Four weeks in, your period is late and you’re experiencing what you think might be early pregnancy symptoms; it could be your wish has come true and Mother Nature has worked her magic. Here’s what you need to know about being four weeks pregnant.
Your baby’s development

This week your baby is the size of a… grain of sand – barely visible to the human eye.
If your egg has been successfully fertilised, it will now have made its way to your uterus and implants itself in the uterine wall ready for the months ahead. For some women, this may have happened at the end of week 3 – it all depends upon your cycle and when your egg was fertilised.
Since conception, the cells inside your fertilised egg have been constantly dividing and are now in three main layers.

· The endoderm (inner layer) will form your baby’s intestines, liver and lungs.
·The mesoderm (middle layer) will gradually turn into to your bub’s heart, sex organs, muscles, bones and kidneys.
· The ectoderm (outer layer) will develop into your baby’s nervous system, hair, skin and eyes.
In addition, the placenta and umbilical cord – both essential for the rest of your baby’s development – are beginning to grow too.
Your physical pregnancy changes

If your egg is implanted this week, rather than in week three, you may experience implantation bleeding or spotting. It’s easy to tell the difference between this bleeding and your usual period because it’s usually pinkish or brownish in colour and there won’t be much of it.

If you’re not pregnant, your period will make its usual appearance around this time, which means you get to try again over the next month.

Around week 4, some women will also experience some of the early signs of pregnancy… or (if you’re one of the few very lucky ones) none at all! Symptoms to watch out for might include:

· Tender breasts due to your heart beating faster to cope with the new life inside you, and a lot of blood flow going directly to your breasts.
· Extreme tiredness is very common as there’s not quite enough blood to cope with that extra-fast heartbeat. Your body is working hard to grow the new little life inside you, which means you’ll feel tired more easily.
· Slight pelvic cramping as your uterus becomes home to a fertilised egg. This can feel similar to menstrual cramps.
The onset of nausea and morning sickness can hit at any time, not just in the morning. The causes of nausea in pregnancy are numerous, but contributing factors are low blood sugar, low blood pressure, hormonal changes, nutrient deficiency (in particular vitamin B6 and iron), an excess of refined, spicy or greasy foods and pressure on the stomach from the growing uterus in the last few weeks of pregnancy. Morning sickness comes at any time of day and can be debilitating.
Here are my top tips for combating morning sickness:
· Take a vitamin B complex each morning.
· Acupressure wristbands, often marketed as ‘sea sickness bands’, stimulate an acupuncture point called pericardium 6, which is known in traditional Chinese medicine to relieve nausea.
· Eat small, frequent snacks instead of big meals and ensure a protein-rich snack such as two tablespoons of natural yoghurt or a handful of nuts before you go to bed (obviously avoid if you have a history of allergies in your family).
· Sip on ginger tea made with freshly grated ginger.
· Place a bowl of hot water with two drops of peppermint essential oil in your room to help reduce a queasy tummy.
· Deep breathing and relaxation may help to reduce an acidic stomach.

· The very frustrating and inconvenient need to visit the bathroom more frequently.
Health and fitness during pregnancy

Make sure you’re relaxed, eating well and drinking plenty of water (with all those extra trips to the bathroom you can easily become dehydrated). Your body is working overtime so your temperature may be a little higher than normal and you may feel hot.

If you usually follow an exercise program there’s no need to stop just because you’re trying to conceive or are now pregnant. In fact, your own personal health and fitness is important for your baby’s growth, so if you don’t already exercise regularly it’s recommended that you start to – pregnancy yoga is a very popular choice and walking is free and easy.
If you’re nervous about exercising when you’re pregnant, don’t be. Exercise keeps you and your growing baby strong and healthy during pregnancy and helps get you ready for labour.
It is normal to have concerns about exercising when you’re pregnant. But when it comes to staying healthy, healthcare professionals advise mums-to-be to exercise regularly and moderately throughout their pregnancy. Keeping active helps your energy levels and your sleep patterns plus boosts your stamina to get you through the next nine months (not to mention your labour). It also helps your body recover faster after giving birth.
The benefits of exercise during pregnancy

Here are some of the best reasons for mums-to-be to get active:

