Multiple pregnancies and Genetic testing

Health Conditions and Pregnancy

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What is it?
Malaria is an infectious disease found worldwide in warmer weather (mainly tropical and subtropical areas). Most people get infected after a mosquito infected with malaria parasites bites them. Others can get it from blood transfusions, organ transplants, or the shared use of needles or syringes contaminated with infected blood.

Pregnancy-Associated Malaria (PAM), also known as placental malaria, is distinctively deadly to both mother and fetus. PAM is usually caused by infection with Plasmodium falciparum, the most dangerous malaria-causing parasites that infect humans. A pregnant woman is more susceptible to contracting malaria and related complications. Some sources mention that pregnant women are more likely to get infected or develop complications repeatedly because immunity is lowered naturally during pregnancy.

Malaria in pregnancy gets in the way of transferring essential substances that typically cause stillbirth, spontaneous abortion, premature delivery, or dangerously low birth weight. Problems can also include placental deficiency, hypoglycemia (deficiency of glucose in the bloodstream.), and anemia (lack of red blood cells). Apart from high mortality risk, infants with low birth weight are at increased risk of poor cognitive and social development. It can also lead to increased chances of getting sick as adults, such as type 2 diabetes and cardiovascular diseases.


It can range from mild to severe and can develop between 7-30 days after infection. Most people get a high fever, chills, headache, sweating, muscle soreness, and fatigue. At the same time, others can also have nausea, vomiting, diarrhea, anemia (low red blood cell count), or jaundice (yellowing of the skin and eyes). It can also lead to kidney failure, seizures, confusion, coma, or death, but rare cases.

  • Treatment:
    Malaria is not passed through breast milk, so breastfeeding will not give your baby malaria. The prevention of low birth weight related to malaria during pregnancy remains a priority in research. However, if you get infected and are pregnant, you should visit your doctor to avoid serious complications.

    For severe malaria caused by the Plasmodium falciparum parasite, an intravenous drip (used to put fluid or medicines directly into a vein) medication is usually recommended. For some types of malaria, medication taken weekly until you give birth is recommended. However, not all malaria medications are safe for pregnant women, and some have associated risks. Therefore, it is essential to discuss the best option with your doctor. You cannot completely be immune to malaria, so protecting yourself is very important.

  • Prevention:
    Mosquitoes that spread the infections are more active at night. To prevent infection, close all your windows and do not leave the door open when you go in and out of your room/house. You should wear light-colored clothing (mosquitos do not like dark colors), wear long-sleeved clothes, and stay in a cool room (if possible because mosquitoes do not like the cold). Remember to use mosquito nets and chemical mosquito repellents (ones that are safe to use while pregnant). You should also keep your area clean by destroying the mosquitoes’ breeding areas (still water) and emptying all containers with old water.


What is it?

HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (acquired immunodeficiency syndrome), which is the late stage of HIV infection due to weakening the immune system. There is currently no effective cure for HIV. Once people get HIV, they have it for life, but it can be controlled and live long, healthy lives while also protecting their partners with proper medical care. People get infected only through blood, semen, vaginal fluids, and breast milk transmission. The virus is not spread by casual contact (hugging or touching), touching items touched by an infected person, saliva, sweat, or tears that are not mixed with an infected person’s blood).

There is a 15 – 45% chance of passing HIV from mother to child anytime during pregnancy, childbirth, and breastfeeding (called perinatal transmission) if the proper precautions are not taken. Suppose the mother gets infected while she is already pregnant. In that case, the baby is protected due to the protective barrier formed by the placenta. In early pregnancy, contraction by blood is possible since the placenta isn’t yet fully developed. If the baby gets infected, it can affect all its bodily functions and be fatal. The baby can get infected during labor because the placenta will be separated. However, advances in research have made it possible for several women to give birth without transmitting. 

Some women get complications in their pregnancy such as preterm labor, low birth weight, perinatal mortality (death of a fetus), high blood pressure, diabetes, and growth restriction of the baby. It’s usually recommended that women living with HIV give birth naturally (vaginal birth) unless there is another reason why this would be difficult. If vaginal birth is difficult, it may be safer to have a cesarean section, which removes the baby from the womb. If a mother has a high viral load, they may also be advised to have a cesarean section.


Once HIV gets into your blood, it will multiply and infect white blood cells (specifically the T lymphocytes). Symptoms will appear in 3-6 weeks and last for less than 10 days. Symptoms can include fever, night sweats, fatigue rash, headache, swelling in your neck, armpits, & groin, sore throat, body ache, joint pains, nausea, vomiting, and diarrhea. After these symptoms are gone, the virus will continue to multiply and attack the immune system until it breaks it down, which may take 10 years.


Suppose you have never taken HIV drugs before pregnancy, in your first trimester, or taken medication and found out you are pregnant in the 1st trimester. In that case, your doctor will discuss your treatment plan. Your doctor will prescribe treatment that will not affect your baby. Treatment should be started immediately. Most HIV medicines are safe during pregnancy and will not increase the risk of birth defects. Usually, pregnant women can use the same HIV treatment process as non-pregnant women. Unless, of course, if the known side effects outweigh the benefits.

Anti-viral treatments or Antiretroviral therapy (ART) focus on reducing perinatal transmission and help manage the virus to help protect both you and your baby. Medications that bring down viral load (measure the virus in your blood) help prevent it from passing on to your baby. You have to take extra precautions to avoid infections since HIV reduces your immunity. Practicing good hygiene, healthy eating, and exercise are critical to a healthy pregnancy with HIV.


The best way is not to get infected, but if you do, you need to take precautions to prevent transmitting it to your baby. As soon as you are positive, you have to start medications immediately. After giving birth, your baby needs to take HIV medicine for 4-6 weeks. 

Your doctor may recommend a cesarean (C-section) delivery to lower the risk of transmission. A vaginal delivery can be an option if your HIV is managed well and your viral load is not detectable. When breastfeeding, there is a risk of transferring. Therefore, your doctor might recommend not nursing and only using formulas. You should also not pre-chew your baby’s food.

Heart conditions

What is it?

Heart conditions include a range of diseases, disorders, and conditions affecting the heart and blood vessels. Heart conditions have different types, including angina (chest pain with short and sharp attacks), heart attack, atherosclerosis (buildup of fats, cholesterol, and other substances in and on your artery walls called plaque), heart failure, cardiovascular disease, and cardiac arrhythmias (abnormal heart rhythms). Other heart conditions include congenital heart defects (present at birth), cardiomyopathy (weakened or abnormal heart muscle and function), infections of the heart, and heart valve disorders.

When pregnant, the heart works harder to pump more blood to help the baby develop and grow. Labor and delivery also add to the heart’s workload. If you have heart disease, it can lead to symptoms similar to a heart attack. Some underlying heart conditions cause minimal to no problems during pregnancy. In contrast, others may be much riskier and increase the chance of complications. Simple congenital heart defects can be repaired, and mild heart valve deformities & heart murmurs are generally considered low-risk. Congenital heart disease will increase your risk of a miscarriage, premature birth, or a low birth weight of your baby.


Symptoms include fainting (blood pressure & volume changes), trouble breathing when laying down (might also be caused by the growing uterus), palpitations (rapid, strong, or irregular heartbeat), heart murmurs, chest pain, fatigue, and dizziness.


Women with pre-existing heart conditions, like chronic high blood pressure, heart disease, and high cholesterol, should carefully monitor it before getting pregnant and after giving birth. Your doctor may advise you to get regular exercise, prescribe medications or other treatments. Regular ultrasounds are needed to monitor your baby’s growth and development.  


Almost 50% of pregnant women develop heart arrhythmias (abnormal heartbeat). There are usually no symptoms and are only discovered when taking the woman’s pulse. However, symptoms like dizziness, lightheadedness, or palpitations occur occasionally. To assess the heart’s rhythm, an electrocardiogram (ECG, test that detects and records your heart’s electrical activity) or 24 hour Holter monitor (a small, wearable device that keeps track of your heart rhythm) may be recommended. If symptoms continue or worsen, arrhythmia treatment may be considered.


If your blood pressure rises suddenly, it could be a sign of preeclampsia (high blood pressure and damage to another organ system, usually liver and kidneys). Your doctor will prescribe you medication if your blood pressure gets dangerously high. 


Depending on the severity, a C-section may be required or an assisted vaginal delivery with forceps or vacuum to avoid pushing towards the end of labor. After delivery, some mothers require intensive monitoring to ensure they are recovering from the delivery.


Suppose you have a pre-existing heart condition and plan on getting pregnant. In that case, you should have a pre-pregnancy consultation with a cardiologist (doctor specializing in treating heart problems). 

Suppose you do not have pre-existing conditions and are planning or are pregnant. You should consult your doctor to start a healthy diet and lifestyle changes like exercising, limiting caffeine, and stopping smoking from risking developing heart problems.


What is it?

Asthma is a chronic lung condition where your airways narrow and swell. It may produce more mucus, making it difficult to breathe. Some people have minor asthma, while for others, it is major and intervenes with daily activities and can lead to a life-threatening asthma attack.

Asthma can impact your pregnancy and affect your and your baby’s health. You should treat it effectively to try and prevent complications; however, if you don’t monitor it, the risk of getting complications increases. These complications can include high blood pressure,  damage to other organ systems (usually kidneys), limited fetal growth, premature birth, C-section, and putting your baby’s life in danger. Pregnancy can worsen your asthma if you have severe asthma, especially if you stop taking your medications. 


Women experience different ranges of asthma symptoms when they get pregnant. It could be the same as before they were pregnant, or it could get worse. Symptoms can include heartburn, persistent coughing (especially at night), wheezing (whistling sound) when breathing, and shortness of breath.


Your doctor will provide you with the right medication that is the safest for your pregnancy.  The lower your asthma severity before pregnancy, the better you can control it while you are pregnant. You should regularly take your medications to reduce your asthma attack risk.


You need to take good care of yourself by keeping your prenatal appointments, regularly taking your medications, not smoking, avoiding smokers or dust, and recognizing your warning signs such as coughing, tightening of the chest, and shortness of breath.


What is it?

Diabetes is a chronic disease occurring when the pancreas does not produce enough insulin (hormone regulating blood sugar) called type 1 or when the insulin produced can’t be effectively used called type 2. Lack of insulin or cells that stop responding to insulin will leave too much blood sugar in your bloodstream. Gradually, this can cause serious health problems like heart disease, vision loss, and kidney disease. 

Gestational diabetes is diagnosed first during pregnancy (gestation) when the woman did not have diabetes before she got pregnant. Some long-term diabetes problems (eye problems and kidney disease) can worsen with pregnancy, especially if you have high blood glucose levels. There is also a higher chance of developing preeclampsia (sometimes called toxemia) and too much protein in your urine during the second half of pregnancy. High blood glucose levels can increase the possibility of birth defects like heart, brain, or spine defects. Complications include early birth (preterm), miscarriage or stillbirth ( baby dies in the womb), the baby can weigh too much, breathing problems, and low blood glucose (hypoglycemia).


Diabetes symptoms are the same whether you are pregnant or not. Most women don’t experience symptoms, but some may have increased thirst, dry mouth, frequent urination, and fatigue. You should talk to your doctor if you experience these symptoms. 


It is essential to stay healthy (exercising and eating healthy) and keep your blood glucose as close to normal as possible. If you take oral diabetes medicine, your doctor might switch you to insulin. You should get regular checkups before and during pregnancy to monitor your blood sugar level. Most women with gestational diabetes don’t have it anymore after giving birth. Some continue to have it, referred to as type 2 diabetes.


There are no guarantees to prevent gestational diabetes. The best way is to have a healthy lifestyle before you get pregnant. You need to follow your meal plan, be physically active, take diabetes medicines (if necessary), stop smoking, and take vitamins (if your doctor recommends it).


What is it?

Epilepsy (also known as a seizure disorder) is a chronic neurological (central nervous system) disorder where brain activity becomes abnormal, causing recurrent and unprovoked seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. This might be genetic or because of a brain injury. People with epilepsy have abnormal electrical signals in the brain that cause a seizure. They cause severe muscle or very mild with barely any symptoms.

Most women with epilepsy can deliver healthy babies but require special care during their pregnancy due to random seizures. Pregnancy does not cause epilepsy, but women with epilepsy are more likely to have more seizures during pregnancy. This could be due to medicines that treat epilepsy working differently during pregnancy, such as not being absorbed or not working. Seizures during pregnancy can cause low fetal heart rate, decreased oxygen to the fetus, fetal injury, premature separation of the placenta from the uterus (placental abruption), miscarriage due to trauma (falling during a seizure), preterm labor, premature birth, birth defects (spine and brain), stillbirth, smaller size, and severe bleeding in newborn. Babies who have mothers with epilepsy are likely to develop seizures when they get older.


Epilepsy symptoms are the same for women who are pregnant and not. A woman may have frequent seizures with no known cause. In addition to seizures, the most common symptoms are headaches, mood swings or energy shifts, dizziness, fainting, confusion, and memory loss. Some women may also feel that they are about to have a seizure right before it happens.


The most important thing is to continuously monitor and manage your epilepsy with prenatal and postnatal care. You have to visit your doctor regularly, who might prescribe you medications to be taken in small doses to prevent or control your seizures. Your doctor will choose the type of medication with the least side effects for your pregnancy.

It is uncommon to have seizures during delivery, but it is possible. If you have a seizure, it might be stopped with intravenous (fluids injected into a vein) medication. If the seizure does not stop, your doctor might perform a C-section. You are more likely to have a seizure during labor if you had frequent seizures in your third trimester. Your doctor will review the best delivery method with you to avoid the increased risk of seizures during your delivery. Women with epilepsy might use the same pain relief methods during labor and delivery as other pregnant women.


There are no guarantees to prevent gestational diabetes. The best way is to have a healthy lifestyle before you get pregnant. You need to follow your meal plan, be physically active, take diabetes medicines (if necessary), stop smoking, and take vitamins (if your doctor recommends it).


What is it?

It is a condition when a person has excessive fat that increases the risk of getting more health problems like heart disease, diabetes, high blood pressure, and certain cancers. It is caused by inherited, physiological, and environmental factors, poor diet, and exercise choices.

Pregnant women normally gain weight, but obesity can cause several health risks for you and your baby. Complications like stillbirth and recurrent miscarriage, gestational diabetes, high blood pressure and damage to other organ systems (usually liver and kidneys), cardiac dysfunction, sleep apnea (sleep disorder where breathing is interrupted repeatedly during sleep), and C-section and the risk of C-section complications. The baby will also be susceptible to health risks such as birth defects, significantly larger than average, impaired growth, childhood asthma, and obesity.


Epilepsy symptoms are the same for women who are pregnant and not. A woman may have frequent seizures with no known cause. In addition to seizures, the most common symptoms are headaches, mood swings or energy shifts, dizziness, fainting, confusion, and memory loss. Some women may also feel that they are about to have a seizure right before it happens.


The best treatment is to lose weight. Pregnant women who are obese need to start a diet and exercise routine to improve their own and their baby’s health. Talk to your doctor before you begin to determine the best type of exercise routine while you are pregnant. You should start slowly and build slowly. Since your joints aren’t strong, you should start small with walking and swimming. Do not overdo your workouts because it can be dangerous to your baby. You should also eat nutritious foods and avoid empty calories like fast food, fried food, soft drinks, pastries, sweets, and microwave dinners.


The only way to prevent obesity is to have a regular exercise routine while eating a healthy and balanced diet. 

Thyroid Disease 

What is it?

It is a medical condition that keeps the thyroid gland (found in front of the neck and produces hormones to help regular other organs) from making the right amount of hormones. Thyroid disease occurs when the thyroid gland makes too much (hyperthyroidism) or too little (hypothyroidism) hormones. Thyroid hormones control metabolism in your body, and without monitoring, they can affect your entire body. When there are too many hormones, your body uses energy too quickly, making you tired, faster heartbeat, losing weight without trying, and making you feel nervous. When there are too few hormones, you will feel tired, gain weight, and not tolerate cold temperatures. 

Both conditions make it difficult to get pregnant. Thyroid hormones are crucial for the normal development of your baby’s brain and nervous system. Your baby depends on your supply of thyroid hormone for the first trimester. However, after 12 weeks, your baby’s thyroid works independently can not risk transmission but can’t make enough thyroid hormones until 18-20 weeks. Thyroid disease can cause complications during pregnancy like miscarriage, premature birth, low birth weight, preeclampsia (dangerous rise in blood pressure in late pregnancy), thyroid storm (sudden, severe worsening of symptoms), congestive heart failure (a condition where the heart muscle is wear and cannot pump as it used to), stillbirth, and anemia. Thyroid disease can affect the baby in ways like a fast heart rate, early closing of the soft spot in the baby’s skull, poor weight gain, and irritability.

Postpartum thyroiditis is a thyroid inflammation that causes stored thyroid hormone to leak out of your thyroid gland. It affects about 1 in 20 women during the first year of giving birth and is more common in women with type 1 diabetes.


Some signs of hyperthyroidism in pregnancy include fast and irregular heartbeat, fatigue, difficulty dealing with heat, shaky hands, unexplained weight loss. Some signs of hypothyroidism include extreme fatigue, difficulty dealing with cold, muscle cramps, severe constipation, trouble with concentration, and memory loss. Postpartum thyroiditis usually has no symptoms, but it can be irritability, trouble dealing with heat, tiredness, sleeping, and a fast heartbeat.


You may not need treatment if you have mild hyperthyroidism during pregnancy. However, if it is severe, you might be prescribed antithyroid medicines that prevent too much thyroid hormone from entering your baby’s bloodstream. Hypothyroidism treatment consists of medications that replace your hormone that the thyroid can no longer make. You should visit your doctor regularly to monitor the progress of your pregnancy. Postpartum thyroiditis doesn’t usually need treatment. Although, if the symptoms are irritating you, your doctor might prescribe a beta-blocker (medicine that slows your heart rate).


To reduce the risk of thyroid disease, you should perform a thyroid neck check, minimize soy intake, have a thyroid X-ray (but be careful of other X-rays since the thyroid is vulnerable to radiation), consider supplements, avoid environmental toxins, do not go on a starvation diet, eat well, and stop smoking.

Rh Factor / Rhesus factor 

What is it?

It is a type of protein inherited and located on the red blood cells surface. You are Rh-positive if your blood has the protein and negative if your blood lacks the protein. Most people have Rh-positive. The Rh factor is needed when it comes to blood donations and transfusions. Rh-positive people will not make anti-Rh antibodies, but Rh-negative people will produce the antibodies that attack the Rh-positive blood. Hence, an Rh-positive can receive both positive and negative transfusions, but Rh-negative can only receive Rh-negative blood.

It doesn’t mean that you’re unhealthy if you’re Rh-negative. It is only a concern if you are pregnant and negative, but your baby is positive. This is called Rh incompatibility, where your immune system produces Rh antibodies that attack your baby’s blood cells because it is seen as a foreign object. This happens when your and your baby’s blood come into contact through miscarriage, abortion, ectopic pregnancy, molar pregnancy, bleeding & abdominal trauma during pregnancy, tests that require cells or fluids to be withdrawn, and delivery of a baby (either vaginal or cesarean).

These antibodies don’t cause harm to your first pregnancy. However, suppose your next baby is also positive. In that case, these antibodies might damage your baby’s red blood cells leading to life-threatening anemia (the baby’s body can’t replace the destroyed red blood cells quickly). 


You will not have any symptoms if you have Rh compatibility. However, your baby will develop symptoms after birth like pale skin & mucous membranes (lining the cheeks and gums), limp & sleepy, jaundice (yellowing of skin and whitening of eyes), trouble breathing, and swelling of face, arms, & legs.


You don’t need treatment if you and your baby are both Rh-negative. Suppose you are negative and your baby is positive. In that case, your doctor will inject you with Rh Immune Globulin (Rhlg) (a medication that prevents antibody production) after each blood contact.

Your baby will require treatment if there is an Rh incompatibility. Treatments can be phototherapy to decrease jaundice, blood transfusions through the umbilical cord and after birth to treat severe anemia, Immunoglobulin to decrease the red blood cells destruction. Your baby might get brain damage even if s/he has been treated. The incompatibility can be fatal to your baby.


You cannot pick the Rh factor your baby gets. However, if you are negative and your baby is positive, your doctor may inject you with Rhlg before the antibodies are produced. These injections are usually administered in the 28th week of your pregnancy and up to 72 hours after birth.

Rh Factor / Rhesus factor 

What is it?

Is a dangerous infectious disease that affects the lungs, mainly spread through tiny droplets into the air due to the coughing, sneezing, or release of fluids of an infected person. If it is left untreated, it can spread to other organs. There are two types called active and inactive or latent TB. Active is when you get sick and contiguous. Latent is when you have the infection but aren’t contagious (the bacteria are inactive). Other than the lungs, TB can infect the kidneys, uterus, brain, bone, and bone marrow.

TB can cause serious risk to a pregnant woman and her baby if it isn’t diagnosed and treated before it worsens. Early diagnosis and appropriate treatment (within 2 weeks) can benefit the baby. Late diagnosis and treatment can lead to fetal mortality, prematurity, growth delay, and low birth weight. A woman with untreated active TB can infect her baby. Breastfeeding is safe for mothers treated with first-line anti-TB drugs since it only has a small presence in breast milk and is not toxic.


Symptoms aren’t unique and can seem like regular pregnancy changes like increased respiratory rate, loss of appetite, and fatigue. The symptoms depend on where the bacteria is growing in your body. Symptoms for TB in the lungs can include severe cough (lasts 3 or more weeks), chest pain, coughing up blood (referred to as hemoptysis) or coughing up sputum (mucus in the lungs), fatigue, weight loss, indigestion, loss of appetite, chills, fever, and night sweats.


The same anti-TB drugs used for non–pregnant women can be used by pregnant women. Your doctor could treat you with a combination of 4 drugs for 6 months which includes the first 2 months (initial phase) of 4 antibiotics and pyridoxine (prevent vitamin B6 deficiency) the last 4 months (continuation phase) of treatment of 2 main antibiotics and pyridoxine. The drugs can reach the baby but have no effects. However, some TB medications should be avoided because it can damage the fetus. Discuss with your doctor to determine the safest one to use. 


You have to avoid people infected with TB, practice good hygiene,  and get vaccinated. If you get infected, you have to be treated early to prevent TB from reaching your baby. The baby is unlikely to be infected while in the womb.


What is it?

It occurs when the baby’s feet are pointed towards the birth canal instead of its head. This happens for about 3-4% of all pregnancies. A baby isn’t considered breech before the 35/36 week mark. Breech happens in situations like the pregnant woman having a history of multiple pregnancies, multiple babies at once, history of delivering prematurely, has placenta previa (placenta partially or fully blocks the neck of the uterus which interferes with regular delivery of a baby), uterus containing either too little or too much amniotic fluid and abnormally shaped uterus or other problems such as fibroids (tumors made of smooth muscle cells and fibrous connective tissue that develop in the uterus). 

The complications that come with a breech pregnancy can include high chances that your baby will get stuck in the birth canal and for the umbilical cord cutting off the baby’s oxygen supply.


There are 3 types of breech positions. Complete breech is when the baby’s butt points down, and the legs are folded at the knees with the feel tucked in. Frank breech is when the baby’s butt points down, and their legs are straight up in front of their body, with their feet near the face or head. Footling breech is when one or both of the baby’s feet point down hence being the first part of the body to come out. 


