Human Sexuality - Chapter 10 - Conception, Pregnancy and Childbirth

What are the main provisions of the "Assisted Human Reproduction Act?"

1) A ban on human cloning 2) A ban on selection of a baby's sex for non-medical purposes 3) A ban on payment to a surrogate mother 4) A ban on payment to a sperm donor.

Why is the birth rate among Canadian women lower now than in past generations?

1) Improved access to safe, effective contraception allows women to choose whether and when they'll have children, how many they'll have and how far apart they'll space them. 2) More women are completing post-secondary education during their child bearing years and are therefore delaying motherhood. 3) Increasing numbers of women choose to limit the number of children they have, so they can continue working full time. 4) Financial constraints lead some women to limit the number of children they decide to have. 5) It's becoming more and more socially acceptable in Western society to choose not to have children.

What are some common female fertility issues? (4)

1) Irregular ovulation, including failure to ovulate. 2) Obstructions or malfunctions of the reproductive tract, often caused by infections or diseases involving the reproductive tract. 3) Endometriosis 4) Declining hormone levels of estrogen and progesterone that occur with aging and may prevent the ovum from becoming fertilized or remaining implanted in the uterus.

What are some common fertility problems found in men? (8)

1) Low sperm counts 2) Irregularly shaped sperm (eg,. malformed heads or tails.) 3) Low sperm motility 4) Chronic diseases such as diabetes 5) Infections such as STIs 6) Injuries to the testes 7) Autoimmune responses, in which the man produces antibodies that deactivate his sperm 8) A pituitary imbalance and/or thyroid disease.

How long is the average gestation period?

40 weeks.

What is prepared childbirth (the lamaze method)?

A child birth method during which a woman learns how to relax and breathe in patterns that conserve energy and lessen pain, with the help of a coach (usually the father) who's present during the birth. The lamaze method is also called prepared childbirth. The lamaze method is flexible about the use of anaesthetics. Many women report some pain during delievery and are given anesthetics. However, the Lamaze method appears to help women to gain a greater sense of control over the delivery process.

What is fetal alcohol syndrome (FAS)?

A cluster of symptoms in the infant caused by maternal alcohol consumption during pregnancy. These symptoms are typified by development lags, characteristic facial features, and a smaller-than-average body and brain. Facial features include: underdeveloped upper jaws, flattened noses, and widely spaced eyes. Although research suggests that light drinking is unlikely to harm the fetus, FAS has been found among the children of mothers who drank only 60ml of alcohol a day during the first trimester.

What is Rh incompatibility?

A condition in which antibodies produced by a pregnant woman are transmitted to the fetus, where they may cause brain damage or death. It occurs when an Rh-negative woman carries an Rh-positive fetus.

What is the Zona pellucida?

A gelatinous layer that surrounds the ovum.

What is human chorionic gonadotropin (hCG)?

A hormone produced by a woman shortly after conception. hCG stimulates the corpus luteum to continue producing progesterone. The presence of hCG in a woman's urine indicates that she's pregnant.

What is pregnancy induced hypertension (pre-eclampsia)?

A life-threatening condition characterized by high blood pressure. It may affect women late in the second or third trimester of pregnancy. If left untreated, it can lead to maternal and/or fetal death. Babies born to women with pregnancy-induced hypertension are often undersized or premature.

What is laparoscopy?

A medical procedure in which a long narrow tube (a laparoscope) is inserted through an incision in the navel, permitting visual inspection of the organs in the pelvic cavity. Is often used in the diagnosis of endometriosis.

What is a cesarean section?

A method of childbirth where the fetus is delivered through a surgical incision in the abdomen. C-section is most likely to be advised when normal delivery is difficult or threatens the health of the mother or the child.

What is in vitro fertilization (IVF)?

A method of conception in which mature ova are surgically removed from an ovary, and placed in a laboratory dish with sperm.

When does ovulation and menstruation resume after giving birth?

A non-nursing mother doesn't resume actual menstrual periods until two to three months postpartum. The first few cycles are likely to be irregular. Many women incorrectly assume that they'll resume menstruating after childbirth by having a menstrual period and then ovulating two weeks later. In most cases, the opposite is true . Ovulation precedes the first menstrual period after childbirth. A woman can therefore become pregnant before the menstrual phase of her first postpartum cycle.

