PREGNANCY AND REPRODUCTION: SIGNS INDICATING PREGNANCY
Woman's Intuition
There are some women who seem to have an inbuilt intuition that is unexplainable. They simply know
that pregnancy has taken place.
They have a "feeling" or a "hunch" or whatever. "I just feel pregnant," is frequently their total explanation of the situation. "I feel different, that's all." Most physicians accept this, and go along with the feminine instinct which usually proves to be correct! After all, you can't argue convincingly with a determined female when her mind is made up, the doctor probably says to himself. But added to this is his own professional experience of dealing with hundreds of women over many years. He knows natural instinct is often correct. Maybe it is one of those interesting whims of nature, and after all, the world is full of these in various avenues of life.
However, there are quite a few other indications that pregnancy has taken place, chief among them being:
Nausea and Vomiting. This is the so-called "morning sickness" of pregnancy. Nobody is quite sure why it is called "morning" sickness, for it can occur at any time over the twenty-four-hour cycle of the day. It is common in the morning, but it is frequently at midday and towards evening.
In fact, this takes place in well over 50 per cent of women between the fourth and ninth week after the last menstrual period. Fortunately, more feel nauseated than those who actually vomit. In only a small number does it become a serious, disabling symptom. But added to other symptoms, it can often be of valuable assistance in confirming a diagnosis.
Frequency of Urination. The woman usually notices a marked increase in the desire to pass urine. The amounts passed may only be small. There is usually none of the burning or discomfort that takes place with bladder and urinary tract infections. It is due to the physiological changes occurring in the pelvic area, and is quite a normal event. But, it also helps the physician to form a diagnosis of your pregnant state accurately. It is a good indication to you too, before you make that initial visit to the doctor.
Breast Changes. Changes that occur in the breast itself constitute a fairly early sign. Very early in pregnancy, increasing amounts of chemicals called hormones are produced by the ovary and womb. These actively circulate to all parts of the system. Basically they help to prepare the womb in particular, but also the body in general for the impending event.
The breasts play a major part in pregnancy, and these are geared to become active so that a natural, normal food supply will be readily available for the new infant immediately he makes his debut into the world.
So, the hormones start acting on breast tissue right from the start. The breasts tend to become enlarged. The nipples likewise enlarge, becoming more prominent, and often quite tender. The areola, the pigmented area surrounding the nipple, darkens. In women who have never before been pregnant, the normal, natural pinkish color gradually changes to a darker shade, and finally becomes a dark brown. Once it assumes this darker color, it remains this way for the remainder of one's life.
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PREGNANCY: HOW CAN I BE SURE?
A big question that looms large in the mind of a woman is the query: "Am I really pregnant? How can I be sure?"
In many cases, the situation is fairly obvious from the start. But in others, it is quite obscure. Of course, one thing is certain: time will yield the answer in every case. But nearly every woman has a burning desire to know with some accuracy if she is or is not pregnant, if there is any such possibility.
The first sign is usually a missed period in a woman who normally menstruates regularly, and who is not following any contraceptive routine while engaging in normal marital relations with her husband.
A few lucky women seem to commence their menstrual bleeds with amazing regularity. Indeed, "I can set my clock by it all," some claim. At a given hour on a given day each twenty-eight days, menstruation sets in. So, if this suddenly did not occur, it is excellent presumptive evidence that conception has taken place.
However, most women are not built with such mechanical precision. Just the same, menstrual regularity within a day or two each month can still produce similar presumptive suggestion of conception.
The normal menstrual cycle has very wide variations. Although many women average a twenty-eight-day cycle, the range may swing from twenty days up to forty days or even more. Indeed, some women go as long as forty-five days, and occasionally, some manage two or three periods a year!
It is with these women that accuracy in pinpointing pregnancy is a little more difficult. But there are many other pointers to pregnancy, so that one individual sign, although it may be very important in some women, is not the criterion by any means.
However, with the "regular" ones, the missed period is often the first obvious sign, and the one that sends the majority scuttling off to their doctor post haste. Many doctors likewise consider that a missed period in a normally menstruating woman is to be considered due to pregnancy until proved otherwise.
