What to Expect When You're Expecting
Updated multiple times every year, America’s pregnancy bible answers all your questions.
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
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- When can I take an at-home a pregnancy test?
- How can I eat for two if I’m too queasy to eat for one?
- Can I keep up my spinning classes?
- Is fish safe to eat? And what’s this I hear about soft cheese?
- Can I work until I deliver? What are my rights on the job?
- I’m blotchy and broken out—where’s the glow?
- Should we do a gender reveal? What about a 4-D ultrasound?
- Will I know labor when I feel it?
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
What to Expect When You're Expecting
Updated multiple times every year, America’s pregnancy bible answers all your questions.
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
- When can I take an at-home a pregnancy test?
- How can I eat for two if I’m too queasy to eat for one?
- Can I keep up my spinning classes?
- Is fish safe to eat? And what’s this I hear about soft cheese?
- Can I work until I deliver? What are my rights on the job?
- I’m blotchy and broken out—where’s the glow?
- Should we do a gender reveal? What about a 4-D ultrasound?
- Will I know labor when I feel it?
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
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Overview
Notes From Your Bookseller
Literally the only book you need when you’re pregnant. Every question answered. Every scientific insight provided. Every best and worst practice, dietary do’s and don’ts, and most importantly—can you have coffee? Don’t go into the wild world of pregnancy without this.
Updated multiple times every year, America’s pregnancy bible answers all your questions.
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
- When can I take an at-home a pregnancy test?
- How can I eat for two if I’m too queasy to eat for one?
- Can I keep up my spinning classes?
- Is fish safe to eat? And what’s this I hear about soft cheese?
- Can I work until I deliver? What are my rights on the job?
- I’m blotchy and broken out—where’s the glow?
- Should we do a gender reveal? What about a 4-D ultrasound?
- Will I know labor when I feel it?
Your pregnancy explained and your pregnant body demystified, head (what to do about those headaches) to feet (why they’re so swollen), back (how to stop it from aching) to front (why you can’t tell a baby by mom’s bump). Filled with must-have information, practical advice, realistic insight, easy-to-use tips, and lots of reassurance, you’ll also find the very latest on prenatal screenings, which medications are safe, and the most current birthing options—from water birth to gentle c-sections. Your pregnancy lifestyle gets equal attention, too: eating (including food trends) to coffee drinking, working out (and work) to sex, travel to beauty, skin care, and more. Have pregnancy symptoms? You will—and you’ll find solutions for them all. Expecting multiples? There’s a chapter for you. Expecting to become a dad? This book has you covered, too.
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Product Details
| ISBN-13: | 9780761187486 |
|---|---|
| Publisher: | Workman Publishing Company |
| Publication date: | 05/31/2016 |
| Series: | What to Expect Series |
| Edition description: | Fifth Edition, Revised |
| Pages: | 656 |
| Sales rank: | 515 |
| Product dimensions: | 5.80(w) x 9.00(h) x 1.50(d) |
About the Author
Heidi Murkoff is the author of the What to Expect® series of pregnancy and parenting books. She is also the creator of WhatToExpect.com and the WhatToExpect app, which reach over 11 million expecting and new parents, and the What to Expect Foundation, a nonprofit organization dedicated to helping underserved families expect healthy pregnancies, safe deliveries, and healthy, happy babies.
Read an Excerpt
Excerpt from:
What to Expect When You're Expecting
WHat You Can Expect At Your First Prenatal VisitThe first prenatal visit is the most comprehensive of all the prenatal visits. (See the Appendix for an explanation of the procedures and tests performed.) A complete medical history will be taken, and certain tests an procedures will be performed only at this exam. One practitioner's routine may vary slightly from another's. In general, the examination will include:
Confirmation of Your Pregnancy.
Your practitioner will want to check the following: the pregnancy symptoms you are experiencing; the date of your last normal menstrual period, to determine your estimated date of delivery (EDD), or due date (see page 6); your cervix and uterus, for signs and approximate age of the pregnancy. If there's any question, a pregnancy test may be ordered if you haven't already had one.
A Complete History.
To give you the best care, your practitioner will want to know a great deal about you. Come prepared by checking home records and refreshing your memory, as necessary, on the following: your personal medical history (chronic illness, previous major illness or surgery, medications you are presently taking or have taken since conception, known allergies, including drug allergies); your family medical history (genetic disorders and chronic illnesses); your social history (age, occupation, and habits, such as smoking, drinking, exercising, diet); your gynecological and obstetrical history (age at first menstrual period, usual length of menstrual cycle, duration and regularity of menstrual periods, past abortions, miscarriages, and live births; course of past pregnancies, labors and deliveries); and factors in your personal life that might affect your pregnancy.
