What to expect when you're expecting (18 page)

Read What to expect when you're expecting Online

Authors: Heidi Murkoff,Sharon Mazel

Tags: #Health & Fitness, #Postnatal care, #General, #Family & Relationships, #Pregnancy & Childbirth, #Pregnancy, #Childbirth, #Prenatal care

Your Obstetrical History
In Vitro Fertilization (IVF)

“I conceived my baby through in vitro fertilization. How different will my pregnancy be?”

Some well-deserved congratulations on your IVF success! With all you’ve been through to get to this point, you’ve earned some smooth sailing—and happily, you’re likely to get it. The fact that you conceived in a laboratory rather than in bed shouldn’t affect
your pregnancy all that much, at least once the first trimester is over. Early on, however, there will be some differences in your pregnancy and your care. Because a positive test doesn’t necessarily mean that a pregnancy will be sustained, because trying again can be so emotionally and financially draining, and because it’s not known right off how many of the test-tube embryos are going to develop into fetuses, the first six weeks of an IVF pregnancy are usually more nerve-wracking than most. In addition, if you’ve miscarried in previous tries, intercourse and other physical activities may be restricted. As an added precaution, the hormone progesterone will likely be prescribed to help support your developing pregnancy during the first two months.

But once this period is past, you can expect that your pregnancy will be pretty much like everyone else’s—unless it turns out that you’re carrying more than one fetus, as over 30 percent of IVF mothers do. If you are, see
Chapter 16
.

The Second Time Around

“This is my second pregnancy. How will it be different from the first?”

Since no two pregnancies are exactly alike, there’s no predicting how different (or how similar) these nine months will be from the last. There are some generalities, however, about second and subsequent pregnancies that hold true at least some of the time (like all generalities, none will hold true all of the time):

You’ll probably “feel” pregnant sooner. Most second timers are more attuned to the early symptoms of pregnancy and more apt to recognize them. The symptoms themselves may vary from last time—you may have more or less morning sickness, indigestion, and other tummy troubles; you may be more tired (especially likely if you were able to nap in your first pregnancy but now barely have the chance to sit down) or less tired (perhaps because you’re too busy to notice how tired you really are or because you’re so used to being tired); you may have more urinary frequency or less (though it’s likely to appear sooner).

Some symptoms that are typically less pronounced in second and subsequent pregnancies include food cravings and aversions, breast enlargement and sensitivity, and worry (since you’ve already been there, done that, and lived to tell about it, pregnancy is less likely to induce panic).

You’ll “look” pregnant sooner. Thanks to abdominal and uterine muscles that are more lax (there’s no gentler way to put that), you’re likely to “pop” much sooner than you did the first time. You may notice, too, that you’ll carry differently than you did with baby number one. Baby number two (or three or four) is liable to be larger than your firstborn, so you may have more to carry around. Another potential result of those “loosened-up” abdominals: Backache and other pregnancy pains may be exacerbated.

You’ll probably feel movement sooner. Something else to thank those looser muscles for—chances are you’ll be able to feel baby kicking much sooner this time around, possibly as early as 16 weeks (maybe sooner, maybe later). You’re also more likely to know it when you feel it, having felt it before. Of course, if the last pregnancy left you with lots of extra abdominal padding that you haven’t been able to shed, those first kicks might not be so easy to feel.

You may not feel as excited. That’s not to say you aren’t thrilled to be expecting again. But you may notice that the excitement level (and that compulsion to tell everyone you pass in the street the good news) isn’t quite as high. This is a completely normal reaction (again, you’ve been here before) and in no way reflects on your love for this baby. Keep in mind, too, that you’re preoccupied (physically and emotionally) with the child who’s already here.

You will probably have an easier labor and a faster delivery. Here’s the really good part about those laxer muscles. All that loosening up (particularly in the areas involved in childbirth), combined with the prior experience of your body, may help ensure a speedier exit for baby number two. Every phase of labor and delivery is likely to be shorter, with pushing time significantly reduced.