Doctors usually suggest a C-section for all babies with breech positions, particularly premature because they are smaller and more fragile. Since premature babies have a larger head than their bodies than full-term babies, they can’t stretch the cervical opening as much, making it more difficult for the head to emerge.


Your doctor may be able to turn the baby when you’re between 32-37 weeks pregnant. There are different ways of turning the baby.

  •  External version (EV): this is a procedure where the doctor manually turns the baby’s position using her/his hands through your stomach. This is usually possible between 36 and 38 weeks of pregnancy. It requires two people to perform along with constant monitoring of the baby. However, some reports state that the procedure is only effective 50% of the time. 
  • Inversion is a popular method where pregnant women invert their bodies to prompt the baby to flip. Some methods are the pregnant woman standing on her hands underwater, elevating their hips with pillows, or taking the stairs to help the pelvis elevate.


STI & Pregnancy

What is it?

It is an infection spread predominantly by sexual contact, including kissing, vaginal, anal, and oral sex. Some STIs can also be transmitted from mother to child during pregnancy, childbirth, and breastfeeding. An infection is when a bacteria, virus, or parasite enters and grows in or on your body.

Getting infected with an STI while pregnant can cause severe problems for you and your baby. STIs during pregnancy can cause many complications such as: 

  • HIV: pregnant women can pass HIV to their babies during pregnancy, labor, and vaginal delivery, or breastfeeding if it isn’t diagnosed before or early in pregnancy to reduce the risk of transmission.
  • Hepatitis B: when pregnant women get infected close to delivery, the risk of transmission is the greatest. Transmission can be prevented if infants are treated immediately after birth.
  • Chlamydia: can cause preterm labor, premature rupture of the membranes, and low birth weight. It can be transmitted to the babies during vaginal delivery. It can be treated with an antibiotic if it’s diagnosed during pregnancy.
  • Syphilis: can cause premature birth, stillbirth, and death after birth. Untreated infants have a high risk of complications involving multiple organs.
  • Gonorrhea: untreated gonorrhea can cause premature birth, premature rupture of the membranes, and low birth weight. It can be transmitted to the babies during vaginal delivery.
  • Hepatitis C: can increase the risk of premature birth, small size for gestational age, and low birth weight. This type of liver infection can be passed to the baby during pregnancy.

Other side effects include eye infection, pneumonia, blood infection, brain damage, blindness, deafness, and chronic liver disease.


General symptoms include sores or bumps (genitals, mouth, or rectal area), pain when urinating’ unusual discharge from penis or vagina, unusual vaginal bleeding,pain during sex, sore & swollen lymph nodes (tissue that contains white blood cells, which fight infection), especially in the groin, lower abdominal pain, and rash on the body, hands, or feet.


STIs like chlamydia, gonorrhea, and syphilis can be treated and cured with antibiotics during pregnancy. STIs caused by viruses like hepatitis B, hepatitis C, and HIV cannot be cured. For some, antiviral medications are given to reduce the risk of transmitting it to your baby. 


To prevent you from getting STDs, risk of transmission, make sure to get regular checkups for you & your partner, use condoms consistently & correctly, and get vaccinated against HPV and hepatitis.



Miscarriage or spontaneous abortion is the loss of pregnancy (unplanned or death o the fetus) naturally before twenty weeks of pregnancy and is referred to as a miscarriage.

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What is it?

 Miscarriage or spontaneous abortion is the loss of pregnancy (unplanned or death o the fetus) naturally before twenty weeks of pregnancy and is referred to as a miscarriage. When you have a miscarriage, it can increase the risk of another spontaneous abortion in a future pregnancy. A key indicator for spontaneous abortion is a dilated cervix.

Risk factors due to the mother include being older than 35, having a history of spontaneous abortion, being overweight, smoking cigarettes, using cocaine, alcohol, high doses of caffeine, having infections, and poorly controlled chronic disorders such as diabetes, hypertension, & thyroid disorders.

Risk factors due to the father include being older than 35, structural abnormalities in sperm chromosomes, abnormal sperm shape, damage in the sperms’ DNA, excessive stress, smoking cigarettes, using cocaine, alcohol, high doses of caffeine, and infection,

Problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), abnormal womb structure, weakened or injured cervix, problems with the immune system, chromosome abnormalities, molar pregnancy (abnormal tissue in the uterus in place of a fetus), ectopic pregnancy (embryo attaches outside the womb and is fatal to the fetus) and hormonal problems such as Polycystic ovary syndrome (PCOS) (when the ovaries are overly large causing a hormonal imbalance).

Caused by the baby: Genetic/chromosome problems (A fetus may receive the incorrect number of chromosomes, resulting in improper development)

Complications include:

  • Infection
  • Pelvic abscess (life-threatening collection of infected fluid in the fallopian tube or ovary)
  • Septic shock (a widespread infection that causes organ failure and dangerously low blood pressure)
  • Pain
  • Hemorrhage (severe bleeding)
  • Uterine perforation (accidental piercing of the uterus during a procedure
  • Difficulty conceiving or recurrent miscarriages
    • Pelvic pain
    • Bleeding or brownish-colored discharge 
    • Burst of liquid (after the fetal membrane breaks)
    • Passing clots (a thick mass of liquid stuck together, usually blood)
    • Abdominal cramps 
    • Lower back pain
    • Weight loss

    Your doctor will perform examinations that typically include checking the vagina, uterus, cervix for abnormalities, assessing the fetal viability, getting an ultrasound check, and blood tests. Surgical procedures like D&E and Vacuum aspirations can be recommended to remove all fetal tissue. You might be prescribed medications to help ease pain, increase hormone levels, stop bleeding, and keep you healthy. You might be recommended to avoid strenuous activity, sexual intercourse, and best rest.



    A miscarriage often can’t be prevented, but in some cases, you can reduce your chances by:
    Exercise and eat healthy
    Keep your body weight within healthy limits
    Manage stress
    Do not smoke (avoid secondhand smoke as well)
    Do not drink alcohol or take other drugs
    Limit or eliminate caffeine
    Check with your doctor before taking any over-the-counter medicine
    Avoid environmental risks such as radiation, infectious diseases, and X-rays
    Protect your stomach
    Avoid contact sports or activities that are at risk of injury

    Classifications of Spontaneous abortion

    1. Threatened: is characterized by symptomatic or ‘threatened’ expulsion of the fetus. However, the cervix isn’t dilated, and the embryo or fetus remains viable. There is vaginal bleeding and slight abdominal cramping, and miscarriage is possible, but pregnancy can be saved sometimes.
    2. Inevitable : is characterized by an ‘inevitable’ expulsion of the fetus when the cervix is dilated, whether the embryo or fetus is viable or not. There is heavy vaginal bleeding, lower back pain, & cramping. Due to cervical dilation, a miscarriage will almost always occur. This typically occurs before the 16th week of pregnancy.
    3. Incomplete: is characterized when all of the pregnancy tissue isn’t removed from the uterus (some of the baby’s or placenta’s tissue leaves your body, while some remains in your uterus). There is constant and heavy vaginal bleeding, abdominal cramps, and the passing of blood clots or pieces of tissue. This typically occurs before the 16th week of pregnancy.
    4. Complete: is characterized by ‘complete’ removal of the fetus from the uterus. There is intense abdominal pain, vaginal bleeding until all the tissue is removed and the cervix is not dilated. This typically occurs before the 12th week of pregnancy.
    5. Missed: is characterized when the embryo dies, but the fetal tissues remain in the uterus for several weeks until it gets dispelled naturally or with induced abortion. Sometimes, there is a brownish vaginal discharge, and the cervix isn’t dilated. This typically occurs before the 12th week of pregnancy.
    6. Septic: is characterized when there is fetal tissue remaining after induced abortion and causes a miscarriage due to an infection in the uterus. It is often due to the procedure performed by an untrained person and using nonsterile equipment. There is fever, chills, vaginal discharge that smells bad, continuous vaginal bleeding, abdominal cramping, and pelvic pain.
    7. Recurrent or Habitual: is when there are three or more consecutive miscarriages during the first trimester. Repeated miscarriages need to be medically evaluated for chronic problems such as hormonal dysregulation and infection. Recurrent miscarriage is when a woman has two or more consecutive pregnancy losses. 1% of women who have one miscarriage experience a second one. However, increases to 20% for the second, 25% for the third, and 30% after the third consecutive miscarriage.
        • Hormonal / Endocrine disorders
        • Anatomical (abnormal uterus or weakened cervix)
        • Infection
        • Inherited thrombophilia (predisposition to develop blood clots)
        • Immunological 
        • Genetic (chromosome abnormalities)
        • Lifestyle (alcohol, smoking, drugs)
        • Unknown
        • Vaginal bleeding
        • Pelvic pain
        • Loss of morning sickness
        • More frequent urination

        Tests are usually done after a woman has experienced 2 or 3 abortions. Some tests to determine the cause include ultrasonography (using ultrasound to produce diagnostic images of the internal organs of the body or fetus) and blood tests.


        Treatment for recurrent abortion may help a woman’s womb hold the fetus. Treatment depends on medical conditions, chromosomal abnormalities, uterine abnormalities, immune system issues, and more. Recurrent miscarriages can cause psychological stress, so it is essential to have a strong support system. For chromosomal causes, treatment can be in vitro fertilization (IVF). For anatomical causes, treatment can be minor surgery. For immunological and blood clotting causes, treatment can be blood-thinning medications. For hormonal abnormalities, treatment to balance hormones is recommended.

        Postabortion Care (PAC)

        It is a care service that treats women with complications of abortion following spontaneous abortion and unsafe abortion. PAC reduces maternal mortality & morbidity and includes both medical and preventive care. Essential elements of PAC include emergency treatment of incomplete abortion & potentially life-threatening complications and post-abortion family planning counseling & services.

        After your procedure, your doctor will provide you with specific after-care instructions, but sometimes it isn’t enough to reduce undesirable side effects. Some methods to increase comfort include:

        • Use heating pads to relieve cramps
        • Stay hydrated, particularly if you’re vomiting or diarrhea
        • Have a support system to help with emotional changes due to the hormone shift
        • Rest for a day or two to recover at home
        • Take medication to decrease cramps and pain
        • Massage the area where you have cramps
        • Wear a tight-fitting bra to reduce breast soreness

        Every woman seeking PAC care should receive physical and emotional support. The woman must be aware of precisely what will happen before, during, and after the procedure, including pain relief, immediate & future side effects, and possible complications. If the patient is an adolescent, additional care and attention are required to prepare her for the whole process.

        A diagnosis should assess injury or permanent damage to internal and external organs, permanent damage to the bladder or bowel that cause chronic problems, permanent infertility, possible death due to complications like infection and hemorrhage.

        Healthcare providers need to be prepared to manage unsafe procedures including providing treatment for signs of inevitable, incomplete, and septic abortions. Manual Vacuum Aspiration (MVA) is a procedure that can safely and effectively treat women with incomplete abortion, either spontaneous or induced.

        Multiple Pregnancies & Genetic Testing

        Multiple Pregnancies 

        Multiple pregnancies

        Multiple pregnancies occur when more than one egg is released and fertilized casual fraternal twins/more. With multiple pregnancies, you will usually go through the same symptoms as a single pregnancy but more intensely, more painful, and harder to manage. There are two types called identical (monozygotic), non-identical (dizygotic), or fraternal. 

        • Identical: occurs when a single fertilized egg splits into two or more embryos creating same-sex babies (2+ boys or 2+ girls) with the same genes. 
        • Non-identical: occurs when 2+ separate eggs are fertilized with 2+ sperms. They can have the same or different sex. These siblings only share 50% of the chromosomes like any other siblings born at different times. They are more common than identical. 

        Causes; There aren’t any concrete explanations for multiple pregnancies. Everyone has a chance, and therefore it doesn’t have to run in the family. However, some studies show non-identical pregnancies are more common in certain ethnic groups (such as more twins for Africans and the lowest chances for Asians) if the mother is 35 years old or above and if it runs on the mother’s side of the family. 

