Please feel free to add your own questions in the comments section if you think there are others more important =)
1. When do I need to wear maternity clothes?
So much of this depends on your current size and style of clothing. If you’re a very slim build with slim clothes, you will start feeling “full” in them as early as 8 weeks. Most of my very svelte friends needed some bigger pants (but not maternity) around 12 weeks. To the outside world, they didn’t look pregnant, but they themselves knew! I would say it is normal, no matter what your size, to need at least one or two sizes up around the end of the first trimester. And it is probably normal to breach your first maternity pants between 16 and 20 weeks—not the huge belly pants but ones with stretchy waists or slight bellies—as well as your first maternity shirts. The hugest maternity clothes usually come into play somewhere between the 7th and 8th month when your baby steadily starts putting on its own weight. I’m sorry, but you will eventually look like a boat =)
But so much depends on your size, style, and pattern of weight gain. Some women gain 10 pounds in the first months and need bigger clothes sooner. Others are on their third and fourth children so a slight “belly” seems to appear immediately! And yet if you’re one of those unfortunate souls vomiting non-stop for the first three months, you won’t need a bigger size for awhile because you’re not gaining weight. Some women still are apologizing for their too-small bellies up to the five-month mark. And significantly larger ladies tend to not gain much weight in their pregnancy and may be able to get away with their regular size until the last trimester. One plus-size friend of mine gained only 8 pounds until the last six weeks of her pregnancy, when she upped to 12 pounds. Then there’s the matter of taste: some women want to jump into maternity styles immediately because they’re so excited. Others want to forestall the maternity thing until the last minute possible. So it’s all in the details. Do what works for you.
2. When do I need to go to the doctor?
Generally speaking, it’s a good idea to get your first pregnancy check-up sometime between 8 and 12 weeks. Even if know exactly when you conceived and you’re perfectly healthy, the person in charge of your health during pregnancy will want you to have an ultrasound for dating purposes. And the earlier the ultrasound (like at 8 weeks rather than 13), the more accurate the delivery date will be. That delivery date will be etched into your mind, the mind of your practitioner, and the schedule of your practitioners’ office forever, so you want it to be accurate. Many midwiferies and birthing centers have limits to the number of ladies they can deliver in a particular month, so get on the “schedule” early if possible.
If you haven’t made up your mind about which doctor, which hospital, which birthing center, or home-birth… go to a local doctor anyway before the end of your first trimester. (Call your insurance company for an OB/GYN covered in your area if you don’t know where to go.) Even if you end up switching from him/her, the results of your initial tests can be easily transferred to the person you choose later. The first visit will entail a blood test to confirm pregnancy and all important blood stats, and probably a pelvic exam, urine test, and basic medical history questionnaire. (If there was, sadly, any major problem like an ectopic pregnancy, they can catch it then.) Then they will ask you to schedule that first ultrasound. Once these details are locked in, you can take all the time you want to find the pregnancy/birthing place that most fits you, even up to the fifth month if it takes that long. By 18-22 weeks, you’ll need to be committed to a place because there is another more important ultrasound at that point, as well as a couple routine tests.
3. Do I need prenatal vitamins? Which ones are best?
There are lots of different opinions out there, and I have a post somewhere about it. But the controversial answer is that “yes” vitamins are important to prevent Spina Bifida, and that a prenatal vitamin is supposed to be more specially formulated for pregnant women than your regular brand. But do your own research. I was happiest with Shaklee’s because they were organic and seemed to be absorbed better, and because you could get them without iron (which made me nauseous and constipated).
4. How much weight should I gain? Will I ever be able to lose it?
Common wisdom is 25-35 pounds with skinnier ladies needing more weight and heavier ladies needing less. But often times skinny ladies don’t gain that much, maybe 20 pounds. And lots of people gain more. I gained 55-60 pounds with three of my pregnancies and lost it each time except for maybe 5 pounds. Pregnancy weight is different than other weight and is lost differently. You lose about 12-20lbs in the first week after delivery. Breastfeeding can help (but sometimes postpone) the weight coming off. Often times a regular healthy eating pattern is enough to slough off the rest (i.e. as opposed to “dieting”), especially if you are in your 20s.