· Pregnancy hormones relax your ligaments and muscles in preparation for labour, so practising core-strengthening exercises will reduce the risk of damage to your joints.
· General exercise helps women maintain a healthy weight during pregnancy and also aids a speedy return to their pre-baby weight
· Doing exercises that improve posture and strengthen back muscles reduce strain as your baby belly grows.
· Moderate exercise such as walking and swimming could help you have a faster labour and help your body to recover more quickly after the baby is born.
· Pelvic-floor exercises reduce the likelihood of delivery complications.
· The energy you burn can help control stress levels to get you through each week of your pregnancy.
Exercise also benefits your baby, both while she’s in the womb and also after birth, because:

· It improves oxygenation and increases blood flow to the placenta.
· There’s less chance of mothers who exercise getting gestational diabetes, so babies are a healthier weight when they reach full term.
· ‘Happy’ exercise endorphins are believed to have a positive effect on your unborn baby.
· Group exercise offers pregnant women a social network – and prenatal friendships can help reduce the likelihood of post-natal depression.
Is it safe to exercise while pregnant?

Your body changes week to week during pregnancy, so it’s important to listen to what it’s telling you. There are times when you may experience symptoms that say enough is enough – and in the first trimester you might just not feel up to it.

If any of the following occurs during exercise, take a break and speak to a doctor immediately:

· You experience headaches, dizziness or feel faint.
· You have swollen hands, feet, calves or face.
· You have vaginal bleeding, contractions, or any sign that your labour may have started.
Long term signs you should stop exercising include:

· You are not gaining sufficient weight through your pregnancy, or if your baby seems less active than usual.
· You have high or low blood pressure or heart disease. Seek medical advice before you undertake a regular fitness programme.
Best exercises with a bump

Be realistic and if you’re unsure, seek medical advice. There’s no need to act like a contestant in The Amazing Race Australia – save that for when your baby hits toddler stage! Here are our exercise tips for the best (and worst) forms of activity you can do.
Top 5 workouts for your pregnancy

· Yoga – there are many prenatal yoga classes for safe and relaxing exercise.
· Swimming and water aerobics – the water supports your weight, making it one of the best forms of exercise for mums-to-be.
· Power or speed walking – if you’ve got the energy you’ll enjoy the aerobic benefits.
· Cycling – either on a stationary bike or outside.
· Pilates – great for strengthening your core and keeping you supple for labour.
Exercise pregnant women can continue

Certain forms of exercise are fine to continue if you’ve been practising them prior to falling pregnant, but aren’t advisable for absolute beginners – running and strength training are prime examples.

As your body releases the hormone relaxin, joints become softer and therefore more prone to injury which is why doctors don’t advise novices to take up running while pregnant. However, if you are an experienced runner, you can keep up your regular routine until it no longer feels comfortable with your growing belly.

Activities to avoid

· Contact sports – especially in the third trimester, as balance can be affected by your changing weight and centre of gravity.
· Anything with a high risk of falling, such as horse riding, skiing or ice-skating.
· Vigorous racquet sports such as squash and tennis, or any sport which raises your core body temperature by more than one degree.
· Weightlifting.
Top 5 pregnancy ‘keep fit’ tips

1. Avoid overheating by staying out of saunas and spas, not exercising on overly hot days, and trying to keep your body temperature stable. Sweating heavily? You’re probably overdoing it.
2. Don’t exercise to the point of exhaustion – a good guide is being able to maintain a conversation while exercising. If you get breathless, you’re going too hard.
3. Keep hydrated by drinking plenty of water.
4. Invest in comfortable training clothes such as a suitable sports bra, running shoes or swimmers. Some brands have maternity sportswear ranges designed with your needs in mind.
5. If you don’t feel you have the energy to exercise, listen to your body and take a rest.

Your week 4 pregnancy checklist

· If you bought a pregnancy test last week, use it! If not, buy one now. (It’s not uncommon for women to do more than one test as the excitement takes over.)
· If the test is positive, congratulations! Call your partner to share the good news.
· Book an appointment with your GP to talk you through what happens next.
· Decide with your partner if you’re going to tell anyone and, if so, who.
· Once you come back down from Cloud 9, read our I’m pregnant, now what? feature.
· Take care of your health and nutrition.
· It may also pay to read up on miscarriage as well, just to be aware of the caution you should exercise even with this great news.
With around 20 per cent of all pregnancies in Australia ending in miscarriage there is a good chance that you or someone you know has experienced pregnancy loss. Knowing what to expect, what happens to your body and how it affects your future can all help you to cope.
What is miscarriage?

