Choosing a perfect fit maternity bra may not be an easy task. Aside from the alterations in the size and shape of breasts during pregnancy, sometimes the nipples may be sore that makes it agonizing to wear a brassiere.  During pregnancy, it is best to wear a nursing bra instead. Breasts during pregnancy undergo various changes especially in cup size which increases as buildup of milk supply come about in preparation for breastfeeding. The size, however, becomes steady after a regular schedule of infant feeding is established. One of the features a nursing bra offers is how it can be adjusted to contain changing cup and band size in pregnancy and nursing.

Nursing brassieres are exclusively made for pregnant and lactating mothers. One of the aspects given extra effort in manufacturing these undergarments is comfort. However, most of them may not look as appealing as regular bras. A number of manufacturers are currently working on the ‘appeal’ element as most women prefer the same charm with pre-pregnancy intimate garments. Similar to regular underwear, nursing brassieres comes in an adjustable with four hooks for added support. These items are wider which has clasps that can be folded down when feeding.

Wearing a small brassiere adds up pressure on breast tissues resulting to strain and impede the passageway of milk. Approximately 80% of nursing women are wearing the wrong size of undergarment, hence guidelines to obtain the perfect size is of utmost importance. Suggested tips in choosing perfectly-fit brassieres are as follow:

Tip Number 1: Obtain Accurate Measurement.

1. Band Size: Wear a non-padded brassiere that fits well. Facing the mirror, wrap the tape measure around your rib cage below the bust line. The measuring tool should be in parallel with the floor. Fractional measurements should be rounded off to the nearest whole number. Add 4” if the measurement is an even number. If it is odd, add 5”.
2. Cup Size: With the non-padded bra, measure the fullest part of the bust, round of the findings to the nearest whole number.
3. Subtract the band size from the cup size. And refer to the conversion chart for your exact brassiere measurement. For example:

• Band size: Under measurement is 35 + 5” = 40
• Cup size: 43
• 43 – 40 = 3” or Cup ‘C’

Tip Number 2: Look for features of a good maternity bra which includes:

• More flexible fit. An undergarment that comes with three or more back closures allows one to loosen the band as your breasts increase in size.
• The band of the undergarment should lie snugly under the breasts and on the rib cage. It should not creep up on the breast tissues to prevent too much pressure on the passageway of the milk.
• Cup sizes should be large enough to contain the depth of the breasts. When breast tissues are spilling out on top and under the arms, the brassiere is not providing enough support.
• Opt to using undergarments made of cotton fabrics if you are pregnant in hot seasons such as summer.

Tip Number 3: Opt for maternity brassieres with a wide strap to get the best support. Furthermore, straps should also be cushioned and non-stretch.

Tip Number 4: Underwire brassieres should never be worn when sleeping. These items are not discouraged but soft cups and non-wire underwear are usually more comfortable. When breasts are at their fullest size, non-wire bras are found to offer more comfort. If you prefer an underwire garment, be sure check for accurate size to prevent pressure on the breast tissues.

Brassiere Measurement Chart

The HPV vaccine is the first vaccine ever to protect against cancer.

What is HPV?

HPV (human papillomavirus) is a common virus that affects both men and women. There are many different types of HPV. Most types do not cause any symptoms and will go away on their own. However, some types of HPV can cause diseases of the sex organs (genital area). If the virus does not go away on its own, it can develop into cervical cancer, abnormal cells, or genital warts, depending on the HPV type.

Who gets HPV?

You can get HPV from any sex act involving genital contact with a person who has HPV. The chance of getting HPV is greatly reduced by using protection (like a condom) during the sex act. Many people who have HPV may not show any signs of it. So, they can pass on the virus to others without even knowing it.

What happens if I get HPV?

In most people, the body’s immune system will fight off HPV. If your body does not fight off HPV, it could develop into genital warts or abnormal cells in the cervix. Abnormal cells in the cervix could lead to cervical cancer.

What is cervical cancer?

