• Persistent headache
• Vision changes
• Upper stomach pain
• Nausea or vomiting
• Swelling of the face or hands
• Sudden weight gain
• Trouble breathing

Preeclampsia can happen to any pregnant person, but some people are at greater risk. Black women in the U.S. have a 60% higher risk of developing preeclampsia compared to white women. Also, there may be a higher risk of developing preeclampsia if you have:

• Chronic high blood pressure or kidney disease before pregnancy
• Obesity: If overweight or obese, you are also more likely to have preeclampsia in more than one pregnancy.
• Age: Pregnant women over 40 are at a higher risk
• African American ethnicity: Among those who have had preeclampsia, non-white pregnant women are more likely than white women to develop preeclampsia again if pregnant.
• Previous diagnosis of preeclampsia.
• Family history of preeclampsia 
• Carrying multiples (twins, triplets, etc.)

Patients with risk factors are often prescribed low-dose aspirin to lower their risk of developing preeclampsia. However, using risk factors alone misses many women who go on to develop preeclampsia. 

Preeclampsia screening in the first trimester

You and your provider can now understand if you are at risk for preeclampsia.  

Preeclampsia testing during the first trimester is now available. This new screening is done between 11 and 14 weeks of pregnancy via a simple blood test ordered by your healthcare provider. The test is an option for anyone pregnant, including those with a low to average risk for preeclampsia or first-time pregnancies.

How does it work?

The test checks your protein levels and how your placenta is working and growing. It looks at two biophysical markers – mean arterial pressure (MAP) and uterine artery pulsatility index (UtAPI)-in addition to the placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A). These markers provide important insights into your preeclampsia risk. Low levels of PlGF and PAPP-A can indicate that the placenta isn’t functioning well. High levels of MAP and UtAPI suggest high blood pressure and resistance to blood flow. These are all potential indicators of preeclampsia.

This new test is one of the many screenings and exams you will take during pregnancy. It’s important to have a shared discussion with your provider about the testing process. You are your best advocate, so ask about the tests you believe are right for you. Regular visits and tests from your healthcare provider are crucial. They are key for monitoring your health and finding early signs of preeclampsia. Make sure to follow up with your healthcare provider to continue testing for preeclampsia risk throughout your pregnancy, especially if you’re in a high-risk group. 

For more information about this new preeclampsia screening test and other preeclampsia screening tests, visit https://womenshealth.labcorp.com/patients/pregnancy/preeclampsia.

Read more

• Preeclampsia: how healthcare providers detect it
• Blood pressure during pregnancy: why you should track it

Sources

• “Preeclampsia and Pregnancy.” American College of Obstetrics and Gynecologists (ACOG). ACOG. October 2020.  https://www.acog.org/womens-health/infographics/preeclampsia-and-pregnancy.
• “Who is at risk of preeclampsia?” National Institute of Child Health and Human Development (NICHD) National Institute of Health (NIH), NICHD.NIH June 2022 https://www.nichd.nih.gov/health/topics/preeclampsia/conditioninfo/risk.

How much should I exercise?

A 2017 study showed that 30 to 60 minutes of exercise two to seven times per week may reduce hypertension. If possible, try to space out exercise during the week. This rest may help your body recharge. 

What is the best kind of exercise?

There isn’t one “best” kind of exercise. It depends on your level of comfort and what you enjoy. For example, if you were a runner before becoming pregnant, you can likely continue. If you’re new to exercise, try fast walks and low-impact options such as prenatal yoga, walking, light weights, and swimming. See how you feel and shift your plan as needed. 

What exercise should I not do?

This will depend on your health. However, some exercises are usually riskier than others. Try to avoid exercises that:

1. Involve collision, physical contact, and falling
2. You haven’t done it before becoming pregnant
3. Make you feel overly tired

What are the risks?

If you have a healthy pregnancy, exercising while pregnant has no known risks. It will not increase your risk of miscarriage, low birth weight, or early delivery. 

Is there anything else I should remember?

Yes! Here’s what to keep in mind:

1. Listen to your body 
2. Focus on what works for you 
3. Work with a trusted healthcare provider 

You and your healthcare provider can work together to make sure you are safe and comfortable. You can also read more about preeclampsia and exercise below.

