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CHAPTER 9: Conception, Pregnancy, and Birth
1. In the U.S., nearly ________ of all pregnancies are unplanned.
a. 10%
b. 25%
c. 50%
d. 75%
Answer: C
Most pregnancies are unplanned.
2. The earliest methods of medical pain control for childbirth required the mother to be
deeply sedated, a state known as ________.
a. unconscious
b. general anesthesia
c. dementia
d. hypnosis
Answer: B
General anesthesia was one of the earliest methods used for medical pain control in
3. The obstetrician and professor at Edinburgh University who discovered the use of
chloroform during the birth process is ________.
a. Dr. James Young Simpson
b. Dr. Samuel Chloroform
c. Dr. Michael Eaton Ether
d. Dr. Marie Antoinette
Answer: A
Dr. James Young Simpson discovered chloroform for use during the birth process.
4. ________ refers to an earlier method of childbirth pain control that used a combination of
two injectable drugs: morphine and scopolamine.
a. Midnight zone
b. Twilight zone

c. Midnight sleep
d. Twilight sleep
Answer: D
Twilight sleep used a combination of two drugs: one for pain relief (morphine) and another
for amnesia (scopolamine).
5. Married couple Tim and Tia are biologically capable of conceiving, but feel more
comfortable and content to live lives that do not include parenting. They prefer to be called
a. childless
b. child-free
c. childphobic
d. selfish
Answer: B
Couples who choose not to have children are called “child-free” or “childless by choice”
rather than “childless.”
6. Karen is going through puberty. Her mother explains that her ovaries contain
approximately ________ oocytes.
a. 400
b. 4,000
c. 400,000
d. 4,000,000
Answer: C
At puberty, a girl’s ovaries contain approximately 400,000 oocytes.
7. Women, on average, release one egg each month, a process called ________.
a. conception
b. ovulation
c. dilation
d. egg expulsion
Answer: B

Ovulation refers to the release of an egg each month.
8. Miranda got her first period at age 13. She discovers that the term used to describe a girl’s
first menstrual period is ________.
a. menarche
b. bleeding
c. menopause
d. monumental
Answer: A
Menarche refers to the beginning of menstruation during puberty.
9. These two hormones play an important role in ovulation:
a. FSH and TH
b. FSH and LH
c. LH and TH
d. TH and PUT
Answer: B
FSH and LH cause the wall of the follicle at the edge of the ovary to break down, and about a
day later the follicle ruptures, releasing the ovum into the abdominal cavity.
10. During the ________ phase, the growth of new follicles in the ovaries is suppressed and
the lining of the uterus thickens in preparation to receive a fertilized egg.
a. follicular
b. hormonal
c. estrogen
d. luteal
Answer: D
The luteal phase occurs after ovulation, when the growth of new follicles is suppressed and
the lining of the uterus thickens.
11. Marty is reading a book about puberty and male reproduction. He learns that the sperm
cells develop in the ________.

a. seminiferous tubules
b. vas deferens
c. prostate
d. epididymis
Answer: A
Each testicle contains hundreds of feet of tightly coiled seminiferous (“seed-bearing”)
12. Sperm cells that are beginning to develop in a man’s testicles today will not be ready to
be ejaculated and able to fertilize an ovum for approximately ________ days.
a. 7-10
b. 17-20
c. 50-55
d. 68-72
Answer: D
The length of time needed for the sperm cells to develop is 68-72 days.
13. Matt and Monica have been trying to get pregnant for two years. No wonder it is so
difficult! They just found out that the average couple is fertile for only about ________ each
a. 1 day
b. 6-7 days
c. 11 days
d. 14 days
Answer: B
The average couple is fertile for approximately six to seven days each month.
14. At the time a fertilized ovum enters the uterus, it is called a(n) ________.
a. follicle
b. seed cell
c. zygote
d. oocyte

Answer: C
The zygote is a fertilized ovum moving down the fallopian tubes to the uterus.
15. Immediately upon fertilization, a hormone called ________ begins to be released;
pregnancy tests measure the level of this hormone in a woman’s urine to determine
a. estrogen
b. hCG
c. testosterone
d. progestin
Answer: B
HCG is the hormone produced by the body when a woman is pregnant.
16. What is the correct sequence of events that follow fertilization of an egg?
a. zygote, blastocyst, embryo, fetus
b. blastocyst, embryo, zygote, fetus
c. embryo, blastocyst, zygote, fetus
d. zygote, embryo, fetus, blastocyst
Answer: A
The fertilized egg begins as a zygote, then becomes a blastocyst; once implantation occurs it
is referred to as an embryo.
17. At the end of the eight weeks following implantation, the embryo becomes known as a(n)
a. morula
b. blastula
c. ovum
d. fetus
Answer: D
The term fetus is used to describe an embryo after eight weeks of pregnancy.

18. Carrie was distraught when she miscarried, but found herself even more upset when her
doctor told her that another name for a miscarriage is ________.
a. embryonic detachment
b. uterine failure
c. spontaneous abortion
d. early contractions
Answer: C
Spontaneous abortion is another term for miscarriage.
19. The term quickening refers to when ________.
a. a mother begins to feel fetal movement
b. the fetus begins to have a detectable heart beat
c. the major organ systems in the fetus have developed
d. the fetus develops discernable sex characteristics
Answer: A
The first movement of the fetus that is felt by the mother is called quickening.
20. Another name for ectopic pregnancies is ________, because they often occur there.
a. ovarian pregnancies
b. embryotic pregnancies
c. tubal pregnancies
d. cervical pregnancies
Answer: C
A pregnancy complication in which a fertilized ovum attaches and begins to grow outside the
uterus, most commonly in the fallopian tube.
21. The most common cause of miscarriage involves ________.
a. one or more serious genetic fetal abnormalities
b. having an older father and younger mother
c. physical activity
d. eating certain foods