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PROBLEMS OCCURING DURING PREGNANCY: HEADACHES, FAINTING. VARICOSE VEINS
Headaches, palpitations and fainting
The fainting heroine (who also happened to be pregnant) has been the cliché of thousands of old-time novels and movies. (The other one used and reused with monotonous regularity was the doctor delivering the baby at home. He needed buckets and buckets and more buckets of boiling water. Generations of modern-day doctors are still asking what he did with all that boiling water!)
However, as many pregnant women know so well, it is not uncommon to develop sensations of feeling faint. Or there may be recurring bouts of head pain, often mild, and seldom really severe. An awareness of the heart beating in the chest, with or without actual exercise is also quite common.
None of these symptoms is serious. Indeed, they may occur to a certain extent in most pregnant women. It is merely due to the altered nature of the body's blood reservoirs.
With the advent of the pregnant womb, a large amount of blood is transferred from the usual body circulation to the pelvic regions where it is needed to succour the new, developing life.
For this reason, these other circulatory abnormalities tend to take place.
The symptoms are not serious. They are not dangerous. They do not indicate any sinister disease process. They are entirely self-limiting, and will phase out automatically in due course.
Varicose veins
The development of prominent blood-vessels, particularly in the lower limbs, is common during pregnancy. Indeed, very few women manage to escape this to some degree. In some cases it is very marked, and unfortunately these may persist after the confinement.
Frequently the limbs will ache, and the more prominent the veins, the greater the discomfort. They are aggravated by long hours of standing, especially on hard surfaces such as concrete floors. Many women who continue working during pregnancy and have to stand all day may find the complaint quite distressing.
Varicose veins are often an inherited factor, so if your parents had them severely, then you are most probably headed in a similar direction.
They are produced by the increasing mass in the pelvis pressing on the great veins as they return blood from the lower limbs. With the increased stress, the valves in the vessels that help the return of blood frequently break down, and this often produces lumpy nodules so characteristic of varicose vessels.
Much can be done to assist, however. Keeping off hard surfaces for prolonged periods of time is important.
Wearing elasticized stockings can often be very helpful. Special maternity fashions are available in many areas which provide both for this type of hosiery, as well as adequate room for the expanding abdomen. They are highly successful.
Whenever possible, keep the lower limbs elevated, preferably at a level equal to or higher than the hips. This assists the blood flow back to the body with the help of gravity. Some women find it helpful to lie on their backs on the floor and place their limbs at right angles to their body up against the wall. This has a similar mechanical beneficial effect. It can add greatly to personal comfort. Simple massaging of the limbs, using a soft, sweeping movement from the feet upwards, can also help.
Sometimes doctors may inject some of the more prominent veins, but this is best left until after the confinement. Many vessels will disappear at this time, and then the most persistent problems may be dealt with. But other doctors feel that varicose veins should not be tampered with until after the reproductive days are over permanently.
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ANNOYING PROBLEMS OCCURING DURING PREGNANCY
For most women, the days of pregnancy are happy and relatively free from discomfort and trouble. However, it is inevitable that a few abnormalities occur from time to time. After all, major changes are taking place in the lower pelvic area. A rapidly growing mass is developing there, and with the passage of time, gradually pushes up into the abdominal region. When this happens, organs are forced to move to make way. In addition, certain unusual pressures and stresses are produced.
Besides this, the massive production of extra chemicals by the pelvic organs often has a profound effect on the entire system. Although women automatically adjust to these altered circumstances in a very remarkable manner, some produce symptoms which tend to cause them some worry. The majority are self-limiting, and are cured without interference. But some suggestions can assist in alleviating other symptoms.
Here are the main symptoms that may produce some temporary discomfort, together with some recommendations as to how they can be overcome.
Heartburn
The small valve at the lower end of the food passage (the oesophagus) leading to the stomach tends to become lax. For this reason acids from the stomach can readily regurgitate or "reflux" into the lower end of the oesophagus.
This produces a burning sensation commonly referred to as heartburn. It is merely a name, and has nothing to do with the heart muscle itself. It has no sinister connotation, and is not indicative of disease.
