Finding out you're pregnant may be an eagerly anticipated event — or it may come as a complete surprise. That's why OB-GYN and Modern Fertility medical advisor Dr. Eva Luo, MD, MBA always asks how her patients feel when they first tell her about a positive pregnancy test result. "Even if [the pregnancy is] desired, there could be lots of mixed feelings as patients are about to undergo a big life change," she says.
On top of the broad range of emotions that can be associated with getting a positive pregnancy test result, you’ll likely be wondering: What do I do now? In this article, we'll answer your most pressing questions about early pregnancy and break down the steps you can take after getting a positive pregnancy result if that pregnancy is desired.
But before we get into it, here are the biggest takeaways upfront:
- Early on in pregnancy, human chorionic gonadotropin (hCG) levels increase roughly 50% every day. At-home pregnancy tests are designed to detect hCG in your urine.
- If you follow the instructions for your at-home pregnancy test, false positive results are rare.
- If you get a positive pregnancy test result, call your healthcare provider. They'll likely schedule an appointment eight weeks in where they'll confirm the pregnancy and its location via ultrasound, as well as run other important tests and screenings.
- If you haven't already been taking daily prenatal vitamins with at least 400 micrograms (mcg) of folate (aka methylfolate or folic acid), start them as soon as you can.
Now that you've gotten the TL;DR, let's get into the details.
First things first: A refresher on the science of at-home pregnancy tests
You can test for pregnancy either through urine tests or blood tests. At-home pregnancy tests compare urine human chorionic gonadotropin (hCG) levels to a predetermined hCG threshold that indicates pregnancy (most frequently between 10 and 25 mIU/mL).
What's hCG again? After implantation, a structure called the chorion (that forms around the embryo) begins producing hCG and eventually develops into part of the placenta. Early on in pregnancy, levels of hCG increase roughly 50% every day, and some research suggests a relationship between hCG and symptoms like morning sickness and vomiting during the first eight weeks of pregnancy (which about 70%-80% of pregnant people report experiencing). The majority of people who do experience these symptoms will report them being resolved by the beginning of the second trimester, which is also when hCG starts to stabilize.
How soon can you use a home pregnancy test?
Different pregnancy tests will come with different instructions, and it’s important to follow those instructions closely to have the most accurate pregnancy test possible (up to 30% of people have trouble following instructions, which may lead to false readings):
- While most pregnancy tests will detect a pregnancy on the first day of a missed period, some tests (like the Modern Fertility Pregnancy Test!) are designed to detect a pregnancy as early as six days before your missed period (though tests are the most accurate starting the day of your missed period).
- Start testing about two weeks after ovulation.
- You can technically take the test at any time of the day, but it’s best to take it in the morning using your first void (aka your morning urine), which will have the highest concentrations of hCG.
- If your periods are irregular, making it hard to figure out when your next period would have started, you can track ovulation and luteinizing hormone (LH) surges and use that information to test instead.
P.S. If you're using the free Modern Fertility App, you'll get personalized recommendations for the best times to test for pregnancy each cycle.
How can you confirm the results of a positive pregnancy test?
As we'll cover in the next section, it's important to reach out to your healthcare provider as soon as you see a positive pregnancy test result so you can get prenatal care scheduled. At your first appointment, which happens around eight weeks after your last menstrual period (LMP), your provider will confirm your pregnancy (most likely via ultrasound, but sometimes through a blood test). Before coming in, your healthcare provider may recommend testing again at home — just in case you initially got a false positive result.
Getting a positive result followed by a negative one (or your period) can be confusing. If a pregnancy test is used correctly, however, producing an inaccurate result is rare. That said, there are a few situations in which false positive results may occur because of elevated hCG levels:
- Some fertility treatments involve hCG hormone injections (but the system will usually be clear of the excess hormones a few weeks after the injection)
- Certain tumors produce elevated hCG (hCG tests were originally developed to detect these)
- After a recent miscarriage or chemical pregnancy (an early pregnancy loss that occurs around five weeks of pregnancy, soon after the embryo implants in the uterine lining)
What about false negatives? These can happen when hCG is not detected, despite a current pregnancy. This could be the result of:
- Testing too early (before your hCG levels are high enough for a test to detect a pregnancy)
- Testing with urine that is too diluted (which is why manufacturers typically suggest testing in the morning with your first urination of the day)
If you get a negative result but think you may still be pregnant, take another pregnancy test a few days after your negative result.
