and the pointed part the spine. The heartbeat can usually be seen on ultrasound from about 6 weeks after your last period.
• Your belly will be the same size as pre-pregnancy, but you may experience some fatigue, breast engorgement, frequent urination which will fade up by time, so don’t be worried.
• Your diet should include enough calcium because your baby is using calcium for his growing bones. Folic acid (400 micrograms daily) should ideally be started before you conceive; if you have not started it yet, start it now and continue until 12 weeks.
• All pregnant women should take folic acid and vitamin D (10 micrograms a day). Your doctor may advise a higher dose of folic acid (5 mg) if you have diabetes, a BMI of 30 or more, a previous baby with a spine defect or take epilepsy medicines, and extra supplements such as vitamin B12, calcium or iron if you are vegetarian, have lactose intolerance or are expecting twins.

4 Weeks Pregnancy

• By this time your baby looks like an alien, and the larynx, internal ear, and eye lens are already formed, although you may not recognize them. Also, little limb buds will form the arms, elbows fingers, legs, toes. The small tail you may see at this stage disappears later; the spinal cord forms from the neural tube along your baby’s back.
• During this week, your symptoms will increase, and you may start to have morning sickness. It is linked mainly to the rising pregnancy hormone (hCG) and other placental hormones; progesterone also slows the stomach and bowel, which adds to nausea and bloating.
• Your first (booking) visit should ideally be before 10 weeks. You will be weighed, your blood pressure measured and your obstetric and medical history taken, and blood tests ordered: complete blood count, blood group and Rh factor with antibody screen, tests for hepatitis B, HIV and syphilis, thalassaemia/sickle-cell screening where relevant, a diabetes risk check (HbA1c or fasting sugar if you are at risk), and a urine culture.
• You should start Folic acid, and a nutritional and lifestyle advice is given for you.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist