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Pregnancy Q&A

This column is for informational purposes only and is not intended to constitute medical advice, diagnosis, or treatment. If you have a medical problem, please call toll-free 1-800-230-PLAN for an appointment with the Planned Parenthood health center nearest you.

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I’m pregnant. Should I get the flu vaccine?

Yes — vaccinations are the best way to protect yourself from the flu. This year, you will need to get two flu vaccinations — a seasonal flu vaccine and an H1N1 vaccine. This will protect you from the different types of the flu that are around this year. You can get both shots at the same time.

It’s especially important for you to get flu vaccinations because normal changes to your immune system during pregnancy can make you more sensitive to the flu. In fact, pregnant women are much more likely to need to be hospitalized for complications from H1N1 flu than other people who get it.

There are two ways that flu vaccinations are given — as a shot and as a nasal spray. Because you’re pregnant, you will need to get the vaccine that is given as a shot. It contains a flu virus that has been killed. The nasal spray is not given to pregnant women because it contains a live virus that has been substantially weakened.
 
Many women ask if flu shots are safe during pregnancy. The answer is yes. The flu shot is safe at any point during pregnancy. Millions of pregnant women have gotten flu shots with no problems. Some women are concerned about the H1N1 vaccine because they think of it as a new and untested vaccine. The fact is that both the seasonal and H1N1 vaccines are made the same way and both are safe.

A small amount of mercury is used to preserve flu vaccines that are packaged in multi-dose vials. There is no evidence that mercury is harmful to use during pregnancy, but some women are concerned about it. As a result of this concern, the makers of the vaccines have made single-dose flu shots with no preservatives. If you are concerned about mercury, you can ask for preservative-free seasonal and H1N1 vaccines. But rest assured that the shots are safe with or without mercury.

This week is National Influenza Vaccination Week — a great time for all people to get flu vaccinations. The H1N1 vaccine is free, but you or your health insurance may be charged a small fee for giving you the shot. With the seasonal flu shot, you or your health insurance will be charged for the vaccine and a small fee for giving you the shot. 

You may be able to get flu vaccines from your doctor, obstetrician, midwife, retail pharmacist, retail acute care center, or other health care provider. Many Planned Parenthood health centers also offer flu shots. Use our health center locator to find the health center nearest you. Regardless of where you decide to go to get your shots, call ahead to make sure the shots are available. If you have not had the seasonal flu vaccine yet, make sure you specify that you need both vaccines — the seasonal flu shot and the H1N1 flu shot.

I’m pregnant. At what point in my pregnancy is it called a baby?

Women have different feelings about when to call it a baby. For some women, it is a baby from the first moment the pregnancy is confirmed or even suspected. For other women, the pregnancy doesn’t become a baby until much later. What’s most important is how the woman feels about it.

Most medical authorities, including Planned Parenthood, agree that it becomes a baby after birth when it takes its first breath. But we value women’s differing feelings about when to use the words embryo, fetus, or baby.

If you would like to learn more about how pregnancy develops, you may like to read our stages of pregnancy page.

Can my girlfriend get pregnant if we have sex when she has her period?

It's not likely, but it can happen. It is possible for a woman to get pregnant from intercourse during her period, especially if her menstrual cycle is brief.

In a 20-day cycle, for example, ovulation — the release of the egg — may very well occur on Day 6 of her cycle. Her period begins on Day 1. It lasts about five days. But a man's sperm can fertilize an egg up to six days in her body. Let's say this couple has unprotected vaginal intercourse in the first two days of her period. The live sperm can wait to join with her egg when it is released on Day 6. This could cause a pregnancy.

It is also possible that a woman may think she is having her period when she is not. It is also possible to get pregnant during breakthrough vaginal bleeding.

It's not only women with short cycles who need to be careful about unprotected vaginal intercourse during menstruation. Even when cycles are long and regular, ovulation may occur on different days in different cycles. That's why abstinence is necessary for several days in a row for women who choose to use fertility awareness-based methods of contraception.

How soon after sex can pregnancy be detected?

Pregnancy tests can detect pregnancy after a missed period  some can even detect it before a missed period.