Reviewed by the Ovia Health Clinical Team

Read More

• Preeclampsia: What you need to know 
• Being your own health care advocate
• Low-impact exercise during pregnancy
• What’s a risky exercise during pregnancy?

Sources

• Magro-Malosso, Elena R. “Exercise during pregnancy and risk of gestational hypertensive disorders: A systematic review and meta-analysis.” Obstetrics and Gynecology. 96(80: 921-931. Web. August 2017. 
• “Healthy Pregnant or Postpartum Women.” Centers for Disease Control & Prevention. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. June 3, 2022. https://www.cdc.gov/physicalactivity/ basics/pregnancy/index.htm
• “Exercise During Pregnancy: Frequently Asked Questions.” The American College of Obstetricians and Gynecologists. The American College of Obstetricians and Gynecologists. December 2021. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy#:~:text=Regular%

Medications and vaccines

Immediately after giving birth, routine care for newborns includes a few different treatments. It can be really helpful to know more about these recommendations ahead of time!

An antibiotic eye ointment, called erythromycin, is a clear gel that is gently squeezed into each eyelid. It looks greasy, but should not cause your baby any discomfort. It helps to protect against an eye infection called neonatal conjunctivitis that can be caused by many different bacteria present in the vagina, or rarely in amniotic fluid. Neonatal conjunctivitis can cause serious complications like blindness and requires IV antibiotics for treatment. In some states, you may not be able to sign refusal for this medication, it is mandated by law. 

Vitamin K is a small injection of — you guessed it — Vitamin K. Vitamin K is essential for forming blood clots. After infancy, our bodies develop bacteria in the gut that make Vitamin K for us. But when they’re born babies don’t have this in their bodies yet. The shot gives them protection against bleeding while they develop their own gut bacteria to take over the job of making the vitamin for them. 

Not having enough vitamin K can cause bleeding issues that range from minor — like a little extra bleeding after getting a shot — to a severe condition called Vitamin K Deficiency Bleeding, which can be fatal. Many parents are curious about using oral Vitamin K as an alternative to the shot. This is an option, but because Vitamin K in this form is processed through the digestive system (instead of going directly into the muscle and being absorbed into the bloodstream with the shot), oral doses have to be given weekly and are less effective than a one-time injection of the vitamin. Therefore, they are not typically offered or recommended. 

Hepatitis B is the only vaccine recommended for newborns. It is part of a 3 dose series, which is continued at your well-baby visits. If you have tested positive for Hepatitis B during pregnancy, the routine for your baby’s care will be slightly different.

Hearing, hearts, and jaundice

Some routine testing, like a hearing screen, cardiac screening, or bilirubin scan, are brief and non-invasive. Checking your baby’s hearing, pulse oximetry, and their jaundice level are all things you can expect before going home. If there are any red flags on those tests, your pediatric provider will discuss your options and next steps (which are often just re-checking the tests at a later hour or day). 

You might wonder why it’s so important to do these tests in the first days of your baby’s life. Let’s break it down. 

Hearing test 

A hearing test is important because even a newborn baby is already learning language. If their hearing is impaired (even in just one ear) knowing and addressing it early on can make a big difference for your baby’s language development. 

Oxygen levels

A pulse oximetry test of your baby’s oxygen level in different parts of the body — usually done by putting a sticker with a red light on your baby’s hand and foot. This test can help to catch worrying heart problems that happen in about 1 in 1,000 babies and might otherwise go unnoticed. 

Jaundice screening 

Jaundice screenings, often also done with a special light placed on your baby’s skin, make sure that bilirubin levels aren’t getting too high. Sometimes instead of a skin sensor, this is checked using a blood test, collected along with the blood sample discussed below. High bilirubin levels can cause problems like lethargy, poor feeding, and in some rare extreme cases, brain damage.

Newborn screening

Newborn screening is another test that is typically done after your baby is 24 hours old. It involves a small blood sample. You might picture having your blood drawn in your arm as an adult, but this test requires a very small sample and it can be tricky to find a tiny newborn vein. So most of the time, a heelstick is used. Your baby will have their foot warmed and then a small prick is made in their heel. Some babies barely notice, others might cry. Blood is collected onto a paper form, which is sent to your state’s processing lab by the hospital. 

