What is Pregnancy? How does one get Pregnant?

Pregnancy (conception/fertilization) most commonly occurs when a spermfertilises an egg by joining with it during sexual intercourse without contraception, (or assisted reproduction).
 
The fertilised egg moves down into the uterus and implants itself into the uterus lining where it begins to grow and develop into anembryo. The embryo grows into a foetus.

Conception only takes place at a particular time of the month in the female during her menstrual cycle.

What are the early symptoms of Pregnancy?

Early symptoms of pregnancy can include:

These symptoms don’t always mean that you are pregnant, so it is best to do a simple pregnancy test.

How do I know I am Pregnant?

Take a Pregnancy Test. This is either a urine or blood test at any laboratory. You can also get a home pregnancy kit from any leading pharmacy in your city.

Procedure to check pregnancy on pregnancy strip:

• Collect the urine specimen in a clean container
• Take out the strip from the foil to use immediately (use the opened strip within one hour)
• Immerse the strip into the urine sample with the arrow end pointing towards the urine. Be sure that the urine level remains below the line marked under the arrow
• Take out the strip after 5 seconds and put away for 5 minutes for the result to appear
• Positive (Pregnancy): Two distinct red bands will appear.
• Negative (No Pregnancy): Only a single red band will appear.
• Invalid: If there is no line or a single faded line, then repeat the test with a new urine sample and strip.
• If the pregnancy test is positive: consult a doctor/gynecologist. If you have concerns or questions regarding your pregnancy test result, or have an unwanted pregnancy call the 24/7 toll free number 0800-22333 or Email :
  onlinedr@srhmatters.org

Sex in Pregnancy

Sex is considered safe during all stages of a normally progressing pregnancy So what exactly is a normally progressing pregnancy? It’s one that’s considered low-risk for complications such as miscarriage or pre-term labor. Talk to your doctor if you’re uncertain about whether you fall into this category.

Many women find that they lose their desire and motivation for sex late in the pregnancy partially because sex becomes uncomfortable as their bodies get larger and partially because they’re preoccupied with the impending delivery and the excitement of becoming a new parent. Also many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy; this is completely normal and happens due to fluctuating hormone levels in their body.

When It’s Not Safe

Two types of sexual behavior are Not safe for any pregnant woman:

1. If you engage in oral sex, your partner should not blow air into your vagina. Blowing air can cause an air embolism (a blockage of a blood vessel by an air bubble), which can be potentially fatal for mother and child.

2. You should not have sex with a partner whose sexual history is unknown to you or who may have a sexually transmitted disease (STD), such as herpes, genital warts, chlamydia, or HIV. If you become infected, the disease may be transmitted to your baby, with potentially dangerous consequences.

Also in the presence of certain complications or risk factors, your doctor would label your pregnancy as high-risk and advise against sexual intercourse. Some of these risk factors include;

• A history or threat of miscarriage
• A history of pre-term labor (you’ve previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)
• Unexplained vaginal bleeding, discharge, or cramping
• Leakage of amniotic fluid (the fluid that surrounds the baby)
• Placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is down so low that it covers the cervix (the opening of the uterus)
• Incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery
• Multiple fetuses (twins, triplets, etc.)

Multiple Pregnancy (more than one fetus):

A pregnancy in which there are more than one fetus is called Multiple Pregnancy.

• Why Multiples?

Several factors contribute to the development of a multiple pregnancy:
Heredity: A history of multiple births on a woman’s side of the family increases her chances of having a multiple pregnancy.
Number of prior pregnancies: Having more than one previous pregnancy, especially a multiple pregnancy, increases the chance of having a multiple pregnancy.
 
Delayed childbearing: Older women who get pregnant are more likely to have multiples.
Infertility treatment: Fertility drugs, which stimulate the ovaries to release multiple eggs, or assisted reproductive technology (ART), which transfers multiple embryos into the womb (such as in vitro fertilization, or IVF), greatly increase a woman’s chance of having a multiple pregnancy.

• The Risks of Multiple Pregnancy?

Following can be the risks involved in a case of multiple pregnancy:

i. Pre-term Labor (Labor beginning before completion of 37 weeks resulting in premature births)

• The premature babies (born before completion of 37 weeks of pregnancy) can have many health challenges especially increased risk of acquiring different infections and malnutrition
• Placental problems such as placenta previa in which case the likelihood of normal vaginal delivery diminishes considerably
• Fetal growth problems
• And finally, the mother who is pregnant with more than one fetus is at higher risk of developing certain pregnancy related medical conditions such as

Pre-eclampsia: High blood pressure during pregnancy which itself is a risk factor for pre-term labor and sometimes miscarriage.

Gestational Diabetes: Diabetes of pregnancy which puts the mother at higher risk of developing permanent diabetes later in her life.

• Avoiding Problems During a Multiple Pregnancy:

Eating properly, getting enough rest, and making regular trips to the doctor are critical measures for any expectant mother to stay healthy. And a woman with a multiple pregnancy might be scheduled for more frequent appointments with her doctor than a woman who is pregnant with a single fetus.

• Nutrition:

As with all expectant mothers, folic acid is extremely important. Taking folic acid 1 month prior to and throughout the first 3 months of pregnancy will decrease the risk of neural tube defects (such as spina bifida, a back bone problem).
 
Another dietary requirement that needs to be increased if you’re expecting more than one baby is protein, which has several important functions. First, proteins serve as the building materials of body tissue. They also act as enzymes that regulate chemical reactions to keep a body growing and functioning. Chicken, fish, meat and pulses are good source of proteins.
 
