4 Weeks Pregnant: What to Do — Complete Guide
At four weeks pregnant, you have likely just discovered you are expecting. This is an exciting and sometimes nerve-wracking moment, especially if this is your first pregnancy. At this stage your baby is roughly the size of a poppy seed, and the embryo is beginning to implant into the lining of your uterus. You may not feel pregnant yet, but important changes are already underway.
What is happening in your body
During week four, the fertilised egg has travelled down the fallopian tube and embedded itself in the uterine lining. The placenta and amniotic sac are beginning to form, and your body is producing human chorionic gonadotropin (hCG), the hormone that pregnancy tests detect. Some women notice light spotting known as implantation bleeding, which is perfectly normal. You might also experience mild cramping, tender breasts, and fatigue.
What to do this week
Book an appointment with your GP
Even though it is early, contact your GP surgery to let them know you are pregnant. They will arrange your first midwife appointment, often called the booking appointment, which usually takes place between weeks eight and ten. In the UK, you can also self-refer directly to your local maternity unit in many areas.
Start taking folic acid
If you have not already begun, start taking 400 micrograms of folic acid daily. This helps reduce the risk of neural tube defects such as spina bifida. If you have a higher BMI, diabetes, or a family history of neural tube defects, speak to your GP as you may need a higher dose of 5mg.
Review your lifestyle
Now is the time to review habits that could affect your baby. Stop drinking alcohol, cut out smoking, and reduce caffeine to under 200mg per day. Check any medications you are taking, including over-the-counter and herbal remedies, with your pharmacist or GP.
Begin thinking about nutrition
Focus on a balanced diet rich in fruit, vegetables, wholegrains, and lean protein. Foods high in iron, calcium, and vitamin D are particularly important. Avoid raw or undercooked meat, unpasteurised dairy, and certain fish such as shark, swordfish, and marlin, which contain high levels of mercury.
What to avoid
- Alcohol completely
- Smoking and recreational drugs
- Hot tubs and saunas, as overheating can be harmful in early pregnancy
- Handling cat litter, due to the risk of toxoplasmosis
- High-impact or contact sports unless your GP advises otherwise
Common symptoms at four weeks
You might notice symptoms similar to premenstrual syndrome. These include bloating, mild cramps, mood swings, and breast tenderness. Some women feel absolutely nothing, which is also completely normal. Every pregnancy is different, so try not to compare yourself to others.
Emotional wellbeing
Finding out you are pregnant can bring a wave of emotions. You might feel thrilled, anxious, shocked, or all three at once. Give yourself time to process the news. If you have a partner, share the discovery with them when you feel ready. There is no rush to tell wider family and friends until you are comfortable.
When to contact a healthcare professional
If you experience severe abdominal pain, heavy bleeding, or shoulder tip pain, contact your GP or call NHS 111 straight away. These can sometimes indicate an ectopic pregnancy, which requires urgent attention.
Summary
Week four is about getting organised and laying healthy foundations. Start your supplements, book your GP visit, and take care of your body and mind. You are at the very beginning of an extraordinary journey.