Birth Control Choice

Birth control or Contraception involves methods that couples can use to prevent pregnancy. Successful and healthy birth control can be achieved by a contraceptive method used by either of the partner.

Women and contraception

Choosing a birth control method is one of the most personal health care decisions you can make. Your choice of Contraception method will primarily depend on your needs. Some women only want to prevent pregnancy while others may also choose Contraception to safeguard themselves from Sexually Transmitted Diseases such as HIV infection which can cause acquired immunodeficiency syndrome (AIDS), chlamydia, herpes, genital warts, Gonorrhea and Syphilis. Your doctor can help you decide the best method for you.

How do birth control methods work?

Birth control methods can work in any of the following ways. They may:

• Prevent the Sperm from reaching the egg.
• Kill or damage Sperm.
• Prevent the release of eggs each month.
• Alter the lining of the Uterus and thereby prevent the fertilized egg from attaching to it.
• Thicken the mucus in the Cervix so Sperm cannot easily pass through it.
• Methods of contraception
  

Avoid sex
The best, easiest and safest method of birth control is avoiding sex.

Barrier methods
The barrier or blocking method of Contraception works by preventing Sperm from getting into the Fallopian Tube and fertilizing the egg. A barrier method needs to be used every time during sex.

• Condoms Condoms are designed for use by both men and women. Condoms also safeguard against sexually transmitted diseases
  

• Spermicides Spermicide is an unscented, unflavored, non-staining, clear and lubricative substance that kills or immobilizes sperms. Using spemicides is not a perfect method of birth control and can even increase the chances of contracting certain sexually transmitted infections and diseases.
  

• Sponge A contraceptive sponge is a small disposable sponge. Sponge blocks sperms from entering the Uterus as well as absorb and kill the sperms. It does not offer any protection against sexually transmitted infections.
  

• Diaphragm The diaphragm is a small, latex, dome-shaped device that fits inside the Vagina. It prevents the Sperm from entering into the Uterus by blocking the Cervix. The diaphragm protects against certain sexually transmitted infections. Doctor’s assistance is required to get the p roper size diaphragm fitted.
  

• Cervical cap A cervical cap is a dome-shaped, soft rubber cap that is fitted by a doctor.The cervical cap acts by blocking the entrance to the Uterus and it also protects against certain sexually transmitted infections, but does not protect against HIV and genital Herpes.
  

Hormonal methods Hormonal methods of Contraception involve the use of hormones like Estrogen and Progestin. Hormonal methods of Contraception do not protect against sexually transmitted infections.

• Oral contraceptives or birth control pills Oral contraceptives or birth control pills are medicines taken by mouth to help prevent pregnancy. They are mostly made of the hormones Estrogen and Progestin which prevent the release of an egg by the ovaries during Ovulation. However, consult with your doctor prior to using birth control pills.
  

• Birth control patches These patches are made of Estrogen and Progestin and stuck on the buttocks, abdomen, upper body or outer arm. Patch is applied weekly for 3 weeks with 1 week patch free interval.
  

• Vaginal ring This is a thin, flexible ring that can be inserted into the Vagina. The vaginal contraceptive ring is coated with hormones like Estrogen and progestin, which are slowly released to prevent pregnancy.
  

• Hormone injections The mode of action of Hormone injections to prevent pregnancy is similar to that of the oral contraceptive pill. Advantage is that instead of daily swallowing a pill, the injection is to be repeated at one, two or three monthly interval depending on the formulation.
  

• Implant An implant is a small flexible rod that is placed just under the skin in the upper arm. It releases progestogen Hormone and works by preventing Ovulation. An implant is effective for 3–5 years. An implant will not protect from Sexually Transmitted Diseases. You will require a doctor’s help to get the implant inserted or removed.
  

• Intrauterine devices (IUD) Intrauterine device is a birth control device that is inserted into the Uterus. It is believed that IUDs either block sperms from reaching an egg, or prevent a fertilized egg from implanting itself on the uterine wall. Once inserted by a doctor they provide effective Contraception for 3–10 years depending on the type being used, but can be easily removed, any time desired.
  

• Sterilization There are different techniques of sterilization for both men and women. Male sterilization is achieved through a surgical procedure called vasectomy. Female sterilization is achieved through a surgical procedure called tubal ligation in which a woman's fallopian tubes are surgically cut or blocked to prevent pregnancy. This permanent method of birth control is intended for individuals who do not wish to ever have more children.

Medical Abortion

This is the newly introduced method of terminating a pregnancy. At your first visit in addition to the history and examination, an ultrasound may be performed to confirm you are less than 7 weeks pregnant. The medical abortion is performed using two types of medicines called Mifepristone (RU486) and Misoprostol. Mifepristone detaches the pregnancy from the uterus. When the Misoprostol is given, the uterus contracts and the pregnancy is usually expelled within 6 to 8 hours.

If you would like to undergo a medical abortion and if you are eligible, the Doctor will give you Mifepristone tablets at the first visit. Upon taking mifepristone at the clinic you may begin to bleed. As each woman's body is different, bleeding varies from woman to woman. Some may experience light bleeding much like spotting towards the end of a menstrual period. Others have heavier bleeding like their regular menstrual period, or like a heavy period. Some women do not experience any bleeding until taking the misoprostol.

You will then return to the clinic after 48 hours for the Misoprostol. This will be administered by inserting the tablets in the vagina. Upon inserting the misoprostol tablets into your vagina, cramping, bleeding, and clotting may begin as soon as 20 minutes. Within the next 6 to 8 hours, most women will miscarry. Cramping may come in waves with increasing and decreasing intensity. You can expect bleeding heavier than a menstrual period with clots. During this time, you will pass the pregnancy although you may not see it since it is very small.

A follow-up exam is scheduled for two weeks later to make sure the process is complete. If you have not yet miscarried, we will perform a surgical abortion. A very small percentage (5%) of women do not pass the pregnancy tissue and need a surgical procedure to complete the process. Most of the side effects when using this early abortion option are caused by the second medication, misoprostol. Side-effects may include heavy bleeding, headache, nausea, vomiting, diarrhea, and heavy cramping. Vaginal bleeding during the induced miscarriage could be extremely heavy. In rare situations it could require a surgical abortion and very rarely, a blood transfusion. If you feel that there are any problems, you can come to the Hospital at any time of the day or night. If pregnancy is continued after taking these medications, there is a risk of fetal deformities.

No confusion, please!

Do not confuse the Abortion Pill with Emergency Contraception Pills. They are completely different medications taken for different purposes. The Abortion Pill causes pregnancy termination and is used after pregnancy is established yet early in the pregnancy (8 weeks since last menstrual period). Emergency Contraception, also known as the "morning after pill" is used to prevent pregnancy after sex when taken within days after unprotected intercourse. Emergency Contraception does not cause abortion and it will not harm an existing pregnancy.

Conception Tips

If conceiving a baby is right on top of your priority list, here are a few fertility tips that help ensure you get pregnant as fast as you can.

Conception TipsEat Healthy
A nutritious diet goes a long way in helping you conceive. So pack your platter with fruits, vegetables and whole grain foods - as these will nourish your body and boost your flagging energy levels.

Take Folic Acid
Start taking a folic acid supplement even before you conceive, as it increases your chance of conception considerably - and is essential at the embryo stage. Fruits and dark-green leafy vegetables are also a rich source of folate.

Cut the Caffeine
Too many cups of coffee (more than 3 cups per day) could contribute to fertility problems. Caffeine is also believed to restrict the growth of the developing baby by constricting blood vessels and reducing blood flow to the uterus. So cut down on the number of cups or switch to de-caf.

Drink Plenty of Water
Water is the body's temperature regulator and lubricant. Research shows that increased levels of moisture in the body helps regulate the over all body temperature and thus, the conditions for conceiving greatly improves.

Monitor Ovulation
Keep track of your ovulation pattern by maintaining a menstrual calendar. You could also use an over-the-counter ovulation kit to predict your fertile days. If you are monitoring your cervical mucus, do your checks before you bathe or swim as these could impact the characteristics.

Be Sperm-friendly
Avoid vaginal sprays and scented tampons (which can cause a PH imbalance in the vagina) - to maintain a sperm-friendly environment. Stay away from artificial lubricants, vegetable oils, glycerin and saliva as all these can kill sperm. Douching also alters the normal acidity of the vagina and may wash away the cervical mucus that is needed to transport the sperm.

Do away with Stress
Studies have indicated that people who live highly stressful lives everyday, or have highly stressful work or jobs have a high tendency to not be able to conceive. As stress causes the body to release hormones that could slow down the fertility cycle, it helps to be stress-free when you are trying to conceive.

Relax in Bed
Stay in bed for a while after you make love, and avoid jumping up and running to the bathroom right after you make love. Lying down (for at least 5 minutes) after you make love increases the chances of the sperm meeting the egg.

Keep Sex Fun
You could use rooms other than the bedroom or schedule your baby making rendezvous for an odd time of day - to maintain the fun and excitement. Remember, you won't be able to keep up the baby making pace for very long if sex starts feeling like a chore.

Make Love as often as you can
Frequent lovemaking during your fertile period (the five days leading up to ovulation) most often results in pregnancy. Making love at least every 48 hours during this period, will ensure that there's a fresh supply of sperm waiting in the fallopian tube.

