There are many situations that lead women to ask the question “Am I pregnant.” The following questions are some of the most frequently asked questions that the APA receives regarding early pregnancy issues.
Can I be pregnant and still have a period?
Pregnant women can have some light irregular bleeding during pregnancy, but it should not be like a “normal” period. Some women can confuse this for their period because often it can come right around the time she was expecting her normal period. The irregular bleeding or spotting that can occur during pregnancy is often a dark brown color or a light pinkish. It should not be enough bleeding to fill pads or tampons over a few days. If you are bleeding enough to fill pads and tampons, then this would be a good indication that you are probably not pregnant.
What if I have a positive pregnancy test and then start bleeding?
About 25-30% of pregnant women experience some type of spotting or bleeding in early pregnancy. This can be a result of many different factors including implantation bleeding, infection, cervical irritation, ectopic pregnancy or a threatened miscarriage. Many women who have this light bleeding go on to have normal pregnancies and healthy babies. About half of the women who experience some light bleeding will go on to have heavier bleeding that will ultimately result in miscarriage. Unfortunately there is no way to predict whether or not vaginal bleeding will progress to miscarriage. If you experience light bleeding that continues to get heavier, accompanied by painful cramping, back pain or stabbing pains, then you would want to seek medical attention right away. If you experience some very slight spotting that then goes away, you would want to make sure to share this with your healthcare provider so that they are fully informed of everything you are experiencing in your pregnancy.
What if I have symptoms of pregnancy followed by a heavy period?
If you are having some weird symptoms that made you think you may be pregnant, but then have heavy bleeding, you may want to see a healthcare provider to find out what is going on. This could be caused by a hormonal imbalance, an infection, or a possible miscarriage. But the only way to know for sure is by seeking medical care.
What if I notice some cramping and I am pregnant?
Pregnant women can have some light cramping early in pregnancy. The cramping is often like light menstrual cramps through the lower abdomen or on one side or the other. The cramping is often a result of all the changes that are occurring in the uterus. The uterus is experiencing change as the implanted egg begins to grow and develop. Some light cramping may also be from the small cyst that can develop on the ovary at ovulation called the corpus luteum cyst. A small cyst forms in the spot on the ovary where the egg pops out before making its journey to the uterus. This cyst then produces progesterone until the placenta has formed enough to begin producing its own progesterone. This small cyst can cause some discomfort for women in early pregnancy.
Can the exact date of conception be determined accurately?
Many women have questions about the date of possible conception, and unfortunately figuring this out is not always so easy. The assumption is that if a woman has pretty regular menstrual cycles, then she will be ovulating during a certain time of the month. Ovulation is the time when conception can take place because that is when an egg is made available. The problem is that most women do not ovulate on an exact date each month, and many women have a different ovulation day from month to month. If you also take into account that sperm can live in the body 3-5 days after intercourse has taken place, this can make figuring out conception very difficult. Most doctors use the first day of the last period (LMP) and ultrasound measurements to gage the gestational age of a baby and determine when the baby was conceived. But these are just tools used to estimate the dates—it is very hard for anything to tell what the exact date of conception really is. Most people do not realize that ultrasounds can be off up to 5-7 days in early pregnancy and up to a couple weeks off if the first ultrasounds are done farther into the second trimester or beyond. Due dates are not an accurate tool for determining conception since they also are only an estimation date (only 5% of women give birth on their due dates). If you are seeking the estimated date of conception for paternity reasons, and intercourse with two different partners took place within 10 days of each other, we strongly encourage that paternity testing be done; this testing can be done during pregnancy and after the baby is born. It is the only way to accurately know who the father is.
If I have a negative pregnancy test after I have missed my period, does that mean I am not pregnant?
A negative result can mean that you are not pregnant, you took the test too early, or you took the test wrong. Pregnancy tests vary in their sensitivity (how soon they can detect the hormone hCG), and you may not have given your body enough time to produce enough hCG hormones that will show up on the test. Also, if you let a test sit for too long (after the instructions on the box tell you), the test is invalid. It is best to follow the instructions and wait until you have missed a period before taking the test. Some women show up accurately on a test the day they miss a period, while others may not show up positive until 3-4 weeks after a missed period. We encourage women to test after a missed period; if the result is negative they should wait a week and test again if a normal period has not started.