Answer: A
It is believed that the spontaneously aborted embryo would probably not have survived
beyond the first trimester due to serious genetic fetal abnormalities.
22. Sexual intercourse during pregnancy ________.
a. is usually safe only in the later months
b. should be avoided throughout the pregnancy
c. increases the risk of preterm labor
d. poses no risk to the developing fetus or to the mother
Answer: D
Although a popular belief, no research supports the notion that sexual activity during
pregnancy increases risk of miscarriage.
23. Any substance ingested by a pregnant woman that can cause a fetal abnormality is called
a ________.
a. tetrad
b. colostrum
c. gamete
d. teratogen
Answer: D
Any agent that has the potential to cause a fetal abnormality is called a teratogen.
24. ________ involves the insertion of a small tube through the cervix and into the uterus to
obtain a placental tissue sample.
a. Amniocentesis
b. Ultrasound
c. Chorionic villus sampling
d. Laparoscopy
Answer: C

CVS is a test that requires extraction of a sample of tissue that can be used to diagnose many
genetic abnormalities.
25. Approximately ________ legal abortions occur in the United States each year.
a. 100,000
b. 250,000
c. 1 million
d. 2.5 million
Answer: C
Slightly more than one million legal abortions occur in the United States each year.
26. Nearly ________ of all surgical abortion in the United States occur within the first
trimester of pregnancy.
a. 45%
b. 60%
c. 75%
d. 90%
Answer: C
Nearly 90% of all surgical abortion in the U.S. occurs within the first trimester.
27. The abortion procedure used in the second trimester is called ________.
a. hysterotomy
b. vacuum aspiration
c. dilation and evacuation
d. medications such as RU-486
Answer: C
Dilations and extraction is a method of abortion commonly used when a pregnancy has
progressed beyond the first trimester, involving scraping of the uterine walls and suctioning
out of the contents.
28. Myriam chose to have a medical abortion, which means a(n) ________.
a. abortion performed for medical reasons
b. late-term abortion method

c. drug or drugs administered to terminate a pregnancy
d. drug or drugs administered to prevent complications during surgical abortion
Answer: C
Medical abortion relies on specifically targeted drugs to terminate a pregnancy rather than
surgical procedures.
29. All of the following are true about legal abortions, except that they ________.
a. are considered safe
b. are less risky than pregnancy and birth
c. have little effect on a woman’s future ability to become pregnant
d. lead to depression in most women
Answer: D
Research has found that abortion is safe, less risky than pregnancy and birth, and has little
effect on a woman’s future ability to become pregnant.
30. If Cindy is like most women, she will experience ________ after the termination of an
unwanted pregnancy
a. no mental health problems
b. serious regret
c. lifetime guilt
d. elation
Answer: A
There is no scientific evidence to support the idea that the termination of an unwanted
pregnancy leads to mental health problems in women.
31. The U.S. Supreme Court case in 1973 that legalized abortion was ________.
a. Marbury v. Madison
b. Roe v. Wade
c. Buckley v. Valeo
d. Planned Parenthood v. Texas
Answer: B

The famous U.S. Supreme Court decision in Roe v. Wade legalized abortion in 1973.
32. This chemical is linked to the beginning of childbirth and is thought to signal the uterus to
begin contractions:
a. human chorionic gonadotropin
b. estradiol
c. corticotrophin-releasing hormone
d. follicle stimulating hormone
Answer: C
Corticotrophin-releasing hormone is linked to the beginning of childbirth and signaling the
uterus to begin contractions.
33. Sybil is clearly in stage one labor. Her midwife knows this because it is characterized by
a. dilation of the cervix
b. bleeding
c. desire to push
d. delivery of the placenta
Answer: A
The first stage of the birth process, stage one labor, involves the beginning of contractions of
the uterus.
34. Although Molly’s first baby was born head-first, in her second delivery, her baby was
born feet- or bottom-first. This is called ________.
a. stillbirth
b. backward birth
c. breech birth
d. cesarean birth
Answer: C
In a breech birth, the infant presents itself for birth in positions other than head-first, such as
35. A woman would be in second stage labor when ________.

a. the amniotic sac bursts
b. the cervix begins to dilate
c. she begins to experience Braxton Hicks contractions
d. contractions involve the muscles of the abdomen as well as the uterus
Answer: D
In stage two labor contractions occur closer together, involve the muscles of the abdomen as
well as the uterus, and continue until the infant has been expelled.
36. An episiotomy is a surgical incision in a woman’s ________.
a. cervix
b. vagina
c. perineum
d. uterus
Answer: C
In the past, doctors routinely performed an episiotomy, the surgical cutting of the perineum,
presumed to expand the passageway for delivery.
37. When Patrick was born, the doctor performed a widely used assessment on him
immediately after he was delivered called the ________.
a. APGAR score
b. SAT
c. Fetal Response score
d. hCG score
Answer: A
The APGAR score is a test that analyzes infant health at birth on the basis of skin color,
pulse, reflexes, movement, and breathing.
38. In stage three labor, the ________ is expelled from the uterus with the umbilical cord
a. cervix
b. baby
c. placenta

d. amnion
Answer: C
The final stage of the birth process, stage three labor, is when the placenta is expelled form
the uterus.
39. ________ are hospital-like facilities with basic medical care equipment, that feature a
home-like setting and have, as their primary focus, a natural, family- centered approach to the
birth process.
a. Maternity wards
b. Birthing centers
c. Health centers
d. Home birth wards
Answer: B
Birthing centers have grown in number and popularity throughout the United States, offering
an alternative to a hospital setting.
40. Marsha attended Lamaze classes during her first pregnancy. The Lamaze method teaches
women preparing for childbirth ________.
a. special breathing exercises and relaxation techniques
b. not to use a physician
c. how to deliver the baby by yourself
d. not to use any drugs at all
Answer: A
Lamaze is a way for women to give birth not only fully conscious but also, if they choose,
with no drugs, using special breathing exercises, visualizations, massage, focused attention,
and relaxation training, along with the help of a “coach.”
41. The most common pain relief medications in use today are ________.
a. sedatives
b. local anesthesia
c. regional anesthesia
d. all of the above
Answer: D