During pregnancy, an increased supply of iron is also needed for haemoglobin, the substance in red blood cells that binds oxygen for delivery to the tissues. Insufficient iron can lead to a condition known as iron-deficiency anaemia. Anaemia occurs when the number of healthy red blood cells decreases in the body, and is relatively common in multiple pregnancies.
 
Anaemia can cause a decreased appetite and extreme fatigue during a pregnancy, as well as a reduced oxygen supply to the developing babies. Your doctor will probably prescribe an iron supplement, as your requirement for this mineral usually can’t be met by diet alone.
 
Iron is absorbed more easily when combined with foods high in acid, such as yogurt, and those with high amounts of vitamin C, like orange juice.
Additional fetuses also mean an increased need for all other nutrients (such as zinc, copper, vitamin C, and vitamin D). So it’s important to take your prenatal vitamin supplement every day. But just because you’re carrying more than one baby doesn’t mean you should take more than one prenatal vitamin — one is enough and too much can even be harmful.

• Mode of Childbirth:

Although, the chances of caesarean section (C-section) are higher in cases of multiple pregnancy, many women can deliver more than one fetus through normal vaginal delivery. To help you be more comfortable with the birth process as it unfolds, you should also discuss the options of vaginal delivery versus caesarean section (C-section) with your doctor well before your due date.

Labor Pain Management

The intensity of the discomfort during labor varies from woman to woman and birth to birth. Many moms-to-be choose some kind of pain medication to help them cope with labor. If you have any concerns, it is better that you discuss this matter with your doctor during your pregnancy. Following are the available options that you can talk about:

• Systemic pain medications Systemic painkillers such as narcotics dull your pain but don’t completely eliminate it. They are given to you either by mouth or through injections.

Advantages:

• A simple and easier option which doesn’t required an anesthesiologist.
• Does not result in prolongation of labor

Disadvantages:

• Systemic medication can cause a variety of unpleasant side effects, such as drowsiness, dizziness, and disorientation.
• Some of these drugs may also cause nausea and itchiness.
• Systemic pain medication can affect your baby’s heart rate in such a way that your practitioner or labor nurse will have trouble interpreting the results of fetal heart rate monitoring.
• Narcotics sometimes make it harder for your baby to start breathing on his own after birth, particularly if you’ve had multiple doses during your labor or you’re given a relatively large dose within a few hours of delivery.
• Systemic narcotics may make your baby less alert at birth and may cause him to nurse less effectively early on, making your first attempts at breastfeeding more difficult.

Epidural Block:

• Epidural space is located in the lower part of your back just under the skin around your spine. An epidural delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious. Medication is delivered through a catheter, a very thin, flexible, hollow tube that’s inserted into the epidural space.

Advantages:

• An epidural provides a route for very effective pain relief that can be used throughout your labor.
• The anesthesiologist or nurse anesthetist can control the effects by adjusting the type, amount, and strength of the medication.
• Since the effect of the medication is localized, you’ll be awake and alert during labor and birth.
• Unlike with systemic narcotics, only a tiny amount of medication reaches your baby.
• And, because you’re pain-free, you can rest if you want (or even sleep!) as your cervix dilates. As a result, you may have more energy when it is time to push.

Disadvantages:

• An epidural can slow your labor and often makes the pushing stage of labor longer. The loss of sensation in your lower body weakens your bearing-down reflex, which can make it harder for you to push your baby out.
• Having an epidural makes it more likely that you’ll have a vacuum extraction or forceps delivery, which in turn increases your risk for serious lacerations.
• The drugs used in your epidural may temporarily lower your blood pressure, reducing blood flow to your baby, which in turn slows his heart rate.
• Narcotics delivered through an epidural can cause itchiness, particularly in your face. They may also bring on nausea
• An epidural raises your risk of running a fever in labor. No one knows exactly why this happens.
• In one in 100 women, an epidural causes a bad headache that may last for days.

Who can’t have an epidural?

You won’t be able to have an epidural if you have,

• Abnormally low blood pressure (because of bleeding or other problems).
• A bleeding disorder.
• A blood infection.
• A skin infection on the lower back where the needle would enter.
• If you’ve had a previous allergic reaction to local anesthetics.

Spinal block:

A spinal differs from an epidural in two ways: It’s delivered directly into the spinal fluid (and not into the space surrounding your spine), and it’s a one-time injection rather than a continuous feed through a catheter.

Advantages:

• Complete pain relief kicks in after only a few minutes
• In contrast to systemic narcotics, only a tiny amount of medication reaches your baby.

Disadvantages:

• The reduced sensation may make it harder for you to push your baby out, which can make the pushing stage longer
• The drugs may temporarily lower your blood pressure, reducing blood flow to your baby, which in turn slows his heart rate.
• If a narcotic is used, it can cause itchiness, particularly in your face. It may also bring on nausea
• In rare cases, a spinal causes an uncomfortable tingling sensation in your legs or buttocks that lasts a couple of days.
• In one in 100 women, a spinal causes a bad headache that may last for days.

Combined spinal/epidural

A combined spinal/epidural block is a newer technique that offers the rapid pain relief of the spinal block and the continuous relief of the epidural. In early labor, this technique can work like a walking epidural because you rely primarily on the narcotics in the spinal injection for pain relief for the first hour or two (which allows you to continue to walk around). Then you have the epidural to fall back on once the spinal starts to wear off.

How can a woman have a healthy pregnancy?

The key to having a healthy pregnancy is taking good care of your health. See an obstetrician/physician regularly for prenatal visits. Take a balanced diet, with daily prenatal vitamins/supplements.

It has been seen that women who receive regular prenatal care are less likely to have serious problems related to pregnancy and are more likely to deliver healthy babies.