We all have the basic idea, but our grasp of the actual mechanics may be a little sketchy.
Reproduction and the Vagina: An Owner's Manual
A refresher course can be helpful for understanding something as critical as how life begins.
It's surprising how many women, let alone men, aren't 100 percent sure of the biology of reproduction. We all have the basic idea, but our grasp of the actual mechanics may be a little sketchy. How exactly does conception occur? How will your vagina (and the rest of your body) change during pregnancy and childbirth? Will everything ever go back to normal after your child is born? You might wonder what happens if you have more than one baby. Maybe you are trying to get pregnant, but having trouble. Or what if pregnancy is the last thing on your mind right now, and you want to be confident in your birth control?
Don't be embarrassed if you don't have all the answers. We have a handy guide just for you.
The foundation of life
We begin with the miracle of life. After menarche (when you enter puberty), your ovaries release an egg each month, which travels through the fallopian tubes toward your uterus. If you have (unprotected) vaginal sex during this time, sperm from the man's ejaculate may fertilize your egg, and just like that, you're pregnant. The zygote (fertilized egg) will move into the uterus, implanting into the uterine wall, where it will continue to grow for around 37 weeks (average pregnancies are 40 weeks total from the last menstrual period). Conception is most likely to occur during ovulation (usually 12 to 14 days before your next period—if your cycle is 28 days) and the five days leading up to it. Initial signs of pregnancy generally appear within one to four weeks of the first missed period—one of the primary signals prompting women to seek a pregnancy test—and include mild cramping and spotting. Most women find out they're pregnant between weeks four and seven.
Family planning
Now, for women hoping not to get pregnant, birth control has your back, and there are options aplenty. Condoms are one of the most widely available and popular methods. They come in a variety of materials, and all prevent pregnancy (with an average 98 percent efficacy if used correctly every time), with latex and plastic condoms providing the added benefit of preventing STIs.
Another popular option for women, oral contraceptives (pills), are taken daily. They are among the most commonly used forms of birth control—chosen by more than 41 percent of women using B.C.—and are 91 percent effective for the average woman (who doesn't always take it within the same 30 minutes each day). Not fantastic odds, so you may also want to use a condom.
The contraception shot (aka Depo-Provera) is a progesterone-based birth control injected into the arm once every three months. It prevents ovulation and is 99 percent effective. Diaphragms, another birth control option, are inserted into the vagina (with spermicide) and stop sperm from entering the cervix.
Long-acting reversible contraceptives (LARCs) include intrauterine devices (IUDs) and arm implants. At more than 99 percent efficacy, they're the most effective forms of birth control, and work anywhere from 3 to 12 years. Permanent (though usually reversible) options include tubal ligation for women and vasectomy for men.
While many babies arrive around week 40, 73 percent are born before their due date.
The road to reproduction
Pregnancy is divided into trimesters, or three separate stages. The first (weeks 1 through 13) is most associated with morning sickness (which can occur at any time), fatigue and breast tenderness. The baby's organ systems and body structure begin developing.
In the second trimester (weeks 14 through 26), nausea and sleep may improve, but new symptoms, such as back or abdominal pain, constipation and heartburn, are noticed. Babies can now hear your voice, gender is discernible and first movements may be felt.
Final development to survive outside the womb takes place in the third trimester (weeks 27 through 40). Women often become more uncomfortable moving, and experience shortness of breath, hemorrhoids and urinary incontinence. While many babies arrive around week 40, 73 percent are born before their due date, so being ready—physically and mentally—is critical.
The vagina itself changes in many ways during pregnancy. Increased discharge and internal itching are common. Vaginal pH changes, resulting in a different odor and taste. Yeast infections and urinary tract infections (UTIs) are more likely. Veins can intensify on the vulva, and increased blood volume can even cause a blue-ish vaginal hue. On a positive note, increased blood volume can result in significantly intensified orgasms—and yes, having sex during pregnancy is perfectly OK, unless your doctor says otherwise.
Pelvic floor exercises, medications and time can help improve many vaginal issues related to childbirth.
Labor and birth
As pregnancy draws to its natural conclusion, it's time to talk about childbirth. In early labor, a woman's cervix begins to dilate (open). During active labor, the amniotic sac (water) breaks. Uterine contractions commence, becoming more intense and frequent as labor progresses.
Birth itself can take minutes to hours, even more than a day—the process is usually slower for first-time moms. After the baby is delivered, any vaginal or perineal tears (which are common, though do not always occur) will be repaired. Labor can be extremely stressful, physically and emotionally. Women may experience vaginal soreness and bleeding, urinary incontinence, changes in labia shape and color. Most new moms should avoid sex for about six weeks, and orgasms may seem weaker until pelvic floor muscles recover. Long-term changes include a wider, looser, softer or dryer vagina. Perineal pain and pain during sex will affect some women, and pelvic floor problems, vaginal numbness and prolapse of the uterus, bladder or vagina are common. For most (particularly after multiple births), the vagina never quite returns to its pre-labor condition. But, don't stress, it's an extremely elastic organ: Pelvic floor exercises, medications and time can help improve many vaginal issues related to childbirth.
About 12 to 15 percent of all couples have difficulty getting pregnant.
For those trying to get pregnant
If you're a woman hoping to conceive, there are a few things you should consider. Your doctor may recommend you take prenatal vitamins in advance—folic acid, calcium and vitamin D are essential for fetal development, which can be problematic if you don't realize you're pregnant until eight weeks in. Similarly, you should try to eat a balanced diet with minimal caffeine and alcohol, and avoid items like high-mercury fish and unpasteurized soft cheeses (problematic for any developing fetus). You may also want to avoid soda, low-fat dairy and high-glycemic index foods, all of which can decrease fertility.
If you and a partner have gone months with no luck, you're not alone. About 12 to 15 percent of all couples have difficulty getting pregnant. Inability to conceive can be caused by decreased fertility (yours or your partner's) due to medical conditions, as well as stress, improper timing of sex and smoking. A great number of strategies can help improve conception odds, including ovulation tracking and moderate exercise. Sometimes it just takes a little time.
Options for facing infertility
Unfortunately, some people experience significant fertility problems, which become more common with age. For these couples, natural conception may still be possible, and assistance from fertility medications and assisted reproductive technology (ART) can support efforts. During in vitro fertilization (IVF), eggs are collected from your ovaries and fertilized in a lab, before the embryos are inserted into your uterus. Intrauterine insemination (IUI) involves collection of sperm and insertion of it into the uterus during ovulation. Utilizing egg or sperm donors may also be an option, as can surrogacy and adoption. Difficulty with infertility can be heart-wrenching for couples who struggle, but there are options. And there's always hope.
Whether you're looking to conceive or not, understanding how reproduction works is the first step.
Difficulty with infertility can be heart-wrenching for couples who struggle, but there are options. And there's always hope.