Dr. Anjali Arora - 5 Steps to a Healthy Safe and Pregnancy

Teen marriages or pregnancies are common in the Western world like their counterparts of child marriage in the East. Child marriage is defined as any marriage carried out below 18 years of age. The girl at this stage, is not ready physically, physiologically or psychologically to fulfill the responsibilities of marriage and childbearing. Child marriage is related to multiple health risks. Also pregnancy related deaths are high in girls between 15-19 years of age.

Divorce rate among couples under twenty years is known to be high (between 80-85%). Social scientists have found that people who marry young are seldom prepared for marital roles.

On the other hand, there is a gradual decrease in fertility among women after the age of 30. As the age progresses a woman may take longer to conceive, or she may have to face the problems of sub-fertility or infertility.

Women starting a family in their late 20s or early 30s might lead a healthier lifestyle. They are often more educated and better off financially. They may understand the needs of their bodies and look after themselves better in terms of exercise and nutrition. Mature women have more positive perceptions of their bodies, and more readily tolerate the symptoms of pregnancy. At this age women are often independent, confident and know what they want.

It is also a well known fact that older women (>35 years) have a higher chance of having a baby with a genetic abnormality, such as Downs syndrome. There is a marked pattern of increased intervention with the increasing age of the mother. Virtually all studies agree that the rate of caesareans also rise with maternal age.

Once you are prepared for pregnancy and you have decided to go for it, get a general checkup done, to detect if you are suffering from any of the following :

Anaemia

Thyroid disease

Diabetes mellitus

High blood pressure

Thalassaemia

or any other disease which may affect your pregnancy. Also check if you have been vaccinated with Rubella vaccine.

Every woman must have an idea of the anatomy of her reproductive system. She also must note the date of her menstrual cycle in a diary or calender. Before marriage the young lady must be aware of her ovulation time, i.e. the most fertile period. Calculation of pregnancy is from the first day of the last menstrual period.

Every month, in the womans ovaries, a group of immature eggs start to develop in small fluid-filled cysts called follicles. Normally, one of the follicles is selected to complete development (maturation). This is called the dominant follicle. The dominant follicle ruptures and releases the egg from the ovary (ovulation). Ovulation generally occurs about two weeks or (14 days) before a womans next menstrual period begins (i.e. mid-cycle).

After ovulation, the ruptured follicle develops into a structure called the corpus luteum, which secretes two hormones progesterone and estrogen. Progesterone helps prepare the endometrium (lining of the uterus) for the embryo to be implanted.

The egg travels into the fallopian tube where it remains until a single sperm penetrates it during fertilization. The egg can be fertilized for about 24 hours after ovulation.

If no sperm fertilises the egg, the corpus luteum degenerates, reducing or decreasing (ovum) the levels of hormones. This causes the endometrium to slough off, leading to menstruation. This is often known as weeping of the uterus as no fertilization took place.

When the sperm penetrates the egg (ovum), changes occur in the protein coating around the egg (ovum) to prevent other sperms from entering. On fertilization, the babys genetic make-up is complete, including its sex. The mother can provide only XX chromosomes. The father provides the XY chromosomes. If a Y sperm (from the father) fertilizes the egg, the baby will be a boy (XY) and if an X sperm from the father fertilizes the egg, the baby will be a girl (XX).