Mifepristone

Mifepristone is a medication that blocks the action of the hormone progesterone. Progesterone is needed to sustain a pregnancy. Mifepristone has been used, in combination with other medications called prostaglandins, for medical abortion since 1988 in France and China, and since the early 1990's in the United Kingdom and Sweden. It has been more recently licensed in nine other European countries and Israel. In September 2001, Mifepristone was approved for distribution in New Zealand. Millions of women worldwide have safely used mifepristone regimens to end their pregnancies.
How mifepristone works to end pregnancy

Mifepristone blocks the action of progesterone, which is needed to sustain a pregnancy. This results in:

• Changes in the uterine lining and detachment of the pregnancy,

• Softening and opening of the cervix,

• Increased uterine sensitivity to prostaglandin.

Mifepristone is used in combination with another medication, a prostaglandin analogue called misoprostol. Misoprostol causes the uterus to contract, and helps the pregnancy tissue to pass.
How effective is the combination of mifepristone and misoprostol in terminating an early pregnancy?

Approximately 95% of women will have a complete abortion when using mifepristone/misoprostol up to 49 days after the start of the last menstrual period. The remaining women will need a suction abortion either because of ongoing or excessive bleeding, an incomplete abortion (tissue remains in the uterus but there is no growing embryo), or an ongoing pregnancy (a viable growing pregnancy, which occurs in less than 1% of cases).
Treatment regimen with mifepristone/misoprostol

Clinical studies have shown that several variations in mifepristone/misoprostol treatment regimens are safe and effective. Generally, however, once a woman has decided to have a medical abortion, there are three steps in the process of a medical abortion:
Step One

• A medical history is taken and a clinical exam and lab tests are performed.

• Counselling is completed and informed consent is obtained.

• If eligible for medical abortion, the woman swallows the mifepristone pill(s).

Step Two

• This step takes place about two days after step 1.

• Unless abortion has occurred and has been confirmed by the clinician, the woman uses misoprostol. Misoprostol tablets may be swallowed or inserted into the vagina, depending on the treatment regimen.

Step Three

• This step takes place approximately 11-17 days after step 2.

• The clinician evaluates the woman to confirm a complete abortion. It is essential for women to return to the office/clinic to confirm that the abortion is complete.

• If there is an ongoing pregnancy, a suction abortion should be performed.

• If there is an incomplete abortion, the clinician will discuss possible treatment options with the woman. These may include waiting and re-evaluating for complete abortion in a number of days or performing a suction abortion.

Possible side effects of a mifepristone abortion

Side effects, such as pain, cramping and vaginal bleeding, result from the abortion process itself, and are therefore expected with a medical abortion. Other side effects of the medications themselves may include nausea, vomiting, diarrhea, chills, or fever. Complications are rare, but may include excessive vaginal bleeding requiring transfusion , incomplete abortion or ongoing pregnancy which requires a suction abortion .
What women can expect from a mifepristone abortion

• Medical abortion with mifepristone/misoprostol requires at least two visits to a doctor's office or clinic.

• Approximately 95% of women using mifepristone/misoprostol up to 49 days since the last menstrual period will have a complete medical abortion.

• Approximately two-thirds of women will have a complete medical abortion within 4 hours of using the misoprostol.

• Approximately 90% of women will have a complete medical abortion within 24 hours of using the misoprostol.

• Complete abortion generally occurs more quickly when misoprostol is used vaginally rather than orally.

• On average, women may expect to have bleeding and/or spotting for 9-16 days.

• Women may pass clots, ranging in size.

• Some women may see grayish pregnancy tissue.

• If the medications fail to end the pregnancy, a suction abortion should be performed. For this reason, a woman who chooses medical abortion must be willing to have a suction abortion if needed.

Early signs of pregnancy

If you are in tune with your body, you may notice certain signs that you are pregnant soon after conception. However, most women won’t experience any early pregnancy symptoms until the fertilised egg attaches itself to the uterine wall, several days after conception. Others may notice no signs of pregnancy for weeks until they miss their period. You may experience all, some, or none of these signs of pregnancy.

From 1 week after ovulation

Implantation Bleeding
This can be one of the earliest symptoms of pregnancy, a slight staining of a pink or brown colour. It can occur on about day 6 - 12 after conception as the egg attaches itself to the uterine wall. You may also experience some spotting and cramps.

Light bleeding may also occur for other reasons, like menstruation or an infection.

Rising basal body temperature (BBT)
If you have been measuring your basal body temperature, you may notice a rise in temperature 6 -8 days after conception. This is the most consistant early sign of pregnancy, but as all signs if may not occur.

Tender/swollen breasts
If you are pregnant, your breasts may become increasingly tender, similar to the way they feel before your period. This can occur 1 - 2 weks after conception.

Fatigue/Tiredness
Feeling tired or more fatigued is a pregnancy sign which may start as early as the first week after conception.

Backaches
Lower backaches may be a symptom that occurs early in pregnancy.


From 2 weeks after conception

Missing menstruation
If you have regular periods, a missing period is one of the surest signs of pregnancy - prompting women to take a pregnancy test.

Food cravings
Food cravings sometimes can be a sign of pregnancy. Don’t rely on them as a sure symptom as it could be all in your head, or even a sign that your body is low on a particular nutrient.

Altered sense of taste
You may notice that your sense of taste changes. Some women say they have a metallic taste in their mouth, others that they cannot stand the taste of coffee, tea, or a food they usually like.

Frequent urination
Once the embryo implants and begins producing the hormone human chorionic gonadotropin (hCG), you may need to go to the bathroom more often.

Of course, the surest way to find out is by purchasing Pregnancy Tests. They can be used from up to three days before your period is expected.

Pre-Eclampsia in Pregnancy

Pre Eclampsia is the most common serious medical disorder of human pregnancy. It can affect both the mother and her unborn baby. It usually arises during the second half of pregnancy, and can even occur some days after delivery.

In the mother, it can cause several problems of which she may be unaware – such as high blood pressure (hypertension), leakage of protein into the urine (proteinuria), thinning of the blood (coagulopathy) and liver dysfunction. Occasionally, Pre Eclampsia can lead to convulsions (fits), a serious complication known as eclampsia. Also, when a pregnancy is complicated by PE, the baby may grow more slowly than normal in the womb or suffer a potentially harmful oxygen deficiency.
How Common Is Pre Eclampsia?

Pre Eclampsia can affect as many as 10% of pregnancies, which makes it one of the most common pregnancy complications. It occurs more often in first pregnancies. Occasionally, women who have suffered it once find that it recurs in one or more subsequent pregnancies, and rarely a woman who has not experienced it in earlier pregnancies may develop it in a subsequent pregnancy.
What Is The Cause Of Pre Eclampsia?

The precise cause of Pre Eclampsia is unknown. However, genetic factors are probably involved, given women whose mothers and/or sisters have suffered Pre Eclampsia are at increased risk of the disease themselves. There is good evidence that the placenta is centrally involved in the development of Pre Eclampsia.

During pregnancy, the placenta requires a large blood supply from the mother to sustain the growing baby. It seems that in Pre Eclampsia the placenta does not receive sufficient maternal blood for its requirements. When this occurs, damage to the mother’s blood vessels follows, the result of which is increasing blood pressure. Kidney function is also disturbed and blood proteins leak from the mother’s circulation through the kidney into the urine. As Pre Eclampsia worsens, other organs are affected, including the mother’s liver, lungs, brain, heart and blood clotting system. Dangerous complications such as eclampsia (convulsions), cerebral haemorrhage (stroke), pulmonary oedema (fluid in the lungs from heart failure), kidney failure, liver damage and thinning of the blood (disseminated intravascularcoagulation) can occur in serious cases. However, these complications are fortunately rare.
How can Pre Eclampsia be detected and what are the symptoms?

A combination of rising blood pressure and protein in the urine can suggest Pre Eclampsia may be developing. As yet, there is no precise diagnostic test for Pre Eclampsia. However, if a previously healthy pregnant woman develops high blood pressure and proteinuria in the latter half of her pregnancy, then the diagnosis is almost always Pre Eclampsia. Some swelling (oedema) is common in normal pregnancy, but excessive swelling which also involves the face can occur in Pre Eclampsia. In severe Pre Eclampsia, other symptoms can appear, including severe headaches, visual disturbances (such as flashing lights), vomiting and pain in the upper abdomen. While such symptoms may have other less dangerous causes, they should never be ignored during pregnancy.

The relative deficiency in the blood supply from the mother to the placenta limits the baby’s supply of nutrients and oxygen, which may lead to reduced growth of the baby (intrauterine growth restriction) and even oxygen deprivation. The timing of delivery in cases of Pre Eclampsia which arise early in the second half of pregnancy can be particularly difficult, because a very premature fetus may be severely affected by Pre Eclampsia, but on the other hand, cannot be certain of survival outside the womb either.

Once a woman with Pre Eclampsia has developed persistent hypertension and significant proteinuria, the disease is considered to be severe and hospitalisation is required for careful monitoring of maternal and fetal welfare, stabilisation of various complications of Pre Eclampsia and preparation for delivery. Even though some features of pre-eclampsia. can be temporarily improved by treatments, the disease itself is progressive (sometimes slowly, but sometimes rapidly) until delivery. Blood pressure lowering drugs may often be necessary to reduce the risks of complications such as heart failure and stroke. Anticonvulsant drugs such as magnesium may also be required to prevent or treat eclamptic fits. Because of the progressive nature of Pre Eclampsia, once admitted, women are not usually discharged until after delivery.
How Can I Best Prevent Pre Eclampsia?

