2.7.
PRAGNANCY
Pregnancy is the term used to describe the period in
which a foetus develops inside a woman's womb or uterus.
Pregnancy usually lasts about 40 weeks, or just over 9 months,
as measured from the last menstrual period to delivery. Health
care providers refer to three segments of pregnancy, called
trimesters.
First trimester: (period from fertilization to 12th week)
It is the time of most radical change for both the mother and
embryo.
During its first 2-4 weeks of development, the embryo
obtains nutrients directly from the endometrium.
The first trimester is the main period of organogenesis and
the development of body organs.
At 8 weeks, all the major structures of the adult are present
in the rudimentary form and embryo is called a foetus.
It is only 5cm long.
High levels of progesterone initiate changes in the mother’s
reproductive system, the maternal part of the placenta grow,
the uterus become larger, ovulation and the menstrual cycle
stops.
Second trimester: (period from 13th to 26th week)
In the second trimester, the uterus grows enough for the
pregnancy to become obvious.
The foetus is very active and grows to about 30cm in length.
Hormones levels stabilize as HCG (Human Chronic
Gonadotropin) declines, the corpus luteum deteriorates and
the placenta completely takes over the production of
progesterone which maintains the pregnancy.
Third trimester: (period from 27th week till the parturition)
In the third trimester, the foetus grows to about 3-4 kg in
weight and 50 cm in length.
As the foetus grows, the uterus expands around it.
The mother abdominal organs become compressed and
displaced, leading to frequent urination, digestive blockages
and strain in back muscles.
2.8. PLACENTA:
Placenta is a disc-like
structure that forms a
connection between the
embryo and the uterine
wall.
It is consisting of
numerous villi that
increases the surface
area for absorption. It is an organ of exchange that provides
oxygen and nutrients to foetus and removes waste produced
by foetus.
It also removes wastes from the blood of the growing
foetus. This structure attaches to the inner wall of the
uterus and the umbilical cord develop from it.
Functions of Placenta:
The placenta acts as an important endocrine gland during
pregnancy.
Placental hormones include- oestrogen, progesterone,
human chorionic gonadotropin(hCG) and human
placental lactogen (hPL).
Placental hormones are required for pregnancy
establishment and maintenance as well as for foetal
growth.
It stores glycogen for the foetus prior to the formation of
the liver.
It allows selective diffusion, preventing the passage of
harmful materials from maternal blood to foetal blood.
2.9. PARTURITION
It is the process of giving birth to a child, and the placenta
from the uterus to the vagina is called parturition.
It is also called the phase between labour to childbirth or
delivery.
The labor or childbirth process is called parturition, which
occurs approximately 38 weeks after fertilization.
This process consists of three distinct stages of labor.
The first, the stage of dilation, begins with the onset of
standard, hard contractions of the uterus and ends with
complete dilation of the cervix.
1. Dilation Stage:
Uterine contractions begin from the top, forcing the baby
towards the cervix.
Contractions are accompanied by pain caused by
compression of blood vessels.
Oxytocin induces uterine contractions which become
stronger and stronger due to stimulatory reflex.
As the baby is pushed down in the uterus, its head comes to
lie against the cervix.
The cervix gets dilated and the vagina also shows similar
dilation.
This stage of labour can normally last up to few hours.
It ends in the rupturing of amniotic sac of the foetus.
2. Expulsion Stages:
During this stage, the uterine and abdominal contractions
become stronger.
In normal delivery, the fetus passes out through the cervix
and vagina with head in the forward direction.
It takes around 20 to 60 minutes.
The umbilical cord is tied and cut off close to the baby’s
naval.
3. After Birth:
After the delivery of the baby, the placenta separates from
the uterus and is expelled out as “after birth”, due to severe
concentrations of the uterus.
This process happens within 10 to 45 minutes of delivery.
2.10. Lactation:
“Lactation is the process of milk secretion from the
mammary glands of a female after childbirth.”
Lactation is the process of milk secretion from the
mammary glands of a mother soon after childbirth.