Despite what some people think, pregnancy doesn't start the day a couple has intercourse. It can take up to seven days after sex for the sperm and egg to join and form a fertilized egg. Then, it can take up to eight days, or more, for the fertilized egg to bury itself in the lining of the uterus. Pregnancy begins when this happens.

Pregnancy tests work by detecting a hormone called the human chorionic gonadotropin hormone (HCG). HCG doesn't start being released until the fertilized egg implants itself and pregnancy begins.

If you do not want to be pregnant and you've had unprotected vaginal intercourse, don't wait to take a pregnancy test. Emergency contraception can be started within 120 hours (five days) after intercourse.

Plan B emergency contraception is now available over the counter for women 18 and older.  Plan B and other forms of emergency contraception are also available by prescription for all women.  Contact your local Planned Parenthood at 1-800-230-PLAN to get EC or to get a prescription for EC if you are younger than 18.  You may also get EC at your local pharmacy if you are older than 18.

 

My friend says that life begins when the egg and sperm join together. I say that it begins when a baby takes its first breath. Which of us is right?

All kinds of people — theologians, philosophers, scientists, lawyers, legislators, and many others — hold very different views about when life begins. In fact, both the egg and the sperm are living things before they meet and join. There's no real argument there.

The really hot question is, "When does being a person begin?" Most medical authorities and Planned Parenthood agree that it starts when a baby takes its first breath.

Some of our oldest religions have changed their views about this question many times over the centuries. Today, some people sincerely believe that being a person begins when the egg is fertilized. Some, just as sincerely, believe that it begins with birth. And lots of others believe it begins somewhere in between.

What we are all sure about is that a pregnant woman is a person. We know for sure that she has morals, feelings, human needs, and a conscience. Because of this, we know that she is the only one able to make a decision about her pregnancy options. She does it based on her own needs, ethics, and religious belief about when being a person begins. It would be wrong to force her to observe someone else's religious belief.

My current boyfriend and I have been together for nearly five years and have never used any type of birth control whatsoever, and I have not gotten pregnant with him once. My periods have always been extremely irregular, and sometimes I skip several months without seeing any spotting at all. Does it sound like I am sterile?

Statistically, 85 out of 100 women of reproductive age will become pregnant during one year of unprotected vaginal intercourse. Usually, couples are advised to have an infertility evaluation if they cannot start a pregnancy after a year of trying. Couples who have unprotected vaginal intercourse for five years without a pregnancy, even though they are not trying, may learn that one or both of them have impaired fertility. To be sure, both partners need to be tested. Fertility testing for men is generally simpler, less intrusive, and less expensive than it is for women.

In 35-40 percent of infertile couples, the woman has a condition that leads to infertility. In 35-40 percent of infertile couples, the man has a condition that leads to infertility. And in 20-30 percent of infertile couples, both the woman and the man have conditions that lead to infertility.

There are many reasons why a woman may be infertile. She may not ovulate, she may have blocked tubes, her cervix may not produce enough mucus to keep sperm alive, or the lining of her uterus may be unable to accept a fertilized egg. Many tests are performed to determine the reason a woman is infertile. An infertility doctor will help each woman determine the reason for her infertility and what can be done to correct it.

A man may be infertile because he doesn't have enough sperm, there is something wrong with his sperm, or he has blocked tubes. In one of the first tests for a man's fertility, a sample of ejaculate is examined to see if there is sufficient healthy sperm to cause pregnancy.

Treatment varies, depending on the causes. Women who want to be tested should contact an obstetrician/gynecologist who is an infertility specialist. Men who want to be tested should contact a urologist who has experience in fertility testing for men.

How accurate are pregnancy tests after abortion?

The pregnancy hormone, HCG (human chorionic gonadatropin), can remain in the body for up to 60 days after an abortion. Similarly, HCG levels can be measurable for weeks after childbirth. This can lead to pregnancy tests with false positive results.