But why?

The biggest question is, what are they screening my baby for? And that’s a great question! The answer varies because testing is a little bit different in each state. In general, the test covers multiple conditions that a baby can be born with and are impossible to see on a physical exam. Most of these conditions have treatments that are important to start early in life, so testing is essential.

It can be helpful to check what the testing requirements and suggestions are in your area, and discuss any particular concerns you have with your pediatric provider — such as a family history of a metabolic disorder. You can look up what your state tests for here if that information isn’t provided by your hospital. If you give birth outside of a hospital, it’s recommended that you have newborn screening done between 24 and 48 hours of life. This can typically be done by your home birth or birth center provider, or at a lab. 

Reviewed by the Ovia Health Clinical Team

Read more

• Recommended immunization schedule for baby’s first year
• Baby check-ups

Early baby movement

Many feel those first swishes and flutters some time between week 16 and week 20, but it can be tough to distinguish between these tiny sensations and gas. Still, these first movements are exciting and reassuring. They’re generally not consistent, and it’s very normal to go days without feeling any movement at all during these weeks. 

Baby movement during weeks 24-28

By this time, most people are able to sense their baby move daily. You might have a sense of their natural rhythm (do you have an early bird or a night owl?). By 28 weeks, many healthcare providers recommend a daily “kick count” if you have any concerns about how often baby is moving. You can find out more about how to do that with the Ovia Kick Counter here.

Which movements are normal?

As your baby grows, you may be able to distinguish between kicks, punches, and stretching. After a big meal, you may notice baby moving much more than usual. This is not cause for alarm — it’s a natural reaction to an increase in your blood sugar. Increased movements are generally a very reassuring sign of how baby is doing. Sometimes you may notice a rhythmic bouncing feeling — generally these are hiccups! They are very common (some babies get them every day), and again, not a cause for concern (just super cute). 

What if I’m not feeling anything?

If you’re early in pregnancy (before 20 weeks) it is completely normal not to have felt baby move quite yet. After that point, the types of sensations people have varies. In particular, those who are pregnant with their first baby and those with anterior placentas are less likely to notice all of their baby’s movements. You and your provider can work on a plan after 28 weeks to count movements or use another method to check on baby’s wellbeing. 

For any parent after 28 weeks, losing the sensation of baby moving can be really scary and should be addressed. If kick counting doesn’t offer any reassurance, you should always feel empowered to contact your provider or seek more urgent care, as there are many ways to check on your baby!

Reviewed by the Ovia Health Clinical Team

Read more

• Counting baby’s kicks
• Pregnancy by week

Sources

• Aya Mohr Sasson, Abraham Tsur, Anat Kalter, Alina Weissmann Brenner, Liat Gindes & Boaz Weisz (2016) Reduced fetal movement: factors affecting maternal perception, The Journal of Maternal-Fetal & Neonatal Medicine, 29:8, 1318-1321, DOI: 10.3109/14767058.2015.1047335
• Mangesi L, Hofmeyr GJ, Smith V, Smyth RMD. Fetal movement counting for assessment of fetal wellbeing. Cochrane Database of Systematic Reviews 2015, Issue 10. Art. No.: CD004909. DOI: 10.1002/14651858.CD004909.pub3. Accessed 26 May 2022. https://www.chop.edu/conditions-diseases/fetal-movement-counting.

Hand expression

Even if you don’t want to collect and store colostrum, learning how to hand express colostrum at the end of pregnancy is so valuable. It is much easier to learn a skill when you’re well rested and have some privacy than when it’s an immediate or urgent need just after giving birth. 

Your body starts to produce colostrum as early as 20 weeks. Some people find they leak small amounts of it or that their bra is stuck to their nipples at the end of the day. If you’re interested in collecting and saving colostrum during pregnancy, experts generally recommend waiting until 37 weeks. Your OB provider can help you create a timeline that works for you!

Hand expression can take some practice to master, and you may find that each breast needs a slightly different touch or technique. We love this short video that shows some different ways to express those precious drops. The best way to save colostrum is in very small syringes that are about 1-3 mLs in size. You can label and freeze the syringes until you’re ready to thaw and use them.  

Who does it help?

