One of the risks commonly associated with college students and vaginal-penile sex is pregnancy. 85% of couples who do not use any type of contraception will get pregnant within a year of sexual intercourse. This is a huge number! Without going into either “how babies are made” or “the birds and the bees” talk, the next few pages will address pregnancy, pregnancy testing, potential complications, and infertility as they relate to both college students and heterosexual couples in general.

What is pregnancy?

Seems like a silly question, but the answer is important. Pregnancy is defined as the condition of gestation, being “with child,” or carrying young. Pregnancy occurs following the fertilization of an egg by a sperm and the implantation of the developing embryo in the woman’s uterus. This process does not occur in the space of an hour, or even a day. It is impossible to detect human chorionic gonadatropin (HCG), the hormone release by the embryo, until at least ten days after conception, and most tests won’t detect HCG for up to two weeks. More on this in the pregnancy testing section which follows.

Symptoms of pregnancy: Any or none of the following may be present

• Missed or scant menstrual periods (It is important to note that some pregnany women experience a small amount of vaginal bleeding around the time of an expected period and mistake this for a regular period)
• Breast tenderness
• Fatigue
• Nausea and vomiting (”morning sickness,” though it may occur at any time of day)
• Frequent urination, irregular bowel movements, constipation
• Mood swings
• Bloating and weight gain
• “Mask of pregnancy” (the slight darkening of the skin on the face)
• In addition, a pelvic examination will show a softening of the cervix and an enlarged uterus after one month

Importance of Early Pregnancy Diagnosis

Early diagnosis enables a woman to begin prenatal precautions (such as cessation of alcohol, tobacco, and drug consumption) AS SOON AS POSSIBLE. It also provides early detection of possible pregnancy complications, such as ectopic pregnancy (see information below). Finally, it allows a woman who may be considering abortion as an option the time for adequate counseling and decision-making, as well as undergoing the abortion when it is safest for her- within the first 10 weeks of pregnancy.

Pregnancy Danger Signs: If there is any possibility a woman is pregnant and any of the following occur, notify a health practitioner right away

• Intense abdominal pain
• Irregular bleeding or spotting paired with abdominal pain when your period is late or after an abnormally light period
• Fainting or dizziness that lasts more than a few seconds
• Following a late last period, heavy bleeding that possibly contains blood clots, with cramping more severe than usual
• A period which is unusually prolonged AND heavy (6-7 days of heavy bleeding)
• Fever

Advice for Pregnant Women

No matter what decision is made regarding pregnancy (abortion, adoption, or continued pregnancy and parenting), it is important to practice prenatal precautions. First, a woman should schedule an appointment with a practitioner to discuss her pregnancy. In the meantime, however, these guidelines should be followed:

• Nutrition: Maintain a balanced diet. Avoid dieting, raw meat, and unpasteurized dairy products
• Avoid alcohol
• Avoid exposure to illegal drugs
• Stop smoking
• Do not take any medications (prescription or non-prescription) without first consulting your physician or nurse practitioner
• Exercise moderately, but avoid extremely strenuous activities that could raise your body temperature
• Avoid hot tubs and saunas
• Use condoms if there is any chance you could be exposed to sexually transmitted diseases

Possible Pregnancy Complications

1. Ectopic pregnancy
   • Definition- the fertilized egg implants somewhere other than in the uterine lining (usually in a fallopian tube).
   • Reasons- scarred tubes, inflammation of the uterine lining
   • Risks- previous ectopic pregnancy, previous tubal surgery, previous pelvic inflammatory disease (PID)
   • Symptoms- initially all the same as a normal pregnancy. Later, stabbing pain, cramps, neck, or shoulder pain may develop
   • Treatment- must be immediate because of the risk of tubal rupture. Either remove the fertilized egg and save the tube or remove the tube.
2. Miscarriage
   • Definition- a normal uterine pregnancy resulting in a spontaneous abortion
   • Reasons- genetic abnormalities, structural problems of the uterus, infection, weak cervical muscles, hormonal imbalances, toxins, blood incompatibility
   • Note- 1/6 of all pregnancies end in miscarriage, and 75% of these miscarriages occur before 12 weeks
3. Cesarean Section
   • Definition- surgically removing a baby through the abdominal muscle rather than through the vaginal canal
   • Reasons- serious diabetes, baby in the wrong position, problems with the umbilical cord, active herpes lesions, fetal distress