Week 6: The Face Takes Shape

This week the face begins to take shape! Small indentations mark where the nostrils will be, the eye lenses are forming, and the early structures of the ears are developing. It is remarkable to think that so much is happening when the baby is still only the size of a lentil.

The brain is growing rapidly, and the embryo curves into a small C-shape. Your baby is now about 4 mm long, but development is happening at an impressive pace — new cells are forming in the hundreds of thousands every minute.

For many pregnant people, this is also the week nausea really makes itself known. Hold on — for the vast majority, nausea eases after the first trimester.

Baby's Development

Facial features forming: Nostrils, eye lenses, and ear canals begin to take shape as small folds and indentations in the head
Brain grows rapidly: The different parts of the brain are differentiating, and the brain is the fastest-growing organ right now
Heart more developed: The heart now has four chambers and beats around 100–120 times per minute — almost twice as fast as your own heart
Digestive system: The first structures of the stomach, intestines, and liver take shape
Arm buds: Small buds that will become arms and legs are beginning to appear
Neural tube closes: The neural tube, which will become the brain and spinal cord, closes during these days — this is why folic acid is so important

The Heart's Development

The baby's heart is one of the first organs to start functioning. In week 6, the primitive heart already has four chambers and pumps blood through the tiny body.

The heart rate is around 100–120 beats per minute and will increase to 140–170 beats per minute over the coming weeks. At an early ultrasound (usually done from weeks 7–8), the heartbeats can be seen as small, rapid movements. For many parents, this is a deeply moving moment — the first visible evidence that a tiny person is really growing in there.

The heart started as a simple tube that began beating around day 22 after fertilization. It folds and gradually forms the four chambers that will pump blood throughout life.

The Neural Tube Closing

The neural tube is one of the first structures to form in the embryo, and it is the precursor to the brain and spinal cord. In week 6, the process of the neural tube closing is ongoing — a critical developmental phase.

It is precisely during this period that neural tube defects such as spina bifida can occur if something goes wrong. This is the main reason why 400 micrograms of folic acid daily is recommended from at least one month before conception — folic acid is essential for this closure to happen normally.

Your Body

Nausea may intensify: Many find that nausea is stronger now than in previous weeks. Weeks 6–8 are often the worst
Frequent urination: The growing uterus puts pressure on the bladder, meaning more trips to the bathroom
Mood swings: Hormonal changes can make feelings swing between joy, tears, and frustration — completely normal
Food preferences change: You may develop a strong aversion to foods you normally like, or suddenly crave something very specific
Increased saliva production: Some pregnant people notice increased saliva, especially alongside nausea
Tender breasts: Breasts can be swollen, tender, and feel heavier than usual
Fatigue: A deep, pervasive tiredness is very common in the first trimester

Morning Sickness — What You Should Know

About 70–80 percent of all pregnant people experience nausea in early pregnancy. Despite the name "morning sickness," it can strike at any time of day. It is caused mainly by rapidly rising hCG levels and increased progesterone production.

For most people, nausea eases between weeks 12 and 16, though some experience it throughout their entire pregnancy.

Effective strategies for relief include:

Eat little and often: Avoid an empty stomach — keep crackers or dry bread by the bed to eat before getting up
Avoid strong smells: Many pregnant people are extra sensitive to smells — let others cook if cooking triggers nausea
Ginger: Tea with fresh ginger or ginger drops can ease nausea
Acupressure wristbands: Some find relief from pressure on the wrist (P6 point)
Rest: Fatigue can intensify nausea — allow yourself to sleep more
Cold drinks: Cold water with lemon can be easier to drink than room-temperature water
Avoid fatty foods: Rich and heavily spiced meals can worsen nausea

Good to Know

Many pregnant people experience strong food cravings or aversions during this period. It is completely normal to suddenly not be able to stand the smell of coffee or to have an intense craving for specific foods. Listen to your body, but try to maintain a varied diet as well as you can.

Drink enough water, even if it means more trips to the bathroom. Good fluid balance is important for the blood volume that increases considerably during pregnancy. Aim for at least 1.5 liters of water per day, ideally more.

If nausea is very troublesome, there are safe over-the-counter remedies available. Talk to your pharmacist or midwife about what may help you. Certain antihistamines (such as doxylamine) are considered safe for pregnancy nausea by major health bodies.

It is important to remember that all pregnancies are different. Some have very little nausea, while others struggle significantly. Both are completely normal, and absence of nausea does not mean anything is wrong with the baby.

Many people wonder whether it is safe to have sex during pregnancy. According to WHO and major obstetric bodies, sex is completely safe for most people throughout pregnancy. The baby is well protected by amniotic fluid and the cervix.

Hyperemesis Gravidarum — Severe Pregnancy Sickness

While most people manage with standard nausea-relief strategies, approximately 1–3 percent of pregnant people experience a more serious form of nausea called hyperemesis gravidarum (HG).