What are critical periods of vulnerability?

A period when an embryo or fetus is most vulnerable to the effects of a teratogen. Critical periods correspond to the times when the structures most affected by the teratogens are deveoping. The heart, for example, develops rapidly from the third to the fifth week after conception. It may be most vulnerable to certain teratogens at this time.

What is Chadwick's sign?

A physician used tool to diagnose pregnancy characterized by a purplish vagina and cervix.

What is prolactin?

A pituitary hormone that stimulates milk production. It comes from the root words that mean "for milk." Prolactin stimulates lactation two to three days after childbirth. Oxytocin, which is secreted in response to suckling, causes the breasts to eject milk.

How long is the normal gestation period?

A pregnancy can be dated from the onset of the last menstrual cycle before conception, which makes for a normal gestation period of 280 days. A pregnancy can also be dated from the date at which fertilization is assumed to have taken place, which normally corresponds to two weeks after the beginning of the woman's last menstrual cycle. In this case, the normal gestation period is 266 days. A pregnancy can also be dated through an ultrasound scan during the first trimester.

What is an ectopic pregnancy?

A pregnancy in which the fertilized ovum becomes implanted somewhere other than the uterus. Most ectopic pregnancies occur in the fallopan tubes. If ectopic pregnancies do not abort spontaneously, they must be removed by surgery or via medicines.

What is a miscarriage?

A spontaneous abortion.

How is sexual orientation related to teen pregnancy?

A study of 74,000 teenagers in British Columbia led by UBC's Elizabeth Saewye found that pregnancy rates are higher among sexually active gay, lesbian, and bisexual teenagers than among heterosexual teenagers. Based on qualitative interviews and focus groups, Travers, Newton and Munroe concluded that pregnancy involvement among sexual minority youth can be understood as a response to hetero-sexism, where the "dominance of heterosexuality" in youths' lives produces extreme pressures to conform to hetero-sexist expectations of relationships and desire to prove one's heterosexuality through heterosexual sex. Sexual assault can also lead to pregnancy among lesbian youth.

What is surrogate motherhood?

A surrogate mother is artificially inseminated by the partner of an infertile woman or by one of two men who are a couple. She carries the baby to term and then turns the baby over to the father and his partner. Surrogacy is legal in Canada, but there can be no contract and it is illegal to pay a woman to be a surrogate.

What is the umbilical cord?

A tube that connects the fetus to the placenta.

What is rubella? How can it affect the developing fetus?

A viral infection that can cause mental retardation and heart disease in an embryo. It's also called german measles. Women who contract rubella during the first month or two of pregnancy, when rapid differentiation of major organ systems takes place, may bear children who are deaf or who develop mental retardation, heart disease or cataracts. Most Canadian women have either had rubella as children or have been vaccinated against it. Women who don't know whether they're immune to rubella may be tested. If they're not immune, they can be vaccinated BEFORE pregnancy.

What are some psychological changes that occur during pregnancy?

A womans psychological response to pregnancy reflects her desire to be pregnant, her physical changes and her attitudes towards these changes. Women with the financial, social and psychological resources to meet the needs of pregnancy and child-rearing welcome pregnancy. Other women may question their ability to handle pregnancy and childbirth. Or they may fear that pregnancy will interfere with their careers or their mates' feelings about them.

What is acquired immunodeficiency syndrome (AIDS) and how can it affect a developing fetus?

AIDS is caused by the human immunodeficiency virus (HIV). Because it's blood borne, HIV is sometimes transmitted through the placenta to infect the fetus. Rupturing blood vessels i the mother and baby during childbirth provide more opportunities for HIV transmission. The majority of babies born to mothers who are infected with HIV do not become infected themselves. Using antiviral medication can minimize the probability of transmission. HIV can also be transmitted to children by breastfeeding.

What is adoption?

Adoption is another way for people to have children. Despite the occasional conflicts between adoptive parents and biological parents who change their minds about giving up their children, most adoptions create loving new families. Adopted children may, in some cases, feel less secure than biological children with their caregivers. Everything else being equal however, the younger a child is at the time of adoption, the more smoothly the adoption seems to go. Despite potential challenges, most adopted children and adoptive parents fare well.