The best way to minimise the harm that Pre Eclampsia may cause in a pregnancy is to regularly attend for antenatal check-ups, so that the chance of detecting Pre Eclampsia in its earliest stages is optimised. If a woman is at particular risk of Pre Eclampsia, then it would be wise for her to attend a specialist obstetrician or maternity hospital with skill and experience in the management of Pre Eclampsia and its complications. Such women especially should consult with their doctors early in pregnancy, or even before pregnancy, to plan their antenatal care. All women should ensure that their blood pressure is checked regularly during pregnancy and that their urine is examined for the presence of protein. While small amounts of protein in urine specimens may be normal during pregnancy, amounts greater than a “trace” should not be ignored and should lead to further investigations to determine the cause of the proteinuria. Besides Pre Eclampsia, attention may be drawn by this simple antenatal test to other pregnancy problems such as urinary tract infections.

Women should always report worrying signs or symptoms to their doctor during pregnancy. Often there may turn out to be no cause for alarm, but it is a simple matter to have a blood pressure measurement, a urine check, a blood test or other investigations/ examinations to be sure that Pre Eclampsia is not the cause of the symptoms or signs of concern. Unfortunately, Pre Eclampsia does not provide a woman with early warning symptoms or signs so never miss an antenatal appointment!!
Personal Stories of Pre Eclampsia
Christine’s Story

I spent the first 5 months of my pregnancy in and out of hospital due to Hyperemesis Gravidarum, an abnormal condition of pregnancy where I could not stop vomiting. At 20 weeks gestation instead of putting on weight, I had lost 12kgs. By the time I was 22 weeks I still required anti-nausea drugs 3 times every day. Despite still feeling nauseous every day the vomiting had stopped, allowing me to finally eat and more importantly keep food down.

An underlying kidney disease increased the risk of complications during my pregnancy, one of which was Pre Eclampsia. By around 26 weeks my blood pressure started to slowly creep up a little each visit. Some protein was evident in my urine so I started to have fortnightly visits with the obstetrician. At my 28-week appointment the Ob decided to order another ultrasound, he had concerns that the baby had stopped growing. The results stated that my baby was 1-2 weeks smaller than the dates would suggest, and that it was nothing to worry about!

By the following visit my blood pressure had become borderline and I was told to see my GP in the middle of the fortnight. At this stage I had a persistent headache, being a headachy and migraine person I didn’t think anything of it. The one thing that did concern me was that during a 24 hour urine test that I completed over the weekend, it seemed as though none of the fluid I was drinking was coming back out of me. Little did I know that this was being caused by the pre-eclampsia. Thankfully I had made an appointment to see my GP on the Monday afternoon. It was then discovered that my blood pressure was 160 over 110, I was told to go straight to the hospital.

When I arrived at the hospital they planned to control my blood pressure via medication and complete bed rest for as long as possible. As a precaution they gave me steroid injections to prepare the babies lungs for an early delivery. In anticipation of potential complications they transferred me to a major hospital, which was better equipped to handle pre-term infants.

The following day was spent nervously completing tests and awaiting results. Later that same evening my whole body started to shake uncontrollably, and while attached to a foetal heart monitor I watched my unborn babies heart rate drop repeatedly to dangerously low levels. At this point the decision was made to perform an emergency caesarean. As we had discovered everything about pregnancy and evidently birth was completely out of our control, we just had to accept the situation and hope for the best. So while being prepped on the operating table I was not at all surprised at the discovery that the epidural had not worked! A general anaesthetic was organised and at 8.47pm that evening our tiny little boy Kyle Reid, weighing 2 pound 3 ounces (1040gms) was delivered.

It was explained that the Pre-eclampsia symptoms would get worse before they got better. This meant that I remained in the labour room until stabilised on the 4th day. I remember that my vision was very blurry and I experienced temporary hearing loss. I still had the shakes and was apparently quite puffy due to all that fluid my body was saving for a rainy day! I do remember asking my Mum if it was all a bad dream, had I ever been pregnant, and more importantly did I really have a baby? The nurses refused to take me to see him, and said that he was too sick to come up to me. It really felt like my worst nightmare, every time I was lucid enough to remember, my heart broke again, the only contact with my tiny baby was through a Polaroid photograph. On the 3rd day the nurses relented, they felt that keeping me from my child was becoming detrimental to my health so I was finally wheeled up to see him!

Upon further investigation of my placenta, massive calcification was discovered, we were told that our baby would have been lucky to survive another 2 weeks in utero. It makes me shudder to think what may have happened if we hadn’t gone to the GP in between visits to the obstetrician. We really are lucky parents to have our beautiful son. Kyle remained in hospital for 8 weeks, experiencing ups and downs, he came home weighing a whopping 4 pound 5 ounces (2045gms). The ups and downs continued throughout the first year and I am glad to say he is now a healthy, happy 18 month old. My blood pressure remained a problem for about 4 months after the delivery, requiring medication to control it. My eyesight was also poor for a couple of months but thankfully like my blood pressure it all returned to normal after a short while.
Anne’s Story (may be upsetting for some readers).

After two miscarriages, I was thrilled to find I was pregnant and doing well. At 23 weeks, my feet had become so swollen with fluid that I found it difficult to wear shoes, but I thought this was quite normal in pregnancy. At 25 weeks, the swelling spread to my hands and face, I couldn’t open my eyes because of the fluid. The local GP said it was an allergy. Blood pressure was slightly raised; I had severe headaches, indigestion and heartburn. At 26 weeks, the obstetrician found my blood pressure and protein was extremely high.

I was told I would die if I wasn’t delivered within 24 hours. He took me immediately by taxi to the hospital for an emergency Caesarean section, but delivery was delayed by 24 hours as the risk of heart attack or stroke was so great. The next day, under general anaesthetic, my daughter Brooke was born, weighing (804gm) l lb 12.5oz. It was discovered that I had had an abruption and a huge blood clot had formed between the placenta and my baby daughter. Her chances of survival had dropped from 30 percent to 10 percent. Brooke struggled long and hard for life.

After delivery I lapsed into a coma, lasting six days. The massive amounts of fluid made my brain swell, causing vivid hallucinations, aggressive behaviour and fear for my life. I was blinded for a period of time, alternating with double vision. Even today, it’s hard to believe that I lost six days out of both our lives.

On day six I saw my beautiful daughter for the first time. She was so tiny and grey-looking. The ventilator tube took up most of her face. There was very little of her that I could touch, due to all the tubes and equipment attached to her. I didn’t feel like a mother. I couldn’t hold my baby.

Brooke had sustained severe brain damage as a result of Pre-eclampsia. I cried an ocean of tears.

My little miracle, Brooke, came home 93 days later. With her she brought much love and happiness. Her struggle for life ended thirteen months and eighteen days later. But she leaves us with much determination and inspiration.

This is the first time I have put pen to paper to publicly share my experience, in the hope that I can help other bereaved parents.

Early Pregnancy Signs

One of the most trying times in a woman’s life is when she suspects that she may be pregnant. Whether or not you have yet missed a menstrual period or taken a test, you may be experiencing symptoms that just make you wonder. Taking a look at some of the early pregnancy signs is a good way to determine if you need to take a home pregnancy test or make a doctors appointment. Some women experience no symptoms at all, but most pregnant women have at least a few body clues as to the idea that they may be pregnant.

There are many early pregnancy signs, some of which are similar to those symptoms you get around the time of your menstrual period. Mild cramping and bloating are very common in early pregnancy and can be mistaken for premenstrual issues. Mood swings due to increasing levels of hormones are also often mistaken for symptoms of PMS. Breast soreness or tenderness is another confusing sign women tend to overlook early on. However, if you are experiencing these signs and your period does not start or is nothing more than spotting, you may want to take a pregnancy test.

Stomach issues are some of the most common early pregnancy signs. Most times this is displayed as morning sickness, which is nausea or vomiting. The name morning sickness is a bit misleading, because it can occur at any time of the day. This can sometimes be brought on by sights or the extreme sensitivity to smell that some women experience in early pregnancy. Some women have strange food cravings, while others are constantly hungry. Each woman will react differently to the changes in her body and hormone levels, so none of these signs are considered abnormal.

There are various other early pregnancy signs that can seem quite random, but are not unusual or unheard of. Early weight gain can be a sign that your body is preparing to support another human being. Dizziness and faintness are also not unusual. Increased vaginal discharge can be a frightening thing, but is very common. Frequent urination is sometimes an annoyance in early pregnancy, but tends to get better for a while before returning in the third trimester. Headaches, due to all the hormonal changes in your body are not an uncommon occurrence. These are just a small sample of the various symptoms women get, so don’t be surprised if you experience other seemingly strange signs during early pregnancy.

Your body will go through many things throughout pregnancy, so be prepared. These early pregnancy signs are just a taste of what is to come. Some of these symptoms will disappear as quickly as they came, only to be replaced by a new sign. Other symptoms will stick with you until the day you deliver your baby. A trained medical professional can help you to make sense of the things you are experiencing, whether or not these symptoms are actually signs of pregnancy, so please consult a doctor whenever necessary.

