Dad’s Guide

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Spine: .672”
Pregnancy & Childbirth/Parenting
g Easier!
Making Everythin
When it comes to pregnancy, your role as a dad has
changed so much in the past few decades that it’s
hard to know where to turn for guidance. Now you
do! This hands-on, friendly guide is packed with
practical information for fathers-to-be, covering all
of the logistical, physical, and emotional aspects of
pregnancy from your unique perspective.
• Take the fear out of fatherhood — find out what
modern fatherhood means, determine if you’re ready
for the financial and emotional demands of a baby,
and learn what you don’t know about conception
• Pregnancy and childbirth 101 — get the lowdown
on what to expect during pregnancy, labor, and
delivery, from your perspective as well as your
partner’s
• So you’re a father — oh, boy (or girl)! — discover
how to care for your newborn — from bottle feeding
to changing diapers to soothing your baby
Open the book and find:
• How a fetus develops in every
trimester
• Advice on when and how to
share the good news
• Tips on baby gift registry and
setting up the nursery
• What to expect during labor
and delivery
• What to expect the first six
months after the baby arrives
• The 4-1-1 on feeding and
changing diapers
• Tips for dealing with common
illnesses and emergencies
• Survival tips every new dad
needs to know
• Be the perfect postpartum partner — support your
partner by helping with the baby and household,
and by attending to her emotionally as well
Dad’s Guide to Pregnancy
A practical, hands-on
guide for fathers-to-be
e
d
i
u
G
s
Dad’
y
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n
a
n
g
to Pre
Learn to:
• Grasp the logistical, physical, and
emotional aspects of pregnancy
Go to Dummies.com®
for videos, step-by-step examples,
how-to articles, or to shop!
• Understand what to expect at
doctor’s visits
• Be a supportive partner during
(and after) pregnancy
• Know what to expect during
labor and delivery
$15.99 US / $18.99 CN / £12.99 UK
ISBN 978-0-470-76790-0
Matthew M. F. Miller
Matthew M. F. Miller is a writer/editor, stay-at-home
dad, and author of Maybe Baby: An Infertile Love Story.
Sharon Perkins, RN, is the author of several books,
including Breastfeeding For Dummies.
Author of Maybe Baby: An Infertile Love Story
Sharon Perkins, RN
Miller
Perkins
™
Registered nurse and author of
Breastfeeding For Dummies
Spine: .672”
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• Checklists
• Charts
• Common Instructions
• And Other Good Stuff!
s
p
p
A
e
l
i
Mob
To access the Cheat Sheet created specifically for this book,
go to www.dummies.com/cheatsheet/dadsguidetopregnancy
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Dad’s Guide to
Pregnancy
FOR
DUMmIES
‰
by Matthew M. F. Miller
and Sharon Perkins
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Dad’s Guide to Pregnancy For Dummies®
Published by
Wiley Publishing, Inc.
111 River St.
Hoboken, NJ 07030-5774
www.wiley.com
Copyright © 2011 by Wiley Publishing, Inc., Indianapolis, Indiana
Published simultaneously in Canada
No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or
by any means, electronic, mechanical, photocopying, recording, scanning or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the
Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400, fax (978) 646-8600.
Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley
& Sons, Inc., 111 River Street, Hoboken, NJ 07030, (201) 748-6011, fax (201) 748-6008, or online at http://
www.wiley.com/go/permissions.
Trademarks: Wiley, the Wiley Publishing logo, For Dummies, the Dummies Man logo, A Reference for the
Rest of Us!, The Dummies Way, Dummies Daily, The Fun and Easy Way, Dummies.com, Making Everything
Easier, and related trade dress are trademarks or registered trademarks of John Wiley & Sons, Inc. and/or
its affiliates in the United States and other countries, and may not be used without written permission. All
other trademarks are the property of their respective owners. Wiley Publishing, Inc., is not associated with
any product or vendor mentioned in this book.
LIMIT OF LIABILITY/DISCLAIMER OF WARRANTY: THE PUBLISHER AND THE AUTHOR MAKE NO
REPRESENTATIONS OR WARRANTIES WITH RESPECT TO THE ACCURACY OR COMPLETENESS OF
THE CONTENTS OF THIS WORK AND SPECIFICALLY DISCLAIM ALL WARRANTIES, INCLUDING WITHOUT LIMITATION WARRANTIES OF FITNESS FOR A PARTICULAR PURPOSE. NO WARRANTY MAY BE
CREATED OR EXTENDED BY SALES OR PROMOTIONAL MATERIALS. THE ADVICE AND STRATEGIES
CONTAINED HEREIN MAY NOT BE SUITABLE FOR EVERY SITUATION. THIS WORK IS SOLD WITH THE
UNDERSTANDING THAT THE PUBLISHER IS NOT ENGAGED IN RENDERING LEGAL, ACCOUNTING, OR
OTHER PROFESSIONAL SERVICES. IF PROFESSIONAL ASSISTANCE IS REQUIRED, THE SERVICES OF A
COMPETENT PROFESSIONAL PERSON SHOULD BE SOUGHT. NEITHER THE PUBLISHER NOR THE
AUTHOR SHALL BE LIABLE FOR DAMAGES ARISING HEREFROM. THE FACT THAT AN ORGANIZATION OR WEBSITE IS REFERRED TO IN THIS WORK AS A CITATION AND/OR A POTENTIAL SOURCE
OF FURTHER INFORMATION DOES NOT MEAN THAT THE AUTHOR OR THE PUBLISHER ENDORSES
THE INFORMATION THE ORGANIZATION OR WEBSITE MAY PROVIDE OR RECOMMENDATIONS IT
MAY MAKE. FURTHER, READERS SHOULD BE AWARE THAT INTERNET WEBSITES LISTED IN THIS
WORK MAY HAVE CHANGED OR DISAPPEARED BETWEEN WHEN THIS WORK WAS WRITTEN AND
WHEN IT IS READ.
For general information on our other products and services, please contact our Customer Care Department
within the U.S. at 877-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002.
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not be available in electronic books.
Library of Congress Control Number: 2010939503
ISBN: 978-0-470-76790-0
Manufactured in the United States of America
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About the Authors
Matthew M. F. Miller is a dad to one, an uncle to ten, and a “father”
to anyone who will listen to his countless nuggets of unsolicited
advice. Author of the book Maybe Baby: An Infertile Love Story,
Matthew is a graduate of the University of Southern California’s
Master of Professional Writing program.
Matthew lives in Chicago where he is a full-time work-at-home dad,
providing childcare for his daughter while working as the healthand-wellness editor for a national newspaper syndicate. In his spare
time (because there’s just so much of that!), Matthew is a musician,
runner, tennis enthusiast, and baker.
Sharon Perkins has never been a dad, but she’s had lots of experience on the mom side of parenting, with five children and three
grandchildren. Almost 25 years as a registered nurse in fertility,
labor and delivery, and neonatal intensive care have also taught her
a thing or two about pregnancy and babies.
Sharon lives in New Jersey with her husband but would live in
Disney World if it were legal. The opportunity to write about what
she does for a living has been a dream come true.
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Dedications
From Matt: Whether writing this book, watching tennis, or taking a
nap, I am inspired, awed, and grateful for the love and support of
my wife, Constance, and our beautiful daughter, Nola. Thank you
for a charmed life.
From Sharon: This book is dedicated to my three grandchildren,
Matthew, Emma, and Jessica, who keep me current on what’s going
on in the world of kids.
Authors’ Acknowledgments
From Matt: Writing about family takes a deep, rich understanding of
what it means to be a good person, and I am grateful to my mom,
dad, sisters, nieces, and nephews for teaching me how to be one.
Also, a very special thanks to my favorite doula, Holly Barhamand,
for teaching and empowering me to explore and educate myself
about what childbirth means to me.
As this is my first For Dummies tome, I am particularly grateful to
the folks at Wiley, but also to Sharon herself. She took me under her
wing and made this one of the most rewarding, fun experiences of
my writing career. To my agent, Grace Freedson, you are a joy to
work with and I look forward to the next amazing opportunity you
bring my way.
Finally, thank you to my wife and, most importantly, to our daughter, an IVF baby born after nearly three years of waiting. And
although we waited a long time for you, every day since your birth
has been counted among the best of my life.
From Sharon: Wiley took a chance on me with my first book,
Fertility For Dummies, almost ten years ago, and I’ve been extremely
grateful ever since. In particular, Lindsay Lefevere, Erin Mooney,
Chrissy Guthrie, and Caitie Copple have been the usual pleasure to
work with throughout this book’s creation.
Matt Miller has been the easiest coauthor ever! From day one, our
writing styles meshed, and this book just flowed. Thanks, Matt, for
making this a piece of cake.
And, last but not least, I thank my family for giving me so much raw
material to work with over the years!
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Publisher’s Acknowledgments
We’re proud of this book; please send us your comments at http://dummies.custhelp.
com. For other comments, please contact our Customer Care Department within the U.S. at
877-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002.
Some of the people who helped bring this book to market include the following:
Acquisitions, Editorial, and Media
Development
Senior Project Editor: Christina Guthrie
Executive Editor:
Lindsay Sandman Lefevere
Copy Editor: Caitlin Copple
Assistant Editor: David Lutton
Technical Editor: Jared Beasley
Editorial Manager: Christine Meloy Beck
Editorial Assistants: Rachelle S. Amick,
Jennette ElNaggar
Art Coordinator: Alicia B. South
Cover Photos: © Image Source/Corbis
Cartoons: Rich Tennant
(www.the5thwave.com)
Composition Services
Senior Project Coordinator: Kristie Rees
Layout and Graphics: Samantha K. Cherolis
Proofreaders: John Greenough, Toni Settle
Indexer: Becky Hornyak
Illustrator: Kathryn Born
Publishing and Editorial for Consumer Dummies
Diane Graves Steele, Vice President and Publisher, Consumer Dummies
Kristin Ferguson-Wagstaffe, Product Development Director, Consumer Dummies
Ensley Eikenburg, Associate Publisher, Travel
Kelly Regan, Editorial Director, Travel
Publishing for Technology Dummies
Andy Cummings, Vice President and Publisher, Dummies Technology/General User
Composition Services
Debbie Stailey, Director of Composition Services
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Contents at a Glance
Introduction ...................................................... 1
Part I: So You Want to Be a Dad . . . .................. 7
Chapter 1: Fatherhood: A Glorious, Scary, Mind-Boggling,
and Amazing Experience .................................................................... 9
Chapter 2: Beyond the Bed: Conception Smarts ................................. 23
Part II: Great Expectations:
Nine Months and Counting ............................... 45
Chapter 3: Surviving Sudden Doubts and Morning Sickness:
The First Trimester ........................................................................... 47
Chapter 4: Growing Into the Second Trimester ................................... 65
Chapter 5: The Fun Stuff: Nesting, Registering, and Naming ............. 79
Chapter 6: Expecting the Unexpected .................................................. 95
Chapter 7: In the Home Stretch: The Third Trimester ..................... 113
Chapter 8: The Copilot’s Guide to Birthing Options ......................... 129
Part III: Game Time! Labor, Delivery,
and Baby’s Homecoming ................................ 149
Chapter 9: Surviving Labor and Delivery ........................................... 151
Chapter 10: Caring for Your Newborn ................................................ 173
Chapter 11: Supporting the New Mom................................................ 197
Part IV: A Dad’s Guide to Worrying ................ 217
Chapter 12: Dealing with Difficult Issues after Delivery ................... 219
Chapter 13: Daddy 911: Survival Tips for Bumps, Lumps,
and Scary Moments ........................................................................ 233
Chapter 14: Time and Money: The High Cost of Having a Baby ...... 255
Chapter 15: Planning for Your New Family’s Future ......................... 277
Part V: The Part of Tens ................................. 293
Chapter 16: Ten Things She Won’t Ask for but Will Expect ............. 295
Chapter 17: Ten Ways to Be a Super Dad from Day One .................. 301
Index ............................................................ 307
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Table of Contents
Introduction....................................................... 1
About This Book ........................................................................ 1
Conventions Used in This Book ............................................... 2
What You’re Not to Read .......................................................... 2
Foolish Assumptions ................................................................. 3
How This Book Is Organized .................................................... 3
Part I: So You Want to Be a Dad . . . ............................... 3
Part II: Great Expectations: Nine Months
and Counting ................................................................ 4
Part III: Game Time! Labor, Delivery,
and Baby’s Homecoming ............................................ 4
Part IV: A Dad’s Guide to Worrying ............................... 4
Part V: The Part of Tens .................................................. 4
Icons Used in This Book ............................................................ 4
Where to Go from Here ............................................................. 5
Part I: So You Want to Be a Dad . . . ................... 7
Chapter 1: Fatherhood: A Glorious, Scary, MindBoggling, and Amazing Experience . . . . . . . . . . . . . . .9
Looking at the Concept of Fatherhood ................................. 10
A father? Who, me? ........................................................ 10
Reacting to a life-changing event ................................. 10
Dealing with fears of fatherhood ................................. 11
Debunking a few myths of fatherhood ........................ 12
Becoming a Modern Dad ......................................................... 14
Changes in your personal life....................................... 15
Changes in your professional life ................................ 15
Lifestyle changes to consider ...................................... 16
Deciding to Take the Plunge (Or Not) ................................... 17
Determining whether you’re ready ............................. 17
Telling your partner you’re ready ............................... 18
Telling your partner you’re not ready ........................ 18
Being patient when one of you is ready
(and the other isn’t) .................................................. 19
Dealing with an unexpected pregnancy ...................... 19
Welcoming long-awaited pregnancies......................... 20
Glimpsing into the Pregnancy Process Ahead ..................... 20
First trimester ................................................................ 21
Second trimester............................................................ 21
Third trimester............................................................... 21
While You Were Gestating ...................................................... 22
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x
Dad’s Guide to Pregnancy For Dummies
Chapter 2: Beyond the Bed: Conception Smarts . . . . . .23
Understanding Conception ..................................................... 23
Baby making 101 ............................................................ 23
Conception statistics..................................................... 27
Answering commonly asked questions
about getting pregnant .............................................. 27
Evaluating Health to Get Ready for Parenthood .................. 28
Uncovering female health issues that
impact conception ..................................................... 29
Recognizing issues that cause
fertility problems in men .......................................... 30
Assessing lifestyle choices that affect
eggs and sperm .......................................................... 31
Keeping Sex from Becoming a Chore .................................... 33
Choosing the best time for conception ...................... 33
Looking at do’s and don’ts for scheduling sex .......... 35
Taking a Brief Yet Important Look at Infertility ................... 36
Knowing the facts about infertility .............................. 36
Checking on potential problems when
nothing’s happening .................................................. 37
Working through it when your
partner needs treatment ........................................... 38
Exploring solutions when your sperm
don’t stack up ............................................................. 39
Deciding how far to go to get pregnant ...................... 42
Sharing Your Decision to Have a Baby.................................. 42
Considering the pros and cons of spilling the beans...43
Handling unsolicited advice about reproduction...... 43
Part II: Great Expectations:
Nine Months and Counting................................ 45
Chapter 3: Surviving Sudden Doubts and
Morning Sickness: The First Trimester . . . . . . . . . . .47
Baby on Board: It’s Official! .................................................... 47
Reacting when your partner breaks the news ........... 48
Making the announcement to friends and family ...... 48
Overcoming your fears of being a father .................... 49
Finding a Practitioner Who Thinks Like You ........................ 50
Finding a doctor who works for both of you.............. 50
Attending the first of many prenatal visits ................. 52
Going to the first ultrasound ........................................ 52
Baby’s Development during the First Trimester ................. 53
He may not look like much now, but . . . ..................... 53
Amazing changes in weeks 7 to 12 .............................. 54
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Dealing with Possible Complications in
the First Trimester ............................................................... 55
Miscarrying in early pregnancy ................................... 55
Understanding ectopic pregnancy .............................. 57
Coping with pregnancy loss ......................................... 58
Common First Trimester Discomforts — Yours and Hers ... 58
Helping your partner cope with the symptoms
of early pregnancy ..................................................... 59
Getting used to strange new maternal habits ............ 60
Taking on your emerging support role ....................... 62
Chapter 4: Growing Into the Second Trimester . . . . . . .65
Tracking Baby’s Development during
the Second Trimester .......................................................... 65
Growing and changing in months four and five ......... 66
Refining touches in the sixth month ........................... 67
Checking Out Mom’s Development in
the Second Trimester .......................................................... 67
Gaining weight healthfully ............................................ 68
Looking pregnant at last! .............................................. 70
Testing in the Second Trimester ............................................ 71
Preparing for the risks of tests and ultrasounds ....... 72
Understanding blood test results ................................ 72
Following up on the test results .................................. 73
Scrutinizing ultrasounds ............................................... 73
Having Sex in the Second Trimester...................................... 75
Maintaining a healthy sex life during pregnancy ....... 75
Addressing common myths and concerns ................. 76
Exploring Different Options for Childbirth Classes ............. 77
Chapter 5: The Fun Stuff: Nesting,
Registering, and Naming . . . . . . . . . . . . . . . . . . . . . . . .79
Preparing the Nursery and Home, or “Nesting” ................... 79
Making the house spic and span — and then some ... 80
Setting up the nursery................................................... 81
Arranging the nursery for two or more ...................... 83
Baby-proofing 101 .......................................................... 83
Understanding the Art of the Baby Registry ........................ 85
Doing your homework ahead of time
to get exactly what you want ................................... 85
Finding out what you need — and what you think
you won’t need but can’t live without! .................... 86
Discovering five things you don’t
have to have but will adore ...................................... 89
Checking out five things you don’t have
to have and will never adore .................................... 90
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Dad’s Guide to Pregnancy For Dummies
Surviving the Baby Shower ..................................................... 90
Naming Your Baby ................................................................... 91
Narrowing down your long list .................................... 92
Reconciling father/mother differences of opinion .... 92
Discussing choices with friends and family ............... 93
Chapter 6: Expecting the Unexpected . . . . . . . . . . . . . . .95
Managing Pregnancy-Related Medical Issues....................... 95
Pregnancy-induced hypertension................................ 95
Gestational diabetes ...................................................... 96
Placenta previa .............................................................. 97
Mandatory bed rest ....................................................... 98
Handling Abnormal Ultrasounds ......................................... 100
Birth defects ................................................................. 100
Fetal demise.................................................................. 101
Preparing Yourself for Preterm Labor and Delivery ......... 102
Recognizing the risks of preterm delivery ............... 102
Handling feelings of guilt ............................................ 103
Navigating the NICU .................................................... 103
Knowing what to expect with a preemie .................. 105
Clarifying common problems ..................................... 105
Learning the ropes — er, wires.................................. 106
Preparing for preemie setbacks ................................. 107
Taking baby home ....................................................... 107
Hi, Baby Baby Baby: Having Multiples ................................ 108
Multiple identities: What multiples are
and who has them.................................................... 108
Health risks for mom ................................................... 109
Risks for the babies ..................................................... 110
Keeping Cool in Monetary Emergencies ............................. 111
Checking out your insurance limits .......................... 111
Covering the cost of unexpected
medical expenses ..................................................... 112
Chapter 7: In the Home Stretch: The Third Trimester . . .113
Tracking Baby’s Development during
the Third Trimester ........................................................... 113
Adding pounds and maturing in
the seventh and eighth months ............................. 114
Getting everything in place in the ninth month ....... 114
Finding Out What Mom Goes Through in
the Third Trimester ........................................................... 116
Understanding your partner’s physical changes .... 116
Heeding warning signs ................................................ 118
Bracing for your partner’s emotional changes ........ 118
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Sympathizing with her desire
to have this over, already ....................................... 120
Dealing with tears, panic, and doubts....................... 120
Getting Your Paperwork in Order ........................................ 122
Understanding your insurance .................................. 122
Preparing for the costs if you don’t
have insurance ......................................................... 124
Guaranteeing a smooth admissions
process at the hospital............................................ 125
Whose Baby Is This, Anyway? Dealing with
Overbearing Family Members .......................................... 126
Picking a Pediatrician ............................................................ 126
Chapter 8: The Copilot’s Guide to Birthing Options . . . 129
Making Sure Your Birth Practitioner Is a Good Fit ............ 130
Screening potential practitioners .............................. 130
Working with a midwife .............................................. 131
Getting some additional help with a doula............... 132
Choosing Where to Deliver ................................................... 133
Delivering at a hospital ............................................... 134
Exploring alternative options:
Using a midwife at home ......................................... 135
Looking at Labor Choices ..................................................... 136
Going all natural or getting the epidural .................. 137
Taking it to the water .................................................. 138
Creating a Birth Plan.............................................................. 138
Visualizing your ideal experience .............................. 139
Drafting your plan ........................................................ 140
Sharing your birth plan with the world .................... 143
Picking the Cast: Who’s Present, Who Visits,
and Who Gets a Call.................................................................. 145
Deciding who gets to attend the birth .......................... 145
Planning ahead for visitors......................................... 146
Planting a phone tree .................................................. 146
Part III: Game Time! Labor, Delivery,
and Baby’s Homecoming................................. 149
Chapter 9: Surviving Labor and Delivery . . . . . . . . . . . .151
When It’s Time, It’s Time — Is It Time?............................... 151
Avoiding numerous dry runs (yes, it’s us again)..... 152
Knowing when it’s too late to go ............................... 153
Supporting Your Partner during Labor ............................... 154
Figuring out how she wants to be supported .......... 154
Not taking the insults seriously ................................. 154
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Dad’s Guide to Pregnancy For Dummies
Looking at What Happens during and after Labor ............ 155
First stage ..................................................................... 155
Second stage................................................................. 156
Wrapping things up after the birth............................ 157
Helping baby right after delivery ............................... 158
Undergoing Common Labor Procedures ............................ 159
Vaginal exams .............................................................. 159
IVs .................................................................................. 159
Membrane ruptures..................................................... 160
Fetal monitoring ........................................................... 161
Coping with Labor Pain ......................................................... 163
Enduring it: Going natural .......................................... 163
Dulling it: Sedation (No, not for you) ........................ 164
Blotting it out: Epidurals ............................................. 164
Deviating From Your Birth Plan/Vision ............................... 167
Having a Cesarean.................................................................. 168
Scheduled cesarean section ....................................... 168
Unplanned cesarean delivery..................................... 169
What to expect before the operation ........................ 170
What to expect during the surgery ........................... 171
Getting past disappointment...................................... 172
Chapter 10: Caring for Your Newborn . . . . . . . . . . . . . .173
Knowing What to Expect When Baby’s Born ..................... 173
Looking at newborns ................................................... 173
Rating the reflexes ....................................................... 175
Feeding a Newborn ................................................................ 176
Choosing to breast-feed .............................................. 176
Bottle-feeding basics ................................................... 179
Changing Diapers ................................................................... 181
Cleaning baby boys ..................................................... 182
Cleaning baby girls ...................................................... 183
Bathing Basics ........................................................................ 183
Holding Your Baby ................................................................. 185
Cosleeping Pros and Cons .................................................... 186
Back to Sleep: Helping Baby Sleep Safely
and Comfortably................................................................. 187
Coping if baby hates being on his back .................... 187
Swaddling your little one ............................................ 188
Preventing the flat head look ..................................... 188
Soothing Baby Indigestion .................................................... 190
Crying with colic .......................................................... 191
Gas ................................................................................. 191
Reflux............................................................................. 192
Scheduling Immunizations .................................................... 193
Skipping some shots? .................................................. 194
Spreading them out ..................................................... 194
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Table of Contents
xv
Chapter 11: Supporting the New Mom . . . . . . . . . . . . .197
Handling Housework during Recovery ............................... 198
Getting the house in order ......................................... 198
Taking care of meals.................................................... 202
Calling in backup ......................................................... 203
Supporting a Breast-Feeding Mom....................................... 204
Making the decision to breast-feed ........................... 204
Offering lactation support .......................................... 206
Including yourself in the process .............................. 207
Dealing with Postcesarean Issues ........................................ 208
Helping with a normal recovery ................................ 208
Knowing when to call the doctor............................... 209
Riding the Ups and Downs of Hormones ................................ 209
Thinking before speaking in the sensitive
postpartum period................................................... 209
Shedding light on physical symptoms ...................... 210
Supporting her baby blues ......................................... 211
Recognizing postpartum depression ........................ 211
Sleeping (Or Doing Without) ................................................ 212
Coping with Company ........................................................... 213
Dealing with grabby grandmas .................................. 214
Managing unsolicited advice ...................................... 214
Handling hurt feelings when you want to be alone ....215
Approaching Sex: It’s Like Riding a Bicycle ........................ 216
Part IV: A Dad’s Guide to Worrying ................. 217
Chapter 12: Dealing with Difficult
Issues after Delivery . . . . . . . . . . . . . . . . . . . . . . . . . .219
Coping with Serious Health Problems................................. 219
Congenital defects ....................................................... 219
Developmental delays ................................................. 220
Illnesses......................................................................... 222
SIDS ................................................................................ 222
Watching Out for Postpartum Issues .................................. 224
Getting through the “baby blues” .............................. 224
Taking a look at postpartum depression .................. 224
Acting fast to treat postpartum psychosis ............... 227
Managing Grief ....................................................................... 228
Going through the stages of grief .............................. 228
Why, why, why? Getting past the question .............. 229
Grieving together and separately .............................. 229
Determining when grief has gone on too long ......... 230
Talking to Other People about Your Child ......................... 231
Telling other people .................................................... 231
Handling insensitive remarks ..................................... 232
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Dad’s Guide to Pregnancy For Dummies
Chapter 13: Daddy 911: Survival Tips for Bumps,
Lumps, and Scary Moments . . . . . . . . . . . . . . . . . . . .233
Handling Inevitable Illnesses ................................................ 233
Nursing baby through common
childhood diseases .................................................. 234
Staying alert for scarier diseases............................... 239
Protecting Baby from Common Accidents and
What to Do When They Happen ....................................... 240
Taking care of baby after a fall................................... 240
Staying safe in the car ................................................. 241
Managing Medical Crises at Home ....................................... 243
Don’t panic! Don’t panic! ............................................. 243
Calling the doctor ........................................................ 243
Open Wide, Baby! Administering Medicine ........................ 244
Taking a Baby’s Temperature .............................................. 245
Choosing a thermometer ............................................ 246
Taking a rectal temperature ....................................... 247
Recognizing fevers ....................................................... 248
Deciphering Diaper Contents ............................................... 249
Knowing what’s normal .............................................. 249
Checking out color changes ....................................... 250
Teething Symptoms and Remedies ..................................... 250
Reacting to Medicines and Vaccines ................................... 251
Vaccination reactions — yours and your baby’s .... 252
Medications that cause reactions.............................. 252
Dealing with Food Allergies .................................................. 253
Introducing new foods ................................................ 253
Recognizing allergic reactions ................................... 254
Preventing allergic reactions ..................................... 254
Chapter 14: Time and Money: The High Cost
of Having a Baby . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255
Creating a New Work/Life Balance with Baby .................... 255
Taking time off with paternity leave.......................... 256
Managing sick time when you’re back at work ........ 258
Dealing with after-work expectations ....................... 259
Reprioritizing your commitments ............................. 260
Readjusting When and If Mom Goes Back to Work ........... 262
Making going back to work easier on mom .............. 262
Deciding to be a stay-at-home parent ....................... 264
Helping mom adjust if she doesn’t
go back to work ........................................................ 266
Becoming a stay-at-home dad .................................... 267
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xvii
Exploring the Expected (And Unexpected)
Costs of Baby ...................................................................... 268
Deciding what baby really needs ............................... 268
Bracing yourself for the costs of
must-have baby supplies ........................................ 269
Comparing childcare options and costs ................... 271
Managing Your Money .......................................................... 273
Prioritizing your needs ............................................... 274
Determining where to cut costs................................. 275
Chapter 15: Planning for Your New Family’s Future . . .277
Securing a Financially Sound Future ................................... 277
Prioritize your expenses ............................................. 278
Create a budget (and stick to it) ................................ 279
Pay down your debt .................................................... 280
Create an emergency fund .......................................... 281
Buy disability insurance ............................................. 281
Contribute to a retirement account .......................... 282
Work with a financial advisor .................................... 282
Mind your credit score ............................................... 282
Saving Money for Your Child’s Education .......................... 283
Getting the Lowdown on Life Insurance ............................. 284
Making sure you and your partner have
adequate life insurance ........................................... 284
Considering a policy for your baby ........................... 285
Health Insurance Options for Newborns ............................ 286
Adding baby to an existing work-paid plan .............. 286
Buying coverage just for baby ................................... 287
Obtaining free and low-cost care
for uninsured kids .................................................... 288
Taking Care of Legal Matters ................................................ 288
Creating a will............................................................... 288
Establishing power of attorney .................................. 291
Part V: The Part of Tens.................................. 293
Chapter 16: Ten Things She Won’t Ask for
but Will Expect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295
Keep It Complimentary ......................................................... 295
Start a Baby Book................................................................... 296
Disguise Fitness as Fun ......................................................... 296
Curb Your Advice................................................................... 297
Attend Prenatal Appointments ............................................ 297
Plan a Getaway ....................................................................... 298
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Dad’s Guide to Pregnancy For Dummies
Register for a Prenatal Parenting Class ............................... 298
Do Your Homework and Spread the Word ......................... 299
Learn Prenatal Massage ........................................................ 299
Clean High and Low ............................................................... 300
Chapter 17: Ten Ways to Be a Super Dad
from Day One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301
Overcome Fragility Fears ...................................................... 301
Trust Your Instincts............................................................... 302
Bond Skin-to-Skin, Eye-to-Eye ............................................... 302
Manage Frustrations .............................................................. 303
Embrace Your Goofy Side ..................................................... 304
Get Out .................................................................................... 304
Teach Baby New Tricks......................................................... 305
Roughhouse the Safe Way .................................................... 306
Read Aloud . . . and Not Just from Baby Books .................. 306
Send Mom Away ..................................................................... 306
Index............................................................. 307
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Introduction
W
elcome to impending fatherhood! Being a dad is better
than you can ever imagine and far less scary than you’re
probably believing it to be. One of the main reasons we wrote this
book was to empower men to get actively involved in every aspect
of the childbirth process, as well as the care, feeding, and loving
of newborns. Most dads-to-be have only a dim idea of what parenthood is going to be like, and their excitement mixes liberally with
sheer terror and trepidation. We hope this book will spare you
some of that fear and trepidation by giving you the knowledge you
need to feel confident.
Traditionally, men have been removed from the processes of
pregnancy, labor and delivery, and raising children. On TV, fathers
have long been portrayed as emotionally distant, bumbling fools
incapable of changing diapers, getting kids to go to bed, or handling any of the routine tasks that mothers seem to do with ease.
In reality, today’s dad is confident, capable, and totally in love with
his children — and not afraid to let it show. Not that it all comes
easily and naturally. Learning how to support your pregnant partner and, subsequently, to care for a newborn, takes time, effort,
and education.
Most men in the world will become fathers at some point, and
most will enter the experience without much knowledge of how
babies develop, how to be a supportive partner, or what their role
should be in the process. But not you. The savvy readers of this
book will be prepared for just about anything — and will know
exactly what it takes to be an equal partner on the pregnancy (and
parenting) journey.
About This Book
This book answers all the burning questions you have about the
impact your partner’s pregnancy will have on your life. We tell you
how your sex life will change, because we know that’s at the top of
your list. But we also explain everything you ever wanted to know
about how a fetus develops, what it’s like to live with a pregnant
woman, and how your pocketbook will be hit by adding a new
member (or members) to your family.
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2
Dad’s Guide to Pregnancy For Dummies
We also delve a little into what to expect the first six months or so
after the baby arrives. We walk you through the ins and outs of feeding, changing diapers, dealing with common illnesses and emergencies, and how to stay sane and true to yourself through it all.
In short, you will close this book feeling completely prepared for
fatherhood. You won’t be, because no one ever is, but you’ll at
least feel like you are until the baby comes.
Conventions Used in This Book
Following are a few conventions we used when writing this book:
✓ We don’t know if your baby is a boy or girl — you may not
even know that yourself. So we use he and she interchangeably throughout.
✓ Because we also don’t know if your medical practitioner is a
doctor or midwife, or a pediatrician or nurse practitioner, we
use the term medical practitioner when we talk about anyone
medical.
✓ We call your partner your partner, because that’s what she is,
in every sense.
✓ We use italic font to highlight new terms, and we follow them
up with a clear definition.
✓ Boldfaced font indicates keywords or the action in numbered
steps.
✓ Monofont is used for Web addresses.
What You’re Not to Read
If you decide this book is too long, you may decide to skip some of
it, so you want to know what’s not very important. Naturally, we
think every word we’ve written is not only essential but brilliant,
so we’re the wrong people to ask. However, info marked with the
Technical Stuff icon may be more than you want to have to think
about. Information marked with this icon is certainly interesting
and helpful, but skipping it won’t impede your understanding of
the topic in the slightest.
Also, we’ve included sidebars throughout the book (look for grayshaded boxes) that often contain interesting but nonessential
information and personal stories, and we give you permission to
skip them if you really have to.
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Introduction
3
If your partner is already pregnant, congratulations! That means
you can skip Chapter 2, which discusses conception. And we hope
everyone will be able to skip reading Chapter 12, which discusses
problems that can come up after delivery. However, you may still
want to skim this one so you’ll know where to turn in the unfortunate event of complications.
Foolish Assumptions
If you picked up this book, we assume you fall into at least one of
the following categories:
✓ You don’t know much about pregnancy.
✓ You’re an expectant dad.
✓ You’re hoping to become an expectant dad.
✓ You are already a father but are looking to learn new tricks for
the next go-round.
✓ You know an expectant dad and would like to get into his
head and understand why he’s behaving the way he is.
Expectant dads are often the forgotten partner in the new familyto-be, and they need all the understanding they can get.
How This Book Is Organized
This book starts with the process of getting pregnant and ends
with practical information on day-to-day dad stuff. However, we
know you may not be interested in reading about the journey
straight through from beginning to end. So feel free to start wherever you want. If tomorrow is your first ultrasound appointment,
jump right into that section so you know what to expect. If your
partner isn’t pregnant yet but you want to read about labor, go
right ahead. Every chapter of this book is modular, which means
you can understand it without reading other chapters first.
Part I: So You Want to Be a Dad . . .
Becoming a dad is one of the most exciting times of a man’s life,
but that doesn’t mean you don’t also have concerns and questions.
This part dives into the normal fears and frustrations associated
with deciding to start a family and the actual process of getting
pregnant — and no, you don’t already know it all!
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4
Dad’s Guide to Pregnancy For Dummies
Part II: Great Expectations: Nine
Months and Counting
Your partner may be the one who’s pregnant, but you’re in it for
the ride, too. From morning sickness to labor, we tell you exactly
what happens during pregnancy, from your perspective as well
as hers and the baby’s. We also talk about the fun stuff, like baby
showers (okay, maybe not so fun for you) and naming, and the not
fun stuff, like potential health issues for mom and baby. We also
give you an overview of birthing options so you can talk knowledgably with your partner about what she wants to do.
Part III: Game Time! Labor,
Delivery, and Baby’s Homecoming
No one ever said labor and delivery are fun, but they are interesting, and you have a lot to learn if you want to win the supportive
partner of the year award. This part covers everything about actually having the baby, from the first contraction to the first all-night
crying session — which just may come from an exhausted parent,
not the baby!
Part IV: A Dad’s Guide to Worrying
This part touches on all the things that keep you up at night worrying after the baby’s born. We discuss possible postdelivery issues
such as congenital defects and postpartum depression as well as
baby’s inevitable illnesses. If your worries are more monetary, we
also advise you on handling your money with an expensive new
baby and planning for your family’s financial security. We also help
you stay sane and happy with suggestions for managing your time
so that you don’t let the new baby take over your life.
Part V: The Part of Tens
The Part of Tens is just fun. We touch on how to be both a super
dad and a super partner. We also talk about what it’s like to be a
stay-at-home dad.
Icons Used in This Book
Icons are another handy tool you can use as you work your way
through this book. If you find the tips really helpful, for instance,
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Introduction
5
you can skim through and search for that icon. Conversely, when
you see a Technical Stuff icon, you can know that information is
completely skippable (though certainly worth the extra time, if you
have it).
Following is a rundown of the icons we use in this book:
The Remember icon sits next to information we hope stays in your
head for more than two minutes.
TechnicalStuff goes into more detail than you really need to understand the facts, but you may find it interesting if you’re an especially curious type.
The Tip icon gives helpful insider info that you may take years to
learn on your own.
Whenever we use a Warning icon, you’d better sit up and take
notice, because not heeding our warning could be disastrous for
you or your loved ones.
Where to Go from Here
This is where we tell you to go read the book, already!
Although you can start absolutely any place and get the benefit of
our expertise, if your partner isn’t yet pregnant or is newly pregnant, we suggest starting at the beginning and reading right on
through. It will calm your nerves, we promise.
If you’re the last-minute type of guy and you’re reading this book
just a few months (or weeks!) before the impending birth, you can
certainly skip the first trimester stuff (at least this time around)
and start wherever makes the most sense for you.
And if you got this book at the beginning of the pregnancy but
never got around to opening it until now, when baby has his first
case of sniffles, that’s okay too — we still have plenty of valuable
information for you. Pregnancy is the start of the adventure, but
the fun continues long after.
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Dad’s Guide to Pregnancy For Dummies
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Part I
So You Want to
Be a Dad . . .
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C
In this part...
hances are, the road to fatherhood wasn’t something
you dwelled on much in your earlier years. When you
decide to begin a family, though, exciting thoughts about
conception alternate with fears of not being a good dad
and concerns about money, time, and a brand-new way of
life. In this part we look at the doubts and worries that
consume every new dad-to-be and explain the mechanics
of getting pregnant. You may think this is one area where
you need no help, but many couples find getting pregnant
a frustrating struggle, and even those who don’t can benefit from a refresher course on Conception 101.
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Chapter 1
Fatherhood: A Glorious,
Scary, Mind-Boggling, and
Amazing Experience
In This Chapter
▶ Exploring what it means to be a father today
▶ Understanding what will change in your life
▶ Facing the decision of whether to have a baby
▶ Looking down the long road ahead
A
pparently congratulations are in order: Either you’re going to
be a father sometime within the next nine months or you’re
in the planning stages of becoming a dad. Either way, you’ve come
to the right place. You’ll face no bigger life decision than choosing to become a parent (and no bigger jolt than being told baby is
coming if you didn’t expect it!), and the best gift you can give to
your soon-to-be child is confidence. And the only way to feel confident before you’ve ever been a parent is to get yourself prepared
for the unknown journey that lies ahead.
Perhaps you’ve already been floored by equal doses of joy and
fear, which is a good sign that you recognize the magnitude of the
change but you’re up for the challenge of fatherhood. Emotions
run deep when confronted with the prospect of raising a child,
mainly because it’s a huge commitment and responsibility that,
unlike a job, never has off-hours. Babies are expensive, confusing,
time consuming and, for many fathers, they represent the end of a
carefree “youth” that extends well into adulthood.
Experiencing a jumble of feelings is normal, and the more you take
those emotions to heart and explore what fatherhood means to
you — and what kind of father you want to be — the easier the
transition will be when baby arrives.
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10
Part I: So You Want to Be a Dad . . .
Looking at the Concept
of Fatherhood
What exactly does it mean to be a father? The answer depends on
the kind of father you want to be for your child. In recent years,
movies, TV, and even commercials have begun to transition from
the bumbling, know-nothing father of yore to the modern dad
who is just as comfortable changing a diaper as he is fixing a car.
Fathers today range from traditional to equal partners in every
aspect of parenting.
The majority of parents today don’t adhere to the traditional masculine and feminine roles that our parents and grandparents grew
up with. Women work, men work, and caring for the home — inside
and out — is both partners’ responsibility. Today, fatherhood is a
flexible word that’s defined by how involved you want to be in the
rearing of your child, but the more involved you are in your child’s
upbringing, the more likely he is to be a well-adjusted, loving, and
confident person.
A father? Who, me?
Yes, you. As strange as it sounds, you are going to be a father. A
great one at that, because just through the mere act of reading
this book, you’re taking the proverbial bull by the horns and doing
your homework to learn what it takes to be a good dad from day
one. As they say, anyone can be a father, but it takes someone
special to be a dad.
Even if you’ve never held a baby before, don’t let self-doubt rule
the day. Being a good father isn’t about knowing everything about
everything; it’s about loving and caring for a baby to the best of
your abilities. So don’t be afraid. Yes, that’s easier said than done,
but being fearful of what lies ahead doesn’t change the fact that
you’ve got a baby on the way, however far off.
You may feel silly, but start by saying the words “I’m going to be a
father” out loud a few times. Maybe even look into a mirror while
you say it. If the thought of fatherhood scares you, you need to get
used to the label, and the more you say and internalize it, the more
it will become you.
Reacting to a life-changing event
Devolving into a tearful, slobbering mess upon finding out that you
are going to be a father isn’t unusual. Neither is throwing up, passing
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Chapter 1: Fatherhood
11
out, laughing, swearing, or any of the normal, healthy reactions
people have upon receiving life-altering information.
If your reaction isn’t 100 percent positive, that’s okay, too. Just
remember that your partner likely won’t be particularly thrilled if
you get upset, defensive, or angry when she tells you she’s expecting. As best as you can, react to the news with all the positivity you
can muster. You’ll have plenty of time to revisit any concerns or
frustrations after you’ve given the situation some time to sink in.
Some dads-to-be go into fix-it mode upon hearing the news, ready
and eager to crunch budget numbers, baby-proof the entire home
in a single night, begin make college plans 18 years in advance, and
so on. Feeling like you need to get everything in order before baby
arrives is normal, but remember that you can’t do it all in a day, and
take some time to celebrate before you dive into the practical side
of life with baby. (Turn to Chapter 3 for more on handling the news.)
Dealing with fears of fatherhood
Even men who have been lucky enough to be surrounded by positive male role models for their entire lives still find themselves
doubting whether or not they have what it takes to be a dad. It’s
like the fear of starting a new job amplified by 100. Part of being a
good father is taking the time to confront these fears so that when
baby comes, you won’t be parenting with fear.
Following are some of the common fear-based questions men ask
themselves in regard to fatherhood:
✓ Am I ready to give up my present life (free time, flexibility,
freedom) to be a dad?
✓ Will I have time for my pastimes and friends?
✓ Will I ever sleep again?
✓ Is this the end of my marriage and sex life as I know it?
✓ Do we have enough money to raise a child?
✓ Do I know enough about kids to be a good dad?
✓ Am I mature enough to be a good role model for my child?
✓ What if the baby comes and I don’t love him?
Your head may be spinning with all of the questions you ask yourself, and although you can’t answer them all right away, you need to
address them at some point. However, plenty of men have felt unprepared and unwilling and turned out to be great dads, so don’t despair
if your initial answers to the questions above are mostly negative.
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12
Part I: So You Want to Be a Dad . . .
Parenthood involves a lot of sacrifice, but it doesn’t have to sound
the death knell for your identity or happiness. Talk with your partner, a trusted friend, or a therapist — anyone who will listen to you
and support your concerns without getting defensive — about the
questions you have. Some of your fears, as you will find, have no
basis in reality. Others, such as the fear of losing yourself and your
free time, will require you to prioritize your time and energy.
Regardless of what your fears may be, don’t let them fester. No
man is an island, and you can’t effectively deal with all those emotions by yourself. Starting an open dialogue with your partner will
keep you both on the same page, which is a good start toward
making you an effective parenting duo.
Debunking a few myths of fatherhood
Many of the concerns or fears you likely have originate from the
many long-standing myths of what a father’s role should be in the
life of a child. Not all that long ago, men stood in the waiting room
at the hospital during delivery and returned to work the next day.
The landscape of fatherhood has changed quickly, leaving the
modern dad wondering where he fits in the parenting scheme.
Following are some of the most common misconceptions about
fatherhood. We debunk those myths to help you understand how
to be a more-involved father.
Myth #1: Only the mom-to-be should have
input about labor and delivery
While the focus is on your partner — she is, after all, the one carrying your child — you also matter, and you have the right to voice
your opinions along the way. Throughout the pregnancy, share what
you’re experiencing and let her know what you’re afraid of. She has a
lot to think about and worry about, too, but the more you deal with
those issues together, the stronger your relationship will become.
If you have thoughts and opinions about what kind of delivery
option you’re most comfortable with, share those with her as
well. Although ultimately you need to let your partner pick the
childbirth option that’s best for her, she deserves to know your
feelings on the matter. Getting involved in the decision-making process isn’t just your right; it’s the right thing to do. You can turn to
Chapter 8 to start getting informed on the options and many decisions to be made.
Myth #2: Men aren’t ideal caretakers for newborns
Boobs are generally the issue at the forefront of this myth. No, you
won’t be able to breast-feed your child or know what it’s like to
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Chapter 1: Fatherhood
13
give birth. Because they don’t have that initial connection, a lot of
fathers wonder what exactly they’re supposed to do.
Mother and baby are attached to each other for nine months, but
after baby arrives, it’s open season on bonding and caretaking.
When your partner isn’t breastfeeding, hold, rock, and engage in
skin-to-skin contact with your baby. Changing diapers, bathing,
and changing clothes are just a few of the activities that you can
do to get involved. And the more involved you get, the less likely
you are to feel left out of the equation. Chapter 10 provides tips for
caring for your new baby so you can feel confident in your abilities.
Myth #3: You will never have sex or sleep ever again
Good things come to those who wait, and you will have to wait. Sex
won’t happen for at least six weeks following delivery, and even
then you have a long road back to normalcy. For many couples, a
normal sex life following childbirth isn’t as active as it once was,
but you can work with your partner to make sure both of your
needs are being met.
One need that will deter your sex life — and override the sex need —
is sleep. Babies don’t sleep through the night. They wake up hungry
and demand an awake parent to feed them, burp them, and soothe
them back to sleep. Some babies begin sleeping through the night
at six months while other kids won’t until the age of 3. The good
news is that they all do it eventually, and when you begin to understand your baby’s patterns, you’ll be able to figure out a routine that
allows you to maximize the shut-eye you get every day.
Myth #4: Active fathers can’t succeed in the business world
Unless work is the only obligation you’ve ever had in your adult
life, you’re probably used to juggling more than one thing. Fathers
who are active in the community or fill their schedules with copious hours of hobbies will have to reevaluate their priorities. Family
comes first, work comes second, and with the support of a loving
partner and a few good baby sitters, you’ll be able to continue on
your career trajectory as planned.
In fact, being a dad may just make you a more effective worker.
Having so many demands on your time will make you better at
time management and maximizing your workday. Focus on work at
work and home at home, and you’ll succeed in both arenas.
Myth #5: You’re destined to become your father
Destiny is really just a code word for the tendency many men have
to mimic the patterns and behaviors that are familiar because they
grew up experiencing them. However, if you didn’t like an aspect of
your father’s parenting or don’t want to repeat a major mistake or
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Part I: So You Want to Be a Dad . . .
flaw that he perpetrated, talk about it with your partner. The more
you talk about it, the less likely you are to repeat that mistake
because you’ll engage your partner as a support system working
with you to help you avoid it.
But don’t forget to replicate and celebrate the things your father
may have done right. You’ll be chilled to the bone the first time
you say something that your father used to say, but remember
that repeating the good actions isn’t a bad thing. Don’t try to be
different from your father “just because.” Identify what he did that
was right, what was wrong, and use that as a blueprint for your
parenting style.
Myth #6: You will fall in love with your baby at first sight
Babies aren’t always so beautiful right after being born, but that’s
to be expected, given what they’ve just gone through to enter the
world. Don’t feel guilty if you look at your baby and aren’t immediately enamored with him. Emotions are difficult to control, and
for some fathers — and even mothers — falling head-over-heels for
your baby may take some time.
Childbirth is a long, intense experience (as we describe in
Chapter 9), so allow yourself adequate time to rest and get to
know the new addition to your family. If you suffer from feelings
of regret, extreme sadness, or experience thoughts of harming
yourself or the baby, seek immediate medical assistance.
Becoming a Modern Dad
Dads today are involved in every aspect of a child’s life. They’re
no longer relegated to teaching sports, roughhousing, and serving as disciplinarians. Modern fatherhood is all about using your
strengths, talents, and interests to shape your relationship and
interactions with your child.
Modern dads change diapers, feed the baby, wake up in the middle
of the night to care for a crying child, and take baby for a run.
They do not “baby-sit” their children; they’re capable parents, and
no job falls outside of the realm of a modern father’s capabilities.
Though all that involvement does mean you’re going to put in far
more effort and time than previous generations, it also means that
you’re bridging the gap of emotional distance that used to be so
prevalent in the father-child experience.
In addition to reading the sections below, you can flip to the chapters in Part IV for information and advice on making changes and
stepping into the practical role of daddy.
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Chapter 1: Fatherhood
15
Changes in your personal life
If what you fear most is losing the freedom to spend as much
time as you want engaging in leisure activities, then you are in for
some mammoth sacrifices. Babies require you to say no to a lot of
commitments that the prebaby you would have agreed to partake
in. Don’t make a lot of outside-the-home plans that you consider
optional, at least at first.
For the first six months, going out at night will be challenging,
especially if your partner is breast-feeding, and even more so if you
don’t live near family. However, as your baby ages, leaving him
with a baby sitter becomes more feasible and less stressful.
Perhaps what you fear the most is the impact baby will have on
your relationship with your partner. This fear is valid, given that
you will scarcely find time for the two of you to be alone. But that
doesn’t mean you won’t have time to connect.
Just because going out as a couple is tough to manage doesn’t
mean you can’t have ample one-on-one time. Plan stay-in dates that
start at baby’s bedtime. Order food or make a fancy dinner, queue
up a movie, or bring out your favorite board game. Try not to talk
about baby. Rather, focus on each other and talk about topics that
interest you both.
Changes in your professional life
Depending on the requirements of your job, your daily routine may
go completely unchanged aside from the uptick in yawns due to
late-night feedings and fussiness. Thoughts of your new family may
make focusing difficult, especially when you first return to work
following any paternity leave or vacation you take. In time, you’ll
settle back into a normal routine, and work just may become the
one arena of your life that provides a respite from parenting duties.
Workaholics, however, will find themselves at a crossroads. Some
will choose to cut back on hours spent at the office while others,
hopefully with the full support of their partners, will proceed with
business as usual. There is no right or wrong way to balance a
demanding job with a new baby as long as you and your partner
both are comfortable with the arrangement and you spend enough
quality time with your child.
What is quality time? It’s time you spend with your child, focusing on
your child. Some people say quality time has nothing to do with the
quantity of time you spend with your child, but we feel it is affected
by the amount of time you devote to your child. Give as much as you
can, because the old adage is true — they grow up so fast.
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Part I: So You Want to Be a Dad . . .
Some dads even leave the workforce altogether or take work-athome positions in order to provide full-time childcare for their newborn. If you choose this route, make sure to check out Chapter 14,
where we discuss some important considerations of being a stayat-home dad.
Lifestyle changes to consider
Bad habits are hard to break, but when you have the added stress
of a child, those bad habits can be even harder to conquer. That
said, you’re about to have a child — a sponge that will soak up
your every word and action — so it’s time to clean up your act.
Following are a few lifestyle alterations to consider making so you
can lead by example without reservation:
✓ Quit smoking/drinking too much/taking recreational drugs.
Second-hand smoke increases the risk of illness for your child,
as well as the likelihood that she will become a smoker as an
adult. Frequent overconsumption of alcohol makes you less
likely to be a responsible parent capable of making good, safe
decisions for baby. In fact, alcohol and drugs often lead to
harmful and neglectful decisions that can land you in legal
trouble and your child in the foster care system.
✓ Start an exercise regimen. Physically active, healthy parents
get less run down and are less susceptible to illness. Plus,
you’ll want to live a long life with your children.
✓ Lose weight. If you’re heavily overweight, you’re more susceptible to illness and a shortened lifespan, and furthermore,
children of obese parents are more likely to be obese. Kids
learn nutrition and lifestyle habits from their parents, so set
a good example and give your child a fair shot at a long,
healthy life.
✓ Eat healthier. Your partner needs to be extremely diligent
about eating pregnancy-positive foods, so use this time as an
opportunity to get your diet in order. Soon enough, you’ll be
cooking for three, and if you’re already in the habit of preparing healthy foods, you’ll have no trouble providing proper
nutrition to your child.
✓ Control your anger/censor your potty mouth. Kids learn how
to treat and interact with others at a very young age. Start
revising your behavior now and get used to swearing less,
before your kid picks up some nasty communication habits.
✓ Spend less money on nonessential items. Teaching kids fiscal
responsibility is just as important as teaching them social
responsibility. Plus, kids aren’t cheap, so stop spending $50
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17
per week on beer and start banking your savings to provide a
sound, secure future for your family.
✓ Organize and de-clutter your home. Create a safe, livable
place for your new addition, which also helps decrease the
amount of stress in your life.
✓ Develop routines. Be it running errands, cooking, phone calls,
or paying the bills, get systems in place to ensure that everything gets done with the least amount of hair pulling. Knowing
who does what when keeps you on track when baby throws a
wrench into everything.
Deciding to Take the
Plunge (Or Not)
For some of you, the question of whether or not you’re ready for
fatherhood comes too late. Others may be reading this book as a
first step in planning for the future. Deciding the right time in life to
have a baby isn’t an easy task, especially because circumstances
change on a seemingly daily basis.
However, family planning is an essential step that can minimize
what ifs, frustrations, and regrets. Once you have a baby, you can’t
take it back. Knowing when you’re ready to be parents and then
trying to conceive means that when you actually do get pregnant,
the time will indeed be right. Or at least as right as any time can
be, as you have such little control over life’s variables.
Determining whether you’re ready
How does it feel when you know you want to be a father? And
how can you know when you’re actually ready to start trying for a
baby? Those questions have no simple answers, because the feeling is different for everyone, but suffice it to say, you’ll know when
you know.
One sign to look for is a prolonged interest and fascination with
the babies of friends and family members. Women call the growing
desire for a baby a biological clock, and many men experience similar feelings. The desire to procreate, to have your genes carried on
in the species, can be powerful.
Just make sure it’s a desire that lasts more than a day. Also, make
sure that you take the time to analyze the impact baby is going to
have on your life. If you’re in the final two years of a college program, it may be in your best interest to wait. If you’re unemployed,
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Part I: So You Want to Be a Dad . . .
perhaps you want to put off trying until you find a job you like that
can support a family.
Just because you’re ready doesn’t make now the right time. Don’t
decide to have a baby on an impulse. Think about the impact a
child will have on your time, money, and home, and if you don’t
see any major obstacles, then by all means, proceed. Obviously
you can choose to proceed even if having a baby now doesn’t
make sense on every level, but please make sure first that you can
provide a loving, safe home and can pay for all the things baby
needs to thrive.
Telling your partner you’re ready
You can tell your partner anytime and anyplace that you’re ready
to take the plunge into parenthood, but however you broach the
subject, remember that she may not be as ready as you. A good
way to introduce the subject is by asking her questions about her
feelings on when the right time is to have a baby.
Let her know how excited you are, but also let her know that
you’ve thought about the finances and logistics of having a baby,
too. Fatherhood involves a lot more than choosing a name and
a nursery theme. A big part of feeling ready is knowing that the
person you’re going to have a baby with isn’t just enamored with
the idea of a baby but is also prepared for the practicalities of
responsibly starting a family.
You don’t have to outline every aspect of how and why you’re
ready, but treat the idea with respect and let your partner know
you’re sincere by proving that you’ve actually thought it through.
Telling your partner you’re not ready
If your partner is already pregnant, do not under any circumstances tell her you’re not ready. If, however, the two of you
simply are exploring the idea of having a child, now is the perfect
time to speak your piece and let her know that you’re just not prepared for fatherhood.
Reasons for not being ready vary from practical (not enough
money or time) to logistical (still in school, caring for a sick
parent) to selfish (not ready to share the Xbox). No reason to not
be ready is wrong, but if your partner is ready for a baby, don’t
expect her to be fully supportive.
Regardless, don’t agree to have a child before you’re up for the challenge just so your partner doesn’t get angry with you. Be honest,
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Chapter 1: Fatherhood
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because when she’s pregnant, you can’t do anything to change the
situation. If you’re uncertain now, be honest and speak up!
Being patient when one of you
is ready (and the other isn’t)
Being on different pages can be an uncomfortable position for any
couple, especially when it comes to the kid issue. Men have long
been saddled with the Peter Pan label whenever they announce
they aren’t ready to “grow up” and have kids. Women are unfairly
chastised for choosing career over family if they aren’t ready to
have a child.
Everyone has his reasons for wanting or not wanting to have a
baby, and every one of them is valid — at least to the person who
isn’t ready. Attempting to persuade your partner, or vice versa,
to have a baby is not recommended. Having a child with someone
who isn’t ready is setting up your relationship — and your relationship with the child — for failure.
If one of you isn’t ready, try to work out a timeline as to when the
wary party will be ready. If you can’t set a definitive date, choose
a time when you will revisit the topic. Check in with each other
on the topic at least every six months. Nagging the other person
isn’t a good idea, but if it’s something one of you wants, then you
should continue to work toward a solution.
Seek counseling at any point if you and your partner are fighting
about the issue frequently, or if one of you makes the decision
that you never want children. Couples who find themselves at an
impasse about whether or not they will have children often need
the guidance of a trained professional.
Dealing with an unexpected
pregnancy
Unplanned pregnancies aren’t uncommon, and, for the majority
of people in a committed relationship, adjusting to the surprising
news is often no more than a minor bump in the road. If you unexpectedly find out that you’re going to be dad, do not get angry with
your partner. Blaming the other person is easy when emotions run
high, but don’t forget how you got into this situation in the first
place. It does, indeed, take two.
Birth control and family planning are the responsibility of both the
man and the woman, and accidents sometimes happen. The best
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Part I: So You Want to Be a Dad . . .
thing you can do in this instance is to talk with your partner about
your options and start making a plan about how to give that child
the best life you possibly can. Having a child unexpectedly is not
the end of the world, and you don’t have to feel ready to have a
baby to be a good father.
Welcoming long-awaited pregnancies
Getting pregnant isn’t always as easy as they make it look in the
movies, as the millions of infertile couples know all too well. (And if
you and your partner are dealing with infertility, turn to Chapter 2
for help.) Finding out that you’re pregnant after a long wait brings a
mixed bag of emotions, most of which are joyful.
If you and your partner have been struggling to get pregnant, you
likely feel relieved that you’re about to get the gift you’ve been
working so hard to find, but don’t be surprised if you have difficulty adjusting to life outside of the infertility world. After months
and years of scheduled sex, countless doctor visits, and suffering
month after month of disappointment, not everyone transitions
into the pregnancy phase with ease.
You also may struggle with a hypersense of fear due to previous
miscarriages, close calls, and years of disappointment. Make sure
to allow yourselves the opportunity to gripe, complain, worry,
and grieve for a process that took a lot of patience and energy.
Frustrations that were bottled up for the sake of optimism may
finally surface, which is absolutely healthy.
Just because you’ve finally achieved your goal doesn’t make all the
feelings of sadness and frustration suddenly disappear. If you and/
or your partner are having trouble letting go of the feelings that
gripped you during your fertility struggle, you can find countless
support groups, online communities, and blogs that provide both
of you a place to talk about what you’ve been through. You can
also learn transition tips from others who have been through the
same thing. Moving forward will get easier, but it can take time —
and a heaping helping of support.
Glimpsing into the Pregnancy
Process Ahead
When you get used to the idea of being a father (which you hopefully will), you may wonder what comes next. For the uninitiated,
first-time dad, the nine months of pregnancy are a whirlwind of
planning, worrying, parties, nesting, name searching, doctor visits,
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and information gathering as you move toward baby’s birth. In the
following sections we lay out what you can expect in each trimester (period of three months).
First trimester
In the first trimester, which encompasses the first three months
of pregnancy, your partner suffers from the majority of pregnancy
symptoms, such as nausea, intense sleepiness, unexplained tears,
and the all-important cravings.
By the end of the first trimester, your baby grows to be about 3 or
4 inches in length and weighs approximately 1 ounce. At that time
your baby’s arms, legs, hands, and feet are fully formed, and your
baby is able to open and close her fists. The circulatory and urinary systems are fully functional. Secondary body parts, such
as fingernails, teeth, and reproductive organs, begin developing.
Turn to Chapter 3 for more information on what happens during
the first trimester.
Second trimester
During the second trimester, most of your partner’s early pregnancy symptoms disappear, but her body undergoes visible
changes. She begins to look and feel pregnant, and may begin
struggling with the not-so-fun aspects of carrying a child, such as
weight gain and forgetfulness.
This is also the time when the fun stuff begins. Around week 20,
your partner has the ultrasound that can determine the sex of the
baby — if you choose to find out and if the baby allows the ultrasound technician a clear view. It’s also the time when you register
for your baby shower, prepare the nursery, weed through countless
baby names, attend birthing classes, and baby-proof your house.
By the end of the second trimester, your baby is roughly 14 inches
long and weighs approximately 2 pounds. Her skin is still be translucent, but her eyes begin to open and close, and your partner
likely starts feeling movements and even baby’s tiny hiccups.
Check out Chapter 4 to find out more about the second trimester.
Third trimester
Assuming all goes according to plan and your baby goes full-term
(isn’t premature) or somewhere close to it, the third trimester
is one of the longest three-month periods of your life. Your partner begins to feel uncomfortable as her body makes it difficult to
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Part I: So You Want to Be a Dad . . .
move and sleep in a normal way, and you both get antsy about the
impending arrival.
To make the most of the time, you and your partner need to take
care of business, mainly picking a pediatrician who you’re comfortable with and has a similar parenting philosophy as you and your
partner, crafting your birth plan, hiring a doula if you want one,
getting your maternity and paternity leave squared away, ensuring that you understand your insurance benefits, creating a phone
tree to announce baby’s arrival, and finishing up any odd projects
around the house that need to be done prior to baby’s arrival.
During the third trimester, your baby is fully developed and
focused on growing larger and stronger for life on the outside. This
is also the last time for many, many years that you and your partner exist solely as a couple, so be sure to take the time to indulge
yourselves in the things you love to do together. Life may feel like
it’s on pause for at least the first six months of baby’s existence, so
get out now and enjoy the freedom of childlessness. Soon enough,
your life will be a lot more complicated and busy — and happy,
too. Very, very happy. Chapter 7 gives you more information on
what to expect and do in the third trimester.
While You Were Gestating
Because the first few weeks of pregnancy will probably be rather
uneventful, now is a good time to start a time capsule for the year
your baby will be born. Many years down the road, when your
child is an adult, it will be a touching, informative look back at the
time when he entered the world. For you and your partner, it will
be a fun, celebratory action to kick off the pregnancy festivities.
Keep movie tickets stubs, take-out menus, a newspaper from the
day you found out your partner was pregnant (as well as clippings of the most important headlines of the year), favorite ads,
magazine clippings, and so on. Make a mix CD of the most popular
songs, as well as one of your favorite music.
As you choose names, add the list of all potential names into the
time capsule. When you choose a paint color for the nursery, put
in the paint color card. Any decision you and your partner make
for the baby is a good candidate for inclusion. It may seem silly
now, but in 20 years it will be the best gift you can give your child.
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Chapter 2
Beyond the Bed:
Conception Smarts
In This Chapter
▶ Finding out why getting pregnant is harder than it looks sometimes
▶ Improving your health and lifestyle to help your chances
▶ Determining the right time for fertilization (and making it a good time)
▶ Understanding and dealing with infertility issues
▶ Talking to your family about your baby plans
Y
ou may have spent years trying not to get pregnant, so
the change from not trying to trying can be mind boggling.
Something even the most clueless people manage to do effortlessly
can cause you to lose sleep at night and turn sex into a job. Getting
pregnant is hard work sometimes.
In this chapter we tell you how to make the getting pregnant process
not just painless, but fun, even if it takes longer than you expected.
Understanding Conception
You can’t get pregnant any old time you want; your partner has to
be ovulating and releasing an egg, and you have to be sending some
good swimmers her way. The whole baby-making process can be so
complex that it seems like a miracle people are on earth at all. This
section tells you about the mechanics of how eggs and sperm actually get together and what they need from the two of you.
Baby making 101
Getting pregnant requires that several players be on the scene at
the right time: namely, good sperm and a mature egg. If the two
meet in the fallopian tube, which is the conduit from the ovary
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Part I: So You Want to Be a Dad . . .
down to the uterus, join together to form a fertilized egg, and then
float down to a uterus with a lining that’s exactly the right thickness to facilitate implantation, pregnancy occurs. If any of those
factors are amiss, well, that’s when things get complicated.
Producing a mature egg
Before she’s even born, a woman has all the eggs she’ll ever have.
Unlike sperm, no new eggs are being produced; the original eggs are
just matured, usually one at a time. Mature eggs are produced from
immature ones (called oocytes), located in the ovaries, through a
complex interaction of three hormones during the menstrual cycle.
Those hormones — estradiol (a form of estrogen), follicle stimulating hormone (FSH), and luteinizing hormone (LH) — work like this:
1. FSH stimulates the ovaries, which produce estrogen.
2. Estradiol production starts to mature a number of eggcontaining follicles, small cystlike structures that contain the
immature eggs.
3. One follicle, called a lead follicle, continues to develop
while the rest atrophy.
4. Around day 14 of the menstrual cycle, LH kicks in to
mature the egg and move it to the center of the follicle so it
can release.
5. The egg releases from the follicle and begins to float down
the fallopian tube. This is where you come in.
Figure 2-1 shows the events of a menstrual cycle when pregnancy
does not occur.
Sending in some good sperm
Sperm can only fertilize an egg that’s mature, so you need to either
have sperm waiting in the tube when the egg is released or get
some there within 12 to 24 hours after ovulation, because that’s
how long the egg can live. Sperm (shown in Figure 2-2) live for at
least a few days, so having sex the day before ovulation, or even
two days before, is usually adequate. If your partner is monitoring
her ovulation, give it one more shot the day of ovulation.
Making the journey and attaching to the uterus
After fertilization, the new potential life has to make it down the
tube to the uterus, where it implants. The journey from fallopian
tube to uterus takes between five to seven days, on average, and
implantation normally occurs seven to ten days after conception.
The fallopian tube is normally a fairly straight tube, but if it’s been
damaged by infection so that it’s twisted or dilated, the embryo
may wander around in the crevasses and never get to the uterus.
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Chapter 2: Beyond the Bed: Conception Smarts
1
Uterus
Fallopian tube
Egg
Egg matures
in ovary
Ovary
2
Uterine
lining begins
to thicken
Egg
Egg is released
into fallopian tube
Vagina
Uterine lining
continues
thickening
3
Egg
enters
uterus
Egg
4
Uterine
lining
continues
thickening
Uterine lining sheds
as menstrual fluid
Egg
Egg, unfertilized, is shed
Figure 2-1: Every event in the menstrual cycle has a purpose.
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Part I: So You Want to Be a Dad . . .
Head
Midpiece
Tail
Figure 2-2: Sperm are compact swimming machines.
Even worse, it may implant in the tube, which is an ectopic pregnancy. The tube has no room for a developing fetus, so an ectopic
pregnancy is doomed from the start and can cause serious, lifethreatening bleeding if the tube ruptures.
Even after the embryo reaches the uterus, it’s not always clear
sailing. The uterine lining has to be just right for implantation.
Estrogen thickens the lining before ovulation, and progesterone
released from the corpus luteum, the leftover shell of the follicle
that contained the egg, prepares the lining after ovulation.
Why so many sperm?
Women produce one egg a month, most of the time, and men produce millions of
sperm. You may wonder, why the huge disparity? Because of the inability of one sperm
to do the honors. Only one sperm makes it into the egg, but it takes many sperm to
break down the coating that surrounds the egg. And while eggs get to drift downward
from the ovary to the fallopian tube, sperm have to swim upstream. Needless to say,
some fall by the wayside.
Sperm also are produced in large quantities because many are abnormal, having
two tails, no tails, round tails, small heads, large heads, or abnormally shaped
heads. Abnormal tails make navigation difficult, and abnormal heads often indicate
chromosomal abnormalities.
Only 50 to 60 percent of sperm need good motility, or movement, for a sperm sample
to be considered normal, so lots of sperm don’t make the grade, creating a need
for more numbers.
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Chapter 2: Beyond the Bed: Conception Smarts
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If either of these hormone levels are low, the lining may not be
able to support a pregnancy. Your partner’s doctor can assess the
uterine lining by ultrasound and prescribe extra progesterone if
needed to achieve pregnancy.
After the embryo reaches the uterus and implants, the implanting embryo begins to produce human chorionic gonadotropin, or
hCG, the hormone that pregnancy tests measure. hCG levels aren’t
detectable until the embryo implants, or around the time of the
first missed period.
Conception statistics
If you don’t get pregnant the first month you try, the wheels in
your head may start turning as you obsess about why this is taking
so long. Pregnancy is by no means a sure thing, even when you do
everything right and have no major fertility issues. In any given
month, statistics say that:
✓ Out of 100 couples under age 35 trying to get pregnant in a
given month, 20 will achieve their goal, but 3 will miscarry.