Colostrum collection can benefit many parents. Those who have experienced low supply or who have risk factors for low supply may want extra colostrum on hand to avoid excessive newborn weight loss or reduce the risk of jaundice. 

Those with gestational diabetes or who take beta blockers may want to collect colostrum to use in case of low or unstable blood sugar instead of using formula. 

Parents of multiples, babies who have IUGR, and babies with diagnosed genetic or physical differences may also benefit from having extra colostrum saved. There are a variety of reasons why it can come in handy. Talk to your provider or a lactation professional about the pros and cons. 

For some people, hand expression causes temporary but uncomfortable cramping, so it’s always a good idea to check in with your OB provider beforehand to see if there are any activities you should avoid that may cause contractions. Again, it’s generally recommended to wait until 37 weeks to try hand expression or colostrum collection.

Helpful tips

The best time to practice hand expression or collect colostrum is when you’re relaxed and not in a rush. Often people find that being warm and post shower/bath is a great time. Some gentle breast massage can help warm things up as you get started. Once a day is generally enough for practice until you get the hang of it. You may consider expressing more than once a day if you are actively collecting and storing. Keep in mind that at first, you may see just a hint of clear wetness or nothing at all.

If you’re collecting colostrum you’ll want to:

• Wash hands and have clean spoons, container/syringe ready
• Express for few minutes on each side collecting drops (aim for 10 drops and measure how much this is to make future collection easier, for example 10-15 drops might equal 1 mL)
• Date and store your colostrum in the freezer

Now that you have a little bit more information about hand expression and colostrum harvesting, you can make an informed decision about what is right for you!

Read more

All about colostrum

Breastfeeding basics

 

Content created withThe National Birth Equity Collaborative

Preterm birth increases the risk of complications and often results in a NICU (Neonatal Intensive Care Unit) stay. Preterm delivery can be scary to think about, but there are many ways that you can prevent it, in some cases with zero complications. Read on to learn more. 

Preterm birth impacts Black women and babies 50% more than their white peers. This disparity exists due to racism and bias within the healthcare system itself. Still, there are actions you can take early in your prenatal care to advocate for yourself and your baby.  

Understanding the risk factors

We don’t know all of the causes of preterm delivery, but what we do know is that the chances of preterm birth  can be impacted by the following conditions:

• A history of having a procedure done on your cervix after an abnormal pap smear
• Shortened cervical length early in pregnancy
• A previous preterm birth
• Carrying multiples (twins, triplets, etc.)
• Using tobacco and/or other substances 
• Hypertension
• Diabetes

Becoming pregnant shortly after delivering a previous baby (less than 18 months)

Ask what you can do

Talk to your provider about what you can be doing to minimize your chances of delivering early. Providers will frequently recommend:

• Quitting smoking or drug use, if applicable
• Eliminating alcohol 
• Checking your cervical length
• Taking a progesterone treatment if you have a history of preterm birth 
• Managing your blood pressure and blood glucose through the use of medication and physical activity alongside a nutritious diet

Listen to your body

You know your body best, so if you’re ever concerned that something is wrong, reach out to your provider right away. If you’re not sure that what you’re feeling is normal and want to get a better understanding of what people at your point in pregnancy typically experience, reach out to an Ovia Health Coach any time, 7 days a week. You have a right to understand what is going on in your body and to receive care and support throughout your pregnancy.

Read more

• The power of preparing for preterm birth
• Risk factors for preterm labor and birth

Sources 

• “A Health Crisis Impacting Women and Babies of Color.” March of Dimes. March of Dimes. https://www.marchofdimes.org/mission/health-disparities.aspx. 
• “Premature Birth.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. November 1, 2021. https://www.cdc.gov/reproductivehealth/features/premature-birth/index.html. 
• “Preterm Birth.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. November 1, 2021. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. 
• Office of Communications. “What Are the Risk Factors for Preterm Labor and Birth?” Eunice Kennedy Shriver National Institute of Child Health and Human Development, U.S. Department of Health and Human Services. https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/who_risk. 

 

Content created withThe National Birth Equity Collaborative

Blood pressure (BP) measures the force that your flowing blood applies to the walls of veins and arteries — in other words, BP measures how hard your heart is working to pump blood throughout your whole body.

