A Guide on Early and Presumptive Signs of Pregnancy

SimpleNursing Team May 11, 2022
A young blond nurse in blue scrubs consults a pretty young brunette woman for presumptive signs of pregnancy

The sooner you recognize early signs of pregnancy in a patient, the sooner you can begin taking measures to care for the mother and the baby.

Although the primary sign of pregnancy is a missed period, many women experience other symptoms before noticing changes in their menstrual cycle. Pregnancy symptoms fall into three categories — presumptive, probable, and positive — depending on the likelihood of pregnancy.

If you’re a nursing student, you’ll want to make sure you fully understand the early signs of pregnancy and distinguish between presumptive, probable, and positive pregnancy symptoms. We’ll walk you through everything you need to know.

Presumptive, probable, and positive signs of pregnancy

You might have heard about presumptive, probable, and positive signs of pregnancy — but what exactly do these mean?

Presumptive signs of pregnancy are usually noted by the patient and indicate a possibility of pregnancy. While presumptive symptoms imply early pregnancy in most cases, factors like PMS, stress, and illness may also cause these symptoms.

On the other hand, probable signs of pregnancy have the most likelihood of indicating pregnancy. Cervical changes, mild uterine cramping, softening of the cervix, quickening, Braxton Hicks contractions, and a positive pregnancy test are the most common probable signs to watch out for. It is possible to have a false positive on a home pregnancy test, which is why it’s classified as a probable sign.

To confirm pregnancy, health care providers look for positive signs of pregnancy. These include a fetal heart rate (or fetal heartbeat) and fetal movement on an ultrasound, heart sounds by a doppler, and hCG (a hormone secreted by the placenta shortly after incubation) in a urine sample.

11 Presumptive signs of pregnancy

Not every expecting woman will experience symptoms. Still, most women typically develop some classic presumptive symptoms during their early pregnancy — hormonal imbalances, nagging anxiety, and body changes are to blame.

Here are the most common presumptive signs of pregnancy to look for during an assessment:


For most women, the absence of menstruation (amenorrhea) is the first presumptive sign they’ve entered the early stages of pregnancy. Amenorrhea, however, may be caused by other factors, including early menopause, stress, malnutrition, anorexia, irregular menstrual cycles, endocrine imbalances, anemia, diabetes, or medications.


A woman’s body undergoes many transformations and hormonal changes during pregnancy. It’s common for a patient to feel tired while expecting, especially in the first 12 weeks of pregnancy when levels of the hormone progesterone soar. The goal for first-trimester fatigue is to help pregnant women cope by sharing information and developing an activity-rest program.

Increase in urinary frequency

During the first weeks of pregnancy, expecting moms might feel like they’ve been spending more time in the restroom than out of it. You can blame frequent urination on human chorionic gonadotropin (hCG), which increases the blood flow to the pelvic area and increases the softening of the cervix — known as Goodell’s sign.

Nausea, with or without vomiting

Due to the changes in hormones during the first trimester, nausea is a common pregnancy symptom and affects 70% to 80% of pregnant women. Although pregnancy nausea is often referred to as “morning sickness,” it can occur at any time of day.

Breast enlargement

As breasts prepare to make breast milk to feed the newborn, expecting mothers will notice their breasts getting fuller, larger, and heavier. They may also experience tenderness or pronounced nipples.

At the same time, the areola may become darker in color and could grow in size. Breast tenderness is also a common symptom during PMS; therefore, it would be too early to confirm pregnancy if breast changes are the only presumptive sign.


Heartburn is a burning feeling in the throat or chest caused by stomach acid or food traveling toward the throat. Hormonal changes during pregnancy cause the valve between the stomach and the esophagus to reflux, making heartburn a common presumptive pregnancy symptom.

At the same time, the growing uterus puts pressure on the stomach, causing an increased bloating sensation. As a nurse, suggesting a few dietary and lifestyle changes can help prevent and relieve symptoms in patients.


An increase in hormones during the first weeks of pregnancy leads to the dilation of blood vessels, which may cause lightheadedness. Although hormonal changes typically cause dizziness, they might signal more serious health issues in some women — such as infection, a blood clot, insulin resistance, or high blood pressure.

Elevated basal body temperature (BBT)

Basal body temperature (BBT) is the body’s lowest resting temperature, usually measured with a thermometer first thing in the morning. A woman’s reproductive hormones play a significant role in BBT; fertility awareness programs typically track the pattern to aid in pregnancy.

After ovulation, BBT increases and drops again if pregnancy doesn’t happen; therefore, an elevated basal body temperature might indicate an early pregnancy or ovulation.

Food cravings

Food cravings and aversions are common presumptive signs of pregnancy. Common types of foods craved by pregnant women include chocolate, ice cream, fruit, juice, milk, yogurt, cheese, and cream, among others.

Mood swings

Mood swings are another early, presumptive sign of pregnancy. Hormonal changes, the physical discomfort of pregnancy, sleep deprivation, and the upcoming post-baby life changes are factors that send pregnant women on an emotional rollercoaster. The good news for moms dealing with emotional ups and downs is that mood swings are only temporary.

Shortness of breath

As pregnancy progresses, walking up the stairs or carrying out a routine task may seem exhausting for many women. Shortness of breath is a common symptom for expecting mothers, occurring in 60% to 70% of healthy pregnant women. Although dyspnea in pregnancy is typically harmless, difficult breathing is associated with more serious pregnancy complications in some cases.

Studying to become a nurse? See how SimpleNursing can help

As you prepare yourself for your nursing exams, it’s important to fully understand the presumptive, probable, and positive signs of pregnancy. Recognizing the early signs of pregnancy is an important part of your nursing education and your nursing or obstetrics career later on.

SimpleNursing is here to help you prepare for your NCLEX exam with top-notch practice questions, video-based rationales, and comprehensive assessments. With over 1,000 videos, 800 creative cheat sheets, and 3,000 test-prep questions, you can gain access to highly tested content that can help you pass your nursing exams the first time.

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