Now in a new revised and expanded second edition, Bumpin’ will radically transform your pregnancy journey from overwhelmed and confused to one of confidence. With over a decade of experience advising women’s health care and technology companies, Leslie Schrock distills cutting-edge research and practical guidance into a comprehensive pregnancy guide—from conception through pregnancy into the first months with an infant. She also shares her own personal journey, including the curveballs she faced on the way.
This second edition updates the evidence and includes even more practical advice from experts ranging from doulas, ob-gyns, midwives, therapists, prenatal trainers, nutritionists, and researchers so you can make the best decisions for your family. With a look at the science, it tackles pregnancy FAQs and topics like the truth about cleaning up your cosmetics, nutrition, exercise, and epidurals; and the practical, like putting together a baby budget and navigating work before and after birth. New sections in the fourth trimester after your baby arrives go deeper on breastfeeding and bottle feeding as well as sleep and recovery for you.
Inside the second edition of Bumpin’ you will find:
-A trimester-by-trimester overview from conception through the postpartum period and return to work
-How to optimize your fertile window and getting pregnant
-The truth about age, fertility, and managing any issues that arise
-Miscarriage and assisted reproduction treatments like IVF
-Guidance on diet, substance use, and exercise before and during pregnancy
-The science behind your physical changes, leaks, sweats, and every other unexpected pregnancy symptom
-Managing your mental health
-Understanding what happens during birth and creating your birth preferences
-Advice for partners, family members, and friends supporting your pregnancy
-Budgeting, finance tips, baby registry, and hospital checklists
-Updated research on infant feeding and lactation
Warm, funny, and non-judgmental, Bumpin’ will leave you feeling prepared and ready to tackle anything that comes your way.
Now in a new revised and expanded second edition, Bumpin’ will radically transform your pregnancy journey from overwhelmed and confused to one of confidence. With over a decade of experience advising women’s health care and technology companies, Leslie Schrock distills cutting-edge research and practical guidance into a comprehensive pregnancy guide—from conception through pregnancy into the first months with an infant. She also shares her own personal journey, including the curveballs she faced on the way.
This second edition updates the evidence and includes even more practical advice from experts ranging from doulas, ob-gyns, midwives, therapists, prenatal trainers, nutritionists, and researchers so you can make the best decisions for your family. With a look at the science, it tackles pregnancy FAQs and topics like the truth about cleaning up your cosmetics, nutrition, exercise, and epidurals; and the practical, like putting together a baby budget and navigating work before and after birth. New sections in the fourth trimester after your baby arrives go deeper on breastfeeding and bottle feeding as well as sleep and recovery for you.
Inside the second edition of Bumpin’ you will find:
-A trimester-by-trimester overview from conception through the postpartum period and return to work
-How to optimize your fertile window and getting pregnant
-The truth about age, fertility, and managing any issues that arise
-Miscarriage and assisted reproduction treatments like IVF
-Guidance on diet, substance use, and exercise before and during pregnancy
-The science behind your physical changes, leaks, sweats, and every other unexpected pregnancy symptom
-Managing your mental health
-Understanding what happens during birth and creating your birth preferences
-Advice for partners, family members, and friends supporting your pregnancy
-Budgeting, finance tips, baby registry, and hospital checklists
-Updated research on infant feeding and lactation
Warm, funny, and non-judgmental, Bumpin’ will leave you feeling prepared and ready to tackle anything that comes your way.
![Bumpin': Navigating the Wild, Weird, and Wonderful Journey Through Pregnancy from Conception to Birth and Beyond](http://img.images-bn.com/static/redesign/srcs/images/grey-box.png?v11.11.4)
Bumpin': Navigating the Wild, Weird, and Wonderful Journey Through Pregnancy from Conception to Birth and Beyond
384![Bumpin': Navigating the Wild, Weird, and Wonderful Journey Through Pregnancy from Conception to Birth and Beyond](http://img.images-bn.com/static/redesign/srcs/images/grey-box.png?v11.11.4)
Bumpin': Navigating the Wild, Weird, and Wonderful Journey Through Pregnancy from Conception to Birth and Beyond
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Overview
Now in a new revised and expanded second edition, Bumpin’ will radically transform your pregnancy journey from overwhelmed and confused to one of confidence. With over a decade of experience advising women’s health care and technology companies, Leslie Schrock distills cutting-edge research and practical guidance into a comprehensive pregnancy guide—from conception through pregnancy into the first months with an infant. She also shares her own personal journey, including the curveballs she faced on the way.