A Complete Physical Examination.
This may include: assessment of your general health through examination of heart, lungs, breasts, abdomen; measurement of your blood pressure to serve as a baseline reading for comparison at subsequent visits; notation of your height and weight, usual and present; inspection of extremities for varicose veins and edema (swelling from excess fluid in tissues) to serve as a baseline for comparison at subsequent visits; inspection and palpation of external genitalia; internal examination of your vagina and cervix (with a speculum in place); examination of your pelvic organs bimanually (with one hand in the vagina and one on the abdomen) and also through the rectum and vagina; assessment of the size and shape of your bony pelvis.
A Battery of Tests.
Some tests are routine for every pregnant woman; some are routine in some areas of the country or with some practitioners, and not others; some are performed only when circumstances warrant. The most common prenatal tests include:
- A blood test to determine blood type and check for anemia.
- Urinalysis to screen for sugar, protein, white blood cells, blood, and bacteria.
- Blood screens to determine immunity to such diseases as rubella.
- Tests to disclose the presence of such infections as syphilis, gonorrhea, hepatitis, chlamydia, and in some cases, AIDS).
- Genetic tests for sickle-cell anemia or Tay-Sachs disease.
- A Pap smear for the detection of cervical cancer.
- A gestational diabetic screening test to check for any tendency toward diabetes, particularly for women who have previously had an excessively large baby or gained excessive weight with an earlier pregnancy.
Come prepared with a list of questions, problems, and symptoms you would like to talk about. This is also a good time to bring up any special concerns that weren't addressed at an earlier consultation.
What You May Look Like
By the end of the first month, your baby is a tiny, tadpole-like embryo, smaller than a grain of rice. In the next two weeks, the neural tube (which becomes the brain and spinal cord), heart digestive tract, sensory organs, an arm and leg buds will begin to form.
What You Might Be Feeling
You may experience all of these symptoms at one time or another, or only one or two.
Phycically:
- Absence of menstruation (though you may stain slightly when your period would have been expected or when the fertilized egg implants in the uterus)
- Fatigue and sleepiness
- Frequent urination
- Nausea, with or without vomiting, and/or excessive salivation (ptyalism)
- Heartburn, indigestion, flatulence, bloating
- Food aversions and cravings
- Breast changes (most pronounced in women who have breast changes prior to menstruation): fullness, heaviness, tenderness, tingling; darkening of the areola (the pigmented area surrounding the nipple). Sweat glands in the areola become prominent (Montgomery's tubercles), looking like large goose bumps; a network of bluish lines appear under the skin as blood supply to the breasts increases (though these lines may not appear until later)
- Instability comparable to premenstrual syndrome, which may include irritability, mood swings, irrationality, weepiness
- Misgivings, fear, joy, elation
- any or all of these
Fatigue
"I'm tired all the time. I'm worried that I won't be able to continue working."
It would be surprising if you weren't tired. In some ways, your pregnant body is working harder even when you're resting than a nonpregnant body is when mountain-climbing; you just can't see its efforts. For one thing, it's manufacturing your baby's life-support system, the placenta, which won't be completed until the end of the first trimester. For another, it's adjusting to the many other physical and emotional demands of pregnancy, which are considerable. Once your body has adjusted and the placenta is complete (around the fourth month), you should have more energy. Until then, you may need to work fewer hours or take a few days off if you're really dragging. But if your pregnancy continues normally, there is absolutely no reason why you shouldn't stay at your job (assuming your doctor hasn't restricted your activity and/or the work isn't overly strenuous or hazardous; see page 72). Most pregnant women are happier and less anxious if they keep busy.
Since your fatigue is legitimate, don't fight it. Consider it a sensible signal from your body that you need more rest. That, of course, is more easily suggested than done. But it's worth a try.
Baby Yourself.
If you're a first-time expectant mother, enjoy what will probably be your last chance for a long while to focus on taking care of yourself without feeling guilty. If you already have one or more children at home, you will have to divide your focus. But either way, this is not a time to strive for Super-Mom-to-Be status. Getting adequate rest is more important than keeping your house white-glove-test clean or serving dinners worthy of four-star ratings. Keep evenings free of unessential activities. Spend them off your feet when you can, reading, watching TV, or scouring baby-name books. If you have older children, read to them, play quiet games with them, or watch classic children's videos with them rather than traipsing off to the playground. (Fatigue may be more pronounced when there are older children at home, simply because there are so many more physical demands and so much less time to rest. On the other hand, it may be less noticed, since a mother of young children is usually accustomed to exhaustion and/or too busy to mind.)
