# Human Sexuality and Gender/Pregnancy

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## Pregnancy
### Ectopic Pregnancy

    An ectopic pregnancy is one that occurs outside of the uterus. There are around 11,000 cases each year. Some of the causes for an ectopic pregnancy are a history of infertility, increased age and smoking are just a few. The most important cause is pelvic inflammatory disease with the causal agent being Chlamydia. Ectopic pregnancies cannot be determined from a physical examination. It needs to be referred to someone who is familiar with this type of case. If an ectopic pregnancy should occur there are several treatment options available, depending on the severity of the problem will determine the treatment. Methotrexate is a medication that can be administered for those less severe cases. However, for those cases that are more severe the appropriate procedure would be a laparotomy.

### Teenage Pregnancy

    The United States of America is known to be a leader in adolescent pregnancy. However since 1991 teen pregnancy rates in the United States have declined. A study was done by Santelli et al. in 2007 to find out what was responsible for the declining rates in adolescent pregnancy. The Federal government had provided funding for abstinence-only education in schools since 1998. However, Santelli and his colleagues found that the declining adolescent pregnancy rates between 1995 and 2002 were mostly attributable to improved contraceptive use.

## Birth
### Caesarean Section

Caesarean section (C-section) is a form of child birth that has been on the rise across the world. Many mothers who have undergone emergency C-sections during a prior childbirth have to make a decision whether they want to undergo another C-section or attempt a vaginal birth. In Australia, there are a total of over 35% repeat Caesarean sections. In a study conducted of 20 interviews by women who had previously undergone a C-section, it was found that most mothers chose elective Caesarean over vaginal birth, as they knew what to expect and were aware of the risks. Some women chose this decision without even considering other possibilities, believing this practice was "an easy way out." Many of these women elect the Caesarean section because they believe an attempt at having a natural birth would ultimately result in the procedure. C-section births account for one out of every five child births in Australia.[1]

### Post-partum Depression

    Post-partum depression, a more serious case of the "baby blues" usually arises within the first 4 weeks after a woman gives birth; signs and symptoms include depressed mood, mood swings, reduced interest in hobbies, change in appetite or weight, insomnia, fatigue, decreased concentration, and thoughts of harm or suicide. PPD (post-partum depression) is said to be caused by changes in levels of hormones such as estrogen and progesterone which naturally occur after giving birth, and also certain environmental factors or concerns. M. Kaitz (2006) performed a study on 366 Israeli first time mothers consisting of two questionnaire interviews, one gauging mother's concerns and the other determining infant difficulty, performed at 3 and 6 months post-partum. Findings conclude that PPD and it's severity is based on concerns such as family health, return to work, mother's well being,relationships and support, infant care, and spouse. Return to work and family health were the two biggest concerns at 3 and 6 months. According to Kaitz, women with higher than average scores were more likely to have had an obstetric complcation, perceive their infant as difficult, and work more hours outside of the home as opposed to women with lower scores. Also, infant temperament and excessive work hours have a positive correlation with mother's concern scores; the perception of a difficult infant is often tied to emotional distress, and challenges in working was a higher concern in women with younger infants.

## Infertility
#### In Other Countries

There is a growing issue of infertility in Iran. Infertility affects many marriages and causes burdens to many females in Iran. A web-based study concluded that there was a 2.8% of current infertility based on self-reports by 10,418 non-menopausal married women ranging from 15 to 49 years old. The results of this study suggest that the best age for married women to minimize the chances for infertility is 20 to 27. This study concluded that “almost 21-22% of Iranian women experience…infertility at some time during their married life.”[2]

#### Infertility Statistics

According to National Survey of Family Growth, CDC 1995, approximately 6.1 million women and their partners in the U.S. are affected by infertility. Ten percent of the total reproductive-age population, men and women both are equally affected by infertility. 85% to 90% of infertility cases can be treated with regular medical treatments such as medication or surgery. While In some cases, assisted reproduction techniques such as in vitro fertilization (IVF) are used, which cost about 0.07% of U.S. health care costs.[3]
In most relationships families focus on the women if infertility occurs and almost excludes the male of not being fertile, when in fact most males are not fertile. According to Schneider and Forthofer infertility affects one out of six couples of childbearing age or approximately 15% of the couples of childbearing age. With sperm counts dropping from 40 to 50% it increases male related infertility. Sperm counts have dropped in males more than half in the last 50 years.

