How pregnancy happens

The most common way for a pregnancy to occur is by unprotected sexual intercourse (penis in vagina) between a woman and a man; however this is not the only way a woman can become pregnant.

There is a small risk for a woman to become pregnant during sexual activities that don’t involve penetration of the penis. If ejaculate fluid (cum or pre-cum) gets into the vagina during any sexual activity, sperm can make their way into the uterus, and a pregnancy may occur.

Some women require assistance to become pregnant and this can be for reasons including couples experiencing male/female infertility; women who have a female partner; and single women. There are different methods of assisted reproductive technology available that may help these women to achieve pregnancy.

If you have unprotected sex, or if the condom broke during sex, or if you’re worried that your other form of contraception may fail (e.g. you forgot to take your pill on time), there is a pill called the Emergency Contraceptive Pill (ECP) that girls can take to prevent an unplanned pregnancy. The ECP works by stopping or delaying the release of an egg from the ovaries. It prevents around 85% of unplanned pregnancies that would have occurred without the ECP.

The ECP is effective up to five days after unprotected sex, but the sooner you take it the more effective it is. It is best to take it within 24 hours of unprotected sex. You do not need to see a doctor to get the ECP; it is available at the pharmacy without a prescription. The pharmacist will need to ask you a few questions and will explain to you how to take the ECP and any side effects you may experience. The ECP can cost $20 to $30, or sometimes more.

Your next period may be late or early and it is a good idea to have a follow up pregnancy test in a few weeks to make sure you are not pregnant. It is also a good idea to get a sexual health check if you haven’t had one, or if you have a new partner. It’s best to discuss this with your GP, pharmacist, or you can call Family Planning NSW Talkline 1800 658 886.

Find more information about the ECP here.

Signs of pregnancy can include:

• Missing a period
• Feeling sick (nausea) or vomiting
• Having sore or larger breasts
• Feeling dizzy or tired
• Passing urine more frequently than usual

The signs of pregnancy are a result of hormonal changes that are taking place in the woman’s body. Some women will experience all of the above signs; others may experience just one or two; others none at all.

If you are sexually active, and think you are pregnant or if your period is more than a week late, it’s important to do a home pregnancy test or to see your doctor as soon as possible.

If you think you are pregnant it is important to have a test to confirm the pregnancy.

A pregnancy test can be done on a urine or blood sample. You can take a pregnancy test from the first day of a missed period but, for a more accurate result, it is best to wait until your period is a week overdue.

You can buy a home pregnancy test from a pharmacy or supermarket and obtain the result at home. Home pregnancy tests are simple to use and the test is done with a sample of urine.

A pregnancy test can also be done at a family planning clinic, GP practice, Women’s Health Centre or other health service. The sooner you find out for sure, the more time you will have to think about your options.

If the test is negative – but you think you may be pregnant – you should repeat the test in another week or see your doctor.

If a pregnancy is not planned, it can be quite a shock and cause a lot of different emotions. It is important that you take the time you need to make the best decision for you at this point in your life. Your decision will be affected by a range of things, including your personal circumstances; the level of support available; and how many weeks pregnant you are.

The options with an unplanned pregnancy are:

• Continuing the pregnancy and choosing to parent
• Continuing the pregnancy and choosing adoption / foster care
• Terminating the pregnancy (abortion)

Pregnant?…Working through your options is a booklet for people who have an unintended pregnancy (or those who work with them) and are unsure of what to do. This resource includes information about the options available, some of the issues to consider, where to go for support and tools to assist decision-making.

It can be helpful to talk to someone you know and trust. However sometimes it is useful to speak to someone else.

If you need someone to talk to you can call Family Planning NSW Talkline 1300 658 886.

Other services that can help include:

• NSW Pregnancy Choices Helpline (NSW Health) – www.pregnancychoices.org.au or 1800 008 463
• Children by Choice
• Pregnancy Birth and Baby

Every time a girl and a guy have sex there is a chance of pregnancy. The only 100% effective method of preventing pregnancy is by not having sex (abstinence). However, if you choose to be sexually active, it’s a good idea to know the facts on contraception so you can minimise your chances of an unplanned pregnancy.

Contraception stops a sperm from fertilising an egg, so people can have sexual intercourse (penis in vagina) while preventing an unplanned pregnancy.

There are many different types of contraception, but no method is ever 100% effective. Not all contraceptive methods work the same way, and most have benefits and some downsides. That’s why it’s important to consider all the types of contraception available to pick one that best suits you and your partner’s health and lifestyle needs.

Condoms are the only form of contraception that provide protection from sexually transmissible infections (STIs) and unplanned pregnancy when used correctly. However, girls might like to consider using a hormonal form of contraception as well – such as the contraceptive implant (‘the rod’) or ‘the pill’ – to further reduce the chance of pregnancy.

Another important thing to remember is that pre-ejaculate (pre-cum) – the fluid that comes out of the penis it is aroused – can also contain sperm (and STIs), which is one reason why the ‘withdrawal’ or ‘pulling out’ method is not a very effective form of contraception.

Explore What contraception suits me more information.

