Sexual Health and Pregnancy
Conception
Conception happens when the sperm from the man combine with the egg from the woman. This usually can occur if a couple has unprotected vaginal intercourse, especially in the several days before the woman ovulates. To prevent conception, birth control methods should be used, such as condoms and hormonal contraceptives. Even if the man does not ejaculate inside the vaginal canal, semen that contacts the outside of the vulva can be pulled inside to fertilize an egg. For this reason, it is possible (although unlikely) for a couple to conceive without having any vaginal intercourse: semen that comes in contact with the vagina can cause conception anyway.
If a couple wants to conceive, they should have unprotected vaginal intercourse, and neither partner should be on hormonal contraceptives. Learning a fertility awareness method, or using devices called Ovulation Predictor Kits (OPKs), may help couples know to have intercourse on the woman’s most fertile days. If you and your partner want to conceive a baby, it is important to consult a doctor to talk about the various risk factors involved in pregnancy. It isn’t common, but a woman can suffer severe physical problems and even death from an unhealthy pregnancy.
Parenthood
Having a baby is a big deal, and couples should not attempt to conceive without talking about the consequences. A baby requires a lot of effort and patience, and it is a big responsibility to take care of a newborn baby.
Having a baby before high school graduation increases a person’s risk of dropping out of school, having a lower-than-average income, and needing government assistence or charity services. In addition, children born to teenage parents are at higher risk of committing crimes and going to jail.
Know if you are pregnant
It is important to know if you are pregnant or not. Women commonly suspect they are pregnant if they do not get an expected period. During pregnancy, the normal menstral cycle ceases, and women will not menstrate again until after the pregnancy is over.
Modern over-the-counter pregnancy tests are just as accurate as tests at a doctor’s office. Pregnancy tests become accurate between one and three weeks after the last act of intercourse (or other sexual contact in which semen came near the woman’s vagina). There are two reasons for this delay. First, sperm can live for up to five days before fertilizing an egg. Thus, a woman may have sex on Monday and not become pregnant until Friday. Second, a newly created embryo does not implant in the woman’s uterus until six to twelve days after fertilization. Before implantation, there is no method available to detect pregnancy.
Many women occasionally have longer menstrual cycles („late periods”) without being pregnant. Stress will delay ovulation, and menstruation does not happen until about two weeks after ovulation. Women who frequently have longer menstrual cycles may worry needlessly about being pregnant. These women may benefit from fertility awareness, which allows them to predict the length of even irregular cycles.
Prenatal Care: The medical care that you get for yourself and your baby while you are pregnant
If you are pregnant, it is important that you see a doctor. Pregnant women should receive prenatal care, to protect their own health, and the health of their unborn babies. Pregnant women have different nutritional needs from non-pregnant women.
Women who take folic acid supplements before becoming pregnant significantly lower the risk of certain birth defects. As half of pregnancies in the United States are unplanned, all sexually active women should take folic acid supplements.
Stages of Pregnancy
Pregnancy begins with fertilization, when the sperm from the man join with the egg from a woman. Fertilization, also called conception, occurs in the fallopian tubes, and the newly created embryo will continue to develop in the fallopian tubes for several days. Six to twelve days after fertilization, the embryo will embed itself into the uterine wall, where it will begin secreting hormones that can be detected by pregnancy tests. Because pregnancy cannot be detected before implantation, some groups define conception, the beginning of pregnancy, as the time of implantation.
Doctors count the beginning of pregnancy as the first day of the woman’s last menstrual period (LMP). Because ovulation happen on average two weeks after menstruation, a newly created embryo is already two weeks old! It is normal and common for ovulation to happen earlier or later in the menstrual cycle, however, so often age estimates based on LMP will be wrong. Sometimes doctors will do an ultrasound of an early pregnancy to estimate its age (based on size of the embryo). This measurement is more accurate than calculation from a woman’s LMP.
Development of all major proto-organs is complete seven weeks after fertilization, about nine weeks LMP. At this point, the embryo is called a fetus. The fetus continues to develop until the end of pregnancy.
The average pregnancy lasts 40 weeks from a woman’s last menstrual period (this would be 38 weeks from fertilization). Pregnancy lengths of between 38 and 42 weeks are considered normal. Any baby born before 38 weeks is considered premature, and is at increased risk for health problems. Pregnant women should ask their doctor to describe the symptoms of premature labor, and should call their doctor or go to the hospital if they are worried they might be in premature labor.
Miscarriage
Over 25% of pregnancies end in miscarriage, almost all in the first trimester. Some of these miscarriages may occur without a woman ever knowing she is pregnant. While there are medical treatments for later-term pregnancies that threaten to miscarry, there are no known treatments for early miscarriages. It is believed that most early miscarriages are caused by chromosomal defects in the embryo or fetus.