When should you schedule an appointment with your healthcare provider after finding out you might be pregnant?
Call your healthcare provider as soon as you get a positive pregnancy test result so you can schedule your first prenatal appointment about eight weeks after your last menstrual period (LMP). This initial visit is a good time to review with your provider any questions you may have about your pregnancy. (Heads up: This visit is usually longer than a typical doctor’s visit because your OB-GYN will have a lot of information to collect and review.)
Since COVID-19 has expanded telehealth prenatal care, some providers may review medical history and provide initial counseling before eight weeks through telehealth visits — though the appointments after eight weeks (which will include ultrasounds, exams, and lab work) will need to be in person.
Like we mentioned earlier, that first 8-week appointment is when your pregnancy and its location will be confirmed via ultrasound — though sometimes confirmation of pregnancy may happen through a blood test. Why is the location of the pregnancy important? In the rare event of an ectopic pregnancy (2% of pregnancies), when the egg is fertilized outside of the uterus, this can lead to complications.
Can you schedule an in-person appointment earlier than eight weeks into your pregnancy? That isn't usually recommended, but there are some situations in which it might be. "Bleeding, cramping, sudden abdominal pain — that warrants a call to the office at any time of the day. If unsure of what to do and feeling severe pain, head to the emergency room and call us on the way," explains Dr. Luo. Early visits may also happen to address nausea or vomiting, which may happen over the phone unless an in-person appointment is necessary. "While that first appointment may not be until eight weeks, this doesn't mean you shouldn't call whenever there is a concern," says Dr. Luo. "We are here for you from the start."
Positive pregnancy test results after assisted reproductive technology (ART)
If you've undergone assisted reproductive technology (ART) to get pregnant, like in vitro fertilization (IVF), you can expect more lab tests early on — and your fertility doctor will likely confirm the pregnancy via blood work (and possibly conduct ultrasounds) much earlier in your pregnancy. Oftentimes, your fertility doctor will continue providing you care until about 8-10 weeks into your pregnancy before transitioning you to an OB-GYN.
What can you do before that first prenatal appointment?
Once you find out you're pregnant and are waiting for your first prenatal appointment, there are many steps you can take to prioritize both your health and the health of your pregnancy:
- Take a daily prenatal vitamin if you aren’t already (like Modern Fertility’s prenatal multi!) with at least 400 micrograms (mcg) of folate (aka methylfolate or folic acid).
- If you’re taking any other medications, call the provider who prescribed them to discuss pregnancy safety and whether or not you should discontinue use. (Here's one list of medications that aren't safe while pregnant.)
- Stop drinking, smoking, or vaping.
- Eat 2-3 servings of fish per week that's high in DHA (which can also be found in prenatal vitamins if you're vegetarian or vegan) and low in mercury (salmon's a good option!), and wash fruits and veggies. (General guidelines for pregnancy nutrition can be found here.)
- Avoid undercooked or unheated fish and meat, unpasteurized dairy, and anything linked to listeria.
- If you’re experiencing any nausea, try bland foods, smaller portion sizes, and ginger (ginger ale, ginger tea, etc.) to settle your stomach.
- Pay attention to exercise, which is actually recommended during pregnancy. You can find exercise guidelines for pregnancy here, but everyone's bodies are different. Talk to your healthcare provider for personalized recs.
- Drink lots of water.
How will your healthcare provider calculate your due date?
The due date your healthcare provider gives you is merely a calculation of when you'll be 40-weeks pregnant (full term is 37-40 weeks) — it's not meant to be an exact prediction of when you'll actually give birth.