The most common pain medications in use today are sedatives, local anesthesia, regional
anesthesia, and the epidural.
42. Kathryn is among the ________ of pregnant women who elect to have a C-section, even
though it is determined NOT to be medically necessary.
a. 10%
b. 25%
c. 50%
d. 75%
Answer: B
Nearly one quarter of C-sections are not medically necessary, but are voluntarily chosen by
the pregnant woman.
43. All of the following are true about postpartum depression except that it ________.
a. is a clearly defined psychological disorder
b. involves many of the symptoms of other forms of depression
c. typically involves a troubling lack of interest in the new baby
d. is brought on about ambivalence about the new baby
Answer: D
Postpartum depression is a defined psychological disorder involving many of the symptoms
of other forms of depression.
44. Most doctors and midwives recommend waiting at least ________ after birth to have
a. 6 days
b. until she is through breastfeeding
c. 6 weeks
d. until their child is in school
Answer: C
For heterosexual couples, most doctors and midwives recommend waiting at least six weeks
after birth to have sexual intercourse in order to allow adequate time for the woman to heal
and for the cervix to close fully.

45. Infertility problems affect about ________ couples of reproductive age.
a. 2%
b. 4%
c. 10%
d. 37%
Answer: C
In the U.S., the number of couples who meet the definition of infertility is estimated to be
10%, which works out to approximately five million couples.
46. Infertility is due to a male sperm factor (e.g., low number, poor quality, or low mobility)
________ of the time.
a. 10%
b. 25%
c. 40%
d. 65%
Answer: B
Male sperm factor is the cause of infertility in 25% of cases.
47. About 20% of infertility is due to ________in women.
a. ovarian problems
b. blocked Fallopian tubes
c. tilted uterus
d. none of the above
Answer: A
Ovarian problems in women contribute to 20% of infertility.
48. The problem of infertility related to sperm cells may include all of the following except
a. too few sperm cells are ejaculated
b. if the sperm cells cannot swim well enough to move up into the fallopian tubes
c. if they lack the enzymes required to penetrate the ovum

d. poor sleeping habits
Answer: D
The typical problems with sperm cells include too few sperm cells, the sperm cannot swim
well enough, and they lack enzymes needed to penetrate the ovum.
49. Increasing age is associated with ________ fertility, especially in women.
a. increasing
b. decreasing
c. longer
d. higher
Answer: B
Increasing age is associated with decreasing fertility, especially in women.
50. Which fertility testing method would require the use of an X-ray?
a. semen analysis
b. post-coital exam
c. hysterosalpingogram
d. endometrial biopsy
Answer: C
Hysterosalpingogram (HSG) is an X-ray that allows the doctor to view the interior of the
uterus and fallopian tubes to check for malformations or blockages.
51. Sandra had been struggling with infertility. Her doctor recommended she have a(n)
________, which would allow her doctor to have a direct, internal look at the ovaries,
fallopian tubes, and uterus.
a. endometrial biopsy
b. hysterosalpingogram
c. IVF
d. laparoscopy
Answer: D

Laparoscopy is a surgical procedure in which a tube with a tiny camera and light is inserted
through a small incision in the abdomen.
52. In an attempt to get pregnant, Jasmine had a procedure that involved inserting a small
tube through her cervix and injecting sperm directly into her uterus. This reproductive
technology is known as ________.
a. IUI
b. IVF
d. Clomid
Answer: A
Intrauterine insemination, or IUI, introduces sperm cells directly into the uterus, thereby
placing them closer to the fallopian tubes and enhancing the odds of conception.
53. Barry and Barbara confide to their family members that their baby is a “test tube baby,”
which means that ________.
a. its embryonic and fetal development occurred in a test tube
b. it was fertilized outside its mother’s body
c. its embryonic development occurred outside its mother’s body
d. it was conceived with artificial eggs and sperm
Answer: B
In IVF, also referred to as “test tube babies,” the egg is fertilized with sperm in a petri dish in
the lab and then placed into the women’s uterus.
54. In an effort to become pregnant after many years of trying, more and more couples are
turning to ________, which involves the removal of mature eggs from a female’s ovary and
fertilizing them with sperm in a laboratory before surgically implanting them in the woman’s
a. gamete intrafallopian transfer (GIFT)
b. embryo transplant
c. zygote intrafallopian transfer (ZIFT)
d. in vitro fertilization (IVF)
Answer: D

In IVF, also referred to as “test tube babies,” the egg is fertilized with sperm in a petri dish in
the lab and then placed into the women’s uterus.
55. ________ involves the placement of a mixture of egg and sperm directly into the
fallopian tube.
a. Gamete intrafallopian transfer (GIFT)
b. Embryo transplant
c. Zygote intrafallopian transfer (ZIFT)
d. In vitro fertilization (IVF)
Answer: A
GIFT is nearly the same as IVF, except fertilization occurs naturally in the fallopian tubes.
56. ________ involves the fertilization of eggs by sperm, in vitro, with the fertilized eggs
being transferred back to the female’s fallopian tube.
a. Gamete intrafallopian transfer (GIFT)
b. Embryo transplant
c. Zygote intrafallopian transfer (ZIFT)
d. In vitro fertilization (IVF)
Answer: C
ZIFT combines IVF and GIFT.
57. In ________ a single sperm cell from the man is injected using a microscopic needle,
directly into each harvested egg from the woman. The resulting zygote is then transferred
after a few days into the woman’s uterus.
a. IVF
Answer: D
ICSI was developed to assist couples when the man’s sperm production is very low, the cells
have poor shape or mobility, or some other problem exists with his sperm or semen that
makes the other ART methods ineffective.
58. Louise Brown is best known as the ________.

a. first test tube baby
b. doctor who invented IVF
c. first woman to use IVF to get pregnant
d. woman who legalized ART
Answer: A
Louise Brown is the first in vitro fertilization (“test-tube”) baby, born in 1978.
59. The combined pregnancy rate for all ART methods is approaching ________ for women
under the age of 35.
a. 10%
b. 25%
c. 50%
d. 75%
Answer: C
About half of women under 35 years old using ART become pregnant.
60. According to the text, when considering adoption, it is important to consider all of the
following except ________.
a. cost
b. whether you prefer a child from your home country or from a foreign country
c. if you need to have a child with your genes
d. the child’s IQ
Answer: D
There are many factors to consider with adoption, including cost, if you prefer a child from
your home country, and if you need a child with your genes.
1. Acceptance of the use of chloroform for childbirth grew rapidly when Queen Victoria
demanded and received chloroform during the birth of her eighth child in 1853.
Answer: True

