4 Weeks Pregnant: What to Do This Week

At four weeks pregnant, you may have only just found out you're expecting. This is typically when a home pregnancy test turns positive, and your period is just due or a few days late. It can feel surreal, exciting, and a little overwhelming all at once — that's completely normal. Here's what you should actually do this week.

Your Week 4 Pregnancy Checklist

If you haven't already, begin taking a folic acid supplement today. The NHS recommends 400 micrograms (mcg) of folic acid every day from before conception until you're 12 weeks pregnant. Folic acid helps protect your baby's developing neural tube, which forms in these very early weeks. You can buy folic acid at any pharmacy or supermarket without a prescription. Some prenatal vitamins contain folic acid along with other nutrients — look for one that also includes vitamin D (10 mcg daily, as recommended by the NHS).

If you have certain medical conditions or take certain medications (including epilepsy medication), your GP may recommend a higher dose of 5mg — so it's worth mentioning this at your first appointment.

Book an appointment with your GP

Contact your GP surgery this week to let them know you're pregnant. In many areas, GPs refer you directly to your local midwifery team rather than booking their own appointment. This is called your booking appointment and usually happens between weeks 8 and 10. The sooner you register, the sooner you're on the system and can access antenatal care.

You don't need to see a GP before your midwife booking appointment in all cases, but it's worth calling to ask how your local surgery handles pregnancy referrals.

Stop drinking alcohol

There is no known safe level of alcohol in pregnancy. The NHS advises women to avoid alcohol entirely during pregnancy. Four weeks is very early, but your baby's development is already underway, so stopping now matters.

Review your medications and supplements

Some medications are not safe in pregnancy, including ibuprofen, certain antibiotics, and many herbal remedies. If you take any regular medication — prescription or over-the-counter — check with your GP or pharmacist as soon as possible. Do not stop prescribed medication without medical advice, as that can carry its own risks.

Avoid certain foods

The NHS has clear guidance on foods to avoid in pregnancy. From week 4, you should avoid:

• Raw or undercooked meat and fish
• Unpasteurised cheeses (including most soft mould-ripened cheeses such as brie and camembert)
• Raw or lightly cooked eggs (unless they carry the British Lion stamp)
• Liver and liver products (pâté, liver sausage)
• High-mercury fish such as shark, swordfish, and marlin
• More than two portions of oily fish per week

Cut back on caffeine

The NHS recommends keeping caffeine intake below 200mg per day during pregnancy. A typical mug of instant coffee contains around 100mg, a mug of tea around 75mg, and a can of cola around 40mg. Check labels on energy drinks and soft drinks too.

Take vitamin D

In addition to folic acid, the NHS recommends all pregnant women take 10 micrograms of vitamin D every day. This supports healthy bone development in your baby and maintains your own bone health throughout pregnancy. Many pregnancy multivitamins include vitamin D, but check the label to confirm the dose.

Practical Tips for Week 4

Rest when you need to. Fatigue is one of the earliest pregnancy symptoms, driven by rising progesterone levels. If you're exhausted, rest. Your body is doing a huge amount of work even though you can't see it yet.

Stay well hydrated. Aim for around six to eight glasses of water a day. If morning sickness has started, small sips throughout the day can help more than drinking large amounts at once.

Keep your pregnancy private for now if you prefer. Many people choose to wait until after their 12-week scan before telling friends and colleagues, but there is no rule. Some people find it helpful to tell a close friend or family member early for support.

Avoid DIY and decorating. If you're planning to get the nursery ready, some activities like stripping old paint (which may contain lead) or working with solvents should be avoided. This is a conversation for later — for now, just focus on the basics.

Eat little and often if nausea has started. Nausea at four weeks is common. Keeping something in your stomach — dry crackers, plain toast, or a small snack — can help manage it. Cold foods are sometimes easier to tolerate than hot ones.

When to Seek Help

At four weeks, contact your GP or call 111 if you experience:

• Heavy bleeding (more than a light spotting)
• Severe one-sided abdominal pain
• Fever above 38°C
• Pain in your shoulder tip

Call 999 or go to A&E if you collapse, feel faint with severe pain, or experience very heavy bleeding that soaks through a pad quickly. These can be signs of an ectopic pregnancy, which is a medical emergency.

Light spotting (known as implantation bleeding) around week 4 is common and usually not a cause for concern, but mention it to your midwife or GP.

Frequently Asked Questions

The two most important things are starting folic acid immediately and registering your pregnancy with your GP. Beyond that, stop drinking alcohol, review any medications with your pharmacist or GP, and familiarise yourself with the foods to avoid in pregnancy. You don't need to do everything at once — getting those basics right this week is enough.

When should I tell people I'm pregnant?

There is no right or wrong time. Many people choose to wait until after their 12-week scan, when the risk of miscarriage falls significantly. Others tell close family or a trusted friend earlier for support, especially if they're experiencing symptoms. It's entirely your decision — do what feels right for you.

Do I need to see a doctor straight away?

You don't usually need an urgent appointment at four weeks unless you have symptoms that concern you. Contact your GP surgery to register your pregnancy and find out how the local referral process works. Your first proper antenatal appointment (the booking appointment) will typically be around weeks 8 to 10.

Always speak to your midwife or GP for advice tailored to your personal circumstances.