A missed period, or a nagging feeling that something has changed, is usually what prompts the question. Here is how pregnancy is confirmed, and what to do once it is.

Early signs

Signs vary a great deal, and some women notice almost nothing early on:

  • A missed period
  • Tiredness — often marked, and often the first thing women notice
  • Nausea, with or without vomiting
  • Tender or swollen breasts
  • Passing urine more often
  • Changes in appetite, food aversions, or a metallic taste
  • Mood changes

None of these confirms pregnancy on its own — several overlap with premenstrual symptoms. A test is what settles it.

Home urine test

Home tests detect human chorionic gonadotrophin (hCG), a hormone produced once a pregnancy implants. They are accurate when used correctly.

When to test: most tests are reliable from the first day of your missed period. Testing earlier than that can give a negative result even when you are pregnant, simply because hCG levels are still low. If you test early and get a negative but your period does not arrive, test again after a few days.

Tips for an accurate result: use the first urine of the morning, when hCG is most concentrated, and follow the timing on the packet exactly — reading a test too late can produce a misleading line.

A faint line is still a positive. The strength of the line reflects how much hCG is present, not how healthy the pregnancy is.

Blood test (serum beta hCG)

A blood test measures the exact amount of hCG rather than simply detecting it. It can pick up a pregnancy slightly earlier than a urine test.

It is not needed routinely — a positive home test plus a scan is enough for most women. It is used in specific situations: when the diagnosis is uncertain, when there is bleeding or pain and an ectopic pregnancy is being ruled out, or in early pregnancy after fertility treatment. In those cases the test is often repeated after 48 hours, because how the level changes is more informative than a single reading.

Early scans

There are two different scans people often confuse:

  • An early viability or confirmation scan, from about 6 weeks. This is done when there is a specific reason — bleeding, pain, a previous ectopic pregnancy or miscarriage, or uncertainty about dates. It confirms the pregnancy is in the womb and looks for a heartbeat.
  • The dating scan, at 8 to 12 weeks. This is the routine first scan, and it gives the most accurate estimate of your due date. See our guide to the dating scan.

Very early on, a transvaginal scan gives a clearer picture than an abdominal one. It is safe in pregnancy and no more uncomfortable than an internal examination.

Symptoms that need urgent attention

Most early pregnancies are straightforward, but some problems need seeing quickly. Seek medical help without delay if you have:

  • Severe or one-sided abdominal pain
  • Vaginal bleeding, particularly with pain
  • Shoulder-tip pain
  • Feeling faint, dizzy or collapsing

These can indicate an ectopic pregnancy, where the pregnancy has implanted outside the womb. It needs prompt assessment. Also seek advice if you cannot keep fluids down because of vomiting.

What to do once it's confirmed

  1. Start folic acid straight away if you have not already.
  2. Register with your local public health midwife.
  3. Arrange antenatal care — a booking visit after about eight weeks, with a scan and blood tests.
  4. Review any regular medicines with a doctor rather than stopping them yourself.
  5. Stop alcohol and smoking.

See our guide to a healthy early pregnancy for what happens next.

The bottom line

A home urine test from the first day of your missed period will usually give you a reliable answer, and a faint line counts. Blood tests and very early scans are used when there is a specific reason. The routine first scan is at 8 to 12 weeks. Start folic acid immediately, and seek help urgently for severe or one-sided pain, bleeding, or feeling faint.

References

  1. National Health Service. Finding out you're pregnant [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/pregnancy/finding-out/
  2. National Health Service. Ultrasound scans in pregnancy [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/pregnancy/your-pregnancy-care/ultrasound-scans/
  3. National Institute for Health and Care Excellence. Ectopic pregnancy and miscarriage: diagnosis and initial management. NG126. London: NICE; 2019. Available from: https://www.nice.org.uk/guidance/ng126