And don't wait until nightfall to take it easy
- if you can afford the luxury of an afternoon nap, by all means indulge. If you can't sleep, lie down with a good book. A nap at the office isn't a reasonable goal, of course, unless you have a flexible schedule and access to a comfortable sofa, but putting your feet up at your desk or on the sofa in the ladies room during breaks and lunch hours may be. (If you choose to rest at lunch hour, don't forget to eat, too.) Napping when you're mothering may also be difficult, but if you can time your rest with the children's nap-time (if they still nap), you may be able to get away with it
- assuming you can tolerate the unwashed dishes and the dust balls under the bed.
Accept your mother-in-law's offer to vacuum and dust the house when she's visiting. Let your dad take the older kids to the zoo on Sunday. Enlist your husband for chores like laundry and marketing.
Get an Hour or Two More Sleep Each Night.
Skip the 11 o'clock news and turn in earlier; ask your husband to fix breakfast so you can turn out later.
Be Sure That Your Diet Isn't Deficient.
First-trimester fatigue is often aggravated by a deficiency in iron, protein, or just plain calories. Double-check to make certain you're filling all of your requirements (see the Best-Odds Diet, page 80). And no matter how tired you're feeling, don't be tempted to rev up your body with caffeine and candy bars, and cake. It won't be fooled for long, and after the temporary lift, your blood sugar will plummet, leaving you more fatigued than ever.
Check Your Environment.
Inadequate lighting, poor air quality ("sick building" syndrome), or excessive noise in your home or workplace can contribute to fatigue. Be alert to these problems and try to get them corrected.
Take a Hike.
Or a slow jog. Or a stroll to the grocery store. Or the time to do a pregnancy exercise routine. Paradoxically, fatigue can he heightened by too much rest and not enough activity. But don't overdo the exercise. Stop before that exercise high dissolves into a low, and be sure to follow the precautionary guidelines on page 195.
Though fatigue will probably ease up by month four, you can expect it to return in the last trimester -probably as nature's way of preparing you for the long sleepless nights once the baby has arrived.
When fatigue is severe, especially if it is accompanied by fainting, pallor, breathlessness, and/or palpitations, it's wise to report it to your practitioner...
Table of Contents
- Forword to the Second Edition: Another Word From the Doctor ..... XV11
- Forword: A word from the Doctor ..... XV111
- Introduction to the Second Edition: Why This Book Was Reborn ..... XX
- What's in a Month?
- Introduction: How This Book Was Born ..... XXII
- Part 1: In The Beginning
- Chapter 1: Are You Pregnant? ..... 2
- What You May Be Concerned About ..... 2
- Signs of Pregnancy
- Pregnancy Tests
- Possible Signs of Pregnancy
- Probable Signs of Pregnancy
- Positive Signs of Pregnancy
- Testing Smart
- Due Date
- What It's Important to Know: Choosing (and Working with) Your Practitioner ..... 8
- A Look Back
- What Kind of Patient Are You?
- Obstetrician? Family Practitioner? Nurse-Midwife?
- Type of Practice
- Finding a Candidate
- Birthing Alternatives
- Making Your Selection
- Making the Most of the Patient-Practitioner Partnership
- Protecting Yourself Against Malpractice
- So You Won't Forget
- Chapter 2 : Now That You Are Pregnant ..... 18
- What You May Be Concerned About ..... 18
- Your Gynecological History
- Previous Abortions
- Fibroids Incompetent Cervix
- Your Obstetrical History Repeating Itself
- Repeat Cesareans
- Your Family History
- Pregnancies too Close Together
- Tempting Fate the Second Time Around
- Having a Big Family
- Being a Single
- Mother Having a Baby After 35
- Age and Testing for Down Syndrome
- The Father's Age
- In-Vitro Fertilization (IVF)
- Living at a High Altitude
- Religious Objections to Medical Care
- RH Incompatibility
- Obesity
- Herpes
- Signs and Symptoms of Genital Herpes
- Other STDs (Sexually Transmitted Diseases)
- Fear of Aids
- Hepatitis B
- An IUD Still in Place
- Birth Control Pills in Pregnancy
- Spermicides
- Provera
- DES
- Genetic Problems
- Your Opposition to Abortion
- What It's Important to Know: About Prenatal Diagnosis ..... 42 Amniocentesis
- Amnio Complication
- Ultrasound
- Fetoscopy
- Maternal-Serum Alpha-Fetoprotein Screening
- Chorionic Villus Sampling (CVS)
- Reducing the Risk in Any Pregnancy
- Other Types of Prenatal Diagnosis
- Chapter 3: Throughout Your Pregnancy ..... 52
- What You May Be Concerned About ..... 52
- Alcohol
- Cigarette Smoking
- Breaking the Smoking Habit
- When Other People Smoke
- Marijuana Use
- Cocaine and Other Drug Use
- Perils in Perspective
- Caffeine Sugar Substitutes
- Your Pregnancy Lifestyle
- The Family Cat
- Hot Tubs and Saunas
- Microwave Exposure
- Electric Blankets and Heating Pads
- X-Rays
- Household Hazards
- Let Your House Breathe
- The Green Solution
- Air Pollution
- Occupational Hazards
- Getting all the Facts
- Quiet Please
- What It's Important to Know: Playing Baby Roulette ..... 76
- Weighing Risk vs. Benefit
- Chapter 4: The Best-Odds Diet ..... 80
- Nine Basic Principles for Nine Months of Healthy Eating
- The Best-Odds Daily Dozen
- What's in a Pill?