✓ If your partner is in her late 30s, you have a 10 percent chance of
pregnancy each month, but a 34 percent chance of miscarriage.
✓ If she’s older than 40, you have only a 5 percent chance of
pregnancy each month, and more than a 50 percent chance of
miscarriage.
The good news is that 75 out of 100 30-year-olds trying to get pregnant will become pregnant within a year of trying, and 66 percent
of 35-year-olds will get pregnant in a year. Around 44 percent of
40-year-olds become pregnant within a year. Over age 40, variables
such as hormone levels affect pregnancy rates, and generalizations
are hard to make.
Answering commonly asked questions
about getting pregnant
Getting pregnant may seem straightforward, but what exactly does
it take? Here are some answers to the most common concerns:
✓ How long does it take?
On average, more than half of couples get pregnant within
the first six months of trying and four out of five are pregnant
within one year.
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✓ Does having more sex increase the chances of pregnancy?
No. In fact, due to the amount of time it takes for semen
volume to build back up to normal levels following ejaculation, overdoing it around ovulation time by having sex several
times a day can deplete your sperm count, which probably
won’t be a problem if you have a normal sperm count, but can
be if your count is low.
✓ Should we only have sex with my partner on her back and
me on top?
It’s a myth that this standard position is the best way to get
pregnant. While it may help the semen stay in better, there
is no scientific proof that the sexual position you choose has
any effect on conception rates.
✓ Does my partner’s past use of the birth control pill mean it
will take longer?
It varies from person to person. One woman can miss a single
pill and end up pregnant while others may take a little longer.
Just remember, the chances of getting pregnant the first
month are small, but the average couple is pregnant within a
year regardless of past birth-control usage.
✓ Is it okay to drink and smoke when trying to conceive?
If you’re ready to be pregnant, you should give up smoking immediately. Occasionally having a drink or two when
you’re trying to become a mom or dad won’t likely produce a
negative outcome, but the general rule of thumb is to live as
though your partner is pregnant from the moment you begin
trying to conceive. Check out the next section for more tips
on getting healthy to improve the odds of conception.
Evaluating Health to Get
Ready for Parenthood
Some health issues and bad habits can make it harder to get pregnant. A few months before trying to get pregnant, take inventory of
behaviors and health issues and get yourselves into the best shape
possible, not only so that you can get pregnant without difficulty
but also so you’ll be healthy new parents.
Checking out your physical health before trying to get pregnant
isn’t difficult. See your doctor, let him know you’re trying to get
pregnant, change any medications that may impact fertility, and
run some blood tests.
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Uncovering female health issues
that impact conception
Many female health problems can cause fertility difficulties.
Some affect egg production and the menstrual cycle; others affect
egg transport and implantation, like fibroids and fallopian tube
damage. Many can be improved after you identify them.
Sexually transmitted diseases
One of the biggest fertility busters in the age of sexual freedom is
sexually transmitted diseases, or STDs. The following STDs can
affect female fertility in these ways:
✓ Chlamydia, if not treated promptly, increases by 40 percent
the risk of pelvic inflammatory disease, which damages the
fallopian tubes. Women with PID are seven to ten times more
likely to have an ectopic pregnancy. Eighty percent of women
who have had chlamydia three or more times are infertile.
✓ Gonorrhea also increases the risk of PID and ectopic pregnancy.
✓ Syphilis can cause miscarriage, stillbirth, and developmental
delays and blindness in your unborn child.
STDs need to be treated early with antibiotics before damage is
done to the tubes. Having a hysterosalpingogram (HSG), a dye test
to assess the patency of the tubes, is a good idea if your partner
has any concerns about whether her tubes have been damaged in
the past.
Endometriosis
Endometriosis, implantation of the tissue that lines the inside
of the uterus in places it doesn’t belong, is common; 5.5 million
women in the United States suffer from it, and 40 percent of women
with endometriosis have fertility issues.
Endometriosis tissue bleeds at the time of the menstrual period
and leads to scarring and pain. Endometrial implants can be
removed in some cases, but they tend to recur. Most endometriosis is found in the pelvis, near the uterus, but it can turn up
in some odd places, like the lungs. In vitro fertilization (IVF) can
increase the chances of pregnancy in women with endometriosis.
Polycystic ovary syndrome
Polycystic ovary syndrome, PCOS, affects between 5 to 10 percent
of women of childbearing age, and can cause anovulation, or failure
to produce a mature egg. PCOS is associated with an abnormal
rise in male hormones, called androgens; all women have some
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Part I: So You Want to Be a Dad . . .
male hormones, but women with PCOS have more than normal.
They’re often overweight and have excess body and facial hair,
thinning head hair (just like some men), and acne. Women with
PCOS also have a higher rate of type 2 diabetes, heart disease, high
cholesterol, and high blood pressure. Fertility medications may be
needed for women with PCOS to get pregnant.
Thyroid problems
Thyroid problems are common in women of childbearing age and
can cause anovulation (failure to recruit and develop eggs). A
simple blood test checks for thyroid function. Low thyroid levels
can raise prolactin levels, which can also interfere with ovulation.
Fibroids
Fibroids are common uterine growths (rarely cancerous) that
occur in up to 75 percent of women and often cause no problems
with conception. However, fibroids can grow big enough to interfere with embryo implantation or to cause preterm labor in some
women. See Figure 2-3.
Fibroids are easily seen with pelvic ultrasound, and can be
removed surgically if they appear to be interfering with pregnancy.
Fallopian tube
Uterus
Ovary
Uterine wall
Fibroids
Figure 2-3: Fibroids grow into the uterine lining and occasionally interfere with
pregnancy.
Recognizing issues that cause
fertility problems in men
Sperm take a long time to make. Sperm you ejaculate today have been
three months in the making, so if you’re working on health problems
or making lifestyle changes, give them enough time to take effect.
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While male health issues may seem less important to a quick conception, your health problems can interfere with conception. Here
are a few examples of potentially problematic issues:
✓ Diabetic men often have problems with erection and ejaculation. Presumably if you have a problem with erection, you’re
already well aware of it, but ejaculatory issues may not be
quite as obvious. Retrograde ejaculation, where sperm get
pushed into the bladder rather than out through the urethra,
can affect diabetic men.
✓ Men who take high-blood-pressure medications called calcium
channel blockers may have sperm that don’t penetrate eggs
well; other blood pressure medications may cause retrograde
ejaculation.
✓ Toxins common to the workplace, such as lead, X-rays,
inhaled anesthetics in the operating room, and a host of other
environmentally damaging substances can also be damaging
your internal plumbing if you work with them frequently.
✓ STDs can also take their toll on the male reproductive system.
Chlamydia and gonorrhea can cause an infection and inflammation in the epididymis, part of the testes where sperm develop.
Syphilis can cause low sperm count and poor motility.
Assessing lifestyle choices that
affect eggs and sperm
You can impact your chances of pregnancy every month with your
lifestyle choices. Yes, giving up bad habits is painful, but not getting pregnant month after month is pretty painful, too. Take the
step of cutting the following bad habits out of your life before you
start trying to get pregnant.
Smoking
Smoking can affect sperm and eggs and increase miscarriage rates.
Nearly one in four adults smoke in America. If either of you is a
smoker, quit for at least a few months before trying to get pregnant. It may help you avoid these pitfalls:
✓ Smokers have sperm that are less motile (capable of moving
spontaneously). They have a long way to go to reach the egg,
so they need all the motility they can get.
✓ Smokers have lower sperm counts and more abnormally
shaped sperm, which are chromosomally abnormal.
✓ Female smokers have more eggs that are chromosomally
abnormal.
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✓ Female smokers have a 50 percent higher rate of miscarriage.
✓ Smokers are two to four times more likely to have ectopic
pregnancy, pregnancy that implants outside the uterus.
Drinking alcohol
Alcohol has far-reaching issues for the fetus long past the moment
of conception, so cutting out alcohol before trying to get pregnant
and avoiding it like the plague after getting pregnant are essential
for your partner. It won’t hurt you, either. Heavy drinking, three or
more drinks a day for a guy, can decrease sperm quantity and quality. And a drink doesn’t have to be hard liquor; one beer is a drink.
Using drugs
Two commonly used drugs can affect male fertility: marijuana and
anabolic steroids. Marijuana lowers testosterone levels in males,
and testosterone is the male hormone responsible for male sexual
functioning and sperm production. Sperm counts are lower and
sperm is less motile in men who use marijuana regularly.
Steroid use is more common than you may think: 6 to 7 percent
of all men have used steroids to build muscle mass. Steroids suppress testosterone production and can cause irreversible damage
to the sperm production line. Avoid anabolic steroids at all costs.
Maintaining an unhealthy weight
Unfortunately, being overweight is a huge problem, and it’s getting
bigger all the time. Around 20 percent of women of childbearing
age in the United States are obese. Women who are overweight
may not ovulate, and if they don’t ovulate, they can’t get pregnant.
One Australian study showed that obese women were only half as
likely to get pregnant as normal-weight women.
However, being underweight can also interfere with ovulation.
Overall, 12 percent of infertility issues are related to being over- or
underweight. Fortunately, either losing or gaining weight in these
cases results in pregnancy 70 percent of the time.
Issues that may never have crossed your mind
Sometimes behaviors you may never have considered can negatively impact your chances of pregnancy. Here are a few:
✓ Douching: Although between one-third to one-half of childbearing age women do it, it’s not only unnecessary, it’s potentially harmful. Women who douche are 73 percent more likely
to have pelvic inflammatory disease, which can seriously
damage the fallopian tubes and increases the chance of ectopic pregnancy by about the same percentage.
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And because you want your partner around for a long time,
remind her of this statistic: Women who douche are 80 percent more likely to develop cervical cancer.
✓ Not sitting on the couch enough: No, not really — some exercise is definitely good for you. But some sports, like bicycling,
may cause testicular damage from the pressure of the bike
seat. Women who exercise too heavily may stop having periods (called amenorrhea), and good luck getting pregnant without them.
✓ Spending time in hot tubs and other heat sources: Hot tubs,
tight underwear, saunas, steam rooms, and anything else that
raises the temperature of the testicles is bad for the boys. Hot
tubs may also damage eggs and increase miscarriage rates, so
neither of you should be lolling in the hot tub.
Keeping Sex from Becoming a Chore
As unfathomable as it seems, sex while trying to conceive isn’t
always fun. Couples often begin to feel a sense of duty and pressure when they segue from spontaneity to planning exactly when
to have sex to increase chances of conception. Monitoring rises in
body temperature, charting mucus, and even lying down afterward
to give the semen time to do its job are just a few of the unromantic actions that can take your sex life from crackin’ to clinical.
Pleasure may seem to take a back seat to the goal of having a baby,
and nothing takes the “sexy” out of sex faster than making it feel
like work. In fact, if the sex becomes solely about trying to conceive, you may begin to feel a bit like a sperm-producing machine
that’s only needed during ovulation, and performance issues can
arise (no pun intended).
If for some reason conception takes a while, this feeling will only
increase as you both grow impatient. If you begin to suffer these
feelings, share them with your partner immediately. Plan “sex dates”
that don’t revolve around conception time and discuss ways to
create a more relaxing, less stressful, romantic environment.
Choosing the best time for conception
We’re not talking about the phase of the moon or the alignment
of the stars here; we’re talking about planning to have sex at certain times to increase the odds that you’ll hit the day when an egg
is present and ready to be fertilized. Not all women have 28-day
menstrual cycles, and ovulation doesn’t always occur on day 14
of the cycle. Ovulation does always occur 12 to 14 days before the
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Part I: So You Want to Be a Dad . . .
next period is due, or, to be more accurate, your partner’s period
starts 12 to 14 days after ovulation occurs. You can figure out the
best timing for your conception efforts in several ways, which we
explore in the following sections.
Monitoring ovulation with a kit
Predicting ovulation doesn’t take mind-reading abilities. Simple
observation and a few ovulation predictor kits from the pharmacy
are all you need to pinpoint the big day. Ovulation predictor kits
(OPK) pinpoint the rise in luteinizing hormone that occurs just
before egg release. Your partner urinates into a cup, and then dips
the test stick into the urine and reads the results.
The only drawback to OPKs is that women who have high levels of
LH normally, like women in or near menopause and women with
PCOS, may not get accurate results.
Watching for physical signs of ovulation
Your partner may also be able to tell when ovulation occurs by
these signs:
✓ Cervical mucus becomes more copious, thinner, and more
slippery and stretchy as ovulation approaches.
✓ She may have mittelschmerz, a pain on the left or right side as
the egg releases from the ovary.
✓ Her temperature drops slightly right before ovulation and
rises afterward.
Ovulation can be tracked by keeping a monthly temperature chart,
but it can be a real pain because she has to take her temperature
first thing in the morning, before she gets out of bed, uses the
bathroom, or has a cup of coffee.
Catching ovulation with a regular visit
If you don’t want to closely monitor ovulation, you can take the
easy way and simply have sex on a frequent, regular schedule.
Doctors seem to have differing opinions on how much sex is
enough when you’re trying to get pregnant. Some say every other
day helps build up a good supply of sperm; some say every day is
okay starting a few days before ovulation and continuing (if you’re
not dead yet) until the day after ovulation.
The most sensible schedule suggests having sex every other day, all
month if you’re up for it, starting right after her period ends. Since
sperm live for up to 5 days, having sex the day before ovulation or
the day of gives you a good shot at fertilization, and if you’re aiming
for every other day, you’re bound to hit one or the other.
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Looking at do’s and don’ts for
scheduling sex
Just because you’ve written sex down on your calendar doesn’t
mean it’s just another obligation that eats up your time and lacks
excitement. After all, this appointment has a far bigger upside than
the average visit to the dentist.
Since you have only a few ideal times each month to conceive, you
need to make time for sex on those days, which requires planning
ahead. Follow these do’s and don’ts to make sure your sex life
doesn’t suffer for the sake of conception.
Do:
✓ Put it on your calendar. While it may seem unsexy, it can be
very exciting to look forward to intercourse all week. In fact,
verbal foreplay leading up to intercourse will only increase
the excitement.
✓ Plan a date that night if possible to make it a full-fledged
romantic evening. Making it just about the sex will increase
the pressure to perform.
✓ Engage in foreplay. On TV and in movies, you often see the
ovulating woman demand sex the minute her body temperature leads her to believe it’s the best time. Make sure to keep
it romantic and intimate. Some light massage, touching, and
kissing should do the trick.
✓ Mix it up. Remember that though some positions are supposed to be better when trying to conceive, that doesn’t mean
you have to stay in the same one the whole time.
✓ Keep it spontaneous. Knowing the exact date you’re going to
have sex doesn’t mean the setting has to stay the same. Play
music, light candles, take a warm bath (not too hot — remember, you don’t want to overheat the boys!), or even play out a
fantasy if your partner is onboard.
✓ Help make the aftermath enjoyable. Your partner may want
to elevate her legs and stay in bed for a while after intercourse to give the semen the best chance to stay put. Help her
elevate her legs, and then put on her favorite show or read to
her from a book. Don’t just get up and leave her alone.
✓ Have unscheduled sex. Letting nature run its course every
once and a while is okay, even when your road to conception
is more like driving in bumper-to-bumper traffic than the autobahn. After ejaculation, sperm can live in a woman’s reproductive tract for up to five days.
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Don’t:
✓ Try too hard. Sex carries its own set of complex, anxietyinducing expectations, but now that the expectations include
creating a baby, the pressure can become downright overwhelming. If you experience performance issues, either
mental or physical, due to the stress of the moment, talk it out
with your partner. You won’t do anyone a favor by having sex
as if you’re taking the SAT.
✓ Talk about the baby. Unless talking about getting her pregnant is a turn-on to your partner, keep the baby discussion
out of the sex equation. Although trying to have a baby does
indeed require sex, talking about getting her pregnant while
engaging in intercourse likely won’t set your bedroom on fire.
✓ Drink before you have sex. Alcohol can cause performance
issues, and the last thing you want to do is let your partner
down because you had one too many beers.
✓ Assume your partner isn’t interested in both pleasure and
conception. In fact, studies show that women who orgasm
have a greater chance of conceiving than those who don’t.
✓ Make her laugh afterward. Keeping a good sense of humor
during sex is always a good thing, but after you ejaculate keep
the comedy to a minimum. Laughing tenses muscles that cause
the semen to come out, reducing the chance of conception.
Taking a Brief Yet Important
Look at Infertility
Infertility is an issue that affects more than 7 million people in
the United States, but not getting pregnant within a month or two
doesn’t necessarily mean you’re infertile. Couples under the age of
35 are diagnosed with infertility following 12 months of attempted
reproduction that do not yield a pregnancy.
Knowing the facts about infertility
Imagine 100 average couples under the age of 35 trying to get
pregnant — the following outcomes are expected:
✓ 75 couples are pregnant within a year.
✓ 10 couples are pregnant after two years of trying without
medical intervention.
✓ 10 couples need treatment from an infertility specialist in
order to conceive.
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Causes of infertility can be complex and often hard to diagnose.
Some are related to health and lifestyle issues discussed in the
section “Evaluating Health to Get Ready for Parenthood” in this
chapter. Despite treatments and diagnostic practices that primarily focus on women, the statistics paint a different picture:
✓ One-third of infertility is diagnosed as female-factor.
✓ One-third of infertility is diagnosed as male-factor.
✓ Between 10 and 15 percent of infertility cases are diagnosed
as a combination of male- and female-factor.
✓ About 20 percent of infertility cases are unexplained following
diagnostic testing.
For women, the main causes of infertility are
✓ Ovulatory disorders: No ovulation or ovulation on an irregular schedule
✓ Tubal disorders: Fallopian tubes are blocked or have an infection that interferes with ovulation or sperm travel
✓ Uterine issues: Fibroids (noncancerous tumors in the uterus)
and polyps (growths that can cause blockages)
For men, the main causes of infertility are
✓ Low sperm count: Not enough guys to get the job done
✓ Decreased sperm motility: The sperm has trouble moving forward into the fallopian tubes
✓ Abnormally shaped sperm: Abnormal shapes usually indicate
chromosomal abnormalities
✓ No sperm present in the ejaculate: A blockage somewhere in
the reproductive tract or hormonal disorders can cause an
absence of sperm
Checking on potential problems
when nothing’s happening
For many couples, the first step toward fixing infertility is admitting
that you’re having a problem. It’s not an easy revelation to make,
because it means that at some basic level your bodies are failing
you. Fertility problems aren’t fair, they’re not fun, and they can be
cause for a wide array of emotions, frustrations, and outright anger.
The good news is that we live in an age in which getting pregnant
doesn’t have to be a simple matter of the birds and the bees.
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Throw in a doctor or two, and you may be well on your way to conceiving in no time flat.
If you’re not getting pregnant after a few months, especially if your
partner is older than 35, it’s time to check things out — for both of
you. For her, this may involve the following tests:
✓ Blood tests: These check hormone levels, including follicle
stimulating hormone, or FSH. FSH levels are normally below
9 mIU/ml on day two or three of the menstrual cycle; higher
levels indicate decreased ovarian reserve and the possible
need for medical intervention.
✓ Hysterosalpingogram (HSG): This test injects dye into the
uterus through a catheter placed through the cervix. The dye
outlines the shape of the uterus and fallopian tubes. HSG can
identify blockages in or dilation of the fallopian tubes that interferes with embryo transport, and it also shows fibroids and
polyps in the uterus, which may interfere with implantation.
✓ Hysteroscopy: This test uses an endoscope, a sort of minitelescope, to evaluate the uterus for fibroids or polyps, small
growths that can interfere with implantation. Small fibroids
and polyps can also be removed at the time of the test.
For you, it’s a quick trip to the urologist for a full physical, blood
work, and a semen analysis. This is the only way you can find out
your sperm count and the quality and motility of your sperm.
Collection of semen is just as uncomfortable as it sounds, but
it must be done. Just keep your expectations to a minimum and
forget all of those movie scenes showing posh rooms, dirty magazines, and absolute privacy. If you have to produce in the doctor’s
office or a hospital lab, you may very well find yourself in a bathroom, unable to escape the distractions of screaming children and
the witty banter of the nursing staff.
Some offices allow specimens to be collected in the privacy of
your home and then delivered to the lab within an hour. Ask your
doctor about this alternative, as well as any special instructions
for collection and transportation.
Working through it when your
partner needs treatment
Some female fertility issues are easily dealt with by simply taking
a pill that induces ovulation. But female infertility can also lead
to daily injections of fertility medications, uncomfortable vaginal
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ultrasounds to assess egg development, painful surgeries to remove
fibroids or repair damaged fallopian tubes, and frequent blood tests.
Fixing female fertility issues can be a drawn-out affair that combines inconvenient and uncomfortable procedures with medications that manipulate hormones, a difficult combination if there
ever was one. And if she suddenly views childbearing as a woman’s
most important prerogative, her seeming inability to accomplish it
and subsequent emotions can make fertility treatment a tough time
for both of you.
Even though you may have your own stresses when dealing with
fertility issues, remember that at least you aren’t dealing with a
barrage of excess hormones, and keep your cool if conversations
get complicated.
Exploring solutions when your sperm
don’t stack up
A count of less than 20 million is considered a low sperm count.
Although that may sound like a large number, due to the number
of abnormal sperm in the normal sample as well as the distance
required to reach the egg, it takes a lot of good sperm to achieve
conception.
Sperm is produced on a cycle, so the semen you produce now
actually was created three months ago. If your sperm count is low,
start by thinking back to what was going on then. An illness, medications, or a hot-tub vacation may be the culprit.
Learning the components
What exactly makes a semen specimen normal? The following
guidelines from the World Health Organization (WHO) are deemed
the ideal for baby making:
✓ Volume: About 1.5 to 5 milliliters of semen should be present
in a single ejaculate, equaling about a teaspoon.
✓ Concentration: Strength in numbers is key. You’ll need at
least 20 million sperm per milliliter of ejaculate to hit the
normal range.
✓ Motility: For every man, an average ejaculate contains dead,
slow, and immobile sperm. However, at least 40 percent of
your sperm in a single sample should be moving.
✓ Morphology: Shape is also important to reproduction, and the
lab technician examining your sample takes a close look at
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Part I: So You Want to Be a Dad . . .
how many of your swimmers are normally shaped. A normal
amount of normally shaped sperm is considered to be anything above 30 percent.
✓ Trajectory: Graded on a four-point scale, this test determines
how many of your sperm are moving forward. You’re looking
for a score of 2+ to be considered normal.
✓ White blood cells: Too many white blood cells can indicate
an infection in your groin. A passing grade is no more than 0
to 5 per power field.
✓ Hyperviscosity: Your semen sample should liquefy within
30 minutes after ejaculation. If it takes longer, it reduces
the chances for sperm to swim before being expelled from
the vagina.
✓ pH: Like a AA battery, your semen needs to be alkaline in
order to avoid making the vagina too acidic and, ultimately,
killing the sperm.
In addition to the above, a semen analysis evaluates the following:
✓ Head quality: The head of the sperm contains all of the
genetic material, so if the head is misshapen, it won’t be capable of fertilizing an egg.
✓ Midsection malaise: Believe it or not, this part of your sperm
contains fructose, which gives your sperm energy to swim. If
the levels are low, it can account for slow swimmers.
✓ Tail troubles: Much like a fish, a good tail is required for the
sperm to swim forward. If too many of your sperm have no
tail, multiple tails, or tails that are coiled or kinked, they won’t
reach their destination.
A low sperm count may have you feeling, well, downright low.
Feeling embarrassed is completely natural but also completely
unnecessary. Infertility has no correlation to a man’s masculinity,
nor does it have anything to do with the size of his penis. Having a
low sperm count is no different than having asthma — it’s a medical condition that requires treatment.
Identifying and treating the causes
Because sperm counts are created months out, you’ll need to have
a follow-up semen analysis to see if the issue is corrected by lifestyle changes. Although you won’t be in a rush to do it all again
anytime soon, whether your results are good or bad, schedule
a follow-up analysis four to six weeks after the first one to get a
better, more complete picture.
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The most common cause of a low sperm count is a varicocele, an
abnormality in the vein in your scrotum that drains the testicles.
Varicoceles can cause decreased fertility in the following ways:
✓ Increasing temperature in the testes
✓ Decreasing blood flow around the testicles
✓ Slowing sperm production and motility
Varicoceles are treatable in the following ways:
✓ Surgery: An outpatient procedure during which an incision
is made just above the groin and the swollen vein is “tied
off.” Recovery takes seven to ten days and requires minimal
activity and no heavy lifting. Risks are minimal and include
infection, nerve injury, and the collection of fluid around the
testicles.
✓ Radiographic embolization: Also an outpatient procedure, this
requires the insertion of a catheter through the femoral vein in
the groin. Dye is injected to show where the problem is located
and, when isolated, it’s blocked so blood flow to that vein stops.
Other less-common male-fertility issues include the following:
✓ Hormone imbalances: Medications to adjust hormone levels
may improve sperm quantity.
✓ Chromosomal abnormalities: One such problem is sperm
that lack part of the Y chromosome, the male chromosome.
In vitro fertilization (IVF) and intracycloplasmic sperm injection
(ICSI), where the best-looking sperm are injected directly into
your partner’s egg in the lab, can help overcome abnormal
sperm issues. (See the following section for more info.)
✓ History of cancer: Having treatment for cancer, including lymphoma and testicular cancer, can kill or damage sperm. Many
men freeze sperm before undergoing cancer treatment for this
reason.
✓ Various diseases: Diabetes, sickle cell disease, and kidney and
liver diseases can cause problems. Treatment depends on
your individual issues.
Even if your ejaculate has no sperm at all, a procedure called a
sperm aspiration in conjunction with an IVF cycle may be able to
remove sperm directly from the testicles.
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Part I: So You Want to Be a Dad . . .
Deciding how far to
go to get pregnant
Deciding what steps you’re willing to take in order to get pregnant will be easier after you have a better understanding of the
infertility issues you and your partner are facing. Most infertility
treatments can be quite expensive, so check with your insurance
company to see what is covered. Making the decision based on
finances seems heartless, but if your insurance doesn’t cover a
treatment or medicines, you can be looking at bills in the thousands of dollars.
The most common procedures to aid in pregnancy are the following:
✓ Intrauterine insemination (IUI): A lab tech takes your sperm
sample, pulls out the best of the best, and adds it to a saline
solution, which then is inserted past your partner’s cervix.
This gives the sperm a far shorter distance to travel and a
greater chance for success.
✓ In vitro fertilization (IVF): Sperm meets egg in a lab, and then
the fertilized embryo is placed into the womb. Fertilization
can take place by either placing a concentrated semen
sample in a dish with the egg or via ICSI, intraycloplasmic
sperm injection. In ICSI, a single sperm is injected directly
into a mature egg. Even with ICSI, fertilization may not occur,
because the egg or sperm may be chromosomally abnormal,
which in some cases isn’t evident just by looking at it.
Try not to make too many long-term decisions about how far
you’re willing to go, because undergoing fertility treatments is like
riding a roller coaster, and once you’re on, it becomes harder to
get off. Especially when it feels like your baby could be just around
the next corner. Make decisions month-to-month and procedureto-procedure to avoid stress and allow for an open, ever-changing
dialogue with your partner.
Sharing Your Decision
to Have a Baby
Deciding to try to have a baby is a very big, very exciting step
for most couples, and increasingly it is something many people
choose to share with a select group of friends and family members.
News of an expanding family is usually met with joy, cheers, and
even a few inappropriate jokes about your sex life. But although
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Chapter 2: Beyond the Bed: Conception Smarts
43
sharing good news is fun, you also need to be prepared for people
in the know to ask nosy questions and offer unwanted advice.
Considering the pros and cons
of spilling the beans
Sharing the news means that you’re turning your quest to have
a baby into a mini-reality show that your loved ones are going to
closely follow. Having a well of support during this time can be
great, but having your mom and dad hinting for info every time you
talk on the phone also can feel intrusive.
If getting pregnant takes longer than expected, you’re also setting
yourself up to have to deal with the inevitable questions about
the delay. On the plus side, if you and your partner must deal with
infertility, you’ll need all the support you can muster.
Just make sure you’re both ready to continue sharing information
and dealing with questions from the people you tell. Once their
curiosity is piqued and their excitement sparked, there’s no turning back. (Especially for a first-time grandmother-to-be.)
Handling unsolicited advice
about reproduction
You may think you’ve got a handle on lovemaking, but after you
announce to the world that you’re trying to have a baby, it may
seem like all the folks in your life suddenly morph into Dr. Ruth.
Now that reproduction is fodder for morning news programs and
countless blogs and Internet sites, more people have more sound
bites and nuggets of wisdom to offer you and your partner than
ever before. If your mother tells your partner she shouldn’t be
eating that grilled hamburger because the Today show said so,
or telling you that you really should be wearing boxers instead of
briefs, you may find yourself at wit’s end before you even make it
to the bedroom.
If your loved ones start interfering or offering advice that you don’t
want, thank them for their excitement and interest, but reassure
them that you have the situation under control. Remind them that
people have been having babies forever and let them know that
being bombarded with all this information, be it from them, the TV,
or the newspaper, stresses out you and your partner, and that can
decrease your chances of conception.
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Part I: So You Want to Be a Dad . . .
Not all unsolicited advice is about the act of having sex. Some
people may think you’re too young or too old to have kids. Your
parents may chime in about how expensive kids are, implying that
you’re not financially ready to have a baby. Perhaps your stressedout brother (and father of three) tells you to enjoy your freedom
while you still can.
Whether somebody thinks you’re too immature to be a father
because you still play Xbox or that your wife’s job is too demanding for her to be a mother, remember that the only voices that
matter are yours and your partner’s.
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Part II
Great Expectations:
Nine Months and
Counting
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A
In this part...
fter you’ve gotten past conception, a whole new field
of emotions, experiences, and concerns pops up.
From the sometimes uncomfortable moments of early and
late pregnancy to the thrills of hearing the baby’s heartbeat and seeing the first ultrasound pictures, pregnancy is
a roller coaster ride like no other. This part takes you from
the positive pregnancy test to delivery options, covering
every aspect of fetal and maternal growth as well as the
all-consuming questions of what kind of stroller and car
seat to buy.
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Chapter 3
Surviving Sudden Doubts
and Morning Sickness:
The First Trimester
In This Chapter
▶ Getting the news that your partner is pregnant
▶ Finding a doctor and attending important appointments
▶ Taking a look at fetal growth in early pregnancy
▶ Understanding the complications that can arise
▶ Taking on the role of a supportive partner
F
ew new fathers-to-be actually pass out when they get the big
news that there’s a baby in their future, despite what you see
on old television shows. That’s not to say you may not feel a bit
blown away by the news, though. Whether you’ve been trying for
ten years or just met your partner last month, hearing that you’re
about to be a dad is life changing.
Early pregnancy is not without its physical, mental, and emotional
challenges, and although your partner bears the brunt of it, you
can expect to experience a few symptoms, too. In this chapter we
tell you what happens in the first few months and help you adjust
to one of the biggest events in your life.
Baby on Board: It’s Official!
Nothing is more momentous than hearing from your partner, “It’s positive! I’m pregnant!” If you’ve been trying to get pregnant for a while,
these words are your cue to breathe a sigh of relief — your boys can
swim! In fact, you may feel more relief than excitement at first. Trying
to get pregnant can be quite stressful, as we discuss in Chapter 2, and
the news that your worst fears can be put aside is reason for relief.
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Part II: Great Expectations: Nine Months and Counting
On the other hand, if this was a big “oops” on your part — and many
pregnancies are, even in this day and age — your first reaction may
be more like, “Oh . . . heck,” or worse. Don’t feel guilty if your first
reaction is negative; most of the world’s babies were an “Oh, heck”
at one time. In many cases pregnancy takes time to get used to.
Reacting when your partner
breaks the news
When your partner tells you the big news, try to mirror her
reaction, at least outwardly. If her reaction is, “Oh . . . heck,”
you can go along in that vein also, at least for a minute or two.
Remember, though, that she is gauging your reaction to the
news, and if you act like having a baby is a huge imposition in
your life, she’s going to be really upset, even if she just said the
same things five minutes before.
So try to throw in a few encouraging statements about how you
wanted kids eventually, having a baby will be fun in the winter
when there’s nothing else to do, or whatever encouraging babble
you can come up with at a stressful time.
Some women get very creative with their announcements, from
filling the living room with balloons to baking a cake with a pair of
booties inside. Just try to not choke on one, literally or figuratively.
If she’s gone all out to break the news, you can safely bet that she’s
really excited, so make sure she knows you feel the same way.
Even if you’ve been trying to conceive forever, an initial fear reaction isn’t uncommon. Remember that your partner may also be
feeling some sudden doubts and fears, and allow her to express
them. Under no circumstances is “We spent $20,000 for fertility
treatments and now you’re not sure this is the right time?!” the
right response to her feelings of concern.
Making the announcement
to friends and family
Deciding when to tell family and friends is tricky. On one hand,
telling on the first day of the missed period makes the pregnancy
seem about 15 months long, and telling early means you’ll need
to go through the grief of telling everyone if a miscarriage occurs,
which happens in around 20 percent of pregnancies.
On the other hand, you may have told people you’re trying, and
they may be obsessively counting the minutes until your partner
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Chapter 3: Surviving Sudden Doubts and Morning Sickness
49
can take a pregnancy test, too. If that’s the case, saying, “Gee, we
don’t know yet; we forgot to do the test” is going to come across as
a big insult, and “We’ve decided not to tell anyone” will probably
get you thrown out of the will. If you’ve been going through fertility
treatment, you may feel the need to tell your fertility friends right
away, because they know exactly when your embryo transfer and
pregnancy test took place.
If you’ve already had to deal with a miscarriage, you may be
understandably more reluctant to tell people in the first trimester.
Nearly all miscarriages occur in the first 12 weeks of pregnancy,
and most of those occur before 8 weeks, so waiting until you’re
pretty sure the pregnancy is going well may be prudent.
Whenever and whoever you decide to tell, realize that keeping
news this big to yourself is hard. Even if you and your partner
make a solemn pact not to tell a soul until after the first ultrasound, don’t be shocked and disappointed to find out she’s already
told her best friend, mother, and entire online support group. In
fact, she may have told them before she told you. Be understanding, and sheepishly admit you secretly told your parents, the guys
at the gym, and half your co-workers, too.
Overcoming your fears
of being a father
You have a lot of time to get used to the idea of being a dad, so don’t
worry if you have a lot of fears at first. Even if you aren’t sure you’re
ready to become a father, you’ll be surprised how quickly you come
around to the idea. Besides, the baby will be here before you know
it, ready or not.
When to tell work
For you, letting your work know that you’re a father-to-be may not be such a big
deal, because many workplaces still don’t have any sort of daddy maternity plan.
If yours does, though, let your boss know after the first three months, when you’re
reasonably sure things will go well with the pregnancy.
If your partner is working and dealing with a lot of nausea or other pregnancy
issues, the secret may be out earlier. The boss may not figure it out, but her coworkers may.
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Part II: Great Expectations: Nine Months and Counting
It’s important, however, to use this time to confront any fears
about parenting that you may have. Spend time with the male role
models from your past (and present!) and use them as learning
tools. Ask them what they did right, what they would change, and
what advice they have for you when raising your own child. It may
feel like you’re the first father ever, but you don’t need to reinvent
the wheel when it comes to parenting. If you admire someone
else’s skills, monitor and mimic their behaviors.
Working on overcoming your fatherhood fears is doubly important
if the father in your life wasn’t the best role model for the type of
dad you want to be to your son or daughter. To attempt to come to
terms with any wrongdoings your father may have committed, talk
with a counselor or therapist, or even a trusted friend, about your
relationship with your father and try to identify the mistakes you
don’t want to repeat. Talking about your experience with your own
father can also help heal some of the emotional wounds. Being a
father is hard work, and you don’t want to wait until after the baby
arrives to start overcoming your fears or past traumas.
Finding a Practitioner
Who Thinks Like You
When we talk about finding the right medical practitioner, we’re
not talking personality, although that’s important, too. Finding the
right pregnancy “partner” primarily means finding someone whose
basic philosophies on pregnancy and birth are similar to yours, so
that you don’t find yourself debating every single pregnancy and
birthing decision with your partner’s practitioner.
Medical practitioners’ views can vary tremendously on every facet
of pregnancy, from medication in labor to the vitamins your partner should take, so make sure you’re all in agreement on the biggies before signing up for nine months of visits.
Finding a doctor who works
for both of you
Finding a medical practitioner who both of you like and trust isn’t
as easy as looking in the phone book for the first obstetrician listed
under A. For one thing, many women already see a gynecologist for
routine care. However, not all gynecologists deliver babies; as they
age, they often choose to stop doing the middle-of–the-night phone
calls and races in to the hospital and just do gynecology.
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The situation can get sticky if your partner’s gynecologist doesn’t
do OB (obstetrics) but her partners do, and your partner can’t
stand the gynecologist’s partners. Or you’re thinking about a hospital birth, but you find out her gynecologist has the highest
cesarean section rate in the city. Or, in some cases, you and
your partner may opt for a low-tech birth and want to use a midwife for the pregnancy and delivery. If your partner has been
seeing her current gynecologist since she was 13, she may be
concerned about hurting his feelings by seeing someone else
during her pregnancy.
Your partner and you, if you go to the appointments, will be seeing
a lot of the person who’s going to deliver your baby over the next
eight months, so being comfortable with each other is essential.
Chapter 8 contains a list of interrogations — err, questions you
want to ask your prospective medical partner before planning
on spending the most important occasion of your life with her. In
addition, keep the following tips in mind:
✓ Doctor shopping is not a sin. Your insurance company may
refuse to pay for visits to several doctors, but if you can
afford it, you may want to see a few to decide who works best
for you. The office mood, the length of time you wait, and
the answers you get to your pointed questions can give you
a much better idea of who to choose than just going with a
friend’s recommendation or the information you find on the
Internet.
✓ Find out where your practitioner delivers. Next to how much
you like your practitioner, how much you like the birthing
facility is the most important thing.
✓ Ask who covers when your practitioner is off. Even the best
doctors and midwives take vacation and get sick, and getting
the partner you really dislike for your delivery can make the
birth a bit stressful (although in the end you’ll have the same
baby you were going to end up with anyway, no matter who
delivers him).
✓ Discuss birthing options right upfront. While this conversation may seem premature, the day your partner’s water
breaks is no time to find out that bed rest–labor induction–
epidural and a 50 percent rate of cesarean sections is your
practitioner’s standard labor plan. Asking about a doctor’s
rate of cesarean, for example, can give you insight into his
practices. Throwing out a few questions about water birth or
unmedicated delivery can also allow you to gauge his feelings
by his response.
If you want a midwife delivery, you may be extremely limited in
choices if you don’t live near a large city. Some hospitals have
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Part II: Great Expectations: Nine Months and Counting
midwives who run clinics but don’t do private practice, which may
not be what you want. If you can’t find a midwife, look for an obstetrician who treats childbirth more like a natural event than a pathology.
While you want to be involved, this is not your show. Let your partner
ask the questions and remember that she makes the final decision on
who she feels most comfortable spending the next nine months with.
Attending the first of many
prenatal visits
Many dads now attend prenatal visits, in stark contrast to the dark
ages before 1970 when fathers never went near the obstetricians —
or the labor room, either.
This is what you can expect during the first prenatal appointment:
✓ A vaginal exam: Many guys are not comfortable watching
their partner undergo a vaginal exam. Discuss this with your
partner before you go, because it will definitely happen.
✓ A pregnancy test: Blood may be drawn for specific pregnancy levels, or a simple urine test may be done, even if she’s
already had a positive home test.
✓ Blood tests: Your partner’s blood will be drawn to determine
the blood type and check for certain diseases, such as HIV
and syphilis, which can impact the baby. A complete blood
count, or CBC, to check for anemia will also be done.
✓ Time to talk: Your practitioner or the ancillary staff will go
over the prenatal schedule, prescribe vitamins, and discuss
your specific concerns. Because obstetricians, like other doctors, often seem to have one foot out the door even in the
middle of important discussions, make sure you pipe up and
ask about what’s important to you.
The first prenatal appointment is the longest one and is probably
the most important one for you to attend, so if you’re going to have
trouble getting to a lot of appointments, make sure you’re at this
one if at all possible. The later appointments are often so short you
may wonder why she has to go at all, but rest assured that doing a
few simple tests can prevent big-time problems.
Going to the first ultrasound
Your partner’s practitioner may decide to do an ultrasound in
the first few weeks, often as part of the first OB appointment,
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especially if she has any vaginal bleeding, the time of conception
hasn’t been determined, or if your partner did fertility treatments.
Ultrasounds are done at the doctor’s office, hospital, or radiology
office. Even though you won’t see much, seeing that “something” is
in there is still a thrill! If you can get to this appointment, go. You
may even get to see the tiny heartbeat flicker if your partner is sixplus weeks pregnant.
Baby’s Development during
the First Trimester
When the embryo first implants in the uterus, about a week before
a menstrual period is missed, it’s too small to be seen without a
microscope. Within a week, though, the first signs of pregnancy can
be seen via vaginal ultrasound. While the embryo still isn’t discernable, the gestational sac that surrounds him shows up as a small
black dot. From this point on, fetal growth is an astounding miracle.
He may not look like
much now, but . . .
In six weeks your baby embryo grows from a ball of cells to a recognizable creature, although the exact species is difficult to define.
Following are the changes that occur in the first six weeks of pregnancy, which include the first four weeks, the time from the last
menstrual period to the first missed period.
✓ Week 2: Egg and sperm meet, usually in the middle of the fallopian tube. The zygote formed by the union of egg and sperm
drifts down to the uterus over several days.
✓ Week 3: Implantation occurs 7 to 12 days after fertilization.
There may be a small amount of implantation bleeding as the
embryo burrows into the uterine lining.
✓ Week 4: The menstrual period is missed. A pregnancy test,
which detects minute amounts of human chorionic gonadoptropin, or hCG, may be positive as early as week 4. On
ultrasound, a small dark spot, the gestational sac, may be
seen. The embryonic cells divide into two sections during
this week, one that will become the embryo and one that will
become the placenta.
✓ Week 5: The yolk sac, which nourishes the embryo before the
placenta forms, may be visible next to the gestational sac on
ultrasound. The embryo now consists of three layers that will
develop into different areas of the body.
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Part II: Great Expectations: Nine Months and Counting
✓ Week 6: During this week, the embryo looks like a bent-over
bean with a slight curve at the end. The heart is still a primitive tube, but a flickering heartbeat can be seen on ultrasound
as blood begins to circulate. Arm and leg buds are sprouting,
and the eyes, ears, and mouth begin to form, although they’re
still a long way from a finished product at this point.
Amazing changes in weeks 7 to 12
Although few people would says, “Yes, sir, that’s my baby” by
week 6, between weeks 7 and 12 the embryo really starts to look
human (take a look at Figure 3-1).
✓ Week 7: In week 7, the baby is huge — around the size of a
blueberry! At least he’s something you could see with your
own two eyes, and it’s a 10,000-times increase over his original size. The brain and the internal organs are all growing, and
the arms and legs have primitive hands and feet.
Placenta
Amniotic fluid
Amnion
Chorion
Uterus
Cervix
Double arrow indicates
crown-rump length
Vagina
Figure 3-1: By the end of 12 weeks, the fetus actually looks like someone who
just may be related to you.
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✓ Week 8: Fingers and toes start to form, and the nervous
system is starting to branch out. Those new limbs are moving,
although it will be weeks before your partner can feel movement, even if she swears she’s feeling it already.
✓ Week 9: The baby’s heartbeat may be audible using a
Doppler, which amplifies sound. You’ll never forget the first
time you hear that rapid beat and realize there’s a real human
attached to it.
✓ Week 10: The kid doesn’t even have knees yet, and he’s
already forming teeth in his gums! He does have elbows,
though, and knees aren’t far behind.
✓ Week 11: Your 2-inch bundle of joy is beginning to look like a
real miniature person, one who has brand-new fingernails and
an admittedly large head.
✓ Week 12: The internal organs are growing so much that they
protrude into the umbilical cord (they’ll start moving back into
the abdominal cavity shortly), and the baby is making urine.
Dealing with Possible
Complications in the
First Trimester
Although the majority of pregnancies really do go like clockwork,
things can and do go wrong. In early pregnancy, the biggest threat
is that of miscarriage. One in four women has a miscarriage at
some point in her reproductive life. Another less common threat is
an ectopic pregnancy. We discuss both miscarriages and ectopic
pregnancies in this section and provide some tips for coping if you
experience either of these complications.
Miscarrying in early pregnancy
Miscarriage is more common as women age, and though you may
not consider your partner “old” if she’s older than 40, Mother
Nature does, at least for childbearing purposes. In fact, doctors
used to refer to pregnant women older than 35 as “elderly.” The
reason that miscarriage increases with age is that her eggs, which
have been hanging around since before she was born, have aged,
and you can’t put face cream on eggs and have them look younger.
The good eggs get used up first, so the ones left are more likely to
be chromosomally abnormal. Miscarriage rates by age break down
like this:
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Part II: Great Expectations: Nine Months and Counting
✓ Under age 35: 15 percent
✓ 36 to 40: 17 percent
✓ 41 to 45: 34 percent
✓ Older than 45: 53 percent
Keep in mind that these are averages and that a woman’s actual
risk depends on many other health factors. These numbers
describe the potential risk after a pregnancy is diagnosed. Before
the first missed period, many pregnancies are lost when they start
to implant but then stop growing, usually because they’re chromosomally abnormal.
The symptoms of miscarriage are bleeding that becomes heavier
over time, passing clots, and abdominal cramping. If your partner
is newly pregnant, she may just have what seems like an unusually
heavy period around the time of her period or shortly afterward.
Pregnancies that end this early are often called chemical pregnancies.
Some women have spotty bleeding that isn’t continuous, sometimes called a threatened abortion. (Abortion is the medical term
for a miscarriage.) Some medical personnel still prescribe bed rest
for women with spotting, although studies show it really doesn’t
change the risk of miscarriage.
The overwhelming number of miscarriages are caused by chromosomally abnormal embryos. You and your partner didn’t cause
the miscarriage, and you couldn’t have prevented it. But although
miscarriage is a natural event, it’s still an emotional loss (to varying degrees for different people) and talking about how you feel
is an important part of coping. Allow yourself and your partner to
mourn the loss of the baby, no matter how early in the pregnancy
it occurs.
Having one or two miscarriages doesn’t increase the risk of it
happening again, but women with three or more miscarriages
should see a fertility specialist to determine the cause, if possible.
Following are some of the possible causes of recurrent miscarriage
(three or more losses):
✓ Uterine abnormalities: Fibroids, polyps, scar tissue, or congenital uterine malformations can prevent the pregnancy from
implanting properly in 15 to 20 percent of recurrent miscarriage cases. Surgical correction of the abnormality may help.
✓ Incompetent cervix: An incompetent cervix dilates prematurely because it’s been weakened by trauma or congenital
deformities. Women whose moms took DES to help prevent
miscarriage may have incompetent cervices. Miscarriage
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usually occurs after 12 weeks. Incompetent cervices cause
around 5 percent of recurrent miscarriages and can be treated
by placing a stitch in the cervix to hold it closed.
✓ Chromosomal abnormalities: You or your partner may carry
genes that are causing recurrent miscarriage. Genetic testing
can help determine the cause.
✓ Immune system problems: Women who have autoimmune
disease can have recurrent miscarriages. Treatment with
medication may reduce pregnancy loss.
✓ Low progesterone levels: Sometimes progesterone levels are
too low to sustain a pregnancy, and supplementation helps.
After a miscarriage, many women pass all the tissue and need no
further medical care. Others need tissue surgically removed so
it doesn’t cause infection or continued bleeding. This procedure,
called a dilatation and curettage, or D&C for short, is done as an
outpatient procedure.
If your partner passes tissue, be sure to save it and take it to your
medical practitioner so she can see that everything’s been passed
and possibly test to figure out what happened. When cramping
intensifies, keep a clean container with a lid in the bathroom so
you can collect any tissue as it passes. Take the tissue to your
practitioner’s office as soon as possible; keep the container in the
refrigerator or follow your practitioner’s instructions on where to
take it if a miscarriage occurs during the weekend.
The miscarriage may be diagnosed afterwards as a blighted ovum, a
pregnancy where the embryo stops developing and only the placenta
grows. Blighted ovum is the most common type of chromosomally
abnormal pregnancy. It can’t be predicted or prevented; a certain percentage of embryos are chromosomally abnormal, and one blighted
ovum doesn’t mean problem will recur in the next pregnancy.
Understanding ectopic pregnancy
Sometimes a pregnancy implants in the fallopian tube, or rarely, in
another location, such as the ovary, abdominal cavity, or cervix.
A pregnancy that implants outside the uterus is called an ectopic
pregnancy. Ectopic pregnancies are more common in women who
have damaged fallopian tubes and occur in 1 in 100 pregnancies.
An ectopic pregnancy usually seems to be developing normally
up until around seven weeks. An early pregnancy test is positive,
but if an ultrasound is done, nothing shows up in the uterus. If the
embryo is in the fallopian tube, the tube may appear distended.
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If an ectopic is diagnosed early enough, medication to stop the
pregnancy from growing can be given, which saves the tube or
other implantation sites from being removed. The products of
conception are absorbed naturally and don’t need to be surgically
removed if the drugs are given early enough and are effective.
Rarely, abdominal pregnancies have continued to the point where
the baby reaches viability and can survive after delivery, but such
cases are very rare.
When the ectopic pregnancy gets too far along, bleeding starts,
and the tube is in danger of rupture. At this point, removal of the
fallopian tube is the only way to prevent serious blood loss that
may threaten the mother’s life. An ectopic pregnancy cannot be
removed and replanted elsewhere, so the embryo will be lost.
Signs of ectopic pregnancy in danger of rupture include slight
bleeding, abdominal pain on one side, lightheadedness, shoulder
pain, or passing out. Ectopic pregnancy is a life-threatening emergency. Get to the hospital immediately!
Coping with pregnancy loss
Losing any pregnancy can be devastating. Many people you tell
won’t make coping with the loss any easier with comments suggesting it was “for the best” or that “you’ll have another one,”
either. Many people don’t really see early pregnancy loss as something to grieve over and may not understand it’s hitting you or
your partner so hard.
In fact, one of you may not understand why the other is taking it so
hard. Whether you’re on the same page or not, be respectful of each
other’s feelings and give yourselves time to grieve. It can be gutwrenching to attend christenings, family gatherings with lots of kids
running around, or children’s birthday parties during this time.
Don’t try to handle what you’re really not up for. If your partner doesn’t
want to go see your sister’s new baby right now, run interference for
her. Hopefully your sister will understand that this is a temporary situation, not a permanent rejection of her and your new niece or nephew.
Common First Trimester
Discomforts — Yours and Hers
Early pregnancy can be uncomfortable — for both of you. Though
your partner bears the brunt of it, the first three months of pregnancy
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may bring some unwelcome changes into your life as well. Hang in
there, though — it’ll all be worth it in the end!
Helping your partner cope with the
symptoms of early pregnancy
Early pregnancy brings extreme fatigue and the overwhelming
desire to take a nap, food cravings, food aversions, nausea, vomiting, and a constant need to urinate. Not to mention hormonal
changes that cause pendulum-like mood swings, from crying to
euphoria almost before you can ask what’s wrong.
Knowing the symptoms ahead of time helps you keep your cool
when all around you seems to be falling to pieces. Following are
more things you can do to help your partner through these first
topsy-turvy months of pregnancy:
✓ Let her rest. Although sitting at home all weekend watching
her take two naps a day may not seem like a whole lot of fun,
use this time to get projects done around the house or catch
up on your parenthood reading.
✓ Help her. Shoulder some of her chores for now, especially
the ones that make her nauseated, such as cooking, garbage patrol, dishing out the dog food, and cleaning toilets.
Remember that handling cat litter is strictly verboten for
pregnant women, so that’s your job, too.
✓ Accept her limitations. Maybe you went out to eat several
times a week and now the sight of restaurants makes her sick.
Hang in there. By the middle trimester she’ll be eating everything in sight, and the Szechuan restaurant will still be there.
✓ Don’t take emotional outbursts seriously. Not letting her outbursts get to you is hard when they’re pointed at you and all
your shortcomings, but listen to what she says, accept what
may actually be true, and disregard the rest. Don’t forget to fix
any shortcomings you can, though.
✓ Satisfy her cravings. Not that many pregnant women really
want pickles and ice cream, but if your partner does, get some
for her. Try not to gag as you watch her eat them; you may
have to leave the room yourself.
✓ Plan pit stops. If you’re the type of driver who doesn’t stop
the car unless the road abruptly ends before you reach your
destination, realize that pregnant women really do have to
pee every five minutes; she’s not making up an excuse to go
in to the gas station shop for a frozen custard. Also, because
blood volume increases during pregnancy, blood clots can
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develop if she doesn’t move her legs regularly. Let the woman
get out of the car every few hours!
Getting used to strange
new maternal habits
At times, you may look at your partner and wonder who this
woman actually is. The sweet-tempered woman you once knew
may have been replaced by someone whose head appears to be
rotating at times, and the woman who used to party all night long
barely makes it into the living room to collapse on the couch after
work. You knew having a baby was going to change your life, but
you probably didn’t expect things to change this much so early in
the game.
Take heart: These are temporary changes. After her body adjusts
to the new hormone levels, many of the symptoms will decrease,
and your original partner will start to emerge again.
In the meantime, some of her new habits may be impacting you in
a big way, and you may need to find ways to cope with them. The
following sections help you deal with a few of your least favorite
early pregnancy things.
Vomiting
Although she’s the one vomiting, sometimes you may not be far
behind. Many people have a hard time dealing with vomit, whether
it’s their own or someone else’s. If you have a sensitive stomach,
hearing her heave may inspire the same reflex in you. Staying supportive while holding on to your own cookies can be difficult. You
may want to try the following tips if the sight, sounds, and smell of
vomiting are getting to you:
✓ Dab something under your nose that smells good to you.
This really helps. Peppermint oil can get you through some
tough moments. Nose plugs may also work, if your partner
doesn’t take offense at them. She probably doesn’t want you
to start vomiting too, so she may be okay with them.
✓ Stay cool. People are less likely to vomit when cool air is
blowing on them, so turn the fan all the way up and get a
small fan that can blow right on you. This may help keep your
partner from vomiting, too.
✓ Avoid trigger foods. If certain things really get to her, make
sure they don’t enter your house, no matter how much you
crave them.
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Gaining weight
While weight gain isn’t such a problem during the vomiting weeks,
when the nausea ends, your partner may start eating like food is
going to be taken off the market next week. This can be bad for her
waistline, sure, but it can also be not so good for yours, since you
may find yourself overeating just to keep up with her and matching her weight gain pound for pound. The woman who never let a
chocolate-covered donut in the house may now be eating them by
the cartload.
For both of your sakes, try to put a stop to the madness. You
don’t have to remind her how hard this weight is going to be to
lose later; just talk about your own weight gain and how you’re
afraid you’re not going to play frisbee on the beach with the kid if
you keep eating like this. Don’t turn into the food police; no one
responds well to being told what they should and shouldn’t eat.
Even if your pleas for healthier food choices don’t get her out
of the junk food aisle and back into the vegetable section, force
yourself to cut back on the unhealthy foods. She’s eating for two,
but you aren’t, although you may look like you are about halfway
through the pregnancy. And, all kidding aside, that extra weight
will interfere with your ball-playing and horsey-back-ride abilities
down the road.
Coping with your cravings
If an active sex life was part of your semiweekly (or more) agenda,
you may be in for a rough few weeks. Sex may be the last thing on
her mind in the first trimester. And some types of sex may trigger
her gag reflex, which is the last thing you want to associate with a
previously enjoyable activity! While turning into a monk may not
be on your list of fun things, you can cope with the words “Not
tonight, honey” by
✓ Experimenting with touching. Depending on how open your
partner is to experimentation, you can do a lot to pleasure
each other that doesn’t involve intercourse. In fact, this may
be a great time to start understanding your partner sexually
more than ever before. Find out what she’s up for by taking it
slow, working together to find comfortable positions and techniques, and by being supportive if at any moment she needs
to stop.
✓ Practicing self-release. Masturbation isn’t something most
adults like to talk about, but if you have a voracious sexual
appetite and both you and your partner are okay with the
idea, there’s no shame in taking the matter into your own
hands, so to speak.
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✓ Watching her patterns. If morning sex used to be your thing
but her new thing is promptly vomiting every time she wakes
up, shake things up. Try to engage in sexual activity at times
of day when she’s generally not tired, nauseated, or weepy.
✓ Being flexible — this too shall pass. Some women are ready
for sex sooner than others, and for some, when the sex drive
returns, it’s strong. It may come and go throughout the day.
Be ready to perform when your partner is ready, because the
window of opportunity can be slammed shut before you’ve
had a chance to look outside.
A desire to have sex is normal, and becoming frustrated during the
time she isn’t up for it doesn’t make you a pig. Don’t push the issue
or make your partner feel bad about the lack of sex, but do let her
know that you miss being with her and look forward to when she’s
up for having sex again. In the meantime, work off that extra steam
with a nice run or a game of tennis.
Taking on your emerging support role
Don’t think of yourself either as your partner’s personal assistant
or as the pregnancy police. She may become a diva in her pregnancy, but it’s not your responsibility to do it all. And try to avoid
becoming overprotective of your partner’s physical capabilities,
especially early in the pregnancy. If everything goes well with the
pregnancy, she won’t have many restrictions on her activities. But
that doesn’t mean she’s going to be up for taking care of everything she’s always managed.
For the first several months — and for the last few — your partner
may be too tired/nauseated/hot/and so on to make dinner, walk the
dog, or perform many of the household chores you used to split.
Pick up the slack until she feels good enough to contribute again.
When she’s back in the swing of things, she can move around and
help again. Physical activity is beneficial for both mom and baby.
One of your main roles is ensuring that she eats healthfully and
exercises if and when possible, but the way to do this is by example, not with a whip and chain in hand and bathroom scales placed
in front of the refrigerator. Ask her to take walks with you and help
by preparing meals that will settle her stomach and feed baby’s
growing systems.
Pregnancy does not turn your partner into a child, even though
she’s carrying one around with her. She still gets to make her own
choices about what she eats and when, or if, she exercises, and
you may have to bite your lip if she starts exceeding the weight
limit for your delicate Queen Anne chairs.
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In addition to supporting your partner physically, you need to support her emotionally. She will likely be weepier and more sensitive
than normal. If you’re not the kind of guy who likes to talk about
feelings, I suggest you become that guy for a month or so.
As hormones surge and wane, roll with the punches. Let the little
things go without a struggle, because your partner won’t always be
able to control her reactions the way she used to. Let her dictate
what’s for dinner, and if her stomach turns when you plate the
exact dinner she asked for, don’t take it personally.
Being a rubber wall isn’t easy, but the more you can let things
bounce off you, the easier this time is for everyone. Supporting
your partner throughout pregnancy is a constant game of choosing
your battles and helping her make healthy decisions for her and
the baby. Don’t tell her what she should do — lead by example. It’s
good practice for when you have a kid in the house.
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Chapter 4
Growing Into the Second
Trimester
In This Chapter
▶ Watching baby’s growth in the second trimester
▶ Helping your partner through physical and emotional changes
▶ Understanding prenatal ultrasounds and blood tests
▶ Finding a childbirth class that suits your style
W
elcome to the best three months of pregnancy, for both
you and your partner. The second trimester is universally
regarded as the “golden era” of pregnancy — she’s big enough to
look pregnant and not just pudgy, morning sickness is left in the
dust, and the aches and pains of late pregnancy are still in the distant future. Enjoy these three months, because the next three will
bring much more upheaval into your partner’s life — and consequently into yours!
In this chapter we walk you through the garden of the second trimester, with your first exciting look at your baby, finding out the
sex (if you want to), and few emotional upheavals.
Tracking Baby’s Development
during the Second Trimester
By the end of the first trimester, your baby’s vital parts are all
in place and beginning to perform the functions they’ll carry out
for the next 80 or so years. By the end of the second trimester,
the baby’s lungs, one of the slowest organs to mature, are almost
capable of supporting life with assistance if he’s born very prematurely (23 to 24 weeks is considered the earliest that a fetus can
survive if born early). But the lungs aren’t the only area experiencing change; every body system is becoming more refined with each
passing day.
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Growing and changing
in months four and five
Even though the basic structures are in place, they undergo further refinement in months four and five:
✓ Week 14: The baby’s eyes close for several months while they
develop on the inside.
✓ Week 15: Some women may start to feel flutters when the
baby moves; many women, especially those in their first pregnancy, don’t feel movement for several more weeks.
✓ Week 16: By week 16, hair (including eyebrows) begins to
grow.
✓ Weeks 17–18: Air sacs start to form in the lungs, but the lungs
won’t be able to support life for another six weeks or so.
✓ Week 19: The permanent teeth form in the gums. The baby
can swallow.
✓ Week 20: By this week, the midpoint of pregnancy, the fetus
is around 6.5 inches long and weighs around 10 ounces.
✓ Weeks 21–22: The fetus now has a functioning tongue! A
baby girl’s ovaries contain all the eggs she’ll ever have in life,
around 6 million.
✓ Week 23: The baby can now hear, but more importantly, if
born now, she has around a 15 percent chance of survival.
Figure 4-1 gives you an idea of what these changes look like.
12
16
20
24
Figure 4-1: Months four and five of pregnancy.
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Refining touches in the sixth month
The sixth month continues the refining process; all the major
components are in place, and all the baby has to do is grow and
mature.
✓ Week 24: Your baby has around a 50 percent chance of survival if born at this point. She now weighs around 1.3 pounds.
✓ Weeks 25–26: The spinal cord and lungs are forming more
completely, and the eyes reopen at last!
✓ Week 27: At the end of the second trimester, your baby
approaches 2 pounds and 14.4 inches. The lungs, spine, and
eyes continue their refinement process. Every week increases
the odds of survival if born early.
Check out Figure 4-2 to see how much baby has developed by the
end of the sixth month.
Figure 4-2: By the end of month six of pregnancy, the fetus is likely to survive if
born early.
Checking Out Mom’s Development
in the Second Trimester
The middle trimester of pregnancy may be the best time of your
partner’s life: She feels good, looks “cutely” pregnant, and usually
enjoys these three months, which means that you get to enjoy
them, too! It’s also the time when her sex drive may return and the
urge to begin getting the home ready for baby kicks in.
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During this time, make the most out of your waning days as a
twosome. Later in the pregnancy, your partner may not be up for
doing as much, and after baby arrives all bets are off. So get out
now! Go on dates, take a vacation, or just indulge in all the things
that you and your partner enjoy doing one-on-one.
Now also is the time when your partner’s body goes through a lot
of changes, which means that your support is more important than
ever. Giving up her body for a baby isn’t easy, and the more you
help her deal with the ups and downs of pregnancy, the easier it
will be for everyone.
Gaining weight healthfully
One of the most overwhelming concerns for many pregnant
women is weight gain: They’re afraid they’re gaining too much,
aren’t sure how much they should gain each month, and are desperately afraid that extra weight will be with them for a lifetime.
It’s not unusual for dads-to-be to begin packing on the pounds, too.
Perhaps you also indulged in your partner’s first-trimester cravings.
Maybe she wasn’t feeling up for those long walks you used to take
after dinner so you skipped it, too. If you’re gaining right along with
her, you may have some concerns in this area, too! The following
info may help you help her (and yourself) with weight gain issues:
✓ After the first trimester, a weight gain of around a pound a
week is considered normal.
✓ Total weight gain, on average, should be between 25 to 35
pounds, with underweight women gaining a little more (28 to
40 pounds), and overweight women less (15 to 25 pounds).
✓ Pregnant women need only an extra 100 to 300 calories a day.
✓ The baby contributes around 8 pounds to the total weight;
amniotic fluid, placenta, breast tissue, an increase in uterine
muscle each add another 2 to 3 pounds. The rest is stored fat
and increased blood, each adding around 4 pounds.
Keeping the emphasis on eating well during pregnancy helps you
and your partner ensure that the baby grows well — and that your
partner won’t end up with 40 extra pounds after the pregnancy.
Focus on eating plenty of fresh fruits, vegetables, and healthy
protein sources and limiting junk food, rather than focusing on
the daily weigh-in numbers. Pregnancy is not the time to keep an
obsessive weight chart; even if you fear that she’ll never get back
to her normal weight, rest assured that she most likely will.
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Foods to avoid during pregnancy
In the second trimester, a pregnant woman’s first-trimester distaste for food and
often decreased appetite seem to vanish in the wind. Your partner may now seem
to be chowing down on anything and everything with gusto. Although a healthy
appetite is good for her and the baby, pregnant women must avoid certain foods
that can be harmful to the growing fetus or to their own health. Some of the listed
no-nos aren’t good for you, either, so you can stop eating them together.
Mercury can affect fetal brain, nervous system, and visual development. Most fish
contain some mercury, but some have very high levels of mercury and should be
completely avoided by pregnant women, including the following:
✓ Grouper
✓ Shark
✓ Mackerel
✓ Swordfish
✓ Marlin
✓ Tilefish
✓ Orange roughy
The following fish also have high amounts of mercury, but fish from this group can
be eaten up to three times a month:
✓ Bluefish
✓ Lobster (Maine)
✓ Halibut
✓ Tuna
Following are some other foods to avoid, or at least limit, during pregnancy:
✓ Deli meats: Deli meats may contain listeria, bacteria that can cross the
placenta and cause pregnancy loss.
✓ Soft-serve ice cream/frozen yogurt: Listeria is also the concern here as the
machines used to make the equipment can be magnets for bacteria.
✓ Imported soft cheeses: Soft cheeses can also contain listeria if made from
unpasteurized milk. Brie, Camembert, feta, Roquefort, and Mexican-style soft
cheeses should be avoided unless made from pasteurized milk.
✓ Raw eggs: Raw eggs can contain salmonella, a bacterial infection that can
cause severe vomiting and diarrhea.
✓ Raw meat: Raw meat can contain a number of harmful pathogens, including
coloform bacteria, salmonella, and toxoplasmosis, which can cause severe
fetal complications.
✓ Unwashed vegetables: Unwashed vegetables can also transmit toxoplasmosis
as well as salmonella.
Pregnancy is also not a time to lose weight or avoid gaining it,
unless she’s very overweight and is working with a medical practitioner. If she’s really cutting down on food intake, she may need
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some help dealing with her fear of weight gain. Talk to her medical
practitioner about how to handle the issue, because it’s a pretty
sure bet she’ll take her practitioner’s advice over yours when talking about weight gain.
And remember, leading by example is always the best option. The
healthier you both are during this time, the more likely you are to
continue those healthy eating habits after baby comes. Don’t wait
to start living healthy until baby arrives, because it won’t happen.
Soon enough, it will be your responsibility to teach your child how
to eat as well as you.
Looking pregnant at last!
One annoying aspect of early pregnancy is looking not quite pregnant enough and worrying that you look pudgy instead of pregnant.
Thankfully, by the end of the second trimester, most women definitely look pregnant, although if your partner is overweight, it may
still be difficult to tell, something that may frustrate her to no end.
The days of voluminous maternity wear are, for the most part, long
gone, although most women will invest in a few pairs of maternity
pants with an elastic tummy and a few shirts either in a larger size
than they normally wear or made of a stretchy fabric. Women who
have to dress well for work will probably break down and buy
actual maternity clothes so they don’t look sloppy if their clothes
are just overall too big for them or to avoid the skin-tight “hey, I’m
pregnant, look at my belly!” look that may be considered out of
place in an office.
Many pregnant women today do accentuate their bellies with tight
T-shirts, hip-hugger pants, and two-piece bikinis (not on the streets
of Manhattan, hopefully, although stranger things have happened).
If you’re extremely conservative, the “let-it-all-hang-out” look may
bother you.
Approach your partner carefully with any suggestions as to how
she should dress in pregnancy. Pregnancy hormones may be under
control in this trimester, but they make an immediate reappearance
under duress. There’s really no nice way to say “I hate the way you’re
dressed,” so you may just need to keep your opinions to yourself.
You can try buying her a few articles of clothing that fit your image
of what a well-dressed pregnant woman should wear. She may just
wear them, if for no other reason than that she doesn’t want to
hurt your feelings!
Figure 4-3 shows where the uterus is during the fourth, fifth, and
sixth months of pregnancy, as well as where you can expect it to
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go throughout the rest of the pregnancy. You can see why pregnancy gets really uncomfortable in the third trimester.
Weeks: 12 16 20 24 28 32 36 40
Location of pubic bone
Figure 4-3: Uterine height changes during pregnancy.
Testing in the Second Trimester
The second trimester is often the time for blood tests and ultrasounds that show the baby’s development is on target and no
major problems exist. Blood tests to assess the risk of genetic
defects are usually done between weeks 11 to 13 or 15 to 20,
depending on the tests being done, and screening ultrasounds,
which look at the baby’s major organs for anomalies and often can
determine the baby’s sex, are done around week 20.