The milk, thus produced provides nutrition and immunity to
the young one.
(i)Colostrum:
Colostrum is the first form of breastmilk that
is released by the mammary glands after giving birth. It's
nutrient-dense and high in antibodies and antioxidants to
build a newborn baby's immune system.
It changes to breast milk within two to four days after your
baby is born.
2.11. Reproductive Health:
Reproductive health simply refers to healthy
reproductive organs with normal functions. According to the
World Health Organisation (WHO), reproductive health means
a total well-being in all aspects of reproduction, i.e. physical,
emotional, behavioural and social.
Reproductive Health conveys complete awareness of various
sexually transmitted diseases.
Provides accurate information about sexual life,
reproduction, and contraception methods.
Helps in maintaining safe sexual and reproductive health.
With this awareness, an individual can protect themselves
from sexually transmitted infections and diseases.
It provides complete education to all pregnant mothers about
how to take care of their health, to have proper medicines, to
maintain good health and hygiene when they are pregnant,
have a safe delivery and to deliver a healthy baby.
2.12. Birth Control:
Birth control, also known as contraception,
anticonception, and fertility control, is the use of methods or
devices to prevent unintended pregnancy.
Contraceptive methods are of two main types i.e.
temporary and permanent.
1. Natural method/ Safe method/ Rhythm method:
Natural method/ Safe method/ Rhythm method is a form of
natural family planning to help identify when a person is
ovulating.
It's done by tracking a person's menstrual cycles on a
calendar to either avoid or engage in sexual intercourse
during a person's fertile days.
2. Coitus Interruptus or Withdrawal:
Coitus interruptus, also known as withdrawal, is a traditional
family planning method in which the man completely
removes his penis from the vagina, and away from the
external genitalia of the female partner before he ejaculates.
3. Lactational amenorrhea:
Lactation amenorrhea method (LAM) is a way for
breastfeeding to temporarily help prevent pregnancy.
It must be used correctly to work.
Lactation means your body is making breastmilk and
amenorrhea means you aren't having a monthly period.
Breastfeeding hormones may stop your body from releasing
eggs.
4. Chemical means (Spermicides):
Spermicides are a type of birth control.
When placed in your vagina before sexual intercourse, it
stops sperm from getting to an egg and creating a pregnancy.
Spermicides come in many different forms: gels, creams,
foams, films or suppositories.
It contains a special chemical that impairs sperm and stops it
from reaching an egg.
Spermicides need to be placed in your vagina up to 30
minutes before sex to be effective.
5. Mechanical means / Barrier methods:
Mechanical barriers act as a physical barrier between the sperm
and the egg.
(i) Condom:
A condom acts as a physical barrier
that prevents sperm from entering the uterus and
reaching an egg.
A male condom is a thin sheath made of latex
(rubber) that is worn over the erect penis during
sex.
They prevent STDs (sexually transmitted diseases) and
pregnancy.
(ii) Diaphragm, Cervical caps and Vaults:
Diaphragms, cervical caps and vaults are made of rubber
and are inserted into the female reproductive tract to cover
the cervix before coitus.
These are chemical barriers of conception which are
reusable.
Both devices block sperm and help prevent pregnancy.
Also, both hold a chemical that kills sperm.
(iii) Intra-uterine devices (IUDs):
An intrauterine device (IUD) is a form of birth control that a
healthcare provider inserts into your uterus.
Once it's inserted, an IUD can prevent pregnancy for up to
10 years or more, depending on the specific type.
Your provider can remove your IUD at any time if you
decide to become pregnant.
6. Physiological (Oral) Devices:
Physiological devices
are in the form of oral
contraceptive pills or birth
control pills.
They are hormonal
preparations and check
ovulation by inhibiting the
secretion of follicle stimulating hormone and luteinizing
hormone.
Woman who is using pills does not release ovum at the time
of ovulation and therefore Conception does not occur.
Birth control pill have side effects such as nausea.
7. Other Contraceptives:
Implanon/Nexplanon:
The birth control implant is a tiny, thin rod about the size of
a matchstick.