        Risk factors: Most multiple pregnancies are healthy with healthy babies, but more risks are associated with them. You have a higher chance of anemia (limited healthy red blood cells to carry enough oxygen to your body’s tissues), pre-eclampsia (high blood pressure (hypertension) and high levels of protein in the urine (proteinuria)), gestational diabetes (elevated levels of glucose in the blood during pregnancy), and having a premature birth where more than half of all twins and almost all triplets & more are born prematurely. 

        Pregnancy care: Because these pregnancies have a higher likelihood of growth problems, you will need to visit the doctor more frequently and have more ultrasound exams than a single pregnancy would need. In some cases, one fetus is bigger than the other, called discordant caused by an infection or a problem with the umbilical cord or placenta. However, this doesn’t mean a problem with the babies. With twin pregnancies, there can be vaginal pregnancies that depend on the position, weight, & health of each baby, your health & how the labor is going, and the experience of your doctor. If these conditions aren’t met, then you are more likely to have a cesarean pregnancy for twins or more. 

        • Pregnancy genetic testing (before and after birth)

        It aids in identifying if the fetus has a genetic abnormality that can cause health conditions or birth defects. It is available before you give birth (prenatal genetic testing) and after (postnatal genetic testing). All women need to get genetic testing, especially if you or your partner have a family history of a genetic disorder, are above 35 years old, have a child with a genetic abnormality, previous stillborn, more than two miscarriages, or genital infections. There are two types of testing called screening tests performed to identify the women’s chance of having a baby with chromosome abnormalities and diagnostic tests to determine if the fetus has birth defects. 

        Prenatal genetic testing: can determine certain genetic conditions. You will give a blood or saliva test (to identify your Rh factor, if you have iron deficiency, diseases such as STD, gestational diabetes, thyroid, etc.), urine test (to measure your glucose, protein, ketones (formed when there is not enough sugar or glucose), and bacteria), and other tests by swabbing your vagina or rectum (to check for signs of infection).

        There are different types, but the common ones include carrier screening done on parents to identify certain inherited disorders, prenatal genetic screening done on pregnant women to detect the baby’s defects in the abdomen, heart, & facial features, cell-free DNA/ Non-invasive prenatal screening done on women with an increased risk of health conditions. Carrier screening can be done before or during pregnancy, prenatal genetic screening can be done in the first or second trimester, and cell-free DNA can either be done before or after the first-trimester screening. 

        Postnatal genetic testing: is performed on newborns and can determine inherited anomalies, diseases, and developmental delays in children. Newborns undergo genetic screening called a newborn screening to check for specific genetic abnormalities using blood samples. 

        Screening is recommended for the different types of a genetic disorders (at least 30). These screening tests differ from country to country. Some tests can be those for hypothyroidism (under activity of the thyroid gland), galactosemia (how your body metabolizes galactose), and sickle cell disease (a severe hereditary form of anemia).

          Pregnancy and risks

          Pregnancy & risks

          Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals).

          What is it?

          • Pregnancy is used to describe when a fetus develops inside a woman’s womb or uterus that lasts around 9 months (40 weeks). Your body will change, and it might require you to change your daily routine (sleeping earlier or eating frequent, small meals). As your pregnancy progresses, a lot of the uncomfortable changes will stop. But some women might not feel any discomfort at all. Being pregnant before could make it easier/different when you get pregnant again. Every pregnancy is different. Pregnancy is split into three stages called trimesters. The significant events in each trimester are:

          First trimester (Week 1- 12)

          This stage starts when the sperm penetrates an egg and fertilizes it. The fertilized egg (a zygote) then goes through the fallopian tube to the uterus, where it implants itself in the uterine wall. The zygote comprises a cluster of cells that later form the fetus and the placenta. The placenta connects the mother to the fetus and provides nutrients and oxygen.

          Your body goes through several changes, and hormonal changes affect most of your organ systems. The clear sign of pregnancy is when your period stops. Additional changes can include:

          • Extreme exhaustion
          • Tender, swollen breasts (nipples might stick out)
          • Morning sickness (Upset stomach with or without vomiting)
          • Cravings or disgust for some foods
          • Mood swings
          • Constipation (difficult bowel movements)
          • Frequent urination (more than usual)
          • Headache
          • Heartburn
          • Weight gain or loss
          Second trimester (Week 13 - 28)
          • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

            Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

            • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
            • Stretch marks (stomach, breasts, thighs, or buttocks)
            • Skin around the nipples darken
            • Noticeable line on the skin from the belly button to the pubic hairline
            • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
            • Carpal tunnel syndrome (hands numb or tingle)
            • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
            • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)
          Third trimester (Week 29 - 40)
          • This is the stage where your doctor will look for birth defects and can determine the sex of your baby. Movement can be felt at week 20 of the pregnancy. Footprints and fingerprints are formed, and the fetus wakes up and sleeps at 24 weeks. Babies born at 28 weeks will experience serious health complications such as respiratory and neurologic problems and have a 92% survival rate, according to research made by the NICHD Neonatal Research Network.

            Several women experience less discomfort during this stage compared to the first trimester. There are noticeable changes like the abdomen expanding and feeling your baby move before the trimester ends. Your body will make the necessary changes to accommodate your growing baby. You might experience: 

            • Aching body (back, abdomen, thigh, or groin (area between the abdomen and the upper thighs)
            • Stretch marks (stomach, breasts, thighs, or buttocks)
            • Skin around the nipples darken
            • Noticeable line on the skin from the belly button to the pubic hairline
            • Mask of pregnancy (patches of darker skin on cheeks, forehead, nose, or upper lip that matches on both sides of the face)
            • Carpal tunnel syndrome (hands numb or tingle)
            • Itching (stomach, palms, and soles of the feet). Call your doctor if you see signs of a serious liver problem (Nausea, loss of appetite, vomiting, jaundice (yellowing of skin or whitening of eyes), or fatigue combined with itching)
            • Swelling (ankles, fingers, and face). Call your doctor if you see signs of preeclampsia (sudden or major swelling or gaining weight too quickly)

          Antenatal Care

          It is a care you receive when you are pregnant to check on your baby. Your doctor or midwife will check both you and your baby’s health, give you helpful information for a healthy pregnancy (healthy eating and exercise), discuss choices for your care during pregnancy, labor, and birth.

          You will go through several tests like urine tests, blood pressure checks, pregnancy scans every time you go to the hospital, and screening for sickle cell and thalassemia at 10 weeks of pregnancy. It is normal to have 10 antenatal appointments during your first pregnancy. If you’ve previously given birth, you’ll have about 7 appointments that can be more if you develop a medical condition. 

          Your doctor or midwife will give you a schedule (after discussing with you) for your appointments. These appointments should be in an environment where you can easily talk about difficult issues such as mental health issues, drugs, domestic or sexual abuse. You will be asked about your family’s health or any support you might need to get the best of your pregnancy care. You must go to every appointment since it may influence your choice later in pregnancy.

          Postnatal care

          The riskiest time for the death of an infant or mother is the first few hours or days after giving birth. This is why postnatal care is necessary to help ensure the survival of mother and baby. Both infant and mother are kept in the hospital for the first 24 hours during postnatal care. Your baby needs constant care and attention. Your nurse or doctor will prioritize giving you information on exclusive breastfeeding, cleaning your baby’s skin, umbilical cord care, and keeping your baby warm. You will be getting counseling and education before leaving the hospital on signs of any danger to your baby and the steps you can take immediately.

          This care is even more important for infants who are born too early, too small, suffer from different kinds of infections, or suffocate during delivery to keep you and your infant healthy. Counseling is given to the mother, partner, and available family. Postnatal exams allow doctors to look for anything odd with the mother or baby.

          Danger signs of pregnancy and what to do when she gets these signs

          Almost all women feel pain or discomfort throughout their pregnancy, but some are worse than others and may require them to get immediate medical care. Signs to look out for that are dangerous to your pregnancy are;

          • Unusual discharge or bleeding from your vagina
          • Your water breaking before labor starts or the liquid is greenish or brown color (doesn’t look healthy or clean)
          • Your baby moves less than usual or not at all
          • Cramps or pain in your stomach during the first few weeks of pregnancy
          • Sudden swelling of your hands, feet, or face
          • Pain or burning while urinating combined with a sore back and fever is terrible
          • Painful area behind your calf or knee which is reddened and too warm to the touch
          • Intense headaches that last more than a few hours
          • Blurry or double vision or seeing white flashes or spots
          • Fever above 38° C that lasts more than a day
          • Injury to your stomach
          • 5 or more uterine contractions in one hour before 36 weeks
          • Unable to pee but get very thirsty
          • During late pregnancy, frequent throwing up and getting sick even more so if you have pain and fever
          • Diarrhea nausea, or vomiting for more than a day

          If you get any of these signs, you have to immediately call or visit your doctor to make sure everything is alright and to take the necessary steps for treatment if needed.

          Abnormal pregnancies

          There are several causes for abnormal pregnancies, terrible like issues with the placenta that can be deadly for the fetus. The different types of abnormal pregnancies include pregnancy failure (miscarriage), ectopic pregnancy, and molar pregnancy.

          Pregnancy failure (miscarriage)
          • also known as early pregnancy loss or spontaneous abortion and occurs in the 1st trimester (20th weeks) of pregnancy. Several factors contribute to this, but fetal abnormalities are the most common. Other causes can be a woman who has already experienced miscarriage and older women. The most common symptoms are bleeding from the vagina and uterine cramping. 


          There are different causes for miscarriages, such as genetic issues and a mother’s health conditions. Genetic problems include intrauterine fetus death (embryo formation stops), blighted ovum (embryo doesn’t form at all), problems with the placenta (the organ that joins the mother’s blood supply to the baby’s), molar pregnancy (no development of the fetus but there’s an abnormal growth of placenta), & partial molar pregnancy (abnormal placenta and abnormal fetus growth). The mother’s long-term health conditions include uncontrolled diabetes, infections, uterus and cervix problems, thyroid disease, health disease, immune system disorders, kidney disease, antiphospholipid syndrome (the immune system wrongly produces antibodies that attack the embryo/fetus), Polycystic ovary syndrome (PCOS) (ovaries are larger than usual that can lower egg production and is the leading cause for infertility), and more. 

          Risk factors:

          Multiple risk factors raise the chances of miscarriage, such as a woman who is 35 or above, being overweight, smoking, alcohol, drugs, excess caffeine, food poisoning, physical trauma, and certain medications. 


          Since many causes of miscarriage are unknown, you wouldn’t be able to prevent it, but you can lower your chances by:

          • Quitting smoking, alcohol, drugs

          • Limit caffeine intake (less than 200 mg per day) and herbal teas (maximum 4 cups)

          • Eating a balanced healthy diet and being a healthy weight before getting pregnant

          • Clean fruits and vegetables thoroughly

          • Avoid infections

          • Avoid certain foods like unpasteurized milk/cheese, raw or undercooked meat or eggs, liver,

          Ectopic pregnancy

          occurs when the embryo attaches outside the womb and is fatal to the fetus. This abnormality in pregnancy mainly occurs in the fallopian tube but can also happen in the abdomen, cervix, or ovary. It may cause bleeding and pain in your pelvis. Some women may not have any symptoms unless the site the egg attaches itself to breaks. A ruptured ectopic pregnancy has symptoms such as hemorrhaging (excessive release of blood from blood vessels) and extreme pain, which can cause maternal death; however, if treatment is provided before the rupture, maternal death can be avoided. 


          • Medical treatment: is used to treat an early ectopic pregnancy without heavy bleeding. It is injected into your body, prevents growth cells, and breaks down existing cells. After being injected, your doctor will examine you to check if the treatment has been effective. 
          • Laparoscopic surgery: a small cut is made in the stomach (around or in the belly button) for a thin camera tube to view the area and remove the ectopic pregnancy. There are two types of laparoscopic surgery, and the amount of bleeding and damage will determine the type of procedure. 