Women who are concerned about the accuracy of pregnancy tests during the weeks after abortion may want to take a few tests a few days apart. That can help them see if the levels of HCG are increasing or decreasing. Women who use home pregnancy tests and who are still concerned that pregnancy is continuing or another pregnancy has occurred can consult their clinicians to test for the precise levels of HCG. After at least two tests, the clinician will be able to tell whether the HCG is rising — a continuing or new pregnancy — or whether it is falling — no pregnancy.

I heard that a woman can

No, it is not true. Women can and do get pregnant from rape. In fact, more than five percent of all rapes result in pregnancy. That is one reason why Planned Parenthood is fighting so hard to make it mandatory for emergency rooms across the country to offer emergency contraception to women who have been raped.

Emergency contraception can reduce the risk of pregnancy by 75 to 89 percent. More than 22,000 unwanted pregnancies a year could be prevented if all U.S. women who were raped were provided with emergency contraception.

How do I find out if I am pregnant?

You need to take a pregnancy test to tell if you’re pregnant.  Home pregnancy tests detect pregnancy by identifying the presence of a certain hormone — human chorionic gonadotropin (HCG).  HCG is the hormone that starts being released when a fertilized egg implants in the lining of the uterus and pregnancy begins.  HCG can be detected in the blood and urine of a pregnant woman.  Some of the newer home tests can detect pregnancy from a urine sample as early as a few days after a missed period. 

If you use a home pregnancy test, which are tests done on urine samples, you must follow directions carefully and correctly.  To be sure about whether you are pregnant, it is best to visit a qualified family planning professional for a pregnancy test and pelvic exam.  Depending on your situation, the medical professional will determine whether to use a urine or a blood test — or both.  (Usually the first step for the medical professional is a urine test, which may be able to detect pregnancy earlier than the one you bought in the store could.)

If you are pregnant — whether or not you want to continue the pregnancy — you need to have medical care and counseling as soon as possible. To schedule a confidential appointment with the nearest Planned Parenthood health center, call toll-free 1-800-230-PLAN. Your call will connect you to the Planned Parenthood health center nearest you.

Is it possible to become pregnant if you

Yes, it is. Unlike the old riddle, "What comes first, the chicken or the egg?" we know for sure that the egg comes before menstruation. If there is no pregnancy after the egg is released from the ovary, the lining of the uterus breaks down and a woman has her period. This is also the way her first period starts.

It is very important for a young woman to know that vaginal intercourse before her first period can cause pregnancy. If she decides to have intercourse before her first period, she must be sure to use contraception to avoid an unintended pregnancy.

Can I have my period and still be pregnant?

No.  Menstruation is the shedding of the lining of the uterus after ovulation when a woman does not become pregnant.  So, it is not possible to have a period and be pregnant.   But it is possible to be pregnant and have vaginal bleeding that may seem to be a period.

Vaginal bleeding during pregnancy is not unusual, but it might signal a problem with the pregnancy.  Bleeding happens to one out of five pregnant women.  The causes vary and depend on how long a woman has been pregnant.  A pregnant woman who discovers that she has vaginal bleeding should contact her health care provider, immediately.

Bleeding during pregnancy means an evaluation needs to be done.  The evaluation may include physical exam, sonogram, and blood work.  Only through evaluation will the health care provider be able to determine the likely cause of the bleeding and what a woman’s options are.  Many times the solution for stopping the bleeding is bed rest and no sex. 

Sometimes, hospitalization is needed, depending upon how long a woman’s been pregnant and whether the pregnancy is wanted.  Regardless of the cause and recommended management, your health care provider will want to follow you closely until the bleeding has stopped for some time.  In some cases, intensive follow-up is necessary until delivery.

What are the symptoms of pregnancy?

The most common symptoms of pregnancy are

• frequent urination

• headaches

• inexplicable fatigue

• a missed period

• nausea

• sore or enlarged breasts

The most common symptom of all is a missed period.  But many women, especially young women, normally have irregular periods. These irregularities may include missed periods and other changes in the menstrual cycle. These irregularities can change from month to month.  Although pregnancy is the most common reason for missing a period, irregularity is also caused by illness, travel, worry, or stress.