Queen Victoria's use of chloroform during childbirth in 1853 is historically documented. Her
endorsement of anesthesia during labor helped to popularize its use in obstetrics, leading to
greater acceptance and adoption of pain relief methods during childbirth.
2. Among women of childbearing age in the U.S., over 4 million define themselves as
“voluntarily childless.”
Answer: True
The term "voluntarily childless" refers to individuals, typically women, who have chosen not
to have children despite being of childbearing age. As of the latest statistics available, over 4
million women in the United States self-identify as voluntarily childless, indicating a
significant portion of the population has made this decision for various personal, social,
economic, or environmental reasons.
3. Most women will have approximately 35 to 40 fertile years between menarche and
Answer: True
Menarche marks the onset of menstruation, typically occurring during adolescence, while
menopause represents the cessation of menstruation, usually in middle age. The average age
of menarche is around 12 to 13 years old, and menopause typically occurs around age 45 to
55. Therefore, most women will have approximately 35 to 40 years of reproductive potential
between menarche and menopause.
4. When the ovum is in the uterus, the woman is “officially” fertile.
Answer: False
Fertility refers to the ability to conceive or become pregnant, which is not solely determined
by the presence of an ovum in the uterus. Fertility is influenced by various factors, including
the menstrual cycle, ovulation, sperm viability, and the timing of sexual intercourse relative
to ovulation. While the presence of an ovum in the uterus during ovulation increases the
likelihood of conception, fertility extends beyond this specific moment in the reproductive
5. In health class, Greg learns about sperm production, including the fact that sperm cells are
produced in the testicles.
Answer: True
Sperm production, known as spermatogenesis, occurs within the testes (testicles) of the male
reproductive system. Sperm cells are generated through a process of cellular division and
differentiation within structures called seminiferous tubules, located within the testes. After

maturation, sperm cells are stored in the epididymis before being ejaculated during sexual
6. On average, somewhere between 400,000 and 500,000 sperm cells may be contained in a
single ejaculation.
Answer: False
The average volume of semen ejaculated during a single ejaculation typically contains
millions of sperm cells. Estimates vary, but it's generally believed that an average ejaculate
may contain anywhere from 40 million to 600 million sperm cells, with variations based on
individual factors such as age, health, and fertility.
7. Sue wonders if she will ever get pregnant. Her odds of getting pregnant are 1 in 5 from a
single act of intercourse.
Answer: False
The likelihood of pregnancy from a single act of unprotected intercourse varies depending on
factors such as timing relative to ovulation, fertility of both partners, and the effectiveness of
contraception (if used). While the chances of pregnancy from a single act of intercourse are
not guaranteed, they are generally higher than 1 in 5, especially if intercourse occurs during
the woman's fertile window, which is typically around the time of ovulation.
8. Immediately after the first sperm successfully penetrates the ovum’s outer membrane,
biochemical changes are triggered in the ovum creating a barrier that effectively blocks any
other sperm cell from entering.
Answer: True
After the first sperm successfully penetrates the ovum's outer membrane (a process known as
fertilization), biochemical changes occur within the ovum to create a barrier, preventing
additional sperm cells from entering. This process, called the zona reaction or zona pellucida
reaction, ensures that only one sperm cell fertilizes the ovum, preventing polyspermy
(fertilization by multiple sperm cells), which could result in genetic abnormalities.
9. The third trimester of pregnancy is marked by an increase in the rate of growth of the fetus.
Answer: True
The third trimester of pregnancy, which spans from weeks 28 to 40, is characterized by rapid
fetal growth and development. During this period, the fetus undergoes significant increases in
size, weight, and organ maturation in preparation for birth. The third trimester is a critical
phase of pregnancy when the fetus reaches viability (the ability to survive outside the womb)
and continues to mature in preparation for delivery.

10. “Silent miscarriages” occur so early in the pregnancy that the woman is unaware that she
is pregnant.
Answer: True
A silent miscarriage, also known as a missed miscarriage or missed abortion, occurs when a
woman experiences a miscarriage but does not have any noticeable symptoms or signs of
pregnancy loss. In some cases, the fetus may stop developing or die very early in pregnancy,
often before the woman is aware of her pregnancy. As a result, she may not experience
typical miscarriage symptoms such as bleeding or cramping, leading to the term "silent"
miscarriage. These miscarriages are usually detected during routine prenatal screenings or
ultrasound examinations.
11. Mora is reviewing the research on the various risks associated with sexual and
reproductive issues. According to the research, the risks to the health and life of the mother
from surgical abortion are significantly higher than the risks of pregnancy and giving birth.
Answer: False
Research generally shows that the risks associated with surgical abortion are lower than those
associated with pregnancy and childbirth. Complications from abortion procedures are rare,
especially when performed by qualified healthcare providers in a safe and regulated
environment. Conversely, pregnancy and childbirth carry inherent risks to the health and life
of the mother, including complications such as hemorrhage, infection, and hypertensive
12. Yolanda is terminating her pregnancy through a medical abortion because this method
involves using drugs that can be taken entirely at home. She will not have to see a doctor.
Answer: False
While medical abortion involves the use of drugs (typically mifepristone and misoprostol) to
terminate a pregnancy, it is not entirely conducted at home without medical supervision.
Medical abortion usually requires initial assessment and counseling by a healthcare provider,
who prescribes the medications and provides instructions for their use. Additionally, followup care, including confirming the completion of the abortion and monitoring for
complications, often involves visits to a healthcare facility or communication with a
healthcare provider.
13. Abortion is not related to a higher incidence of any type of cancer.
Answer: True
Numerous scientific studies and medical organizations, including the American Cancer
Society and the World Health Organization, have found no causal relationship between

