Is It Possible to Have No Pregnancy Symptoms?
Every person—and every pregnancy—is different. But if you have no pregnancy symptoms after a positive pregnancy test, you might be wondering if everything is okay. The short answer: Yes, it is possible to experience few to no pregnancy symptoms—especially early on—and give birth to a perfectly healthy baby.
“Some people only know they’re pregnant because they missed their cycle and thought about taking a pregnancy test,” says Paul Sparkzak, MD, an assistant professor of obstetrics and gynecology at the Duke University School of Medicine. Still others may not even notice a missed period and go for many more weeks before suspecting they’re pregnant. Here’s why you may be experiencing a lack of pregnancy symptoms, and what it means (and doesn’t mean) for the health of baby.
Although most pregnancy symptoms start between 4 to 6 weeks of pregnancy, there’s a wide variation in when you might notice that you feel different, says Maris K. Toland, MD, an ob-gyn at Dartmouth Hitchcock Clinics in Bedford, New Hampshire. A missed period, breast tenderness and nausea are the most common early pregnancy symptoms, she adds, although you may also notice that you feel tired, need to pee often, crave (or are disgusted by) certain foods and experience changes in your mood. “Everyone has a different experience in pregnancy. Some struggle with severe nausea, and others sail through the early part of pregnancy without symptoms,” says Toland. “It’s hard to predict in advance. Most of my patients experience at least some noticeable changes in how they feel, but sometimes it’s not obvious!”
It’s even possible to go through most of or even an entire pregnancy without realizing you’re pregnant, although “it usually is relatively rare,” says Sparkzak. These so-called “cryptic pregnancies” make for big news headlines because they’re so unusual. Some research suggests that cryptic pregnancies occur in one in 475 pregnancies at 20 weeks, and one in approximately 2,500 pregnancies at term. That works out to roughly 1,600 surprise births in the US every year.
Some people may not have early pregnancy symptoms—or may not notice them—especially if they have certain medical conditions. For example, it’s hard to notice you’ve missed a period if you don’t have regular periods in the first place. Polycystic ovarian syndrome (PCOS) is a relatively common medical condition that causes anovulation (when an egg doesn’t release from the ovary during the menstrual cycle) and irregular periods. “People can sometimes get two, three, sometimes four months in between menstrual cycles,” says Sparkzak.
Other illnesses or life changes might also make it easier to miss pregnancy symptoms. You may mistake early nausea or fatigue for a viral illness like the flu, says Toland. Many people also have breast tenderness with their menstrual cycles or if they’re on certain types of hormones for contraception. “If a person doesn’t experience symptoms that prompt them to test, a pregnancy can be quite advanced before they realize” they’re pregnant, adds Toland.
What’s more, it’s possible to have spotting (or light bleeding) during pregnancy that you might assume is your period, says Sparkzak. If your pregnancy symptoms are mild, it may not even occur to you that you might be pregnant.
Instances of (much rarer) cryptic pregnancies, where a mom doesn’t realize she’s pregnant until she gives birth, could be caused by a psychiatric disorder. In other cases, these pregnancies are linked to trauma in early childhood or trauma at conception (such as rape or incest). “Sometimes a person may suspect pregnancy, but due to challenging life circumstances or even psychiatric factors, such as a trauma history, they may not be able or willing to accept the possibility of pregnancy and therefore will not seek prenatal care,” says Toland.
Pregnancy symptoms frequently wax and wane, even in the first trimester. And, thankfully, symptoms such as nausea and vomiting tend to fade away for most people by the second trimester. “Typically, these will improve after the first 12 weeks,” says Toland. These symptoms are usually replaced by others linked to the increasing size of baby, such as constipation, back pain and leg swelling.
That said, the sudden disappearance of pregnancy symptoms before 12 weeks may signal that levels of pregnancy hormones have dropped. “Occasionally, an abrupt change in symptoms in the early phases of pregnancy can signify a pregnancy loss or failed embryo,” says Toland. If you notice a sudden, rapid improvement in nausea in the first trimester, especially if you have spotting or bleeding and lower pelvic cramping, it’s worth making an appointment with your provider, she adds.
“I wouldn’t say someone who doesn’t have pregnancy symptoms is at greater risk of miscarriage,” says Toland. However, she adds that many early pregnancy losses occur before a person even realizes they’re pregnant (so symptoms may not have kicked in yet). In fact, only 1 in 10 pregnancies that were previously confirmed by a doctor end in miscarriage. Moreover, some research shows that if you don’t experience pregnancy symptoms but do have a normal ultrasound at a prenatal visit when you’re between 6 and 11 weeks pregnant, the miscarriage risk is less than 2 percent, adds Sparkzak.
If you’re pregnant with no symptoms, it’s important to keep the larger picture in mind. “If everything is looking good with your pregnancy, and you don’t have nausea or other [issues], don’t panic,” says Toland. “But maybe don’t tell your other pregnant friends, because they might be jealous.”
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Paul Sparkzak, DO, is an assistant professor of obstetrics and gynecology at the Duke University School of Medicine. He earned his medical degree from Midwestern University, Chicago College of Osteopathic Medicine. Maris K. Toland, MD, is an ob-gyn at Dartmouth Hitchcock Clinics in Bedford, New Hampshire. She earned her medical degree from Tufts University School of Medicine in Boston.
Case Reports in Women’s Health, Cryptic Pregnancy, June 2023
Cleveland Clinic, Cryptic Pregnancy, November 2022
Obstetrics and Gynecology, Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit, March 2008
StatPearls, Miscarriage, June 2022
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