          Emergency surgery: this is necessary if you have heavy bleeding where you will get an abdominal cut to remove the torn tube, but in some cases, the fallopian tube is saved.

            Molar pregnancy

            occurs when an undeveloped egg gets fertilized, causing the tissue that was supposed to become a fetus turns into a large mole that can grow and fill the uterus. Another way is when two sperms fertilize one egg causing the placenta (organ providing nourishment to the fetus) to turn into a mole. Fetal tissue that is available will have serious defects. Symptoms can be the same as a normal pregnancy but can also have unusual ones like discomfort in the pelvis and vaginal discharge that look like grapes. To treat this pregnancy, the abnormal tissue needs to be removed.

            Surgical treatment is effective for most women called dilatation and auction evacuation (D&E), where a thin tube is used to suck the molar tissue. Another method called dilation and curettage (D&C) is when a sharp object cuts the tissue from the womb’s lining.
            Medical treatment: this is effective for women with partial molar pregnancy and is referred to as medical management or medical evacuation. The drug will make the womb shrink to remove the abnormal cells.

            Placental abruption

            occurs when the placenta separates from the uterus before the baby is born, causing a reduction or prevention of oxygen and nutrient supply to the baby and can cause heavy bleeding in the mother. It happens without warning and is dangerous to the mother and baby. In the worst-case scenario, a placental break might cause fetal death.

            Mild: if you are less than 37 weeks into your pregnancy and your baby’s heart rate is normal, you will be hospitalized to be monitored closely. If your bleeding stops and your baby’s condition is stable, then you could be able to go home.
            Moderate or Severe: if you are after 37 weeks of your pregnancy and the placenta abruption seems very little, you can have a vagina delivery with close observation. However, an immediate C-section will be performed if the abruption gets worse or endangers you or your baby.

            Suppose you get any symptoms, you need to visit your doctor immediately for proper diagnosis and treatment. If you had any of these abnormalities in your previous pregnancy, you should talk to your doctor when you think of conceiving again. This will reduce your chances of going through this painful experience again. In addition to this, you might suffer from negative thoughts about the loss of your baby. Please talk to trusted friends, family, or mental health experts if you have difficulty copying.

            Postpartum Depression

            A new mother suffers severe depression (feels empty and sad) after giving birth that lasts longer than 2 weeks. It is a serious condition that affects your brain, behavior, physical health, and overall day-to-day life. Hormonal changes might trigger these symptoms where some mothers go through anxiety disorders. Some mothers might not feel connected to their baby, feel like they aren’t the baby’s mother, or might not love their baby.


            • Depression gets more and more intense
            • Difficult to work or get things done at home
            • Pulling back from family and friends
            • Lack of care for yourself or your baby (eating, sleeping, washing)
            • Thoughts about hurting yourself or your baby
            • Intense crying, irritability, anger
            • Insomnia or sleeping too much
            • Overwhelming fatigue
            • Feeling shame, guilt, worthlessness, or inadequacy

            Therapy: you talk to your therapist to help you figure out ways to cope with your depression and change your thoughts.
            Medicine: If your therapist believes your depression is severe, she/he will refer you to a doctor to prescribe you antidepressants (the most common medication for depression) to help relieve symptoms of depression. However, it will take several weeks to work.
            Electroconvulsive therapy (ECT): is used for extreme cases of postpartum depression.

            Your doctor might recommend you to take the treatments together or alone after discussing the benefits and concerns of treatment. Treatment is essential for you and your baby. Getting help is necessary for your overall health. 



            A contraceptive is a device, drug, or method to prevent pregnancy. It can be swallowed, injected, attached, or inserted into the body. Contraceptives may be temporary (taken daily, weekly, monthly, yearly, bi-yearly, or more) or permanent. 

            WHAT IS IT?

            A contraceptive is a device, drug, or method to prevent pregnancy. It can be swallowed, injected, attached, or inserted into the body. Contraceptives may be temporary (taken daily, weekly, monthly, yearly, bi-yearly, or more) or permanent. There are several ways to prevent pregnancy, such as: 

            Long-Acting Reversible Contraceptive (LARC)

            Intrauterine Methods (Device / Systems) - IUD

            • What is it?

            An IUD is a small, soft, T-shaped device made of plastic or metal with a string attached. A healthcare professional put the IUD in the uterus (womb) to prevent pregnancy by stopping the egg and sperm from meeting. There are two types of IUD (copper and hormonal). They work in different ways to help prevent pregnancy.

            • Hormonal IUD or IUS

            The IUS thickens the mucus in the cervix, making it harder for the sperm to get to the egg and thins the uterus lining. This makes it less likely that a fertilized egg will attach to it. It also may stop the ovaries from releasing an egg. The IUD can help prevent pregnancy for 3 to 5 years.

            • Copper IUD

            This IUD has a copper wire wrapped around it. It changes the lining of the uterus so that if an egg is fertilized, it’s less likely to attach to it and slows the sperm movement, so it is harder to get to the egg. Depending on the type of copper IUD, it can help prevent pregnancy for up to 10 years.

            • How to use it?

            Your gynecologist inserts an IUD. The best time to have an IUD inserted is during your period, as this is when your cervix is most open. The whole procedure takes less than five minutes. Some women usually choose to take over-the-counter pain medication (ibuprofen) before the procedure since the insertion may cause some mild cramping.


            You must check to see if the string is in the right place every month. Your healthcare provider will teach you how to feel for the strings when inserted.


            The copper IUD protects you from pregnancy as soon as it is inserted. If your hormonal IUD is inserted on days 1 to 7 of your period, it works right away to prevent pregnancy, but if it is on any other day, you need an extra form of birth control (e.g., condoms, abstinence) for seven days.


            Once inserted, an IUD can be removed on request or at the time of expiration, approximately 3 to 10 years later. Removal takes about two to three minutes by your gynecologist. You may experience some normal cramping and bleeding as a result, but this should go away quickly.

            • Advantages
            • They’re predominantly hassle-free. You do not have to remember to do anything or take any birth control medicines regularly. It can help prevent pregnancy for 3 to 10 years (depending on the type).
            • IUDs do not contain estrogen, a hormone that some women can’t take
            • If you decide to get pregnant, you can have the IUD taken out.
            • If you use an IUD for several years, it costs less overall than many other types of birth control. That’s because there are no costs after you have it inserted.
            • They’re safe to use if you’re breastfeeding
            • The copper IUD can be used as emergency contraception (EC) for seven days after unprotected sex or contraceptive failure.
            • The copper IUD may lower your risk of cancer of the uterus.

            • What it doesn’t protect you from
            • An IUD doesn’t protect you from sexually transmitted infections (STIs) and HIV.

            • Common Side Effects
            • Irregular periods (spotting, heavier or longer periods) 
            • Pain when your IUD is put in and cramping, or backaches for a few days after
            • More cramping during your periods (Copper IUD)


            • Effective level (used properly and not) / Failure rate

            • IUDs are so effective because there’s no chance of making a mistake.  The copper IUD is 99.2% effective in preventing pregnancy. The hormonal IUD is more than 99% effective in preventing pregnancy.

            • Who can’t use it?
            • You can’t use a copper IUD if you have an allergy to copper
            • You can’t use a hormonal IUD if you have liver disease or breast cancer
            • You can’t use an IUD if you have an STD, have a recent pelvic infection, are pregnant, have a cervix or uterus cancer, or have unexplained vaginal bleeding.

            • What to do if it falls out?

            The IUD rarely falls out. It usually happens when a woman is on her period during the first three months after getting the IUD or if her flow is heavy. Another reason could be because of a small uterus. This typically includes women who are under 20 or have never been pregnant. 


            An IUD can come out partially without falling out completely. If this happens, it will need to be removed since it can not prevent pregnancy in this state. Another possibility is a perforation (stabbing) through the uterus (womb), which must be surgically removed. If this happens, you need to see your doctor and not have sex without utilizing another form of birth control.

            • Where to find it?



            What is it?

            Contraceptive implants are a long-term birth control option: a flexible plastic rod about the size of a matchstick placed under the skin of the upper arm. The implant releases a low, steady hormone dose to prevent the sperm from reaching the egg and typically suppress ovulation.

            How to use it?

            You must see your doctor to get an implant. After conducting a physical exam, the implant will be inserted under the skin of your upper arm and can stay in place for up to three years. Implant insertions take just a few minutes. They’re done with a local anesthetic, which makes the procedure painless.

            After insertion, you will have a small bandage covering the insertion site. Some bruising, scarring, pain, or bleeding at the insertion site may occur after the procedure.

            If you get the implant during the first five days of your period, it’s immediately effective, but if the implant is inserted at any other point, you should use a backup form of birth control for seven days.


            You do not need to worry about birth control for three years

            If you want to get pregnant, you can be fertile as soon as it is removed 

            It is appropriate for women who can’t use birth control containing estrogen

            Almost anyone, at any age, can have an implant

            What it doesn’t protect you from

            no protection against sexually transmitted infections (STIs)

            Common side effects

            Abdominal or back pain

            Changes in vaginal bleeding patterns, including the absence of menstruation

            Decreased sex drive


            Mood swings and depression

            Nausea or upset stomach

            Potential interaction with other medications

            Sore breasts

            Vaginal inflammation or dryness

            Weight gain

            Effective level (used properly and not) / Failure rate

            It is one of the highest levels of effectiveness of all contraceptives and has a more than 99% effectiveness rate

             Who can’t use it?

            If you are:

            allergic to any components of the implant

            have had severe blood clots, a heart attack, or a stroke

            have liver tumors or liver disease

            have known or suspected breast cancer or a history of breast cancer

            have undiagnosed abnormal genital bleeding

            taking some medications that might counteract the implant (talk to your healthcare provider)

            What if I’m late?

            If you have forgotten to replace the implant after three years, use condoms until it is replaced.

            Where to find it?

            Hormonal Methods

            Short-Acting Hormonal Methods

            Injectable Birth control

            Injectable Birth control

            What is it?

            Injectable contraceptives are long-term hormonal birth control available in a progestin-only form and hormones combined with progestin and estrogen hormones. 

            Combined injectable contraceptives (CICs) are a form of hormonal birth control consisting of monthly injections of combined formulations containing estrogen and progestin to stop the release of an egg each month and prevent pregnancy. It also makes it difficult for sperm to move through the cervix.


            How to use it?

            Injectables are prescribed by a doctor and administered only four times a year. The first shot should be given during the first five days of a regular menstrual cycle and should be administered differently after labor and during the period of breastfeeding. The drug is given in the buttocks or the upper arm. You have to remember to get a new shot every three months to get its full effects.


            If you get your first injection during the first 5 days of your period, it takes 24 hours to become effective, but if it is at any other time, you need to use an extra form of birth control for 7 days. 



            it doesn’t interrupt sex

            it’s an option if you can’t use estrogen-based contraception

            you don’t have to remember to take it every day

            it’s safe to use while you’re breastfeeding

            it’s not affected by other medicines

            it may reduce heavy, painful periods and help with premenstrual symptoms for some women

            many of the symptoms  usually go away after 2 or 3 months


            Though the return of fertility is a bit delayed and that too more with DMPA but more than 80% of women conceive within 1 year after stopping the contraceptive measures.


            What it doesn’t protect you from

            Injectable contraception does not protect against sexually transmitted diseases and HIV.


            Common side effects

            Mild Headaches


            Mood Swings

            Irregular Periods


            Tender Breasts

            Less Interest In Sex

            Upset Stomach (Nausea)

            Weight Gain

            Brittle Bones



            Effective level (used properly and not) / Failure rate

            With perfect use (this means you follow the exact directions all the time), the injection is 99.8% effective, and with typical use (this means not following the exact directions), the injection is 94% effective


            Who can’t use it?