- The Best Odds Diet Food Selection Groups ..... 89
- Protein Foods
- High-Protein Snacks
- Vitamin C Foods
- Calcium-Rich Foods
- Calcium-Rich Snacks
- Green Leafy and Yellow Vegetables and Yellow Fruits
- Other Fruits and Vegetables
- Whole Grains and Legumes
- Iron-Rich Foods
- High-Fat Foods BEST ODDS RECIPES ..... 93
- Cream of Tomato Soup
- Best-Odds Fries
- Power-Packed Oatmeal
- Bran Muffins
- Whole-Wheat
- Buttermilk Pancakes
- Double-the-Milk Shake
- Fig Bars
- Fruity Oatmeal Cookies
- Vegetarian
- Complete Protein Combinations
- Dairy Complete Protein Combinations
- Fruited Yogurt
- Mock Strawberry Daiquiri
- Virgin Sangria
- Part 2: Months and Counting:
From Conception to Delivery
- Chapter 5: The First Month ..... l00
- What You Can Expect at Your First Prenatal Visit ..... 100
- Wbat You May Look Like
- What You May Be Feeling ..... 102
- What You May Be Concerned About ..... 102
- Fatigue
- Depression
- Morning Sickness
- Excessive Saliva
- Frequent Urination
- Breast Changes
- Vitamin Supplements
- Ectopic Pregnancy'
- The Condition of Your Baby
- Miscarriage
- Possible Signs of Miscarriage
- Stress in Your Life
- Relaxation Made Easy
- Overwhelming Fear About Baby's Health
- Picking Up Other Children
- What It's Important to Know Getting Regular Medical Care ..... 116
- A Schedule of Prenatal Visits
- Wben to Call the Practitioner
- Taking Care of the Rest of You
- Chapter 6: The Second Month ..... 119
- What You Can Expect at This Month's Check-up ..... 119
- What You May Be Feeling ..... 119
- What You May Be Concerned About ..... 120
- Venous Changes
- What You May Look Like
- Complexion Problems
- Waistline Expansion
- Losing Your Figure Heartburn and Indigestion
- Food Aversions and Cravings
- Milk Aversion or Intolerance
- Cholesterol
- A Meatless Diet
- A Vegetarian Diet
- Junk-Food Junkie
- Eating Fast Food
- Best-Odds Cheating
- Chemicals in Food
- Reading Labels
- Eating Safe
- What It's Important to Know: Playing It Safe ..... 133
- Chapter 7 : The Third Month ..... 134
- What You Can Expect At This Month's Checkup ..... 134
- What You May Be Feeling ..... 134
- What You May Look Like
- What You May Be Concerned About ..... 135
- Constipation
- Flatulence (Gas)
- Weight Gain
- Headaches
- Trouble Sleeping
- Stretch Marks
- Baby's Heartbeat
- Sexual Desire
- Oral Sex
- Cramp After Orgasm
- Twins and More
- A Corpus Luteum Cyst
- What It's Important to Know: Weight Gain During Pregnancy .... 47
- Breakdown of Your Weight Gain
- Chapter 8: The Fourth Month ..... 150
- What You Can Expect At This Month's Checkup ..... 150
- What You May Be Feeling ..... 150
- What You May Look Like
- What You May Be Concerned About ..... 152
- Elevated Blood Pressure
- Sugar in the Urine
- Anemia
- Breathlessness
- Forgetfulness
- Hair Dyes and Permanents
- Nosebleeds and Nasal Stuffiness
- Allergies
- Vaginal Discharge
- Fetal Movement
- Appearance
- Maternity Clothes
- Reality of Pregnancy
- Unwanted Advice
- What It's Important to Know MAKING LOVE DURING PREGNANCY ..... 164
- Understanding Sexuality During Pregnancy
- When Sexual Relations May Be Limited
- Enjoying It More, Even if You're Doing It Less
- Chapter 9: The Fifth Month ..... 170
- What You Can Expect At This Month's Checkup ..... 1 70
- What You May Be Feeling ..... 1 70
- What You May Look Like
- What You May Be Concerned About ..... 1 7 1
- Fatigue
- Faintness and Dizziness
- Hepatitis Testing
- Sleeping Position
- Backache
- Carrying Older Children
- Foot Problems
- Fast-Growing Hair and Nails
- Late Miscarriage
- Abdominal Pain
- Changes in Skin Pigmentation
- Other Strange Skin Symptoms
- Dental Problems
- Travel
- Eating Out
- Eating Out, Best-Odds Style
- Wearing a Seat Belt
- Sports
- Vision
- A Low-Lying Placenta
- Outside Influences in the Womb
- Carrying Baby, Fifth Month
- Motherhood
- What It's Important to Know: Exercise During Pregnancy ..... 189
- The Benefits of Exercise
- Developing a Good Exercise Program
- Don't Just Sit There...