induced abortion and an increased risk of any type of cancer. This conclusion is supported by
extensive research conducted over several decades, which has consistently failed to establish
a link between abortion and cancer incidence.
14. A review of available research concluded that there is no scientific evidence to support the
idea that the termination of an unwanted pregnancy leads to mental health problems in
Answer: True
Research findings regarding the association between abortion and mental health outcomes
have been mixed, but a significant body of evidence suggests that the termination of an
unwanted pregnancy does not lead to adverse mental health consequences for the majority of
women. Numerous systematic reviews and meta-analyses, which synthesize data from
multiple studies, have failed to find conclusive evidence supporting a causal link between
abortion and subsequent mental health problems.
15. The number of abortions in the United States has been increasing steadily due to easier
access to birth control.
Answer: False
The trend in the number of abortions in the United States is not solely attributed to access to
birth control. Multiple factors influence abortion rates, including changes in social attitudes
toward abortion, shifts in healthcare policies and regulations, availability of reproductive
healthcare services, economic factors, and demographic trends. While access to effective
contraception can contribute to reducing unintended pregnancies and abortions, it is only one
aspect of a complex set of factors affecting abortion rates.
16. When the baby’s head is said to “crown,” this means it is visible at the vaginal opening.
Answer: True
"Crowning" refers to the stage of childbirth when the widest part of the baby's head becomes
visible at the vaginal opening during labor. This typically occurs during the second stage of
labor, just before the baby is born. Crowning marks a significant milestone in the birthing
process, indicating that the baby is moving through the birth canal and nearing delivery.
17. In response to the demand for more personalized, parent-controlled childbirth,
freestanding birthing centers are growing in number and popularity.
Answer: True
Freestanding birthing centers, which offer alternative settings for childbirth outside of
traditional hospital maternity wards, have grown in number and popularity in response to the
demand for more personalized, family-centered maternity care. These centers often provide a

homelike environment, emphasizing natural childbirth practices, comfort measures, and
parental involvement in decision-making. Freestanding birthing centers may appeal to
individuals seeking a less medicalized approach to childbirth and greater autonomy in their
birth experiences.
18. Lamaze, who developed the childbirth preparedness method, took a stand against pain
medication and believed in “all-natural” childbirth.
Answer: False
Lamaze, a French obstetrician, did not take a stand against pain medication or advocate for
"all-natural" childbirth exclusively. Lamaze is best known for developing a childbirth
education method aimed at preparing expectant mothers for childbirth through relaxation
techniques, breathing exercises, and psychological conditioning. While Lamaze emphasized
the importance of natural coping mechanisms and reducing unnecessary medical
interventions during childbirth, he did not categorically oppose the use of pain medication or
medical interventions when warranted.
19. In the U.S. and many other industrialized nations, the number of C-section births has been
steadily rising, but the number of natural childbirth complications has not.
Answer: True
The rate of cesarean section (C-section) births has increased in the United States and many
other industrialized nations over recent decades, influenced by factors such as changes in
obstetric practices, maternal age, medical indications, and patient preferences. However, the
overall incidence of complications associated with natural childbirth (vaginal delivery) has
not necessarily increased in tandem with the rising C-section rate. Complications of natural
childbirth can vary depending on numerous factors, including maternal health, prenatal care,
labor management, and the presence of medical risk factors.
20. Anne is weighing the risks of having a C-section with the risks associated with a vaginal
birth. The risks of a C-section delivery for a normal birth are greater than those of a vaginal
Answer: True
While cesarean section (C-section) deliveries can
21. Overall, the risks of vaginal delivery are greater than those of a C-section.
Answer: False
While both vaginal delivery and cesarean section (C-section) carry risks, the comparative
risks vary depending on individual circumstances, medical indications, and other factors. In
general, vaginal delivery is associated with lower risks of certain complications such as

infection, blood loss, and surgical complications compared to C-section. However, vaginal
delivery also carries risks such as perineal tearing and pelvic floor dysfunction. C-sections
may be associated with risks such as surgical complications, increased recovery time, and
potential complications in future pregnancies. The decision between vaginal delivery and Csection should be made based on individual medical considerations and preferences, and
neither method can be universally considered "safer" overall.
22. Although the chances of pregnancy during lactation (breastfeeding) may be reduced, it is
far from a sure method of contraception.
Answer: True
While lactational amenorrhea (absence of menstruation due to breastfeeding) can suppress
ovulation and reduce the likelihood of pregnancy, it is not a foolproof method of
contraception. The effectiveness of breastfeeding as a contraceptive method depends on
several factors, including the frequency and intensity of breastfeeding, the age of the infant,
and the mother's individual physiology. Lactational amenorrhea method (LAM) is most
effective when specific criteria are met, including exclusive breastfeeding, frequent
breastfeeding day and night, and no return of menstrual periods. However, there is still a risk
of ovulation and pregnancy, particularly as breastfeeding patterns change over time.
23. Bonnie is now 42 years old and feels it is hopeless to try to get pregnant now. Although
increasing age is associated with decreasing fertility, approximately 45% of women over 40
who wish to become pregnant eventually do so.
Answer: True
While fertility declines with age, especially after age 35, it is still possible for women in their
40s to conceive and carry a pregnancy to term. Although the chances of conceiving naturally
decrease with advancing age due to factors such as decreased ovarian reserve and egg quality,
many women over 40 are able to achieve pregnancy with medical assistance such as assisted
reproductive technologies (ART) or fertility treatments. Approximately 45% of women over
40 who actively seek pregnancy eventually succeed, highlighting the possibility of
conception even in later reproductive years.
24. A man’s age significantly affects fertility.
Answer: False
While advanced paternal age can have some impact on fertility and reproductive outcomes, it
generally has less pronounced effects compared to maternal age. Advanced maternal age is a
well-established factor associated with decreased fertility, increased risk of miscarriage, and
higher rates of chromosomal abnormalities in offspring. However, research on the effects of
paternal age on fertility and pregnancy outcomes is less consistent. Advanced paternal age
may be associated with slightly decreased sperm quality and increased risk of certain genetic