            It is less effective on women who are obese. 

            It is not recommended for women with unexplained vaginal bleeding, liver disease, breast cancer, and blood clots.


            What if I miss or I’m late for my injection?

            If your last injection was 13 to 14 weeks ago, you should still be protected from pregnancy. You need to have your injection right away before 14 weeks have passed.


            If your last injection was over 14 weeks ago, use a backup form of birth control and see your healthcare provider right away for your next injection. If you’ve had unprotected sex, you need to get emergency contraception.


            Where to find it?

            Progestin-only Pills (POPs)

            Progestin-only Pills (POPs)

            What is it?

            The progestin-only pill (POP) is a type of birth control pill often called the “Mini-Pill” because it doesn’t contain estrogen and comes in a pack of 28 pills. Progestin is a female hormone that works by preventing the release of eggs from the ovaries and changing the cervical mucus and the lining of the uterus.

            Young and adult women who can’t take estrogen due to an underlying medical condition, sensitivity, or an unwanted side effect are prescribed this pill. They are also used for treating menstrual period problems, cramps, and other conditions.

            How to use it?

            It is beneficial to take the pill when you start your period or the first Sunday after your period begins. You have to take one pill every day at the same time. Every pill is an “active” pill, meaning that all the pills contain progestin, unlike combination pill packs with inactive pills or “placebo” pills in the last row of the pack.  If you’re sexually active, be sure to use a backup barrier method of birth control (condom) for the first 7 days after starting to prevent pregnancy.

            There are 2 different types of POP:

            3-hour progestogen-only pill (traditional progestogen-only pill) – take within 3 hours of the same time each day

            12-hour progestogen-only pill (desogestrel- a synthetic progestogen- progestogen-only pill) – taken within 12 hours of the same time each day

            There’s no break between packs of pills – when you finish a pack, you start the next one the next day. Follow the instructions that come with your pill packet – missing pills or taking the pill alongside other medicines can reduce its effectiveness.


            Can help clear up acne

            Doesn’t require surgery

            No interruption of foreplay or intercourse

            Can be used by women who cannot take estrogen

            Can be used by women who are over 35 and smoke

            What it doesn’t protect you from

            sexually transmitted infections (STIs).

            Common side effects

            Spotting can last a few days until your body gets used to it or for as long as you are taking it

            Not having a period is also common



            Weight gain



            Mood changes

            Breast tenderness

            Abdominal pain


            Effective level (used properly and not) / Failure rate

            If taken correctly, it’s more than 99% effective.

            Who can’t use it?

            Pregnant women

            If you do not want your periods to change

            If you take other medicines that may affect the pill. Talk to your doctor for more information.

            Get unexplained bleeding in between periods or after sex

            Have developed arterial disease or heart disease or have had a stroke

            Have liver disease, severe cirrhosis, or liver tumors

            Have breast cancer or have had it in the past

            What if I miss or I’m late?

            If you’re less than 3 hours (traditional progestogen-only pill) or less than 12 hours (desogestrel progestogen-only pill) late taking the pill, then take the late pill as soon as you remember. Take the pill remaining pills as usual. This might mean that you will have to take 2 pills on the same day. 

            The pill will still work, and you’ll be protected against pregnancy – you do not need to use additional contraception. If you are confused about the pills you have missed, keep taking it but don’t have sex or use a backup method of birth control (condom) until you can talk with your health care provider.

            If you become sick with vomiting or severe diarrhea within three hours after taking it, keep taking the Pill every day. Do not have sex or use a backup method (condom) until 2 days after the vomiting has stopped. If you have very severe diarrhea (6 to 8 watery poos in 24 hours), then this might also mean that the pill does not work correctly.

            If you missed your pill for 2 days and had unprotected sex, you may need emergency contraception. 

            Where to find it?

            Combined Hormonal Methods

            Combined oral contraceptives (COCs, "the pill")

            • What is it?

            The pill is a type of birth control, also known as the combined pill or oral contraceptive pill, containing estrogen and progestogen designed to be taken orally every day by women. The pill works by stopping the ovaries from releasing an egg each month and thickens the fluid around the cervix (opening to the uterus or womb) to prevent the sperm from entering. 

            • How to use it?

            When you start the pill for the first time or after a break from the pill, it can take up to 12 days to start working to prevent pregnancy. This depends on whether you start with the hormone or sugar /placebo pills. You have to take one pill around the same time every day. 

            You will usually have your period while taking the sugar pills. You can skip your period by missing the sugar pills and continuing to take the hormone pills each day. 

            • Advantages
            • Can be used to skip your period
            • Make your periods lighter, more regular, and less painful 
            • improve acne
            • Reduce your chance of getting cancer of the uterus (womb), ovaries, and bowel 
            • Help with symptoms of polycystic ovary syndrome (PCOS) and endometriosis.

            • What it doesn’t protect you from

            STI protection: No. Use external condoms or internal condoms to help protect yourself from STIs.

            • Common side effects
            • irregular vaginal bleeding
            • nausea 
            • sore or tender breasts
            • headaches
            • bloating 
            • acne
            • mood changes

            • Effective level (used properly and not) / Failure rate

            It’s 99% effective at preventing pregnancy with perfect use and 91% effective with typical use

            • Who can’t use it?
            • If you are a 35-year-old or over smoker or stopped smoking less than a year ago
            • you take certain medicines
            • you’re breastfeeding a baby less than 6 weeks old
            • If you have had heart disease or stroke
            • Get regular migraines
            • Have breast cancer or have a family history of breast cancer
            • you’re immobile for an extended time or use a wheelchair
            • you’re at a high altitude (more than 4,500m) for more than a week.
            • active disease of the liver or gallbladder
            • diabetes with complications

            If you’re healthy, don’t smoke, and there are no medical reasons for you not to take the pill, you can use it until you’re 50 years old. You’ll then need to change to another method of contraception.

            • What if I miss or I’m late?
            • If you missed 1 active (hormonal) pill or started a pack 1 day late, take an active (hormonal) pill as soon as possible and then continue taking pills daily. If you missed the pills during the first week and had unprotected sex, you should use emergency contraception for maximum protection, in addition to taking today’s active birth control pill.

            • If you missed 2 or more active (hormonal) pills or started a pack 2 or more days late, take 2 active (hormonal) pills as soon as possible and then continue taking pills daily. You may take one at the moment of remembering, and the other at the regular time, or both at the same time. Use condoms or abstain from sex until you have taken active (hormonal) pills for 7 days in a row.

            • If you missed the pills in the third week of the pack, you should continue taking the active (hormonal) pills in your current pack daily. After taking all the active pills, discard the pack without taking the 7 inactive pills and begin a new pack the next day.

            • If you missed any inactive (non-hormonal) pills, discard the missed inactive (non-hormonal) pill(s) and continue as scheduled. 

            • Where to find it?

            Contraceptive patch

              • What is it?

              The contraceptive patch is a very thin and smooth adhesive tape securely attached to your skin. It is attached to an easily reachable area of your body, such as the lower abdomen, buttock, shoulder blade, or the outer part of the shoulder.

              The patch contains a combination of hormones, which stops ovulation and thickens the cervical mucus, making it less permeable for the sperm.  Hormones are absorbed into the blood through the skin, bypassing the stomach, so this method is suitable for people suffering from gastrointestinal diseases. It doesn’t interfere with daily activities, and it doesn’t come off upon contact with water.

              • How to use it?

              The patch needs to be removed and changed every week for 3 weeks. After three patches, you will have a patch-free week which allows you to have your period.

              The contraceptive patch should be applied to clean, dry, non-hairy skin. Do not use any lotions, make-up, creams, powders, or anything else on the area of the skin before you apply the patch. These can interfere with the patch’s stickiness and make it more likely to fall off. Do not use on areas of skin that are irritated or broken. 

              Each time you change your patch, you should use a different place to avoid skin irritation. You should check each day to ensure that the patch has not fallen off.

              Patches come in a protective pouch and should be kept in the pouch until use. It should be stored at room temperature (not in the fridge or freezer). The used patches should be folded, sticky-side together, before discarding. They should not be flushed down the toilet. 

              You have to keep the patches away from them if you have children since they still contain hormones. Patches should be stored in a child-proof container before being thrown away.

              • Advantages
              • Needs to be applied only once a week
              • Its presence can be verified by sight
              • Does not detach with exposure to water or sweat
              • May improve acne in many cases
              • May improve bone strength due to the estrogen content
              • May reduce the risk of benign breast disease, as well as uterine endometrial and ovarian cancers

              • What it doesn’t protect you from
              • It does not protect against sexually transmitted infections (STIs), including HIV.

              • Common side effects
              • Nausea
              • Breast pain
              • Headache
              • Skin irritation at the patch site
              • Mood changes
              • Changes in menstrual bleeding
              • Weight gain

              • Effective level (used properly and not) / Failure rate

              Despite seeming like nothing more than a piece of bandaid, it is 99.4% effective.

              • Who can’t use it?

              Birth control patches are not recommended for people who weigh more than 90 kg or have a body mass index (BMI) higher than 30 kg/m2. This is because the dosage of medication delivered by the patch can not be adjusted, and therefore there will be the risk of blood clots.

              • What if it falls off?
              • It is unlikely that your contraceptive patch will fall off, as it has been carefully designed to minimize this. If it should become partially detached or fall off, what you should do depends on how long ago it came off.

              • If it was less than 24 hours ago, reattach the same patch in the same location (as long as it is still sticky) or replace it with a new patch.
              • If it was more than 24 hours ago, you must apply a new patch and use a backup birth control method for the first seven days afterward.

              • If it was less than 48 hours, reapply it as quickly as possible if it is still sticky, but if it is not, replace it with a new patch. Do not use anything (such as tape) to try to hold a patch in place that is no longer sticky.
              • If it has been off for 48 hours or longer, or if the time that it has been detached is uncertain: start a whole new patch cycle by applying a new patch as soon as possible. This is now week 1 of the patch cycle. 

              • If you have sex within the following seven days, you need to use additional contraception such as condoms. If you have had sex within the previous five days, you may need to take additional emergency contraception. 

              • If you forget to take the patch off at the end of week 3, take the patch off as soon as possible and apply the next patch on the usual start day of the next patch cycle. This may mean that you do not have a seven-day patch-free break.

              • If you replace the patch with a new one, the day you replace the patch will become the new day of the week you change your patch.

              • Where to find it?

            Contraceptive / Vaginal ring

              • What is it?

                The vaginal ring is a soft, flexible piece of plastic that contains synthetic hormones to be absorbed inside the vagina. It is a hormonal method of contraception obtained by prescription. These hormones help regulate your fertility similarly to how natural hormones work.

                How to use it?

                You need a prescription from your healthcare provider and be sure to tell your healthcare provider if you are allergic to any medicine. 

                The device is inserted into your vagina, which remains for three weeks. It is removed during the fourth week to allow your menstrual period to occur. At the end of the fourth week, the process is repeated. The vaginal ring begins to work immediately, but a second form of birth control should be used during the first seven days of your first month’s use of the vaginal ring.

                To insert a vaginal ring: IMAGE

                Find a comfortable position, such as standing with one leg up, squatting, or lying down. Separate your labia with one hand. Squeeze together the opposite sides of the vaginal ring between your thumb and index finger with your other hand.

                Gently push the vaginal ring deep inside your vagina. An applicator, similar to a tampon, can help with insertion. The exact placement of the ring doesn’t change its effectiveness.

                Try pushing the vaginal ring deeper inside your vagina if you feel discomfort.

                Keep the ring in place for three weeks.

                You don’t need to remove the vaginal ring during sex. But if you prefer, you can remove the ring for up to three hours and then reinsert it.

                To remove a vaginal ring: IMAGE

                Hook your index finger under the rim of the ring or grasp the ring between your index finger and middle finger and gently pull it out.