If you’re planning to have a baby it is advisable to be well informed and well prepared to provide the best care for yourself and your baby. It is a good idea to visit your doctor so you can discuss pre-pregnancy planning and have any check-ups required, ensuring you are physically fit and healthy.

A pre-pregnancy check-up can include:

• General examination
• Blood test to check your iron level, blood type, and immunity against Rubella (German Measles) and Varicella (Chicken Pox)
• Vaccination updates, if required
• STI Test

Your doctor will advise you of recommended supplements to take before and during pregnancy, such as Folic Acid and Iodine. It is also important to discuss with your doctor any medications you are currently taking so that safe alternatives can be prescribed if necessary.

Timing of sexual intercourse can also be an important factor to consider when you are planning to become pregnant. A woman is most fertile around the time of ovulation; about two weeks before her next menstrual period is due. Unprotected sexual intercourse about three times a week prior to, and at ovulation time, maximises the chance of conception.

Family Planning NSW Pre Pregnancy Planning Fact sheet.

For further information and advice, call Family Planning NSW Talkline 1300 658 886.

Information is also available from the Commonwealth government website: Pregnancy, Birth and Baby (Helpline: 1800 882 436).

Most healthy, fertile couples achieve a pregnancy within the first 12 months of trying to get pregnant. Every month that a couple is trying to get pregnant, there is about a 20% chance of being successful.

Some couples will need assistance to become pregnant; this can be due to infertility of either the male or the female, or a combination of factors. Infertility is when a couple have been unsuccessful in achieving pregnancy after one year of trying.

Women’s fertility starts to decline from about the age of 30, with a more significant drop in fertility from the age of 35. After 35 years, the chance of a women experiencing infertility, miscarriage or a problem with their baby increases.

Women over 35 can take twice as long to become pregnant than those under 35 years, however they are advised to seek assistance if unsuccessful in achieving pregnancy after 6 months of trying.

Female infertility may be caused by:

• Ovulation problems (irregular or absent periods)
• Polycystic ovary syndrome
• Blocked or scarred fallopian tubes
• Fibroids or polyps in the uterus
• Endometriosis
• Age of the woman

Male infertility may be caused by:

• Problems with the quality or number of sperm
• Blockages to the passage of sperm
• Functional problems (such as impotence, or as the result of surgery or an accident)
• Hormonal problems
• Age of the man

Other factors that influence fertility can include: lifestyle factors such as diet, being overweight or underweight, drug and alcohol use, or even stress. Sometimes the cause is unknown – this is called unexplained infertility.

For more information about factors that influence fertility go to Your Fertility.

Depending on the reason, doctors have different methods which may assist a woman to become pregnant. These methods are known as ‘assisted reproductive technologies’ (ART) and can include:

Hormonal therapy: there are different types of hormonal therapy available. For women, hormonal therapy can be used to stimulate ovulation. For men, hormonal therapy can be used to stimulate sperm production.

Surgery: is an option for blockages or obstructions within the reproductive organs of a man or a woman.

Artificial insemination: is a method where sperm from a woman’s male partner, or from a donor, are inserted into a woman’s vagina or uterus using a syringe or catheter tube.

In vitro fertilisation (IVF): involves removing some of the woman’s eggs and mixing them with pre-collected sperm from the woman’s partner, or from a donor. Sometimes each egg is injected with a single sperm cell. These eggs are then incubated for a period of time to develop into embryos. An embryo is then inserted back into the woman’s uterus to see if a pregnancy will result.

As with any medical procedure there are risks associated with each method which need to be considered and, despite the advancement in assisted reproductive technologies available, there is no guarantee that a pregnancy will result. Many factors contribute to whether pregnancy will be successful, including: the cause of the infertility, the woman’s age and the method of technology used.

If you are concerned about your fertility, or just have more questions, call Family Planning NSW Talkline 1300 658 886 for information and advice.

More information about assisted reproductive technologies can be found at IVF Australia.

Single women, or women with female partners, who want to start a family may choose to become pregnant using artificial insemination or in vitro fertilisation (IVF).

Artificial insemination: is a method where sperm from a donor are inserted into a woman’s vagina or uterus using a syringe or catheter tube.

In vitro fertilisation (IVF): involves removing some of the woman’s eggs and mixing them with pre-collected sperm from a donor. Sometimes each egg is injected with a single sperm cell. These eggs are then incubated for a period of time to develop into embryos. An embryo is then inserted back into the woman’s uterus (or sometimes into her female partner’s uterus) to see if a pregnancy will result.

These methods are available for women regardless of marital status or sexual orientation. The doctor will discuss the options available, along with the benefits and downsides of each method, to determine which method is best for the woman according to their wants, needs and circumstances.

As with any medical procedure there are risks associated with each method which need to be considered and, despite the advancement in assisted reproductive technologies available, there is no guarantee that a pregnancy will result.

Explore our sexual diversity section for more information about same-sex relationships.

More information about assisted reproductive technologies can be found at IVF Australia.

For further information and advice, call Family Planning NSW Talkline 1300 658 886.