Before you are pregnant
What you should know about trying for a baby
Conception occurs when a man’s sperm fertilises a woman’s egg. To understand conception and pregnancy, it helps to know about the male and female sexual organs and to understand the physical process behind a woman’s monthly cycle and conception itself.
The male sexual organs
The penis is made of erectile tissue. This tissue acts like a sponge and, when it becomes filled with blood, the penis becomes hard and erect.
The testes are contained in a bag of skin that hangs outside the body, called the scrotum. It helps to keep the testes at a constant temperature, just below the temperature of the rest of the body. This is necessary for the sperm to be produced. When it’s warm, the scrotum hangs down, away from the body to help keep the testes cool. When it’s cold, the scrotum draws up close to the body for warmth.
Two tubes called the vas deferens, carry sperm from the testes (testicles) where sperm are made, to the prostate and other glands. These glands add secretions that are ejaculated along with the sperm.
The urethra is a tube that runs down the length of the penis from the bladder, through the prostate gland to an opening at the tip of the penis. Sperm travels down this tube to be ejaculated.
The female sexual organs
A woman’s reproductive system is made up of both external and internal organs. These are found in what is usually referred to as the pelvic area, or the part of the body below the tummy button.
The external organs are known as the vulva. This includes the opening of the vagina, the inner and outer lips (labia) and the clitoris.
The woman’s internal organs are made up of:
- Pelvis: this is the bony structure around the hip area, which the baby will pass through when he or she is born.
- Womb or uterus: the womb is about the size and shape of a small, upside-down pear. It is made of muscle and grows in size as the baby grows.
- Fallopian tubes: these lead from the ovaries to the womb. Eggs are released from the ovaries into the fallopian tubes each month. This is where fertilisation takes place.
- Ovaries: there are two ovaries, each about the size of an almond. They produce the eggs or ova.
- Cervix: this is the neck of the womb. It is normally almost closed, with just a small opening through which blood passes during the monthly period. During labour, the cervix dilates in order to let the baby move from the uterus into the vagina.
- Vagina: the vagina is a tube about three inches (8cm) long. It leads from the cervix down to the vulva, where it opens the legs. The vagina is very elastic so it can easily stretch around a man’s penis, or around a baby during labour.
Hormones are chemicals that circulate in the blood of both men and women. They carry messages to different parts of the body, regulating certain activities and causing certain changes to take place.
The female hormones, which include oestrogen and progesterone, control many of the events of a woman’s monthly cycle, such as the release of the egg from the ovary and the thickening of the womb lining.
During pregnancy, your hormone levels change. As soon as you have conceived, the amount of oestrogen and progesterone in your blood increases. This causes the womb lining to build up, the blood supply to your womb and breasts to increase and the muscles of your womb to relax to make room for the growing baby.
The increased hormone levels can affect how you feel. You may have mood swings, feel tearful or be easily irritated. For a while, you may feel that you can’t control your emotions, but these symptoms should ease after the first three months of your pregnancy.
The woman’s monthly cycle
Ovulation occurs each month when an egg is released from one of the ovaries. Occasionally, more than one egg is released, usually within 24 hours of the first egg. At the same time, the lining of the womb begins to thicken and the mucus in the cervix becomes thinner so that sperm can swim through it more easily.
The egg begins to travel slowly down the fallopian tube. If a man and a woman have recently had sex, the egg may be fertilised here by the man’s sperm. The lining of the womb is now thick enough for the egg to be implanted in it after it’s been fertilised.
If the egg is not fertilised, it passes out of the body during the woman’s monthly period, along with the lining of the womb, which is also shed. The egg is so small that it can’t be seen.
Conception is the process that begins with the fertilisation of an egg and ends with the implantation of this egg into the woman’s womb. A woman is most likely to conceive just after she ovulates, when an egg has been released from one of her ovaries (halfway between her monthly periods). During sex, sperm are ejaculated from a man’s penis into the woman’s vagina. One ejaculation can contain more than 300 million sperm.
Most of the sperm leak out of the vagina again, but some begin to swim up through the cervix. When a woman is ovulating, the mucus in the cervix is thinner than usual to let the sperm pass through more easily. Sperm swims into the womb and into the fallopian tube. Fertilisation takes place if a sperm joins with an egg and fertilises it in the fallopian tube.
During the week after fertilisation, the fertilised egg (which is now an embryo) moves slowly down the fallopian tube and into the womb. It’s already growing. The embryo attaches itself firmly to the specially thickened womb lining. This is called implantation. Hormones released by the embryo and the ovaries prevent the womb from shedding. This is why women miss their period when they’re pregnant.