Cervical cancer is cancer in the cervix. The cervix is the part of the uterus (womb) that opens to the vagina. Cervical cancer is a
serious condition that can be life threatening. HPV is associated with almost all cases of cervical cancer.

What is the HPV vaccine used for?

The HPV vaccine will help protect you from cervical cancer. It also helps protect you from genital warts and some other genital diseases. The vaccine helps prevent these diseases, but it will not treat them. You cannot get these diseases from the vaccine.

Who should receive the HPV vaccine?

The vaccine is for girls and women ages 9 through 26. You should not receive the HPV vaccine if you:

• are allergic to any if the ingredients in the vaccine
• have an allergic reaction after getting a dose of the vaccine

How is the HPV vaccine given?
The vaccine is given as a shot (an injection). Three doses of the vaccine are needed.

• first dose: at a date chosen by you and your doctor or nurse
• second dose: 2 months after the first dose
• third dose: 6 months after the first dose

What else should I know about the HPV vaccine?

• After getting the vaccine, you still need a check up every year. You still need a Pap test as often as your doctor or nurse tells
  you.
• Like all vaccines, the HPV vaccine may not fully protect everyone who gets it.
• The 4 types of HPV that this vaccine protects against cause 70 percent of cervical cancers and 90 percent of genital warts. But the vaccine will not protect against all of the diseases caused by HPV.

What should I tell my health care professional before I am vaccinated or my child is vaccinated for HPV?

It is very important to tell your health care professional if you or your child:

• has had an allergic reaction to a previous dose of the vaccine
• has a bleeding disorder and cannot receive shots in the arm
• has a weakened immune system (for example, due to a genetic defect or HIV infection)
• is pregnant or is planning to get pregnant soon
• has any illness with a fever more than 100 F (38 C)
• takes or plans to take any medicine, including over-the-counter medicine (medicine you can buy without a prescription from your doctor)

Structures of the Male Reproductive System

1.External Genitalia
•The penis contains three columns of erectile tissue and the urethra, which terminates at the glans.
•The scrotum is divided by a septum. Each scrotal sac contains a testis, epididymis, and vas deferens.
•The testes are two ovoid glands that contain seminiferous tubules, in which spermatogenesis occurs, and interstitial cells, which produce testosterone.

2.Internal Genitalia
•The epididymis extends from seminiferous tubules of each testis.
•The vas deferens extends from epididymis and entrs the ejaculatory duct in the prostate gland. This uncoiled, fibromuscular tube is surrounded by arteries, veins, and a thick, fibrous coating.
•The spermatic cord extends from the testis through the inguinal canal to the abdominal cavity. It is a bundle of blood vessels, nerves muscle fibers and the vas deferens.
•The seminal vesicles, positioned behind the bladder, are two convoluted pouches that empty into the ejaculatory ducts and are lined with secretory epithelium.
•The ejaculatory ducts join the seminal vesicles and urethra. They pass through the prostate gland and terminate in the prostatic urethra.
•The prostate gland, located under the bladder and surrounding the urethra, is a walnut-sized gland divided into five lobules by the urethra and ejaculatory ducts.
•The urethra leads from the base of the bladder through the prostate gland to the shaft and glans of the penis and is divided into three sections: the prostatic, membranous and penile urethra.

3.Bulbourethral glands, or Cowper’s glands, are two pea-sized glands located beside the prostate. They drain into the urethra.

Functions of the Male Reproductive System
1.External genitalia
•The penis serves as the male organ of copulation and the passageway for urine. Sexual excitement leads to venous congestion, which causes distension and erection.
•The scrotum protects and supports the testes and sperm.
•The testes produce mature, functional spermatozoa. This is referred to as spermatogenesis, which begins at puberty and continues throughout life. It occurs in several stages:
oSpermatogonia grow and develop into primary spermatocytes each containing 44 autosomes and 2 sex chromosomes, X and Y.
oPrimary spermatocytes divide to become secondary spematocytes, each containing 22 autosomes and 1 sex chromosome, an X or Y.
oSecondary spermatocytes divide to form spermatids, each retaining 23 chromosomes.
oSpermatids mature into spermatozoa.