So returning to your old size is definitely possible. But not common. Also keep in mind that even if you lose the weight, the proportions of your body may change. Breastfeeding (for a long time) is known to make breasts shrink, hips may be slightly wider, and the ratio of fat to muscle on your body will probably change… muscle tone lost, fat gained. So this may make the weight lay differently on your body than before, necessitating a size smaller bra but a size bigger pant. (Also your feet may have gotten wider!). It’s all part of the natural course of pregnancy hormones which relax your bones and make you store fat for the baby. Taking a prenatal exercise class can help you maintain some muscle tone, but don’t be surprised if it doesn’t look or feel as cool as it did before you had morning sickness, cravings, fatigue at 8pm, and a big belly!
5. What do I eat?
Any book or website on pregnancy is probably 50% or more about what you eat. So it’s all in what you relate to. But my simplistic advice is: eliminate processed foods and caffeine. Eat as much fresh food as possible (nothing in a box or bag), and switch your beverages to decaf. There are a million ways to eat super, super healthy (which is ideal), but for the rest of us, these two changes are enough to really bolster your health and your baby’s.
Don’t forget that you are not supposed to be “eating for two.” That is old wisdom. Don’t count calories, but eat functionally (what your body craves) and according to your actual hunger. I found that my real hunger kicked in around the fifth or sixth month. I was ravenous then, and that was ok. I am a firm believer that eating how your body is telling you to during pregnancy makes a difference in how the weight comes off in the end. And eating healthily while you’re pregnant ensures that you won’t feel malnourished after the delivery. (Your baby will be nice and healthy but you won’t!) If you eat for two and include lots of empty or extra calories, you won’t lose that weight and you’ll feel like you’re a starving orphan after the baby comes out. I am sure that “extra 5 pounds” I couldn’t lose between each pregnancy came from about 5 pounds of “extra” cookies I ate while I was pregnant! The rest of the healthy eating weight came right off =)
6. When will my morning sickness end?
Well, most chronic sickness ends somewhere between 12 and 16 weeks. But for a minority, it lingers on. For some, it stops before. It literally can vanish overnight. Because “morning sickness” is such a misnomer, it really depends on what you’re experiencing. Diarrhea, heartburn, stomach cramps, sickness at night, sickness after eating, sickness when anything (even a toothbrush) is in your mouth, sickness at smells, sickness when bending over… all of these things pass for “morning sickness.” I would say that the closer to classic “sickness when I wake up and I stuff a Saltine in my mouth so I won’t puke” you have, the more likely it is to end by the classic 13th week. But make sure your sickness isn’t being caused by your prenatal vitamin first. And make sure that you don’t skip meals because that can make you feel sick at any point in your pregnancy.
p.s. While you should always try to stay medication-free during your pregnancy, a little Pepto, Zantac, or Immodium is not harmful if you get in a bind.
7. When will I find out boy or girl?
You can find out the gender during your halfway-point ultrasound… between 17 and 22 weeks. The external genitalia have developed enough, and the baby is not so big and squashed yet, that the ultrasound technician can usually tell. Other cool landmarks are seeing the heartbeat (as early as five weeks), hearing the heartbeat (usually the third month), feeling the first movements (usually around the half-way point), and feeling the body parts/seeing them move across your belly (when you’re huge!).
8. Hospital, birthing center, or home birth? Natural or medicated?
Each has their pros, and I bet you can guess what they are. I have a longer post on the issue somewhere, but doctors are good for those who feel comfortable with the highest medical access. Doctors are also a must if you have a high-risk pregnancy for any reason (diabetes, suspected birth defects or history, past drug use, carrying multiples…) or if complications arise. They are also a natural choice if you know you want an epidural, although many hospitals allow midwives to oversee low-risk births with epidurals or inductions too. You can be sure that you’re safe in a doctor’s hands, although this method of birthing is increasingly under attack today for the medicalization of the delivery process—including fetal monitors and IVs, and more pitocin, inductions, epidurals, and caesareans than are necessary. That critique noted, it is also true that fetal monitoring can detect a distressed baby, inductions and caesareans which are necessary can be administered, and any complications with the baby postpartum can be expertly addressed in a medical setting.