A sensible approach to eating often brings relief. Avoiding stimulants can do much to help. Ceasing the intake of spices, condiments, sauces and pickles, and reducing the intake of strong tea or coffee will minimize the problem. Small, frequent meals of a bland, non-stimulating nature assist. An increase in the intake of milk and milk products is often useful.
Sometimes the use of antacid mixtures and tablets can bring relief if distress is severe. Alginic acid compound in the form of granules seems to assist some. These are innocuous preparations.
Extra pillows permitting sleep in a semi-upright position help to keep the acid in the stomach where it belongs. Some have found placing a brick under the head of the bed (producing a similar sleeping position) a good idea. However, others find this uncomfortable, and there is a tendency to slip down toward the foot of the bed. (Husbands often complain loudly and most bitterly about this!)
Constipation
Constipation is common during pregnancy, particularly in the latter stages. The intestinal system has a lowered "tone," and tends to become lax. Later on, the added pressure of the large womb also aggravates the situation.
An increased fluid intake helps (preferably by the use of fruit juices or plain water, not increased amounts of tea, coffee or sugary aerated beverages or alcohol-laced drinks).
Endeavour to re-establish normal bowel movements. The usual time for these is after a meal. Set a time each day, say after breakfast, and concentrate on this, and results are often successful.
In recent times the increasing value of adding bulk to the bowel has become well recognized. Adding one to three tablespoonful of simple unprocessed bran to the food at each meal can produce excellent results. Bran absorbs fluid. This increases bowel bulk, and greatly reduces ' 'transit time," the length of time material stays in the bowel.
Bran can conveniently be taken with other foods high in natural fibre. Breakfast foods such as muesli may have bran added. It is also a good idea to add chopped-up dates, dried figs, sultanas and raisins. Add a little milk, or water, and honey if desired.
Muesli is composed of natural grains. The total picture is a meal of relatively high nutritional value. At the same time, it is almost a written guarantee of normal bowel actions.
Using this simple system, the need for laxatives and cleansing enemas - the alternative -is usually quite unnecessary.
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TESTS FOR PREGNANCY
Pregnancy Tests.
With the advent a few years ago of reliable tests collectively referred to as "immuno-chemical tests," it is now possible to obtain quick and accurate results. In fact, by using some forms of the test, an answer can be forthcoming in a matter of minutes!
Those that can be read after two minutes are claimed to be 92 per cent reliable. A similar test which occupies about two hours is said to be about 98 per cent accurate. These degrees of accuracy are very high. When teamed in with the patient's history, the symptoms she describes and the results of the physician's physical examination, it usually leaves very little doubt in anybody's mind whether conception has or has not taken place.
Certain precautions are needed when carrying out the pregnancy tests. Ideally, it is a "first" specimen of urine taken during the initial act of urination for the day. The bottle should be clean and free from contamination by drugs or chemicals. (This could possibly give a false reading.) If there is any time-lapse between the time the urine is passed and the time of examination (and a few hours is most likely), the specimen should be refrigerated.
The doctor is seeking to prove the existence in the specimen of urine of a specific hormone called "H.C.G." This is short for Human Chorionic Gonadotrophin. It is produced by the developing embryo, and actively circulates in the bloodstream. A certain amount is excreted in the urine. If it can be picked up by the use of the test, it is an almost certain guarantee of pregnancy.
However, it takes almost six weeks from the date of the last menstrual period for adequate amounts to be excreted in the urine. Therefore, if the test is carried out before the six-week period, it will most likely yield a negative result, even though the person may be pregnant.
A popular routine is to carry out the H.C.G. test at six weeks. If it indicates negative, and the patient shows many of the other signs of pregnancy, the test is carried out again seven to ten days after. A positive result is then probable, indicating pregnancy has actually occurred.
The doctor will most likely check to see what forms of medication (if any) you are taking. Certain drugs, it seems, can produce incorrect results with the immunochemical test.
The introduction of the simple and accurate immunological pregnancy tests has been a major step forward in the early accurate disgnosis of pregnancy.
