There is no sign of pregnancy by which we can always distinguish it in its early stages; in some instances nearly all the rational signs are absent. The general condition of a pregnant woman is changed in a greater or less degree, but all are not changed alike.
Generally she is plethoric, the pulse is fuller and quicker; the quantity of circulating fluid is augmented, the quality altered by the increase of fibrine; but these changes are not always obvious. Well marked sympathies are excited in various organs; the nervous system may suffer especially; the woman’s temper and disposition may change; she may become capricious, may have likes and dislikes in eating, especially if her digestion is weak; there may be loss of appetite, heartburn, increased flow of saliva, toothache, excitability of mind, sleepiness, etc.; but even when many of these symptoms are present, even when the liver and kidneys are affected, so that the skin is sallow or discolored in patches, and irritability of the bladder causes much pain and distress, these various signs may only furnish a sum of probabilities amounting almost to certainty.
In some cases of pregnancy the skin, instead of becoming sallow, is more florid, with occasional eruptions on the face.
Some women become fat during pregnancy; others lose flesh; their faces, in the early months, are pinched and pointed, and their features altered.
Milk in the breasts, especially in the first pregnancy, is a sign which is said to be reliable; but it is true of some women that, during their period of menstruation, their breasts enlarge; there is a sensation of fullness, with throbbing and tingling pain in them, and that a milk fluid may be secreted; the same symptoms that are present with others at the second month of pregnancy.
Another change is a more marked sign in the breasts. There is at first a soft and moist state of the skin, and the little glandular follicles around the nipples are bedewed with a secretion. This may often be seen at the second month, and it may also be noticed that the veins of the breast look more blue, and that the breasts themselves are firmer and more knotty to the touch.
There are, however, other signs which are more to be depended on than these that have been mentioned.
Females cease to be regular during pregnancy. A healthy married woman, during the period of child-bearing, bases her prediction upon this sign, and is seldom disappointed. But women are not all healthy; disease and disorder of the womb, or other organs of the body, especially of the lungs, may cause suppression of the catamenia; and, on the other hand, the discharge may recur for several months after conception, or even monthly during the period of utero gestation; and, in anomalous cases, some young married women, who had hitherto been quite regular, ceased to menstruate for several months without any known cause.
Morning sickness is one of the earliest signs of pregnancy, as it often occurs within two weeks. The nausea may be slight or it may be very distressing; it may happen to be soon relieved, but it usually continues for three or four months or longer. It varies also as regards the time of day during which it continues to be bad; but if it recurs at the regular time and in the regular manner, it is of great value as an evidence of pregnancy, when combined with other symptoms.
A dark brown areola around the nipple may usually be noticed at the end of the second month; this is a distinguishing sign, especially if it be a first pregnancy. A month or two later, the dark color is more obvious, and it is darker in persons with dark hair, etc. It may be described as being a dark circle, somewhat swollen, or with a puffy turgescence, both of the nipple and the surrounding disk; the surface of the areola studded over and rendered unequal by the prominence of the glandular follicles, the integument covering the part soft and moist; sometimes small mottled patches, of a whitish color, scattered over the outer surface of the areola, and for about an inch all around it.