conditions in offspring, but the effects are generally less significant compared to maternal
age-related decline in fertility.
25. For optimum fertility, a man should abstain from ejaculation and “save up” his semen for
a few days to increase the number of sperm cells in his ejaculate.
Answer: False
Contrary to the popular misconception that abstaining from ejaculation increases sperm count
and fertility, regular ejaculation is actually beneficial for sperm health and fertility. Frequent
ejaculation helps to maintain sperm quality by preventing the accumulation of old, damaged
sperm cells in the reproductive tract and promoting the production of fresh, motile sperm.
Extended periods of abstinence can lead to decreased sperm motility and viability, potentially
reducing fertility. Therefore, for optimum fertility, men are advised to engage in regular
sexual activity or ejaculation, rather than prolonged periods of abstinence.
26. Both frequency of intercourse and timing of intercourse can impact fertility.
Answer: True
Both the frequency and timing of intercourse can influence fertility by optimizing the chances
of conception. Frequent intercourse, especially during the woman's fertile window (the days
leading up to and including ovulation), increases the likelihood of sperm reaching and
fertilizing the egg. Timing intercourse to coincide with ovulation, when the woman is most
fertile, maximizes the chances of conception. Various methods, such as tracking menstrual
cycles, monitoring basal body temperature, and using ovulation predictor kits, can help
couples identify the most fertile days for intercourse.
27. Fertility drugs such as clomiphene citrate have been designed to stimulate ovulation in
Answer: True
Fertility drugs such as clomiphene citrate (Clomid) are commonly used to induce ovulation in
women with ovulatory disorders or irregular menstrual cycles. Clomiphene citrate works by
blocking estrogen receptors in the hypothalamus, leading to increased secretion of folliclestimulating hormone (FSH) and luteinizing hormone (LH). This hormonal stimulation
promotes the growth and maturation of ovarian follicles, ultimately triggering ovulation.
Fertility drugs like clomiphene citrate are often prescribed as a first-line treatment for
ovulatory disorders and are commonly used in conjunction with timed intercourse or assisted
reproductive technologies (ART) such as intrauterine insemination (IUI).
28. Most health insurance covers ART.
Answer: False

While some health insurance plans may provide partial coverage or reimbursement for certain
aspects of assisted reproductive technologies (ART), such as diagnostic testing or
consultation fees, coverage for ART procedures themselves (such as in vitro fertilization, or
IVF) varies widely and is often limited or excluded from standard health insurance plans.
ART procedures can be expensive, involving multiple medical visits, diagnostic tests,
medications, and invasive interventions, making them financially burdensome for many
individuals or couples. Some insurance plans offer separate fertility treatment coverage as an
optional add-on or require patients to purchase specialized fertility coverage for additional
29. Rachel’s fallopian tubes are blocked. Her doctor suggests she consider IVF because this
procedure is typically used when a woman’s fallopian tubes are blocked or missing.
Answer: True
In vitro fertilization (IVF) is a common treatment option for infertility caused by tubal
factors, such as blocked or damaged fallopian tubes. IVF involves retrieving eggs from the
woman's ovaries, fertilizing them with sperm in a laboratory setting, and transferring the
resulting embryos into the woman's uterus for implantation. By bypassing the fallopian tubes,
IVF enables fertilization to occur outside the body, making it an effective treatment
30. ZIFT combines IVF and GIFT.
Answer: True
ZIFT, or Zygote Intrafallopian Transfer, indeed combines elements of both IVF (In Vitro
Fertilization) and GIFT (Gamete Intrafallopian Transfer). In ZIFT, fertilization of the egg by
sperm occurs outside the woman's body, similar to IVF. However, unlike IVF where the
fertilized embryos are transferred into the uterus, in ZIFT, the fertilized eggs (zygotes) are
transferred directly into the fallopian tubes. This method allows the zygotes to travel
naturally into the uterus for implantation. Thus, ZIFT combines aspects of both IVF and GIFT
procedures, making the statement true.

1. In the ________, the pituitary gland at the base of the brain begins to secrete FSH that
enhances the follicle growth and ovum development.
Answer: follicular phase
The follicular phase is the first phase of the menstrual cycle during which the pituitary gland
releases follicle-stimulating hormone (FSH), which stimulates the growth and development
of follicles in the ovaries, leading to ovum maturation.
2. Fertilization usually takes place in the upper region of the ________.
Answer: fallopian tube

The fallopian tubes are the structures through which the mature egg travels from the ovary to
the uterus. Fertilization typically occurs in the upper third of the fallopian tube after sexual
3. The ovum is capable of being fertilized for only ________.
Answer: 12-18 hours
After ovulation, the egg (ovum) is viable for fertilization for about 12 to 18 hours. If
fertilization does not occur within this time frame, the egg will disintegrate.
4. Pregnancy is a two-stage process: ________ and ________.
Answer: conception; implantation
Pregnancy begins with conception, which is the fusion of sperm and egg to form a zygote.
Following conception, the zygote implants itself into the lining of the uterus in a process
called implantation, initiating pregnancy.
5. ________occurs when a fertilized egg implants somewhere in the woman’s body other
than the uterus, most often in one of the fallopian tubes.
Answer: Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, commonly
in one of the fallopian tubes. This condition is dangerous and requires medical intervention.
6. Preterm birth, also known as ________, is the birth of a fetus well before the nine-month
pregnancy period is complete.
Answer: premature birth
Preterm birth, or premature birth, refers to the delivery of a baby before completing the full
37 to 40 weeks of gestation. This can lead to various health complications for the newborn.
7. Nearly ________ percent of all surgical abortions in the United States occur within the first
trimester of pregnancy.
Answer: ninety
Approximately 90% of surgical abortions in the United States are performed within the first
trimester of pregnancy, typically before the 12th week.
8. ________ is a method of abortion used early in the pregnancy in which a small tube is
inserted through the cervix to extract the contents of the uterus.