For a woman to be sure she is pregnant, she must take a pregnancy test — at home or at her health center or health care provider’s office.  If she uses a home pregnancy test, she must be sure to follow the manufacturer’s directions very carefully.

Home pregnancy test kits are available in most drugstores and many supermarkets.

What if you didn’t know you were pregnant and drank and smoked the first month, could that harm or affect the growth and development of the fetus?

It is unlikely that moderate smoking or drinking during the first month of pregnancy will be harmful. But it is very important for a woman to stop smoking or drinking as soon as she knows she is pregnant — whether she smokes and drinks moderately or heavily.

It’s always best to prepare for the birth of a child before pregnancy. But if preconception planning is not possible, a woman still can prepare during pregnancy. The key is taking good care of her health, which includes eliminating or reducing any toxins in her system as well as having good prenatal care. It will help ensure a healthy pregnancy — from embryo, to fetus, to the birth of her child. The healthier a woman is, the stronger she and her child are likely to be.

There are two important points to remember about toxins that can damage the developing fetus:

  • The most sensitive period for causing birth defects is the fifth to the 10th week after the last menstrual period (the third to eighth week of gestation).
  • Damage to the fetus includes injuries that are not birth defects, such as low birth weight, premature delivery, respiratory problems, developmental delays, or even death. The damage that comes from smoking, drinking, or other toxins is, in general, cumulative. This means that the safest way to prevent toxin-related damage is to stop toxin exposure before pregnancy. The longer and heavier a woman smokes, drinks, takes other drugs, or is exposed to other toxins, the more the fetus is at risk of harm.

The pre-embryo — the developing ball of cells — is not exposed to whatever toxins are in a woman’s bloodstream during the several days after fertilization and before implantation. But after implantation, the embryo begins to receive toxins, as well as nutrients, from the woman’s bloodstream. Several days after implantation, a woman will miss her period, may suspect that she is pregnant, and take a pregnancy test. Once she knows she is pregnant, she must stop letting toxins get into her bloodstream.

Preconception planning provides women with time to identify and clear their systems of toxins before becoming pregnant. It may not be possible, however, for all women to plan their pregnancies. But all women who decide to bring a pregnancy to term should arrange for prenatal care as soon as they discover they are pregnant. Women who smoke, drink, use other drugs, or are exposed to toxins in the workplace should talk with their clinicians to develop plans for stopping or for referrals to programs that can help them break their smoking, drinking, or other drug habits. With the help of a health care provider, women exposed to toxins at work may be able to change their work environments in order to minimize exposure to those toxins.

It is also important for toxin-free women to see a clinician regularly for prenatal visits to help ensure a healthy pregnancy. Women who receive prenatal care are less likely to have serious problems related to pregnancy. And babies are much more likely to be born at a healthy birth weight if their mothers received adequate prenatal care.

Is it bad to have sex with someone who is nine months pregnant? Is it bad to have sex with her just before she is due?

It's perfectly okay for pregnant women and their partners to enjoy their sexuality during pregnancy. For some women, the hormonal shifts during pregnancy increase sexual desire. For others, the discomforts of pregnancy decrease sexual desire. But for most women, having sex during pregnancy can help reduce stress and the tensions that can build up during pregnancy.

Most women who want to are able to enjoy sex throughout pregnancy. A pregnant women should avoid vaginal intercourse if either partner has a herpes sore or if she

  • has a high risk of miscarriage
  • has a high risk of premature labor
  • has broken her waters
  • has pain
  • believes labor has begun
  • is unable to find a comfortable position

Additionally, a pregnant woman should abstain for sex play during the last 12 weeks of pregnancy if she has a partner who may infect her with herpes.

Other satisfying forms of sex play can be enjoyed when a couple wants to avoid vaginal intercourse.

Some time ago you answered "no" to a question about whether or not a woman could ovulate more than once a month. But, isn

No. A woman ovulates once each menstrual cycle. For most women, a menstrual cycle lasts about a month. However, if the woman has very brief cycles — 21 days or so — she may ovulate twice in a calendar month, but still only once in each menstrual cycle.