- Playing It Safe
- Choosing the Right Pregnancy Exercise
- If You Don't Exercise
- Chapter 10: The Sixth Month ..... 199
- What You Can Expect At This Month's Checkup ..... 199
- What You May Be Feeling ..... 199
- What You May Look Like
- What You May Be Concerned About ...... 200
- Pain and Numbness in the Hand
- Pins and Needles
- Baby Kicking
- Leg Cramps
- Rectal Bleeding and Hemorrhoids
- Itchy Abdomen
- Toxemia, or Preeclampsia
- Staying on the job
- Clumsiness
- The Pain of Childbirth
- Labor and Delivery
- What It's Important to Know: Childbirth Education . . . . . . .209
- Benefits of Taking a Childbirth Class
- Choosing a Childbirth Class
- For Information on Childbirth Classes
- The Most Common Schools of Thought
- Chapter 11: The Seventh Month ..... 214
- What You Can Expect At This Month's Checkup ..... 214
- What You May Be Feeling ..... 214
- What You May Look Like
- What You May Be Concerned About ..... 215
- Increasing Fatigue
- Concern About the Baby's Well-Being
- Edema (Swelling) of the Ankles and Feet
- Overheating
- Orgasm and the Baby
- Premature Labor
- Don't Hold It In
- Approaching Responsibility
- Accidents
- Lower Back and Leg Pain (Sciatica)
- Skin Eruptions
- Fetal Hiccups
- Dreams and Fantasies
- A Low-Birthweight Baby
- A Birthing Plan
- What It's Important to Know: All About Childbirth Medication ..... 226
- What Kinds of Pain Relief Are Most Commonly Used?
- Making the Decision
- Chapter 12: The Eighth Month ..... 233
- What You May Be Feeling ..... 233
- What You May Look Like
- What You May Be Concerned About ..... 234
- Shortness of Breath
- Not So Funny Rib Tickling
- Stress Incontinence
- Your Weight Gain and the Baby's Size
- How You're Carrying
- Presentation and Position of the Baby
- Hospitals and Cesarean Rates
- Making the Cesarean Birth a Family Affair
- Travel Safety
- Driving
- Braxton Hicks
- Contractions
- Bathing
- Relationship With Your Spouse
- Making Love Now
- What It's Important to Know: Facts About Breastfeeding ..... 251
- Why Breast Is Best
- Why Some Prefer the Bottle
- Making the Choice
- When You Can't or Shouldn't Breastfeed
- Making Bottle-Feeding Work
- Chapter 13: The Ninth Month ..... 256
- What You Can Expect At This Month's CheckupS ..... 256
- What You May Be Feeling ..... 257
- What You May Look Like
- What You May Be Concerned About ..... 258
- Changes in Fetal Movements
- Fear of Another
- Long Labor
- Bleeding or Spotting
- Lightning and Engagement
- When You Will Deliver
- Do-It- Yourself Labor Induction?
- Labor and Delivery Rooms
- The Overdue Baby
- How Is Baby Doing?
- What to Take to the Hospital
- Membrane Rupturing in Public
- Breastfeeding
- Mothering
- What It's Important to Know: Pre Labor, False Labor, Real Labor ..... 268
- Prelabor Symptoms
- False Labor Symptoms
- Real Labor Symptoms
- When to Call the Doctor
- Best Medicine for Labor?
