PREGNANCY

How does it all work? How does it all work?

bladder
reproductive
organs
seminal vesicle
prostate gland
sperm duct

epididymis
testicle

urethra
uterus (womb)
bladder seminal
fallopian tube fallopian tube
vesicle

prostate
gland urethra
ovary ovary sperm
genitals
cervix womb lining duct testicle
(endometrium)
vagina epididymis
genitals clitoris genitals
urethra A man has two testicles (balls).
Sperm are made continuously in great
outer numbers inside each testicle and stored
A woman has two ovaries, lips in the epididymis (a small tube at either
one on each side of her uterus
side of each testicle) until they are fully
(womb). These contain her eggs inner scrotum
mature and ready to be ejaculated.
(ova). She is born with all her lips
penis Sperm are damaged by heat, so the balls
eggs in place.
vagina are carried outside the body in a soft bag
of skin (the scrotum) to keep cool.
anus

2 3
 What is a menstrual cycle? What is conception?
The menstrual cycle is from the FIRST DAY OF A PERIOD until the DAY BEFORE THE Conception is a process that begins with
NEXT PERIOD STARTS. The average length of the cycle is around 28 days, but it can be the fertilisation of an egg by sperm and
as short as 21 or as long as 40. This is normal. Whatever the length, ovulation will ends with implantation. When a man and
happen about 10–16 days before the start of the next period. a woman have sex the man’s penis fits
ight make you want to smoke.
into the woman’s vagina. After ejaculation
back so they feel better.
Each month, the brain sends a chemical message to (coming), sperm are released through the
the ovaries. This causes around 20 eggs to grow in penis into .the
ekomsvagina.
ot tnaw uoy eThey
kam thgswim
im taht snthrough
oitautis dna elpoep di
ian tube

.retteb leef yeht os kcab uoy tpmet ot yrt yam sdneirF

one or other ovary. At the same time the hormone the woman's cervix, into the womb, and
lop

estrogen begins to thicken the lining of the womb. then into the fallopian tubes. If an egg
fal

Usually one egg becomes larger than the others
ovary and is released into the fallopian tube by the ovary.
This is called OVULATION.
Ovulation triggers a second
hormone, progesterone,
to continue to thicken the
endometrium (the lining of
the womb) in preparation for a
fertilised egg.
The egg lives in the fallopian tube for
up to 24 hours. If it is not fertilised
and does not implant to start a
pregnancy, levels of hormones fall,
the womb lining breaks up and a
period happens.
about sperm?
What
At puberty, boys start to make sperm in their testes (balls).
Sperm are made continuously, so you cannot run out of sperm.
It takes about 80 days for a sperm to be produced.
4 5
has been released into the fallopian tube,
hundreds of sperm swim up to reach it.
1. One sperm may attach 2. The egg has now been 3. During the short journey
itself to the egg wall and fertilised and moves down the fertilised egg develops by
slowly penetrate the wall. the fallopian tube towards dividing into two cells, then into
It takes about three hours the womb. four, eight, 16 and so on.
for the sperm to
enter the egg.
4. About
Once the sperm is 3–4 days after
inside, the egg wall
fertilisation,
hardens to make it the egg is now
impossible for other 64 separate
sperm to get in. cells.
5. About 5–10 days after ovulation, the fertilised egg
begins to attach itself to the thick, nutritious womb lining.
Implantation of the fertilised egg has taken place. It is
now called an embryo and the pregnancy has begun…
When the man ejaculates (comes),
Glands in the woman’s vagina and
the sperm travel from the testes
the man’s penis produce secretions
through the sperm ducts to the
which make it easier for the penis
penis. As they travel, fluids are
added to them to produce a mixture
to enter the vagina. A woman
can get pregnant even if the man
called semen. He ejaculates about a
withdraws before ejaculating. This
teaspoonful of semen containing up
is because the fluid which leaks out
to 300 million sperm. Just one drop,
of the penis before he comes (pre-
pinhead-size, contains around 1,500
cum) may contain sperm.
sperm!
 When do you become fertile?

You can get pregnant when you
have sex around the time that you
ovulate. Your fertile time lasts for
8–9 days. But it’s not always easy to
work out when this is – especially if
t might make you want to smoke.
ou back so they feel better.
You ovulate 10­–16 days before the
start of your next period. Although
the released egg will only live for up
to 24 hours, sperm can live for up
to seven days. If sperm are already
Learning to recognise the fertile
and infertile times of the menstrual
cycle can help to plan or prevent a
pregnancy. This needs to be taught
by a trained fertility awareness
Different signs or indications are
observed and recorded every day of
the month. These are:
• changes in body temperature

teacher. • changes in cervical secretions

your periods aren’t regular. present before ovulation, they may
meet the egg when it is released. • menstrual cycle dates.