Protecting the unborn who have disabilitie

Protecting the unborn who have disabilities

It’s time for many of the critics of the Federal Government’s decision to cut Medicare rebates for early ultrasound tests to be up-front about why they’re upset.

Behind the rhetoric about denying choice and compromising women’s health is the more sinister reason for their discontent: the lost opportunities to search for and destroy unborn children with disabilities.

Not that many people have been prepared to put it that plainly.

But their intention is pretty clear: they object to the reduced opportunity to detect and eliminate "abnormalities" using abortion. The perception is that being born with a disability is a fate worse than death.

The demonising of disability is aptly demonstrated by the often-used phrase "severe foetal abnormality".

What this phrase really means is that all unborn children who can be detected with a disability, whether it be spina bifida, Down syndrome or another condition, will be in danger of abortion.

Both spina bifida and Down syndrome are disabilities which present great challenges, but with which many people in our community live happy lives.

These people are not the monsters implied by the offensive term "severe foetal abnormality".

The intolerance of our society for people with disabilities is demonstrated by figures released last year by the Australian Institute of Health and Welfare, which show that in 1987, about seven babies born out of every 10,000 had spina bifida.

By 1996, this had fallen to about three for every 10,000 live births. This fall was not achieved by some miracle of foetal surgery, nor by the increased consumption of folic acid.

In 1996, 46 per cent of unborn children detected with Spina Bifida were aborted, up from 7% in 1987.

Prenatal diagnosis, with the intent of selectively aborting unborn children because they have a disability, is blatant discrimination.

But why does this discrimination exist? Is it the parents’ fault? I don’t think so.

There are lots of parents out there who are scared that their child will have a disability not just because they are caring people, but because they know how difficult it will be for them and their child, often without adequate support for their special needs.

Often parents are given a particularly negative assessment of their child’s prospects if their child is identified as having a disability.

They know that their child must meet our society’s strict physical and mental standards, or be considered of lesser value.

IVF pioneer Dr Robert Edwards, at a conference in France last year, commented that "soon it will be a sin of parents to have a child that carries the heavy burden of genetic disease.

"We are entering a world where we have to consider the quality of our children".

Disabled Peoples International put it best when they commented on a government discussion paper some years ago: "it is a particular tragedy that people should feel that there is so little social support and assistance, and that disability is so appalling that they should seek an abortion lest they raise a ‘defective’ child.

"Indeed, we question a social system which is prepared to fund the elimination and screening of people with disabilities, yet is not prepared adequately to fund the personal care and education services we need to lead autonomous, happy and successful lives in the community."

Cost is another factor that some commentators no longer feel embarrassed to raise.

The Canberra Times’ editorial of January 11 championed early ultrasound tests saying "... the costs may be justified given the long-term costs of bringing up disabled children."

The cost-benefit of allowing a person to be born must surely be a very difficult calculation, not the least because of all the intangibles like the happiness a person can experience just from being alive.

The benefit side of the equation is rarely addressed - it is assumed that a child with a disability will bring no benefit, no happiness to others.

More importantly, it is assumed that the child has no inherent value and that she or he can only be a cost.

During a debate on abortion law in the ACT in 1998, the ACT Department of Health and Community Care advised the Health Minister of the cost - but not the benefit - of every extra child born with a disability.

Ironically, though these life or death decisions often depend on the result of an ultrasound test, the recent Senate report "Rocking the Cradle" found that the tests are not 100% accurate and that sometimes babies are falsely identified as having an "abnormality".

"In some instances normal babies have been aborted because of false-positive diagnoses."

One submission highlighted by the Senate Committee said "I find that most women, once aware of the likelihood of false positive or false negative results with regard to ultrasound do not want the screening."

The more we are willing to accept and support people with disabilities as just a natural part of our community’s diversity, the more compassionate and accepting we will all become.

This discrimination against disabilities doesn’t just mean the end of many unborn children detected with a disability.

It also means that the lives of the people who slip through the screening net are devalued too.

How effective is the Pap smear?

How effective is the Pap smear?
Regular Pap smears every two years can help prevent up to 90 per cent of the most common type of cervical cancer.

Like all screening procedures, the Pap smear has limitations. Sometimes it will not detect early cell changes because the smear did not contain enough abnormal cells. Sometimes samples are difficult to interpret due to blood or mucus on the slide. If this occurs, the general practitioner or nurse may need to take another Pap smear.

What is the cause of cervical cancer?

What is the cause of cervical cancer?
Human Papilloma Virus (HPV), a sexually transmitted infection which in most cases (80%) is cleared by the body’s immune system in 8-14 months. The presence of HPV may be detected by the Pap smear. Some women who have persistent infections may develop abnormalities of the cervix. This is why it is important to have a regular Pap smears.

What are the symptoms of cervical cancer?

What are the symptoms of cervical cancer?

In the early stages of cervical cancer, there are usually no symptoms. The only way to detect changes is if you have a Pap smear.

If you have any abnormal vaginal bleeding (such as intermittent bleeding, bleeding after sex or after menopause), abnormal or persistent vaginal discharge (bloody or offensive), or pelvic pain, you should see your general practitioner.

What is a Pap smear?

In 1928, Dr Papanicolaou discovered that cells in the cervix change in appearance before they become cancerous. The Pap smear, named after the doctor, is used to check changes in the cervix (the neck of the womb) at the top of the vagina. It is a screening tool to find early warning signs that cancer might develop in the future.

The Pap smear is a simple procedure. Cells are collected from the cervix and placed (smeared) onto a slide. The slide is sent to a laboratory where the cells are tested for anything unusual. If abnormal changes are found at screening, further tests will be done to see if treatment is needed.

The Pap smear is not for diagnosing cancer, but rather, for finding early changes which might become cancer.

A Pap smear only takes a few minutes. No drugs or anaesthetics are required and it can be done by a general practitioner, nurse or women's health worker.

The Pap smear does not check for other problems in the reproductive system. It is not a check for sexually transmitted infections. Women who are worried that they may have a sexually transmitted infection should talk to their general practitioner about the tests and treatments available.

Help I think I'm pregnant

Menstruation can be delayed for a few reasons - either pregnancy has occurred or some other factor has come into play.

Please note that the following information applies to natural cycles - that is, if you are not taking the Pill.

When trying to work out why your period is not arriving when it is due, the first question to consider is have you been sexually active that month?


Sexually active - Intercourse

If you think that you have had sexual intercourse without contraception since your last period - you need to determine if you were fertile when intercourse occurred.

You are fertile when you are ovulating - usually mid cycle. This fertile time is generally accompanied by an increase in vaginal or cervical mucus - discharge. This is a signal you are fertile. How do I know I am fertile provides more information on recognising mid cycle ovulation.

And there is also a possibility of being fertile during your natal lunar fertile time.

Two fertile times provides information on your natal lunar fertile time.

If you think intercourse occurred at one of your fertile times - The best course of action at this point is to take a home pregnancy test , you will save yourself the worry and be better armed to deal with the situation.

If it is less than 72 hours since intercourse occurred you may want to consider the morning after pill - This form of emergency contraception is taken in two doses: the first within 72 hours of unprotected sex and the second 12 hours later. These pills work by inhibiting fertilization or implantation. The morning after pill will not work if the woman is already pregnant.
Sexual activity - withdrawal

Withdrawal or where the man pulls his penis out before he comes or ejaculates is NOT a reliable form of contraception. Sperm is often present on the tip of the penis even before he comes - if you are fertile and engaging in this form of intercourse you are running a very serious risk of getting pregnant.

Other sexual activity.

If you haven't had sexual intercourse at all, but have participated in heavy petting, then it is not likely that you are pregnant.
Can you get pregnant without having sexual intercourse?

No you can't , However there is a remote chance of getting pregnant if the penis or sperm comes in contact with the mouth of your vagina when you are fertile, that is, in the presence of your wet, slippery mucus. To be on the safe side, whenever you are fertile keep the penis well away from your vagina.

Another important thing to remember is that sperm can live for up to 5 days, so knowing your body and its fertility and allowing a number of safe days (generally about 5 days) leading up to and after (2-3 days) ovulation / fertile times is essential.

So if your sexual activities have not included any of the risky behaviour above then you probably aren't pregnant and the delay is being caused by other factors. In this scenario the other factors are usually worry and anxiety about being pregnant.

The best thing to do, although not the easiest thing to do is to relax and allow your body to do its thing.

You might want to try visualising your blood flowing, or using affirmations like "I now release the worry of being pregnant and welcome the flow of my blood" or what ever feels comfortable for you.

This might sound a bit weird but our thoughts and emotions have such a profound effect upon our menstrual cycles that it is definitely worth giving it a try.

Run yourself a nice hot bath, use some essential oils or bath salts, light some candles, and just relax and let your body unwind. You may also want to try have your lower back or abdomen massaged, and doing other forms of exercise where you are loosening up your pelvic / hip area.

Irregular cycles gives a more in depth look into some other reasons why your period might be late.

Are You Pregnant?

Pregnancy symptoms vary from woman to woman and even pregnancy to pregnancy. If you're particularly tuned in to your body's rhythms, you may begin to suspect you're pregnant soon after conception. But most women won't experience any early pregnancy symptoms until the fertilised egg implants into the uterine wall, on average six to twelve days after ovulation. Other women may notice no signs of pregnancy until a delayed or missed menstrual cycle, one of the most pronounced and significant symptoms of pregnancy.