Answer: Vacuum aspiration
Vacuum aspiration, also known as suction aspiration, is a common method of abortion used in
the first trimester. It involves the insertion of a small tube through the cervix into the uterus to
remove the contents, including the embryo or fetus.
9. A ________ is usually a woman who has been trained in most aspects of pregnancy, labor,
and delivery but is not a physician or registered nurse.
Answer: midwife
A midwife is a healthcare professional, typically a woman, who is trained to provide care
during pregnancy, childbirth, and the postpartum period. While midwives are highly skilled in
managing normal pregnancies and deliveries, they are not usually physicians or registered
10. The __________ is currently the most popular regional anesthesia method, in which pain
relieving medication is delivered “as needed” through a small tube inserted near the base of
the spine.
Answer: epidural
An epidural is a form of regional anesthesia commonly used during childbirth to provide pain
relief. It involves the insertion of a catheter into the epidural space near the spinal cord,
through which pain-relieving medication can be administered continuously or as needed.
11. A severe form of postpartum depression called ________ may be characterized by
delusions, hallucinations, and extreme mental disorganization, leading to extreme, and often
violent, behaviors.
Answer: postpartum psychosis
Postpartum psychosis is a rare but severe mental health condition that can occur after
childbirth. It is characterized by symptoms such as delusions, hallucinations, extreme mood
swings, and confusion, often leading to dangerous behaviors.
12. Donna and Dave would qualify as a couple experiencing ________ because of their lack
of conception over 12 consecutive months of regular unprotected sex.
Answer: infertility
Infertility is defined as the inability to conceive after 12 months of regular unprotected sexual
intercourse. Donna and Dave's situation fits this definition, indicating a potential fertility

13. Damaged or blocked fallopian tubes are most commonly the result of ________ or
Answer: pelvic inflammatory disease; endometriosis
Pelvic inflammatory disease (PID) and endometriosis are two common causes of damage or
blockage in the fallopian tubes. PID is often caused by sexually transmitted infections, while
endometriosis involves the growth of endometrial tissue outside the uterus, which can affect
the fallopian tubes.
14. ________ is the technique commonly known as the one that produces “test tube babies.”
Answer: In vitro fertilization
In vitro fertilization (IVF) is a reproductive technology commonly known as the process of
creating "test tube babies." It involves fertilizing an egg with sperm outside the body in a
laboratory dish, followed by the transfer of the resulting embryo(s) into the uterus.
15. __________ was developed to assist a couple when the man’s sperm production is either
very low, the cells have poor shape or mobility, or some other problem exists with his sperm
or semen that makes other ART methods ineffective.
Answer: ICSI
Intracytoplasmic sperm injection (ICSI) is a specialized form of in vitro fertilization (IVF)
used to treat male infertility issues. It involves the injection of a single sperm directly into the
egg to facilitate fertilization when sperm quality or quantity is a concern.
1. Describe the journey of the sperm and egg from ejaculation and ovulation to conception,
and then discuss the events that occur from conception to implantation.
Sample response:
The egg that was released from the ovary is drawn up into the fallopian tube. One sperm cell
from the ejaculate must meet and penetrate the egg. Once conception has taken place, this
new organism is called a zygote. Over the course of two to four days, it divides and moves
down the fallopian tube to the uterus. By the time it arrives in the uterus, it consists of about
90 cells. It is now called a blastocyst. On the sixth or seventh day after fertilization, it
implants in the wall of the uterus. The successful attachment is the beginning of pregnancy.
Once implantation occurs, the blastocyst is referred to as an embryo.
2. Discuss the fetal development through the three trimesters of pregnancy.
Sample response:
First trimester

• Month 1. The embryo resembles a tadpole or tiny shrimp; the buds of arms and legs begin
to appear; the heart begins to beat; the embryo is about the size of the eraser on a pencil and
weighs less than 1 ounce.
• Month 2. The embryo grows to about 1 inch long; distinct fingers and toes appear; the heart
muscle has divided into chambers; facial features are visible; the placenta is functioning,
bringing nutrients to the embryo and carrying wastes away; the embryo takes on a more
human appearance.
• Month 3. The embryo, now called a fetus, grows to about 3 inches in length; fingers and
toes have nails; the fetus begins to move in the uterus, but movements cannot usually be felt
by the mother; all vital organs and muscles are formed and functioning by the tenth week.
The fetus now weighs about 1.2 ounces (the equivalent of a dozen U.S. pennies).
Second trimester
• Month 4. Fetal movement increases and includes kicking, sucking, and swallowing; about
20 tooth buds develop; fingers and toes are more clearly defined; the sex of the fetus may
now be determined by observing the growth of the genitals with ultrasound. The fetus grows
to 6 or 7 inches long and now weighs around 6 or 7 ounces.
• Month 5. Fetal activity increases further and may even include rolls, flips, and somersaults;
the fetus enters a predictable waking–sleeping cycle; the mother will feel frequent
unmistakable movements of the fetus; fetal eyelashes and eyelids appear; growth accelerates
to 8 to 10 inches long: and weight increases to nearly a pound by the end of the fifth month.
• Month 6. Fetal skin is red and wrinkled and covered with a protective coating called the
vernix; the eyes open and close; the fetus’s lungs are “breathing” the amniotic fluid in and
out; the fetus is capable of hearing sounds from the outside world; rapid growth continues as
the fetus reaches 11 to 14 inches in length and 1.5 to 2 pounds. If born in this month, the
baby, though very premature, will have a good chance of survival with specialized intensive
Third trimester
• Month 7. The fetus’s taste buds have developed, and it may be observed sucking its thumb;
muscle tone develops through kicking and stretching; clear responses to external sounds may
be observed; layers of fat are forming beneath the skin; internal organs are maturing quickly.
If born prematurely at this time, the baby has a high chance of survival and a normal life with
proper medical care. The fetus reaches 14 to 16 inches long and about 3 pounds by the end of
the seventh month.
• Month 8. The fetus rotates to head-down position; the brain grows quickly; overall growth
is now at a rate of a half pound per week; the fetus’s kicks and elbow thrusts now become
visible from the outside surface of the mother’s abdomen; the fetus’s internal organs, except
for the lungs, are nearly fully developed; the skull bones are flexible and not yet connected to
allow them to compress for passage through the birth canal; size is approximately 18 inches
long, and weight is 4 to 6 pounds at the end of this month.
• Month 9. The fetal lungs develop fully and are ready to breathe air; the skin typically
becomes pink and smooth; the fetus now turns and settles head down, low in the mother’s