What are some psychological effects of a miscarriage?

After a miscarriage, a couple may feel a deep sense of loss and undergo a period of mourning. Emotional support from friends and family often helps the couple cope with the loss. Most women who miscarry are able to carry subsequent pregnancies to term.

How can maternal and paternal drug use affect the developing fetus?

Although most of the attention on drug use during pregnancy is focused on the mother, a father's use of certain drugs may also negatively impact the fetus. Several antibiotics can harm a fetus, especially if they're taken during certain periods of fetal development. Tetracycline may yellow the child's teeth and deform his or her bones. Other antibiotics have been implicated in deafness and jaundice. Acne drugs such as accutane can cause physical and mental handicaps in the children of women who use them during pregnancy.

What is hayluronidase?

An enzyme that briefly thins the zona pellucida, enabling one sperm to penetrate. Once a sperm has entered the ovum, the zona pellucida thickens, locking sperm out.

What is an episiotomy?

An episiotomy is a surgical incision in the perineum that widens the birth canal, preventing random tearing during childbirth.

What constitutes a pre-term infant?

An infant born before 37 weeks gestation.

What is the placenta?

An organ connected to the fetus by the umbilical cord. The placenta serves as a relay station between the mother and the fetus, allowing the exchange of nutrients and wastes.

What kind of medications are used to relieve pain during childbirth? What are some downsides to using medications during childbirth?

Anesthetic drugs, as well as tranquilizers and narcotics, decrease the strength of uterine contractions during delivery. They may thus delay the process of cervical dilation and prolong labor. They also reduce a woman's ability to push the baby through the birth canal. Because they cross the placental membrane, they also lower the newborn's overall responsiveness. There is little evidence, however, that medicated childbirth has serious, long-term consequences for children.

How long can the ovum be fertilized after ovulation?

Approximate 4 - 20 hours after ovulation.

What is a possible reason for the current elevated incidence of infertility?

Because the likelihood of infertility increases with age, the current somewhat elevated incidence of infertility is partially the result of a rise in the number of couples who've postponed childbearing until their 30s and 40s.

Development of the embryo follows what two trends?

Cephalocaudal growth and proximodistal growth. Growth of the head (the cephalic region) takes precedence over growth of the lower parts of the body. The growth of the organ systems that lie close to the axis (proximal to the axis) takes precedence over the growth of those that lie farther away.

How does maternal cigarette smoking affect the developing fetus?

Cigarette smoking contains chemicals such as carbon monoxide and the stimulant nicotine which are transmitted to the fetus. It also lessens the amount of oxygen received by the fetus. Maternal smoking increases the risk of spontaneous abortion, premature rupturing of the amniotic sac, stillbirth, premature birth, low birth weight and early infant mortality. The risks increase with the amount smoked.

What are three factors that have contributed to the declining teen pregnancy rates in Canada?

Compositional factors (eg., demographic aspects of the population. Distal factors (eg., economic inequality) Proximal factors (eg., contraceptive use.)

What is conception?

Conception is the union of a sperm cell and an ovum.

What is donor IVF?

Donor IVF is a variation of the IVF procedure. The ovum is taken from another woman, fertilized, and then injected into the uterus or Fallopian tube of the intended mother. The procedure is used when the intended mother doesn't produce ova.

Why is it normal for a fetus to become less active during the final months of pregnancy?

During the final months of pregnancy, the mother may become concerned that the fetus seems less active. Most of the time, the change in activity level is normal. The fetus has merely grown so large that it's cramped and it's movements are restricted.

What is medicated childbirth?

During the past two centuries, science and medicine have led to the expectation that women should experience minimal discomfort during childbirth. Today, some anesthesia is used to minimize or eliminate pain in most Canadian deliveries.

What is embryonic transfer?

Embryonic transfer can be used with women who don't produce ova of their own. A female volunteer is artificially inseminated by the male partner of the infertile woman. Five days later, the embryo is removed from the volunteer and inserted into the uterus of the mother-to-be, where it becomes implanted.

What is endometriosis? How does it cause infertility? What are some treatments for infertility due to endometriosis?