Whether you're trying to get pregnant, or trying not to, it's important to understand indicators of pregnancy because each symptom may be related to something other than pregnancy.

Below is a list of some of the most common first signs that you may be on your way to becoming a mother. You may experience all, some, or none of these signs that you could be prego:

• Food cravings

Admittedly it's a cliché, but food cravings sometimes can be a sign of pregnancy. Don't rely on a hankering for pickles and ice cream as a sure symptom of pregnancy - it may be all in your head, or even a sign that your body is deficient in certain nutrients - however, if cravings are accompanied by some of the other symptoms on this list, it could mean that you might be eating for two.

What else it could mean: Poor diet, nutritional deficiency, stress, depression, or impending menstruation.

• Darkening of your areolas

If the skin around your nipples darkens, you may be pregnant, though this may also mark a hormonal imbalance unrelated to pregnancy or be a leftover effect from a previous pregnancy.

What else it could mean: Hormonal imbalance unrelated to pregnancy or may be a leftover effect from a previous pregnancy.

• Light bleeding or cramping

Implantation bleeding can be one of the earliest pregnancy symptoms when, about six to twelve days after conception, the embryo burrows into the uterine wall. As a result of this, some women will experience implantation spotting - a slight staining of a pink or brown colour - as well as some cramping.
You might mistake implantation bleeding for a very light period, as spotting can occur around the time you expect your period.

What else it could mean: Actual menstruation, altered menstruation, changes in birth control pill, infection, or abrasion from intercourse.

• Frequent urination

Once the embryo implants and begins producing the hormone human chorionic gonadotropin (hCG) - the pregnancy sustaining hormone secreted by the embryo soon after conception - usually around six to eight weeks after conception - you may find yourself running to the bathroom more often.

What else it could mean: Urinary tract infection, diabetes, increasing liquid intake, or taking excessive diuretics.

• Fatigue

Feeling drowsy? No, make that absolutely wiped. High levels of the hormone progesterone experienced during pregnancy can make you feel as if you've run a marathon when all you've done is put in a normal day's work. This hallmark of early pregnancy can appear as soon as the first week after conception (before a positive pregnancy test can be performed), but don't necessarily assume you're pregnant just because you're feeling exhausted.

What else it could mean: Stress, exhaustion, depression, common cold or flu, or other illnesses can also leave you feeling drained.

• Tender, swollen breasts

If you're pregnant, your breasts will probably become fuller and increasingly tender to the touch, similar to the way they may feel before your period, but more pronounced. These changes may begin as early as one to two weeks after conception.

What else it could mean: Hormonal imbalance, birth control pills, impending menstruation (PMS) can also cause your breasts to be swell and become more sensitive.

• Nausea

As early as a couple of days following conception, you may begin feeling nauseated and queasy; it will often show up between two to eight weeks after conception. Despite the common name of this well-known symptom of pregnancy (morning sickness) it doesn't only kick in during the morning hours: pregnancy-related nausea can be nettle any time of day or night.

If you're lucky, morning sickness won't hit you until a few weeks after conception, and some women are lucky enough to escape it altogether.

What else it could mean: Food poisoning, stress, or other stomach disorders can also cause you to feel queasy.

• Backaches and headaches

Lower backaches and headaches may be symptoms that occur in early pregnancy as a result of the sudden rise of hormones.

What else it could mean: Impending menstruation, stress, back problems, and physical or mental strains, dehydration, caffeine withdrawal, eye strain.

• A missed/different period

When you become pregnant, your next period should be missed. Many women experience bleeding while they are pregnant, but usually the bleeding will be shorter or lighter than a normal period. If you have been sexually active, are late and usually experience clockwork visits from Aunt Flo, it's worth trying a pregnancy test.

What else it could mean: Excessive weight gain/loss, fatigue, hormonal imbalance, tension, stress, stopping birth control pill, or breast-feeding.

• Positive pregnancy test

A positive home pregnancy test is the most definitive sign that you're in the family way. Most home tests recommend waiting to test until at least the first date of a missed period to ensure that adequate amounts of hCG.

İmplantation Bleeding

Implantation Bleeding

Implantation bleeding is an early pregnancy symptom. Although most of us associate bleeding during pregnancy with miscarriage or perhaps even ectopic pregnancy, light bleeding early in a pregnancy may actually be a sign that the pregnancy is progressing well. Around one in 10 women will experience some type of bleeding during pregnancy. In many cases this bleeding is nothing to worry about; however, you should always report any bleeding during pregnancy to your doctor or health care provider.
What Causes Implantation Bleeding?

Many pregnant women report light bleeding, sometimes referred to as "spotting" in the earliest stages of pregnancy. Indeed, this bleeding confuses many women into thinking that they've started their period and are not actually pregnant. Implantation bleeding is caused by a fertilized egg implanting or "burrowing" into the wall of the uterus (also known as the endometrial lining). This is where the fertilized egg will (hopefully) grow into a healthy baby throughout the rest of the pregnancy. During the implantation process, the fertilized egg forms connections to the mother's blood supply and body tissue. These connections will grow into the placenta, through which the baby receives everything it needs to survive in the uterus until birth. While the fertilized egg is implanting, a small amount of blood may be released, this blood exits the woman's body via the vagina and therefore appears similar to menstrual bleeding in many cases.
Differences To Menstrual Bleeding

- Implantation bleeding usually occurs as "spotting" or light, intermittent bleeding which lasts one to three days on average. Menstrual bleeding may last up to seven days and usually exits the body in a constant flow which begins lightly, gathers in strength, and then tapers off towards the end of the menstrual period.

- Implantation bleeding usually takes place 10 to 14 days after fertilization has occurred. Bleeding may occur before your normal menstrual period is due (perhaps around nine days after ovulation). Tracking your ovulation may help you to determine whether you are experiencing implantation bleeding or a normal period. If you have been having unprotected sex and you do experience light, intermittent bleeding before your period is due, there's a chance that it could be a sign you're pregnant.

- Implantation bleeding may appear different in color and texture to your normal menstrual bleed. Implantation bleeding may be pink or brown, whereas menstrual bleeding (once the flow has really started) tends to be redder. Implantation bleeding may even appear as nothing more than a darker colored discharge.
What To Do

Not all pregnant women will experience implantation bleeding. If you know you are pregnant, you shouldn't worry if you don't bleed, as long as you are in regular communication with your doctor and he or she feels that everything is going well.

If you know you are pregnant and you do experience any type of bleeding, even if it has all the characteristics of implantation bleeding, you must see your own doctor or whichever medical professional is available at the time. Lie down and rest until you are examined and don't take any medication unless your doctor tells you to do so. It's important to stay as calm and relaxed as possible at such a time (your doctor needs to make sure the bleeding is not a symptom of something more serious).

If you have been trying to get pregnant (or even if you haven't) and you get an early, light, period, perhaps accompanied by other pregnancy symptoms, you should take a pregnancy test. It may be that this is implantation bleeding!

Father of a Breastfed Baby

Once that due date is circled on the calendar, moms-to-be start to learn about breastfeeding from their health care providers, books and magazines, and talking with friends. That means they’re usually aware of the possible challenges of breastfeeding and the realities of baby care.

But dads may be blissfully unaware of what’s about to happen to their lives. “Before Reagan was born, I hadn’t really thought about breastfeeding much,” says Stephen Kavanagh. “I knew Nicole really wanted to breastfeed, but I didn’t think of any of the complications that could arise. I thought it would be second nature. You know, it’s natural, so why would there be any problems?”

Providing support

Surprise! Natural doesn’t always mean easy. And even when breastfeeding is going well, feeding baby around the clock can be exhausting. The challenge for fathers is often figuring out the best way to provide support when breastfeeding isn’t going as planned, or when mom is feeling worn out. If you urge her to keep trying, are you pushing too hard when she’d rather go to formula? Or if you offer to go out and buy some bottles, are you undermining her efforts to keep breastfeeding? And in the middle of all that, how do you build your own relationship with your new baby?

Breastfeeding can be very important emotionally to a new mother, as Kavanagh soon discovered when his wife began to have sore nipples and difficulties feeding their son. “Reagan was tongue-tied and unable to create a proper latch. I did have thoughts that this might not work and we would have to move to formula. I didn’t say that out loud, though, because I realized that this was very important to Nicole — so I just tried to encourage her and help her find help. But it was very difficult to watch both Nicole and Reagan struggle.”

Simon Dubois and his wife, Judy, overcame some significant breastfeeding hurdles as well when Judy gave birth to twins. The problems seemed almost overwhelming at first. The public health nurse who visited them recommended pumping after each feeding, as well as taking domperidone and herbal supplements to increase milk production. This time-consuming routine seemed to be working, but then Judy developed mastitis that required five days in hospital. This was Dubois’ chance to shine.

“When she was in the hospital, the twins and I roomed in with her so she could continue to breastfeed and I could help with baby care,” Dubois says. “Later, at home, I did all the washing and assembling of the pump. In the middle of the night, I would get up with the babies, deal with the pump, bring Judy a snack and put away the pumped milk. I prepared the bottles and fed the babies while she pumped. I also tried to deal with all the household chores and caring for our two older children.”