No-one likes staying in a hospital for long, but it is nice to have a nursing staff help you and your baby recover for at least 24 hours (the time when most things, if they are going to go wrong, do). You take your baby home knowing that you and he/she have been thoroughly checked out. Hospitals are notoriously brusque and routinized during the labor process, but they are increasingly adaptable to things that women have fought for over the years, including your husband present at all times, rooming in with your baby, breastfeeding (usually there is a lactation consultant on staff), and less prep (no enemas, shaving, etc.). They will, however, use high lighting, noise and commotion when necessary, the laying down delivering position, and rigorous baby cleaning postpartum (including a heel stick) which the modern day natural childbirth camp is normally against.
Birthing centers are a good option for those who want a professionally assisted natural birth. While giving birth at home may be a stretch for some people’s imagination, giving birth at a birthing center can seem like a fabulous option. Midwives and doulas can help you achieve your dream of having a natural childbirth, assisting you with showers, massage, water births, labor balls, and whatever else. Your husband can be with you (but no children) the whole time, and you basically run the show without doctors and nurses telling you what to do. But the best part is the ability to labor and move around freely, in your own clothes, in a pleasant environment, not facing the constrictions of a hospital and its monitoring. You get women who are usually fabulous with birth and relationship-oriented, who are really excellent at everything they do, even emergencies. Plus you have the ability to be transferred to a hospital should something scary come up. The only big downer, other than that you can’t change your mind and get an epidural (!), is the time crunch: you can’t stay if you’re not in active labor, and you have to leave 6-12 hrs after giving birth. That is not a long turn around time.
Home births are good for the naturalists in all of us who really want the old-fashioned and family-oriented experience of delivering the newest member at home. Assuming that your state and community permit it (some don’t), and that you actually own your house (renters cannot home birth), and that you can afford or cover the professional assisting you, home birth can be a great option. Obviously you have no chance of backing out of the natural birth, and delivering in the tub is often promoted for pain management. But lots of moms feel more at home in their own environment, with their own music and surroundings, with their family and any children around them. The professionals are usually amazing, and you can do the birth ANY WAY YOU WANT. So if you feel this calling, check it out. There are more and more people doing it, especially thanks to Ricki Lake’s documentary on “The Business of Being Born.”
On the other hand, the traditionalist in me says that home birth should probably be contemplated after you’ve given birth once already and you know what the labor/delivery process for you personally, actually entails.
9. Do I need to take childbirth classes?
If it’s your first birth, I would recommend at least a video, even if you plan on having an epidural. Because not only is a natural childbirth an amazing thing, but the average woman needs some education about the delivery process. The lady’s delivery on your video will probably not be anything like your delivery, but that’s ok. Even better is to get your husband to watch it with you because—let’s face it—the average man knows next to NOTHING about a woman’s body or delivery. And you both will be faced with the gritty details at some point! Even better is to get your husband to attend childbirth classes with you. The advantage to childbirth classes is the time spent with your husband, the regularity of thinking about the delivery you want, and the community involved with you. The disadvantages includes the cost (although some insurances cover them), the picking of a philosophy (Bradley is very different from Lamaze), the time commitment (especially for career people), and sometimes the teacher.
10. What is labor like?
Well, it is certainly nothing like what you see on the TV. I don’t think I’ve ever seen even one labor/delivery on the TV or movie screen that was anything like my births. So don’t use that as your guide at all. You do not have one contraction that makes you know you’re in labor. Your water usually does not burst all over someone’s feet as a telltale sign. You do not scream and panic like the baby is going to claw its way out. You do not hold the baby in your arms and it’s all over just like that. The real process is different for everyone, but a classic first birth goes something like, several hours of slight labor (milling around your house), several hours of concentrated labor (focused on pain management), two hours of pushing, and an hour of recovery/clean-up time. If you have an epidural, you may have a blissful time (or not). If you have any kind of medical procedure, you will be sitting in a hospital bed the whole time, hooked up to an IV and fetal monitor. And if you are in a birthing center or at home, you are probably walking around, squatting, breathing, and otherwise not screaming your way through the contractions. In most cases, you spend several hours laboring rather normally until you get to the hospital or birthing center rather dilated. Now the pushing part may entail tons of pain like you see on the TV, but not everyone feels that way. The pushing is definitely PUSHING. And then when the baby comes out, there is the afterbirth, possible stitches, and clean-up of both you and the baby which is normally left out of Hollywood once the smiling pink nuzzly thing is laying on your chest =)