Some babies are extremely reluctant to show their private parts
on ultrasound, so not all parents learn their baby’s sex at the first
ultrasound, and insurance may not pay for a second without good
medical cause. If you can’t find out the sex of your child, don’t
stress about it. Buying gender-neutral clothing and nursery décor
is easier than ever. Greens and yellows work for boys and girls,
and you’ll always have time to add touches of gendered colors
after baby comes home.
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Preparing for the risks of
tests and ultrasounds
Having screening blood work and an ultrasound done bring risks
of a kind, as well as benefits. Neither procedure carries any significant physical risk to either mom or baby, but the procedures do
carry a risk of finding out that something is wrong with the baby.
This is knowledge some parents would rather not have.
Most parents prefer to know if the baby has problems so they can
consider their options and prepare for potential difficulties, but
others would not consider terminating the pregnancy under any
conditions and prefer not to know. This is a personal issue that
every parent has to consider for him or herself.
If you are opting not to undergo testing, make sure that your partner’s OB/GYN is supportive of that decision. Be upfront about your
preferences so that you don’t feel pressured by your medical provider down the road. Most midwives will allow you to make special
considerations so long as those decisions pose no risk to the baby
or mother.
Understanding blood test results
Although some prenatal screening tests are for your partner’s
overall well-being and check for potentially harmful medical conditions, second-trimester triple- and quadruple-screen blood tests
are aimed at determining the risk of genetic anomalies in the fetus.
Also used in conjunction with second-trimester ultrasound, quadruple screens help predict the risk that the fetus has Down syndrome, trisomy 18, or neural tube defects such as spina bifida or
anencephaly, where part of the brain is missing.
Quadruple screens test the blood for four things:
✓ Alpha feto-protein, produced by the fetus: High levels of AFP
may indicate neural tube defects, abdominal wall defects, or
multiple pregnancy.
✓ hCG, produced by the placenta: hCG levels may be higher
than normal in Down syndrome pregnancies.
✓ Estriol, a form of estrogen made by the placenta and liver of
the fetus: Estriol levels are low in Down syndrome pregnancies.
✓ Inhibin A, produced by the placenta: Inhibin A levels are
elevated in cases of Down syndrome.
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Following up on the test results
Remember that first and second-trimester blood tests are screening tests only. They do not diagnose congenital defects; they only
indicate the odds that a congenital defect exists. The risk also
varies with maternal age: The older your partner is, the more likely
you are to have a child with a genetic defect, although the risk is
still low.
If your partner’s screening test comes back abnormal, the most
important thing to do is stay calm. An abnormal result only indicates
a need for further testing. Try hard to keep both of you thinking
positive until you have a clear answer on what, if anything, is wrong.
The March of Dimes reports that 5 percent of screening tests are
abnormal, but only 4 to 5 percent of fetuses with abnormal test results
actually have Down syndrome. This is a very small percentage, so stay
optimistic; the odds are highly in your favor for a good outcome.
In the second trimester, amniocentesis may be done between
weeks 15 and 20, when amniotic fluid is easily accessible. A thin
needle is inserted into the fluid through the abdominal wall, and
the fetal cells in the fluid are analyzed. Amniocentesis comes with
a slightly increased risk of miscarriage afterward, so most medical
practitioners don’t recommend doing an amniocentesis routinely.
Women older than age 35, who have a higher risk of having a child
with chromosomal abnormalities, and those with a family history
of genetic problems may consider doing amniocentesis, which can
determine if chromosomal defects such as Down syndrome, hemophilia, cystic fibrosis, and other genetic disorders are present.
Scrutinizing ultrasounds
As excited as you both are for the first prenatal ultrasound, the
actual event can sometimes be a bit of a letdown. Reading ultrasounds is an art, and unless the ultrasonographer is really patient
about pointing things out, you may be unsure of whether you’re
viewing the baby’s head or its tush.
Much depends on the direction the baby’s facing. You may get a
somewhat frightening straight-on face shot, which looks far more
like the creature from Alien than any relative of yours, or you
may get a front-on foot view that looks like nothing more than five
round balls. You may be happy to know the baby has five toes on
each foot, but that’s usually not the main information parents-tobe want. The next section describes what the ultrasonographer is
trained to look for.
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Measuring growth
First and foremost, your medical practitioner wants to know that
the baby is growing as he should. Some of the measurements taken
to check for normal growth include
✓ The length of the longest leg bone, called the femur
✓ The head circumference
✓ The head diameter, called the biparietal diameter
✓ The abdominal circumference
Comparing these measurements to standards assures your practitioner, and you, that the fetus is growing as he should.
Checking for genetic markers
Genetic markers indicate an increased risk of congenital problems,
but as with blood tests, genetic markers only indicate the risk
potential; they don’t diagnose the disease. Some ultrasound markers are known as “soft” markers because they’re often misinterpreted and not as diagnostic as other signs. Soft markers may also
be transient and no longer seen in later ultrasounds. Following are
genetic markers, including soft markers:
✓ Thickness of the skin on the back of the neck: Called nuchal
translucency, thicker-than-normal neck skin indicates an
increased risk of Down syndrome.
✓ Cardiac defects: Around 50 percent of Down syndrome babies
have cardiac defects, which may be visible via ultrasound.
✓ Bowel abnormalities: Around 12 percent of Down syndrome
babies have gastrointestinal defects that may also be spotted
on ultrasound.
✓ Shortened arm and leg bones: Children with congenital
abnormalities often have arms and legs that are shorter than
normal.
✓ Missing nasal bone: Failure to see the nasal bone or a shortened nasal bone on ultrasound may indicate Down syndrome.
✓ Polyhydramnios: An increased amount of amniotic fluid may
be associated with congenital defects.
✓ Kidney abnormalities: Dilated kidneys, missing or small kidneys, and other anomalies may indicate genetic disorders.
Determining the sex on ultrasound . . . or not
While the ultrasonographer’s priority is looking for information
that shows the baby is growing properly, your consuming interest during the first prenatal ultrasound may be the baby’s sex.
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Ultrasonographers who do prenatal ultrasounds are well versed in
not blurting out the sex of the baby and usually ask if you want to
know. Most generically use he or she to avoid calling the baby it if
you don’t want to know, so don’t assume anything by the choice of
words if you’ve requested that you not be told. You can feel legitimately concerned if she starts using the term they, though!
Ultrasounds are generally not done just to satisfy parental curiosity, but rather to catch any potential problems early on. If
the baby’s sex can’t be determined in the first ultrasound and
you absolutely must know in advance, your insurance will likely
require you to pay out-of-pocket for another ultrasound.
If you had your heart set on a girl and it’s as plain as the nose on
your face, even to your untrained eyes, that a little boy is on the
way (or vice versa), remember that it’s normal and okay to feel a
twinge of disappointment. Try to keep it to yourself and concentrate on what you’re probably seeing — a healthy, normally developing child.
If one of you really wants to know and the other doesn’t, strategize
before the appointment so you’re not arguing in front of the ultrasonographer. One method of keeping the news to just one person
is to have the ultrasonographer write down the sex and put it in
an envelope. That way, one of you can look and find out, and the
other person doesn’t have to.
This tactic also works if neither of you want to know at the
moment, but you’re concerned that your curiosity may get the
better of you later. If you have the answer, you can look at it any
time, but you don’t have to.
Having Sex in the Second Trimester
For many women, the libido is back on the ascent during the
second trimester, which will be a big sigh of relief for any guy who
has patiently waited through nausea, exhaustion, discomfort, and
a lack of sexual energy for some long-awaited sex. In fact, some
women become very sexual during this time because they’re flush
with hormones and feeling in touch with their bodies.
Maintaining a healthy sex
life during pregnancy
Forget what you may have heard — sex during pregnancy is safe
as long as your partner is having a normal pregnancy. Her desire
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to have sex may change by the day due to fluctuating hormones,
tiredness, or body aches. She also may struggle with being a sexual
being as she transitions into the role of mother.
The most important thing to do is to keep talking about sex. As you
get back into the swing of things, be open and honest about what
you both need. Explore ways to satisfy each other’s romantic and
physical needs, even if your partner isn’t up for sex.
Don’t be surprised if your partner needs to take it slowly in the
beginning. Stop at any signs of discomfort. As the baby bump continues to expand, you’ll likely find yourselves exploring new positions that offer support for your partner’s stomach. Many women
are most comfortable on their sides or even up on their knees, and
can use pillows for stomach support.
If your partner desires oral sex, it is absolutely safe. Just make sure
not to blow air into the vagina because this can cause an embolism, which can be fatal for the baby and the mother-to-be.
Addressing common
myths and concerns
We’ll just get the myths out of the way right now: Your penis is not
long enough to hit or poke the baby during sex. The baby cannot
see your penis when you’re having sex, and he isn’t afraid of your
penis during sex. Your semen will not get all over the baby upon
completion of sex.
Sex is perfectly healthy during pregnancy. Your baby is protected by an amniotic sac that’s sealed tightly by a thick mucus
plug, which keeps out foreign and unwanted intruders. In a few
instances, however, sex during pregnancy isn’t recommended.
Talk with your partner’s doctor or midwife prior to having sex if
your partner has dealt with any of the following issues:
✓ Miscarriage: If your partner has ever had one, or a medical professional has said she is at risk for having one, check
before sex.
✓ Bleeding: Sometimes vaginal bleeding ranging from normal to
potentially life threatening can occur during the early months
of pregnancy. Sex can cause the cervix to bleed, which can be
alarming if you’re already worried about bleeding.
✓ Preterm labor: If your partner gave birth to a previous child
prematurely, get clearance to make sure having sex is safe.
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✓ Leaking amniotic fluid: Any time amniotic fluid is leaking,
the sterile barrier between the baby and the outside world is
broken, and infection can enter into the uterus and infect the
baby. No sex after her water breaks!
✓ Placenta previa: With the placenta close to or overlying the
cervix in placenta previa, having sex can cause life-threatening bleeding.
✓ Weakened cervix: Sometimes called an incomplete cervix, this
condition means the cervix dilates before full term, which can lead
to miscarriage. A stitch is often placed into the cervix to keep it
closed. Sex can cause uterine contractions that disrupt the stitch.
✓ Pregnant with multiples: Because multiples often deliver
early, you need to avoid anything that can upset the delicate
balance between no children and two — or more — children,
sex included. Semen contains substances that may bring on
labor if the tendency for preterm delivery exists. Besides,
your partner probably has enough going on in there already.
A female orgasm during low-risk pregnancy will not cause your
partner to go into labor prematurely. Contractions of the uterus
associated with sex are not the same as those experienced during
labor (and your partner is very thankful for this!). However, orgasm
achieved by any method can start contractions that can lead to
preterm labor in high-risk pregnancy, so put the vibrator away for
the duration as well.
Some doctors recommend avoiding sex during the final weeks of
pregnancy due to the prostaglandins in semen, which are hormones that can stimulate contractions. On the flipside, if your
partner is overdue, your doctor may “prescribe” sex as a means to
jump-start the contractions.
Exploring Different Options
for Childbirth Classes
Yes, you are expected to attend childbirth classes. The good news
is that today’s market offers a variety of choices that are welcoming to both mother and father. And they aren’t just about learning
how to breathe! These classes are an opportunity to ask questions,
build confidence, and connect with other couples going through
the same experiences you are at the exact same time.
Regardless of the type of class you sign up for, you’ll be taught the
basics in the following areas:
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✓ Techniques for coping with labor and delivery pain
✓ Your role in assisting your partner
✓ What labor feels like/signs of labor
✓ When to call your doctor/midwife/doula
✓ Choosing the birthing option that’s right for you and your
partner
Selecting the class that’s right for you has a lot to do with the
kind of childbirth experience you and your partner want to have.
Whatever class option you select, make sure to meet with the
instructor prior to signing up (and paying the fee!) to make sure
he’s the right teacher for your needs. Ask what is covered in the
class, how many couples are in the class, where the class is held,
and how many weeks the class runs.
Following are the most popular types of classes offered:
✓ Lamaze: Developed in the 1940s by a French obstetrician,
Lamaze focuses on empowering women to be confident in
their abilities to birth children. Its teachings are rooted in
natural childbirth options, and it follows the philosophy that
women shouldn’t be required to have routine medical intervention in childbirth.
✓ HypnoBirthing: Sometimes called the Mongan Method, this
class teaches couples how to use relaxation and visualization
— self-hypnosis — to have a natural, intervention-free childbirth when possible.
✓ The Bradley Method: Also focusing on medication-free, natural childbirth, this class focuses on the roles diet and exercise
play in childbirth, as well as breathing techniques. Generally
includes heavy emphasis on the father’s role.
✓ International Childbirth Education Association (ICEA)
classes: Although they don’t adhere to a particular philosophy, these classes offer certified instructors. Check with the
teacher to find out what to expect.
✓ BirthWorks: The philosophy of this program is that women
instinctively know how to give birth and that they can be
empowered to understand their bodies and respond accordingly to their own labor experience.
✓ The Alexander Technique: These classes focus on utilizing techniques that reduce tension in the body and offer the
mother-to-be freedom of movement during childbirth.
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Chapter 5
The Fun Stuff: Nesting,
Registering, and Naming
In This Chapter
▶ Preparing your home for baby’s arrival
▶ Registering for what you really need to survive
▶ Having fun at the shower (if you choose to attend)
▶ Getting your lengthy baby-name list narrowed down to one
A
s the calendar inches closer to baby’s arrival, usually around
month five of the pregnancy, many soon-to-be parents get
the urge to bring order to the home. What may start as getting the
nursery ready often triggers an avalanche of do-it-yourself projects
and more items added to the ever-growing registry list.
And to make this whole baby thing even more real, this is the
time to think about names. In this chapter we tell you how to get
through the planning and preparing without any major blowups.
Preparing the Nursery and
Home, or “Nesting”
Put down the twigs and leaves — it’s not that kind of nesting. This
nesting is all about making the concept of baby a real thing in your
everyday life.
Nesting can give you a sense of progress in the seemingly endless
pregnancy and serves as the first of many acts of giving and loving
that you will show your baby. It can also be a great motivator for
finally getting the kitchen cabinets repainted and replacing the
broken bathroom tile.
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Making the house spic and
span — and then some
For many pregnant women, the biological need to nest can be powerful. It can also veer into the seemingly irrational as your partner
donates or trashes perfectly good linens, rugs, and towels because
they may have unseen germs. Some women even get the urge to
grab a toothbrush and some disinfectant and literally scrub the
house top-to-bottom. This is perfectly normal.
Try your best to be supportive without breaking the bank on
unnecessary purchases. If your towels aren’t in need of replacing,
suggest having them professionally cleaned instead. Sometimes,
however, the best thing to do when your pregnant partner is going
through a bout of nesting-induced hysteria is to just let her do it.
It’s a natural process, and, as with all things, this too shall pass.
However, don’t just sit back and watch. She may not ask, but she
definitely wants you to help with the cleaning and organizing. Even
if you don’t think everything she’s doing is necessary, she may
be unable to see why it’s not as important to you as it is to her.
Simply ask her how you can help or just join in with the express
knowledge that this is a fleeting phase of late pregnancy.
This is also a time when your partner feels the need to launch a
new set of rules regarding safety and cleanliness, such as no more
shoes in the house or no more dogs allowed on the sofa. If your
partner feels very strongly about something you disagree with,
work together to find a compromise.
Some pregnant women are so bothered by the idea of pet hair, cat
litter, and the suspect grooming habits of animals that they may
start talking about re-homing the family pet. As best as you can, try
to delay any decision-making regarding your pet’s future until after
the baby arrives. Hormones change following pregnancy, and the
last thing you want is a crying partner feeling guilty about giving
up Rover in the heat of the moment. Offer to take over the duties of
pet maintenance for the remainder of the pregnancy and reevaluate monthly.
Pregnant women have to be a little more cautious than normal
while doing work around the house. Take note of the following
household projects and their do’s and don’ts:
✓ Painting: Pregnant women should avoid the urge to paint
the nursery — or any wall, for that matter — because among
other potentially harmful chemicals, latex paint may contain
mercury, and old paint may contain lead; both of which can
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cause birth defects. Sanding and breathing in particles are
also no-no’s. If your partner is going to be around while you
coat the walls, make sure the room is well ventilated and that
no food or beverages are consumed in the room where you’re
painting.
✓ Cleaning: Using eco-friendly cleaning products is always
better, so start during pregnancy. Not only will your partner
avoid exposure to harsh chemicals, but you’ll already be prepared for the day when baby is crawling around and putting
everything in his mouth.
✓ Lifting: It’s a myth that lifting heavy objects lowers a baby’s
birth weight or causes birth defects. (Also, raising her hands
over her head doesn’t cause the baby to become tangled in
the umbilical cord.) But a woman’s center of gravity changes
as her stomach grows and her tendons and ligaments soften.
Lifting objects heavier than 25 pounds in the last few months
of pregnancy can throw off her balance and result in a fall, so
have her leave the heavy lifting to you.
✓ Pet care: According to the U.S. Centers for Disease Control
& Prevention, pregnant women should not clean a cat’s litter
box due to the risk of toxoplasmosis, a parasite in cat feces
that can cause congenital defects in the baby. To further
decrease the chance of toxoplasmosis, make sure you clean
the litter box frequently, keep your cats indoors, and avoid
adopting new cats during pregnancy.
Setting up the nursery
Fun should rule the day when it comes to setting up the nursery,
but overanxious parents-to-be often try to tackle too much at once.
Begin your nursery designing with a planning session. Draw a
bird’s-eye floor plan of the room and start filling in the space with
all the things you need. Decide the placement of all of the furniture, and before you run out and start buying, measure the allotted
spaces to make sure you don’t end up with an overstuffed debacle
à la the Griswold family Christmas tree.
Clearing and painting the room
Unless you’re starting with an empty space, the next step is to
empty the room and find a home for all of your displaced things.
This chore is the least fun thing to do, but don’t put it off. Having
an organized room just for your baby will make you feel less anxious about bringing him home.
When the room is empty, painting is a cinch. Since pregnant
women shouldn’t paint, this is your job. If you don’t have the time
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or desire to paint, find a friend, family member, or local painter to
do it for you.
After the room is painted, have the carpets and rugs deep cleaned,
or refinish the floors if they need it.
Buying and assembling the furniture
When the paint’s dry and the floors are ready, it’s all about shopping and assembly.
Budget some alone time for assembly if possible. Cribs often come
with instructions that seem to be written in Swahili, and they don’t
just pop together. They’re solidly constructed, which is good for
baby’s safety but bad for your frustration threshold. Take your
time and figure on spending a few hours on assembly. Lay out all
of the parts and read through the instructions (yes, actually read
through the instructions!).
Most of today’s instructions offer picture-only guidance, which can
be quite vague and frustrating. If you can’t understand what you
should do based on the company’s illustrations, don’t just do what
you think should be done. Take the time to call. Not only is the
safety of your child at stake, but your warranty, too!
Assemble the crib in the nursery because many cribs are too wide
to fit through doorways, and won’t you be frustrated if you have to
take it apart and do it all over again!
Opinions differ on bumper pads, the quilted bands that are strung
around the bottom of the crib. The Canadian government discourages their use due to the chance of suffocation, and a 2007 study
in the Journal of Pediatrics determined them to be unsafe. Others
believe that with the use of a crib positioner, which keeps baby
sleeping on his back, bumper pads cause little increased risk.
Whether or not it’s worth the risk is up to you and your partner,
but it is a risk. If you use bumpers, make sure you remove them
if you notice your baby creeping toward the bumper in his sleep.
Another option is to use mesh bumpers, which are not padded but
do offer a breathable barrier between baby and the crib’s slats.
Some parents opt to use cosleepers, which are small, three-sided
cribs that butt up to your bed, keeping the baby very close at
hand. This arrangement is ideal for late-night feedings but less
ideal when considering the amount of your personal space you
have to sacrifice.
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Arranging the nursery
for two or more
Not all nurseries accommodate just one little baby. Whether welcoming multiples or adding a second child into a preexisting nursery, creating a space that works for more than one takes a little
extra effort.
Multiples
The only real challenge in accommodating multiples is making
room for them to sleep. Changing tables, dressers, and closets can
easily be shared when you invest in closet organizing systems to
allow more items to be stored in less space.
For twins, some people opt to use a single crib with a crib divider
that literally splits the bed down the middle. It’s great for spacelimited parents, and research shows that twins sleep better when
placed near one another as they were in utero. However, crib
dividers are a short-term solution because as the babies grow,
each needs more space.
If money and space allow, you have many options for twin cribs
that are smaller versions of full-sized units and are generally built
side-by-side. And if you’re having more than two, you may want to
look into bunked cribs, which offer an individual space for each
baby. Most are not notably stylish, but if you’re having more than
two babies, stylish cribs are probably the least of your worries.
Separate-birth siblings
If you’re going to have an older child cede space to the newborn,
the situation won’t be all that different from having multiples. Most
of your work concerns organization and maximizing storage space
with closet organizing systems, baskets, and bins. However, investing in a cosleeper (a three-sided crib that attaches to the side of
your bed) or a portable crib can be a lifesaver when the older child
and the baby aren’t on the same sleep schedules. And if your older
child is still a baby, it also allows for a secure place for the older
child when you’re tending to the newborn.
Baby-proofing 101
You have some time before baby starts getting into things, but that
doesn’t mean that the nesting period isn’t the perfect time to babyproof. In fact, doing it early allows you plenty of time to adjust to the
complicated life of cabinet locks, outlet covers, and doorknob locks.
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To make sure your baby’s safe, take the following precautions:
✓ Get down on the floor, look at the room from baby’s level, and
clear all potential hazards.
✓ Install rubber stoppers at the top of doors to keep baby’s fingers from being pinched.
✓ Remove rubber tips from doorstoppers at floor level because
they’re choking hazards.
✓ Install mesh baby gates in dangerous locations.
✓ Plug in outlet covers on all outlets below waist level.
✓ Install cabinet locks.
✓ Add a toilet-lid lock.
✓ Make sure all rugs and mats have slip-proof pads underneath.
✓ Add foam coverings to the edges and sides of sharp furniture.
✓ Apply doorknob covers to keep toddlers from being able to
open doors.
✓ Find an out-of-reach location for pet supplies and the cat litter
box.
✓ Remove any toxic plants or chemicals that are within baby’s
reach.
✓ Cover the bathtub waterspout with a plastic cover to avoid
head injury.
✓ Put your trash cans in an inaccessible place — to baby, not to
you.
✓ Keep bags and purses off the floor.
Monitoring options
Baby monitors have come a long way in the past few years. Your options range
from hi-def, flat-screen video units to the classic walkie-talkie-like models. If you
live in a larger home, a video monitor may make more sense to save you a lot of trips
to the nursery to check on noises. Even in smaller homes, it can be useful to have
a video screen to check if that little noise was a minor disturbance or something
requiring your immediate attention.
Regardless of your choice, make sure that the unit you purchase can effectively
communicate at the distance between the nursery and the other rooms of your
home. Many monitors now can transmit up to 400 feet.
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When in doubt, move it or remove it. Get into the habit of looking for small items on the floor, closing doors, putting the toilet
seat down, and putting all potential choking hazards out of baby’s
reach. After years of not having to think about where you throw
your keys, retraining your brain takes a while, so start now.
Understanding the Art
of the Baby Registry
If the mere suggestion of free stuff has you lacing up your sneakers
to run out to the nearest baby goods store, slow down. Registering
isn’t as easy as it sounds. Babies need a lot of gear, but they don’t
need everything, so you need to think through your particular
wants, needs, and style before you point the scanner and click.
When you get into the store, registering can be an overwhelming, almost paralyzing experience. Some parents-to-be first realize
how unprepared to care for baby they feel when forced to choose
between different styles of bottles, diapers, and baby monitors.
Some couples enter panic mode and just start registering for one
of everything because they feel like their baby might need it.
You only get free stuff once, so be sure to make the most of it by
getting prepared before you register. The more online research
you do about the differences between various products, the more
competent and confident you will begin to feel about your parenting duties to come. Registering is the perfect opportunity to familiarize yourself with exactly what it takes to raise a baby.
Doing your homework ahead of time
to get exactly what you want
When it comes time to register, everyone who has been a parent
will tell you the things that you won’t be able to live without. In
truth, you have to have very few items in order to raise a baby, but
a lot of modern inventions can make raising a baby easier.
First, consider your space. If your nursery is too small to fit an
entire bedroom set and a glider, you and your partner need to prioritize. The size of the room helps dictate the size and number of
items you can add to it, as well as the style of crib, dresser, changing table, curtains, and every other accoutrement you can imagine.
If a rocking chair is the one thing you must have, plan the rest of
the room around that to make sure you have enough space.
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Register for the essentials first and don’t make your registry too
long, or you run the risk of not getting everything you need. Also,
don’t register for too many clothes, because although clothes are
necessary, everyone will want to buy clothes first, and you may
not get other more vital things. People often throw in an outfit
along with whatever registry gift they purchase, anyway.
Spend time thinking about how you’re going to use your stroller. If
you’re a runner, do your homework about the best running stroller
for you and try them at the store. If you live in a city, make sure
the stroller is durable enough to handle bumpy, uneven sidewalks,
but not too big to make you the enemy of your fellow pedestrians.
If you drive a lot, make sure the stroller folds up small enough to fit
in your car and still leave room for shopping bags.
And before you register for anything, check safety ratings and
parent reviews online. Visit Consumer Reports’ baby section (www.
consumerreports.org/cro/babies-kids/index.htm) for
recalls and safety information.
Finding out what you need — and
what you think you won’t need but
can’t live without!
When you’ve never before had to care for a baby, knowing what
you need — and how many of each thing — is nearly impossible.
Use the basic checklist in this section as your guide.
A system for travel
Travel systems that offer a compatible stroller, infant car seat, and car seat base
in one package are a popular option for new parents. If you’re on a tight budget,
a travel system is an ideal solution to get everything you need for less than $200.
However, many are quite bulky, and the included strollers generally aren’t top-ofthe-line quality.
Travel systems come in many styles, so start by picking the car seat of your choice.
Make sure it has a five-point harness system and that it’s the appropriate size for
your vehicle. Consider the size of the stroller, too, and make sure it fits comfortably
in your trunk. Make sure to collapse the stroller in the store before you buy it to see
how small (or big) it is when not in use.
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Note: We don’t mention certain items, such as a high chair, jumpers,
and play mats, because you don’t need them right away. However,
if you have room to store them, pick the ones you want and register
for them. Remember, though, that when you meet your baby and get
to know him, your idea of what he might like may change. The play
gym you picked out before you met him may not really suit him.
It’s kind of like signing him up for college before he’s born; you may
think Harvard is the best, but he may not like it.
Following are the items you absolutely must include on your registry (in our opinion, at least).
Sleeping and changing essentials:
✓ Cradle/bassinet/cosleeper/crib
✓ Two to four fitted sheets
✓ Crib mattress
✓ Two to four swaddling blankets
✓ Nursery monitor
✓ Changing table or station
✓ Two to three changing pad covers
Furniture:
✓ Nursery seating
✓ Baskets/bins for closet organization
Clothing:
✓ Eight to ten onesies
✓ Six pairs of socks
✓ Three to six newborn hats
✓ Four to six warm, footed pajamas
✓ Two to six bibs
✓ Six to eight burp cloths
✓ Hangers
Toiletries:
✓ Diapers (As many as you have room to store!)
✓ Wipes
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✓ Diaper cream
✓ Baby powder
✓ Baby shampoo
✓ Baby lotion
✓ Infant manicure set
✓ All-natural hand sanitizer
Just in case:
✓ Digital thermometer
✓ Dye-free infant Tylenol
✓ Dye-free gas relief drops
✓ First-aid kit
On-the-go goodies:
✓ Infant car seat
✓ Stroller
✓ Backseat mirror
✓ Car window sun shades
✓ Diaper bag
✓ Portable baby wipe container
✓ Travel-size hand sanitizer
Feeding:
✓ High-quality breast pump (if breast-feeding)
✓ Milk storage bags (if breast-feeding)
✓ Nursing pads (if breast-feeding)
✓ Boppy support pillow
✓ Lanolin and/or gel nursing pads
✓ Bottle brush
✓ Bottle drying rack
✓ One each of six different kinds of BPA-free bottles
✓ Four nipples for each type of bottle
Not all babies take to every type bottle; you may end up trying
many different brands before you find the right one. Avoid registering for too many of the same brand in case your baby refuses
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to use them. You can always return any unopened bottles and
nipples if your baby takes to the first or second brand you try.
Discovering five things you don’t
have to have but will adore
Yes, some things are luxuries, but they can become necessities
if you use them every day and they save your sanity. These five
items may well fit into your “don’t need it, gotta have it” category:
✓ Ergonomic bouncy chair: Not all bouncy chairs are created
equal. Finding one that sits baby upright (great for gas relief)
and allows him to grow with the chair will save you down the
road — but not upfront. A bouncy chair is a perfect sanitysaver for the shower-starved parent and a great place for naps
and playtime for baby.
✓ Hands-free baby carrier: Whether in a sling, a front carrier, or a
pouch, carrying your baby in a hands-free carrier allows you to get
work done around the house and move about more freely. Most
babies love the body-to-body contact. Make sure to try them on
first to make sure the carrier you’re getting fits your body.
Recent recalls of baby slings have called their safety into
question, so make sure you get a model that keeps the baby
upright and able to breathe freely. When a baby slumps in a
curled position, her airway can be compressed.
✓ Snap-and-go stroller: This stroller provides only the skeleton
of a traditional stroller with no seat. Instead, it has bars for a
car seat to snap into, as well as a bottom basket. Infants aren’t
in the bucket-style car seat for very long, which makes the
idea of having a second dedicated stroller seem a bit extravagant. But it’s the smallest stroller on the market, which makes
it ideal for car travel and easy use. You literally snap the car
seat into the stroller and you’re ready to roll.
✓ Wipe warmer: This may seem unnecessary, and in reality, it
probably is. A lot of babies, however, cry less during diaper
changes when the cold, wet wipe straight from the package is
replaced by the warm, cozy wipe straight from the warmer. It
also helps keep the wipes from drying out when accidentally
left open.
✓ Yoga ball: All babies are gassy, and nothing helps get the gas
out better than bouncing. Save your legs and back a lot of
undue stress by sitting on a yoga ball and bouncing the burps
right out of your baby. It’s also a great alternative to a nursery
chair for those with space limitations and a great late-term
pregnancy chair for the woman who can’t get comfortable.
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Checking out five things you don’t
have to have and will never adore
Some things, luxurious or otherwise, are just downright unnecessary. Especially the items that don’t actually make a new parent’s
life any easier. Here are five things you should consider omitting
from your registry:
✓ Baby DVDs/CDs: Before your child has the ability to ask
for the latest Jonas Brothers album/Baby Einstein DVD to
be played ad nauseum, why on earth would you voluntarily
spend your time engaging with this entertainment? Babies
shouldn’t be watching TV, and your child will be just as happy
listening to music from your collection.
✓ Crib mobile: It only takes one time of knocking into a crib
mobile while putting your sleeping baby down to realize that
it’s more of a nuisance than it’s worth. Instead, opt for a natural sounds teddy bear or other system that attaches to the
side of the crib.
✓ Infant shoes: If your child gestates for 18 months and comes
out walking as nimbly as a newborn horse, you will need lots
of for fancy footwear. For the rest of you, forgo the shoes.
Most babies are annoyed by socks, let alone shoes, and for
the most part, babies under the age of 6 months will spend
most of the time in sleepers with attached feet.
✓ Car-charger bottle warmer: If your baby is breastfed, the
milk will most likely be frozen or straight from mom, and the
warmer won’t help. If your child is formula fed, you will be
making bottles as needed. Either way, how often will you need
warm milk in the car? Most babies will be just as happy with
room-temperature milk. Unless you plan on using it for your
coffee, skip this one!
✓ Baby bathtub: Why exactly does your baby need a smaller
version of the same device you already have in your home?
Many parents opt to bathe with newborns and most others
use a clean sink in lieu of the tub. As baby grows, your existing tub will work just as well. Besides, it’s not like you’re
going to give baby his bath-time privacy while you read Sports
Illustrated on the back patio.
Surviving the Baby Shower
These days, baby showers often aren’t just for the mom-to-be and
the other women in your life. If you want to be involved, by all
means, tell the people planning your shower that you want it to be
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a unisex affair. If you don’t want to attend, that’s okay, too, as long
as your partner is fine with that decision. Deciding how much you
want to be involved is up to you and your partner, but don’t forget
that the more involved you are on the front end, the more connected to and involved with that baby you will be down the road.
Traditional showers are female-centric and a bit on the cheesy
side. Men often don’t go because they aren’t really welcome. So if
you don’t want to spend an afternoon sniffing diapers filled with
melted candy bars, let the planners know what kind of shower you
and your partner desire. It can be anything from a lunch at a nice
restaurant to a traditional streamers-and-balloons affair and anything in between.
If you opt to have a coed shower, make sure that everything about
the event is inclusive to people of both sexes. Here are some
simple ideas to make your shower welcoming to all:
✓ Send invitations that are gender neutral.
✓ Invite all of the fathers you know to ensure there are more
men than just you at the shower.
✓ Pick a fun, unique setting or theme, such as a park or a backyard barbeque.
✓ Plan some separate men-only and women-only activities.
✓ Open gifts with your partner. It’s awkward to send her up
there alone and for you not to be part of the fun.
✓ Set up an assembly station where the new gifts can be put
together after they are opened (this idea works best if you
have the shower at your home).
✓ Play a creative game, such as constructing babies out of clay
or holding a diapering competition to see who can wipe,
powder, and diaper a doll the fastest.
✓ Have guests write down a funny story from their childhoods
and then try to match the guest to the story.
Naming Your Baby
When people find out you’re having a baby, the first thing they ask
is, “Is it a boy or a girl?” Question number two is inevitably, “Do
you have names picked out?”
Choosing a name for your baby is one of the most fun and most
challenging decisions you’ll ever make in your entire life. Soonto-be parents spend hours upon hours combing through books and
Web sites, searching for the perfect name and making lists of their
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top choices. And with so many options, the list can easily become
mind-numbingly long and a point of contention. Getting two
people to agree on the same first and middle name for a baby can
devolve from a congenial conversation into something resembling
a Congressional hearing.
The following section helps you and your partner choose the perfect name for your baby with as little stress as possible.
Narrowing down your long list
Just like a to-do list at work or that never-ending list of weekend
projects you’ve been meaning to tackle for years, a long list of
baby names will only distract and overwhelm you. Keeping the list
at a reasonable length makes you more likely to engage in a meaningful conversation about the names that truly are in play.
Remember that you’re not really choosing between 30 names.
Just because you really like all of them doesn’t mean you don’t
like some more than others — you just may not realize it yet. Stop
trying to choose between Evan, Graham, Dexter, and Jude all at the
same time. Instead, pit two names against each other at a time and
choose one. It’s like filling out your March Madness bracket; you
don’t pick the champion without first picking the winners of the
early rounds. This tactic allows you to begin crossing some names
off the list while continually pitting new names against the winner
of the previous round.
At this point, you and your partner shouldn’t take the opinions of
others into consideration. The name is your choice, and unless
you’re ready to justify your choices, get frustrated with other people’s input, and stand up in the face of criticism, keep the contenders to yourselves until you’ve made a final choice.
Reconciling father/mother
differences of opinion
In a perfect world, your favorite name is also your partner’s top
choice. The chances of that happening, however, are slim to none.
When differences of opinion arise, don’t get defensive. Be able to
articulate why you like the name, and even do your research about
the history of the name, the name’s popularity, and any family history regarding the name.
If your partner still doesn’t like it, or you don’t like a name she
adores, allow each other absolute veto power. With so many
names from which to choose, don’t waste your time fighting a
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losing battle. And besides, do you really want your partner to cave
in and name your child something she despises?
For more background information on baby names, check out the
following resources:
✓ Social Security Administration’s Popular Baby Names (www.
ssa.gov/OACT/babynames): For some people, the relative
popularity of a name can have a huge impact on the decisionmaking process. The SSA provides a comprehensive look at
the top 1,000 names from 1880 to the present year and can
help you keep your kid from being one of 17 others in her kindergarten class with the same name — if that’s important to
you.
✓ The Baby Name Wizard (www.babynamewizard.com): This
interactive site takes the info from the SSA site, pumps it into
an innovative chart and provides site-user input about how
names are perceived, an encyclopedia-like “Namipedia” entry
for each name, and a “Namemapper” that charts the popularity of names by state.
✓ Baby Names Country (www.babynamescountry.com): This
site is an exhaustive resource for unique baby names and
their meanings from around the world.
✓ Baby Namer (www.babynamer.com): An encyclopedic reference of names that allows you to create a digital list as you
find names, as well as offering similar names, famous people
with the same name, and possible drawbacks of using the
name, including bad nicknames.
Discussing choices with
friends and family
If you think it’s hard talking about names between the two of
you, just wait until your loved ones start offering their two cents’
worth. No matter what name you choose — be it classic, modern,
or something in between — someone you know is going to tell you
she doesn’t like it. You’ll probably hear it from multiple people,
friends and strangers alike.
Don’t feel the need to defend your choice. In fact, the more you
defend it, the more likely the person is to continue to challenge
you on your choice. Instead, focus on why you chose that name
and don’t be afraid to let other people know the matter is not up
for debate. A playfully delivered, “I guess it’s a good thing this is
my baby and not yours” can put them in their place without too
many hurt feelings.
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Even after the baby is born, the name will be under scrutiny. From
co-workers to cashiers at the supermarket, everyone will inquire
about your baby’s name, and you’ll be confronted with a variety of
reactions. Remember that everyone has his own association with
the name of your child, but at the end of the day, your only association with the perfect name you choose will be the perfect baby
on whom you bestow that name.
Some people are reluctant to share baby names with others
for fear that they may get “stolen” by another friend or family
member. If your partner has this concern and you do not, be very
careful about sharing the name you choose. Though you may think
it’s silly, she won’t take it lightly.
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Chapter 6
Expecting the Unexpected
In This Chapter
▶ Handling maternal medical issues
▶ Dealing with difficult ultrasound discoveries
▶ Knowing what to expect if baby comes early
▶ Managing multiples
▶ Resolving money matters without panicking
Y
ou may assume that things will go off without a hitch during
pregnancy and childbirth, but the fact is that many pregnancies experience some sort of complication. Complications may be
related to your partner’s health, the baby’s well-being, or to the
pregnancy itself. Some complications are relatively minor, but
others can pose a serious threat.
In this chapter we look at some of the things that can go wrong in
pregnancy and guide you through to supporting your partner while
dealing with your own fears.
Managing Pregnancy-Related
Medical Issues
Problems that affect your partner’s health sometimes develop with
frightening speed. Other times problems develop insidiously and
build to a crisis point. Neither is easy for a dad-to-be to deal with,
especially when you have to keep your own fears under control so
you can help your partner deal with hers. We take a look at some of
the most common maternal pregnancy problems in the next sections.
Pregnancy-induced hypertension
Pregnancy-induced hypertension, often called PIH, is a newer term
for elevated blood pressure in pregnant women. It is closely
related to a long recognized disease, preeclampsia, also called
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toxemia. PIH is elevated blood pressure that develops in 5 to 8 percent of women after the 20th week of pregnancy. The signs of PIH
are hypertension, retained fluid in the face and extremities, and
protein in the urine.
Your partner is more likely to develop PIH if:
✓ This is her first pregnancy.
✓ She’s older than 40.
✓ She had high blood pressure before she got pregnant.
PIH is dangerous because it reduces blood flow to the baby and
also to the mom’s major organs, including the liver, kidneys, and
brain. In severe cases of PIH, decreased blood flow to the baby can
cause intrauterine growth retardation, known as IUGR, which means
low birth weight or stillbirth. Your partner may experience
✓ Severe headaches
✓ Blurred vision
✓ Light sensitivity
✓ Abdominal pain
✓ Decreased urine output
New onset of any of these symptoms requires a call to your medical practitioner. Women with PIH often end up on modified or
complete bed rest (see the section “Mandatory bed rest”) or may
at least have to stop working or work a reduced schedule. Resting
on the left side increases blood flow through the placenta, and
decreasing sodium intake can help lower blood pressure. Blood
pressure medications may be prescribed if pressure rises too high.
She will probably need more frequent doctor visits and possibly
more frequent ultrasounds to check on the baby’s well-being.
Rarely, women with PIH need hospitalization to control the symptoms and decrease the chance of eclampsia, which is severe PIH
with seizures. Eclampsia can be life threatening for your partner
and the baby and may require immediate delivery even if the baby
is premature. Part of your job is to watch for changes in your partner’s mental status, such as confusion, irritability, or disorientation, because these changes may precede a seizure.
Gestational diabetes
Gestational diabetes, high blood sugar that develops during pregnancy and disappears after delivery, affects 2 to 5 percent of pregnancies. Glucose testing for gestational diabetes is normally done
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in the second trimester. Women who are diagnosed may be treated
with insulin injections to lower blood-sugar levels.
The problem with high blood sugar in pregnancy is that it
affects the baby, who will also develop high blood-sugar levels.
Gestational diabetes can affect the baby (and you) in several ways:
✓ The baby may grow larger than normal, which can make for a difficult delivery and increase the chance of a cesarean delivery.
✓ Babies whose moms have gestational diabetes are more likely
to be born early and can have a severe and potentially dangerous drop in blood-sugar levels after the delivery.
✓ The baby may have to be monitored in the neonatal unit for a
short time until his blood sugars stabilize, which is probably
not the way you envisioned your time in the hospital.
If your partner is older than 35, is overweight, or has a family history of diabetes, she’s more likely to develop gestational diabetes.
Studies indicate that gestational diabetes is often a sign that she
may develop type 2 diabetes later in life.
The introductions of daily injections and monitoring can add a
whole layer of annoyance to pregnancy, for both you and your
partner. If she cooks, her cooking will probably become a whole
lot healthier, which you may or may not appreciate. If you’re the
chef, you may be expected to devise a new repertoire of healthy
yet appealing meals. The bonus is that you both probably will be
healthier by the end of pregnancy if you follow her new diet.
Placenta previa
Placenta previa is a condition in which the placenta implants
too low on the uterine wall (see Figure 6-1). Usually the placenta,
which transports nutrients to the baby, implants near the top
of the uterus. If too low, all or part of the placenta can cover the
opening to the uterus, the cervix, and cause bleeding.
Bleeding from placenta previa is painless, can happen without warning,
and can be severe enough to require immediate delivery. A known placenta previa can necessitate bed rest and possibly a prolonged hospital
stay to try and hold off delivery until the baby is less premature.
A marginal placenta previa, one that’s near but not covering the
cervix, may allow for a vaginal delivery, but most of the time a
cesarean will need to be done. And sex is out of the question, since
anything that causes contractions or any cervical movement can
start heavy bleeding. Your partner is more likely to have a previa if
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✓ She’s had a previous cesarean delivery.
✓ She’s older than 35.
✓ She smokes.
✓ She’s of Asian descent.
✓ She’s having more than one baby.
Mandatory bed rest
If your partner has a risk of early delivery or other problems, your
medical practitioner may put her on bed rest. Bed rest can mean
anything from not going to work and taking it easy to not getting
out of bed at all, even to go to the bathroom, depending on the
seriousness of the medical condition.
Having your partner on bed rest is difficult for both of you.
However, if bed rest is advised, take it seriously. Bed rest brings its
own risks, mostly the risk of blood clots from inactivity, so doctors
don’t suggest it lightly.
Placenta
Cervix
Figure 6-1: Placenta previa.
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And while bed rest may sound like fun, especially if you’re running
around trying to cook, clean, take the dog out, run errands, and set
up the nursery, trust us, she’s not happy that she’s unable to help
put away the freshly washed baby clothes and hang the pictures
on the wall.
Setting up a bed rest station
Your bedroom may not contain all the elements needed to entertain a sometimes
bored, often dejected woman who’s just itching to get up and paint the nursery.
But any space can be turned into a home inside your home, or inside the hospital, if
necessary. Make sure her living space has all the following comforts:
✓ A method of communication: Unless your house is really small, yelling back
and forth isn’t the best method of communication. Walkie-talkies are great, and
cellphones work too.
✓ A table to hold food and drink: A drawer for snacks means she won’t have to
call for help every time she’s hungry, and a cooler filled with drinks by the bed
also gives her a little independence. Some tables fit over the bed, but a table
next to the bed works fine, too.
✓ Entertainment: A TV, reading material, cards, games, puzzles, and a computer
all help pass the time.
✓ Extra pillows: Spending time in bed is really hard on your back, especially
when you’re pregnant! Invest in extra pillows to facilitate position changes.
And take the Star Wars pillowcase off, too; give her something pretty and
cheerful.
✓ Space to work and something to do: No, she can’t load the dishwasher from
the bed, but she’d probably love to fold baby clothes!
✓ Pen and paper for shopping ideas and other thoughts: She may see something
on TV or think of something she’d like to try for dinner, so give her a way to write
down ideas as they come to her.
✓ Exercise ideas: Even if she can’t run around the bed, she needs to keep the
blood flowing to prevent blood clots in the legs. Depending on what her doctor
says is okay, encourage position changes, ankle circles, and calf flexes several
times a day. Discourage a cross-legged position, which decreases blood flow.
✓ Venting room: In this context, venting has nothing to do with fresh air and
everything to do with letting her get frustrations off her chest. Constant negativity should be discouraged, but frustrated people need to express their aggravation, and better she vents to you than to her doctor — or her mother! So be
available to her, not only just to keep her company, but also to let her vent when
she needs to.
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Many women on prolonged bed rest get depressed, especially if
they have to stay in the hospital rather than at home. Make sure to
keep her in the loop of baby stuff; if it’s okay with her doctor, have
friends visit regularly. You can even suggest that her baby shower
be held while she’s on bed rest, to give her something to look forward to. (See the sidebar “Setting up a bed rest station” for more
ideas on helping her through the restrictions of bed rest.)
Her job is vital, though, and it’s simple — stay put so the baby
stays put for as long as possible. So make her feel like she’s pulling
her weight, because she is. In case you’ve never noticed until now,
women often feel guilty even when they have no reason to. If your
partner has to worry about how all the extra work is affecting you,
she won’t be resting peacefully, and staying calm and relaxed is
essential on bed rest.
Handling Abnormal Ultrasounds
Many couples don’t really relax about a pregnancy until they see
the baby on ultrasound. But some couples don’t come away from
the ultrasound appointment with reassuring news. While ultrasounds aren’t perfect and can miss some abnormalities, they recognize many problems.
In most pregnancies the ultrasound isn’t done until the second trimester, usually around 18 weeks. By this time all the major structures of the baby are in place and can be evaluated. Ultrasounds
may be done earlier if your partner is bleeding or if her doctor has
any other concerns about the pregnancy. If your medical practitioner sees anything suspicious on ultrasound, she may schedule
a level 2 ultrasound, which is done in the same way as a regular
ultrasound but takes a more detailed look at the fetus.
Always research your insurance company’s policy on ultrasounds
during pregnancy, because some may not cover routine ultrasounds or repeat ultrasounds done just to find out the baby’s sex.
Knowing what’s covered and what isn’t prevents shocks to your
pocketbook when an unexpected bill arrives in the mail.
Birth defects
Hearing that your baby has a problem is devastating. Even if a
birth defect is minor, you or your partner may mourn the loss of
the “perfect child.” This reaction is normal, and neither of you
should feel guilty. If a serious defect is found, you’ll need to make
decisions together about what to do.
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Following are some of the most common birth defects in the
United States, according to the March of Dimes:
✓ Heart defects: 1 in 115 births
✓ Musculoskeletal defects: 1 in 130 births
✓ Club foot: 1 in 735 births
✓ Down syndrome: 1 in 900 births; risk increases with age of
mother
✓ Spina bifida (abnormal opening in the spine): 1 in 2,000
births
✓ Anencephaly (lack of part of the brain): 1 in 8,000 births
The most important thing to do when you get bad news is to find
out exactly what you’re dealing with. You may need to see a perinatologist, a doctor who specializes in complicated pregnancies,
and possibly a genetic counselor.
You and your partner may not be on the same page when it comes
to making decisions about birth defects. One of you may be more
optimistic about the situation and the other more pessimistic.
Your feelings will be a jumble, and emotions will run high. Try to
support your partner in whatever she’s feeling, but don’t discount
your own feelings and grief, and don’t feel like you can’t let your
feelings show. No one expects you to be emotionless at a time like
this, and crying with your partner can be a bonding experience.
Expect to go through the five stages of grief: denial, anger, bargaining, depression, and acceptance. Getting to acceptance can take a
long time and a lot of anger. Give yourself the time you need.
Talking to someone outside the situation who listens and doesn’t
tell you what to do, like a friend, religious advisor, or relative, can
be a godsend. And most important of all, don’t play the blame
game. Congenital birth defects are rarely anyone’s fault.
Fetal demise
Even more devastating than the discovery of birth defects on routine ultrasound is the discovery of a fetal demise. The term fetal
demise is usually used to describe the death of the fetus in utero
after 20 weeks. There are many potential causes of fetal demise,
and few if any can be anticipated or avoided.
Fetal demise may be discovered because the baby doesn’t seem to
be moving much, bleeding starts, or amniotic fluid begins to leak,
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but it can also be found during a routine gynecological check up.
Fetal demise occurs in 6.8 per 1,000 pregnancies overall.
Most fetuses are delivered vaginally after labor induction. Parents
are encouraged to hold their baby and give him a name, but at no
time will this be forced on you if you don’t feel it’s the right thing
for you to do. Your partner will be given medication to dry up
her milk supply and will be put in a room off the maternity floor
in most hospitals. Most hospitals will let her go home as soon as
she’s physically stable.
In many cases parents are better able to get though a fetal demise
if they know exactly why it occurred, but sometimes the reason
isn’t obvious. Not knowing why can be very difficult. Again, blame
has no place in the aftermath of a fetal demise.
Preparing Yourself for Preterm
Labor and Delivery
More than 12 percent of all deliveries in the United States are preterm, which means they occur before 37 weeks. Of those:
✓ 70 percent are born between 34 and 36 weeks.
✓ 12 percent are born between 32 and 34 weeks.
✓ 10 percent are born between 28 and 31 weeks.
✓ 6 percent are born before 28 weeks.
The chances of delivering a very small preemie are low. Babies
born between 28 weeks and term may require prolonged hospital
stays, but most ultimately do well.
Recognizing the risks
of preterm delivery
Many preterm deliveries occur without any known cause, but in
a good percentage of cases, doctors can pinpoint the reason. The
following situations all increase the risk of preterm delivery:
✓ Structural abnormalities: An abnormally shaped uterus or an
incompetent cervix, one that starts to dilate from the increase
uterine weight, can cause labor.
✓ Multiple birth: A large percentage of twin, triplets, and other
multiples deliver before 37 weeks.
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✓ Infections: Urinary tract infections can start uterine contractions if not promptly treated.
✓ Hypertension: High blood pressure can reduce blood flow
through the placenta to the baby, causing poor growth that
may necessitate early induced delivery.
✓ DES exposure: Diethylstilbestrol (DES) was a drug given to
millions of women to prevent miscarriage between 1938 and
1971. Women whose mothers took the drug may have structural abnormalities that cause preterm delivery.
Handling feelings of guilt
Guilt is common after a preterm delivery, just as it is after any
other setback in pregnancy. Again, don’t get caught up in what you
and your partner could have done to prevent it, or whose fault it is
that you went for that long walk the day before the delivery. Even if
one of you did something foolish, rehashing it now is pointless.
Put your energies into working with your partner to help your baby
get healthy as quickly as possible. Visit often, and if support groups
are available, get involved; studies show that parents involved in
support groups have less anxiety, anger, and depression.
Navigating the NICU
The neonatal intensive care unit (NICU) is like nothing you’ve ever
seen before. Although hospitals put more emphasis than they used
to on keeping NICUs quiet and more like the womb, they are, by
necessity, fairly noisy, with alarms going off, lights on day and night
so hospital personnel can see what they’re doing, and at the center
of it all, your little baby. She may be hooked up to just a single monitor, or perhaps so laden down with medical equipment and IV lines
that you can scarcely find the baby, as shown in Figure 6-2.
The best way to deal with the NICU is to focus on your little part of
the world. Get to know your baby’s nurses, and stay near your own
baby’s isolette. Asking what’s wrong with other babies is really bad
etiquette, and the nurses won’t (or shouldn’t) tell you, anyway.
Preterm babies are often moved from the hospital where they’re
born to a level 3 nursery, a nursery with advanced technology to
handle complicated preterm issues. This can make your life complicated, especially if the new hospital is some distance from your
house, but your baby’s care is ultimately worth it.
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Overhead warmer
Ventilator
Bilirubin lights
ECG and blood
pressure monitor
Feeding
tube
Medicine in
IV bag
Temperature monitor
Oxygen saturation
monitor
IV pump
Figure 6-2: A preemie baby in the NICU.
Some hospitals with large regional NICUs have facilities that allow
parents to stay overnight for a small charge or for free. Ronald
McDonald houses are examples of facilities available near some
hospitals.
If your partner is still in the hospital and can’t see the baby right
away, make sure you take lots of pictures, not just of the baby, but
also of the neonatal unit and, if possible, of the people taking care
of her. This way she can get a real sense of where the baby is and
picture her in an actual place.
Some regional NICUs provide video feed to community hospitals so
that moms who are separated from their babies can still maintain a
connection until they have a chance to see the baby in person.
Expect the first time you hold your baby to be extremely awkward;
she may be festooned in IV lines, and you’ll probably be scared
to death of her. Don’t worry; it gets easier with time. She’ll have
less equipment attached, and you’ll get to be a pro at dealing with
dangling wires.
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Knowing what to expect
with a preemie
Preemies don’t exactly look like the babies you have pictured in
your mind, especially if they weigh less than 5 pounds. If your baby
is born before 35 weeks, this is what she may look like:
✓ Skinny: Babies born before 35 weeks often don’t have a good
layer of fat.
✓ Big eyed: The lack of fat in her face gives your preemie a
wide-eyed look.
✓ Thin skinned: The blood vessels are more visible in a preemie’s skin.
✓ Hairy — except on her head: Preemies often are still covered with lanugo, a fine downy hair that helps keep her warm
before she develops enough subcutaneous (under-the-skin)
fat. Babies born before 26 weeks, on the other hand, may have
no hair anywhere, and may have very red, gelatinous looking
skin.
✓ Boys may have underdeveloped genitalia: Don’t worry, dad —
they’ll grow.
If you think the baby looks really odd, check with the nurses for
reassurance that everything’s okay, but not within your partner’s
earshot. No matter what she looks like, she’s going to think she’s
the most beautiful person on the planet.
Parents often have a sixth sense or are just more observant of
the little changes in their babies and may notice a change in their
baby’s condition before the staff does. Don’t be afraid to speak up
if you feel something’s not right!
Clarifying common problems
Premature babies often have respiratory problems because their
lungs aren’t well developed. Artificial ventilation may be started
almost immediately and will gradually be decreased as the baby
tolerates the decrease in extra oxygen. Some babies need special
types of ventilation to overcome resistance in their lungs.
Most premature babies have feeding problems. Tiny babies,
under 28 weeks, may not be fed by mouth for weeks or months,
because their digestive systems are too immature to handle food.
Intravenous feeding is given instead, and as the baby grows, tube
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feeding is started. Nippling is begun very slowly, because it can tire
a preemie and use up her energy stores.
Many babies grow very slowly in the NICU. Infections, stress, and
any number of complication can slow growth. Reading the weight
chart and seeing the weight increase by a few grams can be the
highlight of a NICU parent’s day.
Learning the ropes — er, wires
Sometimes knowing what’s what when it comes to the wires and
machines attached to your baby can calm your anxiety. Your average preemie may sport the following wires and attachments.
Breathing apparatus
If the baby can’t breathe on his own, he may be attached to a ventilator via a tube that goes through his mouth or nose down to
his lungs, which delivers a certain number of breaths per minute,
or to nasal prongs, which deliver extra oxygen to his lungs via —
naturally — prongs that fit into his nose. Try very hard not to do
anything that may dislodge the breathing tubes.
Monitoring equipment
Since preemies have an unfortunate habit of forgetting to breathe,
often even babies who don’t need breathing equipment are hooked
up to a monitor that flashes a series of incomprehensible numbers, some with little flashing hearts next to them. The monitor
is attached to the baby by wires that lead from the baby’s chest,
and possibly also from his hand or foot, or even from his umbilical
cord if a line was placed there right after birth.
The machines monitor pulse (that’s the flashing heart), respiration, (the number of times the baby breathes each minute), and
oxygenation levels. Preemie heart rates are from 110 to 160 beats
per minute, on average. Respirations are 40 to 60 per minute.
Oxygenation in the 90s is good. Blood pressure may also be continuously monitored in very sick babies.
The baby’s temperature may also be monitored frequently, if not
continuously. Because preemies have little in the way of fat stores,
they get cold easily, and stress and the extra work of being sick
and trying to grow can use up energy that may otherwise help keep
them warm. The incubator or bed the baby’s laying on also has its
own thermometer to make sure it doesn’t get too hot or too cold.
Intravenous lines
Most NICU babies receive intravenous medications and nourishment, at least at first. IV lines can be very precarious in preemies
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and need to be replaced frequently. The medications infused are
sometimes hard on the veins, which “blow,” necessitating a new IV.
The NICU nurses don’t do it on purpose, believe us; spending time
putting a new IV in a preemie is rarely on the “fun things to do in
the NICU” list.
If your baby has an umbilical line, he may not have a peripheral
line (a line in the extremities or head), but umbilical lines can’t be
used for very long because they’re a potential source of infection.
Preparing for preemie setbacks
Just when you think things are finally moving in the right direction,
your preemie may get sick. Because preemies have decreased ability to fight off infection, and because they’re attached to invasive
equipment that can serve as a portal into the body, infections are
very common among preemies. Some common NICU complications
include the following:
✓ Respiratory infection: The tubes allow entry of germs into the
lungs; pneumonia may develop and need antibiotic treatment.
✓ Respiratory disease: Long-term ventilation can save your
baby’s life but can also contribute to bronchopulmonary dysplasia, damage to the lungs that can take months or years to
fully heal. This problem is more common in tiny babies known
as micropreemies. Some babies with respiratory disease are
discharged to home while still receiving oxygen, which is
decreased gradually as they develop the ability to breathe
better on their own.
✓ Necrotizing enterocolitis: Called NEC by the NICU staff, this
inflammation of the immature digestive system usually occurs
after feedings are started. NEC can seriously damage the intestines. Feedings are temporarily stopped so the gut can heal,
and IV feedings are given instead.
✓ Intraventricular hemorrhage (IVH): IVH is a bleed into the brain
that can range from mild (graded I) to very serious (graded IV).
Around a third of babies born between 24 and 26 weeks have
a bleed, but any baby born before 34 weeks can have an IVH.
Bleeds may occur at the time of delivery or afterward.
Taking baby home
Preterm babies don’t always have to stay in the hospital until they
reach their original due date, and they don’t always have to weigh
5 pounds before being discharged, either. NICUs generally assess
the baby’s condition, the parent’s ability to handle possible
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problems, and the parent’s willingness to learn the baby’s care so
they can do it at home.
Many parents take home babies who are still being tube fed or who
are on monitors to make sure they keep breathing. Others don’t
feel at all comfortable with technical equipment and would rather
have their child in the hospital for a little longer to be monitored.
In fact, feeling completely unprepared to take home a preemie who
has spent weeks or months in the NICU is very common.
If you or your partner starts to go into panic mode about homecoming, get involved with a preemie support group if you haven’t already.
Knowing that other families have done this and the whole family has
survived is very reassuring. And seeing a former 2-pounder tooling
around the block on his bike is the best possible assurance that most
preemies come through their early trauma just fine.
Seriously, going home with the inept pair of you is not the worst
thing your baby will have to face in life, so just do it. Keep that
NICU number on speed dial for a while, though!
Hi, Baby Baby Baby:
Having Multiples
The birth rate of twins, triplets, and more has exploded with the
advent of in vitro fertilization (IVF) and other advanced reproductive technology. Seventeen percent of twins and 40 percent of
triplet births are results of infertility treatment. In 2006 the multiple-birth statistics in the United States broke down as follows:
✓ Twin births occurred in 3,200 per 100,000 deliveries.
✓ Triplets comprised 143 per 100,000 births.
✓ Quadruplets occurred in 9.89 of 100,000 births.
If you’re expecting multiples, find a support group pronto. Not only
are they a great source for used twin or triplet baby paraphernalia,
which can be extremely expensive, but they’re also a source of a
lot of practical info on how to handle more than one baby.
Multiple identities: What multiples
are and who has them
Although infertility treatments are the largest risk factor for multiples, you’re more likely to have multiples if
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✓ Your partner is black. Black women have the highest natural
twinning rate of the different racial groups; Asian women have
the lowest.
✓ Your partner is older than 35. Twins occur naturally around
3 percent of the time in women 25 to 29, and 5 percent of the
time in women 35 to 39.
✓ Fraternal twins (nonidentical) run in her family. Your family
history doesn’t seem to have any bearing on the statistics. If
she’s a fraternal twin, she has a 1 in 17 chance of having fraternal twins.
Twins can be either fraternal or identical. Fraternal twins are created from two different eggs and are no more similar than any
other two siblings. Identical twins are the result of one embryo
splitting into two at a very early stage of development. Siamese
twins, also called conjoined twins, are always identical twins who
didn’t completely split as embryos. Conjoined twins are usually
identified on ultrasound before delivery.
Obviously, boy-girl twins are always fraternal, but if you have two
of the same sex, it may be difficult to tell at first whether they’re
identical or fraternal. The majority of twins, especially twins from
IVF cycles, are fraternal, although IVF also increases the risk of
having identical twins. DNA testing is the only definite way to
determine if twins are identical or fraternal, although sometimes
it’s obvious twins are fraternal, if they look quite different.
Many IVF parents who implanted only two embryos have been surprised to find themselves carrying three fetuses. If this happens to
you, don’t accuse the doctor of putting in an extra embryo he had
lying around! What happened was that one of the embryos split
into identical twins.
Health risks for mom
All the usual pregnancy complaints are intensified during a multiple pregnancy. Annoying issues such as morning sickness, weight
gain, heartburn, constipation, shortness of breath (especially on
any type of exertion), urinary problems, and hemorrhoids are all
likely to be magnified.
Many of the health risks of pregnancy for your partner increase
with the number of fetuses she’s carrying. Multiple pregnancies
are more often medically complicated by:
✓ Gestational diabetes: The increased placental size and hormone production may raise the risk of gestational diabetes in
multiple pregnancies.
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✓ Pregnancy-induced hypertension: High blood pressure after
20 weeks of pregnancy. One in three mothers of multiples
develops PIH.
✓ Anemia: Maternal low red blood cell count.
✓ Hemorrhage: Severe blood loss at the time of delivery.
✓ Placental abruption: Women with multiples are three times
more likely to have the placenta come off the uterine wall prematurely, possibly resulting in severe hemorrhage.
✓ Cesarean deliveries: Cesarean deliveries are pretty much a
given in higher order multiple births because it’s unlikely all
the babies will be head down, and high order multiples are so
small that even if they’re all head down before birth, one or
more are very likely to flip as soon as the first baby is delivered and the rest have more room, possibly necessitating an
emergency cesarean.
For high-order multiples (triplets or more), bed rest during pregnancy is very likely.
Risks for the babies
Twins are five times more likely than single babies to have problems at birth or to die before or soon after delivery. Multiple
pregnancies often deliver early, since the womb has less room for
all the occupants, and preterm babies are known to have more
complications, so these factors account for some but not all of the
risks multiples face. Statistics show that
✓ Approximately 60 percent of twins deliver before 37 weeks.
✓ Thirty-six percent of triplets deliver before 32 weeks.
✓ Eighty percent of quads and more deliver before 32 weeks.
Twins are also more likely to have the following complications:
✓ Twin-to-twin transfusion syndrome can occur only in identical twins who share the same placenta. One twin receives too
much blood, the other too little. Both can cause problems.
✓ Birth defects such as cerebral palsy are much more common
in multiples, and the risk increases with the number of
fetuses.
✓ Cord accidents can occur, such as knots in the cord or entanglement in a cord. Cord accidents reduce blood flow to the fetus.
Identical twins, who develop in one amniotic sac, are more likely
to become entangled in their own or their twin’s cord.
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Your medical practitioner may well suggest that you deliver at a medical center equipped for high-risk births, but if she doesn’t, you should
still plan to do so. Knowing that your babies will have all the technological advances that may be needed in place from the moment of
delivery can really reduce the stress you and your partner feel.
Babies can be transported, if necessary, but it’s stressful for the
babies and for the parents. And if one baby is transported and the
other isn’t, you’ll be trying to split your visiting time between two
hospitals, which is unnecessarily stress inducing.
Keeping Cool in Monetary
Emergencies
Not all pregnancy emergencies involve medical crises: Some are all
about cold, hard cash, or the lack of it. You may have taken a quick
glance at your health insurance policy before you got pregnant,
just to make sure you had the sterling coverage you thought you
had, and you may have even checked the limits of coverage, without ever dreaming that you might rack up a hospital bill of more
than a million dollars for one little baby.
Worse, you may have let your policy lapse just before getting
pregnant — surprise! With unemployment around 10 percent in
2010, many people have no insurance coverage.
It’s possible (probable, even, if you’re normally a healthy twosome) that you have no idea what your insurance actually covers.
Take time to dig through the drawers and find that policy, because
pregnancy illnesses and hospitalization costs can blow your socks
off. Many hospitals today have counselors who help educate you
on your fiscal responsibilities before they let you walk out the
door, but it’s nice to know your coverage ahead of time.
If you find yourself without insurance or with minimal coverage,
ask your healthcare provider or your local hospital about your
options sooner rather than later, so you know ahead of time what
your options are. Community resources are likely available to help
with prenatal care or baby’s care if you are experiencing financial
hardship, and you may get the most benefit from them if you look
into these resources ahead of time.
Checking out your insurance limits
Most insurance policies have their limits clearly listed, including an amount listed as a lifetime benefit. Insurance policies also
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may list your maximum obligation, or deductible, for the year;
for example, you may have a yearly cap of $5,000 on your out-ofpocket expenses for a year, meaning your insurance company pays
everything else. However, you may have to pay every penny of
your deductible before benefits kick in.
Covering the cost of unexpected
medical expenses
Even the best insurance plans leave you footing a certain portion
of the medical expenses. Over the next six months, don’t be surprised to receive separate bills from every wing and department of
the hospital in which you stayed.
A 2001 study reported that as many as one third of bankruptcies
are related to medical debt. Even if you have insurance, using up
your limits can leave you with a hefty bill. Most hospitals have a
social worker or debt counselor who will work with you on bills
that result from being underinsured or if you have no insurance.
Most have debt repayment plans, and many will reduce the bill in
some circumstances.
You may be able to get some aid from the hospital’s charity program or, if your child has an unusual medical condition, from a
foundation involved in the disease.
The main thing to do when faced with a bill that equals the
national debt is not to panic. You have options, and you need to
investigate them. You also need to be upfront with the hospital
from the beginning about your coverage, so you have time to
resolve things before the hospital threatens to hold your partner
or baby hostage. (Don’t worry, they won’t.)
Parents of newborn baby girls have been charged for circumcisions —
mistakes happen, and they can be difficult to find. At the grocery
store, you may not be overly pleased if your receipt only listed your
total charge and not each item individually, but that will be the case
with your hospital bills. If at any point your bill doesn’t make sense —
or it seems like you are paying for the same thing twice or for something you didn’t receive — ask your hospital’s billing department for
an itemized receipt. It will be a lengthy document to comb through,
but it allows you to challenge mistakes and suspect charges, and it
may save you money.
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Chapter 7
In the Home Stretch:
The Third Trimester
In This Chapter
▶ Seeing how baby gets ready for delivery in the third trimester
▶ Putting on weight and dealing with hormones: Mom’s last three months
▶ Understanding your insurance benefits
▶ Choosing a pediatrician early
T
he last three months of pregnancy are when reality hits like
a ton of bricks and you and your partner realize, albeit still
rather dimly, that a real baby is coming to live with you. A baby
with her own personality, a separate person who is developing definite likes and dislikes even before birth and will be able to express
them even when she can’t say a word.
In the third trimester, all the major organs and appendages are in
place, and all the baby has to do is grow. Mom is also doing her
own growing, with an attendant list of common discomforts and
complaints that you’ll become well acquainted with. In this chapter we look at baby’s growth, mom’s growth, and your part in dealing with your family’s expansion.
Tracking Baby’s Development
during the Third Trimester
At the start of the third trimester, your baby is fully formed,
although you wouldn’t think so if you got a look inside the womb.
The eyes are still fused, the skin is gelatinous, and the body fat is
nonexistent, but everything that the baby needs to develop into a
normal newborn is present and accounted for. The following sections provide the highlights of fetal development in the last three
months of pregnancy.