Endometriosis is an abnormal condition in which endometrial tissue is sloughed off into the abdominal cavity, rather than out of the body during menstruation. The condition is characterized by abdominal pain, and may cause infertility. In endometriosis, endometrial tissues which are normally found in the lining of the uterus, implant and grow elsewhere. When they develop on the surface of the ovaries or fallopian tubes, they may bloc the passage of ova or impair conception. About 1 in 6 cases of infertility is believed to be due to endometriosis. Hormone treatments and surgery sometimes reduce the blockage to the point where a woman can conceive.

What are teratogens?

Environmental influences or agents that can damage the embryo or fetus, causing birth defects or spontaneous abortions. They include alcohol, the metals lead and mercury, radiation and disease causing organisms such as viruses and bacteria.

Where does fertilization normally occur?

Fertilization normally occurs in the Fallopian tube.

What are some hormonal changes observed during labour?

Fetus triggers production of prostaglandins which acts as the stimulus that gets uterus to contract. Mother in addition produces oxytocin from pituitary gland in the late stages of labour which results in more powerful contractions and eventually expulsion of the fetus.

What is amniotic fluid?

Fluid within the amniotic sac. It suspends and protects the fetus.

What are some early signs of pregnancy?

For many women the first sign of pregnancy is a missed period. But some woman have irregular menstrual cycles or miss periods because of stress. Missing a period is therefore not a fully reliable indicator. Some women also experience cyclic bleeding or spotting during pregnancy, although the blood flow is usually lighter than normal. If a woman's basal body temperature remains high for about three weeks after ovulation, there's reason to suspect pregnancy, even if she spot-bleeds two weeks after ovulation.

Where is the safest place for a woman to deliver and for her baby to survive?

Greece.

What are some pro's and con's associated with breast feeding?

Health Canada and the Canadian Pediatric Society reccomend breast feeding as the preferred method for feeding infants because it provides optimal nutritional, immunological and emotional benefits for the child's growth and development. The most common reasons mothers give for not breastfeeding are medical factors, such as premature or multiple births or the medical condition of the mother or the infant. One drawback of breastfeeding is that HIV can be transmitted to infants via breast milk. Another drawback is that when undernourished mothers in developing countries breastfeed, their babies can also become malnourished.

What is intracytoplasmic sperm injection (ICSI)?

ICSI can be used when a man has too few sperm for IVF, or when IVF fails. A sperm cell is injected directly into an ovum. This method may be associated with an increase in birth defects, including: heart, stomach, kidney, and bladder problems, cleft palates, hernias and malformation of the penis.

What is gamete infra-fallopian transfer (GIFT)?

In GIFT, sperm and ova are inserted together into a Fallopian tube for fertilization. Conception occurs in a Fallopian tube, rather than in a laboratory dish.

Does breastfeeding affect sexual behavior?

In analyzing literature, researchers at the university of british columbia found that women who breastfeed are more likely than those who bottle-feed to experienced decreased sexual desire, decreased frequency of sexual intercourse and painful intercourse due to lack of vaginal lubrication. LaMarre and her colleagues concluded that breastfeeding decreases both androgen levels, leading to decreased sexual desire and estrogen levels, leading to vaginal dryness. Breastfeeding mothers are also more fatigued, from having to get up at night to feed their infants. Sexuality differences between breast feeders and bottle-feeders diminish considerable after 12 months.

What are some psychological changes that occur in men with regards to pregnancy?

In general, men respond to pregnancy according to the degree to which they want to become fathers. Many men are proud and look forward with great anticipation to having babies. In such cases, pregnancy may bring parents closer together. But male partners who are financially or emotionally unprepared or who don't want to become fathers may consider the pregnancies unwanted.

What are some known causes of misscarriage?

In most cases of miscarriage, a specific cause is not identified. Known causes include chromosomal defects in the fetus and abnormalities of the placenta and uterus. Miscarriage is more common among older mothers. Some miscarriages occur so early that the women don't know they're pregnant.

What is a false pregnancy?

Intensely desirous of having a child - may manifest into physical symptoms.

What are some distal factors affecting teen pregnancy rates in Canada?

It's been shown that teen pregnancy rates are higher among economically disadvantaged populations. It is likely that teenage women who feel optimistic about their futures with respect to education and employment opportunities are more likely to delay child bearing until they're older.

Why are more sexually active teens using contraception now than in the past?