Symptoms of Hyperemesis

You should contact a doctor if you:

Vomit more than 3–4 times daily over several days
Cannot keep food or fluids down
Lose weight (more than 5 percent of body weight)
Feel dizzy or have dark, concentrated urine (signs of dehydration)
Feel very unwell and exhausted
Cannot carry out daily activities

Treatment

Hyperemesis can be treated with:

Prescription anti-nausea medications that are safe in pregnancy
Intravenous fluids in hospital for severe dehydration
Vitamin supplements (especially thiamine/vitamin B1)
Nutritional guidance from a dietitian

It is important to seek help early — you do not have to suffer in silence. HG is a medical condition, not something to simply endure. Sick leave may be appropriate in severe cases.

First Prenatal Appointment

The first prenatal appointment with your doctor or midwife is usually between weeks 8 and 12. It is a good idea to book this now if you have not already. Here is what to expect:

What Happens at the First Appointment

Blood tests: Blood type, Rh factor, hemoglobin (iron), blood glucose, hepatitis B, HIV, rubella immunity, syphilis
Urine sample: Checks for protein, glucose, bacteria, and white blood cells
Blood pressure: Baseline measurement used for comparison throughout the rest of pregnancy
Health history: Discussion of previous pregnancies, illnesses, medications, allergies, and family history
BMI: Height and weight recorded to monitor weight gain
Lifestyle advice: Information on diet, exercise, medications, alcohol, and tobacco

Important Topics to Raise

Any medications you take (prescription and over-the-counter)
Supplements you are taking (folic acid, vitamin D, iodine)
Questions you have about pregnancy
Concerns about nausea or other symptoms
Mental health and how you are feeling emotionally
Work situation and any demands or pressures

Blood Type and Rh Factor

An important blood test at the first appointment checks your Rh factor. If you are Rh-negative and the baby is Rh-positive, your body can form antibodies against the baby's blood. This is routinely monitored, and preventive treatment (Rh immunoglobulin) can be given during pregnancy to prevent complications.

Diet When Nausea Is Bad

When nausea makes it hard to eat, the most important thing is to get something in — perfect nutrition is not the goal during this period.

Foods That Often Work Well

Dry bread and crackers: Easy to digest, can be eaten before getting up in the morning
Rice and pasta: Mild flavors that rarely trigger nausea
Banana: Easy to digest and gives energy
Soups and broths: Provide fluids and nutrients at the same time
Yogurt: Cold and mild, provides protein and calcium
Ice cubes and ice lollies: Cold can ease nausea for some
Ginger tea: Warm tea with fresh ginger can relieve nausea

Tips for Maintaining Nutrition

Eat what you can, when you can — do not wait for set mealtimes
Keep small portions available everywhere — in your bag, on the bedside table, in the car
Drink between meals, not during — fluids in the stomach can worsen nausea for some
Cold foods often smell less than warm ones
Something sour (lemon, pickles) can help some people with nausea

From a Nutritional Standpoint

You do not need extra calories in the first trimester. Focus on quality over quantity, but give yourself grace if nausea means your diet is not ideal for a few weeks. The baby takes what it needs from your body's stores.

Exercise and Physical Activity

It is safe and recommended to exercise in pregnancy. It can even help with nausea:

Walking: Fresh air and moderate movement can relieve nausea and boost energy
Swimming: Gentle on the body. Many pregnant people find it liberating
Pelvic floor exercises: Important to start early — a strong pelvic floor gives better support to the growing uterus and makes birth easier
Yoga: Can help with stress management, relaxation, and breathing exercises useful during labor

Listen to your body — if nausea is too strong, it is completely fine to take it easy. Even short walks provide health benefits. Avoid exercising to exhaustion and make sure to drink enough water.

Mental Health in Early Pregnancy

It is common to experience a wide range of emotions in early pregnancy. Hormonal changes can intensify both positive and negative feelings.

Common Feelings

Joy and anticipation mixed with uncertainty
Worry that something might go wrong
Frustration with nausea and fatigue
Mood swings that feel uncontrollable
Anxiety about finances, work, or relationships

When to Seek Help

Talk to your midwife or doctor if you:

Experience persistent low mood or anxiety
Have difficulty sleeping because of worry
Lose interest in things you usually enjoy
Have thoughts of harming yourself
Have a history of depression or anxiety disorders

Midwives and doctors can help find the right support. There are effective treatments that are safe during pregnancy.

Important Supplements in Week 6

These supplements are especially important in early pregnancy:

Folic Acid

Recommended dose: 400 micrograms daily
Why: Essential for closure of the neural tube, which is happening right now in week 6
Should be started: Ideally from one month before conception, but start now if you have not already
Foods with folate: Dark leafy greens, beans, lentils, whole grains, orange juice

Vitamin D

Recommended dose: 10–15 micrograms (400–600 IU) daily throughout the year
Why: Important for calcium absorption and the baby's bone and tooth development

Iodine

Recommended dose: Around 220 micrograms daily during pregnancy (WHO recommendation)
Why: Necessary for the baby's brain development and thyroid function
Foods with iodine: Dairy products, fish, eggs, iodized salt

Iron

Iron needs increase through pregnancy, but most people do not need supplements in the first trimester
Your midwife checks iron levels at the first prenatal appointment
Eat iron-rich foods such as meat, fish, beans, and dark leafy greens