You may wonder how to tell baby number one about the new baby who’s on the way. Realistic, empathetic, and age-appropriate preparation for your firstborn to make the life-changing transition from only child to older child should begin during pregnancy. For tips, see
What to Expect the First Year
and
What to Expect the Toddler Years.
Reading picture books such as
What to Expect When Mommy’s Having a Baby
and
What to Expect When the New Baby Comes Home
to your child will also help with older sib preparations.

“I had a perfect first baby. Now that I’m pregnant again, I can’t shake the fear that I won’t be so lucky this time.”

Your chances of hitting the baby jackpot once again are excellent—in fact, better still for already having a successful pregnancy under your reexpanding belt. Also, with each pregnancy you get the chance to up the odds even more, by accentuating all those pregnancy positives (good medical care, diet, exercise, and lifestyle choices).

Your Obstetrical History Repeating Itself

“My first pregnancy was very uncomfortable—I must have had every symptom in the book. Will I be that unlucky again?”

In general, your first pregnancy is a pretty good predictor of future pregnancies, all things being equal. So you are a little less likely to breeze comfortably through pregnancy than someone who already has. Still, there’s always the hope that your luck will change for the better. All pregnancies, like all babies, are different. If, for example, morning sickness or food cravings had you down in your first pregnancy, they may be barely noticeable in the second (or vice versa). Though luck, genetic predisposition, and the fact that you’ve experienced certain symptoms before have a lot to do with how comfortable or uncomfortable this pregnancy will be, other factors—including some that are within your control—can alter the prognosis to some extent. The factors include:

General health.
Being in good all-around physical condition gives you a better shot at having a comfortable pregnancy.

Weight gain.
Gaining weight at a steady rate and keeping the gain within the recommended guidelines (see
page 166
) can improve your chances of escaping or minimizing such pregnancy miseries as hemorrhoids, varicose veins, stretch marks, backache, fatigue, indigestion, and shortness of breath.

Diet.
It can’t offer any guarantees, but eating well (see
Chapter 5
to find out how) improves every pregnant woman’s chances of having a healthier and more comfortable pregnancy. Not only can it up your odds of avoiding or minimizing the miseries of morning sickness and indigestion, it can help you fight excessive fatigue, combat constipation and hemorrhoids, and prevent urinary tract infections and iron-deficiency anemia—even head off headaches. And if your pregnancy turns out to be uncomfortable anyway, by eating well you’ll have bestowed on your baby the best chances of being born healthy.

Fitness.
Getting enough and the right kind of exercise (see
page 215
for guidelines) can help improve your general well-being. Exercise is especially important in second and subsequent pregnancies because abdominal muscles tend to be more lax, making you more susceptible to a variety of aches and pains, most notably backache.

Lifestyle pace.
Leading a harried and frenetic life (and who doesn’t these days?) can aggravate or sometimes even trigger one of the most uncomfortable of pregnancy symptoms—morning sickness—and exacerbate others, such as fatigue, headache, backache, and indigestion. Getting some help around the house, taking more breaks away from whatever fries your nerves, cutting back at work, letting low-priority tasks go undone for the time being, or practicing relaxation techniques or yoga can help you chill out—and feel better.

Other children.
Some pregnant women with other children at home find that keeping up with their offspring keeps them so busy that they barely have time to notice pregnancy discomforts, major or minor. For others, all the running around that comes with running after kids tends to aggravate pregnancy symptoms. For example, morning sickness can increase during times of stress (the getting-to-school or the getting-dinner-on-the-table rush, for instance); fatigue can be heightened because there doesn’t seem to be any time to rest; backaches can be an extra pain if you’re doing a lot of child toting; even constipation becomes more likely if you never have a chance to use the bathroom when the urge strikes. You are also more likely to come down with colds and other illnesses, courtesy of older germ-spreading kids. (See
Chapter 20
for preventing and dealing with such illnesses.)

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