It's likely that a range of factors are involved. Perhaps it's because today's teens have an easier time finding information about contraception and sexual health, using sources such as the Internet, and this has made them more knowledgeable about the issues. Perhaps it's because teens feel more comfortable buying condoms or asking their doctors for prescriptions for birth control pills. Perhaps it's because more teens are getting high quality sexual-health education in schools.

What are some proximal factors affecting teen pregnancy rates in Canada?

It's no coincidence that as the teen pregnancy rates in Canada have fallen, the percentage of sexually active teenagers who use contraception has increased.

What are some early effects of pregnancy?

Just a few days after conception, a woman may note tenderness in her breasts. Morning sickness is another common early pregnancy effect. Pregnant women may also experience greater-than-normal fatigue during the early weeks, sleeping longer and falling asleep more readily than usual. They may also experience frequent urination.

What role do sexually transmitted infections play in infertility?

Local infections that scar the fallopian tubes and other organs impede the passage of sperm or ova. Such infections include pelvic inflammatory diseas (PID), which is an inflammation of the woman's internal reproductive tract that can be caused by various infectious agents, such as the bacteria responsible for chlamydia and gonorrhea. Sexually transmitted infections are therefore a major cause of infertility.

What is lochia?

Lochia is a reddish vaginal discharge that may persist for a month after childbirth.

What type of fetus (male or female) is more likely to be lost via spontaneous abortion?

Male fetuses are more likely to be lost in spontaneous abortions, which often occur during the first month of pregnancy.

How does the maternal diet influence the embryo/fetus?

Malnutrition in the mother can adversely affect fetal development and result in a low birth weight. Pregnant women who are adequately nourished are more likely to deliver babies of average or above-average size. Their infants are also less likely to develop colds and serious respiratory disorders. Maternal obesity, however, is linked with a higher risk of stillbirth.

How can certain vitamins negatively affect the developing fetus?

Many pregnant women are prescribed daily doses of multivitamins to maintain their own health and promote healthy pregnancies. Too much of a good thing, however, can be hazardous. While normal doses can be beneficial, high doses of vitamins such as A, B6, D and K have been linked to birth defects.

What is syphilis? How can it affect the developing fetus?

Maternal syphilis can cause miscarriage or stillbirth, or it can be passed along to the child in the form of congenital syphilis. Congenital syphilis can impair the vision and hearing, damage the liver, and deform the bones and teeth. Routine blood tests early in pregnancy can diagnose syphilis. The fetus will probably not contract syphilis if the infected mother is successfully treated with antibiotics before the fourth month of pregnancy.

What are some chances in regards to sexual activity, that occur during pregnancy?

Most health professionals concur that intercourse is safe throughout pregnancy, until the start of labour, as long as the pregnancy develops normally and the woman has no history of miscarriage. Women who experience bleeding or cramps during pregnancy may be advised by their obstetricians not to engage in sex. A study of 188 women showed a decline in sexual activity as pregnancy progressed. The frequency of sexual intercourse was greatest during the first trimester, followed by the second and then the third trimester. Nearly 1 in 4 of the women reported having a fewar of sexual intercourse during the pregnancy. About 10% said they feared intercourse could harm the baby. A few were concerned that sex would be painful.

How can taking narcotics during pregnancy affect the developing fetus?

Narcotics such as heroine and methadone can readily pass from mother to fetus through the placental membrane. Narcotics are addictive. Fetuses of mothers who use them regularly during pregnancy can become addicted in utero. At birth, such babies may experience withdrawal. Women who use narcotics should tell their obstetricians, so measures can be taken to aid their infants before and after delivery.

What are some chromosomal and genetic abnormalities that may affect the developing fetus?

Not all individuals have the normal complement of chromosomes. Some of us have genes that threaten our health. Various medical procedures are used to detect fetal disorders. Parental blood tests can suggest the presence of sickle-cell anemia, Tay-Sachs disease, and neural tube defects. Tests of fetal DNA can indicate the presence of Huntingtons disease, cystic fibrosis and other disorders. The risk of giving birth to a child with Downs Syndrome increases with the mothers age. Amniocentesis can detect Down's syndrome before birth.

What is Naeele's rule?

