How to Make a Baby

By Leslie Shrock, author of Bumpin’

 Though it probably seems like some couples just look at each other and bam! are pregnant, that is not the case for most. You may already know the basics of when and how you can get pregnant from middle school sex ed, your parents, friends, or favorite fertility app. But no matter what you think you know, there are ways to save time and properly calibrate your expectations.

How Ovulation Works

It’s been a while since you got “the talk” after your first period, so here’s a refresher. A typical menstrual cycle is twenty-eight days. Its purpose: to prepare your body for pregnancy. At the beginning of each cycle, estrogen and progesterone mature an egg in one of your ovaries and make the lining of your uterus thick and spongy. Halfway through your cycle, your right or left ovary (usually they alternate months) releases this mature egg through one of your fallopian tubes into the uterus in a process called ovulation. If the egg is fertilized by sperm, it burrows into the newly thick and inviting uterine lining and begins a pregnancy. If it isn’t fertilized, the lining breaks down and the resulting blood and tissue flow out as your period.

For purposes of getting pregnant, your focus is the fertile window before the middle of the cycle—three days before and up to the day of ovulation. It is the most likely time you will successfully become pregnant, as the egg is available to be fertilized for only twelve to twenty-four hours. Sperm, on the other hand, can hang out and live in the reproductive organs for as long as three to five days, which is why having sex before you actually ovulate is a more successful route.

So how do you know if you’re ovulating? Since every woman’s cycle is slightly different, you have to pay attention. There are tried-and-true technology-free methods like cervical mucus monitoring, basal body temperature, or just peeing on an ovulation test. If you want to take things to the next level, you can pair it with one of the many apps or devices available to help you to see trends and, given time, even predict when you’ll ovulate based on your cycle’s history.

Doing It

Sex while trying to conceive isn’t always Kama Sutra–level romantic, especially if you’ve been at it awhile or are attempting to time it with an ovulation peak. If you’re not careful, it can start to feel like a job. So in the spirit of keeping it as stress-free as possible, here are the answers to the most common sex-during-conception questions.

• How many times do we need to do it? More is not always better. When men ejaculate too frequently, sperm quality and quantity goes down. When it doesn’t happen enough, sperm can be too old and slow to get to the egg in a timely fashion. So though it seems logical to have sex five times per day during your fertile window, that is not the best way to get pregnant. To optimize sperm quality and getting them to their destination on time, have sex every other day or once per day at most in the five days leading up to ovulation and on the day of. If you're having sex with the goal of trying to conceive, it's also important to use a TTC-friendly fertility lubricant to protect sperm health. 
• What are the best positions? Clinical research into pregnancy-friendly sexual positions is pretty much nonexistent, and no one position has ever been proven more effective than others. But there is a powerful force that you should consider when trying to conceive: gravity. The closer the sperm starts to the cervix, the more likely it is to get where it needs to go. For that reason, the two most recommended positions are missionary and doggy style. They allow for deep penetration, and in the case of missionary, the sperm is deposited directly into the top of the vagina closer to the cervix. There are many variations, like putting a pillow under your lower back in missionary to tilt your hips up, or lowering down flat from all fours in doggy-style. Rather than obsess about form and technique, mix things up and have fun.
• Will staying on my back afterward help? The meeting of sperm and egg actually happens quickly–strong sperm can complete the whole journey from ejaculation to egg in about ten minutes. So though there is no hard proof that it makes a difference, not getting up immediately after sex doesn’t hurt, and could help. For that reason, some doctors recommend staying on your back with your hips tilted up for ten to twenty minutes to ensure that any sperm that could make it to an egg get their best shot.

Early Signs You Might Be Pregnant

The most obvious is a missed period. But if you’re on the lookout before that happens, there are other signs. You’ll notice a lot of these symptoms could be mistaken for PMS. It can be tricky to know the difference so rather than reading into every single small change, focus on taking good care of yourself until that missed period actually happens.

• Sensitive nipples
• Cramping
• Fatigue
• Nausea
• Frequent peeing (especially at night)
• Change in tastes and smells
• Moodiness
• Implantation bleeding

Implantation bleeding can be confusing. It may seem counterintuitive, but as many as 1/3 of women experience spotting around the time the embryo implants in the uterine lining.

Here are a few ways to differentiate implantation bleeding from your period:

• Timing: Typically happens a few days before your period is due, around ten days after you ovulated
• Duration: It can last for just hours or one to two days
• Color: Lighter pink or brownish in color versus the more vibrant cranberry color that marks your period
• Cramping: More mild cramping than your period, and no growing intensity

Taking THE Test

Though you may want to trust only the top-shelf pregnancy tests with features like digital readout, the underlying technology for detecting human chorionic gonadotropin (HCG), the hormone placental cells produced during pregnancy, is the same whether it involves a paper strip dipped in a cup or a fancy plastic stick you pee on. You’ll later blame HCG for your morning sickness, but for now, its presence in your urine is the most easily detectable early indicator that you are indeed pregnant.

Because HCG levels are low early on, you may get a false negative depending on what time of day you take it and the cycle day. It’s highly unlikely you’ll receive a false positive unless you are going through fertility treatments, as HCG is rarely produced in detectable levels in the body for any other reason. So even if the color on the strip is on the faint side, you are likely pregnant.

When to take the test:

• Though it’s really, really hard, try to wait until your period is due to avoid false negatives and disappointment. If your period is inconsistent, take your first test at least nineteen days after you tried to conceive.
• Always take a pregnancy test first thing in the morning, since HCG levels are at their most concentrated before your urine is diluted with coffee or other fluids. For the same reason, don’t drink ten glasses of water and then test. If you’re testing after five weeks, HCG levels should be high enough to get an accurate result any time of day.
• Read (and follow) the directions on the test you buy. Even though it all seems intuitive (how hard can it be to hold a stick in a stream of urine?), there are ways to do it wrong.
• Check the expiration date (tests become less effective over time).

When taken correctly, home pregnancy tests are reliable (just check that expiration date), so unless you have a history of ectopic pregnancy or other complications, it is unlikely your ob-gyn or midwife will see you before your first ultrasound to confirm the pregnancy.

Conception can quickly become stressful and obsessive, especially timing sex and calculating fertile windows. Add hormonal changes (especially if you just quit taking birth control) or worry when things don’t happen immediately, and any joy in the creation of new life can vanish.

Your mission: Be patient, and find ways to defuse the anxiety and keep things fun.

Schedule a date night over your favorite take out at home. Try to keep each other distracted, especially if getting pregnant takes a bit of time. Keep the lines of communication open. And even if you’re not the type to talk about your feelings, be honest about how you are dealing.