This second edition updates the evidence and includes even more practical advice from experts ranging from doulas, ob-gyns, midwives, therapists, prenatal trainers, nutritionists, and researchers so you can make the best decisions for your family. With a look at the science, it tackles pregnancy FAQs and topics like the truth about cleaning up your cosmetics, nutrition, exercise, and epidurals; and the practical, like putting together a baby budget and navigating work before and after birth. New sections in the fourth trimester after your baby arrives go deeper on breastfeeding and bottle feeding as well as sleep and recovery for you.
Inside the second edition of Bumpin’ you will find:
-A trimester-by-trimester overview from conception through the postpartum period and return to work
-How to optimize your fertile window and getting pregnant
-The truth about age, fertility, and managing any issues that arise
-Miscarriage and assisted reproduction treatments like IVF
-Guidance on diet, substance use, and exercise before and during pregnancy
-The science behind your physical changes, leaks, sweats, and every other unexpected pregnancy symptom
-Managing your mental health
-Understanding what happens during birth and creating your birth preferences
-Advice for partners, family members, and friends supporting your pregnancy
-Budgeting, finance tips, baby registry, and hospital checklists
-Updated research on infant feeding and lactation
Warm, funny, and non-judgmental, Bumpin’ will leave you feeling prepared and ready to tackle anything that comes your way.
Product Details
ISBN-13: | 9781668050118 |
---|---|
Publisher: | S&S/Simon Element |
Publication date: | 01/14/2025 |
Edition description: | Reissue |
Pages: | 384 |
Product dimensions: | 6.00(w) x 9.00(h) x 0.96(d) |
About the Author
Read an Excerpt
Get your Bodies and Lives Ready From genetic screenings to finances, sanity and a healthy pregnancy start before you conceive.
This section may feel like it’s just for overachievers. Consider the below a menu of available options rather than a mandate. Conception, and later pregnancy and parenthood, is about stringing together the parts that feel right to you, and leaving those that don’t.
Preparation for pregnancy is almost always focused on physical health—lifestyle cleanses, what to eat and do. While aspects like quitting birth control (and its accompanying gnarly hormone changes) are important to understand, if your partner is providing sperm, they should get to know how their lifestyle and health impact fertility and an eventual pregnancy. Their medical history, genetics, and daily choices are also major factors in conception.
It’s not just about the raw materials. Most new parents will tell you their relationship changed after having a baby. Some shift in wonderful ways; for example, a couple may feel more bonded. Other changes are less appealing, like having limited time together and less frequent sex or intimacy, or experiencing feelings of bitterness tied to lopsided responsibilities. And how could such a major event not change things?
Family therapists suggest talking about your individual and shared parenting and life expectations before the fog of pregnancy hormones descends. Topics can span the financial implications of childcare, parental leave, sharing baby care and household duties, and values related to how you actually want to raise your child.
Why do this now? Resentment is a huge issue for many couples. More women stay home to take care of their families than men,1 and almost all women, regardless of their professional status, take on more chores. Even in families where both partners work, moms do the majority of scheduling, household labor, and stay home when children get sick. In the early days with an infant, especially if you’re breastfeeding, an equitable division of baby care is not a realistic goal—unless men learn to lactate. But there are plenty of ways that your partner can contribute (sanitation crew, anyone?).
Pregnancy is the wildest transformation of most women’s lives. At times, you won’t feel, look, or even act like yourself. And no matter how marvelous or tuned-in your partner is, they will not completely understand the physical and emotional undertaking that is growing another human being. Instead of expecting psychic powers, tell them directly how to best support you, and be honest about how you’re feeling. And ask them the same questions. Though they aren’t living with the day-to-day of pregnancy, this is a big transition for them, too.
