Malaria fever is a constant threat for women in tropical Africa and they should protect themselves by sleeping under insecticide treated net and also keeping the drains in their environment dry and tall bushes cleared. Symptoms of malaria should be diagnosed and treated promptly. Urinary tract infection is not infrequent in pregnancy because of stasis of urine occasioned by the effect of the pregnancy hormones on the urinary tract and the effect of pregnant uterus on the bladder. In urinary tract infection the woman feels pain when passing urine. Frequent passage of urine is not a reliable symptom of urinary tract infection in pregnancy because many normal women pass urine frequently in pregnancy. When there is a suspicion of urinary tract infection in pregnancy, a sample of urine is sent for culture and sensitivity to the laboratory and treatment is commenced immediately without waiting for the result. This is done because urinary tract infection can affect the kidneys of the pregnant women and cause growth restriction in the baby. A suspicion of urinary tract infection can occur if on routine urine test, protein is detected, particularly in the first trimester of pregnancy. The pregnant women may not have symptoms of urinary tract infection. Further test is necessary to exclude a condition known as asymptomatic bacteriuria. In this condition there is infection of the urinary tract but the pregnant women do not feel symptoms. This infection can affect the growth of the baby and can even progress to full blown urinary tract infection. It should be detected early and treated with suitable antibiotics
Is sex safe in the first trimester?
Sex is safe in pregnancy except under certain conditions which I will discuss later. What is unpredictable is actually your sexual response in pregnancy which varies from one woman to the other and also varies in the same individual from one occasion to another. Your sexual response is also influenced by the hormones of pregnancy that are being released by the placenta. For many women the tiredness and nausea they experience in the first trimester may reduce their interest in sexual intercourse, but this may improve by the 2nd trimester.
Women generally find sexual intercourse more exciting in pregnancy due to very elevated levels of female hormones. These hormones cause changes in the breasts and sexual organs making them more sensitive and responsive.
Sexual intercourse cannot harm the baby in the womb because the thrust of penetration does not get to the womb of the pregnant mother. Infection cannot ascend to the baby because the baby is protected by plug of mucus that prevents ascending infection.
There may be need to modify sexual positions however to suit the comfort of the pregnant women.
There are certain reasons why sexual intercourse should be avoided in pregnancy. These are the following reasons:
(i) Whenever there is bleeding in pregnancy
(ii) When there is a suspicion of broken water
(iii) When the placenta is occupying a low position
Whenever there is a risk of premature delivery. Some health givers may advice against sex if there is a history of recurrent miscarriage. This is however controversial. Some doctors also advice women who are carrying multiple (twins, triplet or more etc) gestation to abstain from intercourse in the last trimester because of the risk of preterm contractions.
In situations where sexual intercourse is prohibited in pregnancy, the couple can also have other forms of mutual sexual pleasuring that does not involve penetrative sexual intercourse.
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