Once pregnancy is confirmed, Naegele's rule can be used to calculate the delivery date. 1) Write down the date of the first day of the last menstrual period. 2) Add seven days 3) Subtract three months 4) Add one year,

What are some compositional factors affecting teen pregnancy rates in Canada?

One compositional factor affecting teen pregnancy rates in Canada is the province or territory in which the young women live.

What is postpartum depression?

One in five or ten women encounters a more serious mood disorder called postpartum depression. PPD begins within four weeks after delivery and may linger for weeks or months. PPD is characterized by serious sadness, feelings of hopelessness and helplessness, feelings of worthlessness, difficulty concentrating and major changes in appetite (usually loss of appetite) and sleep patterns (often insomnia). There can also be severe fluctuations in mood from depression to elevation and then back to depression. Some women show obsessive concern over the well-being of their babies at this time.

What chromosomes to ova carry?

Ova carry X sex chromosomes.

What are some changes observed in life after teenage motherhood?

Overall, teen mothers in Canada had a lower probability than their adult counterparts of completing high school and post-secondary education, even after controlling for family background and other characteristics. But the study found that education may help counter the negative impact of teen motherhood on labor-force participation and income status. Overall women with similar education levels, regardless of when they'd first had children, had a similar likelihood of full-year, full-time employment. Teen and adult mothers with less than highschool education were both less likely to be working in full-time jobs for the full year. On the other hand, teen mothers who completed post-secondary studies were actually more likely than their adult counterparts to work full-time.

What are some methods of inducing ovulation?

Ovulation can often be induced by fertility drugs such as clomiphene (sold as Clomid) which stimulates the pituitary gland to secrete FSH and LH, which in turn stimulate the maturation of ova. Clomiphene leads to conception in most cases of infertility that are due solely to irregular or absent ovulation. Another infertility drug, Pergonal, contains a high concentration of FSH which directly stimulates maturation of ovarian follicles.

What are some maternal diseases and disorders that can affect the developing fetus?

Pre-existing conditions in the mother, such as diabetes, can have significant impacts on prenatal growth and development.

What are some heightened risks associated with preterm and low-birth-weight infants?

Preterm and low-birth-weight infants face heightened risks of infant mortality from causes that range from asphyxia and infections to sudden infant death syndrome (SIDS). Neurological and developmental problems are also common among preterm infants, especially those born at or before 25 weeks gestation.

Which provinces cover the cost of IVF in Canada?

Qubec was the first province or territory to cover the cost of IVF when it began doing so in 2010, and Ontario became the second when it announced in 2014 that it would begin covering the cost.

What is motility?

Self-propulsion. Motility is a measure of the viability of sperm cells.

What is a blastocyst?

Several days into the germinal stage, the cell mass takes the form of a fluid-filled ball of cells which is called a blastocyst. Already some cell differentiation has begun. Cells begin to separate into groups that will eventually become different structures.

What are Braxton-Hicks contractions?

So-called "false labour" contractions which are relatively painless.

What is Hegar's sign?

Soft area between cervix and uterus observed by one month after missing period.

How do PMS symptoms change after giving birth?

Some (but not all) women who suffered premenstrual syndrome before pregnancy find that their periods give them less discomfort after they give birth.

What are some psychological and emotional effects associated with infertility?

Some psychologists have found that dealing with infertility can be likened to dealing with the death of a child. Couples often go through a grief process that involves acceptance of the diagnosis of fertility before proceeding to treatment to help them conceive.

What are some reasons, proposed by researchers, as to the cause of postpartum depression?

Some researchers suggest that PPD is caused by the interactions of biological (mainly hormonal) factors, including that precipitous drop-off in estrogen. Psychological factors may also be involved, such as concerns about life changes wrought by motherhood, concerns about whether she'll be a good mother, marital problems, and a baby who is sick or unwanted.

When are sperm most active?

Sperm are most active within 48 hours of ejaculation.

What chromosomes to sperm carry?

Sperm carry either an X chromosome or a Y chromosome.

Which sperm are faster swimmers?

Sperm carrying a Y-chromosome tend to be faster swimmers than sperm carrying an X chromosome.

What are some methods used to increase sperm counts?

