What to expect when you're expecting (16 page)

Ask for explanations. Find out what the potential side effects of a prescribed medication are, and whether there’s a nondrug alternative. Be sure you know why a test is ordered, what it will involve, what its risks are, and how and when you’ll learn the results.

So You Won’t Forget

Because there’ll be times when you’ll want to do a little writing with your reading, jot down a symptom so you can share it with your doctor, make a note of this week’s weight so you can compare it to next week’s, record what needs recording so you’ll remember what needs remembering—you’ll find plenty of space in the
The What to Expect Pregnancy Journal and Organizer
for all your note taking.

Put it in writing. If you find your practitioner doesn’t seem to have time to respond to all your questions or concerns, try providing a written list. If it isn’t possible for you to get a complete response at the visit, ask if you can get the answers you need through a follow-up phone call or e-mail or a longer visit next time.

Follow your practitioner’s recommendations on appointment schedules, weight gain, bed rest, exercise, medication, vitamins, and so on, unless you have a good reason why you feel you shouldn’t or can’t (in which case, talk it over with your practitioner before you follow your instincts instead).

Remember that good self-care is a vital component in good prenatal care. So take the best care of yourself that you can, getting enough rest and exercise, eating well, and steering clear of alcohol, tobacco, and other nonprescribed drugs and medications once you find out you’re pregnant, or better still, once you start trying to conceive.

If you have a gripe about anything—from regularly being kept waiting too long to not getting answers to your questions—speak up, in as nice a way as possible. Letting a problem fester can get in the way of a productive practitioner-patient relationship.

Insurance companies often serve as mediators between patient and practitioner when there is a conflict or complaint. If you have a problem with your practitioner that good communication isn’t solving, contact your health organization for help.

If you feel you can’t follow your practitioner’s instructions or go along with a recommended course of treatment, it might be because you’re just not on board with the person you’ve chosen to care for you and your baby during your pregnancy, labor, and delivery. In such a case—or if, for some other reason, your relationship with your practitioner just isn’t working—consider looking for a replacement (assuming that’s financially feasible and your medical plan permits it).

T
HE TEST RESULTS ARE BACK
; the news has (sort of) sunk in: You’re having a baby! Excitement is growing (along with that uterus of yours), and so is your list of questions. Many, no doubt, have to do with those wild and crazy symptoms you might already be experiencing (more on those later). But many others may have to do with your personal pregnancy profile. What’s a pregnancy profile? It’s a compilation of your gynecological, general medical, and obstetrical (if you’re not a first timer) histories—in other words, your pregnancy backstory. You’ll be discussing this backstory (which can actually have a lot of impact on the pregnancy story that’s about to unfold) with your practitioner at your first prenatal visit. In the meantime, this chapter can help you take stock of your pregnancy profile and figure out how it may affect—or may not affect—your nine months of baby making.

This Book’s for You

As you read
What to Expect When You’re Expecting,
you’ll notice many references to traditional family relationships—to “wives,” “husbands,” “spouses.” These references are not meant to exclude expectant mothers (and their families) who may be somewhat “untraditional”—for example, those who are single, who have same-sex partners, or who have chosen not to marry their live-in partners. Rather, these terms are a way of avoiding phrases (for instance, “your husband or significant other”) that are more inclusive but also a mouthful to read. Please mentally edit out any phrase that doesn’t fit and replace it with one that’s right for you and your situation.

Keep in mind that much of this chapter may not apply to you—that’s because your pregnancy profile (like the baby you’re expecting. is unique. Read what fits your profile and skip what doesn’t.

“I got pregnant while using birth control pills. I kept taking them for over a month because I had no idea I was pregnant. Will this affect my baby?”

Ideally, once you stop using oral contraceptives, you’d have at least one normally occurring menstrual cycle before you tried to become pregnant. But conception doesn’t always wait for ideal conditions, and occasionally a woman becomes pregnant while taking the Pill. In spite of warnings you’ve probably read on the package insert, there’s no reason for concern. There’s just no good evidence of an increased risk to a baby when mom has conceived while on oral contraceptives. Need more reassurance. Talk the situation over with your practitioner—you’re sure to find it.

“I conceived while using a condom with spermicides and kept using spermicides before I knew I was pregnant. Should I be worried about birth defects?”

No need to worry if you got pregnant while using a condom or diaphragm with spermicides, a spermicide- coated condom, or just plain spermicides. The reassuring news is that no known link exists between spermicides and birth defects. In fact, the most recent and most convincing studies have found no increase in the incidence of problems even with the repeated use of spermicides in early pregnancy. So relax and enjoy your pregnancy, even if it did come a little unexpectedly.

“I’ve been using an IUD as birth control and just discovered that I’m pregnant. Will I be able to have a healthy pregnancy?”

Getting pregnant while using birth control is always a little unsettling (wasn’t that why you were using birth control in the first place?), but it definitely happens. The odds of its happening with an IUD are pretty low—about 1 in 1,000, depending on the type of device used, how long it’s been in place, and whether or not it has been properly inserted.

Having beaten the odds and managed conception with an IUD in place leaves you with two options, which you should talk over with your practitioner as soon as possible: leaving the IUD in place or having it taken out. Which of these options is best in your situation will depend on whether or not your practitioner can—on examination—see the removal cord protruding from your cervix. If the cord isn’t visible, the pregnancy has a very good chance of proceeding uneventfully with the IUD in place. It will simply be pushed up against the wall of the uterus by the expanding amniotic sac surrounding the baby and, during childbirth, it will usually
deliver with the placenta. If, however, the IUD string is visible early in pregnancy, the risk of infection developing is increased. In that case, chances of a safe and successful pregnancy are greater if the IUD is removed as soon as feasible, once conception is confirmed. If it isn’t removed, there is a significant chance that the fetus will spontaneously miscarry; the risk drops to only 20 percent when it is removed. If that doesn’t sound reassuring, keep in mind that the rate of miscarriage in all known pregnancies is estimated to be about 15 to 20 percent.

If the IUD is left in during the first trimester, be especially alert for bleeding, cramping, or fever because having an IUD in place puts you at higher risk for early pregnancy complications. Notify your practitioner of such symptoms right away.

“I’ve had fibroids for several years, and they’ve never caused me any problems. Will they, now that I’m pregnant?”

Chances are your fibroids won’t stand between you and an uncomplicated pregnancy. In fact, most often these small nonmalignant growths on the inner walls of the uterus don’t affect a pregnancy at all.