### In Vitro Fertilization

It is widely known that using assisted reproductive technology to assist pregnancy yields a higher chance of having a multiple birth pregnancy, as opposed to natural conception. In 2000, a study was conducted regarding the rate of multiple births in the United States, due to conception by assisted reproductive technology of women ages 20-39. Out of a population sample of 15,856,809 live births in the US, 109,519 were results of assisted reproductive technology. The annual number of assisted reproductive technology infants increased 44% from 1997 to 2000; the rate of ART (assisted reproductive technology) conceived twins has increased from 9.1% in 1997 to 11.8% in 2000, while naturally conceived twins decreased from 73.2% in 1997 to 67.3% in 2000. Higher rates of twins and triples due to ART increased dramatically with maternal age, showing that ART is used more by older women in search of pregnancy, as opposed to females in their early childbearing years.[4]

## Infertility Prevention

Unfortunately, most cases of infertility are beyond any basic method of infertility prevention. This fact should not however, preclude anyone from trying to conceive from taking some basic preventative measures to ensure they are functioning at a reasonably high level of physical and emotional health during this process. Lifestyle precautions Avoid excessive exercise (which can lead to a variety of menstrual disorders); Cease any recreational drug use; Quit smoking. Smoking has been linked to miscarriages. You can use Nicotine Replacement or Smoking Medication. Minimize caffeine and alcohol intake (alcohol can disturb hormonal balances and lead to miscarriages); Apply methods of stress relief that do not involve alcohol (such as meditation and other relaxation techniques); Practice safe sex to avoid contracting sexually transmitted diseases (STDs); Maintain a reasonably ideal body weight (to prevent hormonal imbalance); Avoid exposure to environmental hazards, including pesticides and heavy metals (such as lead and mercury) ) and are properly protected from radiation (during X-rays, etc); Keep a chart to follow your monthly cycle, as one’s cycle is an important indicator of overall health.

## Heading text

Pregnancy and Adoption BY Amber Joseph
Pregnancy is not always planned and adoption is available as an option. Adoption benefits many people who are unfortunately unable to produce a child or just prefer adopting. There are potential benefits for the birth mother as well. For example, housing assistance maye be available as well as prenatal and delivery expenses paid as needed.
Health precautions In the event an STD is contracted, seek early medical help; Maintain a diet featuring fresh fruits and vegetables (specifically, foods high in folic acid); Weight should be kept under control, Have regular physical examinations (including pap smears); Take the appropriate steps to control health issues such as diabetes and hypothyroidism; Look into your family history of fertility, specifically with your biological mother (genetics play an important role in fertility) Ask your physician or pharmacist about whether any medications you’re taking, including prescriptions, over-the-counter medications and any herbal remedies you take, have been shown to cause fertility.[5]

## References

* ↑ West J Med. 2000 August;173(2):131-134
* ↑ Santelli, John S., Laura D. Lindberg, Lawrence B. Finer, and Susheela Singh. "Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use." American Journal of Public Health 97.1 Jan. (2007): 150-56. Web. 29 Apr. 2011.
* ↑ McGrath, P., & Ray-Barruel, G. (2009). The easy option? Australian findings on mothers' perception of elective Caesarean as a birth choice after a prior Caesarean section. International Journal of Nursing Practice, 15(4), 271-279. doi:10.1111/j.1440-172X.2009.01762.x
* ↑ Kaitz, M. (2006). Maternal concerns during early parenthood. Child: Care, Health & Development; Nov2007, Vol. 33 Issue 6, p720-727, 8p, 3 Charts. Retrieved from EBSCOHOST.
* ↑ Mohammad, K., & Ardalan, A. (2009). An Overview of the Epidemiology of Primary Infertility in Iran.Journal of Reproduction & Infertility, 10(3), 213-216. Retrieved from EBSCOhost.
* ↑ http://www.conceivingconcepts.com/learning/articles/statistics.html (2011)
* ↑ http://web.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=13e7b7e1-744e-431b-be1e-cc536508fab6%40sessionmgr113&vid=9&hid=119
* ↑ Reynolds, M. A., Schieve, L. A., Martin, J. A., Jeng, G., & Macaluso, M. (2003). Trends in Multiple Births Conceived Using Assisted Reproductive Technology, United States, 1997--2000. Pediatrics, 111(5), 1159. Retrieved from EBSCOhost.
* ↑ http://www.conceivingconcepts.com/learning/prevention.html (2011)