2.Internal genitalia
•The epididymis stores sperm as it develops the power of motility and the capability to fertilize the female ovum.
•The vas deferens stores most sperm. During this time sperm continues to mature.
•The seminal vesicles produce yellowish, alkaline fluid rich in basic sugar and protein. This fluid enhances sperm motility by nourishing the sperm and improving pH.
•The ejaculatory duct is the passage through which semen enters the urethra.
•The prostate gland secretes fluid during sexual activity to add volume to semen, enhance sperm motility, and neutralize male urethral and vaginal acidity to enhance fertility.
•The urethra serves as passageway for semen during ejaculation and as a canal for urine during voiding.
•The bulbourethral glands secrete an alkaline fluid that also neutralizes the acid secretions found in the urethra to ensure the safe passage of sperm.

3.    Testosterone, secreted by testicular interstitial cells (Leydig’s cells), is essential for the development and maintenance of male sex organs and secondary sex characteristics. Testosterone secretion begins in utero and increases at puberty. It is controlled by LH and FSH secreted by the anterior pituitary.

Anatomy of Female Reproductive System

Functions of the Female Reproductive System
1.External Genitalia
•The mons pubic protects the pubic bone from trauma.
•The clitoris provides for sexual arousal and orgasm.
•The labia majora and minora protect the external genitalia, urethra, and distal vagina.
•Secretions from Bartholin’s glands lubricate the external vulva during coitus and improve sperm survival.
•Secretions from Skene’s  glands lubricate the external genitalia during coitus.
•The urethral meatus is the external opening of the female urethra.
•The perineal muscle expands during childbirth to enlarge the vagina, allowing for passage of the fetal head.

2.Internal genitalia
•The vagina aids in conception by conveying sperm to the cervix and helps in childbirth by serving as a passageway for the fetus.
•The uterus receives the fertilized egg, provides for implantation, nourishes and protects the growing fetus, and contacts to expel the fetus during childbirth.
•The ovaries produce and release mature ova and regulate the menstrual cycle through the production of estrogen and progesterone.
•The fallopian tubes move the sperm toward the ova and the ova toward the uterus, thereby aiding in fertilization.

3.The pelvis supports and protects the reproductive and other pelvic organs. During the late months of pregnancy, the false pelvis supports the uterus and helps direct the fetus into the true pelvis for birth.

4.The breasts serve to produce and secrete (Lactate) milk for the infant.

Physiologic process of the female reproductive cycle

1.Menstruation Cycle
2.Gestation and lactation
•Fertilization of the ovum by a sperm usually occurs in the distal third of the fallopian tube. About 5 days later, the zygote implants into the uterine endometrium.
•Human chorionic gonadotropin, secreted by chronic villi in the endometrium of a pregnant female, stimulates the corpus luteum to secrete estrogen and progesterone until the placenta takes over.
•From the third to the eight week of gestation, all essential structures of the fetus form. During the remaining weeks these existing structures grow and mature. Throughout pregnancy, the placenta continues to produce progesterone and estrogen. These hormones stimulate growth of the fetus and uterine blood supply, affect contractile activity, stimulate growth of mammary tissue, and affect the woman’s metabolism. Normally, around the 40th week of gestation, the fetus and placenta are expelled from the body. Estrogen and progesterone play a role in initiating parturition. Under the influence of oxytocin, regular contractions increase in frequency and intensity to aid in this process of childbirth.
•The breast produce and release milk for the nourishment of the neonate. The production and release of milk is influenced by prolactin, oxytocin and suckling of the neonate. This process is referred to as lactation.

3.Menopause occurs when menses cease (for at least 1 year), in most women between ages 40 and 55. After menopause, the ovaries atrophy, estrogen levels fall, and changes occur in the vagina, cardiovascular system, skeletal system and integumentary system.