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Adding pounds and maturing in
the seventh and eighth months
Week 27 starts off the final trimester of pregnancy, and don’t think
your partner will let you forget for one minute that she’s been hauling this child around for six months already. While week 27 marks
the beginning of the end of a full-term pregnancy, it also marks the
end of the “easy” trimester.
So if you thought you heard lots of complaints in months four, five
and six, you ain’t seen nothin’ yet! And her complaints are justified.
The baby grows from around 10 inches long and 1.5 pounds at
week 27 to around 18 inches long and 4 to 6 pounds by week 36. That’s
a lot of growth in just nine weeks, and your partner will be feeling it.
In the seventh and eighth months, the baby develops in the
following ways:
✓ Fully develops the lung tissue necessary to breathe outside
the womb: By 36 weeks, most babies can breathe independently without oxygen supplementation.
✓ Matures the digestive tract and kidneys: The ability to
breathe, suck, swallow, and eliminate in tandem is essential
for life outside the uterus.
✓ Begins to see: The eyes open around week 31, and the baby
begins to perceive light and darkness.
✓ Jumps in response to loud noises and recognizes familiar
voices: Go ahead, talk just to him — he’ll turn toward your voice
after he’s born if he’s familiar with it, and “Honey, get me a beer”
aren’t the only sounds you want him to associate with you.
✓ Puts on some fat: Your baby gains weight in these nine weeks
(and so does your partner) because the baby is both growing
and developing fat stores to help him regulate his temperature
after birth.
Figure 7-1 shows the development of your baby in these final weeks.
Getting everything in place
in the ninth month
The ninth month is the home stretch. In these four weeks the baby
assumes the head-down position for good — at least you hope she
does. After 36 weeks, she’s usually too big to go flipping around,
although some babies do manage to turn themselves right-side
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up, which, for birthing purposes, is upside down, or breech. (See
Chapter 9 for more about breech deliveries.)
Figure 7-1: The fetus looks more and more like
a fully developed person in the third trimester.
Your baby doesn’t have much left to do in the last four weeks but
grow and perfect already-in-place systems. In the last month, your
baby will:
✓ Have descended testicles, if he’s a boy: Earlier in pregnancy,
the testicles develop in the abdomen and descend gradually
into the groin before assuming their final position outside the
body. Boys whose testicles don’t descend by the time of birth
are evaluated periodically. Surgery may be required if they
don’t descend by a certain age because the increased body
temperature can damage reproductive organs in males.
✓ Start to develop wake-sleep patterns: Most babies seem to be
more active at night, which may give you some idea of what
you’re in for.
✓ Shed body hair and gain some head hair: Lanugo, the soft
downy hair that covers the fetus earlier in pregnancy, starts
to disappear. Hair on the head may be abundant or nonexistent.
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Dark-skinned babies often have more hair at birth than future
blondies.
✓ Swallow amniotic fluid, urinate, and practice breathing:
Babies get ready to eat by swallowing amniotic fluid, which
also gives the kidneys practice in elimination as urine is
excreted into the amniotic fluid.
✓ Be active: Some babies are thumb suckers even before birth.
She may yawn, grimace, and grab the umbilical cord in her
hand. Kicking gets harder as space becomes tighter, and she’s
likely to stay in position — hopefully head down — without
turning during the last month.
✓ Drop lower into the pelvis: In anticipation of labor, the baby
may drop down so that her head is pressing more directly on the
cervix. This pressure helps thin and dilate the cervix, and also
helps prevent the umbilical cord from falling below her head if
your partner’s water breaks, a dangerous situation known as a
cord prolapse. (See Chapter 9 for more about cord prolapse.)
Finding Out What Mom Goes
Through in the Third Trimester
The baby isn’t the only one who changes in these final months, of
course. Although your partner’s changes on the outside are obvious, if somewhat unnerving at times (Can she really get any bigger
than this? Won’t her skin break apart?), the changes on the inside
are just as dramatic, if not more so.
Getting acquainted with your “new” partner, now known as
mother-to-be-with-a-vengeance, can be as complicated as getting to
know the baby after he’s born. Keep in mind at all times that she’s
going though physical and emotional upheavals the likes of which
you will never be able to fathom, but you need to try.
Understanding your partner’s
physical changes
A pregnant woman at the end of the second trimester still looks
pretty much like her normal self. Your partner may not even be
wearing maternity clothes at this point, letting large shirts (yours,
probably) and pants a size or two larger than her normal size
cover her cute little belly. All that changes in the third trimester
for most women, although some lucky women never look all that
pregnant, even when delivering 8-pound babies.
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Between the seventh and ninth months, expect these changes in
your partner’s physique and physical condition:
✓ The uterus can be felt a few inches above her belly button at the
start of the third trimester, and up under her ribs by the end.
✓ Legs cramps occur because of nerve compression by the
growing uterus.
✓ Backache is common because of the strain from the additional weight in front.
✓ Constipation and hemorrhoids can occur due to sluggish,
compressed bowels. Pain and rectal bleeding can accompany
hemorrhoids. Stool softeners and lots of roughage can help.
✓ Urination becomes almost a full-time job. She may need to get
up in the night to urinate.
✓ Varicose veins may pop out on her legs; they may itch or
ache. Spider veins, small broken capillaries, may also occur
on her face, neck, and arms.
✓ Itchy skin is a huge problem for some pregnant women in the
third trimester. Creams help keep the skin moisturized and
decrease itching.
✓ Heartburn becomes more severe, but despite old wives tales,
it’s in no way related to the amount of hair the baby will have!
✓ Feet and ankles often swell, especially if you’re having a
summer baby. Encourage her to rest with feet up as much as
possible.
✓ Her center of gravity shifts, making falls more likely. Hide her
high heels and, if she’ll let you, take her arm when walking,
like a proper gentleman.
✓ Shortness of breath comes with exertion, because the baby
is pressing on her lungs. When the baby drops, she may feel
relief, but the tradeoff is increased frequency of urination.
✓ She may have trouble sleeping, even though she’s always
tired. Try tying a 6-pound, baby-shaped weight to your abdomen and you’ll quickly understand why.
✓ Breasts may start leaking a few drops of colostrum, the first
fluids produced after birth. They may also look humongous,
since they contain around 2 pounds of extra weight — each!
✓ Vaginal discharge increases, so expect the reappearance of
sanitary pads in the linen closet.
✓ Interest in sex may be at either extreme; it may be the last
thing she’s interested in, or one of the things that interests
her most. Hormones are funny that way. (See Chapter 4 for
more about sex during pregnancy.)
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Contractions may also begin to occur on and off, starting first with
Braxton-Hicks contractions, which don’t change the cervix and are
felt mostly in the front of the abdomen rather than in the back.
As the due date approaches, more contractions may come and go,
usually with just enough frequency to have you leaping for the suitcase and putting it in the car before they peter out. Don’t worry,
the real thing will start soon enough!
Heeding warning signs
Though many complaints of late pregnancy are normal and
expected, some are not. Make sure your partner contacts her medical provider if she experiences any of the following symptoms:
✓ Vaginal bleeding: In the last few weeks of the pregnancy, her
doctor should be told about any type or amount of bleeding, with the exception of bloody show (blood-tinged mucus).
Bleeding can indicate a placental detachment, called a placental abruption, or placenta previa, a low-lying placenta. (See
Chapter 6 for more about both conditions.)
✓ A sudden severe headache: Strong headaches can be a
sign of preeclampsia. (See Chapter 6 for more on the risks of
preeclampsia.)
✓ Severe abdominal pain: This can be a sign of placental abruption, the premature separation of the placenta from the uterine wall, which can be life threatening for mother and baby.
✓ Swelling of her face, hands, and feet: Some swelling at the
end of pregnancy is normal, but facial swelling can also be a
sign of preeclampsia, especially if accompanied by sudden
weight gain, headache, or a rise in blood pressure.
✓ Leaking fluid: This symptom usually indicates the bag of
waters has broken. This is normal at the end of pregnancy, but
not in the seventh or eighth month. Always call if she notices
more discharge than normal or is leaking fluid. After the water
breaks, the baby is more susceptible to infection because its
protective sac is breached. If labor doesn’t begin with 24 hours,
her medical practitioner may consider inducing labor.
Bracing for your partner’s
emotional changes
Hormone levels are very high in the last few months of pregnancy,
and, for many women, with hormones come mood swings. Be prepared for the following emotional changes in the last trimester:
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✓ Irritability: When you don’t feel your best physically, everything irritates you. Try not to be one of the “everythings” that
drives her crazy.
✓ Weepiness: Women find many reasons to cry in the last few
months of pregnancy. They cry because they’re happy, or
sad, or frustrated, or angry. They cry for reasons they can’t
even express to you, which can, of course, be frustrating to
you, but you’ll get over it.
✓ Self-image issues: Pregnancy changes a woman’s body image,
sometimes for the better, sometimes not. Some women resent
the loss of the perfect figure, while others are happy that
pregnancy provides an excuse for the extra weight that’s
always bugged them. Expect to hear her make negative comments, and don’t respond to them in kind. The answer to “Do I
look fat?” is never “Yes.”
Some degree of moodiness, sadness, or depression is normal, but
mood changes in late pregnancy should be fleeting, not permanent.
As many as 10 percent of women become clinically depressed
during pregnancy and need medical intervention, and up to 20 percent develop some depressive symptoms that may also need medical treatment.
Symptoms of clinical depression include sadness that doesn’t
lift, feelings of hopelessness or guilt, difficulty sleeping, constant
fatigue, or behavior not typical for her. Don’t ignore depression
that seems extreme or that doesn’t lift after a few days. (See
Chapter 12 for more on depression after pregnancy.)
Pregnant dad symptoms:
Couvade syndrome
In the past few years, some attention and study has been given to the idea that
expectant dads may develop symptoms similar to those of their partners. This
phenomenon, known as couvade syndrome, may affect as many as 90 percent of
dads-to-be. Weight gain, nausea, backache, and other pregnancy symptoms may
be experienced by dad as a psychological or physical reaction to his own weight
gain, which may be due to eating more from stress or just from keeping up with his
partner. Whatever the reason, rest assured in the third trimester that if you have
“pregnancy pains,” they too will soon be coming to an end.
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Antidepressant medications can be given in pregnancy if her medical practitioner feels the benefits outweigh the risks. Because certain antidepressant known as selective seratonin reuptake inhibitors
may increase the risk of heart defects, respiratory problems, low
muscle tone, irritability, and eating difficulties in the newborn, the
Food and Drug Administration issued a warning about the use of
SSRIs in pregnancy in 2004.
Sympathizing with her desire
to have this over, already
Around the seventh month, many women start expressing a strong
desire to have this pregnancy over and done with. Before you jump
in with long-winded explanations of how the baby isn’t fully developed yet, it’s too early, and other pompous statements about why
being pregnant for just two more months is a good idea, realize
that she isn’t really wanting to have the baby early (well, maybe
she is, a little); she’s just tired and frustrated with being pregnant.
The last few months of pregnancy are no picnic, and unfortunately,
you can’t truly understand what she’s going through. When she
starts talking about getting this baby out by hook or crook the
minute she hits 37 weeks, take it with a grain of salt. She’s every bit
as concerned about the welfare of this baby as you are, and she’s
not going to do anything rash.
Let her vent without giving her a lecture, and in five minutes, she’ll
probably be telling her mom how pregnancy has been the best
time of her life. That’s how hormones go sometimes.
Dealing with tears, panic, and doubts
Doing anything for the first time can be stressful, overwhelming,
and scary. Facing labor, delivery, and motherhood for the first time
certainly qualifies. Yes, you’re also facing fatherhood for the first
time, and dealing with the prospect of labor, seeing your partner
in pain, and a host of doubts and fears, but her concerns are fueled
by hormones and the knowledge that some form of delivery, be it
labor or surgery, is the only way to emerge with a baby after nine
months of pregnancy. The inevitability of the end of pregnancy can
be overwhelming at times.
Your partner won’t be the first woman to ever express the feeling
that she can’t do this, that having a baby was a mistake, or that
she’s changed her mind about the whole thing and wants to call it
off. These feelings will intensify when she’s in labor, so if you deal
with them rationally now, you’ll be better prepared for them then.
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These feelings are temporary, but they’re overwhelming when they
hit. All new parents fear they won’t be good at their new role. The
two of you can approach this fear together by taking the following
practical steps:
✓ Read baby books and online pediatric sites. You’ll still go to
pieces during the first colic episode, but if you know what to
expect, it’s a little easier to handle.
✓ Take a class. Most hospitals offer pregnancy classes that
touch on at least the basics of breast-feeding and newborn
care.
✓ Visit friends with babies. If you have friends or relatives with
infants, hang out with them and pick their brains, if you trust
their judgment.
✓ Talk to your mom and dad. Although time dims the memories
of parenting, your own parents may be able to vaguely recall
their early parenting days and give you some advice based on
their own experiences. After all, you turned out okay, didn’t
you? If you didn’t, don’t ask them.
✓ Talk it out. Experience may change your mind about a
number of parenting issues, but you’ll feel more prepared if
the two of you try to set out some basic ideas about how you
want to raise the baby. This helps avoid drama-filled discussions when one of you wants to put the baby in your bed at
3 a.m. and the other doesn’t, and also gives you the sense of
having some grasp of what parenthood is all about. Expect
your ideas to change frequently in the first actual weeks of
parenthood, though.
Facing your own fears about fatherhood
Today’s new dads may not have had involved fathers as role models as they were
growing up, which can lead to uncertainty about exactly how to approach the
fatherhood thing. The idea that dad should be as involved in child rearing as mom
is a fairly new one, and you may feel uncertain about what your role is.
Because no two families are alike, you and your partner will design your own family
model. You set your own standards here, so don’t worry about what a “good” dad
does or how other people approach fatherhood. You’re going to be a “good” dad,
so however you decide to embrace the parenting role will be the right thing for you
and your partner.
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Allow your partner to vent and express doubts and concerns, but
never fail to reassure her that you know she’ll be a great mom, that
she was born to do this, and that you’ll be helping her every inch
of the way. Feel free to express your own fears and doubts about
being a really good parent, but never in a “Can you top this” way.
Many women at the end of pregnancy have very vivid dreams
about the baby or develop fears that something may be wrong with
him. You can’t do much about these fears except let her talk them
out and reassure her that no matter what happens, you’re there
for her and the baby. However, if your partner becomes fixated on
thoughts that she may harm the baby, or that something is wrong
with the baby, she may be experiencing a severe depressive disorder. Make sure she sees her medical practitioner promptly.
Getting Your Paperwork in Order
Filling out forms and investigating your insurance benefits aren’t
ideal ways to spend a Saturday afternoon, but when the alternative is trying to fill in the blanks while your partner is enduring
the beginning states of a painful labor, well, doing them now is a
no-brainer! The more prepared you are from the business end of
having the baby, the smoother the admissions process at the hospital will go.
Likewise, the better you understand your insurance coverage, the
less likely you are to receive an unexpected (and unexpectedly
large) hospital bill upon your return home.
Understanding your insurance
Although navigating your insurance plan may sound as impossible
as understanding your income taxes, it’s an important predelivery
step for couples. Talk with someone from your human resources
department at work as well as with your insurance company to
fully understand your coverage.
Unites States law says that pregnancy cannot be deemed a preexisting condition by insurance companies, so if you or your partner switched jobs or insurance plans in the middle of pregnancy,
you’re probably still covered. However, the law is limited to group
policies, not individual policies, and has multiple loopholes, so be
sure to carefully research your coverage.
Your personal insurance plan dictates the following factors:
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✓ Length of stay in the hospital: The Newborns’ and Mothers’
Health Protection Act is a U.S. federal law that requires all
insurance companies to cover the hospital stay for 48 hours
after a standard delivery and 96 hours after cesarean. It does
not, however, require that insurance companies cover any or
all of the birth itself.
✓ Where you can give birth: Unless you want to get stuck footing a huge portion of the bill, make sure that the hospital or
birthing center of your choice is an approved facility by your
insurance company.
✓ Who can attend your birth: Not all doctors are covered by
your insurance, either, so make sure that yours is. If you’re
opting for a midwife, investigate the coverage your insurance
provides and make sure your midwife is willing to work with
your insurance company. In rare cases, some insurance plans
cover part of a doula’s fees.
✓ What drugs are covered: It may seem like your insurance
is obligated to fully cover any drug or medicine your doctor
provides your partner, but that’s not always the case. Find
out how much of the total cost of an epidural will be covered,
because they’re quite expensive, and you may need to plan
ahead for the costs you may incur.
✓ Elective procedures: Whether it’s a scheduled cesarean or a
circumcision, not all insurance companies cover procedures
that can be deemed as elective.
✓ Percentage of total cost: 80 percent coverage may seem
like an awesome deal, until you realize your entire stay cost
$10,000 and you’re now on the hook for two grand. Knowing
what to expect allows you to save ahead so when the bills
start arriving, you won’t have to scramble.
Midwives are generally less expensive to employ than a doctor,
and if your insurance covers the cost of a midwife, you likely will
save money going that route. Many midwives even deliver in
hospitals and partner with a doctor to ensure emergency care
when needed.
Home births are the cheapest option of all options but are generally
recommended only for women who fall into the low-risk pregnancy
category. However, if you and your partner are opting for a home
birth, check with your insurance provider to find out how it handles
such situations and what is covered in case of an emergency.
In the case of multiples, the cost will increase by a great deal
because the babies are more likely to stay in the neonatal intensive care unit. Again, assuming 80 percent coverage, you could be
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responsible for 20 percent of a bill that quickly escalates into the
six figures. Also, keep in mind that after mom is discharged, the
costs of travel and staying at or near the hospital while your baby/
babies are in the NICU are up to you.
Here are some other important questions to ask your health insurance provider:
✓ Do you need to notify the provider upon admission into the
hospital?
✓ Are childbirth classes covered by your plan?
✓ Will any portion of a doula’s services be covered?
✓ Is lactation consultation covered?
✓ What newborn care is covered in case of emergency?
✓ Are any prescriptions or medications not covered?
✓ Are any procedures (circumcision, scheduled C-section),
or prenatal tests (amniocentesis) not covered? Are there
exceptions?
During benefits open season at your work, which usually occurs
sometime around the end of the year, check into the labor and
delivery coverage of any alternative insurance plans offered by
your company and consider switching plans or providers to one
that best suits your needs. It may save you thousands of dollars in
hospital bills.
Preparing for the costs if you
don’t have insurance
Under no circumstances is living without health insurance a preferable idea, especially if you’re pregnant or have children. However,
due to myriad reasons, ranging from job loss to self-employment, a
small portion of people find themselves pregnant without coverage.
The costs of all of the tests, ultrasounds, and doctor visits leading
up to and following childbirth are an enormous expense, and many
medical providers won’t even accept you as a patient if you’re
paying out-of-pocket. However, others are happy to work out a
payment plan, which may require a larger upfront deposit. Your
provider options may be limited, but with a little legwork you can
find someone.
Aside from the cost of your partner’s doctor, you have to make
similar arrangements with the hospital for your stay and any medicines, procedures, or operations you may undergo. The same goes
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for the anesthesiologist, who may require that you pay the fee
for an epidural upfront, running you between $1,000 and $2,000,
depending on the provider. And after baby is born, he’ll need more
checkups and vaccinations, and you’ll have to find a pediatrician
who accepts patients without insurance.
With all those expenses, an insurance plan you buy on your own
will probably pay for itself. In the case of job loss, pay for COBRA
coverage for as long as it’s offered to your family. Note: Some
states also offer low- to no-cost healthcare for low-income families
that covers the majority of childbirth costs.
Guaranteeing a smooth admissions
process at the hospital
Think back to the last time you arrived at a crowded shopping mall
with a parking lot packed to the gills with cars and you ended up
walking ten minutes just to get to your store of choice. Now imagine that you drive right in and, miracle of miracles, the parking
spot closest to the door is waiting for you.
If you want that experience upon arriving at the hospital when
your partner is in labor — and believe us, you do — you need to
make sure you fill out all of the preadmissions paperwork at your
hospital or birthing center. This keeps you from having to fill out
forms and answer an endless array of questions when you should
be focused on the woman in pain.
A good time to make sure everything is in order is during your
prenatal visit to the birthing center. The visit is not only a chance
to get to know a few of the faces you may be seeing, but also the
perfect firsthand opportunity to make sure that your partner is in
the system.
Also, you want to make sure that you contact your delivery doctor
or midwife prior to going to the hospital. Many doctors want a call
as soon as labor begins; others just want a 30- to 60-minute headsup before you head to the hospital. And because many labors begin
(and end!) in the middle of the night, you want to give your doctor
or midwife ample time to wake up before heading out the door.
At some point during the admissions process, you may be asked
to leave the room so the nurse can talk to your partner alone.
Although it may seem off-putting at first, this procedure is very
important. Unfortunately, domestic violence is far too common,
and one of the nurse’s duties is to ensure that the woman in labor
and the baby she’s bringing into the world are in a safe environment during labor and delivery. Don’t take it personally!
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Whose Baby Is This, Anyway?
Dealing with Overbearing
Family Members
From the time you share the news of your coming baby, you’ll be
inundated with advice and visitors. Nobody will want to be more
hands-on than your family, and it may grow tiresome and become
a source of angst very quickly the closer to labor and delivery your
partner gets, and especially when you get home from the hospital
and crave some family time.
Mothers, grandfathers, aunts-to-be — they all get nervous, too.
Unfortunately, their offers of assistance and their constant presence can keep you and your partner from some much-needed quiet
bonding time before baby arrives. Your lives are about to change
forever, for the better (baby, baby, baby!) and for the worse
(goodbye sleep and frequent sex!), and you need time to enjoy the
waning bits of childlessness you have left.
Your families love you, and their well-meaning, obtrusive advice,
visits, and purchases are the only way they know how to show
you just how excited they are to meet the new little person you’re
bringing into the family. However, if members of your family are
becoming too involved or over-the-top for your tastes, be sure to
thank them for the love and support and simply let them know that
you and your partner need to take some time for yourselves before
the baby comes.
Depending on how big and how emotionally connected your family
is, consider starting a phone tree to share news earlier in your
pregnancy to save you from having to call every single relative
in your phone book every time you go in for an ultrasound (see
Chapter 8 for details on creating a phone tree). Telling the same
story over and over to 13 aunts, cousins, and neighbors may take
the fun right out of your fun news. That said, don’t cut off communication altogether. Make sure to call the most important people in
your life as frequently as you see fit. It’s an exciting time for everyone, and you won’t want to tarnish a loved one’s joy by letting him
get all the news secondhand.
Picking a Pediatrician
Choosing a pediatrician before the baby arrives may seem unnecessary, but with so much going on in the weeks before and after
delivery, you want to get it checked off the list in the third trimester.
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It may take more time than you think to find someone who agrees
with your stances on breast-feeding, vaccinations, and the necessity of certain in-hospital procedures.
Also, your baby will need to be cleared for checkout from the hospital
by a pediatrician, and the sooner you start working with the doctor of
your choice, the better. Building a relationship between a pediatrician
and your baby increases the likelihood that your child will get the
care she needs. And what better time to start than in the hospital?
Get a list of approved pediatricians from your insurance company
and start your research. Talk to other parents in your neighborhood, as well as friends who live close by. As best you can, choose
a pediatrician who is close to home, because you will be making
the trip many times during the first year. Research feedback the
doctor has received online, too. Considering the sheer number of
hateful things people are willing to post online, take nasty reviews
with a grain of salt, but do take note if a doctor has an overwhelming amount of negative feedback.
Next, schedule an interview with two or three doctors of your
choosing. Here’s a list of questions that you should ask any potential pediatrician to ensure you get the care you want for your baby,
both during your hospital stay and beyond:
✓ How long have you been a pediatrician?
✓ How many doctors are part of your practice?
✓ What are your hours on the evenings and weekends?
✓ Is there an on-call doctor at all times? Is there a charge for
after-hours calls/services?
✓ Are you a family practice doctor or solely practicing pediatrics?
New parents may find it easier for the whole family to be treated
by the same doctor. If you and your partner have strong feelings
about this, make sure to ask if you can be seen too.
✓ Do you offer same-day appointments for illness?
✓ Are you often double booked?
✓ How long is the average wait?
✓ Will I always see you at each visit, or will my baby be seen by
other doctors, nurses, or junior staff members?
✓ What is your stance on formula feeding? How long should our
baby be breast-fed? What formulas do you recommend?
Whatever decisions you and your partner make about feeding
your child, it’s vital that you have a pediatrician who will support your choices.
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✓ Are you flexible with immunization schedules?
Some parents choose to delay vaccinations or use alternate
schedules. Make sure your pediatrician is onboard with your
immunization wishes.
✓ When do you recommend beginning to feed solid foods?
Depending on the doctor, you may be told to start feeding
your child solid foods beginning at 4 months or as late as 6
months. Research varies on what is best, so get educated
and make sure your pediatrician will support your feeding
schedule.
✓ Do you require breast-fed babies to take vitamin D supplements?
Breast-fed babies are often prescribed a supplement for vitamin D, however, not all pediatricians and parents agree that
it’s necessary. Do your research on what feels right to you
and make sure your pediatrician agrees with your decision.
✓ Do you employ a lactation consultant or offer lactation support?
✓ What is your stance on use of antibiotics in children?
✓ How often are the play facilities cleaned?
Also, feel free to show your potential pediatrician your birth plan.
Her reaction to your decisions, such as whether or not to give the
baby a vitamin K shot right after birth or whether or not a baby
needs erythromycin on his eyes, may help guide your decision.
(See Chapter 8 for more on the choices detailed in a birth plan.)
Choose a doctor who most closely aligns with your wants and
desires for your baby. You don’t want to have to start the search
all over again just because a pediatrician doesn’t agree with your
decision to delay vaccinations or give your child formula.
Chat up the other parents in the waiting room to find out the real
dish on how long they have to wait at each visit, how often they
actually see the doctor, and their overall impressions of her caregiving style. Parents are brutally honest, and they are your best
source of information.
If you have a long-time family physician with whom you have a
personal relationship and you don’t plan to have be your child’s
pediatrician, let him know before the baby arrives. Not only is it
respectful, it will help you avoid the awkwardness of having both
your family doctor and your pediatrician show up at the hospital.
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Chapter 8
The Copilot’s Guide to
Birthing Options
In This Chapter
▶ Making basic decisions about labor: Who, what, how, and where
▶ Creating a birthing plan
▶ Picking the people who get to be at the birth
L
abor is nothing like it used to be. From the au naturel days
when biting down on a bullet was the “medication” and the
1950s when every woman was sedated up to her eyeballs while
dad spent the night in the bar, labor has evolved into a family
event that involves medications that really take the pain out of
labor, sleepovers for dad, and champagne dinners the night
before discharge.
One thing about having a baby is sure: There’s no one right way to
do it. For every person who wants to deliver at home on her grandma’s favorite quilt, another person feels that epidural on demand
is the best phrase in the English language. Whatever you and your
partner dream up as the ideal labor experience, rest assured it
probably won’t be the weirdest idea your birthing practitioner has
ever heard.
You have more childbirth options today than ever before. Natural
deliveries, home deliveries, and give-me-everything-you’ve-got
deliveries are all possible. And the good thing is, no one is going
to hold your partner to the ideas you both thought sounded good
before labor started. If she decides she wants an epidural after all,
all she has to do is scream — er, say so.
Although the number of options is much larger than in previous
years, some of them may not be feasible in your situation. For
instance, if your partner has certain medical conditions, such as
preeclampsia, or if the baby has congenital birth defects, they
really need to be under a doctor’s care in a hospital, even if your
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partner had her heart set on a home delivery. Be sure to talk to
the doctor early in the pregnancy about your plans so that she can
advise you on their feasibility and safety and let you know if circumstances change.
In this chapter we review the options that are available and help
you decide what works best for you and your partner. We also provide tips on crafting a birth plan and deciding who’s allowed in the
delivery room.
Making Sure Your Birth
Practitioner Is a Good Fit
Discussing your plans with your current birth practitioner as soon
as you figure out what they are is important. For one thing, he may
not be interested in participating if you’re planning something out
of his comfort zone, and you may need time to find someone who
thinks childbirth in the backyard sounds like fun. If your midwife
balks at assisting you during a delivery that features a medically
unnecessary planned cesarean, you need to find one who doesn’t.
Though many doctors are more flexible about childbirth options
than they used to be, most doctors still have a fairly narrow comfort range, one that likely includes fetal monitoring, intravenous
infusions, and limited time in the hot tub. The practices used by
midwives, on the other hand, have become more mainstream in
many areas, and a midwife may practice only slightly differently
than an obstetrician.
Screening potential practitioners
Whichever birth practitioner you choose, the best way to know if
you’re in the right place is to ask. Both you and your partner should
be there when discussing options, because if the practitioner isn’t
on board with your plan, he may think he can just wait and talk
some sense into the absent parent. Presenting a united front, especially on non-negotiable items (such as home birth, for example) is
best done as a couple. Consider asking these questions:
✓ Where do you deliver? Most doctors only deliver at one or
maybe two hospitals. It wouldn’t be practical for them to run
around from place to place. If you choose a midwife, find out
whether she delivers at homes only or also at hospitals, and
make sure she can do it where you want to be.
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✓ What’s your cesarean rate? The cesarean rate in the United
States and other developed countries is appallingly high.
While cesarean sections are often necessary and lifesaving,
they have a higher risk of complications for your partner and
the baby. A significantly higher rate than your area’s average
is a warning sign that your doctor may be too quick with
the knife.
✓ How many inductions do you do? Nobody wants to be pregnant forever, or even nine months, but pregnancies were
designed to end naturally. Some doctors do way too many
inductions, especially on Friday mornings. Your convenience
isn’t always the goal when the doctor offers to induce labor,
and induced labors have a higher cesarean rate, and cesarean
deliveries cause more maternal and fetal complications.
✓ Who’s on call? Does the doctor come in when her patients go
into the hospital, or is labor managed by residents? Early in
labor, some doctors have the resident check their patient and
call them for instructions; this isn’t necessarily a problem,
but knowing it ahead of time will keep you from badgering the
nurses about when your doctor’s coming in. For midwives,
find out if she has an assistant or backup person to cover for
her if she can’t attend.
✓ How do you feel about [fill in the blank]? If you have an
unusual request, politely approach your practitioner with this
line, rather than demanding, “We want [whatever].” If you
want to both spend labor in the hot tub naked, now would be
a good time to get your practitioner’s feedback on this idea.
Make sure you and your partner are agreed on what you want
before discussing plans with your practitioner, and discuss it well
before labor starts. Arguing in front of the nurses and trying to talk
her out of an epidural at 6 centimeters is considered really bad
form by the hospital staff, and they may not let you use the coffee
machine or show you their hidden stash of emergency snacks for
fainting fathers if they don’t like the way you talk to your partner!
Working with a midwife
A midwife delivery in the hospital or birthing center can be a wonderful option. Midwives really are committed to fewer interventions in labor and give much more personal care. However, your
partner may become so attached to her that you feel a little left
out. Don’t let that happen unless you’re fine with being the third
man; go to appointments and get to know the midwife yourself so
she knows you’re interested in being a real part of the partnership.
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If you and your partner are thinking about delivering with a midwife, check the American College of Midwives (www.midwife.
org) or Midwives of North American (www.mana.org) for options
in your area. Using a search engine or checking chatboards on
sites such as www.mothering.com for information is often the
best way to get other people’s opinions and experiences on what
using a midwife or having a home birth is like.
A personal interview is always the best way to get a feel for not
only the nuts-and-bolts information about education and experience, but also a sense of whether your personalities will “mesh”
for the next nine months. When you interview your prospective
midwife, ask the following questions:
✓ What’s your training? Some midwives have nearly as many
degrees as your doctor, and others have no formal training
at all. But don’t necessarily reject a midwife because of a lack
of diplomas: Some people have a natural ability to deliver
babies, love the work, and have all the knowledge necessary
for a safe outcome, as long as there’s medical backup nearby.
✓ How long have you been doing this? The longer the better.
You see everything if you work in obstetrics long enough.
✓ What’s your backup plan? If she says it isn’t necessary to
have a backup plan, reconsider this person. Having a backup
plan is always necessary.
Getting some additional
help with a doula
Although the word doula may have you picturing some sort of
metal-studded medieval torture device, a doula actually can be
a soon-to-be dad’s secret weapon — one that can take some of
the pressure off your very tense shoulders. A doula is a person,
generally a woman, with a comprehensive understanding of the
birthing process. She is hired by the couple to provide emotional
and physical support throughout labor. Think of her as your very
own in-hospital, labor-specific Google search/motivational speaker.
Services doulas offer include:
✓ Allowing you to participate in labor and delivery as much or
as little as you are comfortable
✓ Assistance in creating a birth plan
✓ Staying with you and your partner throughout labor and delivery (the doctor and nurses will not be present the whole time)
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✓ Facilitating communication of the birth plan and the decisions
of the mother and father to the doctor/midwife and nurses
✓ Giving light massage to both you and your partner during
labor and delivery
✓ Postpartum education and assistance with newborn care,
breastfeeding, and adjusting to family life
If you think doulas are only necessary for deliveries in which the
father isn’t involved, think again. Labor is a complex process,
and as it progresses you and your partner will be asked to make
many decisions about procedures and medications for which you
may not feel fully prepared. A doula can inform you about both
the risks and benefits involved, as well as help you explore other
options that may better suit your birth plan.
Doulas also provide your partner constant support while giving
you the opportunity to step out of the room to grab a quick snack
or take a breath of fresh air. For long labors, a quick 15-minute nap
can make the difference for a worn-out dad-to-be. Doulas ensure
that someone who understands the process and your birthing
choices is with your partner at all times — even when your eyes
are closed.
And doula-ing has a medical benefit, too. Research shows that
couples who have a doula present during childbirth tend to have
shorter labors with fewer complications as well as a reduction in
the use of labor-inducing medications, forceps, vacuum extractions, and cesarean sections.
After your new family returns home, most doulas make a postpartum visit that provides support for mom and baby, and
she also provides telephone support for a specified duration
following birth.
Not all doulas are created equal. Make sure to interview multiple
candidates and ensure that they’re certified by Doulas of North
America (DONA). Make sure that she has had a criminal background check. For more information about hiring a doula, visit the
DONA Web site: www.dona.org.
Choosing Where to Deliver
A century ago, everyone delivered at home. Fifty years ago, everyone delivered in the hospital. Today parents can choose either
option, or may deliver in a special birthing center designed to
mimic the comforts at home while still providing cutting-edge
medical treatment if needed.
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Delivering at a hospital
Hospitals today love to stress how much like home they are while
still having all the most up-to-date equipment at their fingertips.
And though hospitals have come a long way in improving the overall birthing experience, they’re still not home. Some, however, are
better than others at creating a welcoming, open-door policy for
family, so check out the local possibilities, keeping in mind that
your doctor can only practice where he has privileges and that in
the long run a doctor you trust is far more important than lavender
quilts and a pull-out sleeper chair. Here’s what to look for when
you visit different hospitals:
✓ Is it secure? Most hospitals have beefed up security, especially around the maternal and child health area. Hospital
bracelets are embedded with alarm triggers, codes have to
be activated to enter certain areas, and the staff all dresses
in one color so you know who belongs there. It should not be
possible to just walk onto a maternity floor without a pass.
You want security to be tight, even if it’s a pain in the neck.
✓ What are visiting policies? What you’re looking for depends
on your preferences. Do you want your entire family and a
three-piece band present, or are you hoping to have just the
two of you at the delivery and in the mother-baby unit afterward? Keeping family out is much easier if you can quote
“hospital rules.”
✓ How much access does dad have? Many places allow dad
24-hour visiting privileges, but some don’t. Find out the rules
ahead of time so security isn’t called to remove you.
✓ Is the staff helpful? You can tell a lot by the attitude of the
staff even on a short visit. Do they smile and say hello, or
run over your foot with a gurney without even an “excuse
me”? You’re going to spend way more time with the nurses
than with your doctor in labor — in fact, she’s in and out
so fast you may not be quite sure she was there at all — so
your experience will be more pleasant if the nurses are good.
Although you may still draw Nurse Ratched for your labor
nurse, it’s less likely at a hospital with a mission statement
and policies that promote a positive atmosphere. If you’re
planning to use a midwife, find out how the staff will work
with her.
✓ Is anesthesia in house all night? Surprising as it may be,
some small hospitals don’t have an anesthesiologist in the
hospital all night. The anesthesiologist may have to be called
in from home if your partner wants an epidural during the
night. And if the hospital has only one on staff, she may be
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doing an appendectomy just as your partner starts getting
really uncomfortable. Know ahead of time so you can ask for
an epidural early, if need be.
✓ How’s the décor? Consider the appearance of the hospital
room after everything else has been taken into consideration.
Pretty surroundings are nice, but you’ll be too busy to notice
them. And that pretty quilt will be removed from the bed,
because the staff doesn’t want anyone bleeding — or worse —
all over it.
After you make your decision, visit the hospital again. Knowing
exactly what your room will look like and even recognizing some
familiar faces removes a layer of stress as you get ready for delivery. Most hospitals and birthing centers offer tours, but you can
call and schedule a private tour of the facility as well.
While you’re there, take note of the eating options, parking guidelines, and prenatal and postpartum classes offered by your hospital or birthing center. This allows you to plan ahead and offer your
well-wishers the information they need as well as make full use of
the facilities’ offerings.
Many hospitals offer prenatal lactation classes that are taught by
the on-staff lactation consultant who will visit your room after
delivery. The classes are usually free and quite short. Encourage
your partner to attend a class in order to learn the basics of
breast-feeding as well as to initiate a face-to-face relationship prior
to the consultant’s postpartum visit. Your partner will be much
more comfortable asking questions and discussing any issues she
and baby are having if she has met the consultant previously.
Exploring alternative options:
Using a midwife at home
The idea of having your baby at home may appeal to you and your
partner. Home delivery may be an option for you if you meet all
the following strongly suggested guidelines:
✓ You have found a midwife who’s willing to deliver at your home.
✓ You live fairly close to a medical facility in case of emergencies.
✓ You’re not delivering in Montana in January or any other area
where roads are impassable during the part of year you’re due.
✓ You’re both calm, sensible people who are really committed
to the idea of home birth.
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The trouble with labor is that while 99 out of 100 times everything
goes perfectly, you need to be prepared for that one time when
things go bad so quickly you can’t believe your eyes. Having
nearby medical help is really essential, unless your midwife can do
a cesarean in under 30 minutes in an emergency.
Make sure your midwife has a backup plan to cover contingencies
such as sudden illness or other problems that would prevent her
from getting to you for the delivery. Does she have a partner or
someone who covers her? Discuss circumstances that may cause
you to change your mind about home delivery, from ominous
weather to last-minute cold feet.
If you plan to use a midwife at home, be sure to get good answers
to the following questions (in addition to the questions listed in
“Working with a midwife” earlier in this chapter):
✓ What type of equipment will you bring with you? You can
be sure a ventilator and fully equipped operating room won’t
appear out of her black bag, but basic medications like intravenous fluids and Pitocin to prevent heavy bleeding after
delivery and oxygen, plus equipment like an ambu bag to
breathe for the baby in case of problems after birth, should
be in every midwife’s bag.
✓ How long do you stay? “As long as you need me” is a good
answer. She should stay at least an hour or two to make sure
your partner and the baby are behaving normally and to get
nursing started. On the other hand, you may not want her
moving in with you — that’s your mother-in-law’s role. She
should also visit for the next few days to recheck both mother
and baby in case of any late-developing problems.
Looking at Labor Choices
Standard labor practices vary depending on who is delivering
and where you deliver, but no matter the situation, you and your
partner will have to make a number of decisions and can opt to
make dozens of others if you have preferences. Educate yourselves
on common procedures and their pros and cons by talking with
the doctor and doing some reading. One of the biggest issues for
women in labor is deciding whether or not to have an epidural or
other pain medication. In this section we discuss that as well as
another big issue, water births.
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Going all natural or
getting the epidural
The decision about pain medication is one area where, although
you’re welcome to have your say — if you say it nicely — the decision is really up to your partner. As long as she’s not planning to
do anything unsafe, she’s the one who has to go through labor, not
you, so the drug decision should be hers.
The all-natural method of childbirth, which avoids unnecessary
pain medication and medical interventions such as episiotomies,
seems to have peaked about the time the hippie movement went
mainstream and started buying BMWs, but letting nature take its
course in childbirth still has many proponents. Women have been
having babies naturally since forever, and many women find going
through labor without any medication empowering.
Classes that teach breathing and relaxation techniques as a natural way to deal with pain, such as the Bradley Method (see www.
bradleybirth.com for classes near you), are available. A doula,
midwife, or obstetrician who’s supportive of natural childbirth can
also be a good source of information on the pros and cons of delivering naturally and the classes available in your area. Some classes
focus on specific breathing patterns (can you say, “Hoo hoo
hee”?), while others stress learning to listen to your body, relaxation methods, and the benefits of staying upright during labor.
Around 50 percent of women in labor these days have epidurals,
an injection that numbs the nerves from the abdomen down to the
thighs. Epidurals are usually given when labor is well established,
around 4 centimeters, because contractions can slow down if it’s
given too early. Some doctors, though, order epidurals earlier and
then start Pitocin, a labor-induction drug, if contractions slow down.
Epidurals are better than they used to be; they can be run as a
continuous infusion on a pump so they don’t wear off and need to
be re-injected. Some hospitals offer “walking epidurals,” where the
dose given still allows patients to walk, which is better for keeping
labor going than lying in bed.
Some women turn down the epidural but are given intravenous
pain medications to help with labor pains. One problem with IV
medications is that they can depress the baby’s ability to breathe
after birth, so they can’t be given too close to the time of delivery.
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Taking it to the water
Water birth is delivery of the baby while the mother is in a large
tub of water. The baby is delivered while under the water, which is
considered by proponents of the practice to be less traumatic to
him because he’s spent nine months in water. Although water birth
sounds like a warm, back-to-nature experience, no cultures actually practice water birth. This fact doesn’t mean that water birth
doesn’t have some appealing possibilities, mostly for mom-to-be,
who gets to spend most of her labor floating in a tub of water.
Many women find spending some time in labor in water reduces
pain and aids in relaxation.
Babies have never been traditionally born into a vat of water, and
although most babies don’t breathe until they’re out of the water,
a few baby deaths have been related to water birth. Laboring in
water and getting out for the actual delivery may be a safer option
to consider.
Some women absolutely should not have a water birth. The list
includes:
✓ Women giving birth prematurely. (See Chapter 6 for more on
preterm delivery.)
✓ Women with genital herpes.
✓ Women whose babies have passed meconium, the first stool,
before delivery. These babies need their mouth and nose suctioned as soon as the head is delivered, to help prevent meconium aspiration into the lungs.
Creating a Birth Plan
A birth plan is a document that outlines the procedures, medications, and contingency plans that you and your partner are comfortable with throughout labor and delivery. It details your ideal
birth experience while acknowledging the unpredictability of the
process.
A birth plan is not a set of marching orders for your nurses,
doctor, or midwife, so keep it simple and friendly. You share this
document with your entire birthing team, and not all doctors and
nurses are thrilled at the prospect of a couple telling them how to
do their jobs.
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Creating a birth plan requires that you and your partner discuss
what you’re comfortable with and make many important decisions
prior to your arrival at the hospital. The last thing you want to do
is to leave life-altering, labor-changing decisions to be made during
an emotionally wrought time.
Visualizing your ideal experience
Labor and delivery are like reading a choose-your-own-adventure
novel; every decision you make can lead you to a slightly different
outcome.
As corny as it may sound, you and your partner should spend some
time with your eyes closed trying to picture what your perfect experience would look like. Try to be realistic — a pain-free, 60-minute
labor is highly unlikely, and making that dream a reality is beyond
your control. Instead, focus on the things you can control.
When creating a birth plan, consider the following basic questions:
✓ What types of medication is your partner willing/wanting to
have administered?
✓ Do you want to cut the umbilical cord? Do you want to bank
the cord blood? (See the sidebar “To bank or not to bank” for
more information.)
✓ Does your partner want final approval before the doctor performs a vacuum extraction? This involves a suction device
that helps pull the baby out, which can cause painful tearing
of the vagina as well as temporarily misshapen baby heads.
It is a safe and, in some cases, necessary procedure, but
many women want to have the choice as to whether or not it
is performed.
✓ Does your partner want constant or intermittent fetal monitoring? Fetal monitoring tracks baby’s stress levels during
childbirth, and constant monitoring will limit your partner’s
ability to move freely during labor.
✓ Does your partner want to veto an episiotomy? An episiotomy is a surgical incision that enlarges the vaginal opening
to allow the baby to come out more easily. It used to be a
common procedure, but most studies show that letting the
body tear naturally is a better option. An episiotomy is quite
painful during recovery and not an attractive option for most
women unless absolutely necessary for the health of the baby.
✓ Does your partner want to be able to get up and walk around
while laboring?
✓ Are you opting to forgo circumcision?
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To bank or not to bank
Cord-blood banking is the freezing of the blood in the umbilical cord, which is full
of your baby’s stem cells and can be used to treat disease (80 serious diseases
including leukemia, other cancers, and blood disorders) down the road. It’s becoming more popular in the United States, but is it necessary?
To purchase the collection kit (which you take with you to the hospital in order to
collect the cord) and the first year storage fee will cost you between $1,000 and
$2,000, with an annual storage fee of at least $100. Some research shows that using
a matching donor’s stem cells is just as effective as the stored blood, but due to
the raging debate about how stem cells are collected, this is an effective way to
ensure access.
In addition, your baby’s cord blood can be used to treat other stem-cell matches in
your family. It’s more or less an insurance policy that, most likely, you’ll never have
to use. If banking the blood is outside of your financial possibilities, don’t sweat it.
Some research even suggests that letting all the blood from the cord flow into the
baby before cutting is better for the baby’s health, in which case, the blood isn’t
available to be collected, anyway.
In order to make sure you both feel positive about your childbirth
experience, you need to prepare answers to these important questions. Many procedures may be done as a matter of course that
might not jive with you and your partner’s desires, so invest the
time beforehand in order avoid any regrets that you could have
prevented.
Many prenatal classes include exercises that help you visualize your ideal experience, and some even offer help developing
your birth plan. When selecting a class, ask the instructor if these
activities are included as part of the course. Having a third party
involved, be it a doula or your prenatal instructor, may help you
and your partner narrow down your list of what’s truly important
and turn those priorities into a cohesive, effective birth plan.
Drafting your plan
After you and your partner have decided what your ideal birth
looks like, you need to put it into writing. Try to use language
that’s friendly, concise, and represents your flexibility.
Births don’t usually go exactly according to plan, so allow wiggle
room for the unexpected to make sure the nurses and doctors
know that your priority is having a healthy baby at the end of the
day. Here are some basic tips for writing your birth plan:
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✓ Write a nice, short introduction that introduces who you are
and thanks your team in advance for following your plan.
✓ Include a brief overview that states your basic, overall desires
for the kind of labor and delivery you and your partner want.
✓ Break the main body into three sections: labor, delivery, and
postdelivery.
✓ Under each heading, make the major points into a bulleted list
for easy reading.
Keep it to one page unless you know ahead of time that your labor
and delivery are going to be complicated and therefore require
more steps.
Since the majority of what’s being outlined in the birth plan is up
to your partner to decide and ultimately undergo, get involved in
this project by taking the lead. Make her favorite dinner and start
a dialogue. Ask her questions about what she wants and tell her
what you want, too. Take notes during your discussion and then
start composing your birth plan. It won’t happen overnight, but it
will let her know how involved you want to be.
Use the following birth plan as an outline for creating an effective,
concise document for your team:
The Johnson Family Birth Plan
The Midwives at Methodist Hospital Family Center
Parents: Rachel & Evan Johnson
Doula: Holly Barhamand
We’re looking forward to having our baby at Methodist Hospital with
the midwife group and staff! We know you see a lot of birth plans and
we thank you for reading ours.
We anticipate a normal birth and would like to allow the process to
unfold naturally. However, in the unlikely event of a complication, we
will cooperate fully after an informed discussion with the birth team
has taken place. We are also willing to sign release forms if legally
required in order to avoid “routine” procedures we opt against.
Overall, we would like no medication, exam, or procedure to be
administered to mother or baby until it is explained to us and we
have given our consent. Thank you in advance for all of your hard
work and excellent care!
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Labor:
✓ I would like to attempt labor without pain medication — I will
ask (loudly, I’m sure!) if I feel I need something.
✓ We prefer intermittent, external fetal monitoring to continuous
or internal. We consent to admission strip monitoring.
✓ I decline all vaginal or other internal exams except with my
expressed consent at the time.
✓ I prefer to avoid IV. If IV is necessary, please use a saline lock.
Delivery:
✓ I would like to have freedom of movement and position during
delivery — squatting, hands and knees, and so on.
✓ I very strongly prefer natural tearing to an episiotomy.
✓ We very strongly prefer delaying cord cutting until the cord has
stopped pulsating (consent for exception will be considered if
baby is in distress or excess meconium is present).
✓ We decline Pitocin, uterine massage, and pulling the cord.
✓ If surgery is required, Evan and Holly (our doula) need to be
present. I prefer regional anesthesia rather than general, except
in case of an emergency. Please use double-layer sutures when
repairing my uterus.
Postdelivery:
✓ Please place baby on mother’s abdomen immediately. We would
like the baby to remain with parents at all times. We would like
to start breast-feeding as soon as possible and delay potential
interruptions.
We respectfully request the following:
✓ No routine suctioning of the baby’s mouth and nose (unless
needed)
✓ No erythromycin eye ointment
✓ No vitamin K injection (unless there is bruising or birth trauma)
✓ No vaccinations are to be given at this time
✓ No blood to be drawn from baby. We consent to PKU test and
are happy to discuss desired timing of this test with nursing staff.
Thank you for your sensitivity to our preferences and for bringing
your knowledge and care to this great event in our lives.
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As important as this day is, you are not a celebrity, and your unrealistic demands won’t be met with a smile and a nod. Nor will your
team take any unnecessary risks that could harm mother or baby
just to meet the requirements of your birth plan. Keep your birth
plan focused on the elements of the birthing process that can be
controlled, take each hurdle one at a time, and if and when things
begin to deviate from the plan, help your partner to make the best
decisions possible by getting as much information about the risks
and benefits from the knowledgeable members of your team.
Sharing your birth plan
with the world
Unfortunately, labor usually doesn’t begin on that imprecise due
date you’ve been hanging your hat on for the last nine months.
Babies can come early, and with so much to get ready for, you may
find yourself putting off creating and sharing your birth plan. Make
time to write your birth plan toward the beginning of the third
trimester, which will give you plenty of time to share it with your
birthing team and any inquiring relatives and friends.
Going over your plan with the birthing team
Have your birth plan in place far in advance of your due date so
that you can share it with your doctor or midwife during the seventh or eighth month of pregnancy. That gives you time to discuss
the plan and address any concerns he may have. If you’re hiring a
doula, schedule a prenatal visit to go over the document.
Upon arrival at your delivery room, give a copy of your birth plan
to the nurse assigned to your room. Hang a copy on the front of
your door if permitted, as well as on the wall in your room, preferably near where your partner will deliver.
Getting off on the right foot is always a good first step. Deliver
your birth plan to the nurses on duty with a plate of fresh-baked
goodies. Making cookies or cupcakes can be a welcome distraction
during early labor at home and can make the overworked, underpaid nurses more welcoming of your birthing decisions.
Informing family and friends of your plan
Choosing not to have an epidural, opting to use a midwife, or
allowing a doula into your birthing room and not your partner’s
mom/sister/best friend can cause quite a stir. Anything you choose
to do or not do that departs from other people’s birthing experiences not only is “new and weird,” but also can make them feel like
you think the way they did it was wrong.
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Conveying your plans early and often is key to getting everyone on
the same page — or at least reading the same book — by the time
the big day rolls around. Even if you can’t get everyone to agree
with your decisions, don’t sweat it. Thank everyone for their concerns, but assure them that you would never make a decision that
wasn’t both educated and in the best interest of your partner and
child. And, at the end of the day, when the baby arrives nobody
will care how he got here.
Unless you’re openly soliciting advice from others in your lives,
talk about the plan as if it were a done deal. Talking about considerations and decisions you’re making with a larger group of people
means that although you may get a wide spectrum of opinions,
you’ll also get an even wider spectrum of criticism when your
decision doesn’t adhere to everyone else’s recommendations.
However, you and your spouse have the right to decide the birthing option that works best for you. When your plan is in place,
simply tell the people in your lives where, when, and how you plan
on having the baby.
If you and your partner are worried about the reaction your
mother-in-law will have to the news of your plans to have an athome water birth, don’t be afraid to share the news of your personal birth plan via e-mail. That way she’s allowed to have her
reaction without making you feel judged. Also, the more unconventional your birth plan is, the more information your family and
friends will want about your choices. In those instances, it is best
to formulate a detailed, concrete birth plan before sharing the
information.
Many people are quite opinionated when it comes to whether or
not to have a medicated labor as well as whether or not you plan
to circumcise. Don’t feel the need to argue your position; the decision is ultimately yours, and what you want most is to do what’s
best for mother and baby in your eyes. Consider telling people that
you plan on seeing how the events unfold and that you’ll address
mom’s and baby’s needs as you see fit on delivery day. After all,
nobody knows what your partner will need or want until she
needs it.
Get educated on your options and be honest with your friends and
family. If all else fails and someone still insists you’re wrong, have a
confrontation. Arguments aren’t enjoyable, but you’ll be happier if
you have it hashed out before the big day arrives.
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Picking the Cast: Who’s Present,
Who Visits, and Who Gets a Call
Labor and delivery aren’t the times for a family reunion. Having a
baby is exhausting, emotional, and the one time in your lives when
you need to focus on each other and your baby more than anything
else in the world. Which means that you and your partner probably
won’t want many people in the room with you. To avoid any arguments or awkwardness at the hospital when you should be focusing
on other matters, decide in advance who you’ll allow in the room
for delivery, who can visit at the hospital, and how you’re going to
spread news of the birth to everyone who isn’t present.
Deciding who gets
to attend the birth
Deciding who gets to be in the room is a big decision that’s not
yours to make. Your partner’s the one nearly naked under a spotlight in a room of people, so she gets to make the call on who is
allowed to be in the room during labor and delivery. And gentlemen, let’s face it — she just may not want your mother there, no
matter how much your mother would like to be present. As labor
progresses, most women won’t care who sees what because they
will be so focused on birthing the baby, but it’s still best for her
labor to have only the people she wants to have present. Any
stress or distraction in early labor can slow down the process.
In addition to you, the doctor or midwife, a doula (if applicable),
and nurses, some women opt to have a sister or close friend in the
room who can provide her with much-needed emotional support.
Other women decide to have one or both parents present. Again,
check with your hospital or birthing center to see who (and how
many) they allow to be present for a birth.
Telling family members or friends that they need to leave isn’t
easy, but if your partner doesn’t want someone in the room, it’s
your job to politely ask him or her to exit. For instance, if her
father won’t stop offering unsolicited stories about how painful his
foot surgery was in comparison to her labor and she’s on the verge
of clobbering him with forceps, pull him aside, thank him for being
there to support you both, let him know that your partner sends
her love, and then firmly explain that she’s feeling the need to have
silence in the room for the remainder of the delivery.
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Of course this message won’t go over well, but it’s not about other
people at this point. Put your partner’s needs first and worry about
hurt feelings later. Besides, the moment baby arrives, nobody will
remember anything other than how perfect and amazing your new
bundle of joy is.
Planning ahead for visitors
Many people opt to have no friends or family members present in
the delivery room. But it also goes beyond that. Being inundated
with visitors at the hospital may seem like a nice thing in theory,
but in practice it can become overwhelming in a snap. You will be
tired, and your partner and baby will need rest, so make sure to
take enough time for yourselves.
Also, having too many people handle your newborn only increases
the risk of spreading illness. Invite only the most important people
in your lives to the hospital and save the rest for a home visit in
the following weeks. Thank anyone who offers to come and tell
them that you look forward to spending time with them in the
coming weeks. Simply telling someone that your new family will
need rest, not visitors, should do the trick.
However, if someone shows up unannounced who you would
rather not have at the hospital, don’t be afraid to tell her that you
have to keep visits short, say five minutes or so, because your
partner and baby need time to rest. Schedule a follow-up visit if
you wish. If there is someone who you don’t want allowed into
your room, for safety reasons or otherwise, be sure to alert the
staff of the person’s name and description.
There’s never been a better time in your life to focus inward, so
don’t spend time worrying about what other people will think
about your decisions. You can always make up later if someone
is offended.
Planting a phone tree
Spreading the news far and wide can be both exhausting and time
consuming, and after a delivery you and your partner likely won’t
be up for talking to everyone you know. Nor will you have the time!
Nonetheless, everyone you know will request to be alerted within
seconds after baby’s arrival into the world.
Here are some simple tips to make a phone tree, which will require
you to make only one call in order for the news of baby’s arrival to
begin branching out into the world.
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1. Start by gathering all the names and phone numbers of
people you want contacted after your baby is born.
2. Start a list, with the first person as your primary contact.
He or she will be the one person you call upon baby’s
arrival.
3. Write two names side-by-side under the primary contact.
These are the people your primary contact will call.
4. Branching off those two people, write two more names
under each. The two people your primary contact calls will
each have these two phone calls to make. Continue making
the phone tree, assigning each person two calls.
5. Pass out copies of the phone tree to everyone on the list
and instruct them that when they get the call, they’re
responsible for calling the next two people right away.
The phone tree still works if your callers have to leave
phone messages, but the delay will slow down the rest of
the communication.
If your list of contacts is short, consider having each person call
just one other person.
Social network announcements
Sending an update to 500 of your nearest and not-so-nearest friends every time you
have a witty musing about your favorite celebrity may be fun on the average day,
but it may not be appropriate during labor and delivery.
Your partner may want you to keep the world abreast of the baby developments
while she’s in labor, but the most women will prefer that your focus be on soothing
her and not navigating your smart phone.
A word of warning: As easy as it is to communicate using social networking sites,
sharing major news, such as the birth of your child, via Facebook or Twitter will be
offensive and hurtful to some of the more important people in your life. Finding out
your best friend’s baby arrived via a status update that already has 75 comments
will leave those who truly love you feeling a bit cold. Take their feelings into consideration when making announcements throughout the pregnancy process. Make
sure to hold off any major announcements until your phone tree has been initiated.
However, after news of the baby has spread through the appropriate channels
to the appropriate people, social networking sites are a great way to show off
your new bundle of joy to the adoring masses. It may cut down on the number of
visits and phone calls you will receive when you’re basking in the glow of new
fatherhood.
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Part III
Game Time! Labor,
Delivery, and Baby’s
Homecoming
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I
In this part...
f you want to be prepared for labor and delivery as well
as the first hectic days at home, this part gives you all
the necessary details. From knowing what to do when
labor starts to feeding concerns and understanding the
contents of the baby’s diaper, the chapters in this part
equip you to handle the big and little events and changes
that take place in all your lives in a very short time span.
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Chapter 9
Surviving Labor and Delivery
In This Chapter
▶ Determining when labor is really happening
▶ Providing the best support possible
▶ Understanding the normal physical and medical aspects of labor
▶ Dealing with labor pain
▶ Needing a cesarean section
N
o matter how many birth plans you write (refer to Chapter 8
for more on writing a birth plan), and how many times you
suffer through your relative’s birth stories, labor always comes as
a surprise. For many guys, it’s the first time you see your partner
in real pain. Even worse, you know it’s your fault — because she
reminds you of that fact every five minutes. The end result will
be worth it, though, so fasten your seat belt and get ready for the
roller-coaster ride of labor and delivery.
No two labors are alike, so we can’t say exactly what will happen in
your partner’s labor. The only thing most labors have in common
is a beginning and an end, and still, labor can begin in a number of
ways and can end in an operating room, birthing center, back seat
of the car (not to scare you), or in your own bedroom. Although
details differ, knowing approximately how labor will go can reduce
your anxiety by, well, maybe a little bit.
When It’s Time, It’s Time —
Is It Time?
Although you may think you won’t have trouble telling when your
partner is in labor, you may. Contractions often get closer as labor
progresses, but sometimes they don’t. Some women are in a lot of
pain in labor, and some aren’t.
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All this confusion over the start of labor may have you leaping
into the car every time your partner sighs during the last month of
pregnancy; an actual moan may have you reaching for the phone
to call 911. Take 911 off speed dial, though; labor isn’t always clear
cut, but you can follow a few general rules when it comes to heading for the hospital:
✓ If her water breaks, call your medical practitioner. If you’re
having the baby in the hospital, they’ll probably want her to
come in, even if she isn’t having contractions. However, many
women prefer to go through early labor at home, even after
the water breaks. Discuss this with your medical practitioner.
After the water breaks, she has an increased risk of infection
and a small chance that the umbilical cord can prolapse, or
fall below the baby’s head.
✓ If your partner’s a beta strep carrier, go to the hospital as
soon as her water breaks. During pregnancy, women are
tested for beta strep, a common bacteria that can be carried in the vagina. The bacteria normally causes no harm in
healthy women, but after the water breaks, beta strep can
ascend up to the fetus and cause serious infection, so intravenous antibiotics need to be started right away.
✓ If your partner’s in severe pain, even if the contractions are
not regular, call your medical practitioner. Pregnancy complications such as the placenta separating from the uterine
wall, called placental abruption, can cause severe pain and can
be life threatening.
✓ If bleeding like a menstrual period occurs, call your medical practitioner. A small amount of blood-tinged mucus is
common when the mucus plug is passed, but heavier bleeding
needs medical evaluation.
✓ When contractions are regular and getting closer, call your
medical practitioner. They don’t have to be — and may never
be — five minutes apart.
Avoiding numerous dry runs
(yes, it’s us again)
Calling your medical practitioner before going to the hospital and
following his advice can save you many embarrassing excursions
in and out of the labor and delivery ward. Think no one ever gets
sent home without a baby? Think again. Think no one has ever
gotten sent home ten or more times in a single pregnancy? Think
again, again. And yes, the staff will remember you from last week,
and the week before, et cetera, et cetera.
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Many women have contractions in the last month of pregnancy. If
your partner’s contractions aren’t becoming stronger or getting
closer together, this probably isn’t the real deal. Unless her water
breaks, she’s in severe pain, or she’s bleeding, wait until contractions get stronger and closer together. Just being in the labor and
delivery ward really doesn’t speed up the birthing process.
Knowing when it’s too late to go
When your partner can’t walk or talk through contractions that are
progressively stronger and closer together, it’s really time to go to
the hospital. You’ll know this instinctively when she says, “It’s time
to go now.” But if by some chance she’s a woman with short labors
and says she feels pressure, has to have a bowel movement, or
starts to push, dial 911, unless you personally want to deliver the
baby in the back seat or the hospital lawn. (Coauthor Sharon has
seen both situations.) Most emergency medical technicians have
delivered babies before, or at the very least have read the manual
that tells them what to do.
If the EMTs don’t arrive in time, get your medical practitioner (or
anyone’s medical practitioner, actually) on the phone and follow
her instructions. Rapid deliveries are usually uncomplicated, and
your job may consist of calming your partner and not letting the
baby fall on the floor.
In addition:
✓ Don’t pull on the cord or cut it. Cutting the cord, dealing with
the placenta, and worrying about vaginal tears can be done by
people more schooled in such things than you.
✓ Dry the baby off and keep him warm. Skin-to-skin contact
with mom is ideal.
✓ If the baby isn’t breathing, flick his heels. Don’t slap him or
turn him upside down, even if you’ve seen it in the movies.
Don’t dwell too much on the possibility of an unexpected home
delivery. The odds are very small that a first labor will progress so
quickly that the baby delivers at home.
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Supporting Your Partner
during Labor
Women in labor need lots of support. Your partner needs to hear
that she’s doing well, that things are progressing as they should,
and that she really can do this. Even if her mother, sister, doula,
and five of her dearest friends are with her, she needs you. Support
means different things to different women, though, and your job is
to figure out what she needs while in labor and do it.
Figuring out how she wants
to be supported
Your partner may not be in a very talkative mood during labor,
so asking her what she wants you to do may get you kicked right
out of the room. This is one time in her life when she wants you to
think for yourself and take action without being told what to do.
Take the lead by offering choices. Ask her if she wants
✓ A back rub
✓ A massage
✓ A hand to hold
✓ You to sit behind her and support her back
✓ An epidural
✓ You to kick her mom out of the room
✓ Ice chips
✓ To get in the tub
✓ Any of the other labor options you discussed before today
Not taking the insults seriously
Women are not responsible for anything they say during labor, but
you are, so don’t get upset with any suggestions she makes about
your anatomy or comments on your ancestry. And she doesn’t
really mean what she said about your mother, either.
Pain makes people say things they don’t mean and may not
even remember, so don’t file away her remarks for another day.
Vocalizing the pain in this way is both healthy and normal.
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Looking at What Happens
during and after Labor
Although childbirth classes and books do their best to tell you what
will happen in labor, the reality is hard to describe in a book. But
since it’s our job to give you all the facts you can handle, the following sections describe what the normal stages of labor look like.
First stage
The first stage of labor encompasses the time between the first
labor pain and complete dilation, when your partner will begin to
push. Because quite a few things happen during the first stage of
labor, it’s further broken down into early, active, and transition
stages of labor.
Early labor
Early labor is defined as the time between the start of labor and
dilation of the cervix to 3 centimeters. This is the longest part of
labor, sometimes lasting a day or two. During the early stage, contractions are often far apart and irregular. These early contractions
thin and dilate the cervix. In late pregnancy, the cervix is thick, and
the opening between the uterus and vagina is closed.
Normally the cervix thins before it begins to dilate, but there are
no hard and fast rules. Many women are already somewhat thinned
and dilated before labor begins.
Active labor
Things really start to move along during active labor, which is
defined by regular contractions that become stronger and dilate
the cervix from 4 to 10 centimeters. Active labor takes four to eight
hours on average, although subsequent labors are often much
shorter. A woman in active labor usually can’t walk or talk through
her contractions. She also may become a creature you haven’t met
before, one who knows words that may totally surprise you.
You need to be active in active labor, too. If your partner is doing
natural childbirth, she needs help staying focused and breathing
through the contractions. Don’t just tell her to breathe; breathe
with her. Some women want you to count off the seconds, others
don’t. Be guided by her responses, even if they’re a little impolite
at the height of a contraction.
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If she’s having an epidural, your help will also be appreciated. See
the section, “What to expect during epidural placement” for the
do’s and don’ts.
Transition labor
Transition, the hardest stage, is the last part of active labor.
Transition lasts from 7 centimeters to full dilation, or 10 centimeters. If your partner has a good epidural, this stage will probably
breeze by, but if she’s going natural, transition can be difficult.
Transition can last anywhere from a few minutes in someone
having a second or subsequent baby to a few hours in a woman
having her first child. Typical side effects of transition include
✓ Shaking
✓ Vomiting
✓ Intermittent urges to push
Second stage
Second-stage labor lasts from the first push to the final delivery.
Second-stage labor lasts anywhere from two minutes to three-plus
hours. Women with epidurals often push less effectively, and medical practitioners may let the baby “labor down” without pushing if
she’s comfortable and the baby is doing okay.
Push, push, push!
Active pushing requires help from you, but don’t actually push
along with her, or you may have hemorrhoids almost the size of
the baby after delivery. The nurse may ask you to help support
your partner’s legs or to support her back slightly.
The people in attendance at the delivery usually do lots of enthusiastic cheering when mom starts pushing. You’ll find it easy to
be enthusiastic when the baby’s head finally begins to appear,
although a little apprehension about how that big thing is going to
make its way out of your partner’s body is also normal.
Not all women are into the cheerleading scene, though, and actually prefer just to hear a single voice (yours) offering encouragement, or perhaps prefer no loud noises at all. If she looks
aggravated during the cheers (beyond the effort of pushing), ask
her what she wants. Then do it, and ask everyone else to comply.
Most delivery rooms have mirrors near the foot of the bed so that
your partner can see what’s going on. When your medical practitioner takes her seat at the end of delivery bed or table, she may
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block the mirror, but most mirrors can be adjusted so your partner
has a better view if she wants it. Pushing is difficult with your eyes
open, so she may not see much of the actual birth.
If you want to cut the cord, make your wishes known, although
many practitioners will ask you automatically. If you’re turning a
little green, don’t feel like you have to cut the cord. In fact, if you’re
turning a little green, please go sit on the floor, or in a chair, so the
staff doesn’t have to tend to you.
Getting a little lightheaded during delivery is not a sign of weakness. Many guys don’t eat enough while their partner’s in labor,
and you may be standing for several hours helping her push.
Deliveries are very messy; vomit, poop, and blood can make a
pungent odor that can be hard to deal with, even for the most
experienced labor and delivery staff. Try not to add to the mess by
passing out and taking the delivery tray with you.
It’s a miracle!
Birth is miraculous. There’s no other way to put it. Even practitioners who have seen thousands of births are still awed by it at
times. Watching a new human being come into the world is an
amazing privilege, especially when he’s your new human being.
