You’ve just seen the two lines on the test – congratulations!
But as the days go by, you may start to wonder: ‘Shouldn’t I be feeling something by now?‘
No nausea. No cravings for weird food combos.
You feel totally normal and that’s starting to feel a little weird.
For many women, pregnancy is painted as a time of wild symptoms and emotional ups and downs.
So, when nothing seems to be happening, it’s easy to spiral into Google searches and worry.
Is it okay to feel fine?
Could something be wrong?
Or are you just one of the lucky ones?
To clear up the confusion, we sat down with Dr Doris Ng, Consultant Obstetrician and Gynaecologist at KPJ Damansara Specialist Hospital.
With extensive experience and qualifications in women’s health (MBBS, MRCOG – Royal College of Obstetrics and Gynaecology, UK), Dr Doris is here to help answer the big question: Is it possible to have no pregnancy symptoms and still have a healthy baby?
Without further ado, let’s get right into it!
Understanding Cryptic Pregnancy
Motherhood: Dr, many Malaysian mums-to-be are familiar with the classic ‘morning sickness’ and fatigue. But is it truly possible for a pregnancy to progress with absolutely no noticeable symptoms? What’s the medical explanation behind this?
Dr Doris: Yes, it is possible to have no pregnancy symptoms at all, however this is a rare phenomenon known as ‘cryptic pregnancy’.
There are several possible explanations for this.
Some women may not realise they are pregnant due to absent or irregular periods due to conditions such as breastfeeding, PCOS or perimenopause, and may contribute any possible symptoms such as fatigue due to their pre-existing condition.
Pregnancy symptoms such as nausea and ‘morning sickness’ are primarily driven by hormones of human chorionic gonadotrophin (HCG) and progesterone.
Some women have a more gradual increase of these hormones in pregnancy, may be less sensitive to hormonal shifts, or their bodies are just naturally able to tolerate higher levels of these hormones well, leading to minimal or no noticeable pregnancy symptoms.
Tired, Moody or Expecting?
Motherhood: In our Malaysian climate, where heat and humidity are constant factors, how might these environmental conditions mask or alter typical pregnancy symptoms like nausea or fatigue? Could this lead to some women feeling they have ‘no symptoms’ when they might have subtle ones?
Dr Doris: Absolutely! Our hot and humid climate often leaves us feeling tired, dehydrated, fatigue or overheated.
Subtle pregnancy symptoms may be attributed to the weather instead of pregnancy. Mild nausea may also be attributed to dehydration due to excessive sweating instead of pregnancy.
Pregnancy Signs That Often Go Unnoticed
Motherhood: For a first-time mum, especially those juggling work and family, what are some subtle signs that might indicate pregnancy even if the obvious symptoms are absent? Are there any less-talked-about indicators that women should be aware of?
Dr Doris: This is a tough one! The signs may not be obvious – especially if a woman is not actively trying to conceive and notice that her period is late. Even then, she may attribute her late period due to stress!
Some other subtle pregnancy symptoms may include feeling warm or overheated (again, which may be attributed to the weather), poor sleeping patterns or unusually vivid dreams, feeling emotional or having more mood swings compared to normal, changes in appetite, food preferences or cravings, changes in bowel habits such as constipation, or even feeling breathlessness.
Again, these are subtle signs that may be easily written off due to life stressors.
So, my advice would be to note any unusual changes in your daily habits that doesn’t seem to resolve even after you make healthier lifestyle changes.
How Symptoms Affect Postpartum Preparation
Motherhood: Culturally, in Malaysia, there’s a strong emphasis on ‘pantang’ (postpartum confinement) and traditional practices. If a woman has no symptoms, does it affect how she should approach these traditional practices or preparations for postpartum?
Dr Doris: Not at all. Traditional postpartum confinement is practiced in efforts to boost maternal health and speed recovery, to allow time for bonding with the baby, to learn parenting skills from elders and for the mother to receive adequate physical, emotional and social support.
However, not all ‘pantang’ practices are encouraged medically, regardless if you have pregnancy symptoms or otherwise.
For example, the no bathing or no hair-washing rule is unhygienic for the mother, especially in our hot climate, and may lead to infections.
Water or excessive dietary restriction is also discouraged, as it may lead to poor nutrition, dehydration, low milk supply or even life-threatening conditions such as deep vein thrombosis, which are blood clots which may travel to the lung and cause death.
That is why even though new mothers are encouraged to rest, we still advocate them to be active in the home and not lie in bed for 24 hours.
Is Prenatal Care Different Without Symptoms?
Motherhood: From a medical perspective, if a woman experiences no symptoms, does it impact the frequency or type of prenatal checkups she should have? Are there any specific tests or screenings that become more crucial in such cases?