Fertility in women begins to decline when they are in their 30s, Men can be fertile for longer than women.
until after the menopause, when periods eventually stop. Some men in their 70s have fathered babies.

Smoking, drinking, drugs, poor diet and sexually transmitted infections can
How do you prepare for pregnancy? reduce fertility in men and women, and may damage the health of the mother
during pregnancy, or her baby when it’s born.

Stop smoking It may be the most important thing you can do for the health of eat A well balanced diet FOLIC ACID can reduce
your baby. Men and women wanting to start risks to the spine of the baby.
MEN who smoke have weaker erections and less a pregnancy should eat: Women need to take folic acid
healthy sperm. supplements three months
• lots of fruit and vegetables
‘I used to smoke 20 WOMEN who smoke, or whose partners smoke, or before trying for a baby and
Avoid people and situations that might make you want to smoke.
who are exposed to smoke at work, are less likely • plenty of starchy
Friends mayatryday and you
to tempt I feel
backSO
so they feel better. during the first 12 weeks
pleased with myself to conceive. If they become pregnant, they may carbohydrates such as bread,
of pregnancy. Good natural
giving up for the have greater complications during labour and are cereal and pasta
sources of folic acid are:
baby.’ more likely to have a premature birth or stillbirth. • protein such as beans, pulses,
• green leafy vegetables
meat, fish, cheese and eggs.
• breakfast cereals
DRINK SENSIBLY Drinking Drinking too much during pregnancy can damage • some bread.
alcohol may increase the the fetus. The safest approach is not to drink at all.
frequency of sex – a lot If you do drink you should avoid getting drunk, and GET VACCINATED Babies can have severe problems if their mother contracts rubella
of pregnancies happen try to limit alcohol to the occasional drink and not (German measles) in early pregnancy so it's important that women who haven't had it
because people get carried more than one or two units once or twice a week. are vaccinated against it before trying to conceive. This vaccination is now routinely
away – but heavy offered to young babies.
(A unit is a single pub measure of
drinking can reduce spirits, a small 125ml glass of wine, GET TREATed Sexually transmitted infections (STIs) can affect fertility in men and
fertility and even or a half a pint of regular beer, lager or women, and an untreated infection can be passed on to the fetus. Some infections
make men impotent. cider.) A lot of women give up alcohol can’t be cured but treatment can be given to try and prevent the baby getting it. If
altogether during pregnancy. you think you may have an infection, go to a genitourinary medicine (GUM) clinic,
sexual health clinic or your general practice.
6 7
 What are the signs of pregnancy? What’s it like to become pregnant?
If you think you are pregnant, or have
missed a period, you can get a free Becoming pregnant can be a time of For many women the decision to
PREGNANCY TEST at: great happiness and joy. For some, continue with the pregnancy is an
it’s a long-awaited event – the result easy one. For others it is harder.
• a young person’s clinic or Brook of trying for many months (even Some women may decide they want to
might make you want to smoke. clinic (see page 16) years). For others, after the initial have an abortion; others may decide
ou back so they feel better.
swelling or
feeling tired tenderness in the breasts
• some general practices (ask the GP shock, it’s a happy accident. It can to have
.ekothe
ms ot baby
tnaw uoyadopted.
ekam thgim taht snoitautis dna elpoep
or practice nurse) be joyful and welcome, or difficult .retteb leef yeht os kcab uoy tpmet ot yrt yam sdneirF
If you need help in deciding what
• many contraception clinics and scary, or a complete disaster. Or to do, act quickly. You can get
• some sexual health or genitourinary all these things. help from your general practice, a
medicine (GUM) clinics. But some people (even if the young person’s clinic, fpa or other
You can buy a home pregnancy test pregnancy is planned) will feel it’s organisations listed on page 16.
kit from pharmacies. These are very not what they want.
a shorter, lighter reliable.
missing a period period than usual
What about I had mixed feelings I wanted to tell
Fertility Tests? after I found out I was
pregnant. I started
everyone the
minute we
thinking, ‘Oh, no, what found out.
Some women woman's ovulation have we done?’
become pregnant patterns, and the
nausea or vomiting the first time they health of her fallopian
appetite changes (often called morning I could have got used
have sex. Others tubes, cervix and to the idea of being a
(going off sickness, though it’s not have to wait a long womb. dad – but she didn’t
some foods) always in the morning) time. Four out of five Whenever we walked
out together I'd stick give me a chance to
women who have Treatment my tummy out – I just talk it over.
regular.resex without
tteb le