It's also called
Nexplanon and there's a
slightly older version called
Implanon.
A doctor inserts the
implant under the skin of your upper arm.
It releases the hormone progestin to stop you from getting
pregnant.
Permanent Method: -
Permanent methods of contraception involve male or
female sterilisation. Female sterilisation (tubal occlusion)
involves cutting, sealing or blocking the fallopian tubes (which
carry an egg from the ovary to the uterus (womb)).
Vasectomy:
A vasectomy is a surgical operation
carried out under local anaesthetic.
During the operation the Vas Deferens (the
tubes that carry the sperm from the testicles)
are cut and sealed using a non-scalpel
technique.
This stops sperm being released when a man
ejaculates.
Tubectomy:
Tubectomy, also known as tubal
sterilization, is a permanent method of
contraception in women.
It is a surgical process that blocks
the fallopian tubes, thereby preventing
the egg released by the ovary from
reaching the uterus.
Amniocentesis:
Amniocentesis
is a test you may
be offered during
pregnancy to
check if your baby
has a genetic or
chromosomal
condition.
It involves
removing and
testing a small sample of cells from amniotic fluid, the fluid
that surrounds the baby in the womb (uterus).
However, people started misusing it to determine the gender
that led to female foeticide on a mass scale.
Therefore, the government imposed a statutory ban on
amniocentesis.
2.14. Infertility:
Infertility is defined as trying to get pregnant with frequent,
unprotected sex for at least a year with no success.
Male infertility can be caused by low sperm production,
abnormal sperm function or blockages that prevent the
delivery of sperm.
Illnesses, injuries, chronic health problems, lifestyle choices
and other factors may contribute to male infertility.
Problems with ovulation are the most common reasons for
infertility in women.
A woman's age, hormonal imbalances, weight, exposure to
chemicals or radiation and cigarette smoking all have an
impact on fertility.
IVF (In Vitro Fertilization)
During in vitro fertilization,
mature eggs are collected from
ovaries and fertilized by sperm in
a lab.
Then a procedure is done to
place one or more of the fertilized
eggs, called embryos, in a uterus,
which is where babies develop.
One full cycle of IVF takes
about 2 to 3 weeks.
ZIFT (Zygote Intrafallopian Transfer)
Zygote intrafallopian transfer (ZIFT) is similar to GIFT, but
also uses in vitro fertilization (IVF).
Eggs are stimulated and collected using IVF methods.
Then the eggs are mixed with sperm in the lab. Fertilized
eggs
(zygotes) are
then returned
to the
fallopian
tubes with
laparoscopic
surgery.
GIFT (Gamete Intrafallopian Transfer)
Gamete intrafallopian transfer (GIFT) uses multiple eggs
collected from the ovaries.
The eggs are placed into a thin flexible tube (catheter) along
with the sperm to be used.
The gametes (both eggs and sperm) are then injected into
the fallopian tubes using a surgical procedure called
laparoscopy.
ICSI (Intra Cytoplasmic Sperm Injection)
Intracytoplasmic sperm injection (ICSI) is a technique
used during in vitro fertilization (IVF) where a single sperm is
injected directly into the egg for the purpose of fertilization.
AI (Artificial Insemination)
Intrauterine Insemination (IUI)
During an intrauterine insemination (IUI) procedure, sperm is
placed directly into the uterus using a small catheter. The goal of
this treatment is to improve the chances of fertilization by
increasing the number of healthy sperm that reach the fallopian
tubes when the woman is most fertile.
Sperm Bank:
A sperm bank, semen
bank, or cryobank is a facility or
enterprise which purchases, stores
and sells human semen. The semen is
produced and sold by men who are
known as sperm donors. The sperm is
purchased by or for other persons for the purpose of achieving
a pregnancy or pregnancies other than by a sexual partner. Sperm
sold by a sperm donor is known as donor sperm.
Adaption:
Adoption means a legal process that allows someone to
become the parent of a child, even though the parent and child
are not related by blood. But in every other way, adoptive
parents are the child's parents.