Pregnancy: The living hell

It has always been a fear for me that my birth control pills will fail or the condom will break and as a young women, I would fall pregnant. But what does a pregnancy entail, how can we test for pregnancy and under what circumstances does a pregnancy occur? Lets paint a picture, everyday I walk to t...
It has always been a fear for me that my birth control pills will fail or the condom will break and as a young women, I would fall pregnant. But what does a pregnancy entail, how can we test for pregnancy and under what circumstances does a pregnancy occur? Lets paint a picture, everyday I walk to the local job centre, passing on the way plenty of young mums who look barely old enough to have sex, let alone have a baby. While doing this article, I have found out that an astonishing third of under-16s are sexually active and half of under-16s and a third of 16-19s use no contraception the first time they have sex.

So, how does Conception occur?!

Conception occurs when the human egg and sperm unite, usually occurring in the ampulla of the fallopian tube.


There is a specific sequence of events that occurs in conception:

• The sperm passes through the corona radiata, the outermost cell layer of the egg.



• The sperm breaks through the zona pellucida.



• This occurs with the aid of several enzymes possessed by the sperm that break down the proteins of the zona pellucida, the most important one being acrosin.



• When the sperm penetrates the zona pellucida, the Acrosome reaction occurs. This makes the egg impermeable to any other sperms and prevents fertilization by more than one sperm.



• The cell membranes of the egg and sperm fuse together.



• The female egg, also called a secondary oocyte at this stage, completes its second meiotic division. This results in a mature ovum.



• The sperm's tail and mitochondria degenerate with the formation of the male pronucleus. This is why all mitochondria in humans are of maternal origin.



• The male and female pro-nuclei fuse to form a new nucleus that is a combination of the genetic material from both the sperm and egg.

At this point it is important to remember that a man does release sperm during pre-ejaculate (pre-cum) and that it CAN get you pregnant, so precautions must be used!

Now, what are the symptoms of a pregnancy?!

This is a favorite question of everyone who is trying to get pregnant and a good question. There are many signs and symptoms of pregnancy of which I'll try to cover a lot of them here.

Missed Period

This is probably one of the more reliable signs of pregnancy. Although some women will experience implantation bleeding about the time of their period, it is usually lighter and/or shorter than their normal period. This is why you are asked for the first day of your last normal period.





There are even a few women who will have period throughout their pregnancy, although this is rare, it does happen.

If you've been planning for pregnancy, the day that you expect your period is probably well marked in your mind. It is the official day that you can take a home pregnancy test. These tests measure the levels of hCG (hormone secreted during pregnancy) in your urine.

The amount of urine each test can detect varies widely. The amount of hormone each woman secret may also vary, but not as widely. The better tests on the market will measure 25-50 mIUs of hCG, which is usually the amount found in urine between the 4th and 5th weeks of pregnancy. The levels of hCG in your urine and blood will be different.

First morning urine will always contain the highest concentration of hCG. However, most tests do not require that you use first morning urine. You can help better your chances of having enough hCG in your urine by waiting four hours after you last urinated to take the test. This will allow hCG to build up in your urine.

These tests rarely give false results. A negative answer that is later revealed to be a pregnancy is usually the result of the test being performed too early. A positive that later turns out the woman is not pregnant is usually a very early miscarriage. Talk to your practitioner if you have questions about your pregnancy tests and consider calling the toll-free number provided by the test manufacturer. Blood tests are the most accurate and can be performed 7-10 days post-ovulation.

NOTE: There are two types of home pregnancy tests:

1. being the first response pregnancy test, in which you can take up to five days before your period



2. being the normal pregnancy test which you take one the 1st day of your (missed) period.

Morning Sickness

This lovely affliction affects many pregnant women, but by no means all. It's estimated that only 50% of women will experience morning sickness. It is not very well named either. Any variation of sickness is applicable. Some women are sick only in the night, some are sick all day, other women it comes and goes with its own pattern. There is also a difference in whether it's merely a queasy feeling or actual vomiting. Some women will actually have a severe form of morning sickness called hyperemesis gravidarum. This can lead to dehydration and other problems.

Breast Soreness

Ouch! Don't touch that! Breast tenderness is experienced by many women, both during pregnancy and prior to their periods. This usually goes away during the second trimester, or it may be experienced as a heighten sensitivity.

This can be a good thing for some women. Or you can do what many people do: poke your breasts so often to check for tenderness that you can't decide if you caused the tenderness or not.

Headaches

Headaches are more common in pregnancy due to the changes in hormones. This may be a pregnancy symptom, but it is not necessarily a pregnancy sign. There are many things that could cause this, including stress.

Bloating

Some women do begin to bloat nearly immediately. Again, this is a symptom of pregnancy, but not necessarily a sign. There are also women who will have bloating prior to a period.

Vaginal Discharge

Vaginal discharge, without itching or burning, may be a sign of pregnancy. The cervix is building your mucous plug to block the opening of the cervix to help protect your baby from infections, etc. You might notice a slight increase in vaginal secretions. Again, it's shouldn't smell, burn or itch. These would be signs of infection that would require proper medical treatment.