                Discard the used vaginal ring. Don’t flush it down the toilet.

                Wait one week to insert a new ring. Withdrawal bleeding usually begins two to three days after removing the ring. You may still be bleeding when you insert the new ring.


                It only requires the user to change it once a month

                It is a good alternative to contraceptive implants or intrauterine devices

                What it doesn’t protect you from

                The vaginal ring does NOT protect against the transmission of sexually transmitted diseases.

                Common side effects




                Breast tenderness


                Moderate weight gain

                Change of appetite

                Breakthrough bleeding or spotting

                Vaginal infection or irritation and increased discharge


                Decreased sex drive

                Abdominal pain


                An increased risk of blood-clotting problems, heart attack, stroke, liver cancer, gallbladder disease, and toxic shock syndrome

                Effective level (used properly and not) / Failure rate

                If used ideally, the ring is a highly effective form of birth control, but it has a 91% effectiveness rate since humans are prone to errors.

                Who can’t use it?


                Are older than age 35 and smoke

                Have high blood pressure, diabetes, liver disease, unexplained vaginal bleeding

                Have a history of breast or uterine cancer, blood clots, heart attack, or stroke

                Allergic to hormones or sensitive to any components of the vaginal ring

                Taking certain medications for hepatitis C

                Migraines with aura or, if you’re over age 35, any migraines

                What if it falls out?

                If the vaginal ring accidentally falls out, rinse it with cool or warm — not hot — water and reinsert it within two hours. 

                If the vaginal ring remains outside of your vagina for longer than two hours, reinsert the vaginal ring as soon as possible and use backup contraception for a week if the expulsion occurs during the first or second week of vaginal ring use. 

                Discard the ring if the expulsion occurs during the third week of using the vaginal ring and start using a new ring right away, which might cause breakthrough spotting or bleeding. Use a backup method of contraception until you have used the new ring continuously for seven days.

                Where to find it?

            Barrier Methods

            Female Condoms

            Do NOT use male and female condoms at the same time.

            • What is it?

            The female condom, also called an internal condom, is a birth control device that acts as a barrier to keep sperm from entering the uterus to prevent pregnancy. It also protects against sexually transmitted infections (STIs).


            The female condom is a soft, loose-fitting pouch with a ring on each end. One ring is inserted into the vagina to hold the female condom. The ring at the open end of the condom remains outside the vagina. The outer ring helps keep the condom in place and is also used for removal. The female condom can be used during anal sex, too.


            • How to use it? IMAGE


            You insert a female condom is similar to putting in a tampon. It may seem a little tricky at first, but all you need is a little practice. Here’s how you do it:


            • Be careful not to tear it when you open the package.
            • Put the condom in before contact between the penis and vagina or anus.
            • Put lubricant on the closed end of the condom.
            • Find the most comfortable position to put it in. You may prefer to lie down, squat, or stand with one leg on a chair.
            • Squeeze the ring on the closed end of the condom together and insert it in your vagina as far as it will go, just like a tampon. For anal sex, put it as far as it will go.
            • Let go of the ring so that it opens and stays in place.
            • Let the ring on the other end hang about an inch outside your vagina or bottom.
            • Use a new condom every time you have sex.


            • Advantages
            • Protection from STIs
            • Your partner doesn’t need to remove their penis as soon as they ejaculate
            • Suitable for people who are allergic to latex
            • An erect penis isn’t required to keep it in place
            • Can be used or anal sex
            • Female condoms also make life easier by allowing you to prepare for sex. You can put one in up to 8 hours in advance. Your partner may also have a more comfortable experience since female condoms can fit various penis sizes. You may also enjoy extra stimulation to your clitoris from the outer ring.


            • Common side effects
            • If you are allergic to human-made latex, nitrile, or polyurethane
            • Discomfort during insertion, a burning sensation, itching, or a rash


            • Effective level (used properly and not) / Failure rate

            Female condoms work almost as well as male condoms as long as you use them correctly, they are about 95% effective,


            • Who can’t use it?
            • Are allergic to polyurethane or synthetic latex
            • Are at high risk of pregnancy — younger than age 30, have sex three or more times a week, had a previous contraceptive failure with vaginal barrier methods, or not likely to consistently use the female condom
            • Aren’t comfortable with the insertion technique
            • Have vaginal abnormalities that interfere with the fit, placement, or retention of the female condom


            • What if?
            • The condom breaks
            • The condom slips out of the vagina
            • The penis slips between the vagina and the outer surface of the condom
            • The outer ring of the condom gets pushed into the vagina during sex


            Change it as soon as you realize and take emergency contraception.


                • Where to find it?

            Contraceptive Sponge

            What is it?

            The contraceptive sponge is a type of birth control that contains spermicide which kills sperm. It is a soft circular disposable device inserted deep into the vagina and placed over the cervical opening to kill sperm before entering the uterus and fertilizing an egg.  The sponge prevents pregnancy by blocking the entrance to your uterus and slowing the sperm down with the spermicide.


            The sponge can be used alone or with condoms. To best prevent pregnancy, you should use both. Not only that, but condoms can help avoid contracting STIs.


            How to use it?

            You first moisten the sponge with water and then insert it into the vagina. This blocks sperm from entering the uterus. Next, a spermicide that is absorbed in the sponge is continually released. This will decompose the sperm and prevent them from reaching the egg.


            Inserting the Sponge IMAGE


            Wash your hands before inserting the sponge to prevent germs from entering your vagina.

            To activate the spermicide, you have to wet the sponge with at least two tablespoons of water. You can not use saliva.

            You will know the spermicide is active when you gently squeeze the sponge, which gets foamy.

            Fold the sides away from the removal loop to make the sponge narrow. Then, insert the sponge in your vagina with the dented side going in first.

            Once you release it, the sponge will unfold and cover the cervix. The string loop side should be facing out to cover the cervix tightly. Check the position and fit by sliding your fingers around the edges of the sponge. The sponge will be held in place by the walls of your upper vagina.

            The maximum time to insert the sponge before sexual intercourse is 24 hours. It must be left in place for at least 6 hours after intercourse to allow the spermicide to kill the sperm. 

            You are protected from pregnancy even if you have intercourse more than once. It should not be left in place for more than 30 consecutive hours. You will no longer be protected against pregnancy upon removal of the sponge.


            Removing the Sponge


            Wash your hands.

            Use the string loop to pull the sponge out of your vagina. 

            If the sponge turns upside down, find the loop by sliding your finger around the edge of the sponge, or grab the edge with two fingers and carefully pull it out. 

            If the sponge sticks to the cervix, use your finger to lift it away from one side.

            After taking out the sponge, you should check to ensure that the entire sponge has been removed and then throw it away.

            Contact your doctor if you couldn’t remove the sponge or only remove part of it.

            The sponge is for single use only. Do not flush a used sponge in the toilet but instead throw it away in a waste container.



            Does not hinder the sexual experience

            Effective immediately if used correctly

            Small and inexpensive

            You don’t have to see a doctor before using the sponge

            Can be inserted up to an hour before sex, effective for 24 hours

            Can have intercourse an unlimited number of times with each wear


            What it doesn’t protect you from

            The sponge does not protect against STDs and may increase your risk of getting HIV and other STDs. That’s because the spermicide in sponges contains a chemical that can irritate your vagina, making it easier for STD germs to enter.


            Common side effects

            The sponge and the spermicide it releases may cause:


            Vaginal irritation or dryness

            Urinary tract or vaginal infection

            An increased risk of contracting STIs, including HIV


            Effective level (used properly and not) / Failure rate

            For women who have never given birth and use the sponge ideally every time, it’s about 91% effective and 88% with typical use (not perfect).


            For women who have given birth and use the sponge ideally every time, it’s about 80% effective and 76% with typical use.


            Who can’t use it?

            Sensitive or allergic to spermicide or polyurethane

            Have a vaginal abnormality that does affect the way the contraceptive sponge fits

            Have frequent urinary tract infections

            Have a history of toxic shock syndrome

            Recently has given birth, had a miscarriage, or had an abortion

            Are at high risk of contracting HIV, or one has HIV or AIDS

            Younger women (less than age 30) who have sex three or more times a week


            Where to find it?


            What is it?

            Spermicide is a contraceptive containing chemicals that kill sperm or stop it from moving. Spermicide isn’t a very effective birth control method when used alone. You can improve its effectiveness by using a barrier method form of birth control like a condom, diaphragm, or cervical cap.


            It stops pregnancy two ways, by blocking the entrance to the cervix and preventing the sperm from moving well enough to swim to your egg. 


            It’s available in many forms, including cream, gel, foam, film, suppository ( a small, solid pill), and tablet.



            Gels, jellies, and creams

            These come in different consistencies and textures, but all contain about 1 to 5% of the spermicide chemical. They are inserted into the vagina using a syringe-like applicator.



            It contains a high level of spermicidal chemical, about 12.5 percent, and can irritate the genitals. This is also placed using a syringe-like applicator.



            A spermicidal film is a thin translucent layer of spermicide placed on the vagina and absorbed. You insert it by folding it in half twice, then putting it on your finger and sliding it deep into the vagina. It contains about 28% of the spermicide chemical.


            You have to apply it 30 minutes before sex, or the vagina will not fully absorb it. It needs to be stored in a cool, dry place, and make sure your hands are completely dry while applying it. Otherwise, the film might dissolve before you get a chance to use it. 


            Other types

            Spermicides are also available as tablets or suppositories. Tablets and suppositories should be inserted high into the vagina near the cervix approximately 30 minutes before intercourse so that they fully dissolve. 


            How to use it?

            Since there are different types of spermicide, check the directions that come in the package. If you don’t use spermicide correctly, it won’t work as well.


            Inserting spermicide into your vagina is usually pretty straightforward — it’s similar to putting in a tampon. First, check the expiration date. Then, into a comfortable position — you can stand with one foot on a chair, lie down, or squat — then gently insert the cream, film, foam, gel, or suppository deep into your vagina using your fingers or the applicator that came in the package.


            Timing is essential when it comes to spermicide. Some spermicide must be put in your vagina at least 10-15 minutes before sex. And many others are only effective for 1 hour after you apply them. 


            You’ll need to add more spermicide if you want to have sex more than once. However, using spermicide several times a day can irritate and increase your risk for STDs.



            Doesn’t interrupt sex

            Doesn’t have hormones

            They have no lasting effect on a woman’s hormones

            They can be conveniently tucked into your pocket or purse.


            What it doesn’t protect you from

            Spermicide doesn’t protect against sexually transmitted infections. Using it several times a day may increase your risk for HIV and other STIs. That’s because the chemical in spermicide can irritate your vagina and make it easier for STD germs to enter your body. Adding condoms to the mix helps protect you from STDs and gives you an extra boost in pregnancy prevention. 


            Common side effects

            Recurring urinary tract infections due to irritation 

            Irritation increases your risk for HIV and other STDs 

            Allergic to spermicide (soreness or irritation)

            Allergic reaction may lead to itching, burning, or redness


            Effective level (used properly and not) / Failure rate

            72% effective at preventing pregnancy


            Who can’t use it?

            All women can safely use spermicides except those at high risk for HIV infection or already have HIV infection.


            Where to find it?


            What is it?

            A diaphragm is a form of reusable birth control that is a small, dome-shaped cup you insert into your vagina to block sperm from entering your uterus. For added protection, diaphragms are meant to be used with spermicide. The diaphragm can be put in right before you have sex or up to six hours before you have sex.

            There are two kinds of diaphragms:

            Flat Ring Diaphragm: Can be folded into an oval and easily inserted with an applicator provided with it.


            Arcing or Coil Spring Diaphragm: Is a little hard to fold and forms an irregular circle but can be inserted using only your fingers.


            How to use it? IMAGE

            First, you need a prescription to get one.