If you already know whom you’d like to manage your prenatal care, now is a great time to schedule your first chat about improving your fertility and how to later have a healthy pregnancy. Not sure yet? Set an appointment with your current ob-gyn or gynecologist.
Partners, this is a wonderful time to schedule that long-overdue physical or get a semen analysis.
When you go in for an appointment, prepare for a slew of questions that will determine whether your pregnancy will require anything beyond standard-issue prenatal care, or extra steps during conception. Partners, you’ll hear many of the same questions, especially related to lifestyle, family history, and genetic screenings.
Here are the questions you can expect:
- Age
- Family history
- Gynecological history (state of your period, current or past methods of birth control, STDs or abnormal Pap smears, history of infertility or past pregnancies)
- Medical history (chronic conditions, past surgeries or hospitalizations, exposure to infectious diseases)
- Medications and allergies (all prescription or OTC medications and supplements you are taking, including prenatal vitamins, and known allergies)
- Vaccinations (childhood history, Tdap [tetanus, diphtheria, acellular pertussis] vaccine, flu shot, and upcoming travel requiring vaccines)
- Lifestyle (profession; hobbies; relationship status; use of drugs, alcohol, tobacco, and caffeine; exercise, weight and dietary history)
- Emotional history (history of anxiety, depression or mood disorders, eating disorders, current or past domestic violence or sexual assault/rape)
- Genetic carrier screening (family history of birth defects, abnormalities, inherited disorders, miscarriages, or stillbirths)
Pending the answers, your physician may order tests if you have hormone-related issues, get you up-to-date with missing vaccines, and make lifestyle-related suggestions. The latter will definitely include cutting alcohol and caffeine consumption and putting a full stop to smoking and recreational drug use.
On that note, while it’s tempting to downplay questionable behavior with your physician, now is not the time for half-truths. Studies show that women commonly conceal how much alcohol they consume, for example. If your practitioner is given incomplete or slightly fudged information, they can’t provide the best care.
Partner, just because you won’t be carrying the baby doesn’t mean these rules don’t apply to you, too. More and more data shows that men’s behavior and habits impact sperm. Here are a few of the health and lifestyle factors that matter:
- Age (increased risk of chromosomal abnormalities over age forty)
- Smoking or vaping
- Drug and alcohol use (even cannabis, which changes sperm2)
- Weight and diet
- Medications, including prescriptions, OTC treatments, and supplements
- Cancer treatments
Now back to you, ladies. Let’s get real: Pregnancy is a weird time for your body. New medical problems can start, ongoing issues can get worse, and all of these changes can affect the safety and efficacy of medications you’ve taken for years.
Six out of every ten Americans have a chronic condition,3 and four in ten have two or more. If you are in this large and growing pool, or take anything to manage your health, chat with your prescribing physician before trying to conceive.
Yes, partners, this means you, too. Some prescription drugs can impact sperm quality and quantity, so ideally, take care of this a few months before you start trying to conceive.
If you want even more insight into your reproductive health, there are a growing number of direct-to-consumer fertility tests on the market. The majority are available for under $300, and many can be purchased with your health savings account (HSA) or flexible spending account (FSA). Doing the same panel in-office with your doctor is not always covered by insurance, especially if it’s coded as elective, meaning it can be much more expensive to get most of the same information with them.
These tests typically start with a quick physician phone screen. You’ll volunteer a brief medical history, and will be directed to submit a blood sample via a finger prick from home, or by swinging by a local blood-draw center. The markers they test are related to ovarian reserves (the number and quality of available eggs in your ovaries) as well as ovulation and testosterone. The test results are emailed, or released during another phone consultation with a physician, who will walk you through the findings.
Partners, there are test kits for your swimmers, too. The process is similar, though the testing of sperm quality and quantity requires a different sort of contribution. There are basic versions available to do at home with instant results, or mail-in kits that provide more in-depth findings.
