Pregnancy · Symptoms
Trimester Symptom Quiz
Trimester-by-trimester symptom guide. T1: nausea, fatigue. T2: bump, movements, round ligament. T3: Braxton Hicks, oedema. URGENT: bleeding, severe headache, reduced movements, swelling, itching palms/soles. NICE NG201.
Last reviewed 2 June 2026
Trimester symptom triage
Is what I’m feeling normal?
How many weeks pregnant are you?
Tick every symptom you’re currently experiencing
Enter your week of pregnancy and tick symptoms above to see your triage summary.
What’s normal in each trimester
T1 (0-12 weeks)
- Nausea / vomiting (peaks 8-11 wks).
- Fatigue.
- Breast tenderness.
- Frequent urination.
- Food aversions / cravings.
- Mild pelvic cramping.
T2 (13-27 weeks)
- Reduced nausea.
- Energy returns.
- Bump visible.
- Quickening (16-20 wks).
- Round ligament pain (sharp groin).
- Skin pigmentation (melasma, linea nigra).
T3 (28-birth)
- Braxton Hicks (practice contractions).
- Shortness of breath.
- Back, hip, pelvic pain.
- Insomnia.
- Oedema legs / feet.
- Heartburn.
URGENT (same-day) any trimester
- Vaginal bleeding any amount.
- Persistent abdominal pain.
- Severe headache + visual changes.
- Rapid face / hand swelling.
- Right-upper quadrant pain.
- Waters breaking <37 wks.
- Reduced fetal movements.
- Fever >38°C.
- Calf pain / swelling (DVT).
- Chest pain / breathlessness (PE).
- Itching palms + soles (cholestasis).
Pre-eclampsia warning
- Severe headache.
- Visual changes.
- Upper abdominal pain.
- Rapid face / hand swelling.
- Sudden large weight gain.
- High BP at appointment.
Call maternity immediately.
Reduced fetal movements
URGENT same-day assessment. Don’t wait, don’t rely on sugary food / cold drinks (myth). CTG + scan. RCOG GTG 57.
Vaginal bleeding
ANY amount deserves same-day review. Causes range from harmless (cervical changes) to serious (placental abruption). Maternity triage decides.
Obstetric cholestasis
Persistent itching of palms or soles (sometimes whole body) without rash. Risk to baby. URGENT bloods (bile acids + LFTs).
Abdominal pain differential
- Round ligament: sharp brief T2.
- Braxton Hicks: tightening, irregular.
- Labour: regular, increasing.
- Abruption: sudden + bleeding.
- UTI: dysuria + frequency.
- Appendicitis: RIF pain.
Mental health symptoms
Antenatal depression / anxiety affects 10%. Persistent low mood, intrusive thoughts — GP + Whooley / EPDS screening. Safe treatments available.
Different scenarios
Scenario 1: 8 weeks, vomiting + dehydration
Suspect hyperemesis gravidarum. GP / maternity day unit. PUQE score + IV fluids.
Scenario 2: 22 weeks, sharp groin pain on rolling over
Round ligament — common, normal. Resolves with rest.
Scenario 3: 36 weeks, severe headache + blurred vision
Pre-eclampsia risk — maternity URGENT. Don’t drive.
Scenario 4: 30 weeks, baby quieter than usual
Reduced movements — URGENT. CTG.
Scenario 5: 33 weeks, itching palms + soles at night
Obstetric cholestasis check. Bile acids + LFTs same day.
Care guidance
- Know normal vs concerning.
- Reduced movements = urgent.
- Any bleeding = same-day.
- Pre-eclampsia red flags = urgent.
- Cholestasis itching = urgent.
- Trust your instincts.
Sources
- NICE NG201. Antenatal care.
- NICE NG133. Hypertension in pregnancy.
- RCOG GTG 57. Reduced fetal movements.
- RCOG GTG. Obstetric cholestasis.
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Frequently asked questions
What does this symptom quiz do?
Helps identify which symptoms are: (1) NORMAL for your trimester; (2) WORTH MENTIONING at next appointment; (3) URGENT — same-day GP / maternity. Educational + does NOT replace clinical judgement. ANY concerning symptom: contact maternity / GP.
What’s normal in T1 (0-12 weeks)?
NAUSEA + VOMITING (peak 8-11 wks); FATIGUE; BREAST tenderness; FREQUENT URINATION; FOOD AVERSIONS / cravings; MOOD changes; LIGHT spotting (in ~25% of pregnancies; not always concerning); MILD pelvic cramping; CONSTIPATION; HEADACHES. RESOLVED USUALLY by 12-13 weeks.
What’s normal in T2 (13-27 weeks)?