Blood pressure is measured using a sphygmomanometer (also known as a blood pressure cuff), and given as a two-number result, “systolic” and “diastolic”. Only one of these numbers needs to be above or below normal to be considered diagnostically elevated. High blood pressure (hypertension) can be especially dangerous during pregnancy, so it’s important to do your best to keep your blood pressure in the optimal range, which is generally under 120/80.

High blood pressure during pregnancy

High blood pressure can be problematic for everyone, but when you’re pregnant, it could put both of you at risk. High blood pressure may not be the direct cause of a certain complication but can indicate a greater problem. There are many possible risks of high blood pressure during pregnancy.  

• High blood pressure and protein in the urine are the two main symptoms of the pregnancy condition known as preeclampsia. In rare cases, preeclampsia can lead to other conditions causing internal bleeding, seizures, and strokes.
• High blood pressure may often indicate excess stress. Stress has been linked to a higher incidence of miscarriage and overly intense pregnancy symptoms. While it is certainly not always possible to just “stress less,” tracking your blood pressure along with your emotions may help you recognize when to seek advice from your healthcare provider.
• Sometimes, high blood pressure can cause conditions that increase the risk of your baby being born prematurely. A placental abruption, when the placenta is separated early from the baby, is another possible complication of conditions related to high blood pressure during pregnancy.

Heightened risk factors

According to the U.S. Department of Health and Human Services, high blood pressure is 40% more common in Black adults than white adults. This is due to a range of factors including racism and bias in the healthcare system and socioeconomic inequalities and inequities. According to the Healthcare Cost Utilization Project, Black women are also about 60% more likely to develop preeclampsia during pregnancy than white women.

Knowing your body and how it changes during pregnancy, especially your blood pressure, empowers you to seek care accordingly. Monitor your blood pressure and communicate to your healthcare provider any concerns you may have.

Taking control

Blood pressure levels can be an excellent indicator of the health of your pregnancy, and is a great way to monitor against certain complications like preeclampsia. Tracking your blood pressure along with other data can also help draw patterns between certain behaviors. You’ll know how your sleep, nutrition, activity or other behaviors may affect your blood pressure, and vice versa. It’s important to let your healthcare provider know if your blood pressure is consistently elevated.

Read more

• Pregnancy complications and your risk of cardiovascular disease
• Lowering your blood pressure with heart-healthy foods

Sources

• P Kristiansson, JX Wang. “Reproductive hormones and blood pressure during pregnancy.” Human Reproduction. Vol.16, No.1 oo. 13-17. Web. 2001.
• S Kulkarni, I O’Farrell, M Erasi, MS Kochar. “Stress and hypertension.” Wisconsin Medical Journal. 97(11):34-8. Web. Dec-98.
• “Preeclampsia and High Blood Pressure During Pregnancy: FAQ034.” ACOG. American College of Obstetricians and Gynecologists, 9/14/2015. Web.
• “High Blood Pressure in Pregnancy.” National Heart, Lung, and Blood Institute. National Heart, Lung, and Blood Institute, n.d. Web.
• “Placental abruption.” March of Dimes. March of Dimes, 1/12/2015. Web.
• Norton Healthcare. “Pregnant African-American women far more likely to have pre-eclampsia than white women.” Norton Healthcare. Norton Healthcare. May 16, 2018. https://nortonhealthcare.com/news/pregnant-african-american-women-pre-eclampsia/. 
• Heart Disease and African Americans. Office of Minority Health. U.S. Department of health and human services. February 11, 2021. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=19#:~:text=Although%20African%20American%20adults%20are,to%20non%2DHispanic%20white%20women
• Kathryn R. Fingar, Ph.D., M.P.H., Iris Mabry-Hernandez, M.D., M.P.H., Quyen Ngo-Metzger, M.D., M.P.H., Tracy Wolff, M.D., M.P.H., Claudia A. Steiner, M.D., M.P.H., and Anne Elixhauser, Ph.D.

How are the babies?

The phrase “week one of pregnancy” can be a little misleading because, well… you’re not technically pregnant yet. It’s called “week 1” because gestation is counted from the first day of your last period through your due date.

