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As we previously noted, pregnancy occurs when one of the many millions of sperm cells which are contained in a normal male's ejaculate reaches the female's fallopian tubes and penetrates the egg. The fertilized egg then begins to divide and grow until the foetus that it produces is sufficiently developed to come to birth.

          Sign of pregnancy. There are several signs of pregnancy, none of which is entirely infallible but some of which are quite reliable:

          1. Usually, a woman stops menstruating when she becomes pregnant. Occasionally, however, women keep menstruating during their pregnancies. And quite often women stop menstruating temporarily for a variety of reasons other than pregnancy such as illness, anxiety, hormonal imbalance, or living under conditions of stress. Many women who stop menstruating for these reasons are not pregnant; and some, in fact, are sterile.

          2. Often, women become nauseous, ill, and irritable during the first few months of pregnancy and develop so called "morning sickness." Many women, however, feel wonderfully healthy all during pregnancy; while other women develop "morning sickness" for psychological reasons even when they are not pregnant.

          3. As pregnancy develops, a woman's abdomen, which is distended by the growing foetus, normally begins to swell. On the other hand, some women (especially tall ones) swell very little during the first five or six months of pregnancy; while many non-pregnant women swell considerably, because of increased weight, abdominal tumors, or other conditions. It is even possible for a woman to have pseudocyesis, or false pregnancy, in the course of which she swells enormously and seems certainly to be carrying a child but actually is not pregnant.

          4. Several tests, such as the Ascheim-Zondek and Friedman tests, are usually diagnostic of pregnancy. In these tests, urine from a woman is injected into a mouse, rabbit, rat, or frog: and the animal is observed to see if significant changes, caused by hormone substances excreted in the urine of pregnant females, take place. Blood serum may be similarly employed. Urine and blood tests can show diagnostic results in a few hours or a few days, depending on which type of test is employed. The tests give accurate results about two weeks after conception has occurred or ten days after a missed period.

          Urine specimens should be taken before breakfast and consist of at least four ounces of urine. The specimen should be delivered to the laboratory or physician's office in a well washed bottle or other container, be kept cool, and have about three drops of Tricresol, lysol, or creolin added as a preservative if it is to be sent some distance or tested some length of time after being taken.

          Pregnancy tests today are quite reliable, as they show pregnancy in about 98 per cent of the cases if they are positive. If they are negative, however, there is still a sight possibility that the woman may be pregnant.

          1. Examination by a gynecologist can often reveal whether a woman is pregnant three weeks or more after conception has occurred. This kind of examination, however, is also not infallible; as various conditions (such as obesity, retroverted uterus. or a tumor of the uterus or ovary) may make diagnosis difficult. A combination of, a gynecological examination and a properly evaluated test is the most reliable means of early diagnosis.

          2. About four to five months after she has conceived, a woman may feel the foetus moving around inside her. A physician can then use a stethoscope to listen to the heart beats of her unborn child; and at this time an absolutely certain diagnosis of pregnancy is warranted. Prior to this time, diagnosis may be reasonably certain but not absolutely sure. (Guttmacher, 1955).

          Because of the possibility of misdiagnosis, it is moat important that any woman who thinks that she is pregnant undergo a thorough medical examination, often including pregnancy tests, before she assumes that she actually is, Particularly in cases where, for one reason or another, it is necessary to bring the pregnancy to a halt (as in cases where the woman is not able to bear a child because of some severe physical anomalies or emotional disturbance). it is absolutely necessary that a correct diagnosis be made.

          For lack of such a diagnosis, hundreds and perhaps thousands of unnecessary "abortions" occur each year because it was assumed that a woman was pregnant when actually she was not.

          Interruption of pregnancy. Normally, a pregnancy will continue for about nine months, when a full term child is born. Sometimes, however, a woman is not, able to carry her child to full term and the foetus is prematurely ejected from the womb, resulting in what is called a miscarriage. Women who have tendencies toward this kind of spontaneous miscarriage should be under strict medical attention. If, on their physician's advice, they avoid strenuous activity and take prescribed hormones or other medication during the first months of pregnancy they usually can be helped to carry their children to normal labor (Javert, 1959; Masters, Maze and Gilpatrick. 1957).

          From time to time, women will carry their embryos, tend but then have a premature delivery, six, seven, or eight months after conceptions. Such premature births were previously quite hazardous to the child. Today, however, with modern incubation methods, it is usually possible to keep a premature infant alive with little or no ill effects.

          When a pregnancy is artificially interrupted, an abortion results. Most civilized nations of the world, for various reasons, have strictly forbidden such artificial interruption of pregnancy except under unusual conditions as where the life of the mother would be endangered if pregnancy were not interrupted.

         At times, the Soviet Union has been liberal about legalizing abortions and at other times strict. The Scandinavian countries tend to be most consistently liberal in this respect but even they do not cavalierly accept abortions (Tietze. 1959b). At present, legal abortions are quite inexpensive and easy to obtain in Japan and over a million officially reported abortions may be done in a single year.

          In spite of the legal restrictions that are usually placed on abortion, several million abortions appear to occur throughout the world every year because women, often for economic reasons or because they are not married to the fathers of their unborn children, prefer not to complete their pregnancies (Devereux. 1955: Van Emde Boas. 1952) .

          In the United States, one highly qualified and professionally minded physician. G. Loutrell Timanus told a conference on abortion that he had. in a period of thirty years' practice, performed 5.210 abortions himself. He also estimated that another physician whom he personally knew performed about 40.000 abortions over a period of fifty years of practice (I. Rubin. 1959a.) For the United States as a whole, it is impossible to estimate the exact number of abortions that take place but the figures range from 200.000 to 1.200.000 a year, with many authorities inclined to accept the larger figure (Calderone. 1958: H. Rosen. 1954; Rongy. 1933).

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