REDUCED NAUSEA; ENERGY return; BUMP visible 16-22 wks; QUICKENING (movements) 16-20 wks; ROUND LIGAMENT pain (sharp groin pain on movement); MELASMA + linea nigra (skin pigmentation); LEG cramps; CONSTIPATION; HEARTBURN; SHORTNESS of breath (occasionally); MILD oedema.
What’s normal in T3 (28-birth)?
BIG BUMP; BRAXTON HICKS (practice contractions, irregular, not painful, stop with rest); SHORTNESS of breath; SLEEP DISTURBANCE; BACK PAIN; HIP / PELVIC pain (relaxin, SPD); INSOMNIA; OEDEMA legs / feet; HEARTBURN; INCREASED discharge; MEMBRANE sweep + induction discussions 40+ wks.
What needs URGENT contact (any trimester)?
URGENT same-day maternity / triage: (1) VAGINAL BLEEDING (any amount); (2) PERSISTENT abdominal PAIN; (3) SEVERE headache + visual changes; (4) RAPID swelling face / hands; (5) RIGHT-UPPER quadrant pain; (6) WATERS BREAKING before 37 wks; (7) REDUCED FETAL MOVEMENTS; (8) FEVER >38°C; (9) Calf pain / swelling (?DVT); (10) CHEST PAIN / shortness of breath (?PE); (11) ITCHING palms + soles (?obstetric cholestasis).
Pre-eclampsia warning signs?
MEDICAL EMERGENCY. (1) SEVERE HEADACHE; (2) VISUAL changes (flashing lights, blurred); (3) UPPER ABDOMINAL pain (just below ribs); (4) RAPID swelling of face / hands; (5) SUDDEN large weight gain; (6) ELEVATED BP at appointment. CALL MATERNITY IMMEDIATELY. /calculators/pre-eclampsia.
Reduced fetal movements — what to do?
URGENT same-day assessment. (1) DON’T wait. (2) DON’T rely on sugary food / cold drink (myth — doesn’t reliably stimulate). (3) MATERNITY contact regardless of time. (4) CTG, scan, +/- delivery if concerns. RCOG GTG 57. /calculators/movement-tracker.
Vaginal bleeding — always serious?
ANY pregnancy bleeding deserves same-day review. CAUSES: (1) Implantation bleeding (very early); (2) Cervical changes (sex, exam); (3) Miscarriage threat; (4) Ectopic; (5) Placenta praevia; (6) Placental abruption; (7) Show (preceded by labour). MATERNITY triage assesses + scans. NOT all bleeding = problem but ALL need review.
Discharge changes — what’s normal?
(1) INCREASED clear/white discharge (leucorrhoea): NORMAL in pregnancy. (2) GREENISH yellow / cottage-cheese / fishy: thrush, BV, STI — GP. (3) BLOOD-STREAKED: review. (4) WATERS BREAKING: usually clear or pinkish; large gush or persistent trickle — maternity. (5) MUCUS PLUG (‘show’): pink/brown jelly-like in late pregnancy; labour preparation.
Headache — when serious?
MILD-MODERATE headaches common from hormonal changes + posture. URGENT review if: (1) SUDDEN severe; (2) NOT relieved by paracetamol + rest; (3) WITH visual changes; (4) WITH upper abdo pain; (5) WITH high BP. SUSPECT pre-eclampsia (after 20 wks) or other neurological cause.
Abdominal pain — differentiate?
(1) ROUND LIGAMENT pain (T2): sharp groin on movement; brief. (2) BRAXTON HICKS (T3): tightening, irregular, not painful, stop with rest. (3) LABOUR contractions: regular, increasing intensity, persist. (4) PLACENTAL ABRUPTION: sudden severe + bleeding. (5) UTI: dysuria + frequency. (6) APPENDICITIS: RIF pain. (7) ECTOPIC (early): sharp one-sided pain. /calculators/abdominal-pain-pregnancy.
Itching in pregnancy — when concerning?
MILD itching of skin + bump common. CONCERNING: persistent itching of PALMS or SOLES (sometimes whole body) without rash — suspect OBSTETRIC CHOLESTASIS (intrahepatic cholestasis of pregnancy). Risk to baby. URGENT GP / maternity bloods (bile acids + LFTs). /calculators/obstetric-cholestasis.
What about mental health symptoms?
ANTENATAL depression / anxiety affects 10%. SYMPTOMS: persistent low mood, anxiety, intrusive thoughts, panic attacks. NORMAL emotional ups + downs vs persistent + functional. GP + Whooley / EPDS screening. /calculators/whooley /calculators/edinburgh-postnatal-depression-scale. SAFE treatments available.
How does this relate to other calculators on BumpBites?
Companion: /calculators/pregnancy-week; /calculators/pre-eclampsia; /calculators/movement-tracker; /calculators/abdominal-pain-pregnancy; /calculators/obstetric-cholestasis; /calculators/whooley; /calculators/morning-sickness.