Pregnancy

How pregnancy occurs?
Conception begins with fertilisation and ends with implantation. If the sperm meet the egg a pregnancy can occur. Sperm can wait in the cervix, uterus, and Fallopian tube until ovulation. As part of the menstrual cycle, the ovary releases the egg, which travels to the Fallopian tube. There the egg can be fertilised by the sperm. The egg only lives for 24 hours. Only one sperm attaches and is able to enter the egg. Once the sperm is fully inside the egg, fertilisation has taken place. The fertilised egg travels down to the uterus and settles there until it attaches itself to the thick lining. Now implantation is completed, and pregnancy begins. The time from ovulation to implantation may take from 5 to 10 days. Once pregnancy starts, the hormone human chorionic ganothropin (hCG) is produced (this will mark on your pregnancy test if you are pregnant). If the pregnancy develops in the Fallopian tubes or outside the uterus, an ectopic pregnancy occurs. This requires immediate medical attention.

Several changes in the body happen so that the baby is accommodated in the womb, such as an increase in hormone levels and in womb lining, and hence increased blood supply. With higher hormone levels, the pregnant person may feel more emotional and irritable than usual.

Every sperm and egg contain 23 pairs of chromosomes, and when joined they produce a human being containing 46 chromosomes. Chromosomes contain genes which carry the baby's sex, hair, eye and skin colour and other characteristics. The father's sex chromosome may be either X or Y, but the mother's chromosomes are always XX. Thus, it is the father that determines the sex of the baby. If the chromosomes are XY, it is a 'Male', but if the chromosomes are XX, it is a 'Female'.

Signs of pregnancy:

  • Missing a period
  • Morning sickness
  • Nausea
  • Vomiting at any time of day or night
  • Feeling more tired than usual
  • Larger or more tender breasts, tingling sensations
  • More frequent urination, even during the night
  • Craving for specific food items
  • More vaginal mucus
  • Loss of interest in tobacco or specific foods
  • Increased sense of smell

If you think you are pregnant talk to your doctor and carry out a pregnancy test.

Pre-pregnancy care
Prior to getting pregnant one should ensure that the person is in optimal health. This includes:

  • Quitting smoking: smoking affects hormone levels, making it difficult to conceive. Furthermore, it can harm the foetus.
  • Not drinking alcohol: alcohol can increase the risk of miscarriage and effect foetal development. It can also decrease fertility if taken in excessive quantities.
  • Maintaining a well-balanced diet
  • Folic acid or iron supplements
  • Being vaccinated for Rubella and HPV
  • Reducing caffeine intake


Sex during pregnancy
One can continue to have sex during pregnancy, unless it is a multiple pregnancy (i.e. expecting more than one child), has a history of premature delivery, or if any of the following symptoms are occurring:

  • Vaginal bleeding
  • Placenta praevia (the placenta develops low in the uterus, blocking the cervix)
  • Premature dilatation of the cervix
  • Rupture of the membranes

Apart from fatigue and back pain, a number of other complications may arise that make sex difficult during pregnancy:

  • Genital pain
  • Reduced lubrication
  • Urinary tract infections
  • Retroverted uterus, particularly in the first weeks of pregnancy
  • Candida and trichomoniases infections
  • Haemorrhoids
  • Incontinence
  • Vulval varicose veins
  • Deep engagement of foetal head during the later stages of pregnancy

One might also experience a decrease in sex drive and a lack of arousal, as well as concerns over body-image.

Sex after pregnancy
After childbirth, you may experience the following:

  • Vaginal laxity (the vagina may feel looser)
  • Dryness in the vagina
  • Soreness
  • Stitches due to tears during childbirth
  • Pain during sex


Dryness in the vagina:
Due to low oestrogen level the vagina may be dryer. For those who are breastfeeding the hormone levels are lower and the symptoms may be more pronounced. Once breastfeeding stops, hormone levels return to normal and the symptoms may alleviate themselves. If dryness becomes a problem, talk to your gynaecologist or midwife or else use water-based lubricants as oil-based products can cause a lot of problems. It is important to talk to one's partner/s about the situation to create an understanding environment at home.

Soreness and stitches in the perineum: if tears occurred and stitches were done, it is normal to feel uncomfortable and even pain in the perineum. You can talk to your doctor or midwife on possible ways to alleviate the discomfort or pain especially if you are breastfeeding. Change the sanitary pads regularly and always keep your hands clean before and after.

Pain during sex: Do not rush to have sex after having a baby as it might be uncomfortable or even hurt. You may also feel less interested in having sex as you might be over-tired with caring for your baby and other family members. If you are in a relationship, talk to your partner and share this experience with them. Partners may also be as tired as you are and may be baffled at how they are going to approach the subject of sex. You may also feel loved and happier in other close intimate ways such as kissing, hugging, mutual masturbation or oral sex. In the case of the person who gave birth one should first explore with the hands to reassure oneself that pain or discomfort is not present. This helps both to relax together and focus on each other. If you decide to have sex, try to choose positions where the person who gave birth able to control the rate and depth of penetration. Take your time, however if symptoms persist consult your midwife or doctor.

Careful: Choose a method of contraception appropriate for you if you do not want to get pregnant so soon, if you are not breastfeeding and your periods have not started yet. If you have a suspicion of a Sexually Transmitted Infection get yourself and your partner/s checked as soon as possible. Looking after a baby can be very demanding so rest when you can and look after yourself by eating well and drinking a lot of fluids.