With an average 28-day menstrual cycle, ovulation occurs right in the middle (or about 14 days after day one of your period) of your cycle. Whether your babies will come from one egg and one sperm, multiple eggs, or multiple sperm, they’re still waiting in the wings for their chance to fertilize.

So, while it’s called “week one of pregnancy,” you’re not officially one week pregnant (yet).

What’s new with you?

Since the embryos (fertilized eggs) have yet to form, you’re still in the preconception stage or maybe starting an IVF cycle. But if you’ve had multiples before, have a family history of twins, or are planning on transferring more than one embryo for an IVF pregnancy, the possibility of multiples might be at the forefront of your mind.

And while you can take an at-home pregnancy test in a few weeks, an ultrasound won’t be able to confirm whether it’s multiples until week six at the earliest. (Your first ultrasound might be closer to eight or ten weeks, depending on what your healthcare provider recommends).

At this point, you might be looking ahead to figure out your most fertile days so you and your partner know when to have sex. Or if you’re doing IVF, you’re still in the stage before the eggs are fertilized and transferred. And at the time of transfer, you’ll technically be about two weeks pregnant. If you’re doing IUI, you’re still a couple weeks out from the transfer.

Right now is all about taking good care of yourself to prepare for the journey ahead. Getting enough sleep, eating nutritious foods, staying active, drinking plenty of water, and taking a prenatal vitamin can help set you off on the right foot.

Reviewed by the Ovia Health Clinical Team

Read more

• Pregnant with multiples: (Unofficial) week 2
• 1 week pregnant

Sources

• Mayo Clinic Staff. Fetal development: The 1st trimester. Mayo Clinic. 2020. Web. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302.
  
• Tobah, Y.B. M.D What ovulation signs can I look out for if I’m hoping to conceive? Mayo Clinic. 2020. Web. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/ovulation-signs/faq-20058000.
  
• Kliman, H, MD, PhD. Twins. Yale School of Medicine Reproductive and Placental Research Unit. Web. https://medicine.yale.edu/obgyn/kliman/placenta/twins/.
  
• Horsager-Boehrer, R. MD. Patience is key: Understanding the timing of early ultrasounds. The University of Texas Southwestern Medical Center. 2018. Web. https://utswmed.org/medblog/patience-key-understanding-timing-early-ultrasounds/.
  
• Bergman, Kim PhD. Understanding IVF Embryo Development. Growing Generations. 2019. Web. https://www.growinggenerations.com/surrogacy-resources-for-intended-parents/understanding-ivf-embryo-development/.

How are the babies?

Gestation is counted from the first day of your last period. So saying you’re in “week two of pregnancy” is a little misleading, as you’re not actually pregnant quite yet.

If you’re trying to conceive (TTC), this is around the time you’ll enter your fertile window. Ovulation is within the next several days. The egg (or eggs) will be patiently awaiting the sperm’s arrival, hoping to fertilize and complete the journey to the uterus together as newly formed zygotes. There, they’ll become blastocysts, which implant into the uterine lining within a few days. At that point, you’ll officially be pregnant.

If you’re doing IUI, sometime this week, the semen will be transferred to your uterus. With IVF, eggs are retrieved around this time (or thawed if they were previously frozen) and fertilized with sperm in a lab. A few days later, multiple embryos (fertilized eggs) are transferred to the uterus. When implantation occurs, pregnancy begins.

What’s new with you?

Whether you’re trying to conceive without assistance or doing an IVF or IUI cycle, the two-week mark is too soon to take a pregnancy test. You’ll get the most accurate result after your missed period. But if you’re pregnant with multiples, you might have higher levels of the hormone hCG, which is what’s detected in an at-home pregnancy test.

You most likely won’t notice any pregnancy-related symptoms until several days after implantation occurs or potentially later. That said, if you’re carrying twins or multiples, you may experience more intense symptoms than those with only one baby. Still, the earliest signs of pregnancy usually don’t pop up until the fourth week.

Week two is an exciting time, but you’ll have to play the waiting game a little longer. And even when you get a positive, it’ll be another few weeks until an ultrasound confirms you’re having multiples. While counting down the days until it’s official, you might try focusing on eating healthy foods, staying active, and getting plenty of sleep.