Dr Doris: Medically, her prenatal appointments and tests do not change regardless of her pregnancy symptoms.
All pregnant women are encouraged to have a prenatal visit in her first trimester, ideally at least once around 12 weeks of gestation.
We need to check her medical history and to perform an ultrasound to ensure the baby is structurally normal and that the size of the baby corresponds to the gestation.
We also do antenatal screening tests such as haemoglobin to check for anaemia, to look for infections that may affect baby such as HIV, syphilis, hepatitis B or rubella, as well as any genetic screening the parents may wish to do such as first trimester screen or non-invasive chromosome check (NICC) to look for conditions such as Down’s Syndrome.
Generally, in the first two trimesters of pregnancy, the antenatal visits are every month, and become twice a month from the third trimester onwards.
All mothers should attend around 7 to 10 antenatal visits to her doctor, with more may be required if she has any complications of pregnancy.
Can ‘No Symptoms’ Be Risky?
Motherhood: Sometimes, women might mistake a lack of symptoms for a ‘strong’ pregnancy. But is there any potential risk associated with having no symptoms, and how can mums-to-be ensure their pregnancy is progressing healthily regardless?
Dr Doris: Women without pregnancy symptoms do not have an increased risk of miscarriage, with the miscarriage risk decreasing from week 6 to 11 as the pregnancy progresses, just the same as women with pregnancy symptoms.
No pregnancy symptoms may also be attributed to missed miscarriage, where the baby does not continue to grow.
The hormone levels may be low, static or reducing. Hence, the woman does not experience any symptoms at all or have her pregnancy symptoms disappear abruptly.
The only way to check is to visit your doctor for an early ultrasound scan around 7-8 weeks of pregnancy to ensure that the baby has a heartbeat and is growing well.
Folic acid is also an important supplement to take regardless of your symptoms and can help ensure a healthy pregnancy.
Is There Any Truth to Old Wives’ Tales?
Motherhood: Many Malaysian mums rely on advice from family and friends. What are some common pregnancy myths related to symptoms (or lack thereof) that you frequently encounter in your practice, and what’s the factual medical perspective?
Dr Doris: Some common pregnancy myths that I encounter are that if a woman is craving savoury foods she is having a boy, or if she is craving sweet foods she is having a girl.
Another one is that having nausea or morning sickness means it’s a girl, or no vomiting means it’s a boy.
Sadly, these are all myths and there is no way to tell the gender of a baby from the mother’s symptoms!
The only way to tell is to do NICC or to do an ultrasound around 20 weeks of pregnancy.
What ‘No Symptoms’ Might Mean
Motherhood: We know hormonal changes are significant during pregnancy. If a woman has no symptoms, does it mean her hormonal fluctuations are less intense, or are they just being processed differently by her body?
Dr Doris: Yes, that is right!
The medical theories behind why a woman may not experience pregnancy symptoms are that the hormonal changes may be more gradual in some women, or that she is genetically predisposed to tolerate higher levels of the hormones without having any symptoms.
Furthermore, there is new research looking into the health of the father prior to conception and how it affects the placenta, and therefore the mother’s pregnancy symptoms and the growth of the baby as well.
Therefore, all dads-to-be need to live a healthy lifestyle in order to help mums-to-be have a healthier pregnancy.
Can Tracker Apps Catch Early Pregnancy?
Motherhood: With the rise of digital health tracking, many women use apps to monitor their cycles and potential symptoms. If a woman has no symptoms, how can she best utilise these tools to ensure she’s tracking her pregnancy accurately?
Dr Doris: These apps are extremely helpful and I encourage all of my ladies to track their menstrual cycles on it!
If a woman is trying to conceive and has missed her period, it is best to do a home pregnancy test to check if she is pregnant regardless of any symptoms.
Usually when the pregnancy is in very early stages such as 4-6 weeks, she may not have any symptoms at all.
However, pregnancy tests are very sensitive these days and can even detect pregnancy before the period is late.
Always Listen to Your Body
Motherhood: Finally, Dr, what’s the most important piece of advice you’d give to a Malaysian mum-to-be who is concerned about having no pregnancy symptoms? What’s the key takeaway message you want to impart?
Dr Doris: I would tell her to take it as a blessing that she has no symptoms and to enjoy the pregnancy journey!
The most important thing is to come for regular antenatal check ups, especially in the first trimester.
Do visit your doctor once around 7-8 weeks of pregnancy to ensure that all is going well, and again at 12 weeks for the necessary screening tests.
I do hope all mummies find my advice helpful and I wish everyone a happy and healthy pregnancy!
Source: Dr Doris Ng, Consultant Obstetrician and Gynaecologist at KPJ Damansara Specialist Hospital
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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