Sometimes a miscarriage is 'incomplete', meaning some embryonic or fetal tissue is left inside the woman. This tissue can become infected, which is a serious health concern for the woman. Women who know they have miscarried should be monitored by a doctor to verify that the miscarriage was complete. The doctor might make sure the levels of pregnancy hormone (hCG) in the woman’s blood have dropped. An ultrasound could also be performed to see that the woman’s uterus was empty. Even if the doctor is not concerned about infection, the woman may want to finish the process of miscarriage without waiting the weeks it sometimes takes to occur naturally. A procedure called Dilation and Cutterage (D&C) may be used to remove the contents of the uterus.
Childbirth
Type
There are two ways to deliver a baby: vaginally and by C-section. Vaginal birth is where the baby is pushed out the woman’s vagina. C-section is where an incision is made in the woman’s abdomen, and surgeons pull the baby out.
The average woman will recover from a vaginal birth about three times faster than from a C-section. A C-section is major abdominal surgery, and like all surgeries, it carries risks such as infection and blood loss.
In case of delivery complications, however, C-sections can be lifesaving to both mother and baby.
Location
Most women deliver their babies in a hospital. Hospitals have the most up-to-date technology and have surgical teams available to deliver babies by C-section if necessary.
Women may also deliver in a birth center. These centers tend to provide more support for women seeking to avoid medical interventions (such as drugs for pain control). Many birth centers are attached to hospitals, so the resources of the hospital are readily available in case of complications.
Depending on the state they live in, women may also be able to find a medical care provider that will attend a birth at their home. Some women who plan to birth at home will transfer to a hospital to receive pain medicines or for other medical assistance. Studies of planned homebirths in low-risk pregnancies have shown that they are just as safe as planned hospital births.
Pregnancy Difficulties
Health risks
Pregnancy has many possible complications, including pre-eclampsia, gestational diabetes, and blood clots. These conditions pose risks to both the woman and the baby, and are why it is important that pregnant women receive pre-natal care.
Morning Sickness
During pregnancy, especially in the first trimester, women are often nauseous and may throw up. While this condition is called 'morning' sickness, it may occur at any time of day.
Eating frequent small meals and snacks may help reduce the severity of morning sickness. In extreme cases, IV fluids and anti-nausea drugs may be needed to protect the woman’s health.
Ectopic Pregnancy
An ectopic pregnancy occurs when an embryo implants in a location other than the uterus. Most commonly, this is in a fallopian tube (a „tubal pregnancy”), but embryos may also implant in the abdominal cavity. Tubal pregnancies, if allowed to continue, will burst and threaten the woman’s life due to internal bleeding.
Multiple Births
Sometimes a woman can be pregnant with more then one child at a time. 2 fetuses are called „twins”, 3 are called „triplets”, and 4 are called „quadruplets”. If the fetuses are identical, it means that they are split from a single fertilized egg, and therefore have the same DNA. Fetuses that are fraternal are the result of multiple eggs that were released simultaneously, and each fertilized by different sperm.
Couples who are having difficulty conceiving a child may resort to fertility treatments. Fertility treatments known as injectables can cause many eggs to be released, and therefore create the potential for multiple births. If in vitro fertilization is used, the woman and her doctor might choose to place many embryos into the woman’s uterus. It is not unheard of for a couple on such treatments to have groups of 5 babies or more simultaneously, although couples are offered selective reduction (abortion of one or more fetuses to decrease health risks to the remaining fetuses) for any pregnancy higher than twin.
Adoption
A couple may decide it is not in their best interest, or in the interest of their child, to raise a baby. These couples may choose to put their baby up for adoption. In an adoption, the birth parents give their child to another couple. Adoption is considered one of the three options (in addition to abortion or raising a child) available to women and couples who experience unplanned or unwanted pregnancy.
Couples who cannot have children themselves often consider adopting a child or children. Also, couples who have a child or children of their own may want to help other children through adoption. Single people may also choose to grow their family through adoption.
Adoption may be done through a government agency, a private agency, or through a „private adoption.” Government and private agencies require single people or couples considering adoption to go through a homestudy, where a caseworker evaluates their ability to parent a child. Government agencies typically handle adoption cases where the child was abandoned or removed from the parents due to abuse or neglect. Private agencies typically handle adoption cases where the birthparents choose to give their child up for adoption. In countries where private adoption is legal, the birthparents choose a couple to adopt their child without any formal evaluation process.
Abortion
Women may decide it is not in their best interest to continue the pregnancy. Abortion means a doctor helps a woman end the pregnancy, which kills the developing embryo or fetus. Abortion may not be legal in all juridictions, and aborting a pregnancy at certain times in the pregnancy might be illegal as well.
Text is available under the terms of the GNU Free Documentation License from Wikibooks
