Survey Says Women Don’t Really Know How to Get Pregnant, So Here’s How
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“Mommy, where do babies come from?”

It’s a question most parents dread to hear their children ask. Although it’s quite understandable that kids won’t have these answers, the truth is, their mother’s should. Ironically, most don’t.

Results of a controversial new study reveal that an alarmingly high percentage of women don’t know as much about their reproductive health as they should—many think that it helps to have sex multiple times a day and raise your hips afterward when you’re “trying” to conceive. Sadly, they’re mistaken.

Researchers from the Yale School of Medicine noticed so many misconceptions about medicine in their patients, they decided to survey 1,000 women ages 18-40 around the country about reproductive health. The findings, released Monday by Yale and First Response and published in the Journal of Fertility and Sterility, found that 51-percent of women surveyed incorrectly believe that having sex more than once a day would increase their chances of conception. A whopping 40-percent of participants believed lying on their back and raising their hips after sex and using certain sexual positions help with conception, despite the lack of any scientific evidence to back it.  Since only 50-percent of women surveyed had ever discussed their reproductive health with their medical provider, we felt it was time for a little doctor’s visit for all.

We checked in with Lubna Pal, MBBS, MRCOG, MS, who is the Director of the Program for Polycystic Ovarian Syndrome and Associate Chair of Education at Yale University’s Department of Obstetrics, Gynecology & Reproductive Science, to find out what’s really going on here and what a woman hoping to concieve really needs to know. Do you think that some of this bad information is passed down from grandmothers to mothers and then from mothers on to their daughters?
PAL: Many women, especially younger women, identify family and friends as source of information relating to reproductive health. Given however that the surveyed population was “internet savvy”, one can hypothesize that at least some culpability in perpetuation of misperceptions may additionally lie with the “lay press.” Most of the myths and misconceptions, circulating more among older women, such as different sexual positions and elevating the pelvis after intercourse, are not harmful in nature, just unnecessary. What should women in their 20s and 30s ask their OBGYNs about their reproductive health?
PAL: Women should initiate discussions about reproductive health and discuss when and if they plan to have children and how to optimize their health before trying to get pregnant. They should think about quitting smoking, moderating alcohol intake and achieving a normal body weight. If a woman has irregular menstrual cycles, severe pelvic pain or a history of gonorrhea or chlamydia, and she is actively trying to get pregnant, she should seek some help to figure out if any evaluation or treatment may be necessary. All women should seek to protect themselves from sexually transmitted infections since these infections can cause permanent blockage of the fallopian tubes as well as increase risk for tubal pregnancies. Which common misconceptions shared among the women you surveyed do you feel have the most serious implications?
PAL: The belief that you only need to start taking prenatal vitamins with folic acid after you become pregnant perhaps has the most serious implications. Women should begin taking a multivitamin with folic acid well before they start attempting to conceive (ideally several months in advance) in order to minimize risk for neural tube defects such as spina bifida. It is a good idea for all women of reproductive age, and particularly so for those who are sexually active and not consistent in contraception use, to take at least 400mcg of folic acid daily. Most women think more sex equals a higher chance of pregnanct, but it doesn’t. How can she increase her chances of conception?
PAL: Millions of sperm are released during a single sexual encounter and sperm can stay viable within the female body from 3-5 days; multiplicity of ejaculations within a short span of time (more frequently than every alternate day) is associated with a decline in seminal volume and lower sperm concentration. Recognize that a single sperm will do the job of achieving pregnancy if intercourse is timed appropriately. Having sex every other day during the fertile window (the 6 days before ovulation) allows plenty of opportunity for the sperm to be available to meet with its target. The most common misconception was that one should have intercourse in the 2 days after ovulation in order to optimize their chances. In actuality, the fertile window is comprised of the 6 days before ovulation. Learning about your own ovulatory cycle and your own personal physical signs of impending ovulation can be very helpful. A lot of women are convinced that having a child at 40 isn’t such a big risk anymore. What does the research prove?
PAL: Women have many good reasons to postpone pregnancy, but at least these decisions should be well-informed decisions. Research consistently shows that at the age of 35-40, women have about a 50-percent decreased chance of conceiving each cycle, compared to younger women. The risk of miscarriage is about double (or 1 in 4 and increasing to 1 in 2 after age 40). The risk of chromosomal abnormalities, such as Down Syndrome, is increased 4-fold, which is about 1 in 50 when a women reaches the age of 40, and 1 in 20 by the time she is 45. Older women are at higher risk of hypertension, preeclampsia, intrauterine fetal demise (stillbirth), gestational diabetes, placental abnormalities, cesarean birth, and preterm delivery. Women who are older than 40 have even higher incidences of these complications. Many women now rely on different apps to keep track of their menstrual cycles and ovulation. Can this method be trusted? Is it reliable?
PAL: By tracking their menstrual cycle using calendars or apps, women can better predict when they can expect to ovulate each cycle. For women with regular menstrual cycles, it usually reliably occurs 14 days before their period each cycle. Other signs of impending ovulation include clear, mucous vaginal discharge and vague one-sided pelvic discomfort as the ovary is distended with the follicle of the developing egg. Home ovulation predictor kits detect the luteinizing hormone (LH) surge that occurs in the two days before ovulation, so these can also be helpful for women who are having difficulty identifying their fertile window.