Anatomy of Female Reproductive System

Menstruation Cycle— (also termed as female reproductive cycle) can be defined as episodic uterine bleeding in response to cyclic hormonal changes. It is the process that allows for conception and implantation of a new life. The purpose of a menstruation cycle is to bring an ovum to maturity and renew a uterine tissue bed that will be responsible for its growth should it be fertilized. Menstruation cycle is consists of two interrelated cycles: the menstrual cycle and the ovarian cycle. Menarche—is the first menstrual period in girls, may occur as early as age 8 or 9 or as late as age 17 and still be within normal limits.

Four Phases of the Menstruation Cycle
a. Menstrual Phase (days 1–7)—shedding of the endometrium; low
estrogen levels, scanty cervical mucus; lining of the uterus is at its thinnest state; total blood loss during menses range from 30 to 80 ml and iron loss is 12 to 29 mg.
b. Proliferative phase (days 8–11)—endometrium thickens, increasing
estrogen, and cervical mucus becomes more clear, thinner, and more
elastic. This phase is also called follicular, postmenstrual  and estrogenic phase. It is favorable to sperm.
c. Secretory phase (days 18–25)—Estrogen levels fall and progesterone
increases. Endometrium becomes thicker and secretes glycogen to
prepare for the fertilized ovum. If fertilization occurs, the fertilized ovum or zygote will implant in 7-8 days after fertilization.
d. Ischemic phase— (days 26–28) Levels of estrogen and progesterone fall. Spiral arteries, which nourish the endometrium, vasoconstrict causing the endometrium and blood to be shed, which begins the next menstrual phase. If fertilization does not take place, the corpus luteum shrivels as its lifespan is only up to 7 days from the date of ovulation.

Ovarian Cycle
a. Follicular phase (days 1–14)—Ovarian follicle (and ovum) mature
under the influence of FSH and LH. At first, several follicles develop,
but eventually one outgrows the others. The follicles secrete estrogen,
which accelerates maturation. Estrogen affects endometrium, and
ovulation occurs after the LH surge.
b. Luteal phase (days 15–28)—After ovulation, the ovarian follicle
becomes the corpus luteum and produces progesterone, which suppresses
the growth of other follicles. The corpus luteum degenerates
after a week or so, and, if fertilization doesn’t occur, the hormone
levels drop, the endometrium is shed, and the menstrual flow starts.

External Structures
A. Visible Organs of the Vulva

• Mons pubis—covered with pubic hair—located over pubic bones, serves a protective function
• Labia major and labia minora—two pairs of tissue surrounding the outer part of the vulva.
• Vestibule—surrounded by the labia it contains the vaginal opening and
  urethra.
• Vaginal opening
• Clitoris—erectile tissue analagous to the penis
• Urethral orifice
• Perineum—the region of the genital area between the vulva and the anus. This is the location of an episiotomy if performed during birth.

B. Breasts—mammary glands

• Function is to secrete milk for infant—lactation.
• After delivery, the withdrawal of estrogen and progesterone due to the expulsion of the placenta cause prolactin to be produced, which stimulates milk formation. Oxytocin is a hormone that stimulates the release of milk.

Internal Reproductive Organs
A. Located in the Pelvic Cavity

• Ovaries—female gonads located on each side of the uterus. Functions include
  (1) Development and release of the ovum (egg)
  (2) Secretion of the hormones estrogen and progesterone
• Fallopian tubes
  (1) Carry the ovum from the ovary to the uterus.
  (2) Fimbriae sweep ovum into the tube.
• Uterus
  (1) Hollow pear-shaped organ that stretches and enlarges during
  pregnancy to support the fetus.
  (2) Other functions include menstruation and expelling of the fetus
  during labor.
  (3) Divisions of the uterus are: fundus—uppermost portion; corpus—the
  body; cervix—lower third that exits into the vagina through the
  cervical os.
• Vagina
  (1) Curved tube leading from the uterus to the vestibule.
  (2) Functions as a passageway for menstrual flow, organ of copulation,
  and birth canal.