Recalling the medical histories of every single family member and branch is challenging enough, even if you have access to those records. But some conditions don’t present in every generation, so you also may not know about them.
Just in case you slept through high school biology, here is a crash course on the basics of genetic inheritance. After cultivating and testing thousands of pea plants, a monk named Gregor Mendel discovered that three basic principles applied to the passing of traits from parents to their offspring. Mendel’s laws tl;dr: Offspring inherit one genetic marker from each parent independent of any others, and recessive markers will always be masked by those that are dominant.
A genetic carrier screening reveals whether you or your partner carry a genetic marker for any of a number of conditions, and how likely it is that your child will inherit it.4 Done via blood draw, saliva sample, or cheek swab, it’s noninvasive and tests primarily for cystic fibrosis, sickle cell disease, fragile X syndrome, and Tay-Sachs disease. Consumer-grade tests are available to order online, but if you think you might be at higher risk, it’s best to do this screening through your physician.
Screenings start with full medical histories and testing the partner with higher carrier risk. The types of conditions your doctor may ask about are more varied, and you may not be as susceptible to some based on your background. If the results from the first partner’s round of testing are clean, there is no need to do another, as it takes both of you for the condition to be an issue.
If you are both carriers for a serious condition, there are options. You can choose to get pregnant and rely on diagnostic tests to confirm whether your baby inherited the condition. IVF using your own sperm and eggs or donor gametes is another option. The fertilized embryos can be tested before implantation to ensure you will definitely not pass the condition down. A genetic counselor or your physician will guide this process, so you won’t be making these decisions alone.
Could the way your parents or grandparents lived affect the way your baby processes stress? Epigenetics is the study of how lifestyle and health factors impact the inheritance and expression of traits without rewriting the actual DNA sequence, and shows how these changes could influence not only your child, but also the generations after.
Though the term epigenetics was first coined in 1940, we are only beginning to understand its implications. The research is fascinating, and reveals how much weight what we choose to do and put into our bodies carries. For example, it’s no secret that the sons of moms who smoke during pregnancy have a lower sperm count. But smoking carries the same impact if Dad smoked, too, independent of Mom’s actions. One study showed that the sons of fathers who smoked had 51 percent fewer sperm.5
So what are these health and lifestyle factors? They range from sleep patterns, exercise, age, and anxiety levels to where you live and whom you interact with. Epigenetic changes can also happen as a result of exposure to environmental factors like smoke, heavy metals, chemicals like BPA and phthalates, hormones, viruses, bacteria, and nutrients.6
If you’re wondering, Okay, so what do I do about it? the answer is, like everything else related to pregnancy, file under “heard,” and do the best you can to clean up your lifestyle. We simply don’t know enough about epigenetics yet to say definitively if there are preventive measures or ways to reprogram these changes.
AU REVOIR TO BIRTH CONTROL, AND GETTING TO KNOW YOUR CYCLE
Hormonal birth control works (for the most part) by stopping ovulation; no ovulation, no pregnancy. So if you’re taking birth control or have an IUD, the first big step in downshifting to conception mode is to stop or take it out. If you’re on the pill, you can quit whenever you want, though your bleeding schedule and ovulation may be irregular.
For long-term birth-control users, this can be a BIG transition. When you stop, expect some hormonal and mood changes. Gone will be the days of a light, predictable, symptom-free flow, if you were lucky enough to experience that. But good news: If birth control knocked down your libido, it may return once you stop.
The biggest change, however, is that with many formulations, you can get pregnant the very next cycle. The rhythm and pullout methods are not reliable, so be careful and use backup birth control if that is not your goal.
Side effects of stopping birth control:
- Heavier periods
- Cramps
- Irregular cycle length
- Acne
- Weight fluctuations
- Fewer headaches
Exactly when a period will return in full force is different for everyone. Some come right back the first month. Others take longer. Once it does make an appearance, it’s best to complete at least one full cycle before trying to conceive, to more accurately pinpoint your ovulation window. It also helps with more exact dating if you do get pregnant, as your due date is calculated based on the start of your last menstrual period (LMP).