Reviewed by the Ovia Health Clinical Team

Read more

• 3 weeks pregnant with multiples
• 4 weeks pregnant with multiples

Sources

• Mayo Clinic Staff. Fetal development: The 1st trimester. Mayo Clinic. 2020. Web. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302.
  
• Mayo Clinic Staff. Fertilization and implantation. Mayo Clinic. Web. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/multimedia/fertilization-and-implantation/img-20008656.
  
• Mayo Clinic Staff. In vitro fertilization (IVF). Mayo Clinic. Web. 2019. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716.
  
• U.S. Food and Drug Administration. Pregnancy. 2019. Web. https://www.fda.gov/medical-devices/home-use-tests/pregnancy.
  
• Singh, N. et al. Role of early serum beta human chorionic gonadotropin measurement in predicting multiple pregnancy and pregnancy wastage in an in vitro ET fertilization cycle. Journal of Human Reproductive Sciences. 2013. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853879/.
  
• Cleveland Clinic. Expecting Twins or Triplets. 2020. Web. https://my.clevelandclinic.org/health/articles/9710-expecting-twins-or-triplets.
  
• Horsager-Boehrer, R. MD. Patience is key: Understanding the timing of early ultrasounds. The University of Texas Southwestern Medical Center. 2018. Web. https://utswmed.org/medblog/patience-key-understanding-timing-early-ultrasounds/.

How are the babies?

The three-week mark is right around the time when your little bundles of joy (or rather, little bundles of cells) will be implanting into your uterus. This is considered week three of pregnancy because gestation is counted from the first day of your last period. However, implantation is the point when you’re officially pregnant.

The bundles of cells are now separating into layers. The inner cells are dividing and will make embryos (your babies’ bodies), and the outer cells are implanting into the wall of your uterus, forming protective structures called membranes, and the placenta (how the babies will get nutrients from you). As the cells continue to multiply, the embryos will grow bigger and eventually develop into the babies’ body parts and organ systems.

Another cool thing about the three-week mark? The embryos already have genetically predetermined hair and eye color.

What’s new with you?

You’re getting closer to being able to take a pregnancy test, though you might want to wait until after your missed period to get the most accurate result. At-home tests measure the hormone hCG, which begins to be released after implantation and doubles about every 48-72 hours throughout the first trimester.

If you’re pregnant with multiples, you might have higher levels of hCG early on. That said, an ultrasound won’t be able to confirm you’re pregnant with multiples until close to six weeks.

While it might be too soon to take a pregnancy test or get a sonogram, you could start experiencing some early pregnancy symptoms during week three. You might notice light spotting, which could be a sign of implantation. Bloating, mild cramping, and sore breasts are also common during the very early weeks of pregnancy. And those carrying twins or multiples might experience more intense symptoms than people pregnant with one baby.

As you wait to take a pregnancy test, we recommend taking prenatal vitamins, eating nutritious foods, and staying hydrated. And pay attention to how you’re feeling. With lots of changes on the horizon, it’s essential that you take care of your mental health, too. 

Reviewed by the Ovia Health Clinical Team

Read more

• 4 weeks pregnant with multiples
• 5 weeks pregnant with multiples

Sources

• Mayo Clinic Staff. Fetal development: The 1st trimester. Mayo Clinic. Updated March 2025. Web. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302.
  
• MedlinePlus. Fetal development. U.S. National Library of Medicine. Reviewed 8/23/2023 https://medlineplus.gov/ency/article/002398.htm.
  
• American Pregnancy Association. What is HCG? 2020. Web. https://americanpregnancy.org/getting-pregnant/hcg-levels-71048/.
  
• Singh, N. et al. Role of early serum beta human chorionic gonadotropin measurement in predicting multiple pregnancy and pregnancy wastage in an in vitro ET fertilization cycle. Journal of Human Reproductive Sciences. 2013. Web. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853879/.
  
• Horsager-Boehrer, R. MD. Patience is key: Understanding the timing of early ultrasounds. The University of Texas Southwestern Medical Center. 2018. Web. https://utswmed.org/medblog/patience-key-understanding-timing-early-ultrasounds/.
  
• Cleveland Clinic. Expecting Twins or Triplets. 2020. Web. https://my.clevelandclinic.org/health/articles/9710-expecting-twins-or-triplets.