The best time to get pregnant
You’re most likely to get pregnant if you have sex during the seven days before you ovulate. This is usually about 12 days after the first day of your last period.
An egg lives for about 12–24 hours after it’s released. For pregnancy to happen, the egg must be fertilised by a sperm within this time. Sperm can live for up to seven days inside a woman’s body. So if you’ve had sex in the seven days before ovulation, the sperm will have had time to travel up the fallopian tubes to ‘wait’ for the egg to be released.
It’s difficult to know exactly when ovulation happens, unless you’re practising fertility awareness (see External links). But in most women, ovulation usually happens 10-16 days before the start of the next period. The menstrual cycle is counted from the first day of a woman’s period (day one). Some time after her period she will ovulate, and then 10-16 days after this, she’ll have her next period. The average cycle takes 28 days, but shorter or longer cycles are normal.
What determines your baby’s sex
Both the man’s sperm and the woman’s egg play a part in determining the gender of a baby.
Every normal human cell contains 46 chromosomes, except for the male sperm and female eggs. They contain 23 chromosomes each. When a sperm fertilises an egg, the 23 chromosomes from the father pair with the 23 from the mother, making 46 in all.
Chromosomes are tiny threadlike structures which each carry about 2,000 genes. Genes determine a baby’s inherited characteristics, such as hair and eye colour, blood group, height and build.
A fertilised egg contains one sex chromosome from its mother and one from its father. The sex chromosome from the mother’s egg is always the same and is known as the X chromosome. But the sex chromosome from the father’s sperm may be an X or a Y chromosome.
If the egg is fertilised by a sperm containing an X chromosome, the baby will be a girl (XX). If the sperm contains a Y chromosome, then the baby will be a boy (XY).
What makes twins
Identical twins are the result of one fertilised egg splitting into two separate cells. Each cell grows into a baby. Because they originally came from the same cell, the babies have the same genes. They are the same sex and look very like each other.
Non-identical twins are more common. They are the result of two eggs being fertilised by two sperm at the same time. The babies may not be the same sex and will probably look no more alike than any other brothers and sisters.
Twins happen naturally in about once in every 65 pregnancies. A couple is more likely to have twins if there are twins in the woman’s family. Triplets occur naturally in one in 10,000 pregnancies, and quads are even rarer. Nowadays the use of drugs in the treatment of infertility has made multiple births more common.
You may suspect that you are carrying twins if:
- you are very sick in early pregnancy
- you seem bigger than you should be for your dates
- twins run in your family, or
- you have had fertility treatment
It is usually possible to find out through an ultrasound scan by the end of the second month of your pregnancy. You should be told at this point whether the babies are identical or non-identical. If this can’t be determined, you should be offered a further scan.
All multiple pregnancies have a higher risk of complications, particularly premature birth. If your babies are identical it is recommended that you are scanned every two to three weeks from 16 weeks onwards and every four weeks if your babies are non-identical. You may be advised to have a caesarean section and you should discuss this with your doctor, but it is your choice.
It is possible to breastfeed twins and even triplets. You may find that a combination of breast and bottle feeding is best for you, particularly if you have triplets or more.
Finding out if you’re pregnant
Whether or not you’ve had a pregnancy test, you should see a member of the maternity team, such as your GP or midwife, as soon as you think you’re pregnant. Being pregnant may affect the treatment of any current or future illness. Your pregnancy will be treated confidentially, even if you’re under 16. Your maternity team will advise you about the antenatal care choices in your local area.
If you wish to register with a midwife, or you’re not yet registered with a GP and would like to see a doctor, use the Services near you box (bottom right) to find one near you.
The signs of pregnancy
For women who have a regular monthly cycle, the earliest and most reliable sign of pregnancy is a missed period. Sometimes, women who are pregnant have a very light period, losing only a little blood. Other signs of pregnancy are:
- Feeling sick: you may feel sick, or vomit. This is commonly known as morning sickness, but it can happen at any time of the day. If you’re being sick all the time and can’t keep anything down, contact your GP.
- Changes in your breasts: your breasts may become larger and feel tender, just as they might do before your period. They may also tingle. The veins may be more visible, and the nipples may darken and stand out.
- More frequent urination. You may also have to get up in the night to pee.
- An increased vaginal discharge without any soreness or irritation.
- A strange taste in your mouth, which many women describe as metallic.
- Craving new foods, or losing interest in certain products that you previously enjoyed, such as tea, coffee, tobacco smoke or fatty food.
Pregnancy tests can be carried out on a sample of urine from the first day of a missed period. If you’re pregnant, this is about two weeks after conception. You can collect urine at any time of the day. Collect it in a clean, soap-free, well-rinsed container.