New Blood Test for Pregnancy
Since the original urine test for pregnancy was worked out, a quicker and even more reliable one has been developed, and this is now widely used by doctors. In fact, pregnancy can accurately be diagnosed within twenty-four to thirty-six hours of conception. One does not even have to miss a period. It is called the radio immuno assay pregnancy test, or R.I.A. Pregnancy Test for short. Taking a blood sample, a special machine can detect extremely minute traces of H.C.G. circulating in the mother's blood. It is far more delicate and accurate than the H.C.G. urine tests, and will undoubtedly replace it in due course.
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KNOWN CHARACTERISTIC SIGNS OF PREGNANCY
Temperature increase
A fairly valuable sign that is readily available, but not used very much, is the basal temperature sign.
It is well known that the body temperature rises at the time ovulation occurs. This is the moment the tiny egg is released from the ovary. It occurs approximately fourteen days before the expected onset of a subsequent menstrual period. In women with a normal twenty-eight-day cycle, this also means ovulation occurs about fourteen days from the start of a period.
This sign is often used in women being investigated for the inability to fall pregnant (a condition technically referred to as "infertility.") This will be dealt with later on.
At the time of ovulation, the temperature rises, perhaps as much as one degree. This generally falls again after a couple of days. But in the pregnant woman, the rise is sustained.
About this time, most women will have decided to go along to the doctor to discover for sure if pregnancy is under way. Many will have a good idea that conception has occurred, but most women are much happier to have this officially confirmed.
The doctor has a few other ways of checking. First of all, he will listen to your story. Generally he will take notes on a history card, ask a lot of related questions and enter the answers on the card. After this, he will then carry out a physical examination. At the first visit, this may be a complete physical examination, or he may wait until a subsequent visit before he does this in detail.
But he will almost certainly carry out a pelvic examination.
This is simple and quite straightforward. His aim is to confirm pregnancy or otherwise, and frequently in addition to the points you have told him, some physical changes may be checked.
Vaginal Changes. He will examine the breasts for the changes already discussed. Then he will examine the vagina and check the uterus (womb).
Physical changes may have occurred in these regions. The vulva, the loose lips guarding the entrance to the vagina, are frequently a dusky bluish discoloration. This often extends up the front wall of the vagina. The vagina and cervix, the part of the womb that juts into the upper part of the vagina, become softer and more discernible. These are due to an increase in the vascularity of these parts, and are usually evident as early as the fourth week.
Uterine Changes. In the early stages, it is sometimes possible to feel certain changes in the uterus. The doctor will check for the firm cervix of the womb. The upper part, containing the embryo, may also be a little more firm, but the middle part of the womb is softer. However, in plump women this is often very difficult to be certain about, and many doctors feel it is not possible to make a firm decision on "palpation" (as this technique of feeling is called) until many more weeks have elapsed. However, in some instances it may be useful.
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PREGNANCY AND REPRODUCTION: EFFECT OF THE PILL
One point of interest is that in women who take the contraceptive pill, this pigmentation will occur while they are on the Pill. The reason is that the Pill contains hormones similar in nature to those produced during early pregnancy. Their effect on the breast is very similar. Not only will it turn the areola a darker shade, but often it will produce an artificial enlargement of the breast itself.
In fact, many younger women with poor chest development elect to take the Pill exclusively for this reason. Of course, this is not recommended. The sad truth is that as soon as such women cease taking the Pill for any reason, the breasts tend to regress to their original smaller size. Or, as many have discovered to their sorrow, they may diminish even more than in the pre-Pill-taking days. So, any woman reading this and contemplating getting onto the Pill for these reasons should think again. It is not a very good idea for purely cosmetic reasons!
Besides the areola becoming darker and the nipples more prominent, small raised areas occur in the pigmented parts. These are due to little glands that are excited by the hormones, and they become quite prominent. They appear as little raised pimples.
This is not serious and it is not dangerous, and they should not be squeezed or fiddled with. They are not like acne blackheads on the face that are common with some women.
Often as the breast enlarges, veins become a prominent feature. These appear as bluish lines coursing all over the breasts. They are frequently more prominent about the nipple and areola area. This merely indicates that breast activity is occurring. Everything is being geared to the ultimate nutritional care and well-being of the forthcoming infant. Nature is very aware of what the future holds, and makes every effort to be prepared.
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