For Your Partner

Be prepared for food preferences to change dramatically — be flexible with meal plans
Offer to take over tasks involving strong smells, such as cooking, taking out rubbish, and washing up
Remember that mood swings are hormonal and not personal — be patient and understanding
Keep track of when the first prenatal appointment is, and come along if you can
Keep dry bread or crackers available by the bed to help with morning sickness
Read up on the pregnancy timeline so you understand what your partner is going through

Tips for Week 6

Drink plenty of water: At least 1.5 liters per day — good hydration helps with nausea and is important for blood volume
Eat little and often: Small, frequent meals can keep nausea at bay. Avoid an empty stomach — always keep a small snack available
Avoid nausea triggers: Notice which smells and foods trigger nausea, and try to avoid them
Take it easy: Stress and fatigue can intensify nausea — allow yourself to slow down
Talk to your midwife: If nausea is significantly affecting your daily life, there are safe strategies that can help
Book the prenatal appointment: Call your doctor or midwife and schedule the appointment for weeks 8–12

When to Contact a Doctor

Contact your doctor or midwife if you experience:

Vomiting more than three to four times daily over several days
Weight loss due to nausea and vomiting
Dark urine or infrequent urination (signs of dehydration)
Bleeding with pain in the lower abdomen
Fever and chills
Severe one-sided abdominal pain (may indicate ectopic pregnancy)
Inability to keep fluids down for more than 24 hours

Did You Know?

The baby's brain is now growing faster than any other organ. It is forming new nerve cells at an extraordinary rate — approximately 100,000 per minute!
The heart already has four chambers and beats at about 100–120 times per minute. That is almost twice as fast as your own heart.
Your baby is now in a C-shape resembling a tiny shrimp. This shape results from the brain and spine developing faster than the rest of the body.
People with strong morning sickness can take comfort in knowing that nausea is associated with a lower risk of miscarriage. It is the body's signal that the hormones are doing their job.
Your blood volume has already started increasing. Over the course of pregnancy, total blood volume will increase by approximately 50 percent to supply the baby with enough oxygen and nutrients.

Frequently Asked Questions About Week 6

Are mood swings normal?

Yes, mood swings are very common in early pregnancy. They are caused mainly by the powerful hormonal changes occurring in your body, especially rising levels of progesterone and estrogen. You may experience going from laughter to tears in moments. This usually settles somewhat in the second trimester.

Can I have sex during pregnancy?

Sex is safe for most people throughout pregnancy. The baby is well protected by amniotic fluid and the cervix. Neither orgasm nor penetration harms the baby. However, talk to your doctor if you have had bleeding, placental problems, or are at risk of preterm labor.

Why is my sense of smell so much stronger?

Heightened sense of smell is a common pregnancy symptom, likely caused by increased estrogen levels. Many pregnant people find that smells they previously found neutral suddenly trigger nausea. This is probably an evolutionary protective mechanism helping you avoid potentially harmful foods. Heightened smell sensitivity usually eases in the second trimester.

When will I have my first prenatal appointment?

The first prenatal appointment is usually between weeks 8 and 12. At this appointment you meet your doctor or midwife, who takes blood tests, measures blood pressure, and gives you information about the pregnancy. First trimester screening (nuchal translucency + blood tests) is offered around weeks 11–14, where the baby is measured and the due date is more accurately calculated.

Should I tell people I am pregnant?

It is a personal choice. Many choose to wait until week 12, after the risk of miscarriage has dropped significantly. Others tell close family and friends early to have support whatever happens. Some choose to tell their employer early if nausea is affecting their ability to work. There is no right or wrong way — do what feels right for you.

What can I do about extreme fatigue?

Fatigue in the first trimester is mainly caused by high progesterone levels. Your body is using enormous energy to build the placenta and support the baby's rapid development. Make sure you get enough sleep (most people need more than usual), take short rest breaks during the day, eat nourishing food at regular intervals, and do not be afraid to ask for help with daily tasks. This fatigue usually eases in the second trimester, when many experience a new burst of energy.

Is it safe to take pain relief for headaches during pregnancy?

Paracetamol (acetaminophen) is the safest pain reliever in pregnancy. Use the lowest possible dose for the shortest time needed. Avoid ibuprofen and other NSAIDs, especially after week 20. Aspirin should also not be used unless recommended by your doctor. Talk to your doctor or pharmacist if you are unsure.

What is first trimester screening and should I have it?

First trimester screening (commonly called nuchal translucency screening or combined screening) is offered to pregnant people around weeks 11–14. It assesses the risk of chromosomal conditions such as trisomy 21 (Down syndrome), trisomy 18, and trisomy 13. The test is voluntary and consists of an ultrasound that measures the fluid at the back of the baby's neck, combined with a blood test. The result gives a risk estimate, not a definitive answer.

Is it normal to have pain in the lower abdomen?

Mild twinges, cramps, and pulling in the lower abdomen are common in early pregnancy and occur because the uterus is growing and ligaments are stretching. These pains are usually brief and mild. Contact your doctor if you have severe, persistent, or one-sided pain, or if pain is accompanied by bleeding.

Next week: Fingers and toes begin to form, and the baby grows to the size of a blueberry!