Sorting it all out

As I said before some women will sail through pregnancy with never a problem, while others seem to have it all. There are many things you can do to ease these symptoms of early pregnancy (and the later ones too!). Most of these will disappear by the early portion of your second trimester. The only time you should be concerned about disappearing symptoms is when they suddenly stop before the 10th week of pregnancy. This may be nothing, or it could indicate a problem with the pregnancy.

Hang in there!

So, When to Seek Medical Care

If a woman suspects that she is pregnant or has a positive home pregnancy test, she should make an appointment with a health care provider, which could be a doctor, an obstetrician (women's health specialist), a midwife, or a nurse practitioner. Early care (prenatal care) is essential for a healthy pregnancy.

A woman who is pregnant should call her health care provider if any of the following conditions develop:

• Abdominal or vaginal pain



• Bright red vaginal bleeding



• Vomiting more than 3 times a day or vomiting blood



• Severely elevated blood pressure (above 140/90)



• Sudden and rapid weight gain



• Severe headache or changes in vision



• Severe leg or chest pain

Pregnant women should seek care in a hospital's emergency department if pregnant and experiencing any of these conditions:

• Vaginal bleeding through more than 1 pad per hour



• Having severe pain in the abdomen or shoulder or the sensation of being about to pass out



• Passing pink, gray, or white material from the vagina that does not look like a blood clot (The woman who is pregnant should take the material to the hospital.)



• Having a bloody discharge or gush of water from the vagina late in pregnancy (The woman who is pregnant may be going into labor.)



• Having a seizure but without a history of epilepsy (This may indicate eclampsia, a complication of pregnancy.)



• Having an injury, such as a fall, a blow to the stomach or pelvis, or a car accident

Lower abdominal pain late in pregnancy may be labor pains, which are contractions of the uterus. The woman may try to drink a quart of water, lie on her side, and see if the symptoms resolve over two hours. If the symptoms do not resolve, she should see a doctor.

Tests and exams

As a women, I am very wary of what tests and exams I have done, mainly through fear. So I thought it was a good idea as a midwife myself, if I documented what exams and tests will be carried out by a midwife, doctor, Obstetrics or Gynaecologist.

Pregnancy tests: The woman%26rsquo;s urine or blood may be tested.

If a woman%26rsquo;s period is late, she may use a home pregnancy test. This is a urine test kit that can be purchased at a pharmacy or grocery store. The test can indicate whether a woman is pregnant. This type of test is known as a qualitative test. It can only test yes or no for the pregnancy hormone, beta-hCG. If a doctor is considering prescribing a medication that might not be appropriate to take during pregnancy, one of these simple tests may be performed in the office to determine if a woman is pregnant or to make sure she is not pregnant. If the test is performed very early in a pregnancy, the hormone level may still be negative. Some home pregnancy tests might not show positive results until 7-10 days after a missed period.

More sophisticated tests are called quantitative because they measure hCG levels in the blood. This type of testing is completed by drawing blood for testing at a hospital or doctor%26rsquo;s office. These levels indicate how far along a woman is in her pregnancy. If levels of hCG do not rise as she progresses in her pregnancy, it could indicate something is wrong (such as an ectopic pregnancy with low levels) or surprising (high levels may indicate twins).

Ultrasound: A doctor may use sound waves to examine the internal structures such as the uterus, ovaries, and the embryo or fetus.

Transabdominal ultrasound: A jelly is put on the abdomen, and a hand-held sound-wave wand is moved around to look at the internal structures. The woman%26rsquo;s bladder must be full to help transmit the sound waves, so she may be asked to drink 2-3 glasses of water starting an hour before the test. This method works best later in pregnancy when the fetus is well developed. The doctor may have a scan performed during the first trimester to make sure the pregnancy is in the uterus and not outside it (ectopic pregnancy) and to assess the woman%26rsquo;s risk for having a miscarriage. The scan can also tell if more than one fetus is developing. During the remainder of the pregnancy, scans may be used to look for problems, assess the age and development of the fetus, check out its position, and, by 17 weeks, determine the sex. There is no risk to the woman or her developing fetus with ultrasound, and it is not uncomfortable. Ultrasounds help doctors establish the due date. Due dates can now be predicted within 2-4 days.

Endovaginal or transvaginal ultrasound: A long, thin, sound-wave wand is covered with a condom and put inside the vagina. This type of ultrasound is usually performed early in pregnancy to make sure that the embryo or fetus is inside the uterus where it belongs. This type of ultrasound also gives more detail, for instance, about the structure of the woman%26rsquo;s cervix and the early embryonic anatomy.

Blood tests:

• Blood type, Rh status, and antibody test



• Thyroid test



• Urine culture



• Sickle cell screening if of African American heritage



• Syphilis tests, HIV test, and tests for hepatitis B



• Alpha fetoprotein tests

Culture tests:

• Gonorrhea culture (GC) and chlamydia culture



• Group B streptococcal test by 35 weeks



• Test for bacterial vaginosis (BV), an infection in the vagina, if the woman has vaginal discharge

The specialist will perform internal examinations too, these are not painful but may be a little uncomfortable.

Last words:

Dear Reader,

During my training I have seen a lot of women come and go with gorgeous babies, but a baby is not just something that will fix your relationship, help give you stability or any other reason. I have seen a lot of young girls who have a baby now, scared stiff about what their outlook holds for them. Think before you bring a child into world, will you be able to cope?! If not, protect yourself!!

All the best,

Keekee