The fol­low­ing are notes from co-author Robyn Bran­cato, CNM (cer­ti­fied nurse mid­wife) who prac­tices in New York City, or, as she is know here: Won­der­robyn! You can read about both authors in the About tab above. Here they are on the beach in San Diego, when they gave a talk at con­fer­ence there a cou­ple years ago. Robyn on the left, Ann on the right.

Robyn and Ann, Path­way authors

1. Addi­tion to Small Rant: “Resist the temp­ta­tion to watch A Baby Story on TLC! It does not por­tray birth accu­rately, as they con­dense 15 hours of labor into 30 min­utes and play up the drama so that you will be on the edge of your seat! In the major­ity of women, birth is not that dangerous.”

2. Regard­ing: When does con­cep­tion occur? “This is a really inter­est­ing post… I love the dis­cus­sion about at what point con­cep­tion occurs! Per­son­ally, I like the Bib­li­cal notion of quick­en­ing. Even though this varies from woman to woman and can range any­where from 16 to 22 weeks ges­ta­tion, it seems like the most nat­ural theory.”

Dear Reader:  What do YOU think? Did you read the con­cep­tion post on March 23, ’09?

3. About sperm & preeclamp­sia. “Is the con­nec­tion between bar­rier meth­ods and preeclamp­sia actu­ally estab­lished? I have read stud­ies stat­ing the con­trary — that bar­rier meth­ods have no effect on preeclamp­sia rates.”

HURRAY! THIS REQUIRES FURTHER CONSIDERATION.

More infor­ma­tion: The immune mal­adap­ta­tion the­ory sug­gests that tol­er­ance to pater­nal anti­gens, result­ing from pro­longed expo­sure to sperm, pro­tects against the devel­op­ment of preeclamp­sia. Thus, bar­rier meth­ods and being young may pre­dis­pose women to this major dis­or­der of pregnancy.

Evi­dence exists on both sides of this the­ory. Here are two recent stud­ies (one of each) that read­ers may find help­ful in under­stand­ing this idea. Keep in mind that other fac­tors than just sperm expo­sure may be affect­ing research find­ings. But, it does seem that under some con­di­tions, bar­rier meth­ods and amount of expo­sure to sperm can affect the preg­nancy itself.

Ness RB,  Markovic N, Harger G, Day R. Bar­rier meth­ods, length of pre­con­cep­tion inter­course and preeclamp­sia, Jour­nal: Hyper­ten­sion in Preg­nancy 23(3):227–235. 2005.  Results did not sup­port the immune mal­adap­tion theory.

Yousefi Z, Jafarnezhad F, Nas­rol­lai S, Esmaeeli H. Assess­ment of cor­re­la­tion between unpro­tected coitus and preeclamp­sia, Jour­nal of Research in Med­ical Sci­ences 11(6):370–374. 2006. In a matched con­trols study, women with <4 months cohab­i­ta­tion or who used bar­rier meth­ods had higher risks of devel­op­ing preeclamp­sia than those with >4 months cohab­i­ta­tion. Oral con­tra­cep­tion users had a lower preeclamp­sia rate than those who used no oral contraception.

In a com­men­tary arti­cle in OB/GYN News ‚  July 1, 2002, the fol­low­ing note was made by Dr. Jon Einars­son: With insuf­fi­cient expo­sure, preg­nancy may induce an immune response and preeclamp­sia in some women with pre­dis­pos­ing fac­tors such as an endothe­lium that already is sen­si­tive to injury due to age, insulin resis­tance, or pre­ex­ist­ing hypertension.

Is there a plain and sim­ple truth about sperm expo­sure and preg­nancy risks? Alas, no. But, know your cir­cum­stances. If you are young, pro­tect your­self. Wear a con­dom. When you are ready to be a mom, you will be ready to fig­ure out your risks. So, this, too fol­lows the axiom:

Events in life are rarely plain and never simple.