Pregnancy

activity. Mood changes, in fact, often play a very big role in resuming normal sexual functioning. Body image and stress do not play a role in sexuality in the postpartum woman.

PREGNANCY

Pregnancy or gestation is when a fetus or fetuses grow and develop inside the woman’s uterus, usually as a result of sexual intercourse. Any pregnancy can result in miscarriage, intrauterine fetal demise, abortion, or live birth. Childbirth is measured as 40 weeks after the first day of the last menstrual period. The term “embryo” is what the offspring is called prior to eight weeks’ gestation, while fetus is used at eight weeks to the time of birth. There are three trimesters, divided relatively equally. The first trimester is up to 12 weeks’ gestation; the second trimester is between 13 weeks and 28 weeks’ gestation, and the third trimester is from 29 weeks to 40 weeks.

The term gravidity means the number of times a woman has been pregnant, while the term parity refers to the number of times a pregnancy is carried to viability. A nulligravida is a woman who has never been pregnant, while a primigravida is a woman who has had one pregnancy. Multigravida refers to having more than one pregnancy. The woman who is gravida 2, para 1, is pregnant for the second time and has one pregnancy carried to term. Abortions, miscarriages, and stillbirths are the reason why parity might be affected. The nulliparous woman may have been pregnant before but never carried a pregnancy past 20 weeks’ gestation.

A term pregnancy is at least 37 weeks’ gestation in length. Prior to this, the pregnancy if delivered is preterm. A pregnancy that has lasted longer than 42 weeks’ gestation is called a post-term pregnancy. There are risks to the pregnancy if there is delivery before or after what’s considered a “term” pregnancy.

Pregnancy can affect a woman’s health in many ways. Some health issues are secondary to hormonal issues, while others are related to the growth of the pregnancy. Common symptoms are morning sickness, fatigue, constipation, back pain, low blood pressure, swelling, increased urinary frequency, varicose veins, breast tenderness, heartburn, stretch marks, and hemorrhoids.

Pregnancy starts with fertilization, which has been discussed. The zygote, or fertilized egg, divides rapidly and eventually becomes a blastocyst. This is what implants into the uterine wall about 12 days after fertilization. The cells also begin to differentiate into the placenta, which attaches the embryo to the uterine wall, the umbilical cord, and the embryo itself. At the 8th week of development, the embryo becomes a fetus. Once the fetal stage is reached, the risk of miscarriage diminishes, so that most miscarriages happen prior to 10 weeks of development, which is 12 weeks’ gestational age.

The heartbeat happens at about 7 to 8 weeks’ gestation and involuntary movements are seen. Sex organs are seen as different after 12 weeks’ gestation. Brain activity is detected between five- and six-weeks’ gestation. Connections between nerve cells form at 17 weeks’ gestation and continue after birth. Figure 23 shows the different stages of fetal development:

Figure 23. There are numerous changes in the woman’s physiology that occur with each trimester. The first change noted is the absence of menses. The minute ventilation increases by up