uterus, in preparation for birth; activity decreases, producing fewer noticeable movements; on
average the fetus reaches 18 to 22 inches in length and 6 to 9 pounds as the onset of labor
3. What are the stages of labor and how do they progress?
Sample response:
At the onset of labor, called stage one labor, contractions begin as the cells of the uterus, now
the largest muscle in the mother’s body, contract in sequence along its length, pulling and
straightening the uterus and pushing the fetus down toward the cervix. At this point, the
cervical canal is beginning to dilate (become larger in diameter) and efface (become thinner).
During the beginning of stage one labor, the cervix is about 1 to 2 inches dilated and as stage
one labor continues it will continue to dilate to approximately 10 centimeters or about 4
Stage two labor leads to the birth of the baby. Contractions begin to involve the muscles of
the abdomen as well as the uterus itself. The mother has somewhat more control over these
contractions, and many women report that this sense of control seems to reduce the amount of
pain they perceive. At this point, the woman will feel a great deal of abdominal pressure as
her body is working to deliver her baby.
In stage three labor, within a few minutes following the completed birth of the infant, the
placenta (which has joined the fetus and mother throughout pregnancy) is expelled from the
uterus with the umbilical cord attached.
4. Describe the status of C-sections today, and discuss possible reasons why there are so
many C-sections.
Sample response:
In the United States and many other industrialized countries, the number of C-section births
has been steadily rising over the past ten years or so, but the number of natural childbirth
complications has not. In 2009, the U.S. cesarean birth rate reached its highest point in
history, accounting for 33 percent of all births, which represents a 60 percent increase since
1996. Nearly one quarter of C-sections are not medically necessary, but are voluntarily
chosen by the pregnant women. Why so many C-sections? Various possible reasons are
discussed in the birthing literature: (1) More mothers are choosing to have C-sections, (2)
doctors are more willing to recommend them due to fears of malpractice litigation if any
problems arise from a potentially complicated vaginal birth, (3) the average age at which
women give birth has risen significantly, increasing the possibility for complications that may
lead to cesarean births, and (4) C-section births are approximately twice a profitable for the
hospital than uncomplicated vaginal births.
5. Discuss infertility, including the causes, testing, and treatment options. Describe the
fertility testing a couple might encounter if they were experiencing infertility.
Infertility, sometimes called “impaired fertility,” is typically defined as the lack of conception
by a heterosexual couple after 12 consecutive months of trying to become pregnant; that is,
having regular, unprotected intercourse. In the United States, the number of couples who

meet this definition of infertility is estimated to approximately 10 percent, which works out to
approximately 5 million couples.
Causes. Research has shown that the main causes of infertility break down as follows: 25
percent due to a male sperm factor (e.g., low number, poor quality, or low motility), 20
percent due to a female ovarian problem (e.g., no ovulation or poor quality ova), 14 percent
due to a female tubal problem (e.g., fallopian tube blockage), and 41 percent due to other
problems, or there is no identifiable problem in either partner (unexplained infertility).
Testing. The main test for the male is a semen analysis, in which a sample of the man’s semen
(usually gathered through masturbation into a sterile cup) is analyzed microscopically to
check for adequate numbers, movement, and formation of the man’s sperm cells (a do-ityourself home semen analysis kit now exists). For the woman, tests may include a
hysterosalpingogram, also (thankfully) referred to as the HSG, an X-ray that allows the
doctor to view the interior of the uterus and fallopian tubes to check for malformations or
blockages. Sometimes doctors need to have a direct, internal look at the ovaries, fallopian
tubes, and uterus. This is accomplished with a laparoscopy, in which a tube with a tiny
camera and light is inserted through a very small incision in the abdomen
Treatment options. Several fertility drugs such as clomiphene citrate (brand names, Clomid
and Serophene) have been developed to stimulate ovulation in women and the drug may
assist in sperm production and quality in men (Murdock, 2004). Surgical procedures may be
effective in some cases to unblock fallopian tubes, repair testicular or related disorders, or
remove cysts or scar tissue from the uterus, ovaries, or fallopian tubes.
Intrauterine insemination, often referred to as “artificial insemination,” is a rather simple
process of inserting a small tube through the woman’s cervix and injecting sperm cells
directly into the uterus.
Four methods of ART are in current use:
• In Vitro Fertilization (IVF). This technique is probably the best known, the one said to
produce “test tube babies.” It does not involve growing a baby in a test tube, of course, but
rather a process in which ova (eggs) are extracted from the woman’s ovaries during a
laparoscopy, fertilized with sperm in a shallow dish in the lab (in vitro means “in glass”), and
then placed into her uterus through her cervix approximately three days later. Typically, three
to five zygotes are transferred to help ensure at least one pregnancy, and thus this procedure
increases the chances of multiple births.
• Gamete Intrafallopian Transfer (GIFT). This procedure is nearly the same as IVF except
that fertilization occurs naturally in the fallopian tube. As in IVF, eggs are retrieved from the
ovaries and mixed with the father’s sperm in the lab. The sperm and eggs are then transferred
to the fallopian tubes for conception using laparoscopic surgery. This method can be used
only for women who have at least one healthy fallopian tube.
• Zygote Intrafallopian Transfer (ZIFT). ZIFT combines IVF and GIFT. The process for
harvesting and fertilizing the ova is exactly the same as in IVF, but instead of transferring the
zygotes to the uterus, they are placed into the fallopian tube using the laparoscope.
• Intracytoplasmic Sperm Injection (ICSI). This ART method was developed to assist a
couple when the man’s sperm production is very low, the cells have poor shape or motility, or

some other problem exists with his sperm or semen that makes the other ART methods
ineffective. In ICSI, a single sperm cell from the man is injected using a microscopic needle,
directly into each harvested egg from the woman. The resulting zygote is then transferred
after a few days into the mother’s uterus.

Test Bank for Human Sexuality
Roger R. Hock
ISBN's: 9780205989409, 9780133971385, 9780134224961

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