Data points like your cycle length and blood volume and color in combination with a presence or lack of symptoms say a lot about the state of your fertility. We are all conditioned to think they are normal, but PMS symptoms like bloating, cramps, and acne are typically signs of hormonal imbalances. If yours are extreme, talk to your favorite practitioner or ob-gyn to debug.
Since you may be getting to know each other again, here are the basics of a normal, healthy menstrual cycle:
- Full cycle length: twenty-five to thirty-five days (a consistent duration month to month is more important than length)
- Bleeding duration: four to seven days
- Color: bright red (think cranberry juice) with no clots
- Volume: Enough to fill up a tampon, pad, or cup in under four hours. If it’s more than that for several cycles in a row, chat with your ob-gyn.
Use your calendar or one of the many cycle-tracking apps to build a baseline. If your period is irregular or otherwise out of whack, look to diet and lifestyle for simple tweaks. Stress, nutrition, exercise, and sleep all impact it, so try drinking more water and less caffeine and alcohol to start. It’s normal to spot during ovulation, but if you have breakthrough bleeding outside of that time, take note and consult an ob-gyn.
I was on the pill for almost twenty years to control cramping and digestive issues that started when I was a teenager, and I barely had any trace of a period. Most months, it didn’t even occur to me that I had a period at all, since bleeding was so rare. When I quit, I expected a long lead time for my cycle to return normally, but was pleasantly surprised that it came back exactly twenty-eight days later.
My mood swings were a less pleasant surprise. Small things that normally didn’t bother me, like dirty dishes in the sink, were all of a sudden a REALLY big deal. I was less touchy during pregnancy than in that first month off the pill.
We never expected to get pregnant the first time we tried, and on every subsequent attempt. Though our semi-crazy fertility hit rate is not typical, especially considering we are both in our mid-thirties, this is why I advocate for prepping your body in advance, since pregnancy can happen before you expect it.
Eating a well-rounded, veggie-packed diet during pregnancy can be tough, especially if first-trimester morning sickness ensures that all you can choke down is crackers. Combined with its proven reduction in neural tube7 and heart defects, preterm birth,8 low birth weights, and even autism, the magical prenatal vitamin is key from conception through breastfeeding.
The benefits of folic acid, the powerhouse ingredient in prenatal vitamins, were first published by the British hematologist Lucy Wills in 1931.9 She noticed that poor pregnant workers in India suffered from anemia at much higher rates than the wealthy, and tied it to nutrition. She successfully treated these women with liver supplements and Marmite (a salty paste made from yeast extract that’s all the rage in the UK), both of which share a high concentration of vitamin B9. And so it was that the “Wills Factor,” or folic acid, was heralded as a breakthrough in the treatment of nutritional anemias.
Folic acid is the synthetic form of vitamin B9 found in processed foods and most supplements, and still powers the prenatal vitamins we take today. Folate is the naturally occurring version found in foods like eggs, leafy greens, avocado, and liver. Refined grains are enriched with folic acid, so cereal, flour, and pasta in concert with folate-packed kale help, but are not enough to allow you to skip prenatal vitamins.
The ideal time to start taking prenatal vitamins is three months before you try to conceive so levels can build up in your system. When you go shopping, here are the top ingredients to seek out on the label:
- Folic acid (5-MTHF is a great choice if available)
- Iron
- Calcium
- Vitamin D
- Iodine
- Omega-3 fatty acids (DHA and EPA)
- Choline
Though side effects are usually minimal, the iron in prenatal vitamins can cause stomach issues or nausea, so take them at night before you go to bed, with a snack, or look for food-based versions that are easier to digest.
One last biology lesson, this time on the MTHFR gene mutation (it doesn’t stand for what you think it does). The MTHFR gene tells your body how to make the enzyme methylenetetrahydrofolate reductase, otherwise known as MTHFR.10 When you eat food or take supplements containing folic acid, MTHFR converts it into methylfolate, the active format your body can actually use. With the MTHFR mutation, your body cannot properly convert and then absorb folate or folic acid. It is also thought to affect hormones, digestion, cholesterol, and brain function, and may be a cause of recurrent miscarriage.
