Women's Healthcare Topics

4 Weeks Pregnant

Reviewed by James Brann, M.D.

By now you would normally expect your period to arrive. If it does not, there is a good chance you might be pregnant! Even without any of the symptoms of pregnancy, you may just "know" that you are pregnant.

Some women are very in tune with their body and may notice subtle changes associated with pregnancy. If you are one of these women, keep in mind that our minds can often play tricks on us, and the only sure fire way to tell is with a pregnancy test. If the pregnancy test is positive, you've got a baby on board!

However, keep in mind that during 4 weeks pregnant, you may still be waiting to see if you've missed your period or not. Most doctors recommend you wait until after a missed period before taking a pregnancy test.

Most over-the-counter pregnancy tests work by detecting the levels of hCG (human Chorionic Gonadotropin) in your urine. This pregnancy hormone is produced as soon as your baby implants into your uterine lining. If you take a pregnancy test too early, you can have a negative result, even if you are indeed pregnant, because your levels of hCG are not high enough yet.

In some unfortunate cases, taking a pregnancy test early can lead to false hopes. Some women experience a "chemical pregnancy," or a very early miscarriage in which the fertilized egg did not embed properly into the uterine lining. With a chemical pregnancy, you may take a pregnancy test and get a positive result, but then you get your period (miscarriage).

If you have missed your period, but it's been a week and you still test negative with an over-the-counter pregnancy test, call your doctor for a blood test.

You might actually start realizing some early pregnancy changes now. Some women start to feel a little bit tired, which is not a surprise given the remarkable work your body is performing to support your new baby!

Cramping now is normal, and it's a sign of implantation. Some women describe this cramping akin to light menstrual cramps.

Light spotting can also be normal, and it's due to implantation bleeding. The spotting is typically pink or light brown. It should never be heavy, or bright red like your regular menstrual period.

In addition to the signs of implantation, you may start to experience a few early pregnancy symptoms.

Nausea or vomiting (aka morning sickness) can start as early as now in some women, but it's more common at 6 weeks. You may find that you're feeling slightly queasy this week, and the smells of certain foods might make you gag.

Tender, swollen breasts are an uncomfortable pregnancy symptom to expect. Even before you miss your period, your breasts may enlarge and be sore to touch. Many pregnant women describe the sensation as similar to how your breasts feel right before your period – only it's 10 times worse.

Baby Section

Growth and Development of Baby

During 4 weeks pregnant, your little baby is implanting himself into your uterine lining. Your baby is working hard to build a safe, comfortable and warm nest in your uterus. He or she is very tiny right now - less than 1 millimeter long.

At this point in development, your "baby" is only an embryo that consists of two cell layers, which are dividing rapidly to form your baby's body. This early stage of pregnancy is often noted as the beginning of the embryonic period.

The placenta is in its earliest stage of development. Until it is mature and ready to function, your baby receives his or her nutrition from the yolk sac, which is also forming. The yolk sac also produces blood cells until your baby's liver is mature enough to do this. The yolk sac completely disappears by the end of the first trimester, when both the liver and placenta are mature enough to take over its job.

The amniotic cavity is forming. This cavity will eventually develop into the fluid-filled amniotic sac (bag of water) where your baby will grow and develop for the next nine months. The amniotic sac protects your baby from bumps and injury.

Pregnancy Health Section

A Spotlight on Nutrition in Pregnancy

Nutrition in pregnancy is very important concept to understand.

So, it's been confirmed. You have a bun in the oven. Now that you're with child, you have to evaluate your diet. Everyone knows that eating a balanced and healthy diet is best ... but what if you're addicted to junk food? After all, it is very delicious and satisfying.

Junk Food during Pregnancy
Junk food may taste great, but do you want to risk your baby's chance of developing weight problems later in life? Or get diabetes? Plus, when you're pregnant, you have to watch your weight. Being overweight can lead to a high-risk pregnancy, and you will be more likely to need a cesarean section. You are also more prone to gestational diabetes and high blood pressure; both of which can cause harm to your baby.

You can stray from a balanced diet occasionally, as long as it's in moderation. Think about your baby's future first, before reaching for that French fry or Starbucks Frap.

Caffeine during Pregnancy
Addicted to coffee? If you want to reduce your risk of miscarriage, it's best to give up the java for nine months. The American Dietetic Association recommends that caffeine consumption in pregnancy should be limited to not more than 300 mg each day, or approximately three, 5-oz cups of coffee.

