No pregnancy symptoms: is that normal, and when should you book a scan in Singapore?

Having no pregnancy symptoms, or only very mild ones, is common in the first weeks and usually means nothing is wrong. HealthHub says you may feel fine, and that the first clue is often just a missed period. KKH's doctors describe week 5 symptoms as vague, and morning sickness usually starts between weeks 4 and 6 and peaks later in the first trimester, so many women feel nothing much before week 6 or 7. Some never get strong symptoms at all. Symptoms that come and go are normal too. What matters more is what a scan shows: a vaginal ultrasound can usually pick up the heartbeat by the end of week 6, and the dating scan is done between weeks 6 and 12. If you had clear symptoms and they stop suddenly, or you have bleeding or pain, get checked. In Singapore, KKH's Early Pregnancy Assessment Unit sees women under 16 weeks for an early check even without symptoms.

Why some women feel no pregnancy symptoms

Pregnancy hormones affect every woman differently. NUH points out that many early symptoms are subtle and easy to confuse with other things, like a period coming or being tired from work. Breast tenderness, a little bloating or needing the toilet more often are easy to miss.

Timing plays a part too. If you tested early, at four or five weeks, you're testing before most symptoms have started. HealthXchange, writing with KKH's O&G team, says symptoms at week 5 are rather vague, and that the well-known ones such as morning sickness usually peak later in the first trimester.

How you feel doesn't tell you much about how the pregnancy is going; a scan does. Our guide to early signs of pregnancy lists the symptoms you may or may not notice.

When symptoms usually start, week by week

Use our due date calculator to see which week you're in, counted from the first day of your last period. Our 5 weeks pregnant and 6 weeks pregnant guides go through those weeks in detail.

Symptoms that come and go

It's common to feel queasy one day and fine the next, or to have sore breasts for a week and then not. A good day with no nausea on its own isn't a sign that something has happened.

By about 14 weeks, SingHealth says morning sickness usually disappears, so symptoms fading at the end of the first trimester is the expected pattern.

When losing symptoms needs a check

The one pattern worth acting on is a sudden change. NUH lists the warning signs in early pregnancy as vaginal bleeding, period-like cramps and backache, and the absence of signs such as tender breasts and morning sickness. If you had strong symptoms that disappeared overnight, especially before 12 weeks and with any spotting or cramps, ask for a scan.

SingHealth explains why: some women have a miscarriage with no symptoms at all, and it's only found on an ultrasound, which doctors call a missed miscarriage. Early miscarriage happens in up to one in five pregnancies before 12 weeks, SingHealth says, and it isn't caused by food, stress, work, travel, exercise or sex. Our guide to miscarriage risk by week shows how the odds fall once a heartbeat has been seen.

SingHealth also notes that some women with an ectopic pregnancy, where the pregnancy grows outside the womb, have no symptoms at first. SingHealth's advice is to see a doctor early if you've missed a period and have risk factors, such as a previous ectopic pregnancy, an IUCD or IVF.

When and where to book a scan in Singapore

KKH's advice is to contact a polyclinic, a family clinic or KKH itself to arrange your first appointment once you think you're pregnant. HealthXchange suggests booking an obstetrician after a positive test. Your first visits usually include the dating scan, which HealthXchange says happens between weeks 6 and 12. Our guide to prenatal check-ups and scans in Singapore sets out the full schedule.

If you're worried before then:

• KKH's Early Pregnancy Assessment Unit sees women who are under 16 weeks, including those who would like an early assessment though they don't have any symptoms. Expect to spend two to three hours there. KKH warns that a very early pregnancy may be too small to see, and that it can take a few days or weeks before a heartbeat shows, so you may be asked back.
• SGH's Early Pregnancy Unit sees women in the first 14 weeks with bleeding or pain, and takes self-referrals on 6321 4516. SGH says most patients with bleeding or pain go on to have a normal pregnancy.
• KKH's Urgent O&G Centre is open 24 hours for early pregnancy problems under 22 weeks, such as pain or bleeding.

A very early scan that doesn't show a heartbeat yet isn't a diagnosis. KKH says that, depending on how early you are, a heartbeat can take a few days or a few weeks to show up.

Frequently asked questions

Is it normal to have no pregnancy symptoms?

Yes, especially in the first six or seven weeks. HealthHub says you may feel fine, with a missed period as the first clue. Some women have mild symptoms throughout, and many have symptoms that come and go.

When do pregnancy symptoms usually start?

Morning sickness usually starts between weeks 4 and 6, HealthXchange says, and peaks later in the first trimester. Symptoms at week 5 are often vague, so not feeling much before week 6 or 7 is common.

Does no symptoms mean a miscarriage?

Not on its own. Many healthy pregnancies have few symptoms. SingHealth says some miscarriages happen with no symptoms and are only found on a scan, which is why the dating scan matters more than how you feel.

My symptoms suddenly stopped at 9 weeks. Should I worry?

NUH lists the loss of signs such as tender breasts and morning sickness among the early warning signs, so ask your doctor or KKH's Early Pregnancy Assessment Unit for a scan. It's often fine, and a scan settles the question.

When can a scan see the baby's heartbeat?

HealthHub says a vaginal ultrasound can usually detect the heartbeat by the end of week 6. Earlier than that, the pregnancy may be too small to see, and KKH may ask you back for another scan.

Where can I get an early pregnancy scan in Singapore?

Start with a polyclinic, family clinic, your gynae or KKH. KKH's Early Pregnancy Assessment Unit sees women under 16 weeks, and SGH's Early Pregnancy Unit sees women under 14 weeks with bleeding or pain on self-referral.