Crying at deliveries is not unusual. Of course the baby usually
cries and family members often do too, but sometimes even the
staff cries if they’ve gotten really attached to a particular couple.
Don’t expect your doctor or midwife to get all teary eyed, although
it does happen in some cases.
Don’t be surprised if your first feeling upon seeing your baby is
dismay, either. New babies are not always the most beautiful of
creatures. (We discuss newborn peculiarities in Chapter 10.)
If the baby is okay, your practitioner may give your partner the
baby to hold and possibly to try to nurse, if she wants to try immediately. Some centers prefer to dry off, weigh, and assess the baby
before bringing him back to mom to nurse. Either way, within the
first 15 minutes, the baby will be dried off, weighed, and wrapped
up so one or both of you can hold her or your partner can start
nursing.
Wrapping things up after the birth
The placenta is delivered usually within 15 minutes of the birth.
Contractions may accompany the loosening and passage of the
placenta, but if your partner had an epidural, she may not notice.
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If the placenta doesn’t pass within 15 minutes, some medical practitioners give additional medication to help loosen the placenta or
gently tug on it. Both the medication and tugging can cause uncomfortable cramping. Other practitioners give the placenta more time
to release on its own before starting more medical interventions.
Very rarely, a condition called placenta accrete occurs in which
the placenta can’t be removed from the uterine wall. In severe
cases, a hysterectomy is done because the placenta can’t be
removed and severe bleeding often develops.
If your partner has a tear, or if an episiotomy was cut to give the
baby a little extra room and avoid a tear, the wound needs to be
closed after the placenta is delivered. It normally takes about 15
minutes to stitch everything back together. An injection of numbing medication is given before stitches are put in unless your partner’s still completely numb from the epidural. If she didn’t have an
epidural, passing the placenta and stitching may be mildly uncomfortable or annoying.
Many facilities now do delivery and recovery in the same room, so
the bed will be refreshed and your partner’s gown changed after
the mechanics of the delivery are all taken care of. And she can eat!
If she wants something special, you may be sent out to get what
she wants, or, better yet, send one of her friends or her mom out
so you can stay to admire your new family.
Helping baby right after delivery
If the baby doesn’t breathe well at first (many don’t, so don’t
panic), she may be taken right over to the warmer to be given a
little oxygen. Don’t worry; the staff will bring her back to your partner as soon as she’s stable.
As normal as it is to ask a lot of questions and want to know
exactly what’s happening, try to stay to the sidelines so you’re not
interfering with your baby’s care. You want the staff to focus on
taking care of the baby, not talking to you.
Most issues that affect babies right after delivery are related to
breathing. Not breathing inside the womb to breathing on one’s
own is a big transition, and some babies take a few minutes to get
the hang of it.
Oxygen may be given by blow by, which means a tube is placed
near the baby’s nose but not too close to her eyes. If she needs
extra help, oxygen is given with a bag and mask connected to an
oxygen source; the mask fits over her mouth and nose, and the
staff squeezes the bag to force oxygen into the lungs.
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If the baby doesn’t pink up and start crying quickly, she may be
taken to the special-care nursery for further evaluation. You will
usually be welcome to accompany her and find out what’s happening, but don’t forget your partner, still lying on the table feeling as
confused and upset as you are and possibly getting stitches in her
bottom at the same time. Make sure you keep her informed about
what’s happening and let her know you haven’t forgotten about
her. She may want you to follow the baby so you can report back
and tell her what’s going on.
Undergoing Common
Labor Procedures
In the interests of making you familiar with all possible aspects of
labor and delivery, some of the procedures you can expect to see
during labor are detailed in the next sections.
Vaginal exams
Vaginal exams are often uncomfortable, especially when they’re
done during a contraction, but they’re the only way to tell what’s
happening during labor. The cervix is checked for dilation, which
is the only way to assess labor progression. Although your partner may not be overly fond of vaginal checks, you may love them
because they give you new information to convey to friends and
family in the waiting room or on the other end of the phone.
IVs
If you’re delivering in a hospital in the United States, your partner
will most likely have an intravenous infusion, or IV for short. The IV
serves the following purposes:
✓ Supplying fluids: Many hospitals restrict fluids when labor
begins, and getting dehydrated is easy when you’re working
extra hard and not taking anything in. If an epidural is given,
prehydration is necessary to avoid a drop in blood pressure,
which can decrease oxygen flow to the baby.
✓ In case of cesarean delivery: With the percentage of cesarean deliveries now more than 30 percent in the United States,
there’s a very good chance your partner will end up with a
cesarean. If the surgery is done as an emergency, with time
being of the essence, having an IV already in place saves time.
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✓ Covering the hospital’s legal obligations: If a woman has
serious bleeding, an emergency cesarean, or just about any
complication, an IV is necessary to give fluids to replace possible blood loss and maintain normal blood pressure, which
often drops if spinal anesthesia is given for the surgery. Many
hospitals routinely give IVs before they are really needed
because, unfortunately, we live in a litigious society, and in
the case of a malpractice suit, the lawyers will want to know if
she had an IV in place for just such possible emergencies.
After an IV is in place it shouldn’t be terribly uncomfortable, so if it
is, let your partner’s nurse know. Sometimes just retaping the catheter so it’s at a different angle helps with the discomfort. Women
who want to walk without dragging around an IV pole or spend
time in the hot tub can have the IV hep-locked, which means the
end is capped off and the bag of fluid detached. If needed, the heplock is flushed with solution to make sure it’s still working before
the bag is reattached.
Membrane ruptures
Although many women fear that their water will break someplace
embarrassing, like in church or in the middle of aisle three at the
grocery store, only around 10 percent of women’s membranes
rupture before labor starts. Often the membranes are broken by
medical personnel using what looks like a crochet hook to snag the
membranes and tear them. This procedure isn’t painful for your
partner or the baby.
Membranes are ruptured if your practitioner wants to check
the fluid inside the sac for the presence of meconium, a sign of
potential stress, sometime before or during labor. Between 6 to 25
percent of babies pass meconium before delivery; the older the
meconium, the yellower and less particulate the fluid is. Newer
meconium may be dark green, sticky, and form particles that can
be sucked into the baby’s lungs, causing respiratory problems
at birth. The presence of either old or new meconium can cause
respiratory problems at birth, so the fluid is always checked for
meconium as soon as the membranes rupture.
If meconium is present, your practitioner will suck out the baby’s
nose and mouth as soon as the head is delivered to decrease the
chance of inhalation. Keep in mind, however, that meconium can
be inhaled before birth; there’s no way to prevent this from happening because babies take practice breaths while still in the
womb. Most of the time, the baby clears the meconium from the
lungs, and no problems ensure, but it can cause severe lung infection and problems with circulation that require mechanical ventilation until the lungs heal, usually within a few days.
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The membrane may also be ruptured to try to speed up labor,
although labor doesn’t always go faster after the membranes are
ruptured, or so internal monitoring devices can be placed. (See
“Fetal monitoring” for more about the ways your baby’s heartbeat
can be monitored before birth.)
Rupturing membranes can lead to harder, more painful contractions that don’t actually speed up the process, so ask your medical
practitioner why he wants to do this if you have concerns about it.
Fetal monitoring
Fetal monitoring devices record the fetal heart rate and the frequency and duration of the contractions. Don’t let yourself become
so enamored with the technology that you forget about the person
at the other end! Many men love gadgets and start watching the
monitor like it was the educational channel. (See the sidebar
“Understanding fetal heart rates” in this chapter for more on
what’s normal and what’s not.)
Monitoring your partner and the baby externally
External monitoring systems consist of two recording devices
fastened around your partner’s stomach and plugged into a fetal
monitor, which provides a continuous printout of the fetal heart
rate and the contractions. The monitor records the duration of
contractions and the time between them but doesn’t tell you the
strength of the contraction. Each contraction resembles a hill or a
bell-shaped curve, starting low, rising slowly, and then returning
to baseline. Because the device sits on your partner’s abdomen,
attached with a belt, her body shape and position can affect how
the contractions look on the monitor. Contractions that look like
very large mountains on the monitor don’t always indicate really
strong contractions, and tiny hills don’t mean the contractions
aren’t very strong.
The external fetal heart monitor tracks and records the fetal heart
rate but has some limitations as well. It doesn’t record the baby’s
exact heartbeat, but an average of beats. Variability, the difference
in heart rate over a certain time period, can’t be determined by
external monitors, and beat-to-beat variability can help ascertain
how well the baby is handling labor.
A heartbeat that stays the same with little variation may indicate
that the baby is stressed. Short periods of decreased variability
also occur when the baby is asleep. (And yes, babies do take short
naps during labor!) The fetal heart rate may also have a short
period of minimal beat-to-beat variability if your partner gets a
dose a narcotic pain medication.
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Understanding fetal heart rates
A normal fetal heart rate ranges from 110 to 160 beats per minute (BPM). Variations
in the heart rate often occur for a short period of time before returning to baseline.
Babies all have different baselines, so a heart rate of 115 BPM may be normal for
one baby, but bradycardic, or unusually slow, for one whose baseline is 160 BPM.
Brief increases in the heart rate are called accelerations. They occur when the
baby moves, if he runs a fever, or if he develops an infection. If the baby’s heart
beats too fast, your medical provider may say the baby is tachycardic, or tachy.
Tachycardia can become dangerous because less oxygen is pumped out of the
heart with each beat.
Brief drops in the heart rate often occur at the peak of the contraction and are
caused by temporary pressure on the baby’s head during active labor as the baby’s
descends into the birth canal. Bradycardia may also be caused by cord compression, if the baby compresses the cord with some part of his body and oxygen flow
is temporarily decreased.
Bradycardia that lasts just a few seconds is not considered alarming, but bradycardia that lasts after the end of a contraction or that starts after the peak of the contraction, recovering shortly after the end of the contraction, can indicate decreased
blood flow through the placenta.
Any unusual change in the fetal heart rate can be better assessed with continuous
monitoring with an internal fetal monitor, which records an exact representation
of the baby’s heartbeat.
The external monitor also can’t always distinguish between
mom’s heart rate and baby’s. If your partner has a rapid heartbeat
because of fever, anxiety, or other reasons, or if the baby has bradycardia, an extremely low heart rate, it may not be obvious that
the external monitor isn’t recording the right heartbeat.
Monitoring internally
Internal monitors resolve the shortcomings of external monitors
by giving more accurate information. Internal contraction monitors
are inserted directly into the uterus, which makes them able to
record the exact strength of each contraction. You may be disappointed to watch those huge mountains that appeared to be very
strong contractions shrink down to little blips on the monitor,
indicating that the uterus is contracting only mildly, or you may be
excited to see the opposite.
Internal fetal monitors fasten a tiny wire into the baby’s scalp that
records the exact fetal heart rate. This ensures that variability
displayed is an accurate representation of the fetal heartbeat. An
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internal monitor can also differentiate maternal and fetal heart
rates, if it’s difficult to tell whose heart rate is recording on the
external monitor.
Some centers use internal monitors routinely, while others use
them only if they’re having trouble picking up the heart rate or
assessing the contractions. Internal monitor complications occur
rarely, and include infection at the site of insertion or hematoma, a
large bruise.
Coping with Labor Pain
Although you and your partner discussed pain medication options
before the big day (and we discuss making the decision on pain
medication in Chapter 8), nothing is written in stone when labor
actually starts. A staunch au naturel supporter may find herself
asking for an epidural the minute she hits the labor floor, and a
woman who was sure she’s epidural material may find herself
breathing through labor and deciding she’d rather do without one.
Don’t ever be surprised by the decisions of a laboring woman.
Enduring it: Going natural
Going natural was all the vogue in the 1970s but fell out of favor
when epidural anesthesia became available in all but the smallest
hospitals. Natural delivery still does have some advantages, and
there are good reasons to consider an unmedicated delivery. Your
partner may decide to go natural for the following reasons:
✓ Babies whose moms haven’t received medication may be
more alert and may nurse better. Medication does cross the
placenta to the fetus before delivery.
✓ Moving around during labor is easier if you’re not medicated.
Epidural anesthesia usually keeps you in bed, although “walking epidurals” are offered by some centers.
✓ Pushing is easier without an epidural, although some centers
let an epidural wear down enough for mom to be able to push.
✓ Water therapy can’t be utilized if you have epidural anesthesia.
✓ Going through labor unmedicated can be an empowering
experience.
✓ Some women have bad reactions to medications in general
and don’t want to take anything they don’t really need.
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One good thing about going natural is that with a first labor, it’s
almost never too late to change your mind and request an epidural. If she decides she want an epidural at 9 centimeters, in many
centers, she can have one.
Dulling it: Sedation
(No, not for you)
Sedation takes the edge off labor without numbing the lower part
of the body. Typical sedatives given in labor include Demerol,
Nubain, or Stadol, which can be given intramuscularly or intravenously. IV administration takes effect quickly and lasts one to two
hours.
Sedation may be given if it’s too early in the labor to give epidural
anesthesia. Sedation can take the edge off the pain and help your
partner get a little sleep, but it can also slow contractions in
some cases.
Because sedation can reach the baby, narcotics and narcotic-type
medications often are not given if delivery is expected within the
hour because the baby may not breathe well.
Blotting it out: Epidurals
Epidural anesthesia consists of medications given through a catheter placed in the spinal canal. The pro of epidurals is obvious:
They decrease pain. They do have other benefits as well, in some
cases. For example,
✓ Epidurals can help a tense mom relax. Tension can slow labor;
women who are especially tense may benefit from an epidural
to help them relax.
✓ Epidurals provide continuous pain relief. In many cases, a
continuous infusion of medication prevents the medication
from wearing off.
Medications used in epidurals
Several different types of medication are used in epidural anesthesia. Anesthetics such as lidocaine or bupivacaine may be
combined with narcotics such as fentanyl or morphine. Narcotics
decrease the amount of local anesthetics needed to achieve adequate comfort. Narcotics given in an epidural don’t cause drowsiness the way sedatives do.
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What to expect during epidural placement
An epidural can be given at any stage of labor, but usually isn’t
given in very early labor because it can slow progress. Some doctors will start Pitocin, a drug to induce labor, when epidural anesthesia is given in early labor.
A large amount of IV fluid, approximately one bag, is infused rapidly to offset the drop in blood pressure that may occur with epidural anesthesia. This infusion can be uncomfortable because the
fluid is at room temperature and feels cold.
Dads are very much in demand during epidural placement to give
mom a person to lean on so she can get into the proper “curled
shrimp” position for catheter placement (see Figure 9-1). The epidural catheter is placed into the epidural place on the midback by
inserting a metal needle into the epidural space and then threading the catheter through the needle. Only the soft plastic catheter
remains in the back. She must remain sitting up and still, even
through contractions, for a period of five to ten minutes while the
catheter is placed.
Epidural Block
Patient position
Cross-section of spine
Spinal cord
Epidural space
Epidural
needle
Catheter
Needle
introduces
catheter into
epidural space
Catheter
is taped
in place
Epidural pump
sends medicine
through the
catheter
Figure 9-1: Placement of the epidural catheter requires remaining curled up and
still for a short period.
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After the catheter is taped in place, the anesthesiologist assists her
back to a lying down position and assesses her blood pressure and
comfort level for several minutes. In many centers, the epidural
catheter is attached to an infusion pump that delivers a continuous
infusion during labor to help maintain adequate pain relief.
If you feel at all shaky or nervous while your partner receives the
epidural, or if you start to get lightheaded from standing in one
position too long, ask someone else to take over supporting mom
so you can sit down before you fall down.
Sometimes placing the catheter is difficult due to your partner’s
anatomy, and more than one needle stick may be necessary. This
isn’t anyone’s fault, and getting the catheter correctly placed is
important, so you can help by staying calm and keeping your partner calm, too.
When the catheter is in place, a test dose is given, and your
partner’s blood pressure is carefully assessed, because epidural
anesthesia can cause blood pressure to drop. She has to wear an
automatic blood-pressure cuff on her arm for a short period, and
she may find this very uncomfortable. If her blood pressure is low,
she may be tilted slightly to her left side.
Possible side effects of an epidural
Following are some of the side effects of epidural anesthesia:
✓ A rise in temperature: It’s difficult to tell whether infection or
the epidural is causing a rise in temperature, so intravenous
antibiotics must be given to avoid complications in case an
infection is present. Any time mom runs a fever, the fetus may
also develop one, from the increase in womb temperature.
✓ Nausea and/or vomiting: These symptoms may also occur in
labors without epidurals.
✓ Shivering: The fluid infusion or the epidural can cause shivering. Your partner will appreciate extra blankets, especially if
they’re straight out of the warmer.
✓ Hot spots: Sometimes women have an area that doesn’t “take”
to the epidural, and they need to change positions so that the
anesthesia goes to a different area and numbs the nerves that
haven’t been numbed well. In the worst-case scenario, the epidural may need to be re-placed.
✓ Difficulty urinating: Most women can’t urinate well after
the epidural is given, and a full bladder can get in the way of
the baby’s head and slow the pushing stage of labor. A Foley
catheter may be placed to drain urine, or the bladder may be
emptied intermittently.
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Deviating From Your
Birth Plan/Vision
Everyone has some vision of how labor is going to go, even if it
isn’t committed to paper. But most labors don’t follow the book, or
the birth plan. Knowing this ahead of time helps you avoid serious
disappointment. Consider the birth plan as a guideline of what you
would like to happen, with the proviso that mom’s and baby’s wellbeing come first.
Some women feel guilty about taking pain medication in labor if
they were gung-ho to go natural before delivery. If your partner
wants to take pain medication but is hesitating because she feels
like she’s letting the birth plan — or you — down, encourage her
to follow her instincts. Remind her that no one knows what labor
is like until she’s in it, and that most women do end up taking pain
medication in labor. After all, labor hurts!
On the other hand, your partner may have gone from au naturel
woman to “give me the drugs!” seemingly in the blink of an eye,
and you may be the one having a hard time with it and try to
encourage her to stick to the plan. Don’t do it. Encouragement is
fine if she’s just going through a rough spot in transition, for example, but if she’s made her decision, your job is to support her in it.
You may have devised the birth plan together, but she’s the one
going through labor, not you.
If your practitioner participates in a call group and baby comes at
night or on the weekend, you may have a different practitioner for
the actual delivery. After having established a relationship with a
doctor over the past nine months, having a stranger do the delivery can be frustrating, especially if your partner specifically chose
a doctor for his approach to labor. However, rest assured that
whoever delivers your baby will do everything he can to ensure a
safe and smooth delivery. Discuss this possibility with your practitioner in advance to find out what to expect.
If your partner ends up having a cesarean section or if the baby
has any type of problem, large or small, she may feel that something she did in labor caused the problem. Assure her that this is
not the case (because it won’t be). Things go wrong in labor that
are no one’s fault; they can’t be predicted or, in most cases, prevented. Your job is to tell her that she did exactly what she should
have and that she has no reason for regrets. And if you have any
niggling doubts about the wisdom of her labor choices, keep them
to yourself.
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Having a Cesarean
Cesareans now comprise more than 30 percent of all deliveries in
the United States, so the odds of having one are high. Although
cesareans are major surgeries, they’re generally safe for your partner and the baby. However, babies born by cesarean section may
retain more fluid in the respiratory tract than babies born vaginally, and the fluid can be aspirated into the lungs, causing breathing difficulties.
Maternal complications such as infection, anesthesia complications, blood clots, and excessive bleeding can also occur, as with
any surgery.
Scheduled cesarean section
Cesareans may be scheduled ahead of time if you know your partner’s going to need one. Knowing she’s going to have a cesarean
ahead of time helps you to get things ready for her homecoming,
knowing that she’s going to be extremely sore as well as tired.
Your partner may not want to navigate stairs for the first week
afterward, and won’t be able to drive for several weeks.
Reasons for planned cesareans
Reasons for a scheduled cesarean include previous cesarean
delivery and abnormal fetal position, such as breech (feet first) or
transverse (sideways) lie. Most of the time, but not always, these
are determined ahead of time, but babies have been known to
switch positions just a few days before delivery.
Occasionally, women ask for a medically unnecessary cesarean
delivery. Some doctors will perform these procedures, but having
surgery you don’t need is never a good idea. Cesarean delivery is
riskier for the baby because fluid doesn’t get squeezed out of the
lungs before delivery, setting up potential respiratory difficulties.
Multiples are almost always delivered by cesarean, even though
twins who are both vertex (head down) can certainly be delivered vaginally. However, after the first twin is delivered, there’s
an abundance of room in the womb, and the second twin may flip
or turn sideways with the joy of having all that space to himself,
necessitating a cesarean for baby B. No mother wants to experience both a vaginal delivery and a cesarean with all the attendant
discomforts on the same day, so most twins are scheduled for
C-sections.
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Setting the date
Choosing your baby’s birth date can be exciting, but consider the
following caveats:
✓ Don’t choose a weekend day. Most practitioners won’t schedule surgery for the weekend.
✓ Don’t expect to bypass the last three weeks of pregnancy with
an early delivery date. More practitioners are trying to schedule cesareans no earlier than 38 weeks, to avoid preterm
(before 37 weeks) delivery and potential complications.
✓ Understand that the baby may come before your scheduled
date. The baby hasn’t read your birth plan and doesn’t know
that you want him to be born on an auspicious date, and he
may decide to show up a week earlier.
✓ Realize that having an 8 a.m. surgery time scheduled doesn’t
always mean your surgery will be at 8 a.m. Emergency cases
can bump you off the schedule, which is understandable, so
don’t get too upset if you’re delayed because someone else’s
cesarean needs to be done first.
✓ You don’t have to set a date. Some couples decide not to
schedule their delivery but to have the cesarean done when
labor begins so that the baby chooses the time. Your practitioner may not be quite as happy to see you at 3 a.m. as she is
at 8 a.m., though.
Unplanned cesarean delivery
A large percentage of cesareans are unplanned, with the most
common reason cited for an unplanned C-section as “failure to
progress,” which means labor wasn’t progressing as expected.
This can mean a baby too large for the pelvis, an unusual maternal
anatomy, or a practitioner who’s getting antsy about how things
are going.
If labor goes on too long, complications such as infection become
more likely, and doing a C-section is often less stressful than waiting for the situation to possibly deteriorate. And as all too many
practitioners are well aware, the decision to do a C-section is less
likely to be attacked in court than a delay in action that leads to
problems with the mother or baby.
Fetal distress is an undeniable reason for an unplanned C-section,
although true fetal distress is different from potential fetal distress
that could possibly worsen if labor goes on. True fetal distress is
marked by a run down the hall at top speed, minimal surgery prep,
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and often general anesthesia, because it’s the quickest way to put
mom to sleep.
Potential fetal distress or mild distress usually results in a more
leisurely trip to the operating room and a much calmer atmosphere, because the baby isn’t in any real danger yet. And because
you don’t want him to reach that point, a C-section can be the
best option. Trust your practitioner; if she says you need to do a
C-section, do it.
Choosing a medical practitioner whose philosophy on cesareans
as well as other medical interventions fits with yours is essential.
Doctors do have different tolerance levels for deviations from the
norm, and doctors who have a low tolerance for deviance generally have higher cesarean rates because they’re less likely to watch
and wait for a short time before performing surgery.
What to expect before the operation
Certain procedures must be done before cesarean delivery.
Normally, a Foley catheter is placed to keep the bladder empty
so it won’t be injured during the surgery. If your partner already
has an epidural, she won’t even feel the catheter placement; if she
doesn’t, she may be mildly uncomfortable during the procedure.
A preparatory mini-shave is done (if she hasn’t already done it
herself) to eliminate hair where the incision goes. Most cesarean
scars are known as a bikini cut, a horizontal lower abdominal incision (see Figure 9-2). Occasionally a vertical skin incision is done
if the baby or babies lie in a position that makes her — or them —
difficult to reach, or if the surgery has to be done very rapidly.
Your partner may be given medications to reduce the chance of
nausea and to neutralize stomach acids in case of vomiting and
possible aspiration into the lungs. She will also be given an intravenous line if she doesn’t already have one. If spinal anesthesia is
used for the procedure, fluid will be quickly infused, which can feel
very cold. Also, an adequate amount of fluid is necessary to keep
blood pressure from dropping after the cesarean.
Your partner may be taken into the operating room by herself
while you get dressed in a sterile outfit. When you’re allowed in,
you’ll probably be given a seat right near her head so you can talk
to her and support her without getting in anyone’s way. Keeping
the operative area sterile is extremely important during surgery,
and the staff will take care to make sure you don’t inadvertently
contaminate anything.
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a. Low transverse
171
b. Classical
c. Low vertical
Figure 9-2: Most cesarean incisions are done just above the pubic hairline.
What to expect during the surgery
When the surgery actually gets underway, removing the baby takes
between five and ten minutes. You won’t be able to see much,
because a sterile drape is placed between your partner’s head
and the rest of her body. When the baby is delivered, he may be
brought close to your wife so she can see him, but she won’t be
able to nurse immediately or do any type of skin-to-skin contact
due to the sterile operating field.
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If general anesthesia is not used, your partner may feel tugging
during the surgery. This is normal, but she may need lots of reassurance that it is okay.
Because babies born during cesarean sections have an increased
risk of complications, a pediatrician or special-care nursery personnel may be present for the delivery. You’ll be allowed to walk
over to the warmer to see the baby, and in many hospitals, after
the baby is weighed and cleaned, he’ll be given to you to hold next
to your partner.
Getting past disappointment
When you have the baby, you have her; it doesn’t really matter
how she got here. Your partner may not see it that way, though,
and she may mourn the loss of the “perfect” labor and delivery
and feel like she failed the labor test. With so many women having
cesareans today, this feeling of failure is less common than it used
to be, but if you and your partner had your hearts set on a certain
labor scenario, a deviation from the script can be upsetting.
You can be a big help by accentuating the positives in the situation, by reminding her how well she handled the change in plans
and how she put the baby’s needs before her wishes.
Understanding why certain procedures were necessary can be
very important in helping new mothers “grieve” the loss of a perfect delivery. Request a time to speak with the person who delivered your baby so that you and your partner can ask lingering
questions about why the delivery went the way it did.
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Chapter 10
Caring for Your Newborn
In This Chapter
▶ Getting to know your newborn
▶ Deciding on breast- or bottle-feeding, or both
▶ Cleaning up your baby and putting him to bed
▶ Alleviating your baby’s discomfort from indigestion
▶ Preparing for first immunizations
W
alking out the hospital door with a newborn who is still
basically a stranger to you can be a scary experience.
Getting to know your baby is a process that takes time. Fortunately
you’ll be putting in lots of time with this demanding stranger, and
before you know it, you’ll feel as if you’ve known this marvelous
little person all your life. In this chapter we talk you through the
seemingly mundane tasks that help you build a lifetime relationship with your new baby.
Knowing What to Expect
When Baby’s Born
Newborns don’t look anything like the smooth-skinned, dimpled,
smiling babies on TV. A new baby emerges from nine months in a
dark, watery environment, and her skin shows it. She squints like
she’s just emerged from a cave. Although your newborn may not
look exactly like the baby in your idealized dreams, she’ll look
perfect to you — at least after you get used to her in a day or two.
Looking at newborns
What should you expect when your newborn is put into your arms
for the first time? Not the Gerber baby, that’s for sure — although
your baby will be, your partner will assure you, the most beautiful
creature she’s ever seen. You may seriously wonder about
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her taste in human beings. Newborn babies have the following
characteristics:
✓ Small: The average baby is around 7 pounds and 20 inches
long. The reality of how small and fragile a newborn seems
won’t hit you until the first time you hold him.
✓ Red and covered with — what’s that white stuff? Newborns
are amazingly red. They come out a dark red and then turn
a lighter red, which gradually fades to a normal skin color
over a few days. Many newborns are coated, especially in the
creases, with vernix, a creamy substance that protected newborn skin in water.
✓ Wrinkled and peeling: Since he just spent nine months
immersed in water, his entire skin has the equivalent of dishpan hands, and as soon as he begins to dry out, his skin wrinkles because it’s no longer waterlogged. His skin will crack
and peel, especially around the bendable joints like the ankles
and wrists.
✓ Cone headed: You thought the Coneheads weren’t real,
until you met your new baby. If your partner pushed for
any amount of time, or if the baby was delivered by vacuum
extraction, the baby’s head may be pointed at the back, or she
may have a little cone cup, like a jaunty little hat, to the side
of her head. The baby’s head will become round in a week or
so. Cesarean babies usually escape the cone-head look.
✓ Spotted, dotted, and blotched: Newborns often have a variety
of blotches, splotches, whiteheads and other marks that will
fade over time. Milia look like little whiteheads on the baby’s
nose, chin and forehead. Don’t squeeze these; they’ll disappear on their own. The majority of black, Indian, and Asian
babies have what look like black and blue marks on their legs
or buttocks, called Mongolian spots, which fade with time. Red
blotches on the back of the neck, eyelids, and between the
eyes, called stork bites, are immature blood vessels that also
disappear with time.
✓ Not very well put together: Newborns often seem like they
may fall apart if a strong wind comes along. Their heads
wobble alarmingly, and their arms and legs shoot off in all
directions when they’re startled. No wonder nurses wrap
them up tight in blankets.
✓ A bit, uh, out of proportion: You may be saying, “That’s my
boy!” but baby boys may have overlarge genitals due to fluid
retention, trauma during delivery, and hormonal influences.
This condition is temporary. Girls often have swollen genitalia as well, but it’s less noticeable. Also, girls may pass a few
drops of blood from the vagina.
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✓ Swollen breasts: Because of maternal hormones, both baby
boys and girls often have swollen breasts that may actually
produce a few drops of milk. This condition disappears within
a few days.
✓ May have no family resemblance: Before you accuse your
partner that the baby isn’t yours, rest assured that many
newborns look slightly Asian, even if their parents aren’t.
Puffiness and swelling around the eyes make them appear
Asian, and the yellow tinge of jaundice that many babies have
after the first day or two may have you convinced that someone has a lot of explaining to do. Puffiness will improve daily,
and by the end of the week, you won’t be able to stop telling
everyone how much the baby looks like you.
Rating the reflexes
Newborns are active from the minute they’re born. Your baby will
yawn, grimace, and even seem to smile a little. (Yes, the smiles
are really caused by gas at this stage, just like your mother says.)
Babies also have certain reflex actions that are normal at birth.
Your medical practitioner will assess the baby to make sure these
reflexes are present. Lack of normal reflexes can indicate a problem that should be investigated. They include the following tests:
✓ Babinski reflex: When the bottom of her foot is stroked, the
big toe rises and the other toes fan out. The Babinski reflex
lasts for around two years.
✓ Grasp reflex: If the baby’s palm is stroked, she closes her
fingers, a reflex that lasts several months.
✓ The Moro, or startle, reflex: Your baby tremors slightly,
throws back her head, and flails her arms and legs away from
her side in response to a sudden movement or a loud noise.
The Moro reflex lasts five or six months before disappearing.
✓ Rooting reflex: Stroking the corner of the baby’s mouth
makes her turn toward the touch; this helps her find the
breast or bottle for feeding.
✓ Step reflex: When her foot touches a solid surface, she
appears to step, lifting one foot and then the other.
✓ Sucking reflex: When an object touches the roof of the baby’s
mouth, she begins to suck. This reflex doesn’t develop until
around 32 weeks of pregnancy and isn’t fully developed until
36 weeks.
✓ Tonic neck reflex (TNR): If the baby’s head turns to the side,
her arm on that side stretches out and the opposite arm
bends at the elbow, which makes her look like she’s fencing.
The TNR lasts six to seven months.
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Feeding a Newborn
Every baby needs to be fed, but the sheer number of choices to
be made about feeding may have you begging your partner to
consider nothing but breast-feeding for at least the next year.
However, though breast-feeding is best for the baby, it may not be
best for your partner.
While your opinion is probably valued, the final decision about
breast-feeding is absolutely, unquestionably, your partner’s. Many
women just aren’t comfortable with breast-feeding, and a woman
who isn’t comfortable usually won’t do it well. Sure, breast is best,
but bottle-feeding is a perfectly adequate method of feeding.
A number of considerations go into the decision to breast- or
bottle-feed. If your partner has even the slightest interest, breastfeeding for the first few days so the baby receives colostrum, the
first fluids produced, is a good way to start. Colostrum contains
many nutrients and antibodies that are good for the baby. If your
partner hates it, she can stop at any time, but she may love it! If
she stops breast-feeding, though, it’s hard, but not at all impossible, to get the milk flowing again. See Chapter 11 for more on
making the decision to breast-feed.
Choosing to breast-feed
If your partner decides to breast-feed, you may be breathing a
sigh of relief that the nighttime duties won’t fall to you, but not
so fast! Breast-fed babies usually eat more frequently than bottlefed babies because breast milk is more easily digested. If you’re
cosleeping, or even if the baby is across the room, you’ll probably
be awake at 12 a.m., 3 a.m., and 6 a.m., too.
Even if you normally sleep like the dead and wouldn’t wake up if
the Titanic floated through your bedroom, getting up and offering
support for at least one of the night feedings can be a wonderful contribution to your partner and make you feel closer to your
baby. Get your partner a drink, help her get into a comfortable
position, and talk to her if she wants conversation. Late-night talks
are conducive to confidences and discussions you may not have
time for during the day.
If you’re working full-time, getting up in the night is hard but worth
it. Getting to know your new little person and your partner better
is worth the sacrifice, and this time too shall pass, faster than you
can imagine.
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Getting started
Although breast-feeding seems like it should be easy and natural,
it isn’t always. Many women today have no role models for breastfeeding; their moms may not have breast-fed, their friends may not
be doing it, and you’re not much help, either. Most hospitals have
lactation consultants to help new moms get started breast-feeding.
Some also offer at-home visits if needed. If you have a doula, she
will also be invaluable in helping with issues that arise.
And of course, books like Breastfeeding For Dummies (Wiley) cover
everything you need to know and are available for consultation
day and night! The most common problems with breast-feeding
include:
✓ Latch-on problems: Women with large or flat nipples often
have a difficult time getting the baby to latch on. This is frustrating for mom and baby alike, and often ends with both in
tears. If the baby isn’t properly latched, he won’t get a good
milk supply. Patience, and in some cases, using a nipple
shield, which fits over the nipple to give the baby something
to grasp onto if nipples are very flat, can conquer latch-on
problems.
✓ Supply issues: Most women have ample milk supply starting
around the third day after delivery, but some need supplements to increase milk supply. Drinking plenty of fluids, getting enough rest, and eating herbs like fenugreek can help
increase supply. Before a good milk supply is established,
supplementing the baby’s diet with formula or pumping
rather than nursing is discouraged, because sucking increases
the supply. Pumping isn’t as effective as a baby’s suck at
stimulating milk supply. Breast milk is the original supply-anddemand system.
✓ Parental anxiety: Many new parents are obsessed with their
baby’s weight. Breast-feeding can frustrate parents who want
to know how much milk the baby is getting at each feeding.
However, you can still measure his intake if you have a baby
scale; just weigh the baby before and after a feeding and compare. Don’t change his clothes, not even his diaper, or the
weight won’t be accurate. A baby scale can save the sanity of
weight-obsessed parents.
Supplemental bottles
After the milk supply is well established, supplemental bottles of
formula or pumped breast milk can be given. Bottle-feeding is a
nice way for you to be able to feed and bond with the baby occasionally, and it gives your partner a chance to get out of the house
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or actually take an uninterrupted shower. Decreasing the number
of nursing times a day reduces the milk supply, though, so don’t
overdo the supplemental bottles.
Don’t be surprised if the baby doesn’t quite understand what to do
with the bottle at first. Bottle-feeding and breast-feeding require
completely different tongue positioning and techniques on the
baby’s part. Some babies refuse supplemental bottles, which can
be a problem if your partner gets sick or for some reason can’t
breast-feed. While you can feed a recalcitrant breast-feeder with
an eyedropper, it certainly isn’t fun for either of you. Some medical
practitioners recommend an occasional supplemental bottle after
nursing is well established so the baby gets used to taking an
occasional bottle.
Many dads are a little envious of the closeness of the breast-feeding
relationship and enjoy skin-to-skin contact while they feed the
baby. Others find this just too weird. Whichever camp you’re in,
supplemental bottles can give you time to study your baby’s face
in detail and revel in the miracle you’ve created.
Pumping
Pumping to fill a supplemental bottle or if your partner goes back
to work is easier than it used to be. Your partner can use an electric pump that’s more efficient than the old bicycle-horn-type
pumps. A really good pump can be really pricy but is worth it if
your partner is going to use it a lot. Pumping is nowhere near as
efficient as nursing is, so the amount produced may be much less
than you think it should be. This difference is normal and not a
sign that the baby isn’t getting enough milk.
Pumped milk should be stored in feeding sized amounts, especially
if you’re freezing it, because you don’t want to thaw out more
than you’ll use at one time. Use plastic or glass containers with
well-fitted tops, but avoid anything containing bisphenol A (BPA).
Collection bags made specifically for freezing breast milk are ideal.
Don’t use plastic baggies or bags from disposable bottles,
which may leak or contain substances that affect the nutrients
in breast milk.
Breast milk can be stored at room temperature for up to six hours,
in the refrigerator for up to eight days, and in the freezer for up to
12 months.
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Bottle-feeding basics
Bottle-feeding has never been more complicated. Not only do you
have to choose a formula and a nipple type, you have to worry
about the materials the bottle is made of. Recent reports about the
high levels of BPA (a chemical used in plastics) released when bottles are heated in the microwave or dishwasher has made choosing a bottle type more difficult. At least bottles no longer need to
be sterilized on top of the stove: Ask your mom or grandma about
how much fun that used to be!
Winning the bottle battle
Once upon a time, all baby bottles were made of glass. Then parents got tired of being beaned with glass bottles, and everyone
worried about glass bottles breaking when the baby threw it out of
the crib, so plastic bottles were invented about two minutes after
the invention of plastic. Not only were they lighter and unbreakable, but they also came in pretty colors.
Then bottle manufacturers decided to mix things up a bit. Now
bottles and nipples are no longer interchangeable, and bottle
“systems” sometimes include plastic liners and inserts that reduce
air intake and, hopefully, colic. Every bottle has to be used with
its own system, and parents have to decide which works best for
their baby.
Studies have shown cause for concern about plastic bottles releasing the harmful chemical BPA when heated. Some parents have
switched back to glass, but manufacturers now create BPA-free
plastic bottle systems. If you have older bottles and they’re not
BPA free, get rid of them. Spending more money on another whole
bottle system is painful, but it’s better than worrying about poisoning your child every time you warm a bottle in the microwave.
Choosing a formula
After you pick your bottles, you can start worrying about which
formula to use. The array is truly formidable. For starters, you
have to consider powder versus concentrate versus readymade.
Following are the advantages and disadvantages of each type:
✓ Ready to serve can be very convenient for travel, if you use
one can at a feeding. However, it’s out of the question for
everyday use for most people, because a month’s supply is
equal to the national budget of a small European country.
✓ Concentrate comes in small cans, and you dilute it with water
before feeding. It’s easy to use but more expensive than
powder, though it’s cheaper than ready to serve.
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✓ Powder is the cheapest of the three options. If you’re out of
the house, it’s easy to put the powder in a bottle and just fill
with warm water when the baby’s ready to eat. However, it
comes in ginormous cans that take up half your kitchen countertop. It also clumps and takes more effort to shake smooth,
a consideration at 4 a.m. when any effort seems like too
much. Shaking the bottle to mix increases the bubbles and air
inside the bottle, which can cause gasiness, so if your baby is
already prone to gas, powder formula may not be for you.
After you decide on the form of your formula, it’s time to choose
one. This will not be easy; about a hundred different formulas are
on the market, all claiming to be the best (although most grudgingly acknowledge that breast-feeding is also very good). Following
are the general categories of formulas:
✓ Regular: Regular formula is made from cow’s milk and
contains 20 calories per ounce. Regular formula is usually
fortified with iron. Some are also fortified with long-chain
polyunsaturated fats that they claim enhance eye and brain
development, but these claims are not well substantiated.
✓ Enhanced: Enhanced formula, often used for premature or
failure-to-thrive babies, contains 24 calories per ounce.
✓ Soy: Soy-based formulas may be used by parents wanting
to avoid animal proteins. However, soy contains estrogen,
and some studies show that too much soy can be harmful to
infants and children. Make sure to do your research before
you switch to soy.
✓ Hypoallergenic: Babies who are allergic to lactose or soy may
need protein hydrolysate formulas, which are easier to digest.
Nutramigen, Pregestamil, and Alimentum are examples of protein hydrolysate formulas.
Preparing a bottle
The hardest part of preparing some bottles is putting the “system”
together. Some bottles have inserts to put in, and others have little
bags to put in place that hold the formula.
To make a bottle, read the instructions on the formula label. For
powder, you mix a certain number of scoops with a certain amount
of water, sometimes a foggy concept in the middle of the night.
Concentrates are usually diluted 1:1, and ready-to-serve formulas
don’t get diluted at all.
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Never try to “stretch” formula by adding more water than usual or
by adding water to ready-to-serve formulas. You may deprive your
baby of essential nutrition by doing so.
Many parents prefer to use distilled water, sometimes labeled as
nursery water, rather than tap water, but if you have city water,
it’s probably not necessary. Boil the water from the tap if you’re
concerned about it, and use cold water rather than hot, which may
contain more lead from the pipes. Let the water run for 30 seconds
to reduce lead and other mineral contamination.
If you want to use well water, have a sample of it tested to make
sure it doesn’t contain high levels of nitrates or other minerals.
Boiling well water concentrates nitrates instead of removing them,
so it isn’t recommended.
Knowing how much formula is enough
When your baby is brand new, he probably won’t take more than
2 or 3 ounces at a time. The most important thing about bottlefeeding is to not try to force the last drop down your child’s throat.
With childhood obesity at an all-time high and a major health concern, the last thing you want to do is overfeed your child from an
early age.
On the other hand, if he drains the bottle and acts like he’s still
hungry, give him a little more. Babies aren’t machines, and they
don’t take the same amount of formula at each feeding. When he
stops sucking and tries to push the bottle out of his mouth, he’s
had enough.
Changing Diapers
Changing diapers is the task new parents are probably least
excited about. If you and your partner find yourselves playing
“rock, paper, scissors” to determine which of you gets stuck
changing the runny yellow poop that has overflowed out of the
diaper and on to the sleeper, your shirt, and the new leather sofa,
you’re normal.
Diaper duty isn’t fun, but it is necessary an appalling number of
times a day when your baby is new, so rest assured you’ll both
get plenty of experience.
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Circed or uncirced? Making the decision
Circumcision is a procedure in which the foreskin of the penis is removed. For
Jewish parents, circumcision is a religious ritual usually done in a ceremony called
a bris. For other parents, whether or not to have your baby boy circumcised is a personal choice. Twenty years ago, nearly all baby boys were circumcised, but today,
more parents are questioning whether a surgical cosmetic procedure is necessary
in a baby’s first days of life. Around 50 percent of baby boys are now circumcised
each year in the United States.
The main benefit to circumcision is ease in cleaning and avoiding the need to have
the foreskin removed at a later date for medical reasons, but boys who are circumcised also have fewer urinary tract infections. Uncircumcised males are also more
likely to contract sexually transmitted diseases later in life. Some dads just want
their son circumcised so they’ll “look the same.”
Cleaning baby boys
Boys and girls really are different when it comes to diaper changing. When dealing with a baby boy, the worst part is projectile urination. You can easily avoid it if you remember to keep the penis
covered at all times. A few good shots to the eye will reinforce
your memory quickly.
Boys who have been circumcised (see Figure 10-1a), which means
that the foreskin covering the tip of the penis has been removed,
need extra TLC at first. You may need to wrap Vaseline-coated
gauze around the tip for the first few days, depending on your
practitioner’s instructions. The gauze needs to be changed every
time you change his diaper.
When you remove the gauze around the circumcision, you may be
horrified to see that the skin is a yellowish color. This is normal
healing for a mucus membrane. If the area is oozing or has pus or a
foul odor, call your practitioner.
Uncircumcised boys are a little harder to clean, and the foreskin
(see Figure 10-1b) needs to be kept loose. The foreskin doesn’t
retract, or pull back easily, before the age of 1 year or even longer.
Up to this point, only the outside of the foreskin should be cleaned.
When it can be retracted, gently push it back as far as it will go,
which isn’t be very far, and clean with only water. Return the foreskin to its normal position afterward. If the foreskin becomes red
or swollen, have your medical practitioner take a look to make
sure he doesn’t have an infection.
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a.
183
b.
Figure 10-1: A circumcised penis (a) and an uncircumcised penis (b).
Cleaning baby girls
Baby girls aren’t likely to spray the room when you remove their
diaper, but they have their own set of problems. Keep these points
in mind when changing a baby girl:
✓ Girls have lots of cracks and crevasses, and getting all of them
clean is difficult. A runny, poopy diaper goes everywhere. Use
moistened wipes or cotton balls to make sure you remove all
the stool.
✓ Girls are more likely to have urinary tract infections because
of the proximity of the anus and vagina to the urethra, so it’s
really important to make sure the whole area is clean.
✓ Always wipe from front to back. Doing so helps to avoid introducing fecal matter into the vaginal area, which can cause
infections.
✓ Don’t be too gentle. Make sure to thoroughly wipe the opening of the vagina or it can close up. If that happens you will
have to apply a steroid cream to help reopen it, or, even
worse, have it surgically reopened.
Bathing Basics
Few things strike fear into the hearts of inexperienced parents
like the first bath. Take a squirmy baby, soap him all over to make
him incredibly difficult to hold on to, and then put him in a tub of
water. Sounds like a recipe for disaster, or at the very least, parental heart failure, but it doesn’t have to be. Many hospitals now do a
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“trial run” bath to make sure you won’t drown the poor child right
off the bat, but even the least experienced new dad can learn to
give the bath. Remember these suggestions when getting ready for
baby’s first bath:
1. Get your supplies ready first.
Nothing makes a bath more difficult than getting the water
drawn, the baby undressed, and the towel laid out and realizing you forgot to get the soap, or the lotion, or the diaper.
No, the baby doesn’t wear the diaper into the bath —
you need it ready the minute you take him out, though,
especially if your baby’s a boy, unless you want an eyeful
of urine.
2. Put the baby in a comfortable spot.
Undressing him on the toilet lid may seem like a good
idea if you’re bathing him in the sink, or on the counter if
you’re bathing him in a little baby bath, but those surfaces
are cold and hard, even with a towel over them, and they
may be riddled with germs. Get him ready on the changing
table or bed; take off everything except the diaper (urine,
remember?) and bring him into the bathroom wrapped in
the towel.
3. Hold the baby and fill the tub, or have your partner
handle one of those jobs.
Bath water for the baby should be 90 to100 degrees F. You
can monitor the temperature to make sure it isn’t too hot
or isn’t getting too cold with cute little floating bath toys
that have built-in thermometers. If you’re using a sink, pad
it by lining it with a towel. A towel also helps reduce the
slipperiness of a baby bathtub.
4. Before putting the baby into the bath, wet a washcloth
and squirt the baby soap onto the washcloth.
This way you don’t have to do it while you try to hold the
baby in the water at the same time.
5. Undo the diaper tabs, then whip off the diaper and put
the baby in the water.
Don’t give him time to do anything dastardly.
6. Don’t expect the baby to enjoy this new experience
at first.
Yes, he spent 9 months in water, but he’s forgotten already,
and your inexperienced hands aren’t supporting him as
well as the womb did. Some baby tubs have a little sling
or are curved to support the baby. Otherwise, support his
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head and neck with your hand, or the crook of your arm, if
you’re well coordinated.
7. Wash the baby with the soapy washcloth, starting at his
head and working your way down.
Yes, just like you’d wash the wall, or the car. The genitalia should be the last part you wash. When you get to the
bottom (literally), use a clean washcloth if it seems more
hygienic to you.
8. Rinse him off with a clean washcloth.
9. Lift him out of the water and wrap the towel around him.
A towel with a little hood help keep him warm and makes
him look like an adorable elf. Don’t admire him too long,
because you need to get his diaper back on — quickly.
10. Carry him to the changing surface, where the fresh
diaper is already laid out. To keep him warm, keep the
towel over the top half of his body while you put the
diaper on.
11. Dry him off gently and dress him.
Babies have delicate skin, so don’t rub too hard with
the towel.
12. Now collapse on the couch — you’ve earned it!
Holding Your Baby
You’re going to find yourself carrying the baby around quite a bit
during the first few weeks. Babies who are colicky (cry a lot) are
often more comfortable if you keep moving, and moving will help
dispense your tension and anxiety when you’re on hour two of a
colic episode. Babies can be held in several ways, and yours may
have a definite preference. Try these tried-and-true baby holds:
✓ Cradle position: Cradle the baby’s head in the crook of your
arm. Most people hold the baby on the left side, but go with
what works for you.
✓ Over the shoulder: Some gassy babies feel better with pressure on their abdomen, so slinging them up onto to your
shoulder may help get the gas out. However, spit-up-prone
babies and vomiters also like this position, so have a burp
cloth on your shoulder at all times.
✓ Football hold: The baby’s head rests on your hand looking
up, while her body lies on your arm, with her feet pointed at
your elbow.
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Whichever position you choose to hold your baby in, use it often!
Nothing is better for dad and baby bonding than time spent in
close proximity.
Cosleeping Pros and Cons
Cosleeping, or sleeping with the baby in your bed, goes in and
out of vogue. Right now cosleeping is popular with many parents,
although it comes with a twist in some cases: The baby may sleep
in a little sidecar, or cosleeper, that attaches to your bed. You get
the whole bed to yourself, but the baby is right nearby.
Traditional bassinets or small playpens or baby beds also work
well, if you’re not comfortable sharing the bed with the baby. If
you’re still debating about keeping the baby in your bed, or even in
your room, consider the following advantages:
✓ Cosleeping is convenient if your partner is breast-feeding.
Breast-feeding is much easier if you don’t have to get out of
bed to get the baby.
✓ You hear the baby as soon as she starts stirring. While this
itself has pros and cons, the benefit is that she doesn’t have a
chance to work herself into a crying frenzy before a feeding.
✓ It can give you a sense of closeness as a family. To hear your
baby’s soft breathing is reassuring and also enjoyable.
Also consider the following disadvantages:
✓ Very light sleepers, especially light sleepers with a baby
who is also a light sleeper, may find the whole family awake
most of the night. If you’re keeping the baby awake, or she’s
keeping you awake, you’re all going to be excessively cranky.
✓ You may be too worried about rolling over on the baby to
enjoy cosleeping. If you sleep very soundly, and the baby is
right next to you, this can be a concern, but most parents
are very aware of the baby’s presence. If it worries you, a
bassinet or other sleeping arrangement in the room may be
better for you.
✓ If one of you works odd shifts, you may find getting in or
out of the room without waking the baby difficult.
✓ When you put the baby in your bed, you eventually have to
put her out. While your child may prefer to stay in your bed
until she goes to college, you may want your bed back in a few
years. Some children don’t go quietly into the dark night and
put up quite a fight about sleeping in their own rooms.
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Remember that even if you don’t want the baby in your room with
you, baby monitors make it possible to hear the slightest stirring
from another room.
Back to Sleep: Helping Baby Sleep
Safely and Comfortably
Once upon a time, almost all babies slept on their stomachs. The
babies preferred it, they had less gas, and if they spit up or vomited, they were less likely to choke. Then, in 1992, the American
Academy of Pediatricians released new recommendations about
placing babies on their backs rather than stomachs to sleep, claiming that babies were less likely to die of sudden infant death syndrome (SIDS) if they slept on their backs.
The “Back to Sleep” campaign went into full swing in 1994, heavily
promoted by pediatricians. Within a few years, almost all babies
were put to sleep on their backs, at least while they were in the
hospital. Since the back sleeping movement was launched, the
incidence of SIDS-related deaths has dropped by more than 50 percent, from 1.2 deaths per 1,000 live births in 1992 to 0.55 in 2006.
Studies in 2006 showed that overall in the United States, 75 percent
of babies slept on their backs.
A baby who is used to sleeping on his back but is placed prone (on
his stomach) to sleep, possibly by a caregiver not familiar with
the benefits of back sleeping, has an 18-fold increased risk of SIDS,
according to the American Academy of Pediatricians (AAP).
Side positioning was originally considered a viable alternative to
back sleeping, but more recent recommendations from the AAP
are that side sleeping also increases the risk of SIDS, as well as the
risk of the baby moving from a side to a prone position. To further
reduce the risk of injury or death, keep soft fluffy blankets, pillows,
and mattress pads out of the crib as well. A firm sleeping surface
is best.
Coping if baby hates
being on his back
Many babies truly hate sleeping on their backs. They don’t sleep
well, their parents don’t sleep well, and everyone is miserable.
What should you do if you and your baby are both desperate to get
some sleep?
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✓ Tough it out. This is really hard to do, but a good night’s
sleep is not worth the risk of SIDS.
✓ Rock the baby to sleep first. If she’s asleep before you lay her
down, she may stay asleep when you place her on her back.
✓ Use a pacifier. Even if you hate them, pacifiers really do
soothe some babies. The American Academy of Pediatricians
(AAP) recommends using one at bedtime because pacifier use
also decreases the risk of SIDS.
Swaddling your little one
Some parents find their babies are calmer and sleep better when
they’re tightly wrapped in blankets so their arms and legs can’t
go flying off in every direction whenever they’re startled. Nurses
swaddle babies in the hospital for this reason (and because it
makes them look adorable). Even the most fumble-fingered dad
can do this at home, even though it won’t look at all like the
nurse’s version at first. To swaddle, follow these instructions and
also refer to Figure 10-2:
1. Put the blanket on a flat surface like a diamond, with a
point up.
2. Fold the pointy end at the top down about 6 inches.
3. Put the baby on the blanket, with his head just above the
folded-down edge.
4. Pull one of the pointy ends on the side across the baby,
covering his arms, and tuck it behind his back.
5. Bring up the bottom point to the baby’s chin.
6. Repeat Step 4 using the remaining point of the blanket
Make it tight enough to make the baby feel secure, but not
tight enough to cut off his circulation!
Realize that the baby is not going to lay perfectly still during this
procedure. It will take you at least a few tries to get it right.
Preventing the flat head look
Babies now sleep on their backs and also spend hours with their
heads back in swings, bouncy seats, and car seats. No wonder so
many of them have flat heads. A flattened back or side part of the
head, called plagiocephaly, can be more than just a cosmetic problem. Though 20 percent of infants today have flat heads, according
to the AAP, all but 8 percent will round out naturally without treatment by 24 months.
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1.
2.
3.
Figure 10-2: How to swaddle a baby.
You can help prevent plagiocephaly by following these suggestions:
✓ Have tummy time: Babies need to spend some time on
their stomachs when they’re awake to strengthen their neck
muscles. This time also gives the back of the head a chance to
round out!
✓ Carry the baby: Don’t always plop the baby in a swing or
bouncer when he’s awake; carry him around with you so he
gets to see more of the world and he doesn’t put pressure on
his head. Figure 10-3 shows you how to carry your baby in a
carrier, if you’re interested in doing so.
✓ Change the room around: If possible, move the crib from one
side of the room to the other from time to time so the baby
sleeps with his head turned a different way. Or leave the crib
in place and turn the baby, moving him from one end of the
crib to the other.
Plagiocephaly is treated by molding a custom helmet that exerts
pressure on the baby’s head and gradually changes the shape as
the baby grows. The helmet is worn 23 hours out of the day and is
adjusted as the baby’s head begins to round out.
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Deciphering cries
Every baby cries a little differently, and every baby has different cries for different occasions. Differentiating the “I’m hungry” cry from the “I have a gas bubble”
or “I’m all alone and need company” cry takes practice, but eventually you’ll
be like the Amazing Kreskin, able to decipher your baby’s every need from two
rooms away.
And if you have no idea what the kid wants, even when you’ve had her home for a few
months? Do what other parents do: Fake it and try everything until something works.
Some parents resort to teaching sign language to babies who can’t articulate yet so
they’ll have at least some notion of what she wants. Anything is worth a try.
Front pack
Sling
Backpack
Figure 10-3: A baby carrier lets your baby see more of the world and keep your
hands free in the process.
Having your baby wear a helmet 23 hours a day for several months
is understandably upsetting for parents. It’s possible to make
helmet wearing more fun — for you, not the baby — by painting
the helmet or applying decals to cute it up. The babies don’t seem
to mind wearing them; having the plaster mold of their head done
will probably annoy your child far more than the helmet will.
Soothing Baby Indigestion
All babies fuss from time to time, and many have a short fussy
period every single day, usually around the time when you’re the
busiest and have the least patience for it. Although all screaming
seems pretty much the same to you, fussiness can be caused by
one end or the other of the gastrointestinal tract.
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Crying with colic
Colic can send a parent around the bend in no time at all. Colic,
defined by the Mayo Clinic as three hours of crying a day at least
three days a week for three weeks or more in a well-fed, healthy
baby, affects around 40 percent of infants. Colic generally starts
between 3 and 6 weeks of age and ends by 3 months of age. They
may seem like the longest three months of your life.
No one really knows what causes colic, but colicky babies often
pull their legs up to their stomach and act as if they have a belly
ache, so perhaps they do. Breast-fed and bottle-fed babies both get
colic, and changing the formula rarely helps. Things that help calm
a colicky baby include:
✓ Car rides: The motion of the car calms down many colicky
babies. With the price of gas, this can be an expensive solution,
but believe us, you’ll try anything after the first two hours.
✓ Vibration: Vibrating chairs or swings calm some colicky
babies. If you don’t have either of these, you can do what
many a desperate parent has tried: putting the infant seat on
the dryer and turning it on. Whether it’s the motion or the
noise, something about it calms some babies. (Make sure to
remain next to the baby to make sure she doesn’t fall off of
the dryer.)
✓ Position changes: Some babies like pressure on their abdomen, so letting her dangle over your arm while you walk
around may work. Putting her over your knee, face down, and
patting her back may work, too. See Figure 10-4 for help.
✓ Decrease the stimulation: Some babies can’t handle any handling or stimulation when they’re colicky and do better in a
quiet, dark room.
Gas
Babies often need help to get gas out of their stomachs after they
eat. Some babies burp it up spontaneously, but others need to be
patted between the shoulder blades for a few minutes to get the
gas out.
If the baby falls asleep at the end of a feeding without burping,
don’t put the baby down without getting a burp up. He’ll give you
just enough time to fall asleep or get involved with something
before he wakes up with that piercing cry that means a bubble is
stuck. Take a few extra minutes and get him to burp; you’ll be glad
you did.
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Figure 10-4: Try this position if your baby is colicky.
Reflux
Although many babies spit up after feedings, gastrointestinal reflux
disease (GERD) is a whole different entity. Gastrointestinal reflux
(GER — not the same thing as GERD), or normal spitting, occurs in
over half of all babies, but usually is worse between the ages of 1
and 4 months and disappears by 6 to 12 months.
Keeping the baby in an upright position for half an hour or so after
feedings helps reduce GER, and then keeping her at a 30 degree
angle for sleep may help. Some parents elevate one end of the crib
to keep the baby’s head higher than her feet.
Despite what you may be told, studies show that thickening the
formula with cereal does not help, and it may worsen respiratory
problems in children with GERD.
GER is annoying and potentially ruinous to your clothing and the
baby’s, but GERD is a more serious problem. Babies with GERD fail
to gain weight, may have respiratory difficulties from milk aspiration, and may have feeding aversion, which is understandable
since food so often brings them discomfort.
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Keeping your cool during baby meltdowns
Babies sense stress, and an already stressed out, screaming baby will be made
more unhappy by a stressed out, screaming parent. To help maintain control in
difficult situations, try these ideas:
✓ Leave the house: You and your partner can take turns getting out of Dodge for
a short time.
✓ Close the door: For periods of time when you can’t leave the house but truly
can’t take it anymore, put the baby in his room and close the door for a few
minutes.
✓ Get help: When a crying baby brings you to the brink, you may be shocked at
how quickly your anger escalates. Anger management courses can help you
tame an out-of-control temper. Learning to do it now rather than later is beneficial, because this child will be doing things to drive you crazy for the next 50
years. (No, parenthood isn’t easier when your children are adults!)
Breast-fed babies are less likely to develop GER or GERD, because
breast milk digests more easily and empties out of the stomach
twice as fast as formula. Medications to reduce stomach acid or to
keep stomach acid from entering the esophagus may be prescribed
to treat GERD.
Scheduling Immunizations
Immunizations are a very hot topic today, and one that many
parents have vehement opinions about. Although studies have
not supported fears that immunizations are responsible for the
increase in children diagnosed with some form of autism, a brain
disorder that now affects 1 in 105 babies in the United States, many
parents believe the increase in immunizations and increase in
autism are tied together.
The number of injections a baby receives in her first year can seem
overwhelming. Table 10-1 shows the average newborn schedule
of immunizations (some of the series are continued after the first
birthday):
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Table 10-1 Average First-Year Immunization Schedule
Vaccine
Before
Leaving
Hospital
2 Months 4 Months 6 Months 1 Year
Hepatitis B
x
x
x
Rotavirus
x
x
x
Diphtheria/
Tetanus/Pertussis
x
x
x
Haemophilus
influenzae type B
x
x
x
x
Pneumococcal
x
x
x
x
Inactivated
Poliovirus
x
x
x
Influenza
x
Measles/Mumps/
Rubella
x
Varicella
x
Hepatitis A
x
Skipping some shots?
Immunizations are so controversial in some circles today that
you may consider giving the baby some but not all of the recommended vaccines, possibly skipping influenza, hepatitis, and
chicken pox vaccines and splitting the measles-mumps-rubella
injection into three separate shots. Talk seriously with your pediatrician about the advisability of this, and check with your local
board of education, because some schools may require certain
immunizations before your child is allowed to start school.
Spreading them out
Many parents compromise on the immunization question by
spacing the immunizations over a longer time period than that
recommended by the American Academy of Pediatricians. Taking
more time may necessitate more visits to the pediatrician than
are normally scheduled but can make it easier to determine which
injection is causing a reaction if a problem occurs.
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Pediatrician Robert Sears published an alternative vaccination schedule in his book The Vaccine Book (Little, Brown and
Company). Be aware, however, that the American Academy of
Pediatrics has vigorously protested his alternative schedule and
continues to support the current guidelines. Discuss alternative
schedules and the pros and cons thoroughly with your medical
practitioner before making up your mind about vaccinations.
Marking the milestones
Baby books are a wonderful invention; it’s a shame more parents don’t use them
throughout their child’s infancy. Nearly every baby shower includes one as a gift,
and most parents start out with great enthusiasm, recoding every pregnancy symptom, movement, and ultrasound. But when the actual baby arrives, time is precious,
and the baby book often is neglected, although an occasional guilt trip may result
in copious recording for a week or so.
Make every attempt to record your baby’s milestones somewhere. You don’t have
to use a baby book; baby calendars, your own journal, or a blog can be used to
keep track of your baby’s first tooth, word, or step. You may think now that you
could never forget such important milestones, but the sad truth is that you can,
very easily. And if you have more than one child, trying to remember who had croup
and who had chickenpox gets to be impossible. And when you have grandchildren,
many years from now, you can prove to their parents how much more advanced the
grandchildren are compared to them at the same age!
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Chapter 11
Supporting the New Mom
In This Chapter
▶ Helping your partner by doing the dirty work
▶ Providing emotional assistance when her hormones are haywire
▶ Recognizing signs of postpartum problems
▶ Dealing with changes and establishing a new “normal”
A
new baby is a celebrity, with every coo, smile, and gurgle met
with a flash of the camera. A doting parent or grandparent
is always ready to meet baby’s every whim, and your protective
nature makes you feel like you could uproot a mighty sequoia if it
somehow threatened the well-being of your baby. Unfortunately,
that limelight is taken away from the woman who just spent the
better part of a year carrying that child and hours (or days!) in
labor. She suddenly goes from living as an A-list celebrity to feeling
like an out-of-work actress working for tips at the local diner.
This is your chance to step up and shine, new dad, by making sure
your partner feels every bit as adored, pampered, and attended
to as that new bundle of joy. This means taking care of tangible
needs, like making sure the litter box is clean and dinner’s on the
table, and also less-tangible needs, like emotionally supporting
your partner, limiting guests, and getting by on less sleep.
We know that the upheaval of a new baby can be a difficult adjustment for new dads, too, but rising to these challenges has longterm benefits for the health and happiness of your whole family.
The following sections help guide you through the postpartum
needs of your partner and teach you how to be a hero for the new
mom in your life.
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Handling Housework
during Recovery
New moms and dad both experience the stress of adapting to a new
little person who’s still a stranger to you, but moms have the added
burden of uncontrolled hormones and physical recovery from the
delivery. Your partner’s energy needs to be directed at keeping herself together right now, not worrying about the house — or you.
While your partner recovers, gets her hormones back together,
and works into her new routine as a mom, she needs you to pick
up the scut work around the house without being told what to do.
You may not know exactly what that entails, but that’s why we’re
here: to help you with all the things that need to be done. The following sections may look like a list of chores, but remember that a
happy mom means a happy baby — and a happy next six months
for your new family.
Getting the house in order
TV commercials make it appear that men are only good for making
messes and that women derive joy from cleaning up after them,
but in the real world, making sure the home is in tip-top shape is
everyone’s job. Except that now that your partner’s limited to lifting nothing heavier than a baby for the next six weeks, cleaning
has just become fully your responsibility.
You don’t have time to clean every part of the house every day, so
ask your partner point-blank what tasks are most important to her;
then carry out her requests word for word — even if it seems irrational. For example, if she wants the bathroom cleaned every day,
then grab your toilet brush and get scrubbing. She’ll be spending
a lot more time in there following labor due to postpartum bleeding, which can last anywhere from two to eight weeks, so a clean
environment may help her relax and keep her from feeling embarrassed when visitors unexpectedly appear.
Speaking of visitors, well-wishers come bearing a lot of stuff, which
means that clutter can get out of control very quickly. Because
mom is trapped indoors with a baby who’s feeding around the
clock, feeling suffocated by balloons, flowers, and stuffed animals
may only increase her anxiety. Make sure to find a new home for
everything that comes into the house.
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In addition, doing the dishes, vacuuming, and taking out the trash
are some of the obvious tasks that need regular attention. The following sections guide you through some of the more unexpected
tasks you’re about to become intimately acquainted with.
Battling baby’s bottomless laundry basket
Laundry may seem straightforward, but like all things related
to babies, it’s complicated. If you’re already accustomed to the
ins and outs of laundry, you’ll have ample opportunity over the
next few weeks to put these basic skills into action. But laundering baby’s things is a bit different. We break down the important
points for you here:
✓ Wash brand-new infant clothes prior to first use to remove
any chemicals or germs in the fabric. As new clothes arrive,
be sure to remove all price tags, stickers, and plastic tag
holders.
✓ To avoid exposing your baby to dyes and chemicals that
can irritate his delicate skin, wash baby clothes in dye- and
chemical-free detergent. Generally, any detergents labeled
as dye- and chemical-free are okay to use. Using organic is
always best but can be quite pricey. Several detergents, such
as Dreft, are designed specifically to wash baby clothes.
✓ Use the delicate cycles on your washer and dryer. Using the
delicate cycle helps keep the materials used in baby clothing
from shrinking, which they tend to do. And baby clothes are
outgrown fast enough without adding shrinkage to the mix.
✓ Be sure to treat stains — and you’ll have stains — prior
to washing.
Couples opting to take the eco-friendly route of cloth diapers find
the mounting laundry pile an even taller task. Follow these steps to
take care of this particularly dirty laundry:
1. Rinse the diapers.
Solid poops can be shaken off into the toilet and flushed.
Consider installing a sprayer attachment on your toilet to
help with loose stools and urine. It allows you to rinse the
diapers and flush without having to dunk the diaper into
the toilet.
2. Pretreat cloth diapers by placing them in a pail, sprinkling stains with baking soda, and covering the pail to
keep smells at bay for no more than three days.
Place an air freshener inside the pail to help control
odors, too.
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3. Gather a load of no more than two dozen diapers, fastening all tabs on each diaper to keep them from sticking to
each other.
4. Use a quarter to half the amount of laundry detergent
you would for a normal load.
Using a normal amount can lead to detergent buildup in the
fabric. Diapers are designed to absorb, after all, and they’re
not discriminating about it.
5. Wash on a cold/cold cycle.
6. Wash a second time, using a hot/cold cycle to kill any
remaining bacteria.
Dealing with pet duty
Animals require a delicate transition when the baby arrives. To
help reduce the shock of a new human roommate, prior to bringing
baby home from the hospital, wash your pet’s bed or favorite toys
in baby laundry detergent to get her used to what baby will smell
like. You can also prepare your pets by inviting over friends with
babies so your animals adjust to the sounds of babies. Enroll your
dogs in an obedience course to make sure they are well trained
and will lie down on the floor next to you on command.
No matter how well trained or prepared your pets are, take care
when introducing your baby. When baby comes through the door,
be prepared to deal with any jumping, clawing, growling, or roughhousing your pet may want to engage in with both mom and baby.