Labor and Birth

Labor and Birth

Searching for information on labor and birth? Pregnancy-Info provides you with all you need to know about preparing for the birth of your baby.

It’s never too early to start thinking about a birth plan. Preparing a birth plan is a great way in which to stay in control as much as possible of the type of labor experience you will have. A birth plan can include whether to have a home birth or a hospital birth or even a water birth. You may also want to consider keeping a pregnancy journal to record your thoughts and emotions.

Of course, it’s natural to be worried about the different stages of labor. Find out how to tell whether your contractions really mean you’re going into labor as well as other common signs of labor. Here you’ll also find out about when inducing labor is a good option and information on whether natural labor is right for you.

While they’re not always planned, Cesarean sections

Am I pregnant?

Emergency Contraception:

Please note that if you’re visiting this page because you’ve recently had unprotected sex (or the condom broke or you forgot to take your birth control pills) and you’re worried that you may be pregnant, you may want to visit our section on emergency contraception. Emergency contraception (a.k.a. the “morning after” pill) can help prevent pregnancy if taken up to five days after unprotected sex, and is more effective if taken sooner.

Missing your period

If you have been sexually active, missing a period is the most tell-tale sign of pregnancy. If you have missed your period, you may want to consider taking a home pregnancy test.

However, even though a missed period is a common sign of pregnancy, there are other reasons why you may miss a period as well. Diet, excessive exercise and stress may all cause a woman to miss her period. In addition, certain birth control methods such as Depo ProveraTM and Hormonal Intrauterine Devices (IUDs) can also reduce or stop menstrual bleeding.

Some women, particularly younger women, may have irregular menstrual cycles, making it very difficult to predict when her period is due.
If you have lighter, shorter or irregular bleeding

After becoming pregnant, some women may experience what is called implantation bleeding. This bleeding is caused when a fertilized egg implants on the wall of the uterus. Sometimes, a woman may mistake this bleeding for a light period.
Other early symptoms of pregnancy

In addition to missing or having a delayed period, some common signs of pregnancy can include:

* Fatigue: Women may often feel tired or fatigued soon after becoming pregnant.
* Faintness: Some women may feel faint or lightheaded early on in her pregnancy.
* Breast Changes: Breasts may begin to feel tender and/or swollen and heavier. The areola (the circle of skin directly surrounding the nipples) may become darker.
* Constipation, Gas or Bloating.
* Nausea/Morning Sickness: This is a common symptom of pregnancy, although it is also a very common symptom of other illnesses such as the flu. Even though it is called “Morning” sickness, you may vomit or feel nauseous at any time of the day. Nausea may sometimes be triggered by the taste or smell of food.
* Frequent Urination.
* Backaches and Headaches: Backaches are common during pregnancy and can sometimes start early. Headaches can be caused by hormonal changes in pregnancy.
* Mood Swings: Though also a possible symptom of PMS, hormone changes during pregnancy can cause mood swings for some women.
* Cramping: Also a very common symptom of PMS, cramping can occur during early pregnancy.

Understanding these symptoms

It is very important to remember that having any, or even all of the symptoms above, does not necessarily mean that you are pregnant. None of these symptoms are unique to pregnancy. They are all very common and may be caused by PMS or common illnesses such as the flu. In addition, while some pregnant women will have many of these symptoms, others will have only one or two, and still others will have none at all. If you believe that you may be pregnant, you may want to do a home pregnancy test.
About Home Pregnancy Tests:

Home pregnancy tests work by detecting a special hormone in your urine called human chorionic gonadotropin (hCG). If used correctly, home pregnancy tests are quite accurate. However, accuracy of the test depends on several things, most importantly:

* When you take the test: Pregnancy tests are less accurate if they are taken too early after conception. This is because less of the pregnancy hormone is in the urine soon after conception. Many tests will instruct you to wait for one to two weeks and then take a second test to confirm the results of the first. Most urine pregnancy tests are sensitive enough to detect a pregnancy by the first day of a missed period.
* Following instructions: To ensure an accurate result, make sure that you follow all of the instructions carefully, and make sure the test kit has not passed its expiry date.

If the test is negative

If the home pregnancy test is negative, this does not necessarily mean that you are not pregnant. Occasionally, particularly if the test is taken too early, home pregnancy tests give false negatives, meaning the test will indicate that you are not pregnant when it is really too early to tell. Follow the test’s instructions carefully and repeat the test as directed.
If the test is positive:

False positives (when the test tells you that you are pregnant and you are not) are very rare. If a home pregnancy test shows up positive, contact your healthcare provider or a health clinic to schedule a visit.
Next Steps:

If a home pregnancy test confirms that you are pregnant, it is important to speak with a healthcare provider or clinic soon, whether you plan to continue the pregnancy or not.

If you plan to continue the pregnancy, you should contact your healthcare provider or a local health clinic to arrange your first prenatal visit. In the meantime, you should take care to eat well and avoid alcohol, drugs, tobacco and other things that could harm your baby. You should also continue to take or start to take a prenatal vitamin that contains folic acid.

At your first prenatal visit, your healthcare provider can confirm that you are indeed pregnant. He or she will likely measure your height, weight and blood pressure. You may have a pelvic exam including a pap test if you have not had one within the last year, and blood and urine samples may be taken to ensure that you and your baby are off to a healthy start.

Your healthcare professional will also discuss your medical and obstetric history and answer any questions that you may have. At this visit, your healthcare provider will estimate your due date, based on the date of your last period. If you are unsure of when your last period was, your health care provider may arrange for you to have an ultrasound to determine how far along you are in your pregnancy.

Pregnancy Signs

Pregnancy Signs
Here is a list of the many possible signs associated with pregnancy. They are grouped into three categories based on their diagnostic value: positive signs of pregnancy; probable signs of pregnancy; and possible signs of pregnancy. Remember, you can have all of these signs and not be pregnant or, conversely, you can have only a few of them and actually be pregnant. These are only used as indications that should be followed up by your medical practitioner. If you think you may be pregnant, it is recommended that you do a home pregnancy test right away. The earlier you can confirm your pregnancy, the earlier you can start to take better care of yourself.

Possible signs of pregnancy

* No period or amenorrhea; other potential causes of this include fatigue, stress, hormonal problems, illness, extreme weight gain or loss, going off the pill and breastfeeding
* Just "feeling" pregnant
* Nausea and vomiting; this usually occurs two to eight weeks after conception and can also be caused by such things as food poisoning, stress or infections
* Enlargement and soreness of the breasts; this is also seen during pre-menstruation and with birth control pill use
* Increased urination; this can also be a sign of urinary tract infection, stress, or diabetes
* Fatigue
* Ptyalism (Excessive salivation)
* Stretch marks
* Spider veins: For more information on spider and varicose veins, visit our website!
* Quickening (fetal movement); some people often confuse this with gas or bowel contractions.
* Chadwick's Sign (bluish tinge to the vagina and cervix); this is also seen occasionally with impending menstruation
* Colostrum from breasts

Probable signs of pregnancy

* Enlarged abdomen; this can also be a sign of uterine fibroids or a tumor
* Positive pregnancy test
* Change in uterine shape
* Softening of the cervix (Goodell's Sign)
* Enlarging uterus
* Braxton Hicks contractions
* Palpation of the baby
* Ballottement
* Palpation of the uterine artery

Implantation Bleeding
Implantation bleeding can cause you some confusion when you are unsure whether or not you are pregnant. It is not always easy to tell what is break through bleeding, or spotting between periods, and what is actually implantation spotting. The difference between period and implantation bleeding is that implantation bleeding occurs as a result of the embryo burrowing into your endometrium. However, because implantation spotting usually occurs right around the time you would be expecting your period, it is easy to mistake it for your period or as breakthrough bleeding.

Implantation bleeding signs generally include blood that is lighter than menstrual bleeding and is either pink or brown in color. How long implantation bleeding lasts will vary from woman to woman. It is important to note, though, that spotting in early pregnancy is not the same as implantation bleeding.

Positive signs of pregnancy

* Fetal heart tones (this doesn't occur until 10-20 weeks of pregnancy)
* Sonography detection
* X-ray detection

New!
What where your pregnancy symptoms? Did you have morning sickness? Or was it your swollen breasts that gave your pregnancy away? Every woman is different, so share your story of how your knew you were pregnant at Pregnancy Stories.