- Chapter 14: Labor and Delivery ..... 2 7 1
- What You May Be Concerned About ..... 2 7 1
- Bloody Show
- Rupture of Membranes
- Darkened Amniotic Fluid (Meconium Staining)
- Induction of Labor
- Having a Short Labor
- Calling Your Practitioner
- During
- Labor
- Back Labor
- Irregular Contractions
- Not Getting to the Hospital in Time
- Emergency Delivery En Route to the Hospital
- Enemas
- Shaving the Pubic Area
- Emergency Delivery If You're Alone
- Routine
- IVs
- Fetal Monitoring
- Emergency Home (or Office) Delivery
- The Sight of Blood
- Episiotomy
- Being Stretched by Childbirth
- Being Strapped to the Delivery Table
- The Use of Forceps
- Apgar Table
- The Baby's Condition
- What It's Important to Know: The Stages of Childbirth ..... 288
- Labor Positions
- The First Stage Of Childbirth: Labor ..... 290
- The First Phase: Early or Latent Labor
- If You Aren't Making Progress
- The Second Phase: Active Labor
- On to the Hospital
- The Third Phase: Advanced Active or Transitional Labor
- Pain Risk Factors
- The Second Stage Of Childbirth: Pushing and Delivery ...... 299
- A Baby Is Born 1 A First Look at Baby
- The Third Stage Of Childbirth: Delivery of The Placenta, Or Afterbirth ...... .305
- Breech Delivery ..... 306
- Cesarean Section: Surgical Delivery ..... 307
- Part 3:
Of Special Concern
- Chapter 15: If You Get Sick ..... 310
- What You May Be Concerned About ..... 310
- Coming Down With a Cold or Flu
- Gastrointestinal Ills
- German Measles (Rubella)
- Toxoplasmosis
- Cytomega- lovirus (CMV)
- Fifth Disease
- Group B Strep
- Lyme Disease
- Measles
- Urinary Tract Infection
- Hepatitis 1XIV
- Mumps
- Chicken Pox (Varicella)
- Fever
- Taking Aspirin and Nonaspirin
- Taking Medications
- Herbal Cures
- What It's Important to Know: Staying Well ..... 323
- Chapter 16: Coping With a Chronic Condition ..... 325
- What You May Be Concerned About ..... 325
- Diabetes
- Safe Exercise
- Heart Rate for Diabetic Pregnan-cies
- Asthma
- Chronic Hypertension
- Multiple Sclerosis (MS)
- An Eating Disorder
- Physical Disability
- Epilepsy
- Phenylketonuria (PKU)
- Coronary Artery Disease (CAD)
- Sickle-Cell Anemia
- Systemic Lupus Erythematosus (SLE)
- What It's Important to Know: Living With The High-Risk Or Problem Pregnancy ..... 339
- Moms Helping Moms
- Chapter 17 : When Something Goes Wrong ..... 342
- Conditions that May Cause Concern During Pregnancy ..... 343
- Hyperemesis Gravidarum
- Ectopic Pregnancy
- Bleeding in Early Pregnancy
- Bleeding,In Mid- or Late Pregnancy
- If You've Had a Miscarri4ge
- Early Miscarriage, or Spontaneous Abortion
- Late Miscarriage
- Trophoblastic Disease (Hydatidiform Mole
- When a Serious Fetal Defect Is Detected
- Partial Molar Pregnancy
- Choriocarcinoma
- Gestational
- Diabetes
- Chorioamnionitis
- Preeclampsia (Pregnancy-Induced Hypertension)
- Eclampsia
- Lowering the Risks for the Baby at Risk
- Intrauterine Growth Retar-dation (IUGR)
- Repeat Low-Birthweight Babies
- Placenta Previa
- Placenta Accreta
- Abruptio Placenta
- Premature Rupture of the Membranes (PROM)
- Cord Prolapse
- Ve-nous Thrombosis
- Preterm or Premature Labor
- Conditions that May Cause Concern During Childbirth ..... 362
- Uterine Inversion
- Uterine Rupture
- Shoulder Dystocia
- First Aid for the Fetus
- Fetal Distress V
- aginal and Cervical Lacerations
- Postpartum-Hemorrhage 1
- Postpartum Infection
- Chapter 17: When Something Goes Wrong ..... 342
- Conditions That May Cause Concern During Pregnancy ..... 343
- Hyperemesis Gravidarum
- Ectopic Pregnancy
- Bleeding in Early Pregnancy
- Bleeding in Mid-or Late Pregnancy
- If You've Had a Miscarriage
- Early Miscarriage, or Spontaneous Abortion
- Late Miscarriage
- Trophoblastic Disease (Hydatidiform Mole)
- When a Serious Fetal Defect is Detected
- Partial Molar Pregnancy
- Choriocarcinoma
- Gestational Diabetes
- Chorioamnionitis
- Preeclampsia (Pregnancy Induced Hypertension)
- Eclampsia
- Lowering the Risks for the Baby at Risk
- Intrauterine Growth Retardation (IUGR)
- Repeat Low-Birthweight Babies
- Placenta Previa
- Placenta Accreta
- Abruptio Placenta
- Premature Rupture of the Membranes (PROM)
- Cord Prolapse
- Venous Thrombosis
- Preterm or Premature Labor
- Conditions That May Cause Concern During Childbirth ..... 362
- Uterine Inversion
- Uterine Rupture
- Shoulder Dystocia
- Fist Aid for the Fetus
- Fetal Distress
- Vaginal and Cervical Lacerations
- Postpartum Hemorrhage
- Postpartum Infection
- Coping With Pregnancy Loss .....366
- When Multiple Fetuses Aren't Thriving?