Pelvis

A. Bones—support and protect pelvic contents

• Sacrum—wedge-shaped bone formed by the fusion of five vertebrae
• Coccyx—small triangular bone at bottom of the vertebral column.
• Innominate bones
  (1) Ilium—upper prominence of the hip
  (2) Ischium—L-shaped bone below the ischium. Distance between the
  ischial spines is the shortest diameter of the pelvic cavity.
  (3) Pubis—slightly bowed front portion of the innominate bone. The
  pubis meet at the front of the pelvis to make up the joint called the
  symphysis pubis. Below the symphysis is a triangular space called
  the pubic arch, under which the fetal head passes during birth.

B. Pelvic floor—muscular floor of bony pelvis, supports pelvic contents

• Levator ani—major portion, made up of four muscles
  (1) Ileococcygeus
  (2) Puboccygeus
  (3) Puborectalis
  (4) Pubovaginalis
• Coccygeal muscle—underlies sacrospinous ligament a thin muscular
  sheet which helps the levator ani support the pelvic contents

C. Pelvic shapes—vaginal birth is never ruled out because of pelvic type
without a trial of labor.

• Android—narrow, heart shaped, similar to shape of male pelvis—not
  favorable for vaginal birth
• Anthropoid—widest from front to back—usually adequate for vaginal
  birth
• Platypelloid—widest from side to side—not favorable for vaginal birth
• Gynecoid—“classic” female pelvis—approximately 50 percent of
  women and it’s the best for vaginal birth

Functions of the Female Reproductive System

Regular exercise during pregnancy can make you look and feel better, help your posture, and lessen discomforts such as backaches and fatigue. The goal of exercise during pregnancy should be to reach or keep a level of fitness that is safe. You should not exercise to lose weight during pregnancy. Some exercises provide aerobic conditioning of the heart and lungs; others relieve stress and tone muscles. For total fitness, an exercise program should include exercises that provide both conditioning and strengthening.

• Note: Always follow the Pregnancy Exercise Guidelines for your own safety.
• To ensure that a fitness program is appropriate for you, check with your doctor or midwife before starting or continuing to exercise during pregnancy.

Exercise

Following are exercises that strengthen and stretch muscles that support the back and legs and promote good posture-muscles of the back, the abdomen, the hips, and the upper body. These exercises not only will help ease back pain but also will help prepare you for labor and delivery.

Upper Body Bends

This exercise strengthens the muscles of your back and torso.

• Stand with your legs apart, knees bent slightly, with your hands on your hips.
• Bend forward slowly, keeping your upper back straight. You should feel a slight pull along your upper thigh.
• Repeat 10 times

Diagonal Curl

This exercise strengthens the muscles of your back, hips, and abdomen. If you have not already been exercising regularly, skip this exercise.

• Sit on the floor with your knees bent, feet on the floor, and hands clasped in front of you.
• Twist your upper torso to the left until your hands touch the floor.
• Do the same movement to the right.
• Repeat on both sides 5 times.

Forward Bend

This exercise stretches and strengthens the muscles of your back.

• Sit in a chair in a comfortable position. Keep your arms relaxed.
• Bend forward slowly, with your arms in front and hanging down.
• If you feel any discomfort or pressure on your abdomen, do not push any further.
• Hold this position for a count of 5, then get up slowly without arching your back.
• Repeat 5 times

Trunk Twist

This exercise stretches the muscles of your back spine, and upper torso.

• Sit on the floor with your legs crossed, with your left hand holding your left foot and your right hand on the floor at your side for support.
• Slowly twist your upper torso to the right.
• Do the same movement to the left, after switching your hands (right hand holding right foot and left hand supporting you).
• Repeat on both sides 5-10 times.

Backward Stretch

This exercise stretches and strengthens the muscles of your back, pelvis, and thighs.

• Kneel on hands and knees, with your knees 8-10 inches apart and arms straight (hands under your shoulders).
• Curl backward slowly, tucking your toward your knees and keeping your arms extended.
• Hold this position for a count of 5, then come back up to all fours slowly.
• Repeat 5 times.