includes:
.ekoms ot tnaw uoy ekam thgim taht snoitautis dna elpoep diovA
ef yeht os kcab uoy tpmet ot yrt yam sdneirF
wanted everybody to
know.
using contraception • hormone
will conceive within injections to
a year, so many encourage My mother was Everything we'd
ovulation thrilled but she told me planned for was
doctors recommend later that it was funny turned upside down –
feeling bloated or frequent urination trying for at least • other methods knowing that there would I was walking around
period-like cramps (peeing a lot) a year before such as artificial now be two generations shell-shocked.
insemination younger than her.
referring a couple
for fertility tests and bringing the
and treatment. egg and sperm
Tests investigate together outside
the number, shape the womb –
sometimes known THE LAW It’s up to the woman whether to tell a man she is pregnant.
and movement of the
digestion changes mood changes man's sperm, the as assisted In law, he has no right to be informed, or to be involved in her pregnancy.
conception or IVF.
8 9
 What happens in pregnancy? The baby’s sex
People normally have 3RD trimester placenta
Pregnancy starts when the fertilised egg successfully two sex chromosomes womb
For the rest of the pregnancy the fetus
implants into the lining of the womb. A normal in every body cell. But amniotic
each sex cell (egg or is growing and putting on weight and the
pregnancy lasts from 37–42 weeks (nine months) fluid
sperm) only contains one organs (particularly the lungs) are still
and is measured from the first day of the last period. of them. developing. Most settle into a head-down
Pregnancy is talked about in trimesters (three-month
hat might make you want to smoke.
t you back so they feel better.
(cephalic) position by around 36 weeks. Any
periods), because each trimester is very different. time after 37 weeks the baby is ready to be
After eight weeks, the embryo is called a fetus. born. The average weight at 40 weeks (term) umbilical
is 3–4kg and the length from the top of its cord
1st trimester head to its bottom is 35–37cm. cervix bladder
SIX weeks 12 weeks A male has an X and ad a A few of the cells from the it needs for the rest of the Before pregnancy,
All the major The fetus has (smaller) Y chromosome. fertilised egg develop into the pregnancy. It can filter the womb weighed
organs (heart, arms and legs, placenta (afterbirth). This out bacteria, but smaller 50g and was about
lungs, liver, etc) fingers and toes, forms a roughly circular area molecules (such as viruses, or the size and shape
of a small pear.
are forming; the a face and all 32 attached to the inside lining most drugs which the mother
spinal cord is there permanent tooth buds. of the womb. The umbilical takes) will reach the fetus, But at 40 weeks
and the heart is The heart is working, cord connects the placenta to for example rubella, alcohol, it’s about 30cm
long, weighs 1kg,
beginning to beat. pumping blood to all the fetus (it’s attached to what nicotine, colds. and, if it were
The embryo is just parts of the body. A female has X and X. becomes the tummy button). At birth the placenta weighs filled with fluid,
over 1cm long and The fetus is about By 12 weeks it supplies the about one-sixth of the baby’s would hold up to
weighs less 76mm long and fetus with all the nutrients weight. six litres!
than 1g. weighs 15g.
MISCARRIAGE – when a An Ectopic LATER MISCARRIAGE
pregnancy is lost – can pregnancy is AND STILLBIRTH
2nd trimester occur for a number of when a fertilised Miscarriage occurs less often
When an egg is reasons due to problems egg implants in later pregnancy. If the fetus
By 20 weeks the bones are starting to
fertilised by a sperm with the pregnancy. itself outside the dies after 24 weeks, when
harden and the pregnant woman may
with an X chromosome, It happens in around womb, usually normally it would be possible
feel the occasional kick or hiccup. The it will be a girl. 10–15 per cent of in the fallopian for a fetus to survive (with
eyes are still closed but the fetus can
pregnancies. Most of tube. This causes medical help), the death is
hear sounds – the mother’s voice, her
them occur during the severe bleeding called a stillbirth.
heartbeat, and her digestive system rumbling.
first 12 weeks. An early and pain. An If a fetus dies in the womb
By 24 weeks the eyes are open. Its heart is beating miscarriage can be like emergency after 20 weeks but does not
at twice the adult rate (120–160 beats per minute). a very heavy period with operation may be miscarry, the mother will
In order to develop its digestive system the fetus is bleeding and cramps. needed.
If it’s fertilised by a have to deliver it. She will
swallowing and peeing in the fluid that surrounds it A GP will advise if any
sperm with a be offered lots of help and
(amniotic fluid). With help, a baby born now may survive, treatment is needed.
Y chromosome, support from medical staff.
though often with major problems. it will be a boy.
10 11
 How does pregnancy feel? How to get ready for the birth

