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4th week of pregnancy

Your guide to pregnancy

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4th week of pregnancy

The 4th week of pregnancy: implantation, first symptoms and pregnancy test - here you can find out everything you need to know about the fourth week of your pregnancy.
  1. SSW - what happens in week 4 of pregnancy
  2. How your baby develops in the 4th week of pregnancy
  3. How you feel in the 4th week of pregnancy
  4. What signs do you have in week 4 of pregnancy?
  5. Is it worth taking a pregnancy test in the 4th week of pregnancy?
  6. What can be seen on the ultrasound?
  7. What you should look out for in the 4th week of pregnancy
  8. Positive pregnancy test in the 4th week of pregnancy - and now?

4th week of pregnancy - what happens in week 4 of pregnancy

Isn't it incredible how something so tiny can evoke so many feelings of happiness in us? In the 4th week of pregnancy, your baby measures just as much as a poppy seed. But as soon as you hold your positive pregnancy test in your hand, you are sure to be overcome with emotion. In part 4 of our pregnancy calendar, you can find out when such a test provides meaningful results, what exciting developments your baby is going through in this 4th week of pregnancy and what else there is to consider.

How your baby develops in the 4th week of pregnancy

4th week of pregnancy: implantation is completed

Fertilisation takes place at the beginning of the 3rd week of pregnancy. Your egg cell fused with a sperm - a new life was created. This fertilised egg then made its way through the fallopian tube into the uterus. In the process, it divided many times and became a blastocyst with over 100 cells. At the end of the 3rd week of pregnancy, this blastocyst found a protective place in the lining of the uterus, where it began to implant. The implantation process, in which the foetal tissue unites with the maternal tissue, is now completed in the 4th week of pregnancy. By the end of this week, the embryo will be connected to your bloodstream and can therefore be supplied with all vital nutrients.

The embryo continues to develop in the 3rd week of pregnancy

Two different cell types have already developed in the blastocyst. The trophoblast cells are on the outside. These anchor the embryo in the lining of the uterus. They will also give rise to the placenta and the amniotic sac. The trophoblast begins to release the hormone hCG (human chorionic gonadotropin). This signals the corpus luteum in the ovary to continue producing the hormone progesterone, which is very important for maintaining the pregnancy.

Inside the blastocyst is the so-called embryoblast. The embryo develops from these cells. These are stem cells, real all-rounders, from which all of your baby's organs and body parts will later develop. The embryoblast also develops a small vesicle: the yolk sac. At this very early stage of pregnancy, this is important for your baby's nutrient supply. From around the 10th week of pregnancy, it will recede when this function is completely taken over by the placenta.

How you feel in the 4th week of pregnancy

The impatient wait continues in the fourth week of pregnancy. You have ovulated, but for the time being you still don't know whether you are pregnant. Are there already symptoms of pregnancy in week 4? Can you already take a test? And what can you see on the ultrasound? We'll tell you.

Practical help for you:
Emergency service midwife Katharina explains the most important things about the maternity pass online.

What signs do you have in week 4 of pregnancy?

Slight bleeding may occur

Depending on when exactly implantation takes place, you may still notice a slight implantation haemorrhage in the 4th week of pregnancy. This is nothing to worry about, but occurs in many women at this early stage of pregnancy. During implantation, the embryonic tissue bonds with the maternal tissue. This can damage the smallest blood vessels in the uterine lining. The bleeding is usually a light red colour and does not last long. However, it is usually much weaker than your regular period.

The basal body temperature remains elevated

If you have already measured your basal body temperature in previous cycles to identify your fertile days, you will have noticed that your body temperature drops again shortly before the onset of menstruation. This is usually the case 10 to 12 days after ovulation. If fertilisation and implantation occurred during this cycle, you will notice that the temperature does not drop. In the event of pregnancy, it will remain at an elevated level for the next 3 months.

The first typical pregnancy symptoms are possible

With implantation, the trophoblast begins to produce the pregnancy hormone hCG. This is responsible for a wide range of pregnancy symptoms in the further course of the first trimester. As the hCG level is still very low in week 4, many women do not notice any signs at all. However, you may experience slight breast tenderness or some nausea at this early stage of pregnancy. An increased urge to urinate, constipation and tiredness can also be attributed to the hormonal changes in your body.

In my workshop on "Pregnancy complaints", I will talk to you about ways to alleviate typical complaints during pregnancy. I want to support you in experiencing these 9 months of your life as symptom-free as possible. Whether you suffer from nausea, heartburn, back pain or water retention, I will explain to you what the causes are and what helps best.

Is it worth taking a pregnancy test in the 4th week of pregnancy?

If you want a baby, you may have been all jittery for the last two weeks and can hardly wait to take a pregnancy test. At the end of the fourth week of pregnancy, the wait is finally over. Around 14 days have now passed since ovulation, the embryo has implanted and the release of the hormone hCG has begun. At the end of the 4th week of pregnancy, the hCG concentration is usually sufficient for standard pregnancy tests from the drugstore or pharmacy to provide a meaningful result.