Signs of Labour

Signs of Labour

Many women worry about false labour and showing up at the hospital too early, only to be sent back home. Others are concerned that they will wait too long, and end up having an unplanned delivery in the car or at home. Do you know what signs and symptoms to look out for? What are the differences between false labour and real labour? When is the right time to call your health care provider or proceed to the hospital? These are questions that almost every pregnant woman is concerned about.
The days leading up to labour

In the days before the contractions of labour begin, the uterus is “awakened” and prepared for labour. The cervix starts to soften and ripen. The body may go through a number of changes, such as the following:

• lightening and engagement, when the baby begins to descend down into the pelvis

• pressure on the pelvis and rectum, cramps and groin pain, and sometimes a persistent backache

• mre fatigue, or alternatively, sudden spurts of energy

• thickening of the vaginal discharge

• diarrhea

• release of a small amount of blood-streaked mucus from the vagina, referred to as the “bloody show”

False or preparatory labour

If you have only the following symptoms, you probably are not yet in real labour:

• irregular contractions that do not get worse or more frequent over time; sometimes they ease with time

• contractions that are of low intensity or short in duration

• pain that is confined to the lower abdomen and groin, rather than the lower back

These contractions may help prepare your uterus and cervix for labour. Monitor the contractions to see if they start to increase in frequency and intensity, and watch out for signs of real labour. If you are not sure whether you are in real labour, call your health care provider or the hospital, and they will provide you with extra guidance.
Real labour

Real labour is characterized by forceful and painful contractions. Here are a few signs and symptoms of real labour:

• ontractions that get progressively stronger, more regular, and more frequent over time

• pain in the abdomen and back, which may also spread to the legs

• release of the blood-streaked mucus from the vagina, referred to as the “bloody show,” if it has not already occurred

• rupture of the fetal membranes, causing a gush or trickle of amniotic fluid from the vagina

When to consult your health care provider

If you have any of the following signs or symptoms, call your health care provider right away or proceed to your hospital:

• regular contractions that are increasing in intensity and frequency

• pain that is worse than you anticipated

• rupture of the fetal membranes: If you feel a gush or trickle of clear fluid from your vagina, it means that your fetal membranes have ruptured. You should obtain medical help if this happens, whether or not you have started feeling labour pains yet. If your fetal membranes rupture before the onset of labour pains – a condition known as premature rupture of the fetal membranes – the baby could be at risk, and you may need to have labour induced.

• significant bleeding from your vagina: This is a medical emergency. If you have bleeding, not just spotting, at any time during your pregnancy or when labour begins, you should proceed to a hospital right away.

It is best to err on the side of caution. So if you think you might be in labour, call your health care provider.

Is a Pap smear safe in pregnancy?

Not only is a Pap smear safe in pregnancy, it is considered mandatory by many obstetricians. An abnormal Pap smear discovered during a pregnancy may determine the management of the pregnancy as well as management of the abnormal Pap. Thankfully, most problems, even most severely abnormal Paps, can be managed after a normal pregnancy concludes.

The Pap is a gentle scraping of cells from the mouth of your womb. It is far, far away from the pregnancy and even the mild spotting it can cause has nothing at all to do with the baby. The cells are delicate and it's not unusual to have a little spotting for a day or two, so don't panic if this happens.

So yes, you need that Pap smear--it's considered good obstetrics and must be part of the prenatal care.

FREQUENTLY ASKED QUESTIONS

Does the abortion hurt?

Every woman experiences the abortion differently. During the abortion procedure, you may feel some menstrual-like (period) cramping for about one or two minutes. Your nurse will give you medications through an intravenous in your arm to relax you and help you feel more comfortable. The doctor will give you a local anesthetic ("freezing"). You may also breathe nitrous oxide ("laughing gas") using a mask. Throughout the abortion, you will be awake and in control by letting us know what you are feeling.

Will this affect my ability to get pregnant in the future?

Your fertility will not be affected when you have a safe, legal and uncomplicated abortion performed by qualified health professionals. You will be tested for (sexually-transmitted) infections at the time of your abortion, and will get some preventative antibiotics. If your tests show that you have an infection, you will be contacted for further treatment. You will also be given instructions on how to care for yourself after your abortion. The abortion procedure will not prevent you from having children later on.

Will I bleed after my abortion?

There is a range of bleeding that can happen after an abortion. Some women don't bleed at all. Some women may bleed for 1 to 2 weeks afterwards, like their menstrual period flow. Some women can bleed or spot for several weeks after their abortion. For all women, their next regular menstrual period will come between 4 to 6 weeks after their abortion. You will be given instructions on what to expect after your abortion.

Can I wear a tampon after my abortion?

We recommend that you don't put anything into your vagina for two weeks after your abortion to help prevent infection. This means that you should use pads instead of tampons for any bleeding. You should also NOT have vaginal sex, baths (okay to shower!), swim in hot tubs or pools, douche or put anything foreign into your vagina. If you do any of these things, you will increase your chance of getting an infection.

Can I have sex after my abortion?

No. We recommend that you don't put anything into your vagina for two weeks after your abortion to help prevent infection. Also, you can get pregnant after your abortion if you are not using a birth control method. Our counsellors can talk to you about birth control choices that would work for you.


Will an abortion increase my risk for breast cancer?

Recent scientific studies using proper methodology show that there is absolutely NO increased risk of breast cancer associated with abortion. Previous studies that claimed increased breast cancer risk have been scientifically shown to be inaccurate and biased.

How long will my appointment be at the clinic?

You should expect to be at the clinic for 2 to 3 hours. The abortion procedure, itself, is very short but you will need time to see your counsellor and nurse, and then recover after your abortion. If you are scheduled for a two-day abortion procedure, you can expect to be at the clinic for 1-4 hours on each day.

Do I have to pay for my abortion?

If you are a BC resident and have valid Medical Service Plan (MSP) coverage (BC Care Card), your abortion will be completely covered by the plan.

If you are from another province and have not been in BC for three months, you will have to pay a fee. However, you can apply for reimbursement of some of that fee from your own provincial health plan.
If you are a visitor to BC, you can get an abortion at the clinic for the following fees:

If you under 12 weeks pregnant: $500
If you are over 12 weeks pregnant: $550

If you require assistance in applying for BC Medical Insurance, please contact us at 604-736-7878.

Do I have to make an appointment?

All women have to schedule an appointment for an abortion or counselling in advance by telephone. No drop-ins are accepted. There is usually a 1 to 2 week waiting time to book an appointment. Please call us at 604-736-7878 to book at appointment.

Do I need a referral from a doctor?

You do not need to get a referral or written note from a doctor to book an abortion at our clinic. However, if you do see a doctor beforehand or if a doctor or clinic refers you to our clinic, please give us their name when you book your appointment. While a home pregnancy test is acceptable, we strongly suggest that you get your pregnancy confirmed at a clinic or doctor's office.

Is my friend or partner allowed into the clinic with me?

You may bring one person, male or female, with you into the clinic. For the security and confidentiality of our patients and staff, you and your friend/partner must show photo ID at the clinic. Also, we need to know the name of the person who will be coming with you ahead of time. Please give us their name when you book your appointment. No children are permitted into the clinic. Only patients are admitted into the medical area of the clinic; any accompanying person can in the waiting area or drop you off and come back to pick you up.

Can I drive after my abortion?

No. Because you are having surgery and getting medications, you cannot operate a motor vehicle for 24 hours after your abortion. You must arrange for transportation to and from the clinic on the day of your abortion. We strongly advise you to have someone take you home after your abortion.

Are your doctors "real doctors"?

Yes. All of our doctors are certified physicians with the College of Physicians & Surgeons of BC. They are all fully trained in doing abortions and have many years of experience in this field.

Do you have picketers or anti-choice protestors?

Fortunately, we rarely see any protestors outside our building or on the street. Our clinic has a legal "Bubble Zone" in front of our building that prevents protestors from picketing on the sidewalk in front of our building and several feet down the street, on both sides of our building. Within this "Bubble Zone", it is illegal for any picketers to protest, take pictures, hand out anti-choice pamphlets, and verbally or physically try to stop or intimidate someone who is going to the clinic. If you see or experience any of these things, you should tell us immediately. We are located in a large building with many other services so it is impossible for anyone to know where you are going when you are entering the building.

Can the fetus feel "pain" during the abortion?

No. The central nervous system of the fetus is not developed sufficiently to "feel" pain during the stages of pregnancy that we perform abortions (up to 16 weeks). There are some studies that suggest that the fetus may be reacting to stimuli after 24 weeks pregnancy, but there is dispute over whether the fetus is actually able to feel pain, as we know it.

Should I do a pregnancy test after my abortion?

It is not necessary to have a pregnancy test after your abortion. In fact, it may take four or more weeks for your pregnancy hormones to disappear from your blood and urine after an abortion. We will advise you if you need further blood or ultrasound tests after your procedure. You may choose to have a follow-up examination 2 weeks after your abortion to make sure that you are returning to normal.

Will I feel sad after my abortion?

Sadness is not unusual in the weeks following an abortion. Understanding that these feelings are normal and talking about them will help you. We offer post-abortion counselling to women who feel that they need it. We can also give you a referral for counselling or you can speak to your doctor if you wish. The rate of psychiatric illness after an abortion is LOWER than after childbirth.

Pregnancy Through The Father's Eyes

Pregnancy Through The Father's Eyes:

Men can and should share in the pregnancy experience as much as possible. Sometimes, because the woman is carrying the baby and experiencing all the physical changes, the man can feel left out. It is important for couples to share the excitement as well as work together through any anxieties that may develop.
Fathers Need To Be Healthy, Too:

As a father-to-be, it's important to recognize the lifestyle choices that can negatively influence a healthy pregnancy. For example, second-hand smoke is harmful to those who breathe it, and studies have shown the danger of smoking to developing babies. Drug and alcohol abuse also create an unhealthy environment. The best thing you can do is eliminate these before a pregnancy; that way you will provide the best possible environment for your partner and the developing baby.

Many women and men who have struggled in the past to quit smoking find that a pregnancy gives them the motivation they need to finally quit.