Carriers of the MTHFR gene are typically asymptomatic. For that reason, medical groups don’t suggest routine testing. If you know you have the mutation, talk to your doctor and choose a prenatal vitamin with the active, already methalyzed form of folic acid, methylfolate (L-methylfolate, L-5-methyltetrahydrofolate, or L-5-MTHF), listed on the label. Even if you don’t have the variant, there is no downside to taking these forms.
Birth defects are reported in roughly 3 percent of US births11 each year. Though it was once a subject of much concern, transmission has declined significantly since 2018. In fact, even if you have Zika while pregnant, there is no guarantee that your baby will be born with issues. Just 5 to 10 percent of confirmed Zika infections during pregnancy are associated with birth defects,12 and the risk is highest if the infection happens during the first trimester.
So what is Zika anyway? It is a virus that causes birth defects like microcephaly (a condition that causes an abnormally small head). It is typically contracted through mosquito bites, but can also be sexually transmitted. Common symptoms include joint pain, eye inflammation, fever, and rash. If you’re worried about an infection, lab testing can confirm a diagnosis.
Even though the Zika threat has been downgraded, the effects of an infection while you are pregnant are serious, especially since there is no approved treatment or vaccine. To avoid it, sadly, you and your partner should avoid travel to places where it’s active. Check the Centers for Disease Control and Prevention (CDC) website for up-to-date guidance on specific destinations. If you are planning to visit a place with active Zika, the guideline is to wait six to eight weeks for the virus to clear your system before trying to conceive. However, Zika can remain in sperm for up to six months. So if your partner has traveled to an active Zika area, or knows he’s had Zika, it’s recommended that you wait those six months before trying to conceive, and use protection if you are already pregnant.
Getting a handle on your health and getting pregnant is only part of the “having a kid” equation. The other major component? Money.
The United States is the priciest place in the world to give birth. An uncomplicated vaginal delivery is more expensive than the British royal family’s private luxury births, costing over $10,000 on average.13 That price jumps to over $30,000 when you add prenatal and postnatal care. Though having insurance helps bring down out-of-pocket costs, plans vary widely when it comes to maternity care, so you should be prepared to spend several thousand dollars outside of your monthly premiums even if things go smoothly.
What about after? Raising a child from birth to age seventeen costs about $233,61014 for middle-income families. This does not include a college education, nor does it account for indirect costs like your time, lost earnings, or missed career opportunities. In the first years of life, the biggest financial outlays are housing and childcare. Full-time day care is roughly $10,000 per year—much more in coastal cities—and a full-time nanny is about $30,000.15
In other words, having a kid is not cheap. Exact expenses vary depending on where you live, but these high costs, especially childcare, come as a surprise to three of every four new parents. Three-quarters of expectant parents assume childcare costs won’t impact their career decisions, but 63 percent report later that they did.
There are tax credits available for families, and contributing to a Dependent Care Flexible Spending Account is another money-saving option, but support from the government or your employer is not a reality for most US families. Though childcare remains one of the most highly sought-after benefits from employers, only one in five currently offers it.
The surprise costs of having children can also have unsavory effects on a couple’s emotional well-being. A study spanning thirty-five countries, eight years, and over a million people16 showed that having kids lowered happiness until you controlled for the ability to pay your bills. For couples who plan for these costs, building a family is more likely to be a universal positive.
How you divide and manage financial responsibilities is unique to your individual careers, your relationship dynamic, and how you visualize the first few years of your child’s life. The earlier you plan and talk about this together, the more prepared you will be to handle surprises, and the less likely you are to fight later.
Humans successfully raised children for thousands of years before BabyBjörn. So while outfitting a nursery and accessorizing your baby can be expensive, you can minimize those optional costs. To start a baby budget, look at your current finances, available savings, and monthly burn rate. The two major pregnancy line items not wholly under your control are medical expenses and childcare, so begin researching and planning those costs before diving into the fun stuff.