Women experience pregnancy differently, In a straightforward pregnancy a

The aim of antenatal (before
not just physically but also emotionally. I felt very alone when I first found out I woman may be looked after by a
was pregnant. My mum and dad wouldn’t birth) care is to look after a woman
midwife – a healthcare professional
Pregnancy alters a woman’s body talk about it and John didn’t want to and her developing baby. A variety of
trained to work with a pregnant
completely. Her skin, breasts, hair, teeth,
at might make you want to smoke. know. My midwife introduced me to antenatal tests may be carried out
you back so they feel better.
two other young single mums and now woman and her family throughout the
digestion and hormone levels all change. depending partly on the woman's
I feel less anxious, with someone who pregnancy, birth and early days with
Her body retains more water and she has understands. age and
.ekomsprevious
ot tnaw uoy ekbirth history.
a new baby. am thgim taht snoitautis dna elpoep di
over a litre more blood. In fact all the major .retteb leef yeht os kcab uoy tpmet ot yrt yam sdneirF
For example, ultrasound scans and
organs undergo changes at this time in order The midwife checks the health and
I felt really confident amniocentesis (sampling and testing
to support both the woman and her baby. and sexy when I was progress of the woman and fetus
the amniotic fluid) may be used to
pregnant! My partner through the pregnancy. The midwife
As well as physical changes women can feel check all is well.
liked that too! can advise about:
strong emotional changes – most find they Information A woman can talk to
• involving both partners in the
laugh and cry more easily than before. In the first three months her midwife and other people, and
I felt tired, nauseous pregnancy
get information from books, leaflets,
and weepy. • local classes to help parents prepare
magazines, the internet, videos and
for the birth and afterwards
I’m right off
antenatal classes.
• local services
coffee, and I For example, in antenatal classes
can’t stand the • meeting other pregnant
she’ll practise breathing,
smell of fried women and their partners
food. relaxation and good
• where to give birth – positions for labour
in hospital or at home. and birth. Partners are
Can a woman have sex usually welcome too.
while she’s pregnant?
EXERCISE Giving birth is Support Many women
Pregnancy can be a tremendous time of change for Yes. With a a very physical activity. choose to have a birth
men too. Concern for his partner, for the baby and healthy pregnancy, You need to keep partner to support them
for himself, and hopes and fears for the birth and his she can have sex fit and active through the pregnancy
future as a parent, all play an important part. right up to the time during pregnancy. and birth. This may be
labour begins. Walking, swimming her normal partner or it
I was scared Will sex harm or continuing with a regular sport may be someone else she trusts
right through the baby? are good preparation for birth. (such as her mum, or a friend).
the pregnancy.
Men need support too. They may talk
No. The fetus is with other men whose partners are
We both felt really protected by the thick
mucus plug that
Classes were really useful; you didn't pregnant or who have had babies,
close. I’ll never forget have to say anything if you didn't
the first time I felt the seals the cervix, by or go to antenatal classes, or see
want to. For me the best bit was
baby move. the amniotic sac, and when us men all went to the pub with their GP, practice nurse, other health
by the strong womb an ‘experienced dad’ to find out what professional or support group.
muscles. we were in for.
12 13
 what is Birth like? What happens What about
after the birth? Being a parent?
Women’s bodies are designed to cope with pregnancy, Some babies are Women and men may experience
give birth and feed a new baby. In reality, all women Having a baby isn’t just about a
born by Caesarean a wide variety of emotions when woman physically giving birth – it’s
experience birth differently. sECTION –  major the baby is born, from joy and awe probably the biggest responsibility
What is labour?
hat might make you want to smoke. surgery involving through to simple relief or even a a man or woman can have.
you back so they feel better.
When she was cutting through the feeling of anti-climax.
Labour can be affected by having contractions abdomen and womb .ekoms ot tnaw uoy ekam thgim taht snoitautis dna elpoep diovA .ekoms ot tnaw uoy ekam thgim taht snoitautis dna elpoep