In addition, changing your unhealthy habits may make it easier for the mom-to-be to change her own habits -- like stop smoking, cutting back on alcohol, and eating a healthy diet. Work together and support each other!
Be Amazed!:

The actual process of how a women's egg and a man's sperm combine and develop into your baby is amazing. Watch the changes that take place in your partner's body and learn about the baby's growth to become a more active participant in the pregnancy experience.

It is helpful to go with your partner to some of her prenatal visits so you can hear the baby's heart beating and see what the baby looks like by ultrasound. You may already feel yourself beginning to bond with the tiny life that has started. On the other hand, it's perfectly ok if you don't feel a connection to the baby at this point. Men react in various ways to this early stage of pregnancy.

Attending the birthing classes together is a good experience for most couples. Not only do the classes tend to bring couples closer during the pregnancy, but it also gives you an opportunity to meet other people that can share similar experiences. This is all a build-up to the finale -- the delivery!

Seeing your baby born is probably one of the most fulfilling experiences you will ever undertake. The gift of life is totally amazing, so get ready!
Anxieties:

Throughout the pregnancy, it is not uncommon for the parents-to-be to have worries and anxieties about parenthood.

Often men have fears associated with being a good father and caretaker. It is important to express all of these concerns with your partner, so that you can both work together in coping with the expected changes and planning your new arrival.

Talk about the fears that you may have -- about the actual day of labor and delivery, about bringing a newborn baby home, and about how to manage the baby's care, your finances, and work logistics.

This is one of the biggest life changes that you will ever go through, so it is normal to feel some anxiety. Once you think through the issues and the baby is born, things will fall into place for you, your partner, and your new baby!

Genetic Counseling

Modern genetics allows us to understand how genetic diseases are inherited based on DNA, genes, and chromosomes. We can now test couples and fetuses for certain inherited disorders, as well as other chromosomal and genetic abnormalities such as neural tube defects, Down syndrome, and cystic fibrosis.

Couples who are thinking about having a child may consider genetic counseling and prenatal diagnosis before conception to predict any possible abnormalities in their child. Others may use the tests after they conceive to evaluate the condition of the fetus.

People who are at increased risk of passing genetic abnormalities on to their children include:

* Jews of Eastern European descent, who may have a high risk of having children with Tay-Sachs or Canavan’s, metabolic disorders that lead to death in early childhood.
* African-Americans, who may risk passing on sickle-cell anemia to their children.
* Couples of Southeast Asian or Mediterranean origin, who are at increased risk of having children with thalassemia, a severe form of anemia.
* People with family histories of inherited disorders, or those who have previously had children with genetic disorders.
* Women who were exposed to toxins that could cause birth defects.
* Women with prior medical conditions or diseases that may affect their fetus, such as diabetes.
* Couples who share a common ancestor.
* Women with a history of multiple miscarriages.
* Couples who have family members with birth defects or severe developmental problems.

Prenatal testing for genetic problems may be done before or after conception. Testing for spina bifida or Down syndrome is done after a pregnancy is established. Besides the couples listed above, counseling and diagnosis are also recommended for mothers over the age of 35, and those who have received abnormal first trimester screening tests (with nuchal translucency and maternal serum).

For those who may be at risk, genetic counseling and prenatal diagnosis are used to help answer some important questions, such as:

* Should we have a baby? Are the chances of having a baby with a genetic defect so high that choosing adoption or artificial insemination may be a better way to start a family?
* How can we treat the fetus' potential defects? Are there surgical techniques available or other medical interventions that may help alleviate problems?
* How do we prepare, physically and psychologically, for the possible outcome of a pregnancy? Are there special educational classes, training, or information that we need in order to raise a child with defects?
* Should we continue the pregnancy? Are the fetus' abnormalities so severe that we might choose to have an abortion?

It is important to remember that preconception testing can only give you the odds of having a child with a certain birth defect; a genetic counselor maps out the specific numbers. You may learn, for example, that you have a one in four chance of having a child with a certain disorder. If you decide to conceive, the fetus may be able to undergo prenatal testing to show whether or not the baby has inherited the disorder.
How Can I Prepare?:

You may wish to discuss genetic counseling with your family, as well as your health care provider, who may refer you to a genetic counselor specially trained to understand the complex issues surrounding heredity and pregnancy. Find out if any medical problems run in your family, especially any problems with child development, miscarriages, stillbirths, or severe childhood illnesses. If you decide to get the blood-screening test, make sure your health care provider talks to you beforehand and answers any of your questions.
What Will Happen?:

You will be required to fill out an in-depth family history, and discuss your family's medical past with the counselor. You and your partner may also take simple blood tests, or undergo an analysis of your chromosomes known as karyotyping. All this information will be considered together to help determine what genetic patterns you may pass on to your children. If you choose to be tested after conception, one of the following tests will be used to obtain fetal cells whose genetic and chemical makeup can be analyzed in a laboratory:

* Amniocentesis, in which fluid is withdrawn from the amniotic sac and analyzed. See amniocentesis for more information.
* Chorionic villus sampling (CVS), which takes a sampling of the cells of the placenta. See CVS for more information.
* Percutaneous umbilical blood sampling (PUBS), which draws fetal blood from the umbilical cord. See PUBS for more information.

What Are The Risks?:

The tests used for genetic counseling have virtually no risks. The tests used after conception, however, may cause infection, damage to the fetus, or miscarriage. For further information, see the articles on amniocentesis, CVS, and PUBS.
Frequently Asked Questions:

Q: If I am in a risk group, do I have to get tested?

A: No. It is up to you whether or not to undergo genetic counseling and prenatal testing. Your religious or philosophical beliefs, family circumstances, and personal desires all are a part of the decision-making process.

Q: If I discover I am a carrier of a certain disease, will I still be allowed to have a baby?

A: Absolutely. The point of genetic counseling and prenatal diagnosis is simply to provide parents with information that they need to make important decisions. A good genetic counselor will help you figure out how to use the information you discover, but will not make any decisions for you. If you are at risk of having a baby with a disorder, you may be able to use assisted reproductive technologies to reduce the chance that your baby will be affected.

Eating Right Before Pregnancy

There is no special diet that will help you get pregnant. However, if you are considering pregnancy, you should eat a balanced diet and take a vitamin and mineral supplement that includes at least 0.4 milligrams (400 micrograms) of folic acid. Folic acid reduces the risk of birth defects, especially problems with the baby’s spine, such as spina bifida. You should also avoid vitamins with high doses of Vitamin A. Steer clear of herbal supplements, because we don’t have good studies on safety of herbs in pregnancy.

If you drink alcohol or use drugs, you should stop before you get pregnant to protect your developing baby. You should also cut down on caffeine when you are trying to get pregnant. Women who consume more than 250 mg of caffeine – about 2 cups of coffee, or 5 cans of soda -- a day may have a harder time getting pregnant, and may increase their risk of miscarriage.

It’s also best to limit the amount of fish that you eat. Seafood contains methyl mercury, which in large quantities can cause birth defects. The FDA recommends that women who are pregnant or planning to become pregnant consume no more than 12 ounces of fish a week, and avoid large ocean fish such as shark and tilefish. Tuna has higher levels of mercury. You should limit your tuna intake to one can of white tuna or one tuna steak per week, or two cans of light tuna per week.

To ensure you are getting all the nutrients you and your baby need, it's best to discuss your nutritional needs with your health care provider before you become pregnant, and again during your pregnancy.

Summary of home pregnancy testing

So which is the best pregnancy test kit? Well, that will really depend upon your individual circumstances, budget and preferences. Here's the Kiwi Families summary of the situation for you:

1. If cost is important, buy a First Response kit from Pak n Save;
2. If ease of use is important, pick any midstream urine test kit;
3. If you want the earliest possible test, pick a Discover kit;
4. If you want privacy and discretion, buy a kit by mail order from an online store.

And good luck from the Kiwi Families team - we all hope you get the test result you are hoping for!

Which is the best home pregnancy test?

Most woman want to be sure that they pick the best pregnancy test available - after all, this is not the time when you want to make a mistake through using a sub-standard product!

The factors that make for the best pregnancy tests are as follows:

• Accuracy - in New Zealand the Ministry of Health (www.medsafe.govt.nz) ensures that all test kits meet the requirement of being at least 99% accurate. You can therefore be assured that any test kit you buy will be highly reliable.
  

• Speed - when you are worried or excited about a pregnancy test result, you want the answer quickly! All the test kits on the New Zealand market will give you the result within 1 to 2 minutes of taking the test.
  

• Ease of use - all of the modern test kits are very easy to use. The midstream urine ones are particularly easy, and in fact are known as easy to use pregnancy tests (EPTs). They have clear instructions, and most use a very simple "line" system that gives you a definitive negative or positive result.
  

• Cost - if you want to keep the costs down then it is best to buy your test kit online or from a supermarket - prices at pharmacies are much more expensive. Our research has uncovered some particularly cheap kits at Pak n Save - see the section above on Costs.
  

• Early use - probably the most important factor for many women is "how early can you use the test"? The kits on the market these days are known as early pregnancy test kits. This is because they can be used as soon as your period is due, or in some cases 4 days prior. The key factor here is how much hCG they can detect. Most kits in New Zealand can detect 25 mIu/mL, but at the time of writing there is one kit that can detect a pregnancy at only 15 mIu/mL of hCG - this brand is called Discover and is effective from up to four days before your period is due.