When a person smokes, some of the oxygen in their blood is replaced by carbon monoxide. If a pregnant woman smokes, her blood and therefore her child’s blood will contain less oxygen than normal. This can cause the fetal heart rate to rise as baby struggles to get enough oxygen.

The particles in tobacco smoke contain different toxic substances that change the blood’s ability to work in a healthy and normal manner. This can affect the placenta that feeds the baby.

Babies born to mothers who smoke:

• Are more likely to be born prematurely and with a low birth weight (below 2.5kg or 5lb 8oz).

• Have a birth weight on average 200g (7oz) less than those born to non-smokers. This effect increases proportionally - the more the mother smokes, the less the child weighs.

• Have organs that are smaller on average than babies born to non-smokers.

• Have poorer lung function.

• Are ill more frequently. Babies born to women who smoked 15 cigarettes or more a day during pregnancy are taken into hospital twice as often during the first eight months of life.

• get painful diseases such as inflammation of the middle ear and asthmatic bronchitis more frequently in early childhood.

• Are more likely to become smokers themselves in later years.

In addition, pregnant women who smoke increase their risk of early miscarriage.

There are however, some risks in having sex during menstruation. These include;

• The likelihood of an HIV-infected woman’s passing the infection to her male partner is higher during her periods

• A woman’s chances of contracting an infection, (for e.g. herpes) from her male partner, are higher during her periods.

• Sex during menstruation puts a woman at higher risk of pelvic inflammatory disease

• A woman is also more likely to pass on other blood-borne diseases such as hepatitis- B or C to a partner during her period

• A woman is more likely to develop yeast or bacterial infections like candidiasis or bacterial vaginosis.

Following points should be kept in mind while having sex during periods;

• It’s advisable to use contraception, preferably a condom, as it will prevent transmission of infections and also protect you against any chances of pregnancy

• Consider using a dental dam while having oral sex during periods. They are available in various sizes and flavors

• Remember to remove your tampon before having sex!

However, in the presence of certain complications or risk factors, your doctor would label your pregnancy as high-risk and advise against sexual intercourse. Some of these risk factors include;

• a history or threat of miscarriage

• A history of pre-term labor (you’ve previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)

• unexplained vaginal bleeding, discharge, or cramping

• Leakage of amniotic fluid (the fluid that surrounds the baby)

• Placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is down so low that it covers the cervix (the opening of the uterus)

• Incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery

• Multiple fetuses (twins, triplets, etc.) (Not always a contraindication)

Reaching orgasm becomes very likely when sexual stimulation (physical or intercourse) is done slowly and when she is fully sexually aroused.

Female ejaculation is a completely normal process and you should not feel embarrassed about it.

The test is commonly done in Pakistan. You can talk to your gynecologist about it.

Every sexually active woman should have this test done every three years starting from after 1 year of her first sexual encounter.