The birth of fraternal twins does not indicate two instances of ovulation in a menstrual cycle. Fraternal twins result from the fertilization of two eggs that are released in the same instance of ovulation — during the same menstrual cycle. Each egg is fertilized by a different sperm. (In the instance of identical twins, there is only one egg and one sperm. Identical twins result when a single fertilized egg divides into two separate pre-embryos very early in its development.)

Because it is not uncommon for one fraternal twin to be bigger than the other, there is a folk belief that the larger of the twins is "older." But this is a mistaken belief. No matter the size difference, both fraternal twins have developed from eggs that were released at the same time, each fertilized by a different sperm.

To sum up: Ovulation — the release of an egg from the ovary into the fallopian tube — takes place once in each cycle. Ovulation most often occurs 14 days before the onset of menstruation.

I've just found out that I'm pregnant, and I don't know what to do.  How can I decide which choice is best for me?

Deciding what to do about an unintended pregnancy can be very difficult.  It is best to make your decision as soon as you can. There is no right or wrong choice for everyone.  Only you can decide which choice is right for you.  You have three choices:

• You can choose to have a baby and raise the child.

• You can choose to have a baby and place your child for adoption.

• You can choose to end the pregnancy.

 

Consider each of your choices carefully.  Ask yourself :

• Which choice(s) could I live with?

• Which choice(s) would be impossible for me?

• How would each choice affect my everyday life?

• What would each choice mean to the people closest to me?

 

It may also help to take time and ask yourself:

• What is going on in my life?

• What are my plans for the future?

• What are my spiritual and moral beliefs?

• What do I believe is best for me in the long run?

• What can I afford?

Talk about your feelings with your partner, someone in your family, your clergyperson, or a trusted friend.  All family planning clinics have specially-trained staff and volunteers who can talk with you about your options.  They will try to make sure that you are not being pressured into any decision against your will.  You may bring your partner, your parents, or someone else, if you wish. 
 
Look for a clinic that will give you complete information about your options.  If you need help, call your local Planned Parenthood.  If you would like to have a confidential conversation about your pregnancy options at your nearest Planned Parenthood, call toll-free, 1-800-230-PLAN.   Beware of so-called "crisis pregnancy centers" that are anti-abortion:

• They may perform your pregnancy tests without medical supervision.

• They won't give you complete and correct information about all your options.

• They will try to frighten you with films that are designed to upset you about abortion.

• They may lie to you about the medical and emotional effects of abortion in order to prevent you from considering this option.

• They may tell you that you are not pregnant even if you are, to fool you into continuing your pregnancy. The delay would keep you from getting early prenatal care or early abortion.

I missed my period. I should have had it last week. Do you think I

"Do you think I'm pregnant?" is the most common e-mail question we receive. We are asked this question thousands of times a year in a thousand different ways. But this is one of the questions that we cannot answer. The only way to be sure of pregnancy early on is to have a pregnancy test. Pregnancy tests are accurate after a missed period  some can even detect pregnancy a few days before a missed period.

To be absolutely sure, it's best to have the test done by a medical professional. They use urine tests to detect pregnancy. Home tests can also detect pregnancy from a urine sample, but make sure to follow directions carefully and correctly. To make an appointment for a confidential pregnancy test with your nearest Planned Parenthood health center, call toll-free 1-800-230-PLAN.

The most obvious symptom of pregnancy is a missed period. Other possible symptoms include

  • nausea
  • inexplicable fatigue
  • sore or enlarged breasts
  • headaches
  • frequent urination

However, it is possible that any combination of these symptoms could also indicate that a woman is premenstrual, or that she has the flu or some other illness.

Many women, especially young women, have normally irregular periods. These irregularities may include missed periods and other changes in the menstrual cycle. These irregularities can vary from month to month. Although pregnancy is the most common reason for missing a period, irregularity is also caused by illness, travel, worry, or stress.

Pregnancy testing is the only way to be sure.

This column is for informational purposes only and is not intended to constitute medical advice, diagnosis, or treatment. If you have a medical problem, please call toll-free 1-800-230-PLAN for an appointment with the Planned Parenthood health center nearest you.
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Pregnancy Q&A