            Before you put it in

            A diaphragm is most effective when it’s used with spermicide. Apply a teaspoon of spermicide into the dome, spread it around the rim, and then insert. 


            Don’t use petroleum jelly or other oil-based creams in your diaphragm. These products may create tiny holes in the silicone. Be sure to check the expiration date because it may not be as effective if it expires.


            How to put it in

            Find the best position to insert your diaphragm by lying down, squatting, or standing with one leg propped up. Whatever position you choose, the idea is that your legs should be wide open and your knees bent.


            To use the diaphragm, follow these steps:


            Wash your hands well

            Apply spermicide to the diaphragm.

            Fold the diaphragm in half and hold it in one hand, with the dome pointing down. Use your other hand to keep your vagina open.

            Place the diaphragm into your vagina and use your fingers to push the diaphragm as far into the vagina as you can.

            Use your finger to wrap the front rim up. It’s helpful to aim for your belly button.

            After placing the diaphragm, check to see if it’s placed correctly. Try inserting your finger into your vagina again to see if you can feel any part of your cervix through the diaphragm. If the device doesn’t cover your cervix, remove the diaphragm and try reinserting.


            You shouldn’t be able to feel the diaphragm once it is in place. If placed correctly, it will stay put even if you cough, squat, sit, walk, or run.


            When to take it out

            Leave your diaphragm in for at least six hours after having sex. If you plan to have sex again that same day, leave it in and apply more spermicide into your vagina beforehand.


            You shouldn’t leave the device in for longer than 24 hours. Doing so may lead to a severe bacterial infection called toxic shock syndrome.


            How to take it out

            Wait at least six hours after having sex to remove your diaphragm. 


            Then, follow these steps:


            Wash your hands well

            Find a comfortable position — lying down, squatting, or standing with one leg propped.

            Place your index finger into your vagina. Hook it over the rim of the diaphragm.

            Gently pull the diaphragm down and out of your vagina. Be careful not to tear the device with your fingernails.


            Diaphragm aftercare

            After you take your diaphragm out, take care to prevent bacteria from settling into the diaphragm. This will preserve the product’s continuous use. With proper care, a diaphragm can last from 2 to 10 years.


            You should:


            Check for holes or other damage. Try filling the dome with water to see if it has leaks. You shouldn’t use a damaged diaphragm. Any holes will allow sperm to enter the cervix and into the uterus.

            Rinse it off and let it air dry.

            Store in a cool, dry container.



            Effective as soon as you start using it, it’s easy to stop using it, too.

            Doesn’t interrupt sex. You can put your diaphragm in up to 2 hours before you have sex (that’s how long the chemicals in spermicide work). 

            Don’t have hormones

            Can use them over and over

            Can have sex during menstruation

            Either partner cannot feel the device

            Portable and can be carried in your purse with ease

            Can be used while breastfeeding

            Can be used if you have medical problems or smoke.


            What it doesn’t protect you from

            The diaphragm does not protect from sexually transmitted infections.


            Common side effects

            Genital irritation, red or swollen vulva/vagina due to silicone sensitivity or by the chemicals in the spermicide 

            Latex allergies

            Irregularities of the vagina or cervix could create additional risks

            Some people get urinary tract infections (UTIs)

            Irregular spotting or bleeding, 


            Effective level (used properly and not) / Failure rate

            If you use your diaphragm ideally every time you have sex, it’s 94% effective. But with typical use, it is  88% effective.


            Who can’t use it?

            If either partner is allergic to latex or spermicide

            If inherited problems and surgery change the elasticity or shape of the vagina, the diaphragm is not the best form of birth control

            Get frequent urinary tract infections 

            Have a history of toxic shock syndrome 


            Where to find it?

            Cervical Caps

            What is it?

            A cervical cap is a silicone cup you insert in your vagina to cover your cervix and keep sperm out of your uterus. Your vaginal muscles hold the cup in place and stop it from being moved during intercourse. The cervical cap is best effective when used with spermicide, which kills any sperm that come into contact with the cap. 


            Cervical caps are smaller than diaphragms and shaped slightly differently. Diaphragms are shaped like a dish, and cervical caps look like hats.


            You can leave the cervical cap in longer than a diaphragm (up to 2 days), but diaphragms are slightly more effective at preventing pregnancy. Consult your doctor to help you decide which one is better for you.


            How to use it? IMAGE

            The cervical cap should be inserted before intercourse. You will need to apply a small amount of spermicide to the hole and the edge of the cap. Pinch the cap so it folds in half, bowl side up to insert. Push the cap into your vagina and down towards your rectum. Then push the cervical cap as far back as you can so that it covers your cervix.


            You can leave the cervical cap in place for up to 48 hours. There is no need to reapply spermicide every time you have sex but remember to leave the cap in place for at least eight hours after intercourse.


            To remove the cap, insert your finger into your vagina and gently push on the dome of the cap. This will release the suction that is holding the cap on your cervix. Pull the strap located on the front of the cap and remove the device.


            Wash the cervical cap in warm water and mild, antibacterial hand soap. Let it air dry or pat with a towel, and store it in its protective case.



            Can be inserted in advance without interrupting intimacy

            Can be used multiple times

            No side effects from hormones

            Small and easy to carry

            Requires less spermicide than a diaphragm

            Rarely hinders the sexual experience

            May be used for repeated intercourse within 48 hours


            What it doesn’t protect you from

            The cervical cup does not prevent STDs.


            Common side effects

            Can cause vaginal irritation

            Some women wind up getting frequent urinary tract infections

            If you’re allergic to spermicide or silicone, you shouldn’t use a cervical cap


            Effective level (used properly and not) / Failure rate

            The cervical cap is fairly effective—better with spermicide. The cervical cap is 86% effective if you have never given birth and is 71% effective if you have.


            Who can’t use it?

            Currently, have a vaginal or cervical infection 

            Have an abnormal Pap smear, and the cause is not known. 

            An abnormally shaped cervix

            A history of pelvic inflammatory disease (PID)

            Are at high risk of or have HIV/AIDS

            If you are younger than age 30 and have sex three or more times a week; 

            Have vaginal bleeding or have a vaginal or cervical infection

            Recently gave birth or had a miscarriage or an abortion

            Recently had cervical surgery


            Where to find it?

            Emergency Contraception

            • Emergency contraception is a birth control measure taken to reduce the risk of pregnancy after having unprotected sexual intercourse or when other regular contraceptive measures have not been used correctly. It is intended to be used occasionally and is not the same as medical abortion. 
            • There are different forms of EC, Emergency contraceptive pills (ECPs), the morning-after pill, and the Copper IUD.

            Copper IUD

            What is it?

            An IUD with a small, soft, T-shaped device made of plastic or metal has a string and a copper wire wrapped around it. It changes the uterus lining so that a fertilized egg is less likely to attach to it and slows the sperm movement to make it harder to get to the egg. 


            How to use it?

            For a copper IUD to work as emergency contraception, a doctor or nurse must put it in within 5 days after you have unprotected sex. The copper prevents pregnancy by interfering with the way sperm moves, making it hard for sperm to swim well enough to get to an egg.


            Effective level (used properly and not) / Failure rate

            The Copper IUD reduces your chances of getting pregnant by more than 99.9 percent if you get it put in within 5 days of unprotected sex. It’s the most effective kind of emergency contraception there is. Unlike morning-after pills, it works the same no matter how much you weigh. 


            One of the most convenient things about getting an IUD as emergency contraception is that it keeps giving you super-effective birth control for up to 12 years. You won’t have to think about emergency contraception again until you stop using the IUD.

            Emergency Contraceptive Pills (ECPs) / Morning After Pill / Post pill

            What is it?

            The emergency contraceptive pill or the ‘Morning After Pill’ is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure, or a sexual assault. Emergency contraceptive pills work by delaying ovulation (the release of an egg during the monthly cycle). If fertilization and implantation have already happened, ECPs will not interrupt the pregnancy.


            How to use it?

            Despite its name, women do not have to wait until the morning after sex to take it. It is more effective the sooner you take it. ECPs are pills that can be taken up to 120 hours (5 days) after having unprotected sex. Some types work best when taken within 72 hours (3 days) after intercourse.



            You can buy the morning-after pill in advance to always have it on hand 

            No serious side effects 

            Requires you only to take one pill


            What it doesn’t protect you from

            Emergency contraception does not protect against STDs. 


            Common side effects

            Irregular bleeding, spotting, or heavier bleeding



            Breast tenderness


            Stomach pain


            Effective level (used properly and not) / Failure rate

            The effectiveness rate varies from 87% to 90% for the 3-day pill and from 72% to 87% for the 5-day pill. 


            Who can’t use it?

            Females who are pregnant


            Where to find it?


            Sterilization is a permanent form of birth control that prevents a woman from getting pregnant or prevents a man from releasing sperm. It usually involves surgery and usually is not reversible.

            Female sterilization is a permanent procedure to prevent pregnancy and works by blocking the fallopian tubes (tubes that carry the egg from the ovary to the uterus ). When your fallopian tubes are blocked or removed after a sterilization procedure, sperm can’t get to an egg and cause pregnancy. But you still get your period after sterilization. It’s a slightly more complex and expensive procedure than male sterilization (vasectomy)


            Sterilization Details

            There are a few different types of tubal sterilization procedures: 

            1. Tubal ligation: is a surgical procedure that permanently closes, cuts, or removes pieces of the fallopian tubes.
            2. Bilateral salpingectomy: is a surgical procedure that removes the fallopian tubes entirely.
            3. Essure sterilization: is a tiny coil put in the fallopian tubes to block them.


            • Never worrying about getting pregnant
            • Do it once, and never have to think about it again
            • It’s safe for almost all women and has an extremely low failure rate
            • The procedure does not affect your hormones, menstruation, or sexual desire.

            What it doesn’t protect you from

            Sterilization does not protect you from STDs.

            • Common side effects
            • A very rare risk that your tubes may reconnect themselves, leading to a pregnancy
            • Possible complications with surgery, like bleeding, infection, or a reaction to anesthesia
            • For the Essure method, the coils may move out of place and damage the uterus during insertion.

            Effective level (used properly and not) / Failure rate

            It’s permanent and more than 99% effective at preventing pregnancy.

            Who can’t use it?

            • Having undergone prior abdominal surgery
            • Have pelvic inflammatory disease, diabetes, or lung disease
            • If you are overweight

            Breastfeeding as a Contraceptive

            In the first few months after childbirth, breastfeeding reduces the chances of pregnancy by preventing ovulation and delaying the return of menstruation. This is called Lactational Amenorrhea, meaning the lack of periods due to breastfeeding. This is because breastfeeding round the clock releases high levels of prolactin (the milk-producing hormone) in the mother’s body. This can be seen as the body’s natural method of spacing out pregnancies to ensure the health and safety of the mother.

            Breastfeeding as a Contraceptive Details

            How to use it?

            These three necessary conditions must be all met for it to be successful. If they are not met, it is time to start using other forms of contraception.


            You breastfeed around the clock. This means that your baby is fed only from your breast, and no other food, water, or liquids are given to the baby.

            Your baby must be six months of age or less.

            Your periods (including spotting) haven’t returned since childbirth.



            Prevents pregnancy right away.

            It’s free and safe.

            It doesn’t interrupt sex.

            It reduces bleeding after you deliver your baby.

            Breastfeeding may reduce your chance of getting breast cancer.

            What it doesn’t protect you from

            It does not protect you from STDs.

            Common side effects

            Breastfeeding can lower vaginal lubrication (getting wet when aroused), making sex uncomfortable. 

            And some people find that nursing makes their breasts feel less sexual.


            Effective level (used properly and not) / Failure rate

            If all the conditions are met, it is 99% effective. During the first 3 months, the chance of pregnancy is practically zero. When it is between 3 and 6 months, the chance of pregnancy is less than 2%, and about 6% after 6 months (assuming mom’s menstrual periods have not yet returned).