When you drink even more coffee, over 5 cups each day (500mg of caffeine), you have a slightly increased risk of miscarriage. Also, caffeine use throughout pregnancy can decrease your baby’s birth weight (fetal-growth restriction).

In summary, moderation of coffee drinking, less than 3 cups each day, does not increase your risk for miscarriage or a small birth weight baby. Now you might be asking, what about decaffeinated coffee? Decaf drinks can raise your cholesterol, but it will not increase your miscarriage risk.

Foods to Avoid during Pregnancy
During pregnancy, you will also need to avoid certain foods. For the best outcome, you should start avoiding these foods now, instead of waiting until later in the pregnancy.

  • Raw and undercooked meats, which can contain harmful bacteria (such as salmonella, listeria, and toxoplasmosis), which can create pregnancy complications.
  • Undercooked and raw eggs can also contain salmonella. This bacteria can lead to miscarriage and stillbirths. Avoid any food products that may contain eggs, such as eggnog and Caesar dressing. Read package labels carefully.

  • Deli meats and imported soft cheeses can sometimes carry listeria. If you love prepared deli meats, make sure that you heat them until steaming hot to avoid getting infected. For cheese lovers, avoid imported, unpasteurized cheeses (such as blue cheese or feta). You can eat soft cheeses that are pasteurized with milk.

  • Certain types of fish should be avoided during pregnancy, as they may have a high mercury content. Several types of large fish, notably tuna, swordfish, shark, king mackerel, and tile-fish, absorb and retain mercury from the water or ingest it when they eat smaller fish. Because these contaminated fish when eaten during pregnancy may expose your unborn baby to unsafe mercury levels, the Environmental Protection Agency and the Food and Drug Administration (2008) currently recommend that pregnant women not eat more than 6 ounces of albacore tuna (large fish) or 12 ounces of small size fish or shellfish a week.

    Mercury exposure for your baby is harmful. It affects the developing nerve cells of the baby’s brain and can cause problems from developmental delays to severe brain damage.

How to Achieve a Balanced Diet
For a balanced diet, you may want to aim to try to get two or three portions of protein every day (lean meats or fish), three servings of dairy (low-fat milk, yogurt, or cheese), several servings of whole grain carbohydrates (rice, bread, or pasta), five servings of vegetables, three or four servings of fresh fruit, and at least one portion of iron-rich food (such as dark leafy green vegetables).

To avoid getting sick of eating one thing, change your menu up. Don't over eat the same thing every day. If you eat chicken and broccoli one day, choose a hearty salad the next day.

If you're struggling with morning sickness, you may want to break up your meals. Instead of three meals, eat smaller meals and snack throughout the day.

If you are overweight and pregnant, don't diet to lose weight. Dieting can lead to undernourished babies, premature delivery, and underweight birth weight.

Eating a balanced diet, along with your prenatal vitamins, will have the best outcome – a happy and healthy baby at the end of 40 weeks!

Weight Gain during Pregnancy

Your pregnancy weight gain at 4 weeks pregnant is less than a pound. By the end of your pregnancy, underweight women will gain approximately 34 pounds, normal weight women 25 to 35 pounds and for overweight women 15 to 20 pounds.

Harmful Substances in Pregnancy

Substance abuse in pregnancy has many harmful effects.

The early weeks of pregnancy are considered a critical time of development. Any exposure to harmful substances now and later in the first trimester is most likely to cause damage to or harm your developing baby. It is extremely important that you do everything possible to try to avoid exposure to any potential pollutants or toxins during this time.

Remember that a common substance implicated in fetal deformities or malformations is alcohol. If you have an addiction, you should talk with your healthcare provider immediately so they can help you determine the best way to proceed.

Many harmful effects have been associated with smoking. The nicotine and carbon monoxide found in cigarette smoke can cause:

  • Low Birth Weight Babies

  • Preterm Delivery

  • Premature Rupture of Membranes (PROM)

  • Placental abnormalities/problems

Did you know that environmental pollutants are just as harmful as other toxins you might ingest during pregnancy? It is important that you are aware of any environmental toxins and pollutants that may harm your fetus during pregnancy. Some of the more common pollutants that can affect fetal development include: lead, mercury, pesticides and PCBs. PCBs are mixtures of chemical compounds. Some women are exposed to certain PCBs at work. If you work in an environment where a variety of chemicals are used, you might check in with your healthcare provider to ensure that your work environment is safe. (next week)