You can get pregnancy tests free of charge from your GP or community contraception clinic. Pregnancy tests are also available at NHS walk-in centres. Many pharmacists and most pregnancy advisory services also offer tests, usually for a small fee. You can also buy do-it-yourself pregnancy testing kits from pharmacists. They can give a quick result, and you can do the test in private. A range of tests is available. The way they work varies, so check the instructions first to make sure that you get the right result.
A positive test result is almost certainly correct. A negative result is less reliable. If you still think you’re pregnant, wait a week and see a midwife or GP again.
Knowing that you’re pregnant
When you find out you’re pregnant, you may feel happy and excited, or shocked, confused and upset. Everybody is different, and don’t worry if you’re not feeling as happy as you expected. Even if you’ve been trying to get pregnant, your feelings may take you by surprise. Some of this may be caused by changes in your hormone levels, which can make you feel more emotional.
Even if you feel anxious and uncertain now, your feelings may change and you may start to enjoy your pregnancy and look forward to having a baby. Talk to your midwife or GP. They will help you to adjust, or give you advice if you don’t want to continue with your pregnancy.
Men may also have mixed feelings when they find out that their partner is pregnant. They may find it hard to talk about these feelings because they don’t want to upset her. Both partners should encourage each other to talk about their feelings and any worries or concerns that they have.
However, your feeling, contact an NHS professional (for example, a midwife, GP or practice nurse) so that you can start getting antenatal care. This is the care that you’ll receive leading up to the birth of your baby.
You may want to tell your family and friends immediately or wait a while until you’ve sorted out how you feel. Many women wait until they’ve had their first scan before they tell people that they’re pregnant.
Members of your family or extended family may have mixed feelings or react in unexpected ways to your news. Try to talk about this with them or with your midwife.
Help and advice for teenagers
If you are a teenager, there is a wide range of services to support you when you are pregnant and after you’ve had your baby. If you’re pregnant on your own, it’s even more important that there are people with whom you can share your feelings and who can offer you support.
Sorting out problems, whether personal or medical, is often difficult when you are by yourself, and it’s better to find someone to talk to than let things get you down. For more information, see Coping if you’re alone. Your midwife or health visitor will be able to give you details of local services. The following national organisations can also give you help and advice.
- Sexwise. If you think you may be pregnant, you can get confidential advice from the Sexwise helpline on 0800 282930 begin_of_the_skype_highlighting 0800 282930 end_of_the_skype_highlighting or get further information from the unthinking website (see External links).
- Brook. If you are under 25, you can visit a Brook centre for free, confidential advice. To find your nearest centre, go to the Brook website or call the national Ask Brook Helpline on 0800 0185 023 begin_of_the_skype_highlighting 0800 0185 023 end_of_the_skype_highlighting.
- Connexions. Teenagers in England can get help and advice from the Connexions service. You have the offer of support from a personal adviser to help deal with the variety of issues so that you can make the best choices for your future. You can find Connexions advisers in a variety of places, including schools, colleges, one-stop shops and through youth and community projects.For confidential personal advice, practical help or details of your local Connexions service phone Connexions Direct, on 080 800 13219 begin_of_the_skype_highlighting 080 800 13219 end_of_the_skype_highlighting, text 07766 413 219 begin_of_the_skype_highlighting 07766 413 219 end_of_the_skype_highlighting or go to the Connexions website.
The Young Woman’s Guide to Pregnancy
The Young Woman’s Guide to Pregnancy is written specifically for women under the age of 20 and includes the real pregnancy experiences of young mums. It is produced by Tommy’s and is available free to teenagers through Tommy’s website.
Carrying on with your education
Becoming a mother doesn’t have to mean the end of your education. If you are still of compulsory school age (i.e. any time before the last Friday in June of the year of your 16th birthday) your school should not exclude you on grounds of pregnancy or health and safety issues connected with your pregnancy, although they may arrange alternative provision. If this is the case, they will talk with you about it. You will be allowed up to 18 calendar weeks off school before and after the birth.
After your return to education, you can receive help with childcare costs through the Care to Learn scheme. Care to Learn also provides support with childcare costs for teenager parents above compulsory school age wanting to take up learning. You may also be eligible for the Education Maintenance Allowance (EMA), available for those above compulsory school age, which provides up to £30 a week. For more information about EMA and Care to Learn phone 0800 121 8989 begin_of_the_skype_highlighting 0800 121 8989 end_of_the_skype_highlighting or visit the Directgov website (see External links).
Somewhere to live
Many young mothers want to carry on living with their own family until they are ready to move on. If you are unable to live with your family, your local authority may be able to help you with housing. Some local authorities provide specialised accommodation where young mothers can live independently while getting support and advice from trained workers.