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Pregnancy
Pregnancy
is the nine-month process in which a baby develops inside a woman's womb
or uterus. Pregnancy results from intercourse or from in vitro
fertilization when a sperm from the male penetrates the woman's ovum or
egg when it has been released from one of her ovaries.
This process is called fertilization and the resulting cell is called a
zygote. The zygote undergoes cell division and keeps dividing as it
passes through the Fallopian tube and is implanted in the uterus. This
occurs in about one week's time and the implanted ball of eight cells is
then called a blastocyst. With the blastocyst implanted in the
endometrium of the uterine
wall, the woman may be said to have conceived and to be pregnant.
The endometrium provides the fertilized egg with a natural nesting place
and immediate nutrition. Also at this time, the placenta - a very
important exchange and filtering system - begins to develop between
mother and baby. Oxygen and nourishment from the mother's blood are
filtered through the placenta to the baby, and waste products from the
child are returned to the mother through the placenta. The baby and the
placenta are connected by the umbilical cord.
A few days after
conception, a transparent sheath called the amniotic sac begins to grow
around the baby. The amniotic sac fills with special fluid, which acts
as a cushion to keep the developing baby safe from outside bounces and
shocks. Each day the fluid in the sac is exchanged for new fluid in a
continual replacement system. Typically, just before the birth of the
baby the sac breaks, releasing about a quart of water through the
vagina. When the amniotic sac releases the fluid, it is said the woman's
"water broke" and the birth of the baby, its passage from
inside the mother out into the world, is imminent. In a normal pregnancy
this usually occurs in the ninth month.
Pregnancy is divided into
three-month periods, called trimesters. The first trimester is the
first, second, and third months of pregnancy; the second trimester is
the fourth, fifth and sixth months; and the third and last trimester is
the seventh, eight, and ninth months. Despite the woman's unchanged
external appearance during the first trimester of pregnancy, many
important developments are taking place within her body. By the end of
the first month, the developing embryo is about one-tenth of an inch
long, has a beating heart, has the beginnings of a head, spinal cord,
nervous system, lungs and the buds of arms and legs. During this phase
of critical development the embryo is particularly sensitive to
influences which could cross the placenta, such as drugs (including
alcohol) or certain infections.
During the second and
third months of the first trimester the embryo continues to develop such
features as bone cells, eyes, ears, nose, fingers, feet and toes. The
refinement of body parts also includes teeth sockets, and the beginning
of fingernails. The budding of the clitoris, and the budding of the
penis and scrotum are also taking place during the second month, but the
sexual organs are not refined enough to distinguish as male or female
until sometime in the third month. The extraordinary process of creation
continues day after day, yet the fetus, as it is called at eight weeks,
is still only two to four inches long and weighs less than one ounce.
But it is already looking unmistakably human.
During the second
trimester the major body systems and organs are still being refined.
Facial features are molded, eyebrows and eyelashes begin to appear and
the eyelids can open and close. Facial expressions, such as frowning,
lips that open and close and turning of the head begin to appear, but it
is not clear that these gestures can be interpreted to mean anything.
The skin of the fetus is very thin and transparent, clearly showing the
blood vessels lying just below. Roughly halfway through pregnancy,
muscles have developed enough to allow the fetus to move its arms and
legs. This is the time when a woman begins to notice the first fluttery
fetal movements, a stage termed "quickening". During the
second trimester, the heartbeat of the fetus can be heard with a
stethoscope and the fetus will grow rapidly, reaching approximately 2
pounds in weight and 14 inches in length.
During the third
trimester it is typical for the fetus to toss and kick quite a bit,
making its presence obvious to the mother. These movements are a sign
that the nerve fibers of the fetus are developing properly. They are
necessary for muscular and skeletal growth, and for the development of
fine motor ability. In the seventh month and the first part of the
eighth the fetus gains weight and grows tremendously. It generally
triples in weight and increases in length by 5 or 6 inches. The
expectant mother's abdomen becomes exceedingly large toward the end of
pregnancy and may cause some back pain and frequent urination due to the
fetus applying pressure to the mother's bladder. In the eighth and ninth
months the baby's organs and structures are developed enough to function
on their own. During the final month of pregnancy the baby, who has been
in an upright position, gradually turns completely over until its head
is pointing downward. It is then ready to be born, as soon as
contractions of the uterus begin to push the baby out through the
vaginal canal and into the waiting world.
Sometimes complications
arise during pregnancy. One common complication is miscarriage.
Miscarriage is the spontaneous separation and discharge through the
vagina of a developing fetus before it is ready to be born. Miscarriage
seems to be the body's natural solution to a pregnancy that is not
developing properly. Most miscarriages occur early in the first
trimester and it is estimated that about 20 percent of all pregnancies
end in miscarriage.
Early miscarriages are
usually not physically painful. The main signs are cramping and
bleeding, much like a heavy menstrual flow. Medical care following an
early miscarriage is recommended in order to insure that all of the
fetal tissue is removed form the woman's body. Because there is a risk
of infection if some tissue remains, a doctor may suggest a procedure
called dilation and curettage (D&C) to remove it.
It is estimated that 75
percent of all miscarriages occur during the first trimester of
pregnancy. The remainder occurs in the second trimester. Any fetus
passed out of the body after the end of the second trimester (24th week)
is called a premature birth. Signs of second trimester miscarriage are
severe, labor-like cramps and heavy bleeding followed by the discharge
of the developing fetus. Medical attention is required to be certain
that all fetal tissue has passed out of the body.