Sperm counts have been increased by vericose vein operations in the scrotum and micro surgeries to remove blocked passageways that prevent the outflow of sperm. Researchers are currently investigating the effects of special cooling undergarments.

What criteria must sperm meet to be considered "normal?"

Sperm must be able to swim for two hours after intercourse and most (60% or more) must be normal in shape.

What are some psychological impacts associated with stillbirths?

Stillbirth has a deep psychological impact on parents, leading in many cases to post-traumatic stress disorder (PTSD), which is characterized by ruminations about the loss, intrusive thoughts and nightmares. When a baby is declared dead while still within the mother, she may need a few hours to adjust to the fact before labour is induced.

What is stillbirth? What are some possible reasons for stillbirth?

Stillbirth, in which the baby is born dead, is the gravest of birth problems. Stillbirth is connected with fetal abnormalities, infection, the mothers medical condition, and pregnancy complications such as pre-eclampsia and problems with the placenta. Yet the majority of causes have no clear cause and are considered unexplainable.

What is morning sickness?

Symptoms of pregnancy, including nausea, aversions to specific foods and vomiting.

How can marijuana use during pregnancy affect the developing fetus?

The active ingredient in marijuana, THC, readily crosses the placenta. Research into cognitive effects of maternal marijuana use suggests that there may be no impairment in the child's global intellectual functioning per se. However there may be increased hyperactivity and impassivity. Researchers also find a connection between prenatal exposure to marijuana and anxiety and depression later in life.

What is the perineum?

The area between the vulva and the anus.

What is the fetal stage?

The fetal stage begins at the ninth week and continues until birth. By about the ninth or tenth week, the fetus begins to respond to the outside world by turning in the direction of external stimulation. By the end of the first trimester, the major organ systems, fingers, toes and external genitals are formed. The gender can be visually determined and the eyes are clearly distinguishable. Near the end of the second trimester the fetus approaches the age of viability. Still, only a minority of babies born at the end of the second trimester who weigh under a kilogram will survive - even with intense medical efforts.

What are some psychological changes that may occur during the postpartum period?

The first few postpartum days are frequently happy ones. However, about 70% of new mothers have periods of tearfulness, sadness and irritability that the APA refers to as "baby blues." Baby blues and other postpartum mood problems are so common that they're statistically normal.

What is the germinal stage (aka. the period of the ovum)?

The germinal stage is the period of prenatal development before implantation in the uterus. Within 36 hours of conception, the zygote divides into two cells. It then divides repeatedly, becoming 32 cells within another 36 hours as it continues it's journey to the uterus. It takes the zygote three or four days to reach the uterus. The mass of dividing cells then wanders about the uterus for another three or four days before it begins to implant itself into the uterine wall. Implantation takes about another week. This period from conception to implantation is termed the germinal stage or the period of the ovum.

What is infertility?

The inability to conceive a child.

What is artificial insemination?

The introduction of sperm into the reproductive tract through means other than sexual intercourse.

The likelihood of maternal and infant mortality is connected with what kinds of factors?

The likelihood of maternal and infant mortality is connected with factors such as the percentage of births that are attended by trained people, the literacy rate of adult women (which is one measure of the level of education of women) and the participation of women in national government (which is one measure of the extent to which a society empowers women.)

What does postpartum mean?

The period following birth.

What are autoimmune responses?

The production of antibodies that attack naturally occurring substances that are (incorrectly) recognized as foreign or harmful.

How long does it take after giving birth to resume sexual activity?

The resumption of intercourse depends on a couple's level of sexual interest, the healing of episiotomies or other injuries, fatigue, the reccomendation of physicians and of course, tradition. Obstetricians usually advise a six-week waiting period, for safety and comfort. Women typically prefer to delay intercourse until it becomes physically comfortable - generally, when episiotomies and other lacerations heal and the lochia has ended. This may take several weeks. Women who breastfeed may find they have less vaginal lubrication, resulting in discomfort during intercourse. Couples may enjoy other forms of sexual activity earlier, as soon as both partners are comfortable.

What factors affect the return of sexual interest and the resumption of sexual activity after childbirth?

The return of sexual interest and the resumption of sexual activity may take longer for some couples than for others. Sexual interest depends more on psychological than on physical factors. Many couples encounter declining sexual interest and activity in the first year after childbirth, generally because childcare can sap energy and limit free time. Generally, couples whose sexual relationships were satisfying before parenthood tend to show greater sexual interest and to resume sexual activity earlier than those who had less satisfying relationships before hand.