- Loss of One Twin
- Why?
- Part4: Last But Not Least: Postpartum, Fathers, and the Next Baby
- Chapter 18: Postpartum: The First Week ..... 374
- What You May Be Feeling ..... 374
- What You May Be Concerned About ..... 375
- Bleeding
- Your Postpartum Condition
- Afterpains
- Pain in the Perineal Area
- Difficulty with Urination
- Having a Bowel Movement
- Excessive Perspiration
- Adequacy of Your Milk Supply
- Engorged Breasts
- When to Call Your Practioner
- Engorgement If You're Not Breastfeeding
- Bonding
- Rooming-In
- Going Home
- Recovery from a Cesarean Section
- What It's Important To Know: Getting Started: BreastFeeding ..... 388
- Breastfeeding Basics
- Baby and Breast
- A Perfect Feeding Team
- When the Milk Comes In
- Best-Odds Nursing Diet
- Sore Nipples
- Occasional Complications
- Medication and Breastfeeding
- Breastfeeding After a Cesarean
- Breastfeeding Twins
- Chapter 19: Postpartum: The First Six Weeks ..... 396
- What You May Be Feeling ..... 396
- What You Can Expect At Your Postpardom Chechup ..... 397
- What You May Be Concerned About ..... 397 Fever
- Depression
- Returning to Prepregnancy Weight and Shape
- Breast Milk
- Long-Term Cesarean Recovery
- Resuming Sexual Relations
- Lack of Interest in Making Love
- Easing Back into Sex
- Becoming Pregnant Again
- Hair Loss
- Taking Tub Baths
- Exhaustion
- What It's Impotant To Know: Getting Back Into Shape ..... 408
- Ground Rules
- Phase One: 24 Hours After Delivery
- Phase Two: Three Days After Delivery
- Phase Three: After Your Postpartum Checkup
- Chapter 20: Fathers Are Expectant, Too ..... 412
- What You May Be Concerned About ..... 412
- Feeling Left Out
- Fear of Sex
- Moodiness
- Impatience With Your Wife's Mood Swings
- Sympathy Symptoms
- Anxiety Over Your Wife's Health
- Anxiety Over the Baby's Health
- Anxiety Over Life Changes
- Your Wife's Looks
- Falling Apart During Labor
- Bonding
- Exclusion During Breastfeeding
- Feeling Unsexy After Delivery
- Chapter 21: Preparing for the Next Baby ..... 424
- Appendix ..... 429
- Common Tests During Pregnancy
- Non-Drug Treatments During Pregnancy
- Keeping Moist
- Best-Odds Calorie and Fat Requirements
- Sources and Resources
- Pregnancy Notes ..... 439
- Index ..... 462
- Afterword ..... 479
- What You Can Expect At This Month's CheckupS ..... 233
Interviews
Exclusive Author Essay
Some things about pregnancy never change. When the first edition of What to Expect when You're Expecting hit bookstores in 1985, pregnant women suffered from morning sickness, constipation, and leg cramps. In 2002 -- sorry, no good news here -- they still do. They experienced symptoms they'd never have associated with pregnancy, like forgetfulness and red palms; growth in places they'd never expected, like in their feet; and a range of emotions, from happiness to anxiety to apprehension to excitement, often within the same five minutes, that often made them doubt their sanity. They still do. They worried about their weight gain, their diet, the changing dynamics of their relationships, about labor and delivery, and most of all, about the health of their babies. They still do. They craved answers to their thousands of questions and reassurance for their thousands of worries. Guess what? They still do.