Here are the inputs and discussions that will inform your budget:
- Research your insurance plan (the next section will help with what to ask) to see how much prenatal and birth care is covered in time to make changes to your plan. If you don’t have insurance, see if there’s a way to enroll on your partner’s plan, or through the exchange.
- Talk about what type of childcare (if any) will be necessary after birth when and if you go back to work or need an extra hand.
- Most parents who stock up on clothes, toys, and gadgets before getting to know their baby’s preferences will tell you they should have waited. Save money by purchasing items like cribs and cots used, borrow as many basics as you can, and remember that although you need a lot of them, kitchen towels work just as well as specialty burp cloths.
- The biggest ongoing infant expenses are diapers and, if you aren’t breastfeeding, formula (though breastfeeding isn’t free either). Standard versions of both cost more than $1,200 per year.
- You’ll wear maternity clothes for only a few months, so look in your closet for pieces with extra room at the waistband or that will stretch to accommodate your growing belly, borrow, buy used, or rent before you invest in a spendy pregnancy wardrobe.
Reviewing your coverage before you get pregnant allows you to check whether your desired birth spot, practitioners, and pre/post services (if you have already chosen these things) are included. Hard costs like deductibles, copays, and out-of-pocket maxes will also help you build a realistic budget. If open enrollment happens during those nine long months, you can upgrade to access new services and cut your out-of-pocket maximum. How much you pay out of pocket depends entirely on the details of your plan. Generally, the higher the premium, the lower the deductible and out-of-pocket costs. The only way to know for sure is to look up the specifics.
Pro tip: Pregnancy is not a “qualifying life event” that allows you to change your coverage outside of open enrollment periods—but birth is. In the thirty to sixty days after the baby pops out, you can add Junior and make further changes to your plan. Upgrading or downgrading afterward will not affect costs related to birth. However, if you decided to go premium while pregnant and want to move to a less expensive plan when you’re done, it’s possible to do so. Just consider the five to seven pediatrician appointments in your baby’s first year of life before you cut, as costs for vaccinations and those visits add up.
So what’s generally covered by insurance?
- Pre- and postnatal doctor’s appointments, labs, medications, and treatments or screenings for conditions like diabetes
- Inpatient experiences including birth, hospitalizations, and assorted hospital fees
- Breast pump and lactation counseling
- Newborn-baby care (shots and tests done in the hospital, vaccines, well-baby visits)
Another huge benefit of understanding your insurance is that you may discover unexpected and cool services that are partially or even fully covered. Again, depending on your plan, these might include acupuncture, physical therapy, a doula, massage, or 24/7 video access to nurses and other health professionals. For those wondering what on earth a doula is, we’ll get there. Yes, visiting complementary practitioners can mean paying up front and submitting claims afterward, which is annoying. But bonus: Navigating that gauntlet is a *fabulous* activity for your partner while you are busy baking your tiny human.
One last thing: Pregnancy is a perfect time to spend those stored FSA (flexible spending account) or HSA (health savings account) dollars. If these accounts are new concepts, think of them as savings accounts built with pretax dollars funneled directly from your paycheck. Spend them on copays, deductibles, prenatal vitamins, baby-related medical items, or postpartum items for you. If you really run out of ideas, you can always stock up on sunscreen. Talk to HR to get one set up if it’s available at your company or your partner’s.
This is the first of several sad reminders that policies supporting families and the health of new mothers are fairly nonexistent in the US today, which is why planning ahead is so critical.
Seventy-five percent of American moms with children under eighteen are employed full-time.17 They are the primary or sole earners for 40 percent of families, yet the United States is the only developed country with no government-sponsored or employer-mandated paid parental leave policy.18 It’s not that way for the rest of the world. Canadian mothers get a full year of paid leave after having a baby. The UK grants thirty-nine weeks. In Finland, it’s three years.
It took until 1993 for the US to approve up to twelve weeks of unpaid leave for each parent through the Family and Medical Leave Act (FMLA). The act requires health benefits be maintained during leave and entitles employees to return to the same or equivalent job afterward. It does not, however, mandate any pay. Though some states and cities have policies to support new families financially, the majority of the responsibility falls squarely on employers.
