Your changing body in the first trimester

Fatigue. Breast tenderness. Cramping. Bloating. Spotting. And a whole lot of emotional upheaval.

Pregnancy may begin with a test strip — but for many, the real signs show up in the body long before the bump. Some symptoms are expected. Others might feel alarming. So let’s gently walk through what’s happening in your body during those first twelve weeks — and how to know what’s normal, and what’s not.

Spotting and cramping

Light spotting often called “implantation bleeding” is common in early pregnancy — typically occurring around the time your period would have arrived. Mild cramping may accompany it, as your uterus adjusts.

• Normal: Light pink or brown spotting that resolves quickly
• Not Normal: Heavy bleeding, bright red blood, or severe pain

Up to 25% of women experience light spotting in early pregnancy without adverse outcomes (van Oppenraaij et al., 2009). 

If bleeding persists or worsens, always consult your healthcare provider.

Nausea, vomiting, and food aversions

Nausea (with or without vomiting) can start as early as week 4 and often peaks around weeks 8–10.

The cause? Rising hCG levels (human chorionic gonadotropin), increased estrogen, and changes in gut motility.

• Normal: Nausea that comes and goes, even daily
• Not Normal: Inability to keep food or fluids down for 24+ hours

A 2020 review found that up to 70% of pregnant people experience nausea, and about 3% develop hyperemesis gravidarum, a more severe condition requiring treatment (Gadsby et al., 2020)

Fatigue and sleep changes

Crippling exhaustion is one of the most common — and surprising — early symptoms.

Your body is working overtime: producing the placenta, expanding blood volume, and adjusting to massive hormonal changes.

1. Normal: Needing naps, sleeping longer or feeling foggy
2. Not Normal: Fainting, shortness of breath, or extreme weakness

Fatigue is reported in 90% of pregnancies in the first trimester.³ Give yourself permission to rest.

Dizziness and lightheadedness

Thanks to increased progesterone and changes in blood pressure, feeling a little dizzy is common — especially when standing up quickly.

• Normal: Brief dizziness that resolves with hydration and rest
• Not Normal: Persistent vertigo, fainting, or visual disturbances

Breast tenderness and fullness

Breast tissue begins changing rapidly under the influence of progesterone and estrogen, preparing for lactation.

• Normal: Soreness, tingling, fullness, or darkening of areolas
• Not Normal: Lumps, sharp localized pain, or redness/swelling

Studies show increased vascularization and glandular growth begin as early as week 4 (Ramsay et al., 2005). 

Constipation and bloating

Progesterone relaxes smooth muscles — including in the digestive tract — slowing things down.

• Normal: Gas, constipation, bloating, or mild discomfort
• Not Normal: Severe abdominal pain or inability to pass stool

Tip: Increase water, fibre, and gentle movement.

Mood swings and emotional sensitivity

Hormonal fluctuations + physical exhaustion = emotional rollercoaster.

• Normal: Feeling tearful, anxious, overwhelmed, or irritated
• Not Normal: Persistent depression, panic attacks, or emotional numbness

Up to 20% of pregnant women experience anxiety or depression, even in early pregnancy (Austin et al., 2007). Early support makes a big difference.

When to call your healthcare provider

• Always trust your instincts. Call your midwife, GP or OB if you experience:
• Heavy bleeding or severe cramping
• Fever over 38°C
• Persistent vomiting or dehydration
• Painful urination or signs of infection
• Sudden swelling in face or hands
• Visual changes or intense headaches

Your body Is doing something extraordinary

Even when you feel like you're just surviving — your body is creating life. It’s okay to feel exhausted. It’s okay to feel unsure.

You’re not failing.

You’re adapting.

And you're doing beautifully.

🧘 Need help with navigating your pregnancy?

We believe in meeting you with empathy, honesty, and support — from the very first flutter of doubt or joy. 

Sometimes it's the little things that can make a difference to your experience. We have hand selected pregnancy specific products in our Pregnancy gift hampers to help you alleviate the physical discomfort and enjoy your experience, as best you can.

👜 Shop Pregnancy gift hampers →

Cited Research & References

1. van Oppenraaij RHF, et al. (2009). Predicting adverse pregnancy outcome in women with threatened miscarriage: a systematic review and meta-analysis. Human Reproduction Update. https://doi.org/10.1093/humupd/dmp007
2. Gadsby R, et al. (2020). Nausea and vomiting of pregnancy: Clinical and research update. BMJ. https://doi.org/10.1136/bmj.m3547
3. Mindell JA, et al. (2015). Sleep patterns and fatigue in pregnancy. Journal of Clinical Sleep Medicine. https://doi.org/10.5664/jcsm.5028
4. Ramsay MM, et al. (2005). Anatomy and physiology of lactation. Baillière’s Clinical Obstetrics and Gynaecology. https://doi.org/10.1016/j.beogyn.2005.02.002
5. Austin MP, et al. (2007). Antenatal screening and early intervention for 'perinatal' distress, depression and anxiety. Australian and New Zealand Journal of Psychiatry. https://doi.org/10.1080/j.1440-1614.2007.02004.