How does a woman know when she is pregnant?
A: Although this question may seem basic, it is in fact legitimate. When working with medical students and doctors in training, I emphasize the need to ask basic questions without embarrassment. More often than not, the answer benefits everyone. So it is with this question.
If you are a man reading this column, resist the temptation to skip this answer. Every man needs to know the information I will discuss in preparation for assuming his share of the responsibility – either for preventing an unwanted pregnancy or in his role as a father-to-be. All men should gain at least a basic understanding of the challenges facing a woman who is pregnant.
Contraceptive techniques can fail for a variety of reasons. Clearly any episode of unprotected intercourse puts a woman at this risk, especially if alcohol or other intoxicants are involved. Women on birth control pills may become pregnant if several pills are missed during a particular cycle or if other medications are administered that interfere with the absorption of the pill and reduce its efficacy. An illness with nausea and vomiting could also prevent birth control pills from working as intended. Improper use of barrier devices (e.g., condoms, diaphragms) can result in an unintended pregnancy. Women with irregular and unpredictable menstrual cycles may not be sure when they are fertile and may not know if pregnancy does occur. It is fairly easy, especially if one has not been pregnant before, to miss the early signs of pregnancy.
The beginning of a pregnancy is the most critical time for both the mother and the developing baby. This is the time to seek early contact with a physician to initiate prenatal care including a physical examination, blood testing, vitamins and dietary counseling, and ultrasonography if indicated. Lack of early prenatal care is associated with a greater incidence of complications for both the mother and baby. If the pregnancy is seen as a problem – for instance if it is unplanned or outside the context of marriage – this would be a good time to look for someone willing to adopt the child. Many people who wish to adopt will offer to pay the expenses associated with the pregnancy. If one feels that an abortion is the only option, this procedure is much safer for the mother early in the pregnancy.
Pregnancy ought to be considered if one or more of any of the following occur:
- A missed menstrual period, a delayed period, or one that is both lighter and later than usual.
- Daily early morning nausea and vomiting.
- Breast tenderness, enlargement, tingling, or darkening of the nipples.
- More frequent urination (when there are no signs of a bladder infection).
- Quickening (feeling the baby move) can be noted as early as 17 weeks for women who have been pregnant before, and at 19-20 weeks for women in their first pregnancy.
There are other physical findings associated with pregnancy that your doctor would look for during a first prenatal exam.
If you think that you’re pregnant, get tested as soon as possible. Buy an over-the-counter test or go to any one of several agencies that will provide the test for free. If the pregnancy is unplanned, find a trusted friend or family member in whom you can confide and make a plan.