Keep animals separated from mom until she’s healed enough to
endure any unexpected pet reactions. When you trust that your
pet won’t react wildly, have the animal sit next to you while you
hold the baby. Reward your pet with treats as you interact with
the baby to begin making a positive connection between the two.
Never hold your baby in your pet’s face as this can cause a possibly dangerous reaction from the animal.
In addition to mediating interactions between your partner and
rambunctious pets and baby and all pets, it’s also your responsibility to complete all pet-related tasks. That means changing the kitty
litter, taking the dog for walks, grooming, and playing. Making sure
your pet’s life stays as normal as possible eases everyone’s transition. For example, if your dog enjoys playing catch, make sure to
play catch with him as often as you did before so he doesn’t make
a negative association between the new baby and your lack of
attention.
After contact with your pets, make sure to wash your hands with
soap and water before handling the baby.
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The weight game
Your partner may not be ready to get back into her pre-pregnancy jeans the moment
she gets home from the hospital. Some women do lose a considerable amount of
weight shortly after delivery, but some actually put on weight due to fluid retention.
And as with all weight loss, unfortunately, losing pounds put on during and after
pregnancy requires time and hard work.
Exercise helps the body recover from pregnancy (and has also been linked to
decreased occurrence of depression), but even with exercise, it takes an average of two or three months before a woman gets back to her normal body weight.
And even then, things will have changed. Stomachs are softer, body parts seemingly have shifted, stretch marks will have appeared, and she’s likely to feel like a
stranger in her own body.
You can help your partner improve her body image and fitness by reminding her
how beautiful you think she is and planning activities that get you both moving
together. A nice walk around the park or the neighborhood is always an enjoyable
activity for the whole family, and following a normal childbirth, women can begin
light walking a few days after returning home. If the gym is her scene, ask her if
she’d like you to hire a personal trainer with knowledge of post-pregnancy fitness.
If the yoga studio is her style, she may enjoy a mom-and-baby yoga class.
Whatever her desires, make sure she has been cleared by her OB-GYN prior to
beginning any workout routine, and she’ll likely be advised to stick with activities
that she engaged in before having the baby. She needs to start small, and you
need to make sure your partner is comfortable. Remind her to exercise at a slow
pace with moderate effort, especially during the first weeks. If she experiences an
increase in bleeding, shortness of breath, or extreme fatigue, have her wait a few
days before trying again.
Most importantly, let any new exercise regimen be her idea. Suggesting that a new
mom join a gym will put you squarely in the doghouse.
Becoming the errand boy
Grab the keys and get rolling, because driving duties are up to
you for a while. Doctors recommend that women who have a vaginal birth don’t drive for two weeks following delivery. That time
increases to six weeks for a cesarean delivery.
Use the hours you spend driving to the grocery store and the post
office (to mail thank-you notes, of course!) to recharge your batteries. Alone time is hard to come by these days.
Don’t forget to extend an invitation to mom and baby, too. Many
women will begin to feel trapped in the house, so as soon as your
partner is up for it, begin including her in outings whenever she
feels up to it. If she doesn’t feel up for it or can’t come along for the
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ride, bring her back some flowers or another favorite treat to make
her feel loved and cared for.
Taking care of meals
For the first few weeks following delivery, you need to manage the
meals, because your partner is likely too physically drained — and
too busy feeding baby — to think about cooking. Whether you’re
the guy who likes to take charge in the kitchen or the type who
routinely forgets to add the cheese packet to macaroni and cheese,
making sure you and your partner are well nourished is one of
your most important roles.
Understanding what she needs
Breast-feeding women need to consume an additional 400 to
600 calories more than they would when eating a normal diet.
That’s because breast-feeding burns about as many calories as a
30-minute run. New moms need to eat energy-packed, nutritious
foods. And with all the extra work you’re doing on reduced sleep,
you do too! Keep the following nutrition do’s and don’ts in mind
when grocery shopping and preparing meals:
✓ Do stock up on milk, yogurt, and other dairy products. Vitamin
D and calcium are especially important for new moms. Some
women are forced to eliminate dairy from their diets because
it can cause excess gas and fussiness in the nursing baby. In
order to get her the nutrients she otherwise would get from
dairy, stock-up on plant-based milk substitutes, such as soy or
almond milk, which have been fortified with vitamins.
✓ Don’t bring home a lot of foods that are high in sugar, carbohydrates, and fat. Nothing is forbidden here, but don’t go
overboard. Not only is it bad for her waistline, but all the
refined sugars, flours, and artificial fats are hard to digest and
aren’t ideal postpartum nutrition for baby or mom As hard
as it is to deny a new mother anything, try to talk her out of
those cravings for fried food.
✓ Do make sure she’s getting enough water. If she’s breast-feeding,
she needs to drink at least 72 ounces of water each day to aid in
milk production. If your tap water doesn’t taste good, pick up a
filtration pitcher or faucet attachment.
✓ Don’t let her (or you!) drink too much alcohol. A glass of wine
or a beer is okay, especially as a way for the new mom to clear
her head and relax. But nursing moms should keep in mind
that what goes in ends up in the breast milk, so moderation
is essential. Non-nursing moms, and dads for that matter, still
must be responsible caregivers, and alcohol lowers inhibitions
and decreases sound judgment. Always drink very responsibly.
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In addition to taking her nutritional requirements into account,
make sure to ask her what sounds good before doing any grocery
shopping. Just like during pregnancy, many women find certain
foods unappetizing and/or nauseating following childbirth.
Putting food on the table
Since you’re going to be getting less sleep and doing more work
around the house, you may not be eager to strap on the apron
three times a day. To make the task easier on yourself, cook meals
that can be eaten multiple times or frozen for future consumption,
such as easy-to-assemble casseroles or pots of soup. If time allows,
this can be a great nesting activity with your partner prior to
delivery, too.
Another great idea that only requires a little work on your end is
to make a bunch of peanut butter sandwiches, put them back in
the bread bag, and store the bag in the fridge, so that she can just
grab one quickly. This would be especially helpful for a mom who’s
going to be home alone during the day when making good eating
choices may be next to impossible with a baby whose needs
come first.
Make sure mom has plenty of nutritious foods around that she
can just grab and eat without either of you having to prep. Yogurt,
nuts, fruit, and precut, precleaned raw veggies should be on hand
as quick energy boosts that require no cooking.
When friends and family ask you what they can do to help, ask
them to bring you a meal in a freezer-safe storage container in lieu
of flowers. Having prepared homemade meals on-hand will help
you avoid the temptation to order takeout or fast food, which is
high in sodium and fat and not the most nutritious for mom and
baby.
Calling in backup
Not every new dad has the luxury of taking ample time off work to
attend to the needs of his partner, which means your partner may
be facing a lot of alone time with baby at a very early stage.
Leaving a new mom alone while you’re off at work isn’t a good
idea. Many women, especially those who delivered via cesarean
section, need physical and emotional support during the daytime
for several weeks following delivery.
Talk to your partner about the needs and desires she has while
you’re at work, then help her find the appropriate support from
friends, family, and neighbors. Make chore lists for daytime helpers so your partner won’t feel burdened by having to ask for help.
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If financially viable, hire a cleaning service. It will be the best gift
you can give to your partner . . . and yourself.
Following the birth of their grandchild, your parents and partner’s
parents may want to visit during this time in order to help, especially when you go back to work. Before agreeing to visits, however, make sure your partner wants them around. All of the advice
and constant companionship from a parental figure may cause her
more stress. She also may want a chance to go it alone without
anyone’s help.
If she does want them around, try to stagger the visits to provide a
longer duration of coverage — and a little more sanity for you and
your partner.
Supporting a Breast-Feeding Mom
Breast-feeding is a full-time job, especially in the first few months,
and although it may be more fun and rewarding than changing
poop-filled diapers, it’s still a lot of responsibility. To the untrained
eye, it may look like your partner is simply sitting in a rocking
chair holding your baby, but she’s actually working very hard to
develop a complicated feeding relationship. This section shows
you how you can help mom and baby be as successful as possible.
If you feel really lost on this subject, check out Breastfeeding For
Dummies (Wiley) for more in-depth encouragement.
Making the decision to breast-feed
If your partner is physically capable of breast-feeding (some medical conditions prevent women from doing so), the decision is ultimately hers. It’s her body, her time, and her commitment. Prior to
the arrival of baby, discuss this topic so you both can research the
benefits of breast-feeding and decide whether or not to do it and, if
so, for how long.
According to the U.S. Department of Health and Human Services,
breast-feeding is an important health choice, and it recommends
that any amount of time a mother and baby can do so benefits both.
Breast-feeding is a natural process, and the milk contains diseasefighting cells that help protect infants from germs, illness, and even
SIDS (sudden infant death syndrome — turn to Chapter 12 for more
info). Infant formula, while meeting the requirements of basic nutrition, does not include the human cells, hormones, or antibodies
that fight disease.
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For the new mother, breast-feeding is a wonderful bonding experience that has been shown to decrease the risk of postpartum
depression and lessen its impact. It also causes more afterpains,
which are spasms that help shrink the uterus back down to normal
size. Producing milk also burns anywhere from 200 to 500 calories
a day. Studies also show it reduces a woman’s risk of breast cancer
and increases her bone density after baby is weaned, reducing her
chances of developing osteoporosis in the future.
The health benefits for baby and mom are good reasons to breastfeed, but be sure your partner considers the following details when
making the decision:
✓ Convenience: Breast-feeding is much more convenient at
home than bottle-feeding, but it can be awkward when you’re
out and about. Although many shopping centers, museums,
and amusements parks have nursing stations, not all do, and
your partner may not be comfortable nursing in public. That’s
why supplemental bottles were invented.
✓ Comfort: Some women are not comfortable with the idea of
breast-feeding. Don’t blame your partner. This discomfort
may be due to a culture that makes breasts into sex objects
rather than feeding machinery.
✓ Ability: Breast-feeding is not possible if breast reconstruction
surgery that cuts the ducts has been done.
✓ Schedule: If your partner is going back to work in a few
weeks, establishing nursing may seem like too much trouble.
But nursing for even a short time is better than not nursing at
all. Encourage her to try, for even a short time. Just don’t be
pushy about it.
The American Academy of Pediatrics recommends breast-feeding
for the first year of a child’s life, and the World Health Organization
recommends breast-feeding for the first two years. However, the
benefits of breast-feeding continue for as long as mother and baby
do it, whether it be three days or three years. The more you support your partner in breast-feeding, the more unparalleled health
benefits your baby will receive.
Whether you start off baby with formula or switch after a period
of breast-feeding, do your research about the best, safest formula
for your child. Many breast-fed babies resist the transition, so be
patient. Then again, you’re probably used to that by now.
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Offering lactation support
LeBron James makes dunking a basketball look as simple as flushing a toilet, but that doesn’t mean you can do it. If your partner
chooses to breast-feed, keep in mind that it’s not as easy as it
looks, especially at first. Issues will arise, and although you can’t
be the one to solve those issues, your support is a major factor in
her success. Be positive and upbeat, listen to your partner when
she talks, and thank her profusely for making such a wise decision
for both the baby’s health and hers.
The most important role for dad is to stay informed about the process of breast-feeding. Many complications can arise, and the more
you know about how to help your partner through those issues,
the more likely mom and baby will be able to work through them.
One of the most common reasons women have for ceasing breastfeeding is that it is uncomfortable or painful. Breast-feeding should
not hurt after mom and baby establish the correct feeding positions
and latches (how baby attaches his mouth to the nipple).
Some of the most common breast-feeding issues are
✓ Sore nipples: This problem is usually temporary during the
first few days as mom adjusts to breast-feeding. For some
women the pain increases, and the nipples become chapped
or cracked. This is most commonly a result of a bad latch and
can be treated by correcting the latch.
✓ Pain from breast engorgement: Engorgement occurs when
the breasts fill up with milk, and can be eased by massage,
milk expression, and warm compresses.
✓ Clogged ducts: This occurs when the breast has not been
completely emptied and it becomes clogged, causing a small
lump to form inside the breast. Heat packs, massage, and
increased feeding from the clogged breast can treat it.
✓ Mastitis: Mastitis is a breast infection that a small percentage
of breast-feeding women get. It can cause fevers, tiredness,
and a hard lump in the breast. Treat with warm compresses,
acetaminophen (Tylenol), and a trip to the doctor for a round
of antibiotics.
Remember that it’s the mother’s decision to quit breast-feeding if
she so chooses and should never be your suggestion. If lactation
issues arise, don’t tell her to throw in the towel and go buy some
formula, no matter how frustrated or tearful she becomes. Listen
to her concerns, help her find resources to correct problems and,
ultimately, be supportive no matter what she decides.
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Breast-feeding 911
If your partner is experiencing discomfort or suffering from a low supply, know
where to go to get her the help she needs. Many hospitals employ lactation consultants and may also provide free breast-feeding support groups your wife can
attend. Some lactation consultants also make home visits to help mom and baby
work out their issues. Here are a few resources to contact when your partner
needs guidance:
✓ The La Leche League International, phone 800-LA-LECHE; Web site www.
llli.org.
✓ International Board of Lactation Consultant Examiners; phone 703-560-7330;
Web site www.iblce.org.
✓ International Lactation Consultant Association; phone 919-861-5577; Web site
www.ilca.org.
✓ Doulas of North America International, phone 888-788-DONA; Web site
www.dona.org.
Whenever your partner decides for any reason to stop breastfeeding, thank her for the time she has invested in doing so and
congratulate her for her achievements. You both should be proud
of the hard, rewarding work you’ve done.
Including yourself in the process
Just because mom does the actual breast-feeding doesn’t mean
that you can’t be involved, too. An important role for dad is to
serve as mom’s arms and legs while she breast-feeds, especially in
the early stages while your partner’s mobility is severely limited by
a baby who eats at frequent intervals all day long. Let your partner
know that you’re happy to get her anything she needs and thank
her for breast-feeding the baby. The more you can anticipate her
needs, the better. Always have a drink and snack at hand, as well
as the TV remote and something to read.
Many women feel frustrated by not being able to do things for
themselves. Reassure her that baby’s constant eating schedule is
only temporary and that it won’t be long before he eats less often
and her mobility returns. Until then make sure to bring your partner everything she asks for without hesitation.
Sometimes fathers of breast-fed babies feel as though they’re
missing out on an important, unparalleled bonding opportunity.
Remember that breast-feeding is about the well-being of your child,
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and although you can’t ever experience what your partner does,
you can join in on the skin-on-skin bonding by letting baby rest on
your bare chest. You can also occasionally give baby supplemental
bottles of pumped milk. (See Chapter 10 for more on supplemental
bottles.)
Dealing with Postcesarean Issues
Not only is the hospital stay longer for a cesarean section than that
of a vaginal delivery — two to four days total — but the recovery
time upon returning home is extended as well. A cesarean delivery
is classified as a major surgery, which means that even if everything goes smoothly, you have to care for a woman who has been
through nine months of pregnancy followed by a serious operation. You also will need to be on the lookout to make sure that no
complications arise while your partner is recovering.
Helping with a normal recovery
Give your partner additional physical support for the first few
weeks. She shouldn’t engage in vigorous exercise or household
chores or even climb a lot of steps. If you have to go back to work
during the first two weeks postdelivery, find a family member or
friend who can come to your home and provide all-day support for
your partner.
Emotionally, it’s important for the new mom to sit and bond with
her baby following a cesarean procedure. Some women experience
feelings of disappointment and can even struggle to bond with a
newborn when unable to give birth vaginally. Most, however, have
no trouble bonding after spending some time together.
If the operation was unexpected, many new dads and moms need
some time to decompress following the stress of the situation.
Following the birth, discuss the events leading up to the cesarean
with your partner. Some new parents find it helpful to discuss the
events with the obstetrician to help deal with any negative feelings
they have about their birth procedure.
Pain management is important following a cesarean, and when
not properly managed it can reduce the chances of successful
breast-feeding and increase the chances of postpartum depression.
Encourage your partner to ask her doctors about appropriate pain
relief medication and how it will affect her breast milk.
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Knowing when to call the doctor
Most women who deliver via cesarean recover quickly and without
incident. However, watch out for these warning signs and contact a
physician immediately if your partner
✓ Incurs a fever in excess of 100 degrees Fahrenheit
✓ Notices pus discharge from the incision
✓ Suffers a swollen, red, painful area in the leg or the breast,
possibly accompanied by flu-like symptoms
✓ Complains of a painful headache that does not subside
✓ Experiences abrupt pain in the abdomen, including abnormal
tenderness or burning
✓ Has a foul-smelling vaginal discharge
✓ Experiences an unusual amount of heavy bleeding that soaks
a sanitary pad within an hour
✓ Feels abnormally anxious, panicky, and/or depressed
Riding the Ups and
Downs of Hormones
If feeling physically normal while exhausted and still carrying a
few pounds of extra baby weight wasn’t hard enough for a new
mom, along come the hormones to make it all even worse. As the
body recovers from childbirth, several months are needed for
a woman’s hormone levels to completely even out. This section
overviews the many changes your partner may experience and
how to deal with them.
Thinking before speaking in the
sensitive postpartum period
If you’ve ever put your foot in your mouth, then you know that you
can accidentally hurt your partner’s feelings via your own thoughtlessness. After delivery you need to be even more careful of what
you say, because for most new dads, your partner’s emotional sensitivity will feel like uncharted shark-infested waters.
Avoid using leading statements, such as “why don’t you just” and
“why didn’t you” when your partner is upset. You don’t have all
of the answers, and she’s not looking for answers, anyway. What
she’s likely seeking is a listening ear and an understanding hug.
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The last thing you ever want to tell a tearful new mother when
she confesses feelings of isolation is, “Why didn’t you just go out
today?” She likely has worked very hard all day taking care of
herself and the baby, and by flippantly suggesting that she should
have done more than she did can make her feel like a failure.
To show support, ask her questions that show you’re listening,
such as “What would make you feel better?” and “What can I do
to help you?” If your partner responds with “I don’t know” or
“Nothing will help until the baby is older/sleeps more/cries less,”
then tell her you want to help in any way possible. If she has
trouble expressing what she needs, you may find yourself becoming frustrated with your inability to fix the problem. Until she can
express her needs, plan some time away for her that doesn’t force
her to make any decisions but instead pampers and caters to her
needs and shows her how much you care.
When your partner is upset about something you said, keep in
mind that hormones are at play, but don’t suggest to her that
hormones are the reason she’s being sensitive. (That will go over
about as well as telling her she’s moody because “it’s that time of
the month.”) The last thing you want to do is imply that her feelings aren’t legitimate. Simply apologize for any and all offending
statements and let her know that you understand where she’s
coming from.
Many new moms also become sensitive to anything involving hurt
or neglected children, which can make TV programs, movies,
and books potential minefields. To the best of your abilities, do
research about the contents of your entertainment. If the movie
you want to watch involves a child death, botched childbirth,
kidnapping, or the destruction of Earth, put it on your queue for
later viewing.
Shedding light on physical
symptoms
Body-drenching night sweats are very common for new moms,
and you can’t do much to help except to set up a fan near the bed.
Sudden hair loss is another physical effect of surging hormones.
In the first few months following delivery, most women begin to
notice a lot more hair coming out in the shower and on the hairbrush. Reassure your partner that this is normal and that it usually
goes back to normal by nine months after delivery. If it doesn’t,
have her seek treatment from a dermatologist.
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Supporting her baby blues
Happiness is only one of the complex emotions you and your
partner will feel following baby’s arrival. The most common and
complicated issue for new mothers is the baby blues, feelings of
exhaustion, insomnia, irritability, nervousness, panic, and that she
will never be a good mother, which usually occurs during the first
few weeks following delivery. Studies show that nearly 80 percent
of women suffer feelings of sadness and loss postdelivery.
Experts believe that shifting hormone levels are partly to blame
but that it’s also a difficult for a woman who has been focused on
giving birth for nine months to suddenly switch gears and focus on
nurturing a newborn. Caring for a child stirs strong emotions and
can make new parents feel an overwhelming sense of responsibility
and fear, both of which are perfectly normal.
Talk openly with your partner about her feelings, as well as any
sad feelings you may be experiencing. Keep reading to find out
how to determine if her baby blues are something more serious
that needs treatment.
Recognizing postpartum depression
While most new mothers experience some feelings of sadness that
eventually pass, 10 to 15 percent of all new mothers suffer from
depression during the first six months postdelivery, and depression requires some care and treatment. Distinguishing between the
baby blues and postpartum depression is not as difficult as you
may think, especially for you. Your partner may not be able to put
her feelings into words or admit she’s depressed, but you can be
alert for signs of depression and have a discussion with her if you
recognize any symptoms. Common symptoms include
✓ Lack of interest in caring for self or child
✓ Loss of appetite
✓ Relentless unhappiness
✓ Incapable of being happy while spending time with baby
✓ Sudden arrival of anxiety and panic attacks
✓ Hearing voices
✓ Disturbing thoughts about harming self or baby
If you believe your partner is depressed, tell her that you’re concerned about her health, allow her to discuss her symptoms and
how she’s feeling, and let her know that what she’s dealing with is a
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serious medical condition. It doesn’t mean she’s a bad mother or a
weak person. Good people can suffer from postpartum depression.
Don’t let her brush the issue aside by saying that it’s just a matter of
feeling sad and that she’ll “snap out of it,” because she won’t.
A depressed new mom needs to be treated by a medical professional immediately, so work with your partner to schedule a session with her doctor. Counseling and antidepressants are very
effective treatments.
Sleeping (Or Doing Without)
Surprise! It’s a baby who doesn’t sleep through the night. Depending on your newborn, you may be woken every hour on the hour
for feedings and comforting. Or you may be one of the lucky parents catching hours and hours of uninterrupted sleep. Every baby
is different, but one thing is constant: Sleep is a precious commodity for new parents.
Babies’ sleeping habits change frequently, but the average newborn
sleeps about eight hours during the day, waking up every hour or
so to eat. They generally sleep another eight hours during the night,
again waking frequently to eat. Newborn sleep cycles are shorter
than those of adults, and they spend more time in light sleep than
adults do, which accounts for the frequent disturbances.
The common rule of thumb is to sleep when your baby sleeps. A
million chores may need to be done around the house, and you
may enjoy an hour watching tennis in peace, but close your eyes
instead. If you nap during the day when you have a chance, you’ll
be in much better shape to deal with a baby who’s ready to party
when you’re ready for pillow time at night. You can take turns with
your partner throughout the night, alternating who gets up each
time or switching nights. Use a schedule that works for you both.
Many babies wake up for good before the sun has a chance to hit
the horizon. If you’re routinely jarred from sleep at an obscenely
early hour, alternate days of getting up early with your partner so
at least one of you can get some additional sleep. That way, when
the early riser’s energy wanes later in the day, the other partner
can step up to help out.
A baby’s internal sleep clock begins to mature between the ages of 6
and 9 weeks and starts to become constant between 3 and 5 months.
By 10 months, the average baby’s sleep cycle is constant, and he
will go to bed and wake up at the same time every day. If you’re still
awake by that time and haven’t become addicted to caffeine, congratulations. Your sleep cycle will start getting longer, too.
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Ferber versus no-cry
Different schools of thought have varying theories about how to help a baby sleep
through the night. Many parents opt to use the Ferber method, created by Dr.
Richard Ferber. Commonly referred to as Ferberizing your baby, this is the classic
cry-it-out system that offers limited comforting for a baby in an effort to teach him
how to fall asleep by self-soothing. An increasing number of parents are beginning
to use alternative no-cry methods that address an individual baby’s sleep issues
and offer parents tools to help babies put themselves to sleep without so many
tears. Generally, a no-cry method encourages a slow, steady process to segue
from cosleeping to crib sleeping that involves building a positive association with
the crib for your baby instead of letting her cry until she falls asleep. Research all
of your options and decide which method suits your parenting style.
Many babies begin sleeping through the night between 4 and 6
months. Then again, many babies begin sleeping through the night
at 1 year of age. Both are normal. Consult your pediatrician if your
baby’s sleep pattern is unmanageable for you and your partner.
Coping with Company
Family and friends will be vying for any opportunity to get their
hands on your baby. Being surrounded by love is important at this
time, but mom, dad, and baby also need to get plenty of rest and to
have sufficient time to bond as a family. And getting plenty of rest
and private family time will help keep you from lashing out at your
mother when she offers yet another “helpful pointer” about the
proper way to fold bath towels.
Try not to schedule multiple visitors at a time, and limit the
number of visits to two or three per day. Now is also the time in
your life when it’s okay to cancel or say no to visits. If Aunt Sarah
is scheduled to drop by in the evening and your partner just needs
to catch some shut-eye, put your partner’s needs first. Reassure
Aunt Sarah that she will get to see the baby in due time. If she’s
offended, she’ll get over it the moment she holds your baby for the
first time.
You and your partner should decide together when it’s a good time
to have people over and when you need some peace and quiet.
However, she may feel guilty about saying no even when you know
very well that having an empty house is in all of your best interests. Don’t be afraid to turn people away without asking your partner so she doesn’t always have to feel like the “bad guy.”
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As visitors cycle through your home, make sure they all wash their
hands or use an alcohol-free hand sanitizer to avoid spreading
germs. If someone is sick, it is your duty to keep him out of your
home. Thank him for his support but let him know that exposing
newborns to illness is dangerous.
Baby will be passed around a lot when company is visiting and
often only handed back to the new mom for feedings. Make sure
that your partner gets plenty of nonfeeding time with the baby to
avoid having her feel like a dairy.
Dealing with grabby grandmas
Sharing isn’t easy — especially for new grandmas. And as they will
gladly tell you (again and again), someday you’ll understand when
you have a grandchild of your own. Until then, you need to manage
everyone’s needs for the next 20-plus years without offending
anyone.
The best way to handle a too-hands-on grandma is to be honest
and respectful. If you want to hold your baby and your mother or
mother-in-law is reluctant to give up the wheel, reach for the baby
and say something such as, “I just can’t hold this little one enough.
I’ve been waiting for this moment my whole life.” There’s nothing
like a display of paternal love to remind a grabby grandma how
important bonding is between parent and child.
Don’t be passive-aggressive in your approach. Avoid asking questions like, “Mom, do you think I could hold the baby now?” You
don’t want to imply you think grandma is being overbearing,
thoughtless, or disrespectful of your time.
If the problem persists, speak to the offending parent in private.
Thank grandma for her love and support, and use only I statements (such as, “I have really been feeling the need to spend more
time bonding with my baby right now, and even though it may not
be what everyone would want, I really need this time”) to convey
how much you want to spend time with your baby.
Managing unsolicited advice
One of the first things to raise the ire of a new parent is a pushy,
well-meaning advice giver. It makes parents feel like they’re the
heroes in a zombie movie who turn around and see a horde of the
undead ready to rip then to shreds. Everyone seems to have opinions when it comes to how to care for your baby, and if you start
paying attention to everyone, it will completely overwhelm you. So
just run. Run far, far away and don’t look back.
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Whether the advice is on how to hold him, how to burp him, or
even how to soothe him when he’s on a crying jag, try to internalize the fact that most people are reaching out with advice because
of the love they feel for your newborn. When advice comes across
as criticism of your parenting skills, shrug it off. You and your partner know your baby’s needs and preferences better than anyone
else. Defer to your instincts. Every baby is different, and what
works for one may cause another one fits of hysteria.
That being said, you may find some advice helpful, so be open to listening to what others who have parented before you have learned.
Don’t be afraid to reach out to others if you have questions, but
never take someone’s advice as gospel. Take the time to do your
own homework and decide what works best for your family.
Don’t feel the need to explain yourself, however. If your Uncle
Robert thinks you’re somehow failing your child by picking him up
every time he cries, don’t be afraid to push back. Say something
like, “I guess the beauty of being a parent is getting to decide how
you want to raise your own child.”
Handling hurt feelings when
you want to be alone
Inevitably at some point you’ll need time to yourself. So will your
partner. Baby love is all encompassing, but you can’t let it overtake
your individuality. Even though visitors have traveled from afar
and people want to shower your new family with affection, you
have to put on your own oxygen mask first, so to speak. Whether
you’re a runner or an avid video gamer, don’t feel guilty about
taking time to do what you need to relax.
Never under any circumstances utter the phrase, “I just need a
break.” Your partner will not like to hear that, because nobody
deserves a break more than a new mom. Let her know that you really
need to blow off some steam in order to continue being the best caregiver you can be. If she’s angry, tell her you understand how she feels
and offer her the same amount of time upon your return. Even the
breast-feeding mom can enjoy a brief walk or a quick run to the store
just to have some time to be on her own again.
Make sure to schedule time for your mental well-being, because
it probably won’t seem like a priority until you’re raving like a
madman because you just need a second of solitude. Keep a calendar and block out times in different colors for family time, dad
time, mom time, and visiting hours.
If family or friends take offense when you say no to a visit or an
invitation to attend a family function, don’t change your mind to
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Part III: Game Time! Labor, Delivery, and Baby’s Homecoming
save their feelings. You deserve time to bond as a family and time
to unwind and just be yourself. Thank them for the offer, be honest
about why you can’t commit to that time, and plan a get-together
for a later date that suits everyone’s schedule.
Approaching Sex: It’s Like
Riding a Bicycle
Hang tight, fellas. It’s gonna be a while. The earliest a woman can
have sex is six weeks following delivery, and that’s only after getting clearance from her doctor. Your hormones may be raging,
but you need to remember that your partner’s genitalia have been
through the wringer, so to speak, and intercourse can severely
jeopardize her healing process.
In addition to needing time for physical healing, most women won’t
be feeling all that sexy for a while. Hormones are the major culprits, but a lack of sleep, breast-feeding, and the difficulty of straddling the roles of mother and sexual being are also hurdles. As
hard as it is to internalize, remind yourself that her lack of physical
interest in you has nothing to do with her feelings toward you. Her
absence of desire isn’t personal; it’s physical.
Some women find their sexual desires return by the time their
doctor okays sex, but for many it can take between 6 and 12
months. Some new fathers also experience a diminished interest in
sex when adjusting to the role of dad.
Even after your partner has healed and desire returns, she may
experience discomfort when returning to a normal sex life. Be prepared to take it slow. You may need several attempts before you
actually have sex to completion. Time will also be at a premium
and baby just may wake up before you finish.
Time will also be at a premium as you work around baby’s schedule, so as unromantic as it sounds, schedule sex with your partner
and slowly ramp up to a frequency that works for both of you. With
so much on your plates, it will give you both the security of knowing the “when” and the excitement of thinking about the “how.”
Birth control also needs to be a talking point for you and your
partner. Many people believe that breast-feeding women cannot
get pregnant, but although breast-feeding does often delay a return
to regular ovulation, some women do ovulate while nursing. Many
breast-feeding women prefer not to go on birth control pills due to
changes in milk supply, so condom usage is common for new parents returning to active sex lives. You can speak with a doctor to
help you both determine a birth control option that fits your needs.
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Part IV
A Dad’s Guide
to Worrying
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In this part...
his part is designed to keep you from staying up all
night worrying about all the things new dads worry
about, from colic to college. We discuss possible complications and newborn concerns, and we devote a whole
chapter to being a supportive partner, lest you forget the
person who gave birth to your progeny. We also help you
plan for your child’s future financial security.
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Chapter 12
Dealing with Difficult
Issues after Delivery
In This Chapter
▶ Learning that your baby has problems
▶ Coping with serious postpartum issues
▶ Grieving together and separately
▶ Telling other people when your baby has problems
N
ot everyone goes home to perpetual roses and lollipops
after their baby is born. In fact, hardly anyone does. But
serious issues in baby or mom are rare, so when they occur, they
can really knock you for a loop. In this chapter we discuss some of
the serious complications that can arise after delivery and how to
handle them. This is a chapter you can skip if you don’t need it —
and we hope you never will.
Coping with Serious
Health Problems
Approximately 1 in 33 babies born in the United States has a congenital birth defect, according to the Centers for Disease Control.
Developmental delays, serious illnesses, and sudden infant death
syndrome are problems no one wants to contemplate when having
a baby, but they can and do happen. The following sections give
you an overview of the most common serious health problems.
Congenital defects
Congenital defects, defects that exist at birth (also simply called
birth defects), are common. Some are minor issues that no one but
the parents would ever notice; others are more serious. The most
common birth defects include
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Part IV: A Dad’s Guide to Worrying
✓ Heart defects: One in 100 to 200 babies born has a heart
defect, which can range from mild to severe. Heart defects
comprise one-quarter to one-third of all birth defects.
✓ Down syndrome: One in 800 babies is born with Down syndrome, which causes distinct physical features and mental
retardation. The percentage is higher in older mothers and
lower in those younger than 35.
✓ Neural tube defects: One in 1,000 infants has neural tube
defects, which affect the brain and spinal column. They
include spina bifida, an abnormal opening in the spine, and
anencephaly, an absence of part of the brain.
✓ Cleft lip and/or palate: One in 700 to 1,000 babies has deformities of the lip and hard palate.
Sixty percent of the time, the reason for the birth defect is
unknown. Inherited disorders, on the other hand, may be suspected ahead of time if a family history of a genetic disorder exists.
Some of the most common inherited genetic disorders include
✓ Cystic fibrosis: A disorder that causes thick secretions in the
respiratory and gastrointestinal tract, cystic fibrosis is the
most common inherited genetic disorder in Caucasians in the
United States, affecting 1 in 3,000 babies. Both parents must
carry the defective gene for a child to have the disease; it’s estimated that 12 million people in the United States are carriers.
✓ Sickle cell anemia: An autosomal recessive disease causing deformities of the red blood cells, sickle cell anemia
affects mostly people of African and Middle Eastern descent.
Approximately 2 million African Americans carry the sickle
cell gene.
Minor birth defects are much more common than serious defects.
Eye, ear, and limb defects; extra digits; abnormal development of
the intestines; and birthmarks may not be life threatening in most
cases, but they can still be devastating for parents. Being concerned about birth defects, especially visible ones, is normal
for parents.
Developmental delays
Many parents keep baby books that chronicle their baby’s progress, and eagerly await each milestone: the first smile, the first
step, the first word. When milestones aren’t met when books say
they should be, or when your friend’s babies are meeting them but
your baby isn’t, doubt, concern, frustration, and a cold fear may
begin to creep into your days.
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Moms are usually the first ones to recognize a problem, so if your
partner voices concerns, don’t belittle them, even if the baby
seems fine to you. Verbalizing fears about your baby’s development takes a lot of courage.
When babies are very young, physical milestones are very important. Babies, after all, don’t dazzle you with their small talk or
charm you with their recitation of The Iliad. If they lift up their
head, it’s a big deal. Rolling over for the first time merits phone
calls to relatives all over the country, and the first gurgle — the
one that startles the baby almost as much as it does you — earns
your undivided attention for the next hour as you try to catch a
command performance on video.
When your baby isn’t keeping up with the other babies on the
block (whether in your mind or in fact), discuss it with your
doctor, who may tell you that all babies are different and that
you’re making yourself crazy. Or he may nod and take notes, which
is really frightening, because even when you know something’s
wrong, having someone else verify it makes it all too real.
If you suspect that your baby isn’t meeting developmental milestones, take a deep breath and consider the following facts:
✓ Babies really do develop at different rates. Milestones
happen at an average age, and an average is just that: 50 percent of babies achieve the goal at a younger age, and 50 percent don’t meet it until they’re past that age.
✓ Babies all have different abilities. Some are more physically
oriented; others are more verbally inclined. Since physical
milestones are all you have to go on at a young age, children
who will shine verbally later may seem to be behind early on.
However, talk to your doctor if your baby doesn’t meet the following milestones:
✓ Turns her head in the direction of a voice or sound shortly
after birth
✓ Smiles spontaneously by 1 month
✓ Imitates speech sounds by 3 to 6 months
✓ Babbles by 4 to 8 months
If your baby does have developmental delays, she’ll need your help
to achieve normal milestones. Getting help early is the best thing
you can do for her.
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Illnesses
Infant illness can be acute (severe but brief) or chronic (long lasting or recurring). Both are terrifying, especially if your baby has
to be hospitalized. A sick baby, especially a chronically sick baby,
changes your family dynamic in major ways and can come become
the unhealthy focus of the entire family. The following suggestions
can help you deal with an illness in your infant, whether acute
or chronic:
✓ Absolutely, positively avoid any hint of the “blame game.”
Even if anything either of you did caused the baby to get sick,
it’s over and done with, so pinning blame on someone will
only make everyone feel worse. Babies can’t be raised in a
bubble, so getting sick is, unfortunately, a fact of life.
✓ Don’t let yourselves get overtired. Especially if your partner
delivered not too long ago, she really needs to get enough
rest. Take turns staying at the hospital or being up with the
baby at home, or one of you could get sick, too.
✓ If your partner is breast-feeding, keep pumping. Stress is
hard on milk supply, and pumping isn’t nearly as effective
as a nursing baby for stimulating the supply, but encourage
your partner to do her best. As long as she keeps it going in
the interim, the supply will build up when the baby is nursing
again.
SIDS
Sudden infant death syndrome, or SIDS, has decreased since pediatricians began recommending that babies sleep on their backs with
the “Back to Sleep” campaign, but it’s still the third most common
cause of death for infants up to 1 year old. More than 7,000 babies
in the United States succumb to SIDS each year.
Identifying the causes and debunking myths
The causes of SIDS still are not clear. However, doctors know that
the following are not causes of SIDS:
✓ Suffocation
✓ Choking
✓ Vomiting
✓ Infections
✓ Immunizations
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SIDS is considered to be multifactorial, meaning that it doesn’t
have just one cause. Several factors must all be present for SIDS
to occur, including abnormalities in the brain, respiratory system,
and possibly the heart.
Understanding what increases the risks
The following factors increase the likelihood of SIDS:
✓ The baby was born premature.
✓ The baby is male.
✓ The baby is of black, Native American, or Native Alaskan
ethnicity.
✓ The baby is between 2 and 3 months of age
✓ The baby is overheated or overdressed. Too many clothes
or an overly heated room may increase the risk of SIDS. SIDS
occurs more often in cooler fall and winter weather when
babies get bundled up.
✓ The baby has a sibling who died of SIDS.
✓ The baby was/is exposed to tobacco. SIDS rates are higher in
babies whose moms smoked during pregnancy or who smoke
around the baby.
✓ The mother used cocaine, heroin, or methadone during
pregnancy.
✓ The baby recently had a respiratory infection.
✓ The baby sleeps on his stomach, especially if he’s switched
from back to stomach sleeping or is overheated and sleeping
on his stomach.
Research also indicates that babies who are breast-fed and those
who suck on pacifiers may have a lower risk of SIDS. Side sleeping
may seem like a compromise if your baby hates being on his back,
but back sleeping is still safer, and many side sleepers roll over
onto their stomachs.
Placing a fan in the window, or even just opening a window, also
has been shown to decrease the risk of SIDS in at least one study.
SIDS deaths dropped more than 70 percent when a fan was placed
in a window and dropped 36 percent when the window was
opened. Better ventilation may decrease carbon dioxide buildup.
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Watching Out for Postpartum Issues
Female hormones are a jumbled mess right after delivery, which is
why women are so emotionally fragile after birth. Add sleep deprivation and insecurities about parenting ability, and it’s amazing
that your partner can function at all.
Mood swings and depression are normal for the first few weeks
or even months after having a baby, but sometimes more serious
problems can arise. One of your jobs is being aware of the signs
of a serious problem and making sure your partner gets help
if needed.
Getting through the “baby blues”
Nearly every new mom experiences the “baby blues,” emotional
mood swings and mild depression triggered by hormone changes
after delivery. Symptoms of baby blues include
✓ Anxiety or feelings that she’s not doing things “right”
✓ Crying for no reason — at least, for what seems like no reason
to you
✓ Difficulty concentrating
✓ Irritability
✓ Mood swings
✓ Periods of sadness
✓ Trouble sleeping
Baby blues normally last just a few weeks after giving birth, so if
symptoms last longer or seem more severe, get your partner to
her medical practitioner for help. Many women don’t recognize
the severity of their own symptoms or don’t have the emotional
energy to deal with them.
Taking a look at postpartum
depression
Postpartum depression, a more serious form of the typical “baby
blues,” occurs in up to 10 percent of women. Some of the symptoms of baby blues and postpartum depression overlap, but postpartum depression is more pronounced, lasts longer, and includes
serious signs that need immediate medical evaluation.
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Recognizing the symptoms
Women with postpartum depression may have the following
symptoms:
✓ Difficulty bonding with the baby: This is a major red flag. If
your partner pushes the baby off on you or says she’s not a
good mom or that the baby would be better off without her,
get medical help.
✓ Thoughts about harming herself or the baby: She may not
verbalize these thoughts, so they may be hard to recognize.
She may want other people to handle the baby because of her
fears that she will hurt him, accidentally or on purpose.
✓ Guilt and shame over her negative thoughts: Again, because
she may not verbalize her thoughts, recognizing what’s
going on may be difficult. Statements like “I’m no good” or
“Someone else would be a better mom to this baby” are warning signs.
✓ Sleep difficulties: She may not be able to sleep, or she may
want to do nothing but sleep.
✓ Disinterest in normal activities, including sex: Seeing old
friends, going out, even everyday activities like cleaning the
house, doing laundry, and watching TV may all go out the
window. While you may at first think she’s just tired, a deeper
reason may be at the root of her continued lack of interest in
life that lasts for several months after delivery.
✓ Loss of appetite: Losing interest in eating is often an early sign
of depression.
✓ Anger and irritability: Her anger may go far beyond a few
swear words when she drops a quart of milk, and can be
frightening.
Postpartum depression usually is not a short-lived disorder, so
don’t try and wait it out, thinking she’ll get over it in a week or two.
Postpartum depression can last up to a year, which can interfere
with maternal-child bonding and seriously disrupt your family.
Children of moms with untreated depression also suffer the consequences, with a higher incidence of behavior problems, sleeping
disorders, feeding problems, hyperactivity, and language delays.
Knowing who’s more at risk
Any woman can have postpartum depression, but the chances of
this developing increase if
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Part IV: A Dad’s Guide to Worrying
✓ She has a history of depression.
✓ She’s recently undergone major life changes. These changes
can include a move, a death, job loss, illness, pregnancy complications, or trouble between the two of you.
✓ She doesn’t have a good support system. Family and friends
make a big difference in the life of a new mom. Postpartum
depression makes it difficult to reach out to others, so a
woman who doesn’t have pushy friends and family who will
check in on her even if she doesn’t call them is very isolated.
✓ The pregnancy was unplanned or unwanted.
Treating the disease
Treatment for postpartum depression may include
✓ Antidepressants: Make sure the doctor knows if she’s breastfeeding so he can prescribe an antidepressant safe for use by
breast-feeding moms.
✓ Hormone therapy: Estrogen replacement to offset the rapid
drop in estrogen after giving birth may be helpful for some
women.
✓ Counseling: Talking things out with a professional is very
helpful for some women.
Taking care of yourself
If your partner is suffering from postpartum depression, a large
part of her normal chores and responsibilities may fall on you. If
you’re trying to hold down a job, make sure your partner’s okay,
make sure the baby’s okay, and run the household on top of it all,
you may start to feel a little stressed yourself.
While rushing in to take over a short-lived crisis is easy, a situation that drags on for months can take its toll on your mental and
physical well-being. Take care of yourself by making sure you
✓ Get enough sleep. Sleep deprivation makes everything look
worse. The very worst time to pore over your worries is the
middle of the night; everything looks insurmountable at 3 a.m.
✓ Eat right. You’ll feel better and be better able to handle situations if you’re not eating junk food.
✓ Call in the troops to help. You may not have readily available
family and friends, but if you do, enlist their aid. Send them
to the store, or have them come over and clean. This is a fine
line, because you don’t want to give your partner the impression that she can’t do all this stuff, even when she can’t. If you
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call in your mom to clean or cook, your partner may view it as
a judgment against her abilities and a sign that you feel your
mom is more capable than she is. Sometimes hiring help for
household chores is a better idea.
✓ Consider taking a leave of absence from work. Some companies offer paid time off for dads or will let you use vacation or
sick time. You can also use Family Medical Leave Act (FMLA)
time for up to 12 weeks of time off, but this will probably
be unpaid time, unless you work for an extremely generous
company. Dipping into savings or borrowing from your 401(k)
isn’t ideal, but if it gets your family through a difficult time, it’s
worth it.
Acting fast to treat postpartum
psychosis
Postpartum psychosis is an extremely dangerous psychiatric disorder that occurs in around 1 to 2 percent of women, usually in
the first few weeks after giving birth. Women with bipolar disease
or previous history of postpartum psychosis are more likely to
develop the condition. Onset is sudden and includes the following
symptoms:
✓ Paranoia
✓ Hallucinations
✓ Delusions
✓ Insomnia
✓ Irritability
✓ Restlessness
✓ Rapidly changing moods
✓ Bizarre thinking
Left untreated, postpartum psychosis can be lethal; the risk of
suicide or infanticide is high. If your partner displays any of these
symptoms, don’t try to talk her out of it or persuade her to see
her doctor. She almost certainly won’t recognize her behavior as
abnormal and in fact will probably consider you to be an adversary. Call 911 immediately.
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Managing Grief
Grief is intense sorrow due to loss. The loss of the perfect child,
the perfect partner, or perfect family can cause grief. The most
important thing to remember about grief, no matter what the
cause, is that it takes time to work through. Don’t be hard on yourself or your partner when you’re grieving, and don’t expect you’ll
be in the same stages at the same time. Everyone works through
grief differently.
Going through the stages of grief
Grief can be caused by many different scenarios, but the widely
acknowledged five stages of grief, described by Elisabeth KüblerRoss, include similar phases whatever the cause.
Whether you’ve found out that your baby has a long-term problem,
your partner if suffering from serious postpartum illness, or your
baby has to be hospitalized, expect to experience the five stages
of grief:
1. Denial: The first stage of grief is often a feeling of “This
can’t be happening to us.”
2. Anger: The second stage of grief is anger, often directed at
God or other people.
3. Bargaining: Trying to make secret deals — “I’ll donate our
savings to this hospital if my baby’s heart surgery saves
him” — often with God (even if you don’t believe in God!) is
common in the bargaining stage.
4. Depression: When reality sets in and you realize that this is
happening to you, fair or not, depression often follows.
5. Acceptance: Eventually you get through the other stages
and settle down to dealing with what you have to deal
with, but you may still go in and out of earlier grief stages
at different times.
Stages may not follow this exact pattern, and not everyone goes
through every stage. Yo-yoing back and forth between several
stages is also common.
Grieving is important during the entire pregnancy process. Even if
your baby is born without incident, you will be going through a lot
of changes. Allow yourself and your partner to discuss the many
things you’re giving up in order to bring this child into the world.
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Even something as silly as giving up your daily latte in order to buy
diapers can become a source of resentment over time. As a general
rule, talk openly and honestly about the changes that affect you
and support each other.
And cut yourself a break — parenting isn’t easy, and it’s perfectly
natural to miss having nights out with friends or even being able
to eat an entire meal before it gets cold. Grieving the little things
doesn’t mean you don’t love your baby — it means you’re dealing
with change in a healthy manner.
Why, why, why? Getting
past the question
When grieving, getting bogged down in why a particular thing has
happened to your partner or child is easy to do. However, it’s not
particularly good for you, especially if there’s no way of deciphering exactly why something happened and most of your thoughts
are purely speculative.
Unless knowing the reason why your problem happened can prevent a recurrence or change a situation, asking “why” doesn’t help.
Wanting a reason is a way of imposing control on a situation, but it
doesn’t help you move forward in helping your child.
Grieving together and separately
Everyone needs time to grieve a loss in their own way. Grieve
together with your partner, certainly, but take time to grieve separately as well. Don’t feel bad about needing to be alone with your
thoughts sometimes. At the same time, the following tips can help
you and your partner get through your grief, both together and on
your own:
✓ Stay physically close. It helps you feel less alone, keeps you
centered on still being a couple, and helps keep your relationship going in a situation that could easily break it apart. Even
if you don’t feel like it, make the effort to hold hands, cuddle
on the couch watching TV, and have sex regularly.
✓ Expect to be discouraged at times. Everyone has moments
when things look much worse than they really are, usually
because they’re tired, hungry, or just plain stressed. Identify
it for what it is: temporary discouragement, not a new permanent negative outlook on life.
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✓ Don’t get upset with your partner. One day you or your partner may be raging at the world, and the next day the other
one may take a turn. Listen to each other without taking
things personally, trying to make it all better, or reproving
them for their feelings.
✓ Arm yourself with knowledge. Knowledge really is power.
Especially if your baby has a genetic or long-term condition,
learning all you can about it helps you be your baby’s best
advocate and can help you and your partner feel like you’re
doing something productive in a frustratingly out-of-control
situation.
✓ Keep a journal, if the thought appeals to you. Journals are
not only good for privately venting feelings and fears that you
and your partner don’t want to share with each other; they’re
also good for looking back later and realizing how far you
really have come.
✓ Find a support group. If you’re coming to terms with a birth
defect, your child or partner is ill, or you’re dealing with a
loss, talking to other parents dealing with the same thing
can be a lifesaver. When relevant, it can also be a really good
source of information on specialists, educational programs,
and other outside help.
✓ Get help for yourself. If you find yourself mentally overwhelmed, seek counseling, either with your partner or alone.
Often just being able to talk through a situation with a person
not involved helps you sort things out.
✓ Tell people when you’re not up to something. Another
baby’s christening, a big family party, or a holiday celebration
may all be beyond your or your partner’s ability to handle at
first. Don’t be afraid to say no to things that you feel would
strip you raw right now. People who love you will understand,
even if they’re disappointed.
Determining when grief
has gone on too long
Grieving can take a long time. But sometimes grief takes on a life
of its own, and a situation called complicated grief can become
permanently entrenched in your or your partner’s life. While
everyone has times when the sadness of circumstances becomes
overwhelming, normally these feelings don’t affect every aspect of
life after the first few weeks or months. Complicated grief may be
taking over your life or your partner’s after a period of time if
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✓ You still feel numb and detached.
✓ You’re preoccupied and bitter about what’s happened.
✓ You can’t perform normal tasks, go to work, or participate in
normal social functions.
✓ You feel life has lost its meaning.
✓ You’re unusually angry, irritable, or agitated most of the time.
✓ You make rash decisions or do things you normally wouldn’t
do, such as drinking too much.
When grief becomes complicated, it becomes self-perpetuating.
This is a time for intervention, either with medication or therapy.
Talk to a grief counselor, psychologist, psychiatrist or other
mental health personnel about your feelings and symptoms.
Antidepressants have been found to help in some cases.
Talking to Other People
about Your Child
Accepting a child’s health problems is challenging enough for parents, and an emotionally sensitive situation is made even more difficult by the fact that eventually you need to inform other people
of the problem. In time you may become accustomed to the comments of well-meaning but blundering family members and rude
strangers, but at first you will likely be uncomfortable and upset.
The following sections give you guidelines for getting through
these situations.
Telling other people
Telling other people that your child has a problem can be gut
wrenching; verbalizing to other people can be almost like hearing
it for the first time yourself. When you tell other people your child
has a problem, try the following tips:
✓ Keep it simple. Especially if your child has an ongoing medical problem, giving out information a little at a time may make
it easier for others to digest.
✓ Keep it positive. Maybe your child isn’t going to be able to
be all you ever hoped for him. Actually, no child ever can!
Remember that your child will be able to have a happy life, no
matter what his disability, and you can enjoy him no matter
what his issues. That positive outlook will express itself in
your message.
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✓ Keep it straightforward. You may be tempted to sugarcoat a
situation when explaining it to others, but there’s no reason
to give them hope that a child will grow to be something he
won’t. Be honest about the situation from the beginning.
Handling insensitive remarks
Unfortunately, people do notice when a child has a birth defect or
development delay and sometimes your hear them whispering to
each other or pointing at your child. As devastating as this is, use
it as a teaching experience if you can. If your child has a visible
birth defect, comments are going to come your way — and your
child will hear and understand those comments as she gets older.
Openly discussing your child’s disability as something not to be
hidden or ashamed of sets a positive example for your child. This
doesn’t mean that you have to freely discuss your child with every
obnoxious person who asks pointed questions. But addressing
questions with an open, accepting, positive attitude tells your
child — and everyone else — that he’s a great kid and that you’re
happy with him just the way he is.
Sometimes you won’t have the patience to deal with questions,
and you don’t have to educate every person who crosses your
path. But when your mood allows it, try the following suggestions
when confronted with insensitive remarks:
✓ Answer a small child’s questions. Children, having no discretion at all, often ask their parents about people with visible
problems at the top of their lungs. Introduce yourself and use
this opportunity to teach others about your child’s disability.
✓ Address an adult’s comments in a nonjudgmental way, if
you’re up to it. Most insensitive remarks are made out of
ignorance, not malice, and even if they were made out of
malice, addressing them politely can take the wind of a person’s puffed sails and, with any luck at all, shame them into
better behavior in the future.
✓ When your own relatives are saying inappropriate things,
address it firmly and in a non-negotiable way. Offer to teach
them anything they’d like to know, but let them know in no
uncertain terms that this is your child and certain comments
will not be tolerated.
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Chapter 13
Daddy 911: Survival Tips
for Bumps, Lumps,
and Scary Moments
In This Chapter
▶ Surviving the illnesses and accidents
▶ Staying cool and handling emergencies
▶ Giving medicine, taking temperatures, and monitoring diapers
▶ Helping your child through teething
▶ Taking a look at reactions to vaccines, medications, and food
N
othing in fatherhood gets your adrenaline flowing like a
“thump” from the other room, followed by a scream, or
worse, by silence. Nothing, that is, except endless vomiting, a
seizing child, or a fender bender with baby in the car.
Fatherhood is full of frightening moments, but most of the time,
babies survive parental ineptitude and concern. No one gets
through babyhood and early childhood without a few accidents,
sicknesses, and spills and thrills along the way. If your child never
has a bruise or bump, you’re probably protecting him too much,
and a child who never gets sick never develops a good immune
system. So take heart when dealing with heart-stopping situations:
They’re an inevitable part of parenthood. In this chapter we review
the most common sources of parental anxiety, tell you what to
do when they occur, and reassure you that, 99 times out of 100,
baby — and you — will be just fine.
Handling Inevitable Illnesses
Most babies are now vaccinated against the most common illnesses, but plenty of illnesses can still infect your baby. And no
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matter how hard you try to protect your baby from illness-causing
germs, you can’t protect him from them all — and that’s okay.
Although hand washing, careful food handling, and cleanliness do
help reduce germs, some germs are necessary. In fact, recent studies indicate that people who keep the bacteria around them at too
much of a minimum are more likely to get sick than people who
share their abode with a few stray germs. Go figure.
You can be sure that your baby will catch something in his first
year, no matter how carefully you clean the shopping cart handles.
In the following sections we tell you the symptoms, causes, and
treatments of common illnesses so you’ll feel prepared when the
inevitable happens.
Nursing baby through common
childhood diseases
Babies have immunity to many illnesses for their first six months
because of antibodies passed on during pregnancy, but after six
months, it’s open season for germs. Following is a rundown on the
most likely candidates for first illness to infect the baby.
Common colds
The common cold is so common that it comes in more than 100 varieties, which is why having a cold this month doesn’t mean you won’t
get another one next month. And because your baby has never had
any of them, she’s likely to have at least one case of the sniffles in
the first year. In fact, the Mayo clinic says that the average baby has
eight to ten colds in the first two years of life, and each one lasts
seven to ten days, no matter how many decongestants you buy. You
may want to consider buying stock in facial tissue.
For most babies, colds aren’t serious, although they are messy.
Typical symptoms of a cold include:
✓ Runny nose, which may start with clear, thin secretions that
turn thicker and yellow or green
✓ Sneezing
✓ Coughing
✓ Decreased appetite (young babies may find it hard to nurse or
drink from a bottle because of nasal stuffiness)
✓ Low-grade fever up to 100 degrees
✓ Irritability
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Babies under the age of 3 months should not be given decongestants at all, and infants younger than 6 months should be given them
only if congestion interferes with breathing or sleeping. Infant acetaminophen or ibuprofen are fine to help the baby feel better.
Although colds aren’t usually serious, babies younger than 3
months old who develop cold symptoms need to visit a medical
practitioner. Babies that young are more likely to develop
pneumonia or other complications from a cold.
Ear infections
Between 5 and 15 percent of babies with colds develop an ear
infection, which just prolongs the misery. Contrary to popular
opinion, tugging on the ears doesn’t always indicate an ear infection, although it can. Other ear infection symptoms include:
✓ Irritability
✓ Head shaking
✓ Refusal to nurse or take a bottle
✓ Mild fever
✓ Trouble sleeping
Breast-feeding when mom is sick
Moms aren’t allowed to get sick — it’s in the code of parenthood. But if your partner does get sick while breast-feeding, you both may wonder about the wisdom of
continuing to nurse.
If she’s already sick, the baby’s already been exposed to the germs before the sickness became evident, so there’s no reason to avoid the baby. Very few illnesses
require her to stop breast-feeding. In fact, moms who develop colds and other
common illnesses develop antibodies that they pass on through the breast milk, so
nursing when sick may actually help the baby. Toxins such as E. coli, salmonella,
botulism, and other gastrointestinal bugs stay in the GI tract and don’t affect the
milk, so breast-feeding is safe.
Your partner should check with the baby’s doctor if she’s taking heavy-duty cold
medication that has a sedative effect, and she should avoid cough syrups with
alcohol contents over 20 percent. Nasal sprays for sinus congestion can dry up
her milk, so use sparingly.
When your partner’s sick, she’s likely to require higher than usual amounts of fluid
to stay hydrated — and a double dose of TLC to keep her going through nighttime
nursing sessions. Getting up yourself and giving a bottle of pumped breast milk for
a night or two so she can sleep will buy you bonus points as a helpful dad.
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The thinking on treating ear infections has changed during the
last few years; ear infections may not require antibiotic treatment,
because more than eight out of ten heal without treatment. Some
doctors treat, and others wait, depending on the severity of the
infection and the symptoms. Pain relievers help with discomfort.
Respiratory syncytial virus (RSV)
Respiratory syncytial virus (RSV) is a lower respiratory illness that
infects most children at least once before age 2. Symptoms include
lethargy, poor feeding, cough, difficulty breathing, and fever. While
most cases are mild, severe illness requiring hospitalization can
occur in small babies and premature or otherwise compromised
infants.
For less severe cases, which occur far more frequently, acetaminophen or ibuprofen help with discomfort. Like most viruses, this
one needs to run its course.
Vomiting
Small children and babies vomit more easily than adults when
they’re ill. Vomiting once at the beginning of an illness is common
and requires no special treatment, but repeated vomiting requires
medical evaluation because of the risk of dehydration.
Signs of serious dehydration require medical treatment. A sunken
fontanel, the soft spot on the top of an infant’s head, extreme
lethargy, sunken eye, or sunken skin that remains raised after you
pinch it deserve an immediate call to the baby’s doctor.
Pediatricians often recommend giving vomiting children younger
than 6 months an oral balanced-electrolyte solution such as
Pedialyte in place of formula, starting with a few teaspoons or
half an ounce every 15 minutes or so. Don’t give plain water to
any child younger than age 1 unless your pediatrician specifically
recommends it. A medication syringe often works better than a
spoon for this if your baby refuses to drink. Gradually increase the
amount you give each time if the baby isn’t vomiting it back up.
Don’t give a volume more than you normally would: for example,
if you normally give 4 ounces of formula every four hours, don’t
exceed that amount.
If no vomiting occurs after 12 hours, slowly start to reintroduce
formula, but stop if vomiting occurs again. Breast-fed babies
should continue to nurse, because breast milk is more digestible
than anything on the planet. However, if vomiting continues, call
your doctor.
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Some medical personnel recommend following the BRAT (bananas,
rice, applesauce, and toast) diet during and after a vomiting illness
for children older than 1 year, after they haven’t vomited for eight
hours or so, because these foods are easily digested. Go slowly
with foods and don’t introduce any new foods until all vomiting
and stomach upset have passed.
Babies who suddenly start vomiting after every feeding even
though they appear healthy and still have an appetite may have
pyloric stenosis, a narrowing between the stomach and small intestine. Pyloric stenosis requires surgery but has no aftereffects;
when it’s fixed, it’s fixed.
Wheezing
Wheezing often follows a cold and doesn’t always mean a baby is
going to have asthma. Children younger than age 2 who wheeze
with respiratory infections are no more likely to develop asthma
than children who don’t wheeze, according to a study published
in 2002 in the American Journal of Respiratory and Critical Care
Medicine. Children who start wheezing at an older age are more
likely to develop asthma.
Wheezing can be scary for parents, and may require prescription
bronchodilators that are breathed in as a mist, using a nebulizer,
to open the narrowed airways and make it easier for the baby to
breathe. Wheezing always requires a call to the pediatrician, especially if the baby doesn’t have a cold or cold symptoms. An object
stuck in the throat or more serious medical conditions can also
cause wheezing. Some children wheeze with every upper respiratory treatment and may need nebulizer treatments whenever they
have bad colds.
A child who is limp and exhausted, who has a bluish tinge around
the lips, or who is struggling to breathe needs immediate medical
attention.
Infectious diseases
Many infectious diseases of old (30 years ago!) have been eradicated, or nearly so, due to vaccines (see the later section “Reacting
to Medicines and Vaccines”). However, vaccines haven’t been
developed for everything, and sometimes a baby is exposed to an
infectious disease before she gets the vaccine. Chicken pox, measles, mumps, and rubella (German measles) vaccines, for example,
aren’t given until age 1, and roseola, a common infectious disease
in infants, has no vaccine.
Being viruses, most common childhood diseases have no specific treatment beyond treating the symptoms and keeping
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the child comfortable. Aspirin should never be given to treat
fever or discomfort, due to the possibility of Reye’s syndrome.
Acetaminophen or ibuprofen are fine if your child is uncomfortable; follow your pediatrician’s instructions on dosing.
Many infectious diseases are accompanied by rashes, so any time
your child has a rash and fever, call your medical practitioner for
advice. He may want to see your child, but then again, in some
cases, he may not want you bringing your infectious child into the
waiting room! If the disease is highly contagious and fairly evident
from the type of rash, such as chicken pox, he may give instructions over the phone without seeing the child. Following are some
common infectious diseases with rashes:
✓ Roseola: Roseola has few complications but often results in
frantic calls to medical personnel because the first symptom,
which lasts for several days, is a high fever. Around day four
the fever breaks and a rash appears. A telltale sign of roseola
is that even with a fever as high as 104 degrees, the child
doesn’t appear ill. Roseola has no treatment and generally
doesn’t cause a great deal of discomfort.
✓ Chicken pox: Chicken pox is unmistakable: small red spots
that form blisters that break and crust. A mild temperature
and respiratory symptoms often accompany chicken pox. In
rare cases, chicken pox can cause encephalitis, brain inflammation that can have long-term consequences. There’s no
way to shorten the duration of the disease, but cool baths and
anti-itch lotions help with discomfort.
✓ Hand, foot, and mouth disease: Although this sounds like
some ghastly disease only ranch hands would catch, hand,
foot, and mouth disease is a common virus that causes blisters on the — yes, you guessed it — hands and feet and in the
mouth. Mild fever can also occur, and the mouth sores can
make it hard for a child to eat.
✓ Measles: Also called rubeola, measles was once a common
disease. From 2000 to 2007, an average of only 63 cases
occurred each year in the United States, but in the first half
of 2008, 131 cases were reported, with most cases not vaccinated or with unknown vaccination status. Measles rarely
occurs before age 6 months, due to maternal immunity being
passed to the fetus. Children with measles usually appear
quite ill and have a rash and high fever.
✓ Rubella: Rubella, sometimes called German measles, is a mild
infection that causes a rash. While not serious for infected children, rubella poses serious risks for pregnant women, causing
a number of birth defects as well as pregnancy loss. Rubella
has become rare in the United States due to vaccination.
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✓ Mumps: Mumps causes pain and swelling in the parotid
glands, resulting in the classic “chipmunk” appearance.
Mumps, like measles and rubella, has become rare in developed countries with the mumps vaccine. Mumps can cause
painful testicular infection in males and affects sterility less
than previously believed.
Staying alert for scarier diseases
Some major-league bacteria and viruses can infect infants, but the
signs are usually pretty obvious: Your baby looks and acts sick,
refuses to eat, cries, and sleeps too little or too much. Rest assured
that if your baby is seriously ill, you’ll recognize the signs. In the
following sections we tell you what to watch for.
Meningitis
Meningitis, an inflammation of the tissues that cover the brain, can
require hospitalization. Meningitis can be bacterial or viral and is
caused by a number of organisms. Vaccination for Haemophilus
influenzae type B, also known as Hib, reduces the chance of meningitis. Symptoms include fever, irritability, poor feeding, rash, seizures,
a high-pitched cry, and stiff neck. In infants, the soft spot at the top
of the head, the fontanel, may be bulging rather than flat. Signs of
meningitis need immediate treatment to prevent complications.
Diarrhea
Although diarrhea may seem like more of a nuisance than a serious
disease, severe diarrhea can cause life-threatening dehydration
in an infant within a day or two. Diarrhea accompanied by fever,
vomiting, or refusal to drink fluids needs immediate treatment.
Diarrhea is most often caused by bacterial or viral illnesses including food poisoning.
The following symptoms indicate serious dehydration that needs a
doctor’s treatment:
✓ Extreme lethargy
✓ Sunken fontanel (the soft spot on top of baby’s head)
✓ Sunken eyes
✓ Sunken skin that remains raised after you pinch it
Loose, frequent stools aren’t always diarrhea; see the section
“Deciphering Diaper Contents” in this chapter for ways to distinguish diarrhea from normal stool.
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Protecting Baby from Common
Accidents and What to
Do When They Happen
You may not think newborns have a lot of accidents, since they’re
not all that mobile, but they do. In this section we go over the most
likely scenarios and tell you how to handle them.
Taking care of baby after a fall
Even a newborn can scoot himself enough to fall off the changing
table or bed, which is why you’re not supposed to leave a baby
unattended, without your hand on him, for even a second. Babies
usually bounce pretty well and rarely break bones in a fall, but the
parental guilt may be enough to put you in a rest home for a week.
Even worse is the “I was holding the baby on the couch and the
next thing I knew there was a thump” fall. Most common in the first
sleep-deprived weeks of parenthood, the “I dropped the baby” fall
devastates guilty parents. Avoid the guilt by not lying down on the
couch holding the baby — and don’t sit up holding her if you’re
feeling really sleepy, either.
Parents rarely drop babies when they’re walking, but a trip on the
sidewalk or over a misplaced toy can send you and baby sprawling. Whenever the baby goes to ground, watch for these signs that
a medical evaluation is in order:
✓ Prolonged crying: Every baby cries after a fall, if for no other
reason than that landing on the ground is startling. Besides,
you’re crying, so baby thinks she should be, too. However,
crying that lasts more than a few minutes may indicate an
injury that should be checked out.
✓ No crying: Obviously, if your baby is completely unresponsive after a fall, call 911 immediately. Give him a minute,
though; he may be too stunned to cry for a few seconds.
✓ Repeated vomiting: A baby who falls with a full stomach may
spit up, but repeated vomiting can indicate a head injury.
✓ Sleepiness: This is one of the trickiest judgment calls of parenthood: What do you do when the baby falls right before
bedtime? Keeping a tired baby awake is nearly impossible,
and you shouldn’t wake him up every few minutes just to
make sure he’s still responsive. Watch him for an hour and
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keep him awake if possible, but don’t stress if it’s not. If it’s
naptime or the middle of the night, let him sleep, but assess
his breathing and color for any changes every few hours
and watch to make sure he’s moving normally in his sleep.
Breathing that becomes very heavy or deep may indicate
a problem.
✓ Inability to move a body part: Babies bones are still made
of mostly cartilage, which bends easily, so she’s unlikely to
break a bone in a fall. If a mobile baby refuses to crawl or use
an extremity, have it checked out.
✓ Gaping cuts: If he falls on a metal object and comes up bleeding, see if the wound’s edges are close together or gaping.
Gaping wounds usually need stitches, glue (no, this is not a
do-it-yourself project!), or butterfly bandages. Take your baby
to a doctor or hospital.
✓ Huge bruises: Foreheads are famous for developing immense
bruises after a bump. Bruises alone aren’t concerning, unless
they’re accompanied by other signs, such as sleepiness, or
if they keep growing. Bruises that bleed excessively can be a
sign of other diseases, such as hemophilia, and need to
be evaluated.
Staying safe in the car
Car accidents are a fact of life, and you can’t always prevent other
drivers from driving badly or from running into your rear end at a
stop light. This is why a properly fitted, age-appropriate, approved
car seat is absolutely essential.
A newborn should never, never, never be held in a moving vehicle.
Not in the front seat, the back seat, or anywhere else. Numerous
studies have proven you cannot hold on to an infant in an accident; the baby will fly out of your arms and straight out the front
or side window into the street, or will be tossed around the car like
a rag doll.