A miscarriage is a pregnancy that ends within the first 20 weeks. Most miscarriages happen within the first trimester and once a pregnancy reaches the 12-week mark, the risk of miscarriage falls to only 2 per cent.

Sometimes, women will experience cramping and heavy bleeding, but for others there are no symptoms and the foetus dies but stays in the uterus. This is known as a ‘missed’ or ‘silent’ miscarriage and women are usually given the option of having a surgical procedure or waiting for nature to take its course and for the foetus to be passed from the uterus.

How common is it?

It is estimated that around 20 per cent of pregnancies end in miscarriage. But some studies* suggest that the actual rate of early pregnancy losses could be as high as between 60 and 75 per cent of conceptions – with the vast majority happening before a woman realises she is pregnant.

However, the rate of miscarriage does increase as women get older. The risk of miscarriage among women in their early 20s is about 12 per cent. By the late 30s the risk is closer to 25 per cent and by the age of 43 more than half of pregnancies will miscarry

Why does it happen?

It’s important to remember that there is almost always nothing that could have been done to prevent a pregnancy being lost and nothing that can be done to hang on to a pregnancy that is destined to end in miscarriage.

The vast majority of miscarriages are unexplained, partly because they are not usually investigated until a woman has two or three in a row. But a random genetic abnormality is the most common cause of miscarriage.

About nine out of 10 genetically abnormal pregnancies will not survive past the first trimester. In normal human cells there are 46 chromosomes, which contain DNA and genes. When cells have the wrong number of chromosomes, the error is known as aneuploidy – the best-known example of which is Down syndrome, which is the result of having three copies of chromosome 21. Around seven out of 10 first trimester losses are caused by chromosome problems.

What is recurrent miscarriage?

While miscarriage is usually a one-time occurrence, up to one in 20 couples experience two miscarriages in a row and one in a hundred suffer three or more – this is known as recurrent miscarriage.

Some of the known causes of recurrent miscarriage are:

· Abnormalities of the uterus
· Blood clotting disorders
· Chromosome abnormalities
· Immune disorders
· Hormonal disorders
· Infections
· Lifestyle factors such as smoking, alcohol and recreational drugs
When do you need to investigate?

If you have three miscarriages in a row, you will usually be referred to a specialist who may order some tests to see if there is an underlying cause. However, more than half of the time these investigations don’t find any explanation for the miscarriages – and this is good news, as it means you are likely to achieve a healthy pregnancy in the future without medical intervention.

Because fertility declines and the risk of chromosome problems increases as we age, women in their mid to late 30s might be referred for investigations after two consecutive miscarriages.

What are the chances of a subsequent pregnancy being successful?

Where no cause for repeated miscarriage has been found, the risk of another pregnancy failing is similar to the age-related risk of having a miscarriage.

Studies suggest that a 20-year-old who has had three previous miscarriages faces a 90 per cent chance of the next pregnancy going to term, while a 30-year-old with the same history has an 80 per cent chance of success. However, by the age of 45 the chance of a successful pregnancy after three miscarriages falls to 54 per cent.

Is IVF an option?

Random chromosome problems are thought to be the cause of the majority of miscarriages, where a genetically abnormal embryo implants in the uterus, but is destined to fail. While the advice to couples will often be to keep trying, the emotional toll of repeated miscarriage can be immense. Also, the chance of chromosome errors increases as women get older.

There are now techniques available that allow scientists to screen an embryo in the lab during the IVF process and to ensure it has the correct number and sequence of chromosomes in the DNA.

The technique, known as CGH (Comparative Genome Hybridization) is usually recommended for older women who have suffered recurrent miscarriage or repeated IVF failure and can vastly improve the chances of a successful pregnancy and healthy baby.

Buy some ginger to help settle your stomach if you’re suffering from morning sickness.
· Look into exercise options for pregnant women.
· Smile – a lot!