Leg Lift Crawl

This exercise strengthens the muscles of your back and abdomen.

• Kneel on hands and knees, with your weight distributed evenly and your arms straight (hands under your shoulders).
• Lift your knee and bring it toward your elbow.
• Strengthen your leg without locking your knee.
• Extend your leg up and back.
• Do this exercise to a count of 5. Move slowly; don’t filing your leg back or arch your back.
• Repeat on both sides 5-10 times.

Rocking Back Arch

This exercise stretches and strengthens the muscles of your back, hips, and abdomen.

• Kneel on hands and knees, with your weight distributed evenly and your back straight.
• Rock back and forth, to a count of 5.
• Return to the original position and curl your back upward as much as you can.
• Repeat 5-10 times.

Back Press

This exercise strengthens the muscles of your back, torso, and upper body and promotes good posture.

• Stand with your feet 10-12 inches away from a wall and your back against it.
• Press the lower part of your back against the wall.
• Hold this position for a count of 10, then release.
• Repeat 10 times.

Sports

Pregnancy is not a time to take up vigorous sports that require good balance or sudden jerky movements, such as softball, skating or tennis. Walking and swimming are the best exercise for pregnant women.

The amount and type of exercise that is best for you during pregnancy depends on your general health, the course of your pregnancy, your fitness and your usual activity level.

Regular, moderate exercise during pregnancy maintains muscle tone, strength and endurance; it also protects against back pain, helps prevent excessive accumulation of body fat, and has a positive effect on your energy level, mood and self-image.

To ensure that a fitness program is appropriate for you, check with your doctor or midwife before starting or continuing to exercise during pregnancy.

1. Get regular exercise (at least three times a week). Avoid spurts of heavy exercise followed by long periods of no activity.
2. Avoid brisk exercise in hot, humid weather or when you are sick with a fever (such as the flu).
3. Avoid jerky, bouncy, or high-impact motions. Activities that call for jumping, jarring motion, quick changes in direction may strain your joints and cause pain. Low-impact exercise is best. A wooden floor or a tightly carpeted surface reduces impact and gives you sure footing.
4. Wear a bra that fits well and gives lots of support to help protect your breasts.
5. Wear the proper shoes for the activity to be sure your feet are well cushioned and to give your body good support. There are shoes designed just for walking, running, aerobics, or tennis.
6. Avoid deep knee bends, full sit-ups, double leg raises (in which you raise and lower both legs together), and straight-leg toe touches.
7. After 20 weeks of pregnancy, avoid exercises that require lying with your back on the floor for more than a few minutes.
8. Always begin with 5 minutes of slow walking or stationary cycling with low resistance to warm up your muscles. Intense exercise should not last longer than 15 minutes.
9. Follow intense exercise with 5-10 minutes of gradually slower activity that ends with gentle stretching in place. To reduce the risk of injuring the tissue connecting your joints, do not stretch as far as you possibly can.
10. The extra weight you are carrying will make you work hander as you exercise at a slower pace. Measure your heart rate at peak times of activity.
11. Get up from the floor slowly and gradually to avoid feeling dizzy or fainting. Once you are standing, walk in place briefly.
12. Drink water often before, during, and after exercise to be sure your body gets enough fluids. Take a break in your workout to drink more water if needed.
13. If you did not exercise two or three times a week before getting pregnant, start with physical activity of very low intensity and, bit by bit, move to higher levels.
14. Stop exercising and consult your doctor or nurse if you get any of these symptoms, and they are unusually severe:
    1. Pain
    2. Vaginal bleeding
    3. Dizziness or feeling faint
    4. Shortness of breath
    5. Irregular or rapid heart beat
    6. Difficulty walking
    7. Pain in your back or pubic area

Pregnancy is not a good time to take up a new, strenuous sport. If you were active before your pregnancy, however, you should be able to keep it up, within reason.

Click here to see a list of pregnancy exercises which you can easily follow.