What is the amniotic sac?

The sac containing the fetus.

What does the second stage of childbirth consist of?

The second stage of childbirth begins after transition, when the cervix is fully dilated and the baby begins to move into the birth canal (vagina). Each contraction propels the baby farther along the birth canal. When the baby's head becomes viable at the vaginal opening, it's said to have crowned. Typically, the baby fully emerges a few minutes after crowning. Full emergence ends the second stage of childbirth, which lasts from a few minutes to a few hours and is shorter than the first stage.

What is the embryonic stage?

The stage of prenatal development that lasts from implantation through the eighth week. It is characterized by differentiation of the major organ systems.

When is the term "infertility" usually applied?

The term "infertility" is usually not applied until a couple has been unable to conceive for a year or more.

What is the third stage of childbirth?

The third, or placental stage of childbirth can last from a few minutes to an hour or more. During this stage, the placenta is expelled and the uterus begins the process of contracting. Detachment of the placenta from the uterine wall may cause some bleeding.

What is transition?

Transition is the process that occurs when the cervix becomes almost fully dialated and the baby's head begins to move into the vagina or birth canal. Contractions usually come quickly now. Transition usually lasts up to 30 minutes and is often accompanied by nausea, chills and intense pain.

Lesbian mothers are also at risk for maternal depression. What are some reasons researchers have put forward for this phenomenon?

University of Toronto researcher Lori Ross has concluded that lesbian mothers may experience more stress than heterosexual mothers, because they receive less support from their own parents and because of societal prejudices. On the other hand, there are factors that reduce stress and the likelihood of postpartum depression in lesbians. Their pregnancies are more likely to be planned, and the division of childcare labor is more equal for lesbian couples than for heterosexual couples.

How has childbirth changed between the twentieth century until now?

Until the twentieth century, childbirth usually happened at home and involved the mother, a midwife, family and friends. Today, women in Canada typically give birth in hospitals, attended by physicians who use surgical instruments and anesthetics to protect them and their babies from infection, complications and pain.

What are some methods for optimizing chance of conception?

Using basal body temperature charts to determine when ovulation is likely to occur. Analyzing urine or saliva for luteinizing hormones using over the counter kits. This method is a more precise way to determine ovulation than the basal body temperature chart. Tracking vaginal mucus. Vaginal mucus is thick, white and cloudy most of the cycle but it becomes slippery and clear for a few days before ovulation. A day or so after ovulation, the mucus again thickens and becomes opaque.

What occurs during the first stages of childbirth?

Uterine contractions efface (thin) and dilate (open/widen) the cervix to about 10cm in diameter, so the baby can pass. Stretching of the cervix causes most of the pain of childbirth. The first stage may last from a couple of hours to more than a day. 12-24 hours of labour is considered about average for a first pregnancies. In later pregnancies, labour takes about half this time. The initial contractions are usually mild and widely spaced, at intervals of 10 to 20 minutes. They may last 20 to 40 seconds. As time passes contractions become more frequent and regular, longer and stronger.

What are some instances that make vaginal delivery difficult? What other circumstances increase the likelihood of a c-section?

Vaginal delivery can be difficult if the baby is large, the mother's pelvis is small or misshapen, or the mother is tired, weak or aging. C-sections are used to bypass herpes and HIV infections in the birth canal. C-Cection is also likely to be preformed if the baby presents for delivery in the breech position (feet downward) or in the transverse position (laying crosswise) or if the baby is in distress.

What are some possible treatments for postpartum depression?

Women who experience PPD may benefit from psychotherapy or drugs. Medications that increase estrogen levels or antidepressants may help. Most women recover from PPD on their own. At the very least, women need to know the problem isn't unusual and doesn't necessarily mean something is seriously wrong with them, or that they're not living up to their obligations.

What is zygote infra-fallopian transfer (ZIFT)?

ZIFT involves a combination of IVF and GIFT. Sperm and ova are combined in a laboratory dish. After fertilization, the zygote is placed in the mother's Fallopian tube, to begin it's journey to the uterus for implantation.