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What To Expect When You're Expecting During The Zombie Apocalypse

What does your birth plan look like in a world overrun by zombies? We asked a doctor.

Spoilers for this week's "The Walking Dead" past this point.

Being knocked up is no picnic, even in a civilized world -- but in a world overrun by the living dead, it's downright dangerous.

And having already seen how tough it is to give birth in the middle of the zombie apocalypse (RIP, Lori), fans of "The Walking Dead" are understandably concerned by the events of this week's episode: Not only is the jury still out on whether Glenn was or was not eaten alive by walkers two Sundays ago, but Maggie, his beloved wife, is pregnant.

But while we can only guess whether Maggie will be forced to carry her baby to term as a widow, MTV News was able to get some expert intel on the ins and outs of continuing the human race when the population has been decimated by zombies. We spoke to Dr. Carol Livoti, an OBGYN and author of "Vaginas: An Owner's Manual," to get the scoop on getting pregnant after the end of the world as we know it.

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MTV News: This show takes place in a world where the living dead have overrun the earth and food is in short supply. Would it be difficult to conceive under those circumstances?

Dr. Carol Livoti: Well, look around the world. The biggest problem in India is malnutrition. Babies are born undernourished, mothers are undernourished. And it affects brain function, growth, it lowers the IQ of the entire population. Malnutrition makes for a malnourished baby, a malnourished adult. But it doesn't seem to affect fertility. Now, if you're so thin and so malnourished -- like someone with anorexia -- that you've stopped menstruating, then you won't ovulate. And if you don't ovulate you won't get pregnant. That is controlled by the pituitary, which is controlled by the hypothalamus, which is the most primitive emotional part of the brain. So if your hypothalamus looks around and says, "There's a famine, we can't waste blood every month, she's barely alive," it'll turn off the entire system.

MTV: Is that something that happens only in a famine situation? Could it also be caused by stress, for instance?

Dr. Livoti: It can also be triggered by athletic amenorrhea. Female marathon runners, many of them don't menstruate. But stress -- how do you measure it? You can't.

MTV: Right. I guess my question is whether the constant threat of being eaten by the living dead might cause a woman's cycle to suspend itself.

Dr. Livoti: Sure, it's possible. But a couple of calm days, two or three days where the zombies aren't attacking, that would be all you need.

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MTV: Previously on this show, a pregnant character who didn't want to be pregnant was planning to cause a miscarriage by taking a massive dose of birth control pills. Is that a remotely possible way of terminating a pregnancy?

Dr. Livoti: That wouldn't do anything. There's about a week's grace in there, before you're pregnant, where if you can take massive amounts of hormones, you can prevent a pregnancy. That's what the morning after pill is: It alters egg quality, it effects fertilization, and it prevents implantation. But if you have an established fetus in your uterus, the hormones aren't going to do any harm at all. People who are pregnant and accidentally continue take the pill before they know they're pregnant, it has no effect on the outcome of the pregnancy. It's like a grain of sand in an ocean of hormones.

MTV: And in a scenario like this, would it be challenging to carry a pregnancy to term? Because of the stress, or physical demands, or lack of nutrition.

Dr. Livoti: If we go back to the caves, people ran 30 miles every day. There was constant danger. But people managed to hold a pregnancy. Of course nobody has ever put a group of women in a system where they're forced to run all day, or where they're terrified all day, to study the effects of that. There's no living example of that kind of society. But it's clearly not a problem for most, or else we'd be extinct.

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MTV: What would you say to a woman who found herself pregnant in the zombie apocalypse?

Dr. Livoti: I would be terrified for her! What would I say? When you feel the urge to push, push your heart out, and hope that the baby comes out.

MTV: Are there any outcomes you would be particularly worried about?

Dr. Livoti: Death! Death! Think of it this way: one in ten women in Afghanistan die in childbirth. Because they have poor medical care, and they're allowed to labor for hours or days before they seek medical help. And they're often afraid to go to the next village, where medical care might be available. In that way it might be very much like a zombie situation. If they hemorrhage, there are no blood banks. If there's infection, there are no IV antibiotics. In the case of obstructed labor, where the baby is in a funny position, or a breech presentation -- if it gets stuck halfway out, at least one of you dies. If the baby dies, it slips out, and you live to fight another day. But if you die first, then usually the baby does too.

MTV: So without any medical resources available, or very limited resources, childbirth is risky.

Dr. Livoti: In an untended, non-medicated environment, your risk of maternal mortality is probably about one percent. That's very high - one in 100 women, in a civilized society, would probably not make it. You get infection, preeclampsia, pregnancy-induced hypertension, which is the number one cause of death. Your blood pressure is going up and you're having convulsions. What do you do, in a zombie world? You don't do much. And ultimately, they'll stroke out and die.

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MTV: What would you do in a non-zombie world?

Dr. Livoti: Medicate. You'd do IV medication, and deliver the baby by cesarean.

MTV: But that would be too dangerous to attempt in a non-hospital setting, I'm guessing.

Dr. Livoti: Well, where are we, in a basement somewhere? Is there a doctor? Is there anesthesia?

MTV: Hypothetically, let's assume you have someone with bare bones medical training - someone who's been to med school, but not an OBGYN. And you might have local anesthesia, but not general anesthesia.

Dr. Livoti: I wouldn't do a cesarean under those circumstances. Opening up a woman's belly in a non-sterile environment without access to IV fluids, antibiotics, is increasing her risk of dying -- much more than having a vaginal delivery.

MTV: It sounds like being pregnant and giving birth in a world overrun by zombies would be dangerous, but not complicated.

Dr. Livoti: We're living in an era now where it's almost like, if you don't take your vitamin pills, you could go to jail. This is a different scenario, it's almost like a throwback. So you have to go back hundreds of years. Look back at life during the bubonic plague, during the 14th century. Then, women delivered in the street.

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