That responsibility is taken on by only 14 percent of US companies, and access is stratified.19 The highest-income workers are 3.5 times more likely to have this benefit than those in the lowest-income positions. Even in highly paid sectors like technology, finance, science, insurance, and other professional services, less than half of companies provide parental leave.
The advantages of parental leave for businesses are proven. Women who take paid leave are over 90 percent more likely to be in the workforce a year after birth than those who don’t. And employee retention isn’t the only reward. Good family policies also help attract talent, improve a company’s brand, and even increase productivity. Given all of this, the number of businesses that provide family benefits is slowly growing.
If you or your partner are lucky enough to have employee-sponsored leave, knowing what to expect financially is much easier. If not, what you’re entitled to differs based on the size of your employer and how long you’ve been working there, as you have to qualify20 to receive FMLA benefits.
Here are the broad strokes: If you work at a public agency or a private-sector company that has employed fifty or more people for at least a year, your employer has to participate. But (there’s always a but!) even if your company is covered, your individual tenure must be at least twelve months—and 1,250 hours—prior to leave.
Confused yet? Here’s a cheat code. If you work at a large company full-time, maternity and paternity leave policies will be spelled out in your HR handbook, so start there before trying to decipher the Department of Labor’s muddle of information. Same deal if you work for the government or a public institution full-time. If you work at a small company, especially one employing fewer than fifty people, it’s trickier, as they are not covered by FMLA rules, and may not yet have set policies. Working part-time may disqualify you from any benefits no matter where you work.
Though financial and life planning may seem like the least sexy part of the conception process, feeling more financially secure while trying to conceive will reduce your stress, which improves your odds of getting pregnant. And planning can ensure the whole having-a-family thing continues to be a positive for you and your partner, and that you are prepared (as much as anyone can be!) for whatever comes your way.
We assume everyone building a family is ready for it. But not all pregnancies are planned! Here’s a secret: Even the most relaxed, assured-looking parents who plan for years have moments, especially when faced with an inconsolable newborn at 3 a.m.
A big mental hurdle for most first-time mothers and fathers is deciding who they are and how they want to show up in the world as parents. This identity is tied to so many things—your age, your professional experience, how you perceive gender roles and responsibilities, your own childhood, and your financial resources, just to name a few.
If you’d like to explore these questions, start by asking yourself why you want to have a child, and if you have a specific idea of what your future family will look like. There is no right answer, just what feels right to you. Then consider what kind of parent you’d like to be. Share with your significant other and see how their personal vision overlaps with yours. Even if you’ve talked about it before, you might find there are areas where you diverge now that it’s all becoming real.
Everyone enters parenting as someone else’s child. We learn habits and behaviors from our parents, which affect the way we approach our own time as parents. Your upbringing does not dictate who you become, but can have unintended side effects if you don’t take the time to digest it. Whether your childhood was complicated or great or somewhere in between, try to reflect on who your parents are, why they did what they did, and how it affected you. Kudos if you’ve already covered this in therapy. If it’s still difficult, it may be worth recruiting some professional help to process.
Ready to start practicing co-parenting and communication? Take a few minutes several times a week to check in with each other. Talk about your days, about what’s working at home, what’s not, and what needs to change. If you’re not always face-to-face, this can also happen asynchronously via text or messenger or video. If you wait to form these habits until an infant is around, they probably won’t stick. As time goes on, these conversations will evolve, as will your individual and shared identities.
When your new addition does finally make his or her appearance, keep the lines of communication open and share your parenting philosophy with others, especially caregivers, family, and friends. If you have a specific value system or set of principles, it’s important to be surrounded by others who share (or are at least willing to adhere to) them.
Figuring out what doesn’t work is just as important as discovering what does, and effort goes a long way even when you make mistakes. And you will make mistakes—every new parent does. Kids have a baseline that you can’t always control, and your relationship with them shouldn’t always be about discipline. We listen to people we trust, so through consistency and flexibility, you can help your children trust you.