But as many things about pregnancy stay the same, at least as many don't.
In the nearly 19 years since I delivered a proposal for What to Expect when You're Expecting and a first baby (within about four hours of each other…it was a busy day), I've seen hundreds of changes. Changes not only in obstetrical practice but in the lifestyles of pregnant women and their partners (an important one being: those partners aren't necessarily their husbands anymore).
Most changes have been for the better. For instance, practitioners and their pregnant patients are getting along a lot better than they used to (or, as it's called it in the sandbox, they're "playing nicely"). Back in the late 1970s and early '80s, the climate in obstetrics was combative, often adversarial. Practitioners, usually obstetricians, tended to be inflexible in their practice, patients intractable in their birthing plans. Today, practitioners are for the most part far more responsive; patients, much more open-minded and better educated. The relationship is more likely to be a partnership -- a partnership that works together toward a shared goal (a healthy mother, a healthy baby), a partnership in which each partner contributes knowledge and insight based on what he or she knows best (practitioner: medicine; patient: her body). Another change is the fact that more of those partnerships are likely to be with midwives, who now deliver 9 percent of the babies born in the United States.
Recommendations about everything from prenatal diagnosis to sex to diet to exercise have changed. Take weight gain: When I was pregnant for the first time, gains of 70 pounds and more were the vogue. Sure, they still happen, but not usually with the practitioner's blessing. The majority of today's practitioners routinely recommend a more reasonable gain of 25 to 35 pounds for most women.
And because obstetrics, like all areas of medicine, is an ever-evolving science, the use of interventions during labor and delivery has evolved with it. Some procedures that were routine at hospital admission a generation ago, such as enemas and shaving of the pubic hair, have been pretty much abandoned; women today can wear their pubic hair any way they care to at delivery. Pain medication, which fell out of favor with the (re)popularization of natural childbirth, is back in style with a vengeance -- more than half of all delivering women now ask for an epidural by name. At the same time, complementary and alternative treatments -- from biofeedback for morning sickness to hypnosis and acupuncture for pain relief during labor -- once the province of fringe practitioners, have entered the mainstream of obstetrical practice. Cesarean rates are down from their all-time high in the 1980s, but they are creeping up once again (and are still considered way too high); vaginal birth after cesarean (VBAC) is now on its way down after becoming almost standard; induction was down, now it's up again, though a backlash may soon bring it back down; and (dizzy yet?) episiotomies and fetal monitoring, routine when I was birthing babies (I had both procedures), are now used only when deemed necessary, which doesn't turn out to be all that often. Further reducing the need for interventions with their special brand of comfort, support, and care are doulas, birth attendants-for-hire who coach both mothers and fathers during delivery and who are showing up at more and more births.
Not only has how women given birth changed, but where. Birthing centers that cater to low-risk deliveries by midwives continue to proliferate, but the most dramatic differences are in hospital deliveries. Family-centered care is the norm -- big brothers and sisters are welcomed with fanfare and sibling classes; fathers aren't just coaching the birth but spending the night. While I had to fight for my birthing room (there were only one or two in many hospitals, offered on a first-come-first-served basis, and none at all in others) today's low-risk expectant mothers can expect to deliver in LDRs (labor-delivery-recovery) or LDRP (labor-delivery-recovery-postpartum) rooms that rival some hotel suites in luxury and convenience (except the room service isn't nearly as good). Jacuzzi, anyone?
Visit a maternity store, and you'll notice one of the most obvious changes: Pregnancy style is no longer an oxymoron. I spent my pregnancies, unhappily, in tentlike dresses that could sleep a family of four beneath their enormous pitch. Today's expectant mothers celebrate their swollen silhouettes in clothes designed to cling, not conceal. They flaunt their bellies proudly in bikinis and in baby tees that reveal more than a glimpse of baby-to-be. Even the expectant mother on the cover of What to Expect when You're Expecting has benefited from this revolution in maternity wear -- besides trading in her '80s perm for a sleek new bob for the third edition, she's retired her shapeless muumuu for a twin set and slacks. Even her shoes, though still sensible, are cuter. Now, that's progress!
Yes, a lot has changed -- in pregnancy and in What to Expect when You're Expecting -- in the 19 years since I first delivered a baby and a book proposal. Great changes, most of them. In fact, every once in a while, I start wondering if I should give pregnancy another chance again, fill up that nearly empty nest, just so I'd be able to experience all those changes for myself. Then I remember about the morning sickness. And the constipation. And the leg cramps. And the sleepless nights. And I think maybe I'll just keep writing about pregnancy instead. After all, some things never change. (Heidi Murkoff)
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