how long it lasts, how tired she needed to grip Cuddling the baby as soon as
.retteb leef yeht os kcab uoy tpmet ot yrt yam sdneirF .retteb leef yeht os kcab uoy tpmet ot yrt yam sdneirF
I thought giving birth I try and
to get the baby out. help out with
and hungry the woman feels, my hand hard. possible helps a woman bond was the hard part
with her baby, and makes practical things
and what support she has. It over with, but being a
During the caesarean he breast feeding easier. It also mother you’re on call like shopping or
usually lasts for 12–24 hours; making a meal.
sometimes less, sometimes more. was just stroking my head, encourages the release of 24 hours a day.
I was able to support which made me feel better. hormones that help to
What are contractions? and hold her while expel the placenta GETTING SUPPORT
Contractions are the clenching she was pushing the Doctors will advise (afterbirth) from Adjusting to being a parent can
and relaxing of the womb baby out. her body. You may be hard for anybody, but it can
on what is needed if
muscles to push the baby down there is an unusual also be given an injection to help to be particularly
out of the womb. It also involves pregnancy, for example expel the placenta. difficult for
stretching the opening of the involving more than one young people.
cervix so the baby can pass I couldn’t sleep
I wanted to baby, or a baby who the first night after the The birth was Parents will
through the vagina to the give birth without pain comes bottom- or feet- birth. I just kept looking wonderful – I not be able
outside world. relief, but it just got too first (breech position) at him – I couldn’t believe wouldn’t have missed to go out so
much! It helped lots and what had happened. it for the world.
IS BIRTH PAINFUL? or lies in an unusual often, and it
I was able to see my can be hard
MOST women find birth baby born.
position in the womb.
Various procedures may POSTNATAL DEPRESSION to maintain
painful. This is normal when
be needed to help get the friendships.
muscles are working so hard! Around one in 10 women gets depressed
baby out. Talking and
Watching TV, listening to music, within weeks (or sometimes months) of
their baby’s birth. Postnatal depression meeting other
using a shower, bath or
forceps (which are like can result in anxiety, sleeplessness and parents can make a woman or
bathing pool, and breathing I listened to my
favourite songs over metal salad servers) can extreme tiredness, leaving a woman her partner feel less alone.
and relaxation techniques,
all help. A birth partner’s and over again – that be placed round the feeling very stressed and unable to cope.
helped me relax during sides of the baby’s head, It is important that she seeks help from After a while, parents may
support can be really useful. want to arrange childcare or
contractions. or a ventouse (which her health visitor, practice nurse or GP.
what about pain relief? babysitting so they can get out
looks a bit like a sink
Women may choose to use pain for a break, go to work, or go
plunger) is placed on top We’d no idea it would change our lives
relief drugs, such as a numbing injection (epidural back into education. They can get
of the baby’s head to help so much. I feel old compared to all
anaesthesia), or therapies such as hypnosis. Some advice from organisations listed
the baby out by suction. my friends who are going out every
women choose to use nothing. weekend without a care in the world. on page 16.
14 15
 Where can I get information?
For information on sexual health, sex These organisations can
and relationships visit www.fpa.org.uk also give you confidential
or check out these FPA booklets. information and advice.
bpas
at might make you want to smoke.
www.bpas.org
you back so they feel better. 08457 304030
For information and advice on
unplanned pregnancy.
Brook
www.brook.org.uk
For sexual health services and
advice for young people.
FAMILY LIVES
www.familylives.org.uk
0808 800 2222
For advice on pregnancy and
birth.
Gingerbread
www.gingerbread.org.uk
0808 802 0925
Support and advice for single
parents.
Marie Stopes
www.mariestopes.org.uk
0845 300 8090
PREGNANCY © FPA July 2014
ISBN 978-1-908249-83-8 For information and advice on
FPA, 50 Featherstone Street, London EC1Y 8QU sexual health.
Tel 020 7608 5240
The Family Planning Association is a registered charity, Quitline
number 250187. Limited liability company registered in
England, number 887632. www.quit.org.uk
Design and illusgtration: CORINNE PEARLMAN
For advice on stopping smoking.
(Comic Company) and WOODROW PHOENIX
Printed by McCorquodale START4LIFE
The information in this booklet was accurate at the time of www.nhs.uk/start4life
going to print. Booklets are reviewed regularly. Next edition For tips and advice
available in 2017. If you would like information on the on pregnancy.
evidence used to produce this booklet or would like to give
us feedback email feedback@fpa.org.uk
Tommy's
www.tommys.org
0800 0147 800
Freephone PregnancyLine
for information on pregnancy.

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