Yes, this warning is meant to create a vivid picture that will scare
you into never riding with your child in your arms. Babies die this
way every year because they were taken out of the car seat to be
fed or soothed for a moment. A moment is all it takes.
Following is essential car-safety information for your baby:
✓ Put newborns and small infants in a car seat designed for
their weight. Never put a newborn in a seat designed for an
older child, or vice versa.
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✓ Never put infants and small children in the front seat, even
if they’re in an approved car seat. The front seat is much
more dangerous for your child if you’re in an accident. Getting
them in and out of the car is easier in the front seat, but put
them in the back. Please.
✓ Use rear-facing car seats for infants up to at least 12 months
and 20 pounds at a minimum. Riding facing backwards is
safer in the event of a crash, and pediatricians now recommend keeping children rear facing to the weight limits of the
seat they’re in. Children do not mind riding backwards, even
up to age 2 or longer, and you can place a mirror so you can
see them.
✓ Don’t use a car seat beyond its expiration date. Yes, car
seats have expiration dates, usually on a sticker on the side of
the seat. The plastic can degrade over time, making the seat
unstable in a crash.
✓ Don’t reuse a car seat that has been in an accident. The car
seat may have been weakened or damaged in the accident and
may not perform as expected if you have another accident.
It’s worth the extra money to get a new one
✓ Don’t borrow a car seat unless you know the expiration
date and know it’s never been in an accident. Don’t take
chances on a car seat that may be damaged in any way, even
if it looks fine.
✓ Read the instructions so you install the seat correctly. A
huge percentage of car seats are found to be incorrectly
installed when checked at car seat clinics.
✓ Don’t carry dangerous loose items in the car, like shovels.
They become missiles in an accident.
✓ Always wear your own seatbelt! It sets a good example and
helps you maintain control of the car in an accident, not to
mention keeps you from flying around the car, possibly landing on the baby.
If you are in an accident, check the baby carefully for bruises
and cuts, especially if the car seat is dented or banged up at all.
Remove the car seat from the car with the baby in it if you can so
you can check for signs of injury without causing more injury to
the neck or back.
Be assured that if your child is in a safe car seat, the chances of his
getting injured in an accident are low. If you don’t think you can
afford a car seat, talk to your medical provider or health department; some organizations offer help with money for car seats.
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Managing Medical Crises at Home
Staying calm while talking about what to do in an accident is much
easier than staying calm if your child actually gets hurt. In the next
section we give you hints on how to stay calm and effective if your
child needs help.
Don’t panic! Don’t panic!
Panic is inevitable when your child is injured, but try not to show
it, because even babies can sense your alarm and respond to it
with a few alarms of their own. Try to remember the following
guidelines when your child crashes into the coffee table or experiences some other medical crisis:
✓ At first glance, it always looks like more blood than it actually
is. Because blood is red, you notice it immediately. The injury
probably isn’t as bad as it first looks.
✓ Head and face wounds can bleed copiously because of the
large number of blood vessels there. Clean up the area, and
you may find just a tiny cut or scrape.
✓ Spurting blood can indicate a cut artery. Hold firm pressure
over the wound with something clean. This injury requires
medical attention, because arteries, unlike veins, do not stop
spurting on their own quickly enough to prevent significant
blood loss. Call 911.
✓ Any injury to the eye should be seen by an ophthalmologist.
If your child has something stuck in his eye, don’t pull it out;
you may make things worse. Call 911.
✓ If you suspect a neck injury, don’t move your child. Call 911
for help.
Calling the doctor
In an emergency, thinking clearly is very difficult. Sometimes you
may even have trouble remembering your doctor’s name, much
less his phone number. To save yourself from fumbling through
the phone book when you want to call your doctor, post the following information on your refrigerator in bold print so it’s visible
not only to you, but to the baby sitter, relative, friends, or anyone
else who may be watching the baby:
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✓ Your baby’s doctor’s name and phone number: Even you
probably won’t remember this information in an emergency.
✓ Your baby’s full name and date of birth: Yes, we’re sure
you’ll remember your baby’s name. But today, with hyphenated last names and moms who keep their maiden names,
don’t be so sure your sitter knows your baby’s last name! And
it’s a pretty safe bet she doesn’t know his date of birth, unless
she’s closely related to you.
✓ Your address: Believe it or not, people tend to go blank on
this kind of information in an emergency. You may not forget
where you live, but your mother-in-law may.
✓ Your phone number: Ditto the above. Everyone’s on speed dial
now; your mother may not even know your phone number!
Taking the precaution of writing down important information may
seem a little silly until you’re actually in an emergency and can’t
seem to remember your own name, much less the baby’s birth date.
When you get the doctor or emergency personnel on the phone,
speak clearly and slowly enough so she can understand you the
first time and not waste time asking you to repeat yourself.
If you have the presence of mind to do so, jot down a few notes
about exactly what happened, because, believe it or not, the actual
details get very jumbled in a crisis, which is why eyewitness stories never jibe.
Open Wide, Baby! Administering
Medicine
Getting a baby to take medicine isn’t as easy as it seems. Even
small babies seem to have an uncanny sense that you’ve spiked
their evening bottle with medicine, and if your partner is breastfeeding, spiking the boob with baby Motrin just isn’t going to work.
When drawing up a dose of medication, remember that a kitchen
teaspoon is not always a teaspoon; it can range from half a teaspoon to two or more. One U.S. teaspoon equals 5 milliliters or
cubic centimeters, usually abbreviated to cc. Milliliters, known as
ml, and cc are the same thing. So if the dose for your child’s age
is half a teaspoon, it’s 2.5 ml or cc. To measure these miniscule
amounts, you need a specially marked syringe, which pharmacies
often provide with medication. If yours doesn’t, beg for one.
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Since a wrestling match will end up with far more medication on
your shirt and on the floor than in the baby, try the following tips
when you really need your baby to take medicine:
✓ Mix the medicine with a small amount of a sweet-tasting
food like baby applesauce. Unfortunately, even small
amounts of medications often change the flavor of the food,
so don’t put a tiny bit of medicine into a large amount of food
hoping to dilute the taste enough so that baby will eat it.
Chances are, he won’t eat all the food, and you won’t know
how much medicine he actually got. Mix the medication into
just a few bits of food he likes, and you may have a fighting
chance of getting it into the baby.
✓ If you mix medication into formula, don’t spike the whole
bottle, because this will be the first time in your baby’s
entire life that he doesn’t chug down an entire 6 ounces of
formula. Mix it into 1 ounce, so he finishes it before he realizes there’s something rotten in Denmark.
✓ Use a syringe to squirt the medicine into the baby’s mouth.
Insert the syringe gently into the corner of her mouth; don’t
try to force her mouth wide open, unless you want to wear
cherry-flavored Tylenol for the rest of the day. Push the
syringe plunger down slowly but steadily, gently holding her
lips closed, and hope for the best.
✓ Some medications can be given in rectal suppositories. This
may not sound like a really great solution, but inserting a
suppository into the rectum is easier sometimes than getting
medicine into a recalcitrant mouth. Just don’t put a suppository into the child’s mouth.
✓ If your child is not an infant, firmly tell him he has to take
his medicine. You may not believe this now, but kids often
know when you really mean business, and they comply. It’s a
miracle when it happens.
Taking a Baby’s Temperature
Taking a baby’s temperature is much easier now than it was a few
years ago. You no longer have to stick a rigid glass thermometer
into a flailing child’s behind and hold it there for three minutes —
in fact, there are very good reasons not to! You can measure temperatures even in tiny babies much easier today.
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Choosing a thermometer
When standing in the big-box baby store looking for items to add
to your baby registry, the sheer number of thermometer types may
stagger you. Talking to friends who have babies may not clarify the
thermometer choices, because everyone seems to have a favorite
method, and hardly anyone agrees with anyone else. Following is a
list of different types of thermometers and their pros and cons:
✓ Digital rectal thermometers: These are the gold standard
for temperature taking, especially for infants younger than 3
months. Rectal thermometers measure internal temperature,
the most accurate way to determine a child’s temperature,
and they have a flexible tip that gives if your child squirms.
They’re accurate and easy to use on some babies, although
others hate them.
✓ Digital oral thermometers: These aren’t practical or accurate
until your child is 3 or 4 years old, because they can’t
hold them properly under their tongue and may bite and
break them.
✓ Axillary thermometer: You can use a digital rectal or oral
thermometer under the arm as an axillary thermometer, but
this method gives the least accurate reading and normally registers as much as 2 degrees lower than a rectal temperature.
✓ Tympanic thermometers: These thermometers, shown in
Figure 13-1a, are used in the ear canal and aren’t appropriate
for use in children younger than age 3 months because their
ear canals are too small to properly insert the cone-shaped
tip. They also may not be accurate for temperatures higher
than 102.
✓ Forehead thermometers: These register temperature as you
roll the tip across the forehead, but they’re not very precise.
✓ Pacifier thermometers: If your baby will suck a pacifier for
three minutes, a pacifier with a built-in oral thermometer (see
Figure 13-1b) may be the way to go.
a
b
Figure 13-1: A tympanic ear thermometer (a) and pacifier thermometer (b).
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Taking a rectal temperature
Taking a rectal temperature is much easier if the baby is lying face
down. Inserting the thermometer while the baby is on his back is
possible, but you’ll have much more difficult keeping him from
flailing around and possibly hurting himself. To take a rectal temperature, follow these steps and also check out Figure 13-2:
1. Put a little Vaseline or other lubricant on the thermometer to make it less uncomfortable to insert.
2. Place the baby over your lap, with his head slightly down
over your thigh.
This brings his rear end up slightly, making the anus, the
opening to the rectum, easier to find.
3. Locate the anal opening visually before you start prodding around with the thermometer tip.
4. Hold the thermometer the entire time that it’s in the
baby’s bottom, to avoid injury.
Taking baby’s temperature with
a rectal thermometer
Tip of thermometer
Rectum
Anus
Figure 13-2: Taking a baby’s rectal temperature.
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If you still have an old mercury thermometer lying around
the house, get rid of it. Don’t just throw it in the trash. The
Environmental Protection Agency recommends taking it to a hazardous waste dump, and throwing them in the trash is actually
illegal in some states.
Recognizing fevers
So when is a fever a fever? It can be hard to know, especially when
you’re juggling half a dozen methods of temperature taking in
an attempt to get an accurate reading. The following guidelines
explain what your medical practitioner means when he talks about
a fever:
✓ In an infant up to age 3 months, a rectal temperature of 100.4
(or oral pacifier temperature of 99.5) or higher needs immediate evaluation. Small babies don’t normally run fevers, so even
these seemingly low temperatures need attention.
✓ Between ages 3 months and 3 years, a rectal fever of 102
or higher should be reported to your medical practitioner.
Although fever is important, the way your child is behaving
is equally important. A child who is still eating, drinking, and
playing happily with a high fever is less concerning than a
lethargic child with a lower fever.
✓ An axillary temperature of 99 or higher may be a fever.
Confirm the exact reading rectally, if at all possible.
✓ Ear temperatures are roughly equivalent to rectal temperatures. If you’re sure the tip is properly inserted into the ear,
call your doctor for a temperature of 100.4 for infants and 102
for ages 3 months to 3 years.
Febrile seizures
Febrile seizures, or convulsions, are extremely scary for parents,
although the child probably won’t remember it. Most febrile seizures occur when the temperature rises suddenly, but the exact
degree of fever isn’t the determining factor of whether a child has a
febrile seizure. Around 3 to 5 percent of children experience febrile
seizures, usually between the ages of 5 months and 5 years.
Don’t try to do anything while your child is having a seizure, other
than trying to cool her off by sponging her down with cool water.
Don’t put anything into her mouth or try to restrain her; more
damage is done by these attempts to prevent damage.
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Move any hard or sharp objects away from the child during a seizure to prevent injury. Remember to move the objects away from
the child; don’t try to move the child away from the objects.
Most febrile seizures last only a few minutes, but your child may
be limp and lethargic afterward. Follow up with medical personnel
immediately after a seizure; your doctor may want you to bring
the baby in immediately or may be okay with a visit the next day
to determine the cause of the fever. Be guided by his advice. Most
parents who have just experienced an infant seizure want the reassurance of a visit.
If your child’s seizure lasts 15 minutes or more, she starts to
turn blue, or she remains unresponsive after a seizure, call 911
immediately.
Treating a fever
Fevers of 100.2 or less don’t always need treatment. Fever is the
body’s way of fighting off infection, so giving your child medication at the first sign of a fever doesn’t help her immune system to
develop. Aspirin is no longer recommended for children, due to
the possibility of developing Reye’s syndrome. Infants can be given
children’s Tylenol or ibuprofen in recommended doses.
Deciphering Diaper Contents
Some parents are inordinately interested in their offspring’s waste
products (mostly parents who were raised to be inordinately
obsessed with their own). But even parents who are pretty casual
about the contents of a diaper can sometimes be concerned about
what appears there.
Knowing what’s normal
Breast-fed babies normally have frequent stools that are often
looser than those of bottle-fed babies. Breast-fed babies’ stools are
often yellow and seedy, whereas bottle-fed babies’ stools may be
tan and firmer.
Babies frequently poop after every feeding in the first month or so,
and then slow down production. Some babies may only “produce”
every few days, which is fine as long as the stool is soft. At the
same time, they may begin to squirm, cry, grunt, and make faces
when pooping, worrying parents that they’re having a hard time
passing stools. What they’re actually doing is becoming aware of
their own bodily sensations.
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However, if stool is hard, comes out in pellets, or if the baby
doesn’t go for several days, call the pediatrician for advice.
Checking out color changes
Stool is usually yellowish or tan in babies who are exclusively
breast-fed and/or formula-fed. When unusual-colored poop makes
an appearance, parents are understandably concerned. Changes in
stool color can be perfectly normal or a sign of a problem, so keep
the following information in mind when deciding whether to call
the pediatrician:
✓ If your baby is on iron-fortified formula, she may have green
or dark stools.
✓ Green stools can indicate an imbalance of foremilk, the first
milk released, and hindmilk, which has a higher fat content.
Too much foremilk and not enough hindmilk can produce
green stools and upset the stomach. Allowing the baby to
nurse long enough on one side — ten minutes or longer — to
get a good dose of hindmilk corrects the problem.
✓ If blood is on the outside of the stool, the baby may have a
small fissure and may need a stool softener, but ask the pediatrician. Make sure the baby doesn’t have a diaper rash that’s
causing the blood.
✓ Bloody, mucousy stools need immediate attention, as they
can indicate intestinal problems.
✓ Dark, tarry stools can indicate intestinal bleeding and should
be evaluated.
Teething Symptoms and Remedies
Parents peer into their infant’s mouths looking for teeth like gold
miners sifting through the silt for nuggets of gold. When it comes
to teeth, the best thing you can do is relax. All children, with very
few exceptions, get teeth eventually, and prying your kid’s mouth
open to search for a pearly white doesn’t make them come in
any faster.
Keeping in mind that these guidelines have many exceptions,
you generally can expect teeth to appear in this order and at
these times:
✓ The first tooth appears between 4 and 7 months.
✓ The two lower middle teeth usually come in first.
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✓ The two upper middle teeth follow next.
✓ The back teeth are the last to come, usually around age 2; you
probably won’t be all that excited by new teeth by then and
may not even notice.
✓ By age 3, your child will have 20 teeth, 10 on each level.
After you get over the thrill of finding a new tooth, you may be
consumed with ways to ease the discomfort of teething. Although
alcohol, an old-fashioned remedy for easing the pain of teething,
should not be applied to baby’s gums, it may help to apply it to
yours. You can decrease teething discomfort in your baby with:
✓ Pain medication such as Tylenol or ibuprofen
✓ Teething gels applied to the gums
✓ Chilled teething rings or other items for baby to bite down on
Teething tablets are popular over-the-counter mixtures of homeopathic medications but should always be cleared by your baby’s
doctor before using them. Teething does not normally cause a
fever higher than 100 degrees, so a fever still needs investigation,
even if your baby is breaking in a full set of choppers all at once.
(Not likely, by the way — teeth tend to trickle in in groups of no
more than two at a time.) Teething can cause:
✓ Drooling
✓ Irritability
✓ Swollen gums
✓ Difficulty sleeping
✓ Difficulty nursing or taking a bottle
✓ Biting on everything within reach
Whether or not teething causes diarrhea, vomiting, and rashes
other than the rashes associated with constant drooling is debatable. Kids can get sick while teething, so don’t assume that teething is responsible for sudden signs of illness.
Reacting to Medicines and Vaccines
Giving a child any type of foreign substance can trigger allergic or
hypersensitivity reaction. New foods are actually the biggest culprit, but medications and vaccinations can also cause reactions.
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Vaccination reactions —
yours and your baby’s
Many parents have concerns about the number of vaccinations
given to infants and worry about which ones their child should
have, when to give them, and possible consequences of vaccinations. Remember that vaccines are given to prevent serious illness;
they’re not given to prevent diseases that aren’t potentially harmful for your child.
Giving two or three injections at one visit, especially when each
one contains more than one vaccine, is concerning to many parents. But the American Academy of Pediatrics stands by the current vaccination schedule recommendations (which you can find
in Chapter 10) and states that giving a number of injections at one
time does not overwhelm the immune system, as some opponents
suggest. They state that children are exposed to 2,000 to 6,000
antigens every day, as opposed to the 150 antigens introduced in
vaccines during the entire vaccination schedule.
While there’s no proof that vaccines are responsible for the
increase in autism and similar issues, vaccines can cause complications in some children. Typical symptoms include fever, pain at the
injection site, redness, or rash. Approximately 3 out of 10,000 children have febrile seizures (see the section “Recognizing fevers” for
more on febrile seizures) after getting the measles-mumps-rubella
(MMR) vaccine, the Merck Manual reports.
The debate about how to spread out vaccines and which ones are
really necessary could fill books — and undoubtedly has — and
every couple has their own feelings about vaccines. The most
important thing in deciding on how, when, and what to vaccinate is
to find a medical practitioner whose opinion you trust, discuss the
pros and cons, and follow her recommendations.
Because many children do run fevers after vaccinations, premedicating your child with Tylenol or ibuprofen before the doctor visit
can prevent a few hours of misery after the injection. Usually fever
is a short-term reaction, so if your child is still feverish and miserable the next day, let the doctor know.
Some children develop a rash after vaccinations. Again, if it lasts
more than a day, ask the doctor about it.
Medications that cause reactions
Any medication can cause allergic reactions, but some are more
likely to cause a reaction than others. Antibiotics are more likely to
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cause an adverse reaction than other medications. Typical offenders include:
✓ Penicillin or any of the same family, such as amoxicillin or
ampicillin (Penicillin causes more allergic reactions than any
other antibiotic.)
✓ Sulfa medications
✓ Cephalosporins
Drug allergies can cause a variety of skin reactions, including
✓ Rashes
✓ Hives, small welts that move around from one area to another
✓ Erythema multiforme, a moving bull’s-eye-patterned rash with
a fever, joint pains, itching, and a overall sick feeling, as well
as painful eyes and sore mouth.
Notify your child’s doctor if any reaction occurs after taking any
medication. Children’s diphenhydramine helps control itching
and swelling in most cases, but follow your pediatrician’s advice.
Severe reactions may require steroids.
Dealing with Food Allergies
Food allergies affect around 1 in 18 babies before age 3. As with
many facets of baby raising, the thinking on solid food introduction and allergies has completely changed since you were a baby,
a fact that can result in heated discussions between you and your
parents.
Introducing new foods
At one time, introducing solids early was all the rage in parenting,
as if having your 2-month-old chow down pureed carrots merited
some sort of parenting prize. Today, pediatricians recommend
waiting until a baby is 4 to 6 months old to introduce new foods to
reduce the chance of developing food allergies, especially the five
most common food allergens, which are:
✓ Cow’s milk
✓ Eggs
✓ Peanuts
✓ Soy
✓ Wheat
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An almost unbelievable 90 percent of food allergies are caused
by one of the big five, which is why the American Academy of
Pediatricians recommends introducing new foods one at a time.
Age at the time of introduction is no longer considered a factor in
whether a child develops allergies after age six months.
Recognizing allergic reactions
Parents who have allergies themselves may be looking for signs of
allergies in their children, and allergic tendencies do run in families. Some common reactions, like reddened cheeks after eating
tomatoes or citrus fruits, aren’t allergies, and lactose intolerance,
caused by a missing enzyme that breaks down milk products, also
isn’t an allergy. Irritability, skin rashes, and intestinal upsets are
the most common signs of food allergy in infants.
Colic, skin rashes, and stomach upsets such as loose stools are the
most common signs of food allergy, but severe anaphylactic reactions with difficulty breathing, hives, and loss of consciousness
can also occur, often within minutes of eating the offending food.
Get medical help immediately if this occurs.
Having previously eaten a food without a reaction is no guarantee
that an allergic reaction won’t occur; reactions don’t occur the
first time a person is exposed to a substance. Always call your
baby’s doctor if a significant reaction occurs and follow his recommendations on treatment.
Preventing allergic reactions
The best prevention for allergy development is exclusive breastfeeding for at least the first 4 to 6 months of life. Some evidence
exists for prevention of wheezing in infancy and early childhood
by exclusive breast-feeding for the first 3 months of life. There’s
no proof that use of soy formulas prevents allergies compared to
cow’s-milk-based formulas; in fact, many children with cow’s-milk
allergies are also allergic to soy.
Cook fruits and vegetables for your infant rather than serving
them raw, because cooking appears to decrease the risk of allergic
reactions. Processed foods, including junior baby foods, contain a
number of ingredients, which makes it hard to tell what an infant is
reacting to if he develops an allergic reaction.
If your child has severe allergies, your pediatrician may recommend carrying an auto-injector containing epinephrine in case of
serious allergic reaction. Fortunately, around 20 percent of children outgrow allergies to foods by the time they hit school age.
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Chapter 14
Time and Money: The High
Cost of Having a Baby
In This Chapter
▶ Balancing work and life with baby
▶ Going back to work, or deciding not to
▶ Preparing for unexpected baby expenses
▶ Spending your money wisely
E
ven before baby arrived you probably never felt like you had
enough time in the day or money in the bank for everything
you wanted to do. Money concerns aren’t a new worry in the
lives of most new parents, but with diapers, baby wipes, and the
cutest clothing you’ve ever seen in your life added to your weekly
expenses, even financially sound parents can quickly begin to feel
strapped for cash.
The only thing in shorter supply than money may be your time.
Sometimes just finding the time to shower in the morning may
feel like a major accomplishment, but keeping your life and self
in order is important for your entire family. Adjusting to a new
life in which baby comes first is a challenge, and even the most
organized parents will find that tasks that used to require minimal
effort are now a major undertaking. In this chapter we take a look
at how to juggle your new responsibilities with your old ones —
with a little fun mixed in to boot.
Creating a New Work/Life
Balance with Baby
Unfortunately, bliss doesn’t pay the bills, which means that unless
you’re embarking on a new journey as a stay-at-home dad or you
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win the lottery while on paternity leave, you will find yourself back
in the throes of work in what feels like the blink of an eye. Don’t be
surprised if for the first few days you find yourself disinterested,
distracted, or bored on the job, especially if your partner is still
at home. In the beginning your mind will be more focused on the
amazing event you’ve just experienced, and the fatigue your brain
may be feeling as a result of less sleep won’t help any.
When you’re working full time again, winding down after a hard
day won’t be as easy as it once was now that you have to help
with baby’s bath time, night feedings, diaper changes, and endless chores. Congratulations — you now have another full-time job
awaiting you when you get home.
Striking an ideal work/life balance is a major challenge for all
parents, and it takes a lot of negotiating, planning, and sacrifice.
From work to home to play, everything becomes a little more complicated to juggle. In the following sections we help you make the
best of a very full plate.
Taking time off with paternity leave
Not so very long ago, new dads were expected back on the job the
day after welcoming a baby into the world. And although we’re still a
long way from equal time off for both mother and father, strides have
been made to allow new dads time to bond with their new family.
Looking at possible time-off options
When planning your time off, consider the following options that
may or may not apply to your employment situation:
✓ Parental leave: A benefit offered by many companies, parental leave is time off that may be paid, unpaid, or a combination of both. Companies usually require that you be employed
there at least 12 months in order to qualify. Parental leave
usually applies to maternal, paternal, and adoption leave, and
policies vary by company. Speak with your human resources
manager to find out your company’s policy — or lack thereof.
✓ Family medical leave: In the United States, the Family
Medical Leave Act of 1993 requires companies that employ
more than 50 people to allow up to 12 weeks of unpaid leave
in a given year for certain medical reasons, including caring
for a new child.
✓ Vacation time: Is there a better way to use your vacation time
than to bond with your new baby? If you don’t qualify for any
of the above time-off options, or the parental leave offered by
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your company is insufficient for your needs and wants, most
companies allow you to use vacation days at the end of the
leave in order to extend your time off. If your company allows
you to use vacation days for emergencies and illnesses, be
sure to save a few days in case you don’t have enough sick
time to get you through the rest of the year.
✓ Sick time: Some companies permit you to use sick time as
part of your leave. Using sick time can be especially beneficial to hourly workers and unsalaried employees who don’t
accrue time-off benefits at a rapid pace or may not be eligible
for all of a company’s benefits, as well as for employees who
haven’t worked for their company long enough.
Just remember not to use it all — babies tend to come down
with all sorts of bugs. And with all of the extra responsibilities
and late nights involved in parenting, you may find yourself in
dire need of a sick day for your own use. Instead of using all
your sick time, inquire about the possibility of using unpaid
time off so you can save those sick days for when you really
need them. Your boss will probably be more willing to give you
unpaid time off for baby’s arrival than for your stuffy nose.
✓ Flextime: Perhaps your company really needs you back ASAP.
Talk with your boss and HR representative about temporarily
working flexible hours or even part time from home. You may
be expected to meet daily and weekly goals and complete all
of your work, but the non-nine-to-five schedule can be helpful
for numerous reasons, especially if baby or mom has health
concerns that require extra care or help.
Discussing your leave options
Before meeting with your employers to find out what arrangements
for leave you can make, speak with other recent fathers in your
company about their experiences to get a better idea of what to
expect. Their information can provide you an opportunity to craft
a plan that meets your needs and adheres to your company’s policies. Some great questions to ask other fathers are:
✓ What was the company’s paternity leave policy at the time
you became a new dad?
✓ How did your boss react to your paternity leave inquiry?
✓ How much time off did they grant you? How much of it was paid?
✓ Did you use the Family Medical Leave Act, and if so, what was
your boss’ reaction?
✓ How did you structure your paternity leave?
✓ Did you ask about using flextime before or after baby’s
arrival? If so, what was their response?
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✓ How much responsibility did you have to take for covering
your job in your absence?
✓ What is the one thing you wish you would have done differently in arranging your time off?
When meeting with your boss and/or HR representative, make sure
to take notes of everything that is said and get any policy-related
statements in writing. In addition to asking about some of the
issues in the questions above, be sure to ask about the company’s
policy regarding additional time off in case of complications with
mom or baby. Also find out if the leave will cause delays in future
raises and how you will pay your share of health insurance if
you’re taking unpaid leave.
Getting all your paperwork in order
Be sure to get the necessary time-off paperwork in order prior
to heading to the hospital. Don’t get defensive if your employer
requires a doctor’s note regarding your leave — nobody is
questioning the fact that you’re a new parent, but rules must
be followed.
Keep a folder with all of the paperwork and forms you need to
secure your time off. Following are some of the forms and papers
to have on hand:
✓ Family and Medical Leave Act application. Your HR office
can give you a copy.
✓ State-sponsored family-leave applications. You need these
forms only if your state’s regulations differ from federal.
✓ Medical time-off verification forms. Include any forms your
family doctor or pediatrician needs to fill out for your HR
department.
✓ Your company’s family-leave policy.
✓ Copies of all e-mail and letters sent to or received from your
boss or HR department regarding your time off.
✓ Vacation time request. This form needs to be approved and
signed by your boss and/or HR representative.
Managing sick time when
you’re back at work
When both parents head back to work, sick time suddenly
becomes a hot commodity. Between baby’s multitude of doctor
appointments, vaccination reactions, fevers, and diarrhea, as well
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as your sitter’s unexpected life moments, you will be required to
leave work more frequently than you used to do pre-baby.
Check with your employer several weeks prior to the beginning of
your leave to find out if flextime or work-at-home days are allowed
in case of child illness or childcare gaps. If they aren’t, stay honest.
Don’t start coughing and sneezing or fabricate some family emergency as a front to mask the real reason you have to leave.
Ask for a performance evaluation a month or so after returning
from paternity leave. If you’re be experiencing bouts of insecurity
and anxiety about how you’re perceived and performing on the
job now that you’re a dad, or feel intimated or scared about asking
for days off because of the new baby, a performance review gives
you an opportunity to address any minor issues that have arisen
before they become full-fledged annoyances for your boss. Be
sure to let your boss know that you’re aware that your schedule is
trickier than normal, and that you appreciate her/his flexibility as
you adjust to a new schedule. Letting your boss know that you’re
open to criticism and want to fix any problems will make you look
like the responsible new parent you have become.
Dealing with after-work expectations
Depending on the business you’re in, you may be used to participating in after-work activities and commitments. However, after
baby arrives, it quickly becomes clear that you no longer have the
ability to attend happy hour three nights a week. Although nobody
wants to be seen as the new dad who suddenly says no to everything and isn’t the same fun, karaoke-loving guy he used to be, a
certain amount of reality will dictate your ability to party instead
of heading straight home to take care of business and spend time
with your family.
Evaluate any after-work requests with the following guidelines to
help you determine the appropriate way to handle them:
✓ Mandatory engagements: Sometimes meetings run late, business dinners take priority, and your boss asks you to work
overtime on a very important project. Always say yes to
anything that’s important to the function and maintenance of
your job, and work with your partner to find help for her at
home if needed.
✓ Occasionally important dates: A beer isn’t always just a beer.
Sometimes going to a bar after work is an important networking opportunity or even where important business decisions
and advancement opportunities are made. Try not to commit
to quasi-important after-work requests more than a few times
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each month unless you can arrange for (and afford) childcare
during that time.
✓ Optional events: Sometimes a beer is just a beer — and
there’s nothing wrong with that, as long as you keep in mind
that you can say yes only so many times without annoying
your partner and it’s best to save those for when it really
counts. If you perceive an after-work event to be merely for
sport, pass unless you need a mental-health night out. Just
remember that every time you say yes, you’re giving your
partner the opportunity to say yes to an activity of her own
down the road. It doesn’t take too many commitments to
severely diminish that all-important family time.
Be proactive in scheduling out-of-the-office social events over
lunch. If you take the lead, you will have control over when they’re
held and won’t feel the need to justify your inability to commit to
activities after work.
If a co-worker challenges your decisions to not attend after-work
events that you perceive to be nothing more than social calls,
don’t feel the need to defend your decision. Let him or her know
that you spend eight hours a day with your co-workers and you
like to spend the rest with your family.
Reprioritizing your commitments
With so much on your plate, you may wonder when you’ll have
time to hit the gym, go to the movies, take your partner on a date,
volunteer at the local farmer’s market, or engage in any of the
myriad activities you enjoy doing. The bad news is that there isn’t
time in the day/week/month to do everything you’ve always done
on top of caring for baby. The good news is that you’ll still have
time to have fun despite your overfull schedule.
Make sure to keep yourself high on the list of priorities, because
you can’t manage work, family, and your social life if you’re run
down, sick, or depressed. If you try to do it all, you won’t do anything very well because you’ll be spread too thin. To have more
energy and stave off illness, take your vitamins, get as much sleep
as possible, eat healthy foods, and continue to make exercise a
priority.
Just as you wouldn’t skip a doctor appointment or just not show
up at work one day, you have to schedule your personal commitments as well. Whether that’s a stroll through the park with your
family, sex with your wife, or time to sit and watch a tennis match
on TV, don’t make your personal time optional, or the balance
between work and life can easily become off kilter.
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How do you make the work/life balance stay in balance? Keep a
calendar and write down everything, even blocking out time you
set aside for fun. Try as best as you can to separate your commitments by focusing on work at work, family during family time, and
you during your scheduled personal time. You can’t make the most
of your time if you’re mentally juggling too many tasks and people.
Figuring out what’s most important to you
Because thinking about everything you need and want to do at the
same time is impossible, make a list of all of your commitments
and activities. You list may include the following activities:
✓ Spending time with your family
✓ Working overtime
✓ Exercising
✓ Socializing with friends
✓ Engaging in hobbies, such as fixing cars or reading
✓ Traveling
✓ Maintaining a healthy relationship with your partner
✓ Doing community service
✓ Participating in clubs, groups, and intramural sports
When you complete your list, ask yourself, “If I could only give
my attention to one thing in life, what would that be?” After you
pick the most important thing in your life, choose the next four so
you’ve designated your top five priorities. As your child grows and
your life changes, frequently revisit this priority list. What’s important to you now may not be as important four months from now.
Figuring out what can go, at least for now
After you set your priorities, drop any unnecessary activities from
your to-do list — at least the ones that require a major time commitment. Sure, a twice-weekly euchre league may be a fun getaway,
but is it really vital to your well-being and that of your family? How
much TV can you cut out of your week and still feel entertained?
Any activity that eats up copious amounts of your time without
much reward should be removed from your regular routine.
Work with your partner, as well as baby sitters and family members, to help you adhere to your priority list. Couples often tagteam to great effect: Mom watches baby while dad attends guitar
lessons, and dad watches baby while mom goes to yoga. And
when your friends and family members offer to baby-sit, try not to
always use that time for errands. Instead, take your partner out for
a night — or an afternoon, which is sometimes easier with babies —
on the town.
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Readjusting When and If
Mom Goes Back to Work
Not every mother (or father, for that matter!) decides to go back to
work. Others have to do so for financial reasons even when their
hearts and tear ducts tell them otherwise. And some mothers and
fathers are excited to get back to the daily routine and job they
love. Everyone’s experience is different, but regardless of what
choice you and your partner make, the transition is challenging.
Making going back to
work easier on mom
Mom gets far more time off work after baby is born than you will
(usually 6 to 12 weeks), which only makes the going-back process
more difficult and emotional for her. There may be tears, running
mascara, threats of quitting her job — lots of them — and it’s your
job (on top of everything else!) to support her through this difficult
transition.
Mom’s innate protective instincts will be at an all-time high the
moment she’s forced to put her 3-month-old baby into full-time
daycare for 40-plus hours every week. When you went back to
work, you had the benefit of transitioning back when baby was at
home with the only other person you trust as much as yourself to
care for your child. Under most circumstances, mom doesn’t get
that luxury, and taking the leap back into business-as-usual won’t
be easy for her.
Try these techniques to ease your partner’s return to the
workplace:
✓ Practice in advance: Getting out the door won’t ever be the
same again, and the last thing you want is a panicked, rushed
mom on her first day back. Much like you did with the trial
run to the hospital before baby’s birth, take the time go
through a trial run for mom’s first day back to work. It will
benefit you, too, since you’ll be involved in the process of getting baby fed and clothed and delivered to the sitter and still
making it to work on time.
✓ Provide mommy alone time: It’s not so unusual for new
moms to cling to their newborns, and in some cases, going
back to work is your partner’s first separation experience
after giving birth. Start slowly by giving your partner blocks
of time to be alone on the weekends or evenings during which
she can practice doing things without baby around.
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✓ Get comfortable with childcare: Trusting someone else to
care for your fragile baby isn’t easy, but the sooner you start,
the easier it will be when that care becomes more frequent.
Start letting friends and family take short shifts watching the
baby, and even ask your future childcare provider to take on
a shift before your partner goes back to work. Also, feel free
to ask your provider for time to observe his or her interaction
with your child on-site.
✓ Stagger the return: Going from full-time mom to full-time
employee overnight can be a major shock to the system. Have
your partner talk to her employer about the possibility of a
staggered return. If the first week back she only works one
day, and then the following week she works three, and so on,
the transition will be much smoother.
✓ Plan ahead for morning: Mornings are tough for everyone,
so don’t leave anything other than showering and getting
dressed for the a.m. because you now have to factor in getting baby ready for the day and travel time to the sitter. Take
time the night before to make lunches, pick out clothing, pack
baby’s diaper bag, and so on to create a calmer mood in the
morning.
If your partner is threatening to quit her job the first day back,
don’t panic and certainly don’t try to change her mind. The best
thing to do is listen to her concerns and give her all the bonding
time she needs with baby upon returning home from work. Tell
her to take it day by day, and that at the end of every week you will
reevaluate the situation. There’s nothing wrong with her making
the decision to stay home, but making the decision when her emotions are heightened isn’t a good idea.
Following are some thoughtful ways to improve your partner’s
emotional state during the transition back to work:
✓ Digitize baby: Buy your partner a digital picture frame for her
desk at work, or even a pocket-sized device if she works in a
nonoffice environment. Add new pictures every day to give
your partner a daily visual jolt of baby, which will help her
feel more connected.
✓ Free nights for bonding: Though you won’t want to shoulder
the chore burden all by yourself forever, consider giving your
wife a get-out-of-jail-free card during her first week back. Allow
her to spend every waking moment with baby to give her the
opportunity to reconnect with her child and not feel like she’s
missing out on everything.
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✓ Shower her with gifts and praise: You don’t have to go overboard, but some flowers on her first day back may go a long
way toward making her smile, at least for a second, during
that first week back. Be sure to tell her how well she’s doing
at adjusting to the changes and that you think she’s a wonderful mother.
✓ Don’t try to fix it: Let her cry and validate her experience,
even if you don’t understand why it’s so hard. Mothers give
birth to the babies, and as deep as the bond between fathers
and kids can run, it’s still different for mom. Call her throughout the day to check in and let her know that what she’s
experiencing is normal.
Deciding to be a stayat-home parent
Making the decision to be a stay-at-home parent can be the fulfillment of a lifelong dream for some parents and a total surprise
to others. If you and your partner make the decision that one of
you will stay at home to care for the baby, thus begins another
exciting, challenging chapter in your new parenthood experience.
However, it isn’t a decision that should be taken lightly. If you’ve
been used to income from both yourself and your partner, losing
half that income will make a profound difference in your lives, and
you and your partner need to carefully consider whether or not
you can make it work.
Considering whether your partner can stay home
Some women know in advance that they don’t want to go back to
work after having a baby, and some come to that decision after
baby arrives. If you can make it work financially and your partner
is refusing to budge, do your best to make arrangements for her to
stay at home that work for both of you. She may have loved her job
before and you thought the routine you’d established as a family
was working fine, but while you don’t always need to understand
why your partner feels the way she does, it is vital that you respect
her right to feel that way.
Take plenty of time to talk it over and make sure staying home
is really a feasible option. When choosing to stay at home, many
costs beyond salary must be considered. If your insurance coverage comes from your partner’s employer and she decides to stay
home, you will have to opt-in to your company’s plan, which will
reduce the size of your check. Also, most companies have an open
season at the beginning of each year during which you can enroll
for insurance. If the decision is made outside of the open-season
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period, you will either be without insurance or forced to pay for
private insurance until that time arrives.
Looking at options when you can’t afford to lose the income
Sometimes the desire to stay home won’t subside, and you and
your partner may be at odds as to what is best for your family. If
your financial situation doesn’t allow for your household income
to be reduced by tens of thousands of dollars annually, stand your
ground. Be understanding to her concerns and desires, but don’t
put your livelihoods at risk in order to make her happy. Most
importantly, don’t rule it out forever. Make a savings plan that you
both can work toward in order to achieve her goal of staying at
home. Encourage your partner to seek out work-at-home opportunities. Work with your partner to create a tangible goal that will
keep your finances in the green and eventually allow your partner
to stay home.
Sometimes both parents want to quit their jobs to stay home and
care for the child. Unless you and your partner are independently
wealthy, this won’t be an option. As unfortunate as it is, the decision will probably come down to money. If you can only afford for
one person to stay home, the logical choice is for the person with
the larger salary to continue working. It’s possible, however, that
the person who makes more money is working long hours and
traveling frequently. Sometimes the decision is better made from
a work/life balance standpoint rather than salary. In this case, lifestyle changes have to make up for the loss of salary, but it can
be done.
Some companies are adapting to the push for flexibility by allowing new parents the opportunity to spend some or all of their work
hours at home. This arrangement can ease your partner’s pain if
she really wants to stay at home with baby but you can’t afford
to lose her income. However, working at home doesn’t eliminate
the need for childcare; you still need someone in the home to help
while your partner gets work done, unless your partner is willing
to work nights and weekends while you take over childcare duties.
Even then, having baby sitters at the ready is a must for busy
times, meetings, and phone conferences.
If you and your partner can both work from home, you may be able
to stagger your work hours so that you take turns caring for the
baby. These kinds of alternate work arrangements can vary widely;
your company may have guidelines in place for such arrangements, or you may have to renegotiate your own plan. Ask your
boss or human resources manager about this option if you’re
interested.
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Helping mom adjust if she
doesn’t go back to work
The adjustment to being a stay-at-home mom can be just as challenging as heading back to work, only in different ways. As wonderful as it is to have the opportunity to raise your own child during
the day, it can be an isolating experience. Some women will find
themselves a bit stir-crazy from all of the indoor time and begin to
crave adult interaction.
Here are some ways to help your partner transition to staying
at home:
✓ Repeat after us: Raising a child is a job. Sure, staying at
home may seem at times like a dream gig — access to the TV
all day, no more commuting — but resist the thought that
she’s got it made. As you know full well by now, taking care
of a baby is exhausting. Babies require full-time attention and
are the most demanding bosses on earth.
✓ Remember that her office is your home. If your partner suddenly has higher standards for the cleanliness and tidiness of
your home, help her keep it that way. She’s now in the house
all day, every day, and as strange as it may sound, you need
to treat your home as her office, too.
✓ Encourage hobbies. Mental boredom is inevitable, no matter
how much you love your child. Stacking blocks, reading
books, and taking long walks can be fun, but urge your partner to take up a hobby that’s just for her that works her mind
and gives her something to focus on other than baby.
✓ Give her personal time. When you get home from work,
you’ll both need some time to decompress from a long day.
Make sure to give her as much time off from baby duty as she
needs. Plan relaxing surprises for her, such as a massage,
every once in a while to make sure her emotional needs are
being met. Work together to create an evening schedule that
allows both parents ample baby-free time. Alternate being
responsible for bath time, reading, the bedtime routine, and
so on, to give both of you free time to do relaxing things. Just
because you’re away from baby all day doesn’t mean that you
should be the sole caregiver once you get home.
✓ Ask her about her day. Just because she’s not in meetings
and dealing with bosses doesn’t mean she won’t need to talk
about the challenges and events of the day. Be sure to ask
how she’s doing — it’s easy to do, but easy to forget.
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✓ Don’t think of her as your maid/errand girl. Just because
she’s home all day doesn’t mean picking up your dry cleaning,
making dinner, grocery shopping, and vacuuming are all her
responsibilities. She has more time to do things around the
house, but don’t give her a list of things to do for you. Being a
stay-at-home mom doesn’t mean you’re her boss. Thank her
profusely for everything she does do, which benefits the both
of you every day.
Some days you hate your job, and the same rings true for the stayat-home parent. Imagine how you’d feel if you never got a day off
from your job. A stay-at-home parent works every day, nights and
weekends, too, so if your partner reaches the boiling point, don’t
hesitate to offer her a day off. Either take a vacation day to stay
home with your child or encourage her to find alternate childcare
for the day.
You may be surprised how much stress will be removed from your
life when your partner transitions to full-time childcare and can
take care of some of the chores and tasks that eat up your precious
weekend, but don’t have unrealistic expectations. Taking care of
a baby is a full-time job as it is. To help both of you adjust to her
stay-at-home schedule, sit down together and work out what her
new role will look like so that you expect the same things. Create a
“job description” that will benefit the entire family and help avoid
frustration down the road, and be open to modifying it if she discovers that, say, doing all the laundry and cooking in addition to
her childcare duties is exhausting her.
Becoming a stay-at-home dad
By no means is the stay-at-home dad a norm in our society. As of
2008 there were roughly 140,000 stay-at-home dads in the United
States, a number that has grown slowly every year in the past
decade. If you decide to stay at home, remember that the rules
outlined for the stay-at-home mom are no different than the rules
for you.
Following are some special considerations for the stay-at-home dad:
✓ Fight for your right to “daddy.” If you’ve never experienced
sexism in your lifetime, get ready for an onslaught. As a stayat-home dad, at every turn you will be confronted by people
who are surprised at your choice, concerned that you don’t
know what you’re doing, and judgmental of your decision to
“throw away” your career. Strangers, especially women, will
fawn over you and even say that it’s so nice of you to “babysit” for mom. Be confident in your decision and let the world
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know that you’re excited about your new career and that men
are capable of more than changing a diaper. Taking care of a
baby is a lot of hard work, but it’s not rocket science — you
can do it!
✓ Make friends with other parents. Be it moms at the park or
daddy playgroups, reach out to other stay-at-home parents
in your neighborhood even before the baby comes. You will
need friends to lean on for advice and last-minute baby-sitting,
and the more you help out your new-parent friends and neighbors, the more options for help you’ll have when you need it.
✓ Utilize your unique skills. Babies are mesmerized by everything, so use your stay-at-home time as an opportunity to play
guitar, further your baking skills, or even start an out-of-thehome business. Having a daytime activity will provide you a
much-needed creative outlet, and down the road, your kid will
learn to appreciate (and mimic) your skills.
✓ Turn off the TV. It’s tempting to keep ESPN on in the background all day, but too much TV isn’t good for babies and
children. Limit your TV time to two hours or less a day while
baby is awake. Naptime is all yours.
Exploring the Expected (And
Unexpected) Costs of Baby
One of the first things you’ll hear from other parents is how
expensive it is to have and raise a child in today’s high-cost world.
According to the U.S. Department of Agriculture, you can expect
raising your child to the age of 18 to cost between $125,000 and
$250,000, and possibly more.
Some costs of having a child are fixed and can’t be avoided. Babies
need food, clothes, diapers, wipes, and a safe, warm place to
sleep. Babies don’t need an entire closet jam-packed with enough
designer-label clothing to make Suri Cruise weep with envy. You
and your partner need to control the urge to shower your baby
with every possible toy or accessory.
The following sections help guide you in spending your money
wisely on only the things baby truly must have.
Deciding what baby really needs
Experts estimate that baby’s first year of life, including daycare,
diapers, clothing, and medical expenses just to name a few, will
cost you about $11,000 — and far more if you live in a city where
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childcare costs alone can exceed $11,000 annually. You’ll find
quickly that the choices you make with your cash have to count.
Some costs arrive early: The average hospital delivery costs
between $7,000 and $11,000, and even with a great insurance plan
you will still be getting hit with a portion of the bill.
Contact your insurance company in advance of baby’s birth to
verify what is covered and up to what cost. This information gives
you a rough idea of how much of the medical bills will be your
responsibility and may even help you make some decisions based
on what you want versus what is covered.
After you bring baby home, his needs are rather modest, but the
costs will add up very quickly if you don’t stick to the basics.
Before you run out and buy the baby bouncy chair, swing, play
mat, and so on, spend some time getting to know what your baby
likes so you won’t be stuck with a lot of unused toys that cost you
a lot of dough.
Most towns have a vibrant baby resale shop or, if not, a hopping
garage sale culture. One thing you’ll learn quickly is that the life
span of baby goods long outlasts the amount of time your child will
actually use it, and there is nothing wrong with buying used items
instead of new. Just make sure that what you buy is clean, in good
condition, and meets current safety standards. Buying secondhand
is a great way to get inexpensive clothing, toys, and strollers, especially since your baby will grow out of all of them before you know it.
Network with the other parents you know, especially those with
older babies or toddlers born in the same season as your baby.
Many parents will happily pass along or sell you the things they no
longer use, which frees up space in their home and cuts down on
the cost for you.
Whenever possible, before you buy anything, give your child the
chance to try it out. Pull down the floor sample or take it out of the
box to make sure your child is engaged with what you’re about to
buy. You may think all bouncy chairs are the same, but your baby
inevitably will like one more than another. To make sure you get
your money’s worth, buy what your baby shows interest in.
Bracing yourself for the costs
of must-have baby supplies
Babies don’t need a lot of stuff, but what they do need tends to
be a bit on the expensive side. If your partner isn’t breastfeeding,
you’ll have to spend a great deal of money on formula, which is
quite expensive. Parents opting to use only organic, chemical-free
goods for their baby will find the costs increase as well.
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Every choice you make will change the weekly amount you spend,
but here is a basic look at what to expect:
✓ Diapers and wipes: If you develop an allegiance to a national
brand of disposable diapers, you’re going to spend $12 to
$15 every week. Many big-box stores offer their own brands,
which can cut the cost in half. Baby wipes present the same
conundrum, with the name-brand options costing $10 to $15
for a month’s supply.
For both diapers and wipes, the cost-per-unit goes down when
you buy a larger-sized box. You’re going to be using wipes
for the foreseeable future, but baby will outgrow diapers, so
make sure not to buy a box that may go to waste. Also, buy
only what you have room to store — it’s worth a little extra to
not have a house overfilled with diapers and wipes.
Upfront costs are higher for cloth diapers than disposable, but you will save money in the long run. Expect to pay
about $200 for the diapers, sized for up to age 6 months, and
another $200 for diapers sized up to age 2. Cloth diapers
increase your energy and water use as well as the amount
of baby-safe laundry detergent you must buy. Total cost for
babies’ first two years in cloth diapers will be about $500.
Bonus: you can use the same cloth diapers for any subsequent children you have, which makes the cost extremely low.
Cloth diaper services are also available, which provide fresh,
clean diapers in exchange for your dirty ones. It cuts out the
hassle of cleaning but does increase the cost.
✓ Feeding supplies: Whether your partner breast-feeds or uses
formula, you’ll have costs to meet.
• Breast-feeding supplies: Breast milk may be free, but
you still need supplies, especially if mom is going back
to work. Aside from a decent breast pump (a one-time
cost of $150 to $400), you need freezer storage bags ($8
to $12 for a two-week supply), as well as nursing pads
for a while ($8 to $12 for a two- or three-week supply).
• Formula: Expect to spend between $150 and $200 per
month on formula, depending on the brand and formula
you choose to purchase. Specialty formulas, including
those for sensitive systems and organic brands, cost
even more. Also, if you use bottles with liners, expect to
spend another $15 to $20 per month.
✓ Insurance and medical expenses: Adding baby to your insurance plan increases the monthly amount withdrawn from your
paycheck. The change in policy must be completed within 30
days of baby’s birth and generally increases the amount by
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$50 to $100 per month, depending on the quality and cost of
your insurance plan. Account for one doctor visit per month
in the first six months to be on the safe side, with the only
cost being the amount of your copay.
✓ Clothing and laundry: Baby-safe laundry detergent costs
more than the stuff you buy for your own clothes, and you
will have to use it for the first 18 to 24 months of baby’s life.
Expect to pay between $8 and $15 for a month’s supply. And,
seeing as babies grow at a rapid pace, you need to allot anywhere from $50 to $100 per month on clothing, which includes
hats, shoes, sleepers, coats, socks, onesies, and outfits so
cute they could make a puppy bark with jealousy.
Some parents opt to use dye-free detergents, such as Tide
Free or All Free and Clear, which are intended for adult use.
Using these detergents for the whole family will simplify the
laundry process and save you money. Make sure to read the
label of any product to make sure it is nontoxic. Also, for
babies with sensitive skin, use 1⁄2 cup of vinegar in the wash
cycle in lieu of fabric softener.
You can save money on clothing by checking out consignment
shops and garage sales and asking for hand-me-downs from
friends with older children. All babies outgrow clothes before
they’re worn out, so you can find a lot of perfectly nice used
items at a fraction of the cost of new.
College may seem a long way away, but it’s never too early to start
saving for your kid’s education. However, if you don’t have a retirement fund or an emergency fund for your own future survival, start
there. You have to take care of your future first, and that responsibility sets a good example for your child. And if you can’t pay
for that college education someday, well, that’s what student loans
are for!
Comparing childcare
options and costs
Paying someone else to care for your child 40 to 50 hours each
week will become your new number-one expense. In fact, depending on where you live, it very well may cost you more than your
mortgage or rent. Taking care of a baby is big business, but it’s
also a huge responsibility, so it comes with an equally huge financial burden.
Like when shopping for cars, you have many options when choosing childcare. Depending on whether you’re looking to buy a luxury
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car (an in-home nanny) or a two-door compact (your neighbor’s
in-home daycare) or something in between, the costs will vary
depending on the services you are promised.
Regardless of which option you choose, create a contract (unless
the provider has one of his own) to make sure you’re getting what
you expect and that you won’t have unexpected costs when you
pay the bill. Go over the following questions with your daycare
provider and get the answers in writing:
✓ Are you licensed to provide childcare in this state?
✓ What training have you received in childcare and education?
What about your staff?
✓ Are you insured in case of accident?
✓ Who is providing the food?
✓ How often and on what day are you expected to pay?
✓ Do you need my permission to take my child in a car?
✓ How much notice do you need to give in order to terminate
the agreement?
✓ Do you frequently have visitors? Are they allowed to interact
with the children?
✓ Will my child always be under your care, or will your spouse/
child/friend/family member be helping?
✓ Do I have to pay when my child is sick or we are on vacation?
✓ How do you discipline children?
✓ What do you charge for days I need to drop my child off early/
pick him up late?
✓ What security provisions are in place?
✓ Are you certified in both infant and child CPR?
Outlining your expectations in writing will reduce your fears and
help prevent any unexpected surprises or litigation down the road.
If after you check out the costs of daycare you’re reconsidering
quitting your job (or having your partner quit her job) and staying
at home, be sure to carefully weigh the points outlined earlier in
“Deciding to be a stay-at-home parent.” Staying at home is expensive in its own way and isn’t a decision to be made lightly.
Private in-home daycare
A friend, neighbor, or local daycare provider who operates a facility out of the home likely will be your cheapest option, depending
on the sophistication level of the facility. Expect to pay between
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$150 and $300 per week depending on your location. Many providers who work in their own homes are also watching their own children, which can reduce the cost to you.
Be sure to visit this type of daycare on a regular weekday during
business hours to see how things function during “high-volume
times.” Some states require certifications for any daycare providing
care for a certain number of children, and you should research the
regulations in your state and make sure the provider is compliant.
Daycare center
A daycare center, also sometimes called corporate daycare, is any
facility that accommodates many children and employs multiple
staff members to care for a wide age-range of children. Depending
on the facility and the qualifications of the people it employs, this
service can cost between $200 and $500 per week. For instance, if
the daycare has child-development specialists on-staff and a play
facility that pulls all the punches, costs will be higher than at a
basic facility.
Make sure the child-to-adult ratio at the facility meets accepted
guidelines. The U.S. Department of Health and Human Services recommends a 3:1 ratio for babies age 0 to 24 months; 4:1 for 25 to 30
months; 5:1 for 31 to 35 months; 7:1 for 3-year-olds; and 8:1 for 4- to
5-year-olds.
Your own in-home nanny
Paying someone to come into your home to provide full-time
childcare for your child and your child alone is a custom and very
expensive option. For many parents, the peace of mind involved in
this setup is worth every penny, especially when you factor in the
time, gas, and stress saved by not having to take your child to the
sitter every day. Costs typically range from $400 to $800 per week,
depending on your location, expectations of the care provider, the
provider’s experience level, and the number of hours the provider
is expected to be in your home.
Managing Your Money
Regardless of your financial situation, the impact of a baby will be
felt early and often. Aside from the frightening amount of supplies,
toys, doctor visits, and clothing, the enormous cost of childcare
will leave you with a lot less cash — and financial freedom — than
you had in the past. Depending on where you live and the option
you choose, you may be paying your childcare provider the same
amount you’d pay for a car payment — every week!
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So perhaps your days of three-dollar lattes are behind you. Maybe
you’ll be buying one less album online each month. Regardless of
your vices and other financial obligations, you’ll need to get your
spending habits in tip-top shape to absorb the high cost of having
children.
Prioritizing your needs
The difference between what you want and what you need is a gulf
roughly the size of the Grand Canyon. The same can be said for
what you want for your baby and what your baby actually needs
in order to thrive. As a parent you have to get the needs of your
entire family in check to secure a financially sound future for all.
Every family’s situation and needs are different, but one rule is universal: Make a budget. Start by taking a realistic look at where your
money goes. Call your credit card company and ask for an analysis
of how you spent your money in the past year (some companies
send you this statement automatically each year), and look at
your bank statements from the same time period, If you struggle to
make cuts, consider meeting with a financial planner. Figuring out
how to spend, save, and survive is a big job, and you don’t have to
go it alone.
Factor in the monthly costs of housing, food, transportation,
investments, insurance, and any medicines you take regularly.
You also have to plan for the unexpected, and with a baby in the
equation you’ll have a lot of unexpected. Starting an emergency
fund is easier said than done, but it’s a must. When you have a kid,
absorbing an unexpected job loss, income reduction, or family
emergency can be debilitating. Try to slowly work your way up to
having six months’ expenses set aside just in case life throws you a
curveball.
As unpleasant as thinking about tragedy is, now is the time to
make sure you have sufficient life insurance coverage for you, your
partner, and your baby. Work with a reputable insurance agent to
make sure that your family will be provided for if the worst were
to happen. Also, make sure that you have short- and long-term disability coverage through your employer. If not, consider buying
your own policy. Missing even one paycheck can spell disaster
for some families, so try to be overprepared for emergencies. See
Chapter 15 for more on insurance and disability coverage.
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Determining where to cut costs
Giving up things you love isn’t easy, but it’s a must now that you
have someone to provide for. Consider cutting costs in the following areas:
✓ Food: Prepackaged and/or snack foods tend to be expensive.
Items such as chips, ice cream, candy, beer, frozen dinners, and soda are not only bad for your body, but also bad
for your budget. You may not be willing to give them up all
together, but try to cut down on the number of purchases of
these high-cost, low-nutrition foods. Also, consider making a
big casserole or stew to eat for numerous meals, which will
reduce both your time in the kitchen and your grocery bill.
✓ Utilities/bills: Take a long, hard look at your monthly
expenses. Do you need both a cellphone and a home phone?
Can you downgrade any of your plans to a lower-cost option
that still suits your needs? If you live in a cold-weather climate, can you go on a monthly payment plan to evenly spread
out the costs of heating your home throughout the year? Are
you in good standing with your credit card company? If so,
ask to reduce your interest rate. Call every insurance company you do business with and see if you can get a lower rate.
Don’t be afraid to ask all of the companies that you do regular
business with for a financial break.
✓ Entertainment: Take a look at the last six months of expenses
and try to cut or reduce the monthly cost of these nonessential items, which are the biggest expendable category for cost
savings. Cable is not a utility, and if you’re struggling to make
ends meet, consider cutting your package down to basic or
even getting rid of cable altogether, even just for a little while.
If you have both cable and a mail-based movie subscription,
do you truly need both? Baby will automatically limit the
days you can go out to dinner, catch a movie, or get tickets
to a football game, but monitor and limit these expenses, too,
especially if you have to pay for a baby sitter when you go out.
✓ Convenience purchases: Sure, buying lunch is simpler than
getting up early to make it in the morning. Same goes for
coffee. If you find yourself a constant consumer of takeout
food, taxis, dry cleaning, bottled water, and other nonessential costs that simply make your life easier, cut back. Even one
less purchase per month can make a major impact on your
bank account.
Turn to Chapter 15 to find out more about budgeting and cutting
costs.
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Chapter 15
Planning for Your New
Family’s Future
In This Chapter
▶ Organizing your finances and putting safety nets in place
▶ Saving for your child’s education
▶ Buying life insurance for worst-case scenarios
▶ Choosing the right health insurance
▶ Creating a will and designating a guardian for your child
D
uring this time of immense joy, you probably resist worrying about the ifs, ands, or buts that could bring all of that
happiness to a screeching halt. You may also think it seems a bit
premature to begin squirreling away cash for her education when
your baby hasn’t even mastered the art of sitting up. But, as the
time-honored, cliché goes, they grow up so fast.
Planning for the future, whether for planned events or unexpected ones, is the least enjoyable part of being a parent because
it reminds you just how fleeting life can be. And nobody wants
to think about what would happen if they died, especially with a
newborn just beginning to enhance life. However, now is the time
to make sure your child will be taken care of, regardless of the circumstances.
Securing a Financially
Sound Future
New parents are saddled with an enormous uptick in caretaking
responsibilities. In fact, your role as caretaker now involves getting
your financial life in order so that you can properly care for your
child today, tomorrow, and even after you and your spouse die.
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Part IV: A Dad’s Guide to Worrying
It’s not the cheeriest item on the new-parent to-do list, but it’s one
of the top priorities.
In this section we share some financial tips that will help to ensure
a bright (and green!) future for your entire family.
Prioritize your expenses
Singling out purchases that you can — and should — live without
can be a real buzzkill. Giving up the little things in life can be a
difficult adjustment, especially for new parents who are already
sacrificing sleep and freedom. For most new first-time parents, the
financial strain of having a child means looking at where you can
cut down on your own expenses. If you fall into this category, this
section helps you make some tough choices.
Your fixed costs are food, housing, electricity, heat, and transportation. The rest is a mix of choices made by you and your spouse
about how to live your lives. There are no hard-and-fast rules about
what to axe from your life, but depending on your particular needs
and your income, the following areas are good places to cut back:
✓ Entertainment: This category includes movie tickets, concerts, cable, magazine subscriptions, music, books, DVDs,
hobbies, sporting events, and so on. With baby occupying
most of your free time, time constraints will help you cut way
back on sporting events, movies, and concerts. And instead
of spending money on some of the other items, get a free
membership to your local library; most have extensive DVD
and CD collections as well as books and magazines. Borrow
movies from your friends, too, or host a movie night and
share in the rental and food expenses.
✓ Food: Whether you eat out often, always dine in, or regularly
grab coffee, you can make a change in your food spending.
Look at your past expenses and find places to save. Even
choosing to eat out one less time each month or spending $10
less per week at the grocery store will save you big over the
long haul.
To replace the fun of eating out, host a dinner party or start
a rotating dinner club with a group of friends. Assign each
attendant a different course so you can drink and dine in style
at a fraction of the cost.
✓ Luxury: New clothing, spa visits, hair care, skin-care products, and new jewelry are a few items that can be downgraded, reduced, or perhaps axed altogether.
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✓ Interest rates: If you have high interest rates, you’re essentially spending money on nothing — clearly a spending habit
you won’t mind changing! Refinancing your home can save
you a bundle in the long run, and if you have good credit, try
to negotiate down your interest rate with your credit card
company. It’s not always easy or possible, but it’s always
worth a call to find out if — and how — you can save.
Create a budget (and stick to it)
After you put your expenses under the microscope and find places
to cut back, make a plan and stick to it. Knowing what you plan to
spend each month allows you to explore savings options, such as
setting up a college account for your baby. Saving money can be
a fun game. The more you save, the more thrilling it becomes to
push yourself further and watch your personal worth rise.
If you find yourselves struggling to spend only what you have designated for each item in your monthly budget, use cash. If you take
$100 to the grocery store, you have exactly that much to spend.
Calculating what you can buy takes more time, but before long
you’ll be able to eyeball what you can and can’t afford.
To make a budget, start by breaking down your finances into the
following categories, placing a monthly spending allotment next to
each:
✓ Mortgage/rent
✓ Home/rental insurance
✓ Electricity
✓ Gas
✓ Cable
✓ Water, sewage, trash
✓ Phone
✓ Internet
✓ Home maintenance
✓ Car payment, insurance, and gas
✓ Childcare
✓ Groceries
✓ Entertainment
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Parenting on the cheap
People tell you that babies are expensive, and, for the most part, they’re right. All of
the things that babies need to survive add up quickly, especially over time, which
is why buying only what you need is of the utmost importance.
Baby stuff is cuter and more expensive than ever before, and more and more parents are buying high-end goods. If you don’t have the money for the $1,000 stroller
that all of the other parents in your neighborhood seem to have, don’t buy it. Your
baby doesn’t need — and won’t remember having — an expensive crib, stroller, or
bassinet, and he certainly doesn’t need nicer clothes than you wear.
Create a monthly budget for your baby expenses. Buy the essentials first and use
any leftover money to buy secondary items, such as new toys. Babies don’t need
a lot to play with; in fact, your tot will probably like the packaging the toy came in
better than the toy itself.
Resale shops aren’t just for hipsters and low-income families. Buying lightly used
goods will save you a fortune, and, considering that babies grow in and out of
clothes, toys, and furniture very quickly, you’re likely to find exactly what you want
at a fraction of the cost. You can also utilize online sites such as Craigslist, eBay,
and Freecycle to get what you need for cheap or even free!
Many excellent software programs, books, and Web sites can help
you make and maintain a monthly budget. QuickBooks is one of
the most popular computer programs for managing your personal
finances and even paying your taxes, and www.mint.com offers
a popular (and free!) online service. For the Dummy-phile, check
out Personal Finance For Dummies, 6th Edition, or Managing Your
Money All-in-One For Dummies (both published by Wiley) for everything you need to know to get your finances in order.
Pay down your debt
Not all debt is equally bad. Some debt, such as student loans and
real estate mortgages, tends to have low interest rates and build
future value. Bad debt is anything with a high interest rate; mainly
credit cards, and especially credit cards used to purchase unnecessary or disposable goods and subsequently not paid off every
month.
Pay off your high-interest debt first, which is most likely your credit
card bills, and do so as aggressively as your finances allow. Don’t
use your cards until all of your debt is paid down and after that,
only use your card for emergencies and essential expenses, such as
groceries. Using it for limited, essential items (that you’ve budgeted
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for) will ensure that you can pay off the balance every month.
Pay for nonessential items with cash, or you’ll end up paying even
more for them if you don’t pay off your balance each month.
After your credit cards are paid off, start paying off your debt with
the next highest interest rate, likely a car loan. Also, paying one
additional mortgage payment every year can take years off of the
length of your loan. Remember, this isn’t about getting rid of debt
altogether. Everyone has debt, and it helps build your credit score.
The goal is to get rid of unnecessary and high-interest debt.
Create an emergency fund
An emergency fund can be a lifesaver for a number of reasons.
Job loss happens when you least expect it. Family members get
sick and require your time and attention. Houses and cars break
down all too often. Whatever life throws at you, it’s going to cost
you some dough. The rule of thumb changes all the time, but most
experts advise saving enough money to cover anywhere from 6 to
12 months of expenses.
If you managed to read that and not faint, take heart — most
people don’t have that much money tucked away, and a lot of folks
never will. However, you have to start somewhere, and the less
you spend, the more you can save. And now that you have a baby
to care for, being able to handle the unexpected expenses is more
important than ever.
Make a plan that works for you and your family. If it’s easier to
start a savings account and slowly move over money each month
after bills are paid, go for it. For some, having a set amount or percentage of salary automatically moved into an account each month
is easiest. To begin saving, try putting 5 percent of your paycheck
into a separate savings account. If after a few months you find you
still have extra money in your primary checking account, start
saving more.
Buy disability insurance
Most companies provide employees the option to buy short- and
long-term disability coverage, which generally pay 60 percent of
your salary in the event that you are injured and unable to work.
If you haven’t signed up for that coverage, do so immediately.
You are far more likely to get injured than die, and the loss of a
salary can sink your family into financial ruin in no time. Shortand long-term disability can provide a source of income for
around two to five years if you’re unable to work.
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If you’re self-employed or your company doesn’t offer coverage,
contact a local life-insurance representative or financial advisor to
help determine the right amount of coverage for you. It’s essential
to have a policy that can cover your family’s expenses if you’re out
of commission.
Contribute to a retirement account
Taking care of yourself first means ensuring that your kids won’t
have to in the future. It is vital that new parents begin saving for
their own retirement. As your kids grow, so will your financial
needs, which means you need to start saving when you’re young in
order to have enough to live the way you want to when you retire.
If your work has a 401(k) or a similar program, make sure you
contribute the maximum amount allowed each year, especially if
your company matches that amount. Consider opening a Roth IRA
account, which allows you to contribute a certain amount of your
earnings to the account each year while making tax-free withdrawals when necessary.
For all of the information you need to establish your retirement
security, check out Retirement For Dummies (Wiley).
Work with a financial advisor
If numbers make your head spin or if you’re not sure you that you
have the right kind or enough of the savings, insurance, and retirement accounts you need for your lifestyle, you may benefit from
working with a financial advisor. Consultations are free, and the
advisors work on commission from sales (of life insurance, investments, and so on), so it won’t cost you anything except your time.
If your advisor is unnecessarily pressuring you into buying her
company’s wares, beware. Her main role is to help you prosper
financially, and if you are not interested in or in the position to
buy something she’s pushing, seek counsel from someone else.
Yes, she has a job to do, but don’t get suckered into something
you don’t want. Always take a day or two to think about a financial
advisor’s advice before committing to anything and, when possible, seek a second opinion.
Mind your credit score
If the only scores you keep track of involve the doings of professional athletes, you’re probably long overdue for a check of your
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credit scores. Your credit scores change all the time, so periodically check to make sure you’re on track and your credit history
has no mistakes. Your credit score affects the interest rates of
every line of credit you have, and a mistake may be costing you on
your mortgage, car payment, credit cards, and student loans.