A brief digression: how pregnancy tests work

Whether an analogue or digital pregnancy test - the way it works is initially the same. The urine tests available on the market detect the pregnancy hormone hCG. This is an antibody reaction. There are hCG antibodies on the test strip. These then bind with the hCG antigens in the urine, resulting in a colour reaction. Depending on the test model, a strip or a cross is visible in the event of a positive test result. In addition, the tests usually have a control field where a discolouration also occurs. However, this strip says nothing about a possible pregnancy, but merely indicates that the test is working. With digital urine tests, the word "pregnant" or "not pregnant" lights up instead of a strip.

The pregnancy tests available today react very sensitively to hCG and provide a 90 to 98 per cent reliable result. As the hCG concentration in urine rises steadily and reaches its peak between the 8th and 12th week of pregnancy, the longer you wait to test, the more likely it is that you will have a positive pregnancy test in your hand.

How is the pregnancy test carried out?

The day of the pregnancy test has finally arrived! Before you take the test, you should read the instructions for use carefully. As the hCG concentration is highest in the first morning urine, it is best to carry out the urine test in the morning. This is especially true if you are testing very early. As the pregnancy progresses, the hCG concentration increases so much that a test at any time of day will be positive.

You have two options: Either hold the test strip directly in the urine stream, or collect some urine in a clean cup and dip the test strip into it. Now you have to wait again. Sometimes the second strip appears immediately, sometimes it takes a few minutes for the result to appear. You should know for sure after five minutes at the latest. If the result is negative but you suspect you may be pregnant, repeat the test in a few days. It may just take a little while until the hCG concentration is high enough.

If you like, you can also have the urine test carried out at a gynaecologist's or midwife's practice. Alternatively, a blood test can be carried out by your gynaecologist or midwife. The hCG concentration is also measured in the blood. Such a blood test can provide a positive result as early as 6 to 9 days after fertilisation. However, such a test is usually only carried out if there is a suspicion that the pregnancy is not intact.

What can be seen on the ultrasound?

Although a pregnancy test may already be positive at the end of the 4th week of pregnancy, it is still too early for an ultrasound. As the embryo is only the size of a poppy seed, it cannot yet be visualised even by high-resolution ultrasound equipment. Your gynaecologist would only be able to determine that the uterine lining is highly developed. The amniotic cavity may already be visible. However, it is better to avoid unnecessary ultrasound examinations and wait until at least the 5th or 6th week of pregnancy. An ultrasound scan is only necessary if you are experiencing pain or severe discomfort.

What you should look out for in the 4th week of pregnancy

At the beginning of this early week of pregnancy, as in week 3, the all-or-nothing principle applies. As the embryo's cells are not yet specialised, a damaged cell can usually simply be replaced by another cell. However, if there is severe damage in these first weeks, implantation does not take place at all and the embryo is rejected with the menstrual bleeding. Many women are unaware of these very early miscarriages.

Have you taken a positive pregnancy test and are now worried that last week's cocktail evening with your girls might have harmed your unborn baby? Then we can reassure you: A positive test proves that the embryo has developed and implanted. You can therefore assume that your baby has not been harmed.

Towards the end of the 4th week of pregnancy, as soon as implantation has been successfully completed, the embryo is connected to your bloodstream. From now on, it will be supplied with nutrients via this. Therefore: Eat a healthy diet and balanced. At the same time, harmful substances can now reach your baby via your bloodstream. For this reason, you should give up alcohol, cigarettes and other drugs completely by now at the latest. If you have to take medication that could be harmful during pregnancy, do not simply stop taking it. However, see your doctor quickly and discuss with him or her which medication you can now take.

Also important is the Taking folic acid. Your need for this B vitamin now increases significantly and an adequate supply is essential for the development of your baby's nervous system.

Try to organise your everyday life in a relaxed manner and avoid unnecessary stress. This can have a negative effect on the development of the embryo. It is completely normal to feel tired frequently from now on. So treat yourself to regular short rest breaks. At the same time, you shouldn't miss out on exercise. Light sports routines such as yoga or aqua fitness will keep you fit and provide you and your baby with an extra dose of oxygen.

Positive pregnancy test in the 4th week of pregnancy - and now?

You may now be holding a positive pregnancy test in your hand. Then congratulations, you're going to be a mum! How do you feel about it? If the pregnancy was planned, you may be bubbling over with happiness. But it's also completely normal if other emotions such as uncertainty and fear are added to the mix. These two lines on the test strip are the start of an incredible adventure that will turn your life upside down. Right from the start, find people you trust with whom you can talk about your feelings.
If you would like midwife support, we are happy to assist you online with our workshops and courses. In our online workshop "Starting your pregnancy" you will get answers to all your questions about the exciting first trimester. If you are already thinking about the upcoming antenatal check-ups, our free workshop "Online prenatal care" help.

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