Last week, the neural tube was closing and the very first structure of the heart was beginning to form. This week, that structure beats — visibly, measurably, for the first time. If you have an early scan this week or next, this is what the sonographer will look for: a tiny, rapid flicker at the centre of the embryo. It is beating approximately 100–160 times per minute — twice as fast as your own heart.
This is one of the more remarkable moments in early pregnancy: not because a foetal heartbeat at six weeks is medically significant in the way it will be later, but because it is the first time something externally verifiable is happening. Up until now, pregnancy has been a fact on a test and a collection of sensations. This is the first moment it can be seen.
Beyond the heart, the embryo is growing rapidly. It has doubled in size from last week — from about 4mm to 6mm — and is now roughly the size of a blueberry. The head is disproportionately large relative to the body, which will remain true for most of the pregnancy; the brain is developing so quickly that the skull cannot keep up. Small buds are forming where the arms and legs will be. The face is beginning to differentiate: two small indentations where the eyes will form, and the earliest hint of a nose and mouth.
They scanned me at six weeks because of some bleeding. I was terrified. And then she said 'there's the heartbeat' and showed me this tiny flicker on the screen. I can't explain how disproportionately enormous that felt. This thing the size of a blueberry, with a flickering heart.
One thing worth noting: if you have an early scan at six weeks and no heartbeat is detected, this does not necessarily mean there is a problem. At exactly six weeks, the cardiac activity may not yet be visible on a standard abdominal scan — and even on an internal scan, it is not always detectable this early. A repeat scan one week later will usually clarify the picture. Not seeing a heartbeat at week 6 is not the same as there being no heartbeat.
If week 5 was when symptoms arrived, week 6 is often when they settle in. The nausea that may have started last week is typically peaking somewhere between weeks 6 and 8 — so if you are deep in it right now, you are very likely at or near the worst of it. That is not a cheerful thing to say, but it is useful to know: this is probably the hardest it gets.
Everything described last week — the fatigue, the smell sensitivity, the nausea, the frequent urination — continues this week and may intensify slightly. Rather than repeating what is already happening, it is worth focusing on a few things that are new or changing.
Food aversions may become more specific and intense. A food that was tolerable last week may become impossible this week. The aversions of early pregnancy can feel irrational and absolute — you cannot reason your way past them. Work around them rather than fighting them.
Constipation — progesterone slows the entire digestive system, not just the stomach. Constipation is extremely common from around this point. Staying hydrated, eating fibre, and keeping gently active all help. If it becomes uncomfortable, speak to your GP — some laxatives are safe in pregnancy, and some are not.
Mood fluctuations — the hormonal environment of early pregnancy genuinely affects emotional regulation. If you feel more tearful, irritable, or emotionally labile than usual, this is a physiological effect, not a personal failing. It typically eases as the first trimester ends and hormones stabilise somewhat.
There is one physical experience worth singling out this week that often causes significant anxiety: bleeding or spotting. Light spotting in early pregnancy — particularly around the time your period would have been due, or after sexual intercourse — is common and frequently harmless. It does not automatically indicate miscarriage. However, any bleeding in pregnancy warrants a call to your midwife, GP, or early pregnancy unit for assessment and reassurance. You do not need to wait and see — call.
The emotional landscape of week 6 is, for many people, heavily coloured by physical misery. When you feel genuinely unwell for days on end — nauseous, exhausted, unable to eat the things you want or be around the smells that were previously neutral — it affects everything else. Mood, patience, the ability to feel excited or present or connected to the pregnancy. This is worth acknowledging directly.
Some people find that feeling physically terrible in week 6 actually helps with the abstraction of early pregnancy — the symptoms are so present that the pregnancy cannot be ignored or feel unreal. Others find the opposite: that feeling ill without being able to tell anyone why, while not yet having any visible sign of what's happening, compounds the strangeness of it all. Both are common responses, and neither is the right way to experience this.
I remember lying on the sofa at week six thinking: this is the least glamorous thing I have ever done. I was green. My husband kept offering food I couldn't look at. The idea that I was secretly growing a person felt completely disconnected from how I actually felt, which was just... terrible. It got better. Eventually it got much better.
If you have a scan this week and see a heartbeat, the emotional response can be unexpectedly complex. Some people feel immediate, profound relief and connection. Others feel strangely flat — a kind of anti-climax after so much anticipation. Others feel their anxiety deepen rather than ease, because now there is something to lose. All of these are normal responses to a moment that carries enormous weight.
If you haven't had a scan and won't have one until the 12-week dating scan, the weeks ahead involve holding uncertainty without external confirmation — which is genuinely hard, and genuinely common. The absence of a scan is not a sign anything is wrong; it is simply how the NHS antenatal pathway works for most low-risk pregnancies. If the anxiety feels unmanageable, speak to your GP about whether an early private scan might help.
Week 6 connects directly to several of our full topic guides — each one covers these themes in depth.
Much of what was true last week remains true this week — the fatigue, the food aversions, the need for patience and presence rather than solutions. If you are already doing those things, keep doing them. They matter even when they produce no visible improvement, because there is no visible improvement to produce right now.
The new dimension of week 6 is the possibility of a scan. If you have an early scan together this week — whether planned or following a concern — be prepared for the range of responses it might produce. If the scan shows a heartbeat, your partner's reaction may surprise you. It may not be uncomplicated joy. It may be relief followed immediately by new anxiety. It may be tears that are hard to categorise. Simply being present in whatever follows is the thing.
If the scan does not show a heartbeat, or if it shows something ambiguous requiring a repeat, the next hours and days will be hard. Your role is not to provide certainty (you cannot), nor to immediately problem-solve. It is to be there, to not minimise, and to let the uncertainty be what it is while making clear you are facing it together.
- The food situation may feel relentless by now. It is. Your partner is not being difficult — the aversions are involuntary and exhausting for them too. Keep asking, keep adapting, keep not taking it personally.
- Physical affection may feel unwelcome. Nausea, breast tenderness, and general physical discomfort mean that touch that would normally be welcome might not be. Ask rather than assume.
- If there's an early scan, come. Whether it is reassuring or complicated, being at the first scan together matters — both for sharing the moment if it is good, and for not being alone if it isn't.
If you haven't registered with a GP yet, do it this week. If you have, and you are still waiting to hear from your midwifery team, it is entirely reasonable to call your GP surgery and ask them to confirm the referral has been sent. Booking appointments typically happen between weeks 8 and 12, and you want to be firmly in the system.
The other action worth considering this week, if the nausea has become severe: contact your GP about anti-nausea medication. As noted last week, safe and effective options exist and are frequently not offered unless asked for. If you are losing weight, unable to keep fluids down, or finding the nausea is affecting your ability to work or function — this is a medical symptom that warrants medical treatment. You do not have to simply endure it.
At your booking appointment — which is coming in the next few weeks — this is worth raising early in the conversation:
Early pregnancy units (EPUs) exist across the UK and can offer reassurance scans, particularly for people with a history of miscarriage, bleeding, or significant anxiety. Your GP or midwife can refer you — or in many areas you can self-refer. The existence of these units is not widely enough known, and accessing them is not wasting NHS resources: it is using services that are there precisely for this purpose.