Credit scores range from 350 to 850. A very low credit score is
any number below 600. An average credit score is between about
650 and 700. An excellent credit score is anything above 700. Your
credit score is reported by three different agencies that provide
three different scores. Checking all three is important so that you
can clear up any mistakes. You can request your free credit report
once a year from each of the following:
✓ Equifax: www.equifax.com
✓ Experian: www.experian.com
✓ TransUnion: www.transunion.com
Saving Money for Your
Child’s Education
Every parent wants his child to get the best college education
money can buy. Not all parents, however, can afford that education, nor do they want their children to accrue mass amounts of
student loan debt.
If you have the luxury of being able to save some money for your
child’s education, you have a number of options. Following are
a few common savings options (check out 529 & Other College
Savings Plans For Dummies [Wiley] for more specifics):
✓ Parents can invest money in a Coverdell Education Savings
Account (CESA), which allows you to save $2,000 a year taxfree. However, CESA funds are considered student assets and
can reduce the amount of student loans available to your child.
✓ Every state offers at least one 529 plan, a state-sponsored
college savings plan that allows you to choose the aggressiveness and amount of money you want to invest. It grows taxfree and it only requires you to fill out an easy form, usually
available on your state’s Web site. After you file the paperwork, you begin depositing money according to the plan you
chose. The investments are even managed by a professional.
Plus, you can begin saving before your child is born.
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✓ You can save in a personal investment account — that is, a
savings, stock, bond, or mutual fund account. These accounts
give you more control to add or remove money, and you earn
capital gains, interest, or dividends. You pay taxes on the
income each year you earn it, but these accounts give you
more freedom to use the savings when and how you see fit.
Depending on what level of access you want your child to
have to the money, set it up to as a trust that can be accessed
with conditions, or simply pay the tuition bills yourself.
If you don’t want a college fund to go to a child if he decides not to
attend college, or you don’t want him to coast through high school
knowing he doesn’t need scholarships, set up a personal investment account in your own name. If your child doesn’t go to college,
you’ll be able to dispense the money at your discretion or keep it
for yourselves. If he does go to college, you can reward your child
for his hard work when the time arrives.
For parents looking to save for college, make sure first that you
have an emergency fund in place and your own future is secure
with retirement savings. Don’t prioritize your kids’ education
above these other crucial savings. After all, you don’t want your
money tied up in a college savings account if your house burns
down, and although there’s no such thing as a retirement loan,
kids for generations have been taking out student loans to pay for
college.
Getting the Lowdown
on Life Insurance
Purchasing life insurance policies in the event that you or your
child dies couldn’t be more outside the spirit of happiness that
comes along with welcoming of a newborn. However, tragedy can
strike in many ways and at any time, and although it’s not pleasant
to think about, life insurance is a must.
Making sure you and your partner
have adequate life insurance
Ensuring your child is well cared for in the event of an emergency
means confronting your own mortality as well. Buying life insurance
for both you and your partner provides a security policy that will
allow your family to continue living the life you’re all accustomed
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to without financial ruin in the event one or both of you were to die.
Now that you’re a parent, it’s your responsibility to make sure that
bills can be paid and food can be put on the table — even in the
event of your death.
Policy needs vary based on your financial circumstances, but the
amount you buy should be enough to cover not just funeral costs,
but a few years of your current income and expenses, as well as
funds to pay off any bad debt you currently have. This safety net
will keep your family financially sound while they deal with their
grief.
Considering a policy for your baby
Buying life insurance for your baby is a controversial and unsavory
topic. Many financial experts say it’s a waste of money because a
life insurance policy is necessary only when the death of the individual will cause financial stress on a family. For many lower- and
middle-income families, however, a policy that would cover the
cost of the funeral is well worth the monthly payment.
Whole-life coverage versus term
Not all life insurance policies are the same. Some policies are
“rentals,” covering a child through a certain age and then offering
no more benefit. If you elect to go the “buying” route for a policy,
it will start your child on the right track to financial security for
retirement. You can choose between two basic types of policies
that determine the price, coverage level, and longevity of the
policy:
✓ Whole-life coverage: As the name implies, a whole-life policy
stays with your child for his or her entire life. This permanent
insurance has a fixed premium that never increases as your
child ages and offers the policy owner a guaranteed cash
value against which the owner can borrow money in case of
emergency.
The coverage is generally between $25,000 to $150,000. Buying
whole-life coverage for your baby usually doesn’t require
a medical checkup. One of the more popular plans is available through Gerber, but most life insurance providers offer
competitive plans, too. It is important to speak with a professional before purchasing. You will not be able to cash out the
whole-life policy at any time for full value, and depending on
your financial situation, saving money in an interest-yielding
account may be a better idea. That way, you can always
access the money you have invested.
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✓ Term coverage: Term insurance is sometimes referred to as
a “rental policy” because the named person on the policy will
never own it like one does with whole-life coverage. Think of
it as magazine subscription with huge financial benefits: As
long as you have a subscription, you’re covered. But when the
subscription runs out — the policy expires — you stop getting
coverage.
The money you invest is simply going toward “what if” protection. The cost is generally a fraction of the price of whole-life
coverage, which is why it’s such an attractive option for some
parents. Plans generally come in 10- to 30-year terms, with
coverage ranging from $25,000 to $150,000. However, premiums are not fixed and do increase as your baby ages.
How much coverage is enough?
Determining how much coverage you should buy depends on your
budget. Buy only what you can afford. The more payout benefit
you purchase, the more you pay each month. If you’re purchasing
term insurance, you don’t need to buy a policy that will exceed
the costs of a funeral and, perhaps, any wage losses due to unpaid
leave during your grieving period.
Buy only what you can afford to pay every month. Talk with a
financial planner to determine if a whole-life policy is actually the
best investment for your child or if another form of savings would
yield bigger rewards for him down the road — and still provide
you a safety net in case of death.
Health Insurance Options
for Newborns
Navigating the health insurance mélange has always been a bit of
a headache. HMO, PPO, what does it all mean? For the most part,
your insurance won’t be any different after you have a baby. The
only thing that definitely changes is the cost. For those parents
without insurance — or those who can’t afford it — the process is
a bit more complex.
Adding baby to an existing
work-paid plan
Don’t worry if baby doesn’t arrive during your company’s insurance open season. Whenever a major life event occurs, such as the
birth of a baby, you’re allowed to change your insurance coverage.
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Check with your HR department to get the proper paperwork for
adding baby.
You won’t actually add baby until after he is born. Your insurance
company will need his name, sex, and birth date in order to issue a
policy. However, baby’s medical expenses will be covered according to your current plan’s postnatal coverage. Policies are retroactive back to birth, but won’t continue to cover baby’s expenses
forever. Most plans require you to add baby within the first month
of life or your child will not be covered under your plan.
The most important thing to consider when adding a baby to your
insurance is the cost of plans. If you purchased your company’s
top-notch insurance plan, the cost may skyrocket out of your price
range with the addition of a child. Don’t just add baby to your
existing plan without first looking at the price of all of the family
plans your company offers. A different plan may save you hundreds of dollars every month.
Look for the plan that offers the highest level of coverage that you
can afford. Also be sure to choose a plan with a reasonable copayment, because your child will be going to the doctor frequently.
Be sure to call your insurance company to add your child to your
plan as soon as possible. Some companies give you as little as 30
days to make the change following the birth of a baby, and because
you’ll be going to the doctor multiple times in those early weeks,
you want to get the changes made ASAP so you won’t be on the
hook for some huge expenses. When you add a child to a plan, the
insurance company usually has a time limit for submitting proof
of birth, such as a copy of the birth certificate, to make it official.
Check with your insurance company for the deadlines and paperwork specific to your plan.
Buying coverage just for baby
Statistics show that more than 46 million Americans live without
health insurance. That number includes 9 million children. If you
are living without health insurance and are about to have a baby,
you’re facing the high costs of labor and delivery, but the money
hemorrhage won’t stop after baby arrives. Your child must have
wellness checks and vaccination appointments frequently, which
means you’ll be shelling out a large portion of your hard-earned
cash to your child’s pediatrician.
Consider buying a health insurance policy for your child. Even if
you can’t afford to buy them for you and your partner and have to
pay for labor and delivery out of pocket, coverage for your baby
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is essential. Policies generally start around $100 per month, and,
ultimately, you’ll spend much less than if you pay 100 percent of
the bills yourself.
Obtaining free and low-cost
care for uninsured kids
If you do not have a work-sponsored health insurance program and
can’t afford to buy a policy for your child, but earn too much to
qualify for Medicaid, explore the free or low-cost coverage options
provided by both the federal and state governments. Your child
may qualify for coverage if you meet certain low-income standards.
Visit insurekidsnow.gov to see if your family qualifies for federal coverage and to find a provider in your state.
If you don’t meet the low-income guidelines, many state-sponsored
programs offer coverage. For the contact in your state, visit the
National Association of Insurance Commissioner’s Web site: www.
naic.org/state_web_map.htm.
Taking Care of Legal Matters
Arranging legal matters is an important step in ensuring your child’s
well-being in the case of your early death. As unpleasant as the topic
may be, you need to sit down with your partner as soon as possible
and make decisions about what will happen to your assets and who
will take care of your child if you die, and what should happen if
either of you is incapacitated. Then make those decisions legally
binding by creating a formal will and establishing power of attorney.
These tasks aren’t fun, but the peace of mind you’ll have is worth it.
Although most of the forms you need to make these decisions and
declarations are available for free online, the only way to make
sure that your forms are valid and written in accordance to state
and federal laws is to have them reviewed by a lawyer. It’s an
added expense, but it’s worth the money to know your family will
be taken care of in the event you are no longer around.
Creating a will
Drawing up a will doesn’t have to be as macabre as reading a
Stephen King novel. As a soon-to-be or new parent, having a will
can bring you peace of mind by leaving no question about what
will happen to your possessions (and children!) when you die. A
will includes three provisions:
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✓ Who will inherit your bank accounts, real estate, vehicles,
and personal property when you die. Most dads have simple
wills that leave everything to their partners and, in the event
they both die, to their children.
✓ Who will be your children’s guardian in case you and your
partner are incapacitated or die. This is your chance to make
sure your child will be cared for by the person of your choice
and not put into foster care.
✓ Who will manage any property and money you leave to your
child until she reaches a designated age. Most people name
a single executor of their will who is charged with carrying
out their wishes. However, some people are more comfortable
having the person responsible for carrying out the will’s commands to be separate from the person who controls the money.
A will doesn’t trump the beneficiaries listed on life insurance policies. Make sure to contact your life insurance company to make
the desired changes to those policies, such as adding your new
child as a beneficiary.
Making your will
You don’t have to go the lawyer route to make a will. Several do-ityourself computer programs and books (such as Wills and Trusts
Kit For Dummies [Wiley]) provide simple step-by-step instructions
for arranging what happens after you die.
Filling in the blanks and hitting print doesn’t automatically offer
you the protection you need. Any will not made with a lawyer
still has to be notarized in order to be valid in the eyes of the law.
Leave a copy of your will with your executor as well as in a safedeposit box.
Make a separate will for each parent. A joint will is binding after
the death of even one person, and that makes it difficult for the
surviving parent to make changes that may better suit his changed
circumstances. Separate wills are especially important when kids
are involved, because finances change and you want your partner
to have access to funds in order to care for your kids. Name your
spouse or partner as the sole beneficiary to ensure that she has
100 percent control of your assets, and have concrete, detailed
discussions about how you want the dispersing of money and
property, as well as your funeral and burial, handled in the event
of your untimely demise.
Appointing guardians
If you have children, guardianship should be addressed when you
create a will. If you work with a lawyer, she will be able to help you
fill out all the necessary paperwork. However, if you use an online
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form or a software program, be sure that it includes the appropriate form for your state.
If you are unsure of the legal requirements, consult your state’s
courts Web site to find the necessary forms. Most forms require a
signature from both parents and the appointed guardian as well as
notarization.
A will allows you to designate temporary guardianship in the case
that your named guardian lives a few states away or can’t come for
your child immediately until the new guardian arrives. This temporary situation will keep your child out of the foster care program
and in the loving home of your choice.
Guardianship is a huge responsibility for the person you ask. When
approaching him, keep in mind that you may not get an immediate
yes. In fact, if the person you ask needs some time to think it over,
it’s a good sign that he understands the responsibility and won’t
make rash decisions he may later regret. This person will not only
be in charge of your child but will also have to cover any of the
financial gaps not covered by the money you set aside to be used
for your child’s upbringing.
If the person you ask declines, ask for more information about why
he refused. Perhaps you have information that can assuage any
fears he may have about the job. However, if the person you ask
(even after further discussion) isn’t up for the job, find someone
else. Yes, it will be disappointing, but respect that person’s honesty and forthrightness in admitting he is the wrong person for the
job. And when it comes down to it, finding the right person is most
important.
Appointing an executor
The person you appoint as executor is in charge of executing your
will, or making sure that taxes and debts are paid and your estate is
distributed according to your will. Avoid appointing someone as an
executor who is also a beneficiary of your will. You can name coexecutors if you want one person to manage your money and the other
to manage, say, your property. It can be good to utilize different
people’s skills and gives you backup if one person drops the ball.
You designate an executor using the same online or software
program you use to make a will, or when creating a will with your
lawyer. Make sure that the person you designate is willing and
able to perform the role. Most forms that designate an executor
for your will require you to provide one or two contingency executors in case the first named executor cannot perform the job. Some
states only recognize executors who live in the same state as the
deceased. Check your states rules before you designate.
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Questions to ask yourself when
choosing a legal guardian
When deciding who would make the best guardian for your child in case of your
death, consider the following questions:
✓ Does the person love my child?
✓ Is the person good with children in general?
✓ How important is it that my child’s guardian be family?
✓ Will my child be uprooted from his/her home to move in with the guardian?
✓ Does the person have the same parenting philosophies I have?
✓ Is the person going to raise the child with the same religious beliefs?
✓ Does the person have any medical conditions that would prevent him from
being a long-term, able-bodied guardian?
✓ Will your child cause too big of a personal, professional, or financial strain for
the person?
✓ Does the person have a stable home life and career?
✓ Will this person guarantee your child has access to family?
✓ Does this person value the same things I do (education, music, community, and
so on)?
When there’s no will
State laws vary, but if you don’t have a will, less than half of your
property and money will go to your spouse and the rest will be
divided among your children. If your children aren’t 18, all money
and property will be managed by a state-appointed trustee until
that time arrives, which means your partner won’t have access to
your money in order to raise your children.
In the event that both parents die without a will, the state will
designate a guardian for the children, which likely will be the most
closely related family member willing to accept the job. While
guardianship is arranged, your child will enter the state’s foster
care program.
Establishing power of attorney
Granting power of attorney to someone gives that person the
power to make decisions — both legal and medical — in the event
that you’re incapacitated. The person you name will be able to
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make important decisions about life support and control of your
bank accounts.
Knowing your options
You can designate four main types power of attorney. Not everyone appoints a person for each, and appointing the same person to
serve in multiple roles is common:
✓ Limited power of attorney: The person you designate will
only be allowed to act on your behalf for a specified amount
of time. This, most likely, will not be helpful when creating a
will that covers the care and guardianship of your children.
✓ General power of attorney: The American Bar Association
refers to this person as your agent, and she has the power to
act on your behalf in every capacity that you did prior to your
incapacitation. This person literally becomes you in the legal
sense until you are capable again of handling your own affairs.
✓ Durable power of attorney: Granting someone this power
means his authority ceases to be recognized by the law after
you pass away, except in the areas you give him control.
✓ Healthcare power of attorney: This person is empowered to
make important medical decisions but has no control over
your finances.
Appointing a power of attorney
Generally included as part of the will-making process, appointing
power of attorney takes only a simple form that usually must be
signed by you and the named power of attorney and then notarized.
Experts suggest choosing someone you trust but who isn’t a close
friend or family member. After all, even if you’ve made it clear
that you don’t want to be on life support for an extended period
of time, your mother may have difficulty pulling the plug. Select a
person who you can trust to follow through with your wishes.
The power of attorney should follow what you outline in your will,
so go over your will with that person to make sure he is comfortable following your orders. If not, find someone else, or complications may arise that will cause added stress for everyone involved.
What’s most important is finding a person you can trust who will
be informed about your wishes and make sure they’re followed.
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Part V
The Part of Tens
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In this part...
he Part of Tens provides practical tips on everything
from reading your partner’s mind to being a super
dad. We also look at the wonderful world of stay-at-home
fatherhood, should you be considering that increasingly
common route.
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Chapter 16
Ten Things She Won’t Ask
for but Will Expect
In This Chapter
▶ Showing your excitement about being a father
▶ Helping your partner with emotional and physical support
D
uring the course of your partner’s pregnancy — and many
months thereafter — she will expect myriad tasks, words of
comfort, and loving gestures from you without her having to ask
for what she wants. Sadly, you weren’t born with advanced psychic aptitude, and therefore you’ll have to infer a few musts to keep
peace around the house.
Follow these ten simple tips to make sure your partner gets everything she needs.
Keep It Complimentary
Face it — you’ll never know what it’s like to give up your body so
that someone else can grow inside of you. That said, it probably
isn’t too hard to remember the last time you got a new haircut or
lost ten pounds and then waited around for someone to tell you
how nice you looked.
Going fishing for compliments is never a fun or fruitful excursion, so
try to spare your partner from going to that length. When her hormones and ever-increasing waistline are waging a full-fledged attack
on her insecurities, remind her early and often exactly how beautiful she looks. And the best part is, you won’t have to lie. It may be
hard to imagine finding your partner gorgeous when she’s carrying
around 30 to 40 extra pounds, but pregnant women glow, and knowing that she’s having your baby can be extremely attractive.
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When she asks you how she looks or if she has gotten fat (and she
will ask you!), flatter her to no end, deny it vehemently, and thank
her for her sacrifices.
Start a Baby Book
Baby books, with their endless pages of blank space calling out for
someone to fill in the missing data, can be a daunting undertaking, especially when chronicling the journey is left solely to the
mom-to-be/new mommy. Most women won’t admit it, but during
pregnancy they’re looking for constant signs that you’re just as
committed to raising a child together as she is. Filling out a baby
book together can be the perfect way to put into words just how
ready you are for baby.
A great way to exhibit your commitment and excitement to the
baby she’s carrying is to buy the best baby book on the market
that suits your styles. If you and the mom-to-be are the long-form
journaling types, pick one that offers lots of space to write about
how you’re feeling during each trimester and your thoughts about
becoming a parent. If you fall into the less-is-more crowd, choose
a book that adheres to a mostly fill-in-the-blank format. Many
themed books are available, running the gamut from religious to
hipster chic, so choose one that represents both parents.
The baby book is a time-honored time capsule that chronicles the
pregnancy and early days of your baby’s life, and like any good time
capsule it should be something fun to put together as a couple that
captures the time and place. Someday that book will mean the world
to your child, so make sure to buy one that you’ll realistically finish.
Disguise Fitness as Fun
Exercise is of the utmost importance to both baby and mommy,
but try telling your partner to get up off of the sofa and go for walk
without having something hard thrown at your head. Getting a
loved one involved in fitness is never easy to do without hurt feelings, so instead of telling her that she needs to exercise, help her
exercise without making it personal.
Turn fitness into a social activity: Plan walks with friends and
family members, or schedule errands together that require you to
get up and move around. Plan a “treasure hunt” date to local baby
stores to scope out the latest gear, or even a hunt with a romantic
bent. Even a trip to the mall can be good exercise so long as you
steer clear of the food court.
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If your partner has a particular interest in a certain type of exercise,
give her a free pass as a gift. Be it yoga, spinning, or running, most
fitness clubs or personal trainers offer prenatal versions of their
classes. Many classes welcome partners, too, and by making it a
couples’ affair it won’t send the message that you think she’s fat.
Curb Your Advice
Never has there been a better time to let go of your desire to be
right at all costs than now, even if you really do know best. Let
your partner complain about her job, her body, the mere fact that
she’s pregnant, or whatever, and don’t take her complaints, gripes,
or outbursts personally. Now, that doesn’t give her free reign to be
a raving lunatic just because she’s pregnant, but don’t try to solve
her problems with your sage wisdom unless she specifically asks
for it. Listen to her and validate what she’s feeling, but don’t tell
her how to fix it.
Also, avoid telling her what to eat, when to exercise, that she
needs to sleep more, and so on. Instead, lead by example. If you
think she should eat more fruits and vegetables, buy more fruits
and vegetables. Or better yet, make meals packed with pregnancy
power foods. If you think she needs to rest more, ask her to sit
down and do a crossword with you. Telling her what to do will not
go over well, so don’t waste your breath.
Attend Prenatal Appointments
Repeat after me: Prenatal appointments aren’t just for the mothers. Yes, she is carrying the baby, but that baby didn’t get there on
its own. You’re in this together, and if she has to make time in her
schedule to attend countless appointments, ultrasounds, and tests,
so should you. It will demonstrate to her that you’re a team in the
raising of this baby, and you’ll be much more excited and invested
in the process by being just as involved as your partner.
Childbirth is an empowering experience for both mother and
father, and the more appointments you attend, the more knowledgeable you’ll be about the entire process. Being an involved
father starts long before the baby arrives. In fact, if you plan on
being a 50-50 partner in the raising of your child, it’s won’t just
happen overnight. You wouldn’t play a baseball game without
practice, and you shouldn’t enter into parenthood without practicing the type of dad you want to be.
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If your work schedule doesn’t allow for you to attend every
appointment, go to as many as possible. Follow up with her immediately after each appointment you miss and ask her for a recap.
Ask lots of questions; your partner will be grateful to know you
care. Many important decisions and discussions occur during prenatal visits, and even if you can’t be present, make sure you remain
part of the discussion.
Plan a Getaway
After baby arrives it won’t be easy to abandon ship and head for
the hills when you need a relaxing reprieve from life. And as the
long wait for baby drags on and you both begin to realize how
much is going to change in your personal lives after he comes, you
may find yourselves looking for one last couples retreat.
Take the lead and plan a trip. Keep in mind that the later she is in
her pregnancy, the closer to home you’ll want to be in case she
goes into labor. Also, her body (and especially her bladder) won’t
be up for sitting in a plane or in the car for long periods of time.
Wherever you go, make the trip romantic, personal, and quiet.
Make it a time to focus on your relationship — just the two of
you — because it won’t be the focus of your lives for some time to
come.
If you plan something during the third trimester, keep in mind that
many airlines have restrictions about how close to her due date
your partner can travel. Check with your airline before booking
tickets, because many require a doctor’s note for travel.
Register for a Prenatal
Parenting Class
The days of prenatal parenting classes that focus solely on breathing and birthing techniques are over. Today’s classes offer opportunities for parents-to-be to explore birthing options, relationships,
the type of parents they want to be, CPR, and infant care. Find a
class that’s welcoming to both mother and father and register,
either through your local hospital or birthing center, or by searching online.
Many communities have fatherhood experts that offer a new brand
of class just for fathers-to-be that explores the myths of fatherhood, what it means to be a father, and male bonding exercises. It
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allows men to confront their fears of fatherhood and any issues
they have in regards to their own fathers. Putting in the work
before baby comes only increases the odds that you’ll be the best
dad you can be.
Do Your Homework and
Spread the Word
Clearly, if you’re reading this book, then you’ve already done the
majority of your homework. Congratulations — you’re going to be
a great dad. Now don’t be afraid to toot your own horn. Not every
dad-to-be is as equipped and awesome as you, and you deserve
credit. Make a point of telling your partner how much you’ve found
out in these pages. Ask her, “Did you know . . . ?” and “Have you
thought about . . . ?” Who knows, you just may teach her something she didn’t know. And is there any better feeling in the world
than feeling accomplished?
At the very least, you’ll set a good example of your own involvement in the future of your relationship. In the past, fathers weren’t
expected to know anything about pregnancy, and it wasn’t all that
long ago that the majority of men stayed out of the delivery room
and returned to work the day after delivery. The more you know,
the more your partner will trust you to care for the baby. Trust is
earned, and by getting educated about babies, you’re earning that
trust that many fathers of the past forfeited.
Learn Prenatal Massage
Pregnancy puts stress on all the body’s joints and ligaments as
muscles (and even bones!) shift and expand, causing mothers-tobe to walk, stand, sit, and sleep in ways that often are at odds with
their normal movements and positions. Add an additional 30 to 40
pounds hanging off her front, and it’s no wonder that your average
pregnant woman gets achy, tired, and downright sore.
Learning the basics of massage can help you help her alleviate
many of those aches and pains — and will make you her hero
after a long day of carrying around your child. Many hospitals and
birthing centers offer prenatal massage classes. Doulas often are
trained in light massage, and if you hire one, be sure to learn techniques from her. If you can’t find someone to learn from, buy or
rent a DVD about prenatal massage, or even buy a book that offers
ample illustrations so you’ll know what to do.
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While you’re at it, consider learning the ins and outs of infant massage. Research shows that infant massage can help babies digest
foods and sleep better, and helps prevent and treat colic. Check
with your hospital or birthing center for more information.
Clean High and Low
The closer you get to delivery time, the more likely your partner is
to desire a clean, tidy home. Limited by a rather large belly and an
unflinching tiredness, your partner won’t always feel like cleaning
or be able to do it. Areas that fall below your partner’s knee level
and things out of her reach are particularly difficult for her during
the latter stages of pregnancy.
But her limitations don’t mean that you have to clean everything
all by yourself. In fact, the exercise involved in cleaning can be
beneficial for her. However, assign yourself the job of picking up
everything from the floor on a frequent basis. Clutter-free floors
and walkways will prevent her from falling and will keep her from
pulling a muscle in her back trying to reach down.
While you’re down there, you have a good view of what baby will
see when he’s crawling around your home. You can always begin
baby-proofing your abode; the extra time you give yourself will let
you get used to the new limitations and restrictions.
Though it’s a myth that a pregnant woman will strangle the baby if
she raises her arms above her head, it may be a rather uncomfortable experience. Take the lead on cleaning the blinds, putting away
dishes in the cupboards, changing light bulbs, and dusting.
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Chapter 17
Ten Ways to Be a Super
Dad from Day One
In This Chapter
▶ Learning how to bond with your baby
▶ Reading, teaching, and playing for fun and for learning
▶ Mastering the art of baby-and-daddy time
W
hen it comes to parenting, what you don’t know won’t kill
you, but it sure can keep you from making the most of the
greatest, most joyous time in your life. After nearly a year of waiting for baby to arrive — or longer in some cases — don’t forget
that now is the time to have fun. Yes, bringing a teeny, tiny baby
into your home evokes a great deal of worrying, but babies aren’t
as fragile as you may think. If you want to be a super dad, try to
follow these tips on how to be a confident, loving, and cool father
from day one.
Overcome Fragility Fears
Animals can sense fear, and when they know you’re afraid, they
exploit your weakness at every turn. The same goes for babies,
albeit without the evil ulterior motive. If you’re afraid of holding
your baby, you probably aren’t providing a solid, sturdy base for
him, and he’ll fuss and cry until somebody who is confident takes
over the reins. The same holds true for diapering, feeding, and
cuddling.
Repeat after us: I am not going to break my baby. He’s designed to
survive a first-time parent like yourself, and as long as you’re not
trying to juggle knives while burping him, chances are that you’re
both going to be just fine. Babies are small, but so long as you take
reasonable safety precautions like never leaving him unattended,
always securing him in a car seat, and listening closely to the baby
monitor during sleep time, you aren’t going to hurt him.
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The most important tip is to take deep, steady breaths and hold
your baby in the same casual-yet-protective way you grasp your
iPad. Don’t fumble with the baby as you lift him up onto your shoulder. Use firm, fluid movements. The more you act like you know
what you’re doing, the more the baby will like what you’re doing.
Trust Your Instincts
Because babies are designed to be cared for by people who don’t
have any education in the raising of children, you have no choice
but to follow your instincts. Babies have been around since, well,
the dawn of man, and all the parents since that time have raised
them their own way. It wasn’t all that long ago that parents and
parents-to-be told stories of their experiences around the campfire
instead of relying on modern inventions such as parenting classes
and Lamaze. We are born with the instinct to care for our children,
and so long as you don’t have mental or emotional impediments
(such as postpartum depression), you’ll just know what to do.
Just remember that nobody can know your baby better than you
do, and despite the seeming lack of faith others may show toward
your judgment (how warmly you dress him, how often you feed
him, how you hold him, and so on), the only truly vital task of the
parent is to ensure safety. Trust yourself, educate yourself, and
you will not steer that little one wrong.
Bond Skin-to-Skin, Eye-to-Eye
Mothers get an amazing opportunity to spend skin-to-skin time
with baby while breast-feeding. This sensory bond is so important
that mere moments after the baby is born, the doctor or midwife
will often place her on mom’s bare chest. Studies show that skinto-skin contact increases the bond that both mother and child feel,
as well as the soothing feeling babies experience from listening
to mom’s heartbeat. Also, a newborn’s eyesight is just powerful
enough to see the distance from the breast to mom’s eyes.
You won’t be breast-feeding, so you have far fewer opportunities to
experience the same closeness. Yes, baby’s head will rest on your
hands and arms, and you can get close and make eye contact, but
that doesn’t provide the same bonded feeling. When baby is only
in her diaper, take off your shirt and place her on your chest. It
may sound a little cheesy, but it’s an important bonding experience
for every parent, not just mothers, and it gives you and baby the
opportunity to meet skin-to-skin and eye-to-eye for the first time.
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Manage Frustrations
Admit it — your son or daughter is the most beautiful sight you’ve
ever seen. As you stare into the wondering eyes of your newborn
you may think it impossible to ever feel anything but absolute
adoration for this child. However, babies often are exhausting and
unmanageable beings who wake you up in the middle of the night,
cry endlessly without giving you a clue as to what’s wrong, and
require 100 percent of your attention.
Feeling frustrated is okay, because parenting, especially when
you’re brand new at it, can and will be a frustrating experience
from time to time. In preparation for when that cute bundle of joy
becomes an obstinate teen, here are some simple ways to manage
your frustration:
✓ Control the controllable. It’s easier said than done, but some
things you can change and some things you can’t. Babies do
not sleep through the night. Babies spit up. Babies cry for no
good reason. Don’t waste your time trying to solve problems
that aren’t really problems. If your baby has a clean diaper, a
full belly, and a gas-free stomach, yet still continues to fuss,
just put on some noise-canceling headphones and let him cry.
Unless something is wrong, don’t worry about him.
✓ Monitor baby’s routine. Keep a log of when baby sleeps,
wakes, eats, poops, and pees. Understanding his routine takes
a lot of the guesswork out of determining what he needs at
any given time. If you discover that your little one starts getting fussy after being awake for 90 minutes, you’ll know how
to structure your day to make sure that everyone — including
you — gets what they need to function.
✓ Blow off steam. Pick your poison — running, video games,
bowling, reading — whatever it is that puts your mind at ease,
and make sure you take time to continue engaging in it. If you
find yourself getting frustrated, spend five minutes doing your
favorite activity. Even a walk around the block can be a great
way to hit your reset button.
✓ Lean on your support system. When the going gets rough and
you feel like you need to get out of Dodge, do it! Call a sitter, a
friend, or a family member to fill in for you, even if it’s just for
an hour so you can run to the grocery store in peace. Don’t
discount the benefits of time alone or with your partner to
make your frustrations dissipate.
✓ Sleep in shifts. Sleep is a hot commodity among the parenting
set, and before long you’ll be coveting every available minute
of shut-eye. However, if baby is constantly waking during the
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Part V: The Part of Tens
night, both you and your partner will quickly lose patience in
the wee hours of the morning. Though it’s not the ideal situation, try taking turns sleeping for blocks of time in the night
and throughout the day while on leave (or the weekends).
You need to get as much sleep as possible, even if those
hours aren’t consecutive. The key to keeping your frustrations
in check just may be two hours of peaceful slumber.
Embrace Your Goofy Side
By now you’ve probably made a list of all of the things you’re not
going to do as a parent. For many too-cool-for-school dads, that list
includes such things as baby talk, funny faces, and the pure lunacy
of dress up, tea parties, and dancing that requires dads to check
traditional masculinity at the door in favor of fun.
Do all the things on that list. Don’t feel stupid and don’t feel
restrained by how you think men should behave. Babies (and kids,
for that matter) love expressive faces, singing, and goofy voices,
and while acting silly may leave you in a shroud of self-consciousness,
you’ll get over it the instant your baby laughs or smiles at your
goofball antics. Allow yourself to have fun, and you’ll reap the
rewards for life.
Get Out
Going to work doesn’t qualify as getting out of the house. Yes, it
may be a nice change of pace to spend time doing things that don’t
require baby wipes and a Pee-Pee Teepee, but the kind of getting
out you need is of the date variety.
You may be surprised to know that getting out of the house is
easier when your baby is younger. Make sure to schedule a date
within the first month of baby’s arrival. Start slowly — new moms
(and many dads) find it hard to leave baby for the first time. Ask
a trusted friend or family member to watch baby while you grab a
quick bite to eat at your favorite restaurant.
Ground rules? Don’t talk about the baby. You may not achieve this
almost impossible goal, but shoot for the stars. You need to connect as adults again, not just as parents, and that brief time away
will remind you why you love your partner so much. And, upon
returning home, you’ll have a welcome reminder of just how much
you love that baby.
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305
Teach Baby New Tricks
You may think babies discover the world of their own volition, but
the truth is that you need to give your little one a push. In fact,
the more time you put into teaching and nurturing your baby, the
prouder you will be when she learns to roll over, clap, wave byebye, or play with a toy. Bonding happens daily with babies, and a
child’s way of thinking is practically set in stone by age 3. You can
have a huge influence on the rate at which your child develops, but
more importantly, you can have a huge influence on your child’s
entire life by getting involved in playtime and the open expression
of love.
Following are some milestones you can help baby achieve in the
first six months:
✓ Tracking objects: Slowly move a colorful object back and
forth and up and down in front of baby’s eyes. This activity
helps the brain begin to follow movement. Sound tracking can
also be done in the same way.
✓ Making sounds: Your baby makes a lot of strange sounds, and
a supremely important part of language development is hearing you repeat those sounds back to her. Babies have their
own language that you don’t understand, and the more they
hear it the more they will talk, which aids in language development down the road.
✓ Reaching and grabbing: Dangle colorful toys and baby-safe
objects in front of your child and wait for her to reach for
them. Encourage gripping by wrapping baby’s hand around
the object and letting go.
✓ Peek-a-boo: Babies will laugh as you disappear and reappear
time and again, all while beginning to understand the idea of
cause and effect. Showing baby the mirror is also a fun, mindexpanding game.
✓ Rolling over: Lay your baby on her back on a play mat or
a colorful rug to encourage her to turn over and begin to
explore. When she can support her own head, give her plenty
of tummy time on her belly, which develops the stomach
muscles and allows her to roll over.
✓ Crawling: New studies show that the way babies’ brains react
during crawling (the right brain controls the left side of the
body and vice versa) is an important milestone that can help
reduce behavioral and mental disorders in children. Help
ensure your child can crawl by putting a coveted toy just out
of reach and waiting for her to come and get it.
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Roughhouse the Safe Way
Though we don’t want to engage in gender stereotyping, fathers
are often more likely to get physical during playtime with their
kids. And although you probably won’t be wrestling with your
newborn (please, don’t wrestle your newborn!), go ahead and
swing him in your arms, hold him up high over your head, rub your
scratchy face into his belly, tickle him, and chew on his feet. Mom
may think it’s too much, but more than likely, baby will think it’s
hysterical. As long as you’re being safe, have fun.
Read Aloud . . . and Not
Just from Baby Books
Read to your baby every single day. Not only will she love the
sound of your voice, but she’ll also learn to speak from hearing the
constant repetition of speech patterns. And the more you read to
baby, the more likely it is that she will develop a strong vocabulary
and the ability to speak at a younger age.
While baby is too young to truly enjoy kid’s books, don’t be afraid
to read her passages from the novels you want to read. It’s a good
way to engage in adult activities while also helping your baby grow
smarter every single day.
Send Mom Away
Unless you’re fortunate enough to be a work-at-home dad like
coauthor Matthew, you’ll need to make sure that you block off
some one-on-one time with your baby. Finding your own way as a
parent and learning how capable you are are important steps in
feeling empowered as a new dad. Which means that mom needs to
go away for a while.
Book an appointment at the spa for your partner and spend the
afternoon doing everyday things with just you and your baby. Take
him for a walk, feed him, change him, or even go out to the coffee
shop and read the paper with him. Regardless of the activities you
do together, this time establishes one-on-one intimacy with your
child and proves to yourself and your partner that you are capable
of taking care of your child on your own.
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Index
•A•
accidents
in cars, 241–242
falls, 240–241
active labor, 155
administering medications, 244–245
admissions process at hospitals, 125
advice
curbing, 297
unsolicited, handling, 43–44, 214–215
after-work requests and expectations,
259–260
age, and miscarriages, 55–56
alcohol
after childbirth, 202
conception and, 28, 32
overconsumption of, 16
Alexander Technique classes, 78
allergies
to food, 253–254
to medications, 252–253
all-natural childbirth method, 137,
163–164
American College of Midwives, 132
amniocentesis, 73
anemia, 110
anger, controlling, 16, 193
antidepressant medications, 120
anxiety with breast-feeding, 177
aspirin, 238
assembling furniture for nursery, 82
asthma, and wheezing, 237
axillary thermometer, 246
•B•
babies. See newborns
Babinski reflex, 175
baby blues, 211, 224
baby books or calendars, 195, 296
baby carriers, 89, 189, 190
baby monitors, 84
baby registries. See registering at
stores
baby showers, coed, 90–91
baby sitters, cost of, 273
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baby-proofing living areas, 83–85
“Back to Sleep” campaign, 187
backpacks for carrying newborns, 189,
190
backs, positioning newborns on for
sleep, 187
backup, calling in, 203–204, 226–227
banking cord blood, 140
bathing newborns, 183–185
bathtub, baby-sized, 90
bed rest
mandatory, 98–100
multiple births and, 110
placenta previa and, 97–98
pregnancy-induced hypertension and,
95–96
beta strep carriers, 152
bills, itemized, asking hospitals for, 112
biological clocks, 17
birth control, 216
birth defects, 100–101, 110, 219–220.
See also chromosomal
abnormalities
birth plan
attendance at birth, 145–146
description of, 138–139
deviations from, 167
sharing, 143–144
visualizing ideal experience, 139–140
writing, 140–143
birthing options. See also cesarean
delivery; epidural
discussing with practitioner, 51–52
location for delivery, 133–136
natural methods, 137, 163–164
practitioner, 130–133
water birth, 138
BirthWorks classes, 78
bisphenol A (BPA), 178
bleeding
at delivery, 110
during labor, 152
from placenta previa, 97–98
during third trimester, 118
blighted ovum, 57
blood pressure medication, 31
blood tests in second trimester, 71–73
bonding with newborns, 302, 306
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Dad’s Guide to Pregnancy For Dummies
bottle warmer for car, 90
bottle-feeding
formula, choosing, 179–180
preparing bottles, 180–181
supplemental, while breast-feeding,
177–178
systems for, 88–89, 179
bottles, plastic, 88, 178
bouncy chairs, 89
bowel movements, changes in, 249–250
boys, changing diapers of, 182–183
BPA (bisphenol A), 178
Bradley Method classes, 78, 137
bradycardia, 162
BRAT diet after vomiting, 237
Braxton-Hicks contractions, 118
breast-feeding
birth control and, 216
cosleeping and, 186
decision about, 176, 204–205
as full-time job, 204
getting started with, 177
illness in mother and, 235
involving father in, 207–208
latch-on problems in, 177
nutritional issues with, 202
prenatal lactation classes, 135
prevention of allergic reactions and, 254
pumping, 178
reflux and, 193
resources on, 207
supplemental bottles and, 177–178
support for, 176, 206–207
vitamin D supplements and, 128
breasts of newborns, 175
breathing issues
after delivery, 158–159
of premature babies, 105
breech position, 114–115
bronchopulmonary dysplasia, 107
budget
for childcare, 273
creating, 279–280
cutting costs in, 275
debt, paying down, 280–281
for deliveries, 269
for first-year necessities, 268–269
for preterm labor and deliveries,
111–112
prioritizing needs in, 274, 278–279
resources for, 280
spending less, 16
for supplies, 269–271, 280
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bumper pads in crib, 82
burp cloths, 185
burping
by bouncing on yoga ball, 89
to prevent gas, 191
business world. See work
•C•
car seats, 86, 241–242
carriers, hands-free, 89
carrying babies around, 189, 190
car
bottle warmer for, 90
safety in, 86, 241–242
cat litter, 81
CDs for babies, 90
cervical mucus, and ovulation, 34
cesarean delivery
emotions related to, 172
IVs during, 159
multiple births and, 110
placenta previa and, 99
planned or scheduled, 168
procedures during, 171–172
procedures prior to, 170
rate of, 131
recovery from, 208–209
types of, 171
unplanned, 169–170
chairs, ergonomic bouncy, 89
changing diapers
for boys, 182–183
essentials for, 87
for girls, 183
chemical pregnancy, 56
chicken pox, 238
childbirth classes, 77–78
childbirth costs, 111–112, 122–125, 269
childcare options and costs, 271–273
chlamydia, 29, 31
chromosomal abnormalities. See also
birth defects
as male-fertility issue, 41
miscarriage and, 56, 57
circumcision, 182–183
classes
birth plans developed in, 140
childbirth, 77–78
prenatal lactation, 135
prenatal parenting, 298–299
cleaning house, 80–81, 198–201, 300
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Index
cleft lip/palate, 220
clothing for babies
cost of, 271
essential, 87
coed baby showers, 90–91
colds, common, 234–235
colic, dealing with, 191, 192
colostrum, 176
commitments, reprioritizing, 260–261
complicated grief, 230–231
complications. See medical issues
compliments, giving, 295–296
conception. See also infertility
basics of, 23–28
best time for, 33–34
common questions about, 27–28
female health issues that affect, 29–30
lifestyle choices that affect, 31–33
male health issues that affect, 30–31
sex life and, 33–36
statistics about, 27
congenital defects, 100–101, 110,
219–220
conjoined twins, 109
Consumer Reports, baby section of, 86
contractions
fetal monitoring and, 161–162
membrane ruptures and, 161
regularity of, 152
during third trimester, 118
vaginal exams during, 159
convenience purchases, 275
convulsions, 248–249
cord accidents, 110
cord prolapse, 116, 152
cord-blood banking, 140
cord, cutting, 157
cosleeping, 82, 83, 186–187
costs, cutting, 275. See also budget
couples, finding time to interact as
after birth of baby, 15, 304
in second trimester, 68
in third trimester, 22
couvade syndrome, 119
Coverdell Education Savings Account,
283
cravings in early pregnancy, 59
credit scores, 282–283
crib
assembling, 82
bumper pads for, 82
mobiles for, 90
for multiples, 83
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309
crying
dealing with, 193
deciphering meaning of, 190
cry-it-out sleep method, 213
C-section. See cesarean delivery
cutting costs, 275. See also budget
cystic fibrosis, 220
•D•
daycare centers, 273
D&C (dilatation and curettage), 57
death of fetus in utero, 101–102
debts, paying down, 280–281
decongestants, 226
dehydration, signs of, 236, 239
delivery. See also cesarean delivery;
preterm labor and delivery
attendance at, 145–146
birth plan and, 138–144
cost of, 269
helping babies after, 158–159
hemorrhage at, 110
insurance coverage for, 122–124
lightheadedness during, 157
location for, 133–136
of placenta, 157–158
practitioner, choosing for, 130–133
pushing during, 156
rapid, 153
voicing opinions about, 12
depression
postpartum, 211–212, 224–227
during pregnancy, 120, 122
risk factors for, 225–226
support role in, 226–227
symptoms of, 225
treatment for, 226
while on mandatory bed rest, 100
detergents, choosing, 199, 271
development of babies
delays in, 220–221
in first trimester, 53–55
in second trimester, 65–67
in third trimester, 113–116
ultrasounds and, 74
diabetes
ejaculatory issues and, 31
gestational, 96–97, 109
diapers
cost of, 270
interpreting contents of, 249–250
laundering, 199–200
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310
Dad’s Guide to Pregnancy For Dummies
diapers, changing
for boys, 182–183
essentials for, 87
for girls, 183
diarrhea, 239
differences in readiness for
parenthood, 19
digital thermometer, 246
dilatation and curettage (D&C), 57
disability insurance, 274, 281–282
discussing names with friends and
family, 93–94
distilled water for formula, 181
doctor shopping, 50–52
douching, 32–33
doula, 132–133
Doulas of North America, 133
Down syndrome, 220
dress during pregnancy, 70
drugs, using
impending fatherhood and, 16
SIDS and, 223
sperm quantity and quality and, 32
DVDs for babies, 90
•E•
ear infections, 235–236
early labor, 155
eating. See food; healthy eating
eclampsia, 96
ectopic pregnancy, 26, 32, 57–58
education, saving money for, 283–284
eggs
mature, production of, 24
smoking and, 31–32
embryo
in first trimester, 53–55
implantation of, 27
journey of down fallopian tubes, 26
emergencies
funds for, 274, 281, 284
handling, 243–244
emotions
about birth defects, 100–101
about cesarean delivery, 172, 208
about fragility of newborns, 301–302
about pets, 80
after childbirth, 14
anger, 16, 193
at announcements of pregnancy,
47–48
dealing with, 120–122
at delivery, 157
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in early pregnancy, 59, 63
frustration, 303–304
grief, 228–231
with infertility, 37
during labor, 154
at learning sex of baby, 75
with miscarriages, 56, 58
postpartum, 209–212, 224–227
with preterm labor and delivery, 103
at prospect of fatherhood, 9, 10–12,
49–50
in third trimester, 118–120
when babies cry, 193
when mother returns to work,
263–264
while on mandatory bed rest, 99
employment. See work
endometriosis, 29
engorgement of breasts, 206
entertainment costs, 275, 278
epidural
medications used in, 164
placement of, 165–166
side effects of, 166
types of, 137
episiotomies, 139, 158
ergonomic bouncy chairs, 89
errands, running, 201
estradiol, 24
executor of will, appointing, 290
exercise
after birth of baby, 201
conception and, 33
disguising as fun, 296–297
starting, 16
while on mandatory bed rest, 99
external fetal monitoring, 161–162
•F•
“failure to progress” and cesarean
delivery, 169
fallopian tubes
in conception, 25, 26
ectopic pregnancy and, 57–58
falls, 240–241
family
dealing with, 126, 203–204, 213–214
discussing names with, 93–94
phone tree for, 126, 146–147
resemblance of newborns to, 175
sharing information on readiness for
parenthood with, 42–43
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Index
Family Medical Leave Act, 227, 256
family planning, 17–20
fatherhood
conceptions of, 10
description of, 14
emotions at prospect of, 9, 10–11
fears of, dealing with, 11–12, 49–50,
121
lifestyle changes and, 16
myths of, 12–14
personal life changes and, 15
professional life changes and, 15–16
readiness for, 17–18
stay-at-home parenting and, 267–268
fatigue during early pregnancy, 58–59
fears
of fatherhood, 11–12, 49–50, 121
of fragility of newborns, 301–302
febrile seizures, 248–249
feeding babies
bottle-feeding, 179–181
breast-feeding, 176–178
cost of, 270
essentials for, 88–89
overview of, 176
when premature, 105–106, 107
solid foods, 128
feelings. See emotions
female health issues that influence
conception, 29–30
female infertility issues, 37, 38–39
Ferber method, 213
fetal demise, 101–102
fetal distress and cesarean delivery,
169–170
fetal monitoring, 139, 161–162
fevers
recognizing, 248–249
treating, 249
fibroids, 30, 37
financial advisor, 282
financial planning. See also budget
disability insurance, 274, 281–282
life insurance, 274, 284–286
retirement accounts, 282, 284
saving for education, 283–284
first stage of labor, 155–156
first trimester
complications in, 55–58
development of baby during, 53–55
discomforts of, 58–66
529 plans, 283
flat head, preventing, 188–190
flextime, taking advantage of, 257
26_9780470767900-bindex.indd 31126_9780470767900-bindex.indd 311
311
follicle stimulating hormone, 24
food
allergic reactions to, 253–254
to avoid during pregnancy, 69
cutting costs on, 275, 278
solid, feeding, 128
forehead thermometer, 246
foreskin of penis, 182–183
formula
choosing, 179–180
cost of, 270
“stretching,” 181
fraternal twins, 109
frequency of sex, and conception, 28,
34
front packs for carrying newborns, 189,
190
frustrations, managing, 303–304
furniture, buying and assembling, 82, 87
•G•
garage sales, 269
gas, dealing with, 191
gastrointestinal reflux disease (GERD),
192–193
genetic disorders, 220
genetic markers, 74
genitals of newborns, 174
GERD (gastrointestinal reflux disease),
192–193
gestational diabetes, 96–97, 109
getaways, planning, 298
gifts, registering for. See registering at
stores
girls, changing diapers of, 183
gonorrhea, 29, 31
goofy side, embracing, 304
grandparents, visits by, 204, 214
grasp reflex, 175
grief
after cesarean delivery, 172
complicated, 230–231
partner and, 229–230
stages of, 228–229
guardians, appointing, 289–290, 291
•H•
Haemophilus influenzae type B
vaccination, 239
hair loss after delivery, 210
hand, foot, and mouth disease, 238
10/25/10 1:07 PM10/25/10 1:07 PM
312
Dad’s Guide to Pregnancy For Dummies
hands-free baby carriers, 89
heads of newborns
flat, preventing, 188–190
shape of, 174
health care for uninsured children, 288
health insurance. See insurance
coverage
healthy eating
after childbirth, 16
in first trimester, 61
foods to avoid, 69
in second trimester, 68
heart defects, 220
heart rate, fetal, 161–162
hemorrhage at delivery, 110
holding newborns, 185–186, 301–302
home, working from, 265
home birth, 123, 135–136
hormones
after delivery, 209–212
in conception, 24
in implantation, 27
infertility and, 38
in third trimester, 119
hospital
admissions process at, 125
asking for itemized bills from, 112
delivery at, 134–135
discharge of premature babies from,
107–108
neonatal intensive care unit, 103–104
hot tubs, 33
household projects, 80–81
household tasks, 198–201, 300
human chorionic gonadotropin, 27, 53
hypertension
pregnancy-induced, 95–96, 110
preterm deliveries and, 103
HypnoBirthing classes, 78
hysterosalpingograms, 29, 38
hysteroscopies, 38
•I•
identical twins, 109
illnesses
dealing with, 222
fevers, recognizing, 248–249
handling, 233–239
medications, administering, 244–245
of mothers, and breast-feeding, 235
preventing exposure of newborns to,
214
26_9780470767900-bindex.indd 31226_9780470767900-bindex.indd 312
serious, 239
teething and, 250–251
temperature, taking, 245–248
immunizations
Haemophilus influenzae type B, 239
reactions to, 252
scheduling, 193–195
implantation of embryos, 27, 53
in vitro fertilization
abnormal sperm issues and, 41
description of, 42
multiple births and, 108, 109
incompetent cervix, 102
indigestion, soothing, 190–193
induction, 131
infants. See newborns
infections
in premature babies, 107
preterm deliveries and, 103
infectious diseases, 237–239
infertility
admitting to problem of, 37–38
deciding on treatment for, 42
female treatment for, 38–39
male treatment for, 39–41
statistics on, 36–37
insensitive remarks, handling, 232
instincts, trusting, 302
insurance coverage
checking on, 111–112, 122–124
co-payments and, 112
cost of, 270–271
for newborns, 286–288
questions to ask about, 124
for ultrasounds, 100
interest rates, 279, 280–281
internal fetal monitoring, 162–163
International Childbirth Education
Association classes, 78
interviewing
birth practitioners, 130–131
childcare providers, 272
pediatricians, 127–128
intrauterine growth retardation, 96
intrauterine insemination, 41
intravenous lines for premature babies,
106–107
intraventricular hemorrhage in
premature babies, 107
irritability during third trimester, 119
IV (intravenous infusion) during labor,
159–160
10/25/10 1:07 PM10/25/10 1:07 PM
Index
•J•
job. See work
•L•
labor. See also preterm labor and
delivery
birth plan and, 138–144
common procedures during, 159–163
coping with pain during, 163–166
determining when not to go to
hospital, 153
determining when to go to hospital,
151–152
first stage of, 155–156
insurance coverage for, 122–124
orgasm and, 77
practitioner, choosing for, 130–133
second stage of, 156–157
support role during, 154
types of, 136–138
voicing opinions about, 12
lactation. See breast-feeding
Lamaze classes, 78
lanugo, 105, 115–116
latch-on problems in breast-feeding,
177
laundering baby items, 199–200, 271
leaking fluids during third trimester,
118
leave options, 256–258
legal matters, arranging, 288–292
life insurance, 274, 284–286
lifestyle changes to consider making, 16
lifting, 81
lightheadedness
during deliveries, 157
during epidural placements, 166
listeria in food, 69
living areas, baby-proofing, 83–85
luteinizing hormone (LH), 24, 34
•M•
male health issues that influence
conception, 30–31
male infertility issues, 37, 39–41
massage, learning, 299–300
mastitis, 206
meal management, 202–203
26_9780470767900-bindex.indd 31326_9780470767900-bindex.indd 313
313
measles, 238
meconium, 138, 160
medical crises at home, managing,
243–244
medical issues. See also cesarean
deliveries
abnormal ultrasounds, 100–102
with breast-feeding, 198
conception and, 29–31
gestational diabetes, 96–97
grief over, 228–231
insensitive remarks about, handling,
232
mandatory bed rest, 98–100
with multiple births, 109–110
of newborns, 219–223
placenta previa, 97–98
pregnancy-induced hypertension,
95–96
sharing information about, 231–232
in third trimester, 118
medical practitioner. See also midwife;
pediatrician
from call groups during delivery, 167
doula, 132–133
finding, 50–52
perinatologist, 101
philosophy on cesareans of, 170
screening, 130–131
medications
administering, 244–245
antidepressants, 120
for blood pressure, 31
in epidurals, 164
during labor, 137
reactions to, 252–253
membrane ruptures, 160–161
men as caretakers for newborns, 12–13,
267–268
meningitis, 239
menstrual cycle, 25
mercury in food, 69
mercury thermometer, 248
midwife
delivery by, 51–52, 123
home delivery and, 135–136
interviewing, 132
Midwives of North America, 132
milestones
delays in reaching, 221
helping babies achieve, 305
recording, 195, 296
milia, 174
10/25/10 1:07 PM10/25/10 1:07 PM
314
Dad’s Guide to Pregnancy For Dummies
miscarriage
in first trimester, 55–57
frequency of, 48
timing of, 49
mistakes of father, repeating, 13–14
mittelschmerz, 34
mobiles for crib, 90
Mongolian spots, 174
monitoring equipment for premature
babies, 106
monitors, video, 84
Moro reflex, 175
multiple births
arranging nurseries for, 83
cesarean deliveries and, 168
health risks for babies with, 110–111
health risks for mothers with, 109–110
hospital costs and, 123–124
preterm deliveries and, 102
risk factors for, 108–109
statistics on, 108
mumps, 239
myths of fatherhood, 12–14
•N•
names, choosing
discussing with friends and family,
93–94
narrowing down long lists, 91–92
reconciling differences of opinion,
92–93
nanny, cost of, 273
natural childbirth methods, 137,
163–164
nausea in early pregnancy, 59
necrotizing enterocolitis, 107
neonatal intensive care units (NICUs),
103–104
nesting
baby-proofing, 83–85
cleaning and, 80–81, 198–201, 300
description of, 79
setting up nursery, 81–82
neural tube defects, 220
newborns. See also development of
babies
bathing, 183–185
bonding with, 302, 306
changing diapers of, 182–183
cosleeping with, 82, 83, 186–187
fears of fragility of, 301–302
feeding, 176–181
flat head, preventing, 188–190
26_9780470767900-bindex.indd 31426_9780470767900-bindex.indd 314
health problems of, 219–223
holding, 185–186, 301–302
indigestion of, soothing, 190–193
looks of, 173–175
love at first sight of, 14
men as caretakers for, 12–13, 267–268
pets and, 200
positioning for sleep, 187
preventing exposure to illnesses, 214
reflexes of, 175
sleep cycles of, 212–213
swaddling for sleep, 188, 189
Newborns’ and Mothers’ Health
Protection Act, 123
NICU (neonatal intensive care unit),
103–104
night sweats after deliveries, 210
no-cry sleep method, 213
nursery
arranging for multiple babies, 83
setting up, 81–82
size of, and registering for gifts, 85
nursery water for formula, 181
nutritional issues with breast-feeding, 202
•O•
obesity, and conception, 32
one-on-one intimacy with newborns, 306
oocytes, 24
oral sex, 76
organizing and de-cluttering home, 17
orgasm and labor, 77
overfeeding, 181
ovulation
infertility and, 37
monitoring, 34
pregnancy and, 24
•P•
pacifier thermometers, 246
pacifier at bedtime, 188
pain
after cesarean deliveries, 208
during labor, 163–166
painting house or nursery, 80–81
parenting classes, prenatal, 298–299
paternity leave, 256–258, 259
pediatrician
choosing, 126–128
discussing immunization schedule
with, 194–195
10/25/10 1:07 PM10/25/10 1:07 PM
Index
pelvic inflammatory disease (PID), 29, 32
penis, circumcision of, 182–183
performance issues when scheduling
sex, 36
perinatologist, 101
personal investment accounts, 284
personal life, changes in, 15
pets
caring for, 81, 200
feelings about, 80
introducing to newborns, 200
phone tree, 126, 146–147
PID (pelvic inflammatory disease), 29, 32
Pitocin, 137, 165
placenta previa, 97–98
placental abruption, 110, 118, 152
placenta, delivery of, 157–158
plagiocephaly, 188–190
planning for future. See also budget;
financial planning
health insurance, 286–288
legal matters, 288–292
plastic bottles and BPA, 178
playing with newborns, 306
polycystic ovary syndrome, 29–30
polyps, 37
positions for sex, and conception, 28
postpartum period
emotions during, 224–227
hormones during, 209–212
power of attorney, establishing,
291–292
practitioner. See medical practitioner;
pediatrician
preeclampsia, 118
pregnancy
first trimester of, 21
long-awaited, 20
second trimester of, 21
third trimester of, 21–22
unexpected or unplanned, 19
pregnancy-induced hypertension,
95–96, 110
pregnant dad syndrome, 119
premature babies (preemies)
common problems of, 105–106
look of, 105
preparing for setbacks with, 107
taking home, 107–108
wires and machines attached to, 106
prenatal visits
attending, 52, 297–298
to birthing centers, 125, 135
26_9780470767900-bindex.indd 31526_9780470767900-bindex.indd 315
315
preparation for mother’s return to
work, 262
preterm labor and delivery. See also
premature babies
guilt with, 103
look of preemies, 105
medical bills from, 111–112
neonatal intensive care unit, 103–104
risks of, 102–103
statistics on, 102
private in-home daycare, 272–273
psychosis, postpartum, 227
pumping to fill supplemental bottles,
178
pushing during delivery, 156
pyloric stenosis, 237
•Q•
quality time, spending
as couple, 15, 22, 68, 304
with infant, 15, 302, 306
•R•
radiographic embolization, 41
rapid delivery, 153
rashes, 238
reactions
to medications, 252–253
to news of pregnancies, 48
to vaccinations, 252
readiness for parenthood
determining, 17–18
differences in, 19
evaluating health and, 28–33
sharing with family and friends, 42–43
telling partner about, 18
reading to newborns, 306
recovery from cesarean deliveries,
208–209
rectal temperature, taking, 247–248
reflexes of newborns, 175
reflux, 192–193
registering at stores
doing homework before, 85–86
essential items, 86–89
nonessential but nice-to-have items,
89
unnecessary items, 90–91
reprioritizing commitments, 260–261
resale shops, 269, 280
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316
Dad’s Guide to Pregnancy For Dummies
respiratory infections or diseases in
premature babies, 107
respiratory syncytial virus, 236
retirement accounts, 282, 284
retrograde ejaculation, 31
Reye’s syndrome, 238
risks of tests and ultrasounds, 72
rooting reflex, 175
roseola, 238
roughhousing, 306
routines, developing, 17
rubella, 238
•S•
safety
in cars, 241–242
Consumer Reports, baby section of, 86
of hospital maternal and child health
areas, 134
of living areas, 83–85
of slings, 89
of visitors, 146
salmonella in food, 69
saving
for education, 283–284
for emergencies, 274, 281, 284
scheduling
immunizations, 193–195
sex for conception, 35–36
Sears, Robert, The Vaccine Book, 195
second stage of labor, 156–157
second trimester
development of baby during, 65–67
sex life during, 75–77
testing during, 71–75
women during, 67–71
second-hand smoke, 16
sedatives during labor, 164
seizures, febrile, 248–249
self, taking time for, 215–216, 260, 303,
304
self-image issues during third trimester,
119
semen analysis, 39–40
sex life
after childbirth, 216
conception and, 33–36
in early pregnancy, 61–62
following childbirth, 13
placenta previa and, 97
in second trimester, 75–77
26_9780470767900-bindex.indd 31626_9780470767900-bindex.indd 316
sex of baby, determining from
ultrasound, 71, 74–75
sexually transmitted diseases (STDs),
29, 31, 182
sharing information
about birth plan, 143–144
about decision to have baby, 42–43
about health problems, 231–232
about pregnancy, 48–49
about readiness for fatherhood, 18
with partner, 299
by phone tree, 126, 146–147
by social networking sites, 147
shoes for infants, 90
showers, 90–91
Siamese twins, 109
siblings, arranging nurseries for, 83
sick time
managing, 258–259
taking after birth of baby, 257
sickle cell anemia, 220
SIDS. See sudden infant death
syndrome
skin of newborns, look of, 174
skin-to-skin contact with newborns, 302
sleep
breast-feeding and, 176
cosleeping, 82, 83, 186–187
essential items for, 87
Ferber method and, 213
following childbirth, 13, 212
frustrations over, managing, 303–304
of newborns, 212–213
positioning newborns for, 187, 223
swaddling newborns for, 188, 189
slings, 89, 189, 190
smoking
after childbirth, 16
conception and, 28, 31–32
SIDS and, 223
Social Security Administration, Popular
Baby Names Web site, 93
solid foods, feeding, 128
sperm
collection of for analysis, 38
conception and, 24
diagram of, 26
infertility and, 37, 39–41
life of, in reproductive tract after
ejaculation, 35
quantity of, 26
smoking and, 31
startle reflex, 175
10/25/10 1:07 PM10/25/10 1:07 PM
Index
stay-at-home parenthood
decisions about, 264–265
fathers and, 267–268
mothers and, 266–267
STDs (sexually transmitted diseases),
29, 31, 182
step reflex, 175
steroids, using, 32
stitches after tears or episiotomies, 158
stomach sleeping, 223
stool, changes in, 249–250
stores. See registering at stores
storing pumped breast milk, 178
stork bites, 174
strollers, 85, 86, 89
sucking reflex, 175
sudden infant death syndrome (SIDS)
back sleeping and, 187
breast-feeding and, 204
myths about, 222–223
pacifiers and, 188
risk factors for, 223
side positioning and, 187
supply issues in breast-feeding, 177
support groups
for grief, 230
for multiple births, 108
for premature births, 103, 108
support role
for breast-feeding, 176, 206–207
for deviations to birth plan, 167
of doulas, 132–133
in early pregnancy, 62–63
in grief, 229–230
household tasks and, 198–201
during labor, 154
meal management and, 202–203
with nesting tasks, 80
overview of, 197–198
postpartum depression and, 226–227
in postpartum period, 209–210
for return to work, 262–264
for stay-at-home mothers, 266–267
in third trimester, 120–122
swaddling newborns for sleep, 188, 189
swearing, 16
syphilis, 29, 31
•T•
tachycardia, 162
teaching newborns, 305
26_9780470767900-bindex.indd 31726_9780470767900-bindex.indd 317
317
teething, symptoms of and remedies
for, 250–251
temperature
ovulation and, 34
rectal, taking, 247–248
teething and, 251
term life insurance, 286
testicles, descended, 115
thermometer, choosing, 246
third trimester
development of baby during, 113–116
emotional changes in women during,
118–120
physical changes in women during,
116–118
threatened abortion, 56
thyroid problems, 30
time alone, needing, 215–216, 304
time capsule, starting, 22
toiletry essentials, 87–88
tonic neck reflex, 175
touring birthing centers, 125, 135
towels for newborns, 185
toxins in workplace, 31
toxoplasmosis, 81
transition labor, 156
travel essentials, 88
travel systems, 86
trips, planning, 298
twins, types of, 109
twin-to-twin transfusion syndrome, 110
tympanic thermometers, 246
•U•
ultrasound
abnormal, 100–102
determining sex of babies from, 71,
74–75
first, attending, 52–53
results of, 73–75
risks of, 72
uninsured
costs of labor and delivery for,
124–125
health care for, 288
unsolicited advice, handling, 43–44,
214–215
urination
frequent, during pregnancy, 59
projectile, of baby boys, 182
utilities, cost of, 275
10/25/10 1:07 PM10/25/10 1:07 PM
318
Dad’s Guide to Pregnancy For Dummies
•V•
vacation time, taking, 256–257
The Vaccine Book (Sears), 195
vaccines
Haemophilus influenzae type B, 239
reactions to, 252
scheduling, 193–195
vacuum extraction, 139
vaginal exams during labor, 159
vagina, openings of, 183
varicoceles, 41
ventilation
for premature babies, 105, 106, 107
in rooms, and SIDS, 223
vernix, 174
video monitors, 84
visitors
coping with, 213–215
planning for, 146
vitamin D supplements, 128
voices, recognition of, 114
vomiting
of babies, 236–237
in early pregnancy, 60
•W•
water
for baths, 184
birth in, 138
for formula, 181
water breaks, 152, 160–161
Web sites
for breast-feeding, 207
for credit rating agencies, 283
for doulas, 133
for midwives, 132
for names, 93
26_9780470767900-bindex.indd 31826_9780470767900-bindex.indd 318
for social networking, 147
for uninsured, 288
weepiness during third trimester, 119
weight gain
in early pregnancy, 61
in second trimester, 68–70
weight loss
after birth of baby, 201
in preparation for fatherhood, 16
well water for formula, 181
wheezing, 237
whole-life insurance coverage, 285
wills, creating, 288–291
wipes
cost of, 270
warmers for, 89
work. See also workplace
adjusting when mother returns to,
262–264
calling in backup for return to, 203, 208
from home, 265
juggling fatherhood and, 13, 15–16
taking leave from, 227
work/life balance
after-work requests and expectations,
259–260
overview of, 255–256
paternity leave, 256–258, 259
reprioritizing commitments, 260–261
sick time, managing, 258–259
stay-at-home parenting, 264–268
workplace. See also work
announcing pregnancies at, 49
toxins in, 31
•Y•
yoga ball, 89
yolk sacs, 53
10/25/10 1:07 PM10/25/10 1:07 PM
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Pregnancy & Childbirth/Parenting
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Making Everythin
When it comes to pregnancy, your role as a dad has
changed so much in the past few decades that it’s
hard to know where to turn for guidance. Now you
do! This hands-on, friendly guide is packed with
practical information for fathers-to-be, covering all
of the logistical, physical, and emotional aspects of
pregnancy from your unique perspective.
• Take the fear out of fatherhood — find out what
modern fatherhood means, determine if you’re ready
for the financial and emotional demands of a baby,
and learn what you don’t know about conception
• Pregnancy and childbirth 101 — get the lowdown
on what to expect during pregnancy, labor, and
delivery, from your perspective as well as your
partner’s
• So you’re a father — oh, boy (or girl)! — discover
how to care for your newborn — from bottle feeding
to changing diapers to soothing your baby
Open the book and find:
• How a fetus develops in every
trimester
• Advice on when and how to
share the good news
• Tips on baby gift registry and
setting up the nursery
• What to expect during labor
and delivery
• What to expect the first six
months after the baby arrives
• The 4-1-1 on feeding and
changing diapers
• Tips for dealing with common
illnesses and emergencies
• Survival tips every new dad
needs to know
• Be the perfect postpartum partner — support your
partner by helping with the baby and household,
and by attending to her emotionally as well
Dad’s Guide to Pregnancy
A practical, hands-on
guide for fathers-to-be
e
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G
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Learn to:
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• Be a supportive partner during
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labor and delivery
$15.99 US / $18.99 CN / £12.99 UK
ISBN 978-0-470-76790-0
Matthew M. F. Miller
Matthew M. F. Miller is a writer/editor, stay-at-home
dad, and author of Maybe Baby: An Infertile Love Story.
Sharon Perkins, RN, is the author of several books,
including Breastfeeding For Dummies.
Author of Maybe Baby: An Infertile Love Story
Sharon Perkins, RN
Miller
Perkins
™
Registered nurse and author of
Breastfeeding For Dummies

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