Generally an egg and
sperm dividing or implanting improperly cause miscarriages. Sometimes a
woman's hormonal level is lower than necessary, causing the lining of
the uterus to weaken and to become unable to hold a fertilized egg.
Often, however, the exact cause of miscarriage remains unknown. In the
majority of cases, having a miscarriage does not affect a woman's
ability to get pregnant again. Miscarriage at any stage of pregnancy can
be an emotionally difficult experience for couples. It is very common to
experience sadness, depression, and a sense of loss as a couple's
feelings of joy and hope about the pregnancy turn to loss, grief, and
often feelings of blame and guilt. Providing each other with support or
seeking support from other couples who have experienced a miscarriage,
or from a professional, are healthy ways to help work through the
feelings resulting from experiencing a miscarriage.
Another pregnancy
complication is an ectopic pregnancy. An ectopic pregnancy is the growth
of the fertilized egg outside the uterus. They usually occur in a
Fallopian tube (which is why they are referred to as a "tubal
pregnancy"). On rare occasion a fertilized egg can implant in a
woman's abdomen, in an ovary, or in the cervix. Ectopic pregnancies
result in the death of the fetus and can be fatal to the mother as well.
They may cause sudden bursting of the Fallopian tube, massive internal
bleeding, sharp pain and weakness resulting from the loss of blood.
These problems typically occur late in the first trimester, usually
between the eighth and twelfth weeks. An ectopic pregnancy may show as a
"positive pregnancy test" and a physician may not see any
early signs of abnormality when examining the woman. Typical signs of
ectopic pregnancy are pain and cramping on the lower right or left side
of the abdomen, bleeding through the vagina, weakness, dizziness or
fainting (signs of internal bleeding) and a regular period, even after a
pregnancy has been detected. If any of these signs appear, a
non-intrusive ultrasound examination can show whether the fetus is
growing in the uterus or elsewhere. Surgery is usually performed as soon
as the condition is diagnosed to avoid the possible bursting of a
Fallopian tube and heavy bleeding that can seriously harm the mother.
Intervention generally involves the removal of the burst Fallopian tube,
though sometimes the tube can be repaired. After such surgery a woman
can still become pregnant, but her chances will be reduced by the
absence of one tube. Also, a woman's chances of having another ectopic
pregnancy increase after having one such pregnancy.
Toxemia is another
relatively common pregnancy complication. Also known as pre-eclampsia,
toxemia is a condition that occurs in some women during the fifth or
sixth month of pregnancy. The exact cause of toxemia is not certain, but
many doctors believe poor nutrition is a large contributor. Symptoms of
toxemia include weight gain and rising blood pressure, then swelling of
the hands and ankles due to water retention, abdominal pain, headache
and poor vision. Toxemia affects the developing baby because the
placenta does not do its job properly, resulting in a smaller baby,
premature delivery or delivery by caesarian. Toxemia can be managed
through rest and a properly balanced diet with the avoidance of excess
salt. Toxemia must be treated and monitored by a physician because if
left unchecked it could lead to the death of the fetus and even the
mother.
Pregnancy can be both a
scary and a joyous time for a woman and her partner. The changes that
pregnancy brings are not only physical but deeply emotional. Depending
on the circumstances of the pregnancy (whether it is wanted or not), it
may bring up feelings of confusion, denial or anger; or it may lead to
emotional growth, maturity and a special feeling of completeness,
despite periods of moodiness and feeling low that accompany many
pregnancies.
It is not uncommon for
pregnant women to feel unhappy about the changes in their bodies as
pregnancy progresses. Nor is it unheard of for men to feel jealous,
neglected and resentful of the great amount of attention and interest
their wives receive during pregnancy. With good communication and a
loving relationship these feelings usually pass without leaving a
residue of major problems about the self or the marriage. The powerful
feelings aroused in both women and men as a result of pregnancy may
result in a change in their relationship. For some it may be an unhappy
change, particularly if an unplanned pregnancy affects finances, living
space, employment or responsibilities. The stress may be felt by one
partner or by both and resolution should be attempted via communication,
honesty, and working at adjusting together throughout the pregnancy.
In many cases pregnancy
brings a couple closer together. The excitement of becoming a family
together and the anticipation of being a mother or a father may create a
different sense of responsibility toward each other and foster a level
of love and warmth not previously experienced.
Pregnancy often has an
influence on a couple's sexual activity, although it has no uniform
effect on sexual feelings or function. Some women find that pregnancy is
a time of heightened sexual awareness and pleasure, whereas others
notice no change or a decline in sexual feelings. Variations in sexual
functioning are also found during different stages of pregnancy. Not
surprisingly, women with morning sickness and high levels of fatigue
during the first trimester often have neither the interest nor the
energy to be sexually active. The second trimester is a time when women
may notice heightened sexuality both in terms of desire and physical
response. In the last trimester some couples find that a bulging belly
makes sexual intercourse difficult; for others adjustments in sexual
positions or non-coital sex solves this problem. Some couples agree to
voluntarily abstain from sexual activity near the end of pregnancy
because of concern about injuring the baby. Though there is usually
little danger of injuring the fetus or the mother, it is best to follow
the advice of a doctor who has been treating the woman throughout her
pregnancy regarding safe sexual practices at all stages of pregnancy.
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Sex