Providers will often date your pregnancy at your first prenatal appointment based on the first day of your last period (LMP). Why? Not everyone knows when they ovulated, so going off your last period gives providers a more solid date to count from. The most accurate method is an LMP consistent with the first-trimester ultrasound. But if there is a big discrepancy (like seven days between predicted due dates), the ultrasound is what's paid attention to. According to Dr. Luo, people with irregular periods are more likely to have an adjusted due date after an ultrasound.
When does it make sense to start telling people you're pregnant?
Deciding when to tell family and friends about your pregnancy is a personal and emotional decision. Because the likelihood of pregnancy loss decreases significantly after the first trimester, people often wait until the second trimester to share the news. But there is no right or wrong time to tell people you’re pregnant, so do what feels right to you.
What can you expect from prenatal appointments throughout your pregnancy?
As your pregnancy continues to develop, your visits with your healthcare provider will change in their focus and frequency. Here's an overview of what you can expect at your in-person appointments throughout your pregnancy:
First trimester: While the appointments you can expect during the first trimester are incredibly varied based on provider, clinic, and geographic location, there are typically two. At these first-trimester appointments, you'll likely undergo the following tests and screenings (unless any of this has already been done before conception or at your preconception appointment):
- Blood work to find out your blood type, check for vaccine antibodies, test for sexually transmitted infections (STIs), and measure A1C to assess diabetes risk (if you have risk factors)
- Prenatal genetic screening tests (like maternal serum analytes or noninvasive prenatal testing, aka NIPT)
- Carrier screening
- Ultrasounds to confirm pregnancy, estimate gestational age, check to make sure the pregnancy is developing in the uterus, see how many fetuses there are, and evaluate the fetal heart rate
- Nuchal translucency (NT) ultrasound between 11 and 13 weeks to test for chromosomal abnormalities
- Vaccines (the flu shot and the COVID-19 vaccine)
Second trimester: Expect prenatal appointments with your provider every four weeks through the second trimester, where the following things may happen:
- Prenatal genetic diagnostic tests if any of the earlier genetic screening tests came back abnormal (chorionic villus sampling, or CVS, between 10 and 13 weeks or an amniocentesis after 15 weeks may be recommended)
- Maternal serum analytes (the second part of the first- and second-trimester blood tests, together often called “the quad screen”) between 15 and 18 weeks to detect chromosomal abnormalities
- A glucose challenge test between the 24th and 28th weeks of pregnancy to screen for gestational diabetes
- Ultrasounds (typically an anatomy or level II ultrasound is performed between weeks 18 and 22) to screen for anatomical abnormalities
Third trimester: In the third trimester, you'll go from biweekly or monthly appointments (depending on the circumstances of your pregnancy) to weekly ones after 36 weeks. Here's what may happen:
- A group B strep swab to check for the presence of group B strep (a common and native bacterial strain) in the vagina
- Ultrasounds to check the position of the fetus
- The Tdap vaccine (for whooping cough)
- Additional lab work may be done (depending on your provider)
Modern Fertility is always here with a heads-up on what's to come
Whether a pregnancy is a complete surprise or not, knowing what to do and what may happen after a positive pregnancy test is important. If you're currently pregnant and want a more in-depth guide for what to expect after that positive result, we've got you covered right here. (For more articles on pregnancy, check out our dedicated section on the Modern Fertility blog.)
If you're currently pregnant, trying to get pregnant, or planning for kids in the future, the Modern Fertility Prenatal Multivitamin has 12 key nutrients to support your body at every stage — even through lactation (whether or not you're breastfeeding/chestfeeding). The Prenatal Multi is easy on the tummy, vegetarian, and comes with a beautifully blue reusable glass jar.
And if you need to test for pregnancy, the Modern Fertility Pregnancy Test will get you results you can trust at an affordable cost. You can start testing as early as six days before your missed period. Plus, download our free app for a countdown to the best testing times each cycle.
Wherever you're at on your reproductive journey right now, the free online Modern Community is here for you with real-talk support. Poke around and get in on the conversations by joining today.
This article was medically reviewed by Dr. Eva Marie Luo, MD, MBA, OB-GYN at Beth Israel Deaconess Medical Center and Clinical Lead for Value at the Center for Healthcare Delivery Science at Beth Israel Deaconess Medical Center.