It's only natural to worry a bit throughout your pregnancy -- after all, this whole baby thing is new, nail-bitingly unpredictable, and you just want so badly for it to go perfectly. And guess what? It usually does. Here, doctors explain the real facts about the things that freak you out most. Read on -- and heave a huge sigh of relief.
THE FEAR: I'll have a miscarriage.
THE (RELAX!) FACTS: It's unlikely. Most pregnancies result in healthy babies (less than 20 percent end in miscarriage), says Karyn Morse, MD, an ob-gyn at Cedars-Sinai Medical Center in Los Angeles. "Remember also that most miscarriages also happen within the first few weeks of pregnancy, when many women typically don't realize they're expecting and wouldn't know if they did miscarry. They'd just get a normal-looking period," she says. After your doctor can see a heartbeat (usually around 6 to 8 weeks) the risk of miscarriage drops to about 5 percent. And there's very reassuring news if you should have one. The odds of having a second miscarriage is very small -- less than 3 percent, says Diane Ashton, MD, MPH, deputy medical director for the March of Dimes. So what causes a miscarriage? Often, it's due to a chromosomal abnormality that prevents the fetus from developing normally, and miscarrying is totally unavoidable -- not because of anything you did or didn't do. But you can lower your risk by not smoking or drinking alcohol and cutting back on your caffeine intake (aim for 200 milligrams or less, or one large cup of coffee, a day).
THE FEAR: My morning sickness is terrible! My baby isn't getting enough to eat.
THE (RELAX!) FACTS: Pardon the comparison, but babies are very good parasites, says Dr. Morse. "They'll absorb all of the nutrition from the foods you do give them -- so even if you're living on only crackers and juice, you don't need to worry," says Dr. Morse. Dr. Ashton agrees: "Unless you're sick to the point that you become severely dehydrated -- and if you were you'd feel so lousy that you'd call your doctor anyway -- morning sickness isn't going to cause any nutritional imbalance or affect the fetus." Just be sure to take your prenatal vitamins and do the best you can, otherwise. "Eat small, frequent meals," adds Dr. Morse. "Little bites tend to be less overwhelming to your digestive system. And eating more often will keep you from getting too ravenous, which is when women tend to feel the most nauseous." If you constantly find yourself over the toilet bowl, your doctor may prescribe an anti-nausea medication that is safe for the baby. And hang in there: Most women are able to stomach a wider variety of healthy foods after about 16 weeks -- which is coincidentally about when your baby needs to start gaining more weight too.
THE FEAR: I'll eat or drink the wrong thing -- and harm my baby.
THE (RELAX!) FACTS: Women today feel a lot of pressure to do all the "right things" when they're expecting, says Dr. Morse. Beyond the basics like eating healthy and taking prenatal vitamins, pregnant gals today worry about every little "Is it safe?" question. But agonizing over every decision will drive you crazy -- and there's no need for it. Your doctor should outline the big no-nos at your first prenatal visit, and you can ask about any major concerns then. Remember, no one can possibly follow every rule and guideline to the letter. And here's the truth: "Even the risks associated from things like eating unpasteurized cheese or dying your hair during your first trimester -- both of which doctors advise against -- are probably very, very small, and we're just being extra cautious," says Dr. Ashton. So don't fret if you accidentally order a turkey sandwich (oops...forgot that cold cuts are off-limits!) or sip a glass of juice at a brunch, then realize it's unpasteurized. And hey, we bet your mom didn't do half the things you're doing for your kiddo -- and look how brilliantly you turned out.
THE FEAR: I'm too stressed out -- and it's hurting the baby.
THE (RELAX!) FACTS: Between those crazy hormones, the sheer exhaustion, and everything else going on these days, it would be weird if you didn't feel a bit on edge every now and then. But stressing over your stress is useless, says Dr. Morse -- especially because a super-taxing day or week at work is not going to harm your baby. Most research shows that intermittent stress (the kind your body gets used to over time) has minimal impact on an unborn baby. While some studies show that acute, severe stress (like losing a job or a death in the family) can increase a baby's risk for things like premature birth, experts agree that it's all about how you handle the situation. Bottom line: If you know you tend to get super-tense, try to take things down a notch, and find a way to reclaim your calm at the end of a bad day -- be it writing in your journal, venting to your hubs, or going to bed an hour earlier.
THE FEAR: My baby will have a birth defect.
THE (RELAX!) FACTS: Like many moms-to-be, you hold your breath during every single prenatal test, hoping the results will prove your baby is healthy and developing on track. And it's overwhelmingly likely that she is. The risk of your baby having any birth defect is only 4 percent -- and that includes serious ones as well as all of the thousands of other identified abnormalities, many of which are small and insignificant, like a problem with a toenail, or a tiny heart defect that goes away soon after birth without causing any health issues. Even if a screening test (like an ultrasound or quad screen) comes back abnormal, it doesn't necessarily mean there's actually a problem, and in many cases, subsequent tests confirm that everything is fine, says Dr. Morse. The best way to protect your baby: Take a multivitamin with folic acid before pregnancy and pop your prenatal vitamins daily to reduce the risk of brain and spinal defects, and talk to your doctor about any specific concerns you have. She should be able to give you a clear idea of the true risks, given your family history and age, and help put your "what if" worries in perspective.
THE FEAR: I'll go into labor too early.
THE (RELAX!) FACTS: This one might be on your worry radar because the rate of premature births has been steadily increasing (it's just shy of 13 percent). But more than 70 percent of these babies are born between 34 and 36 weeks -- far enough along in the pregnancy that the risk of serious complications or developmental issues, while not nil, is much lower. And there are actually quite a few things you can do to lower your risk of delivering early: Don't smoke or drink alcohol, have regular prenatal checkups, and take your prenatal folic acid supplements every day. A recent study of nearly 40,000 women found that those who popped the vitamins for a year prior to conception and throughout their pregnancies were between 50 and 70 percent less likely to deliver early than those who didn't take them. The researchers believe that folic acid may prevent certain genes from malfunctioning and causing premature labor.
THE FEAR: I'll never lose all this baby weight.
THE (RELAX!) FACTS: Every giant-bellied gal on the planet worries about getting her pre-baby body back. And it doesn't help to see celeb after celeb snap back to their skinny selves the instant they're wheeled out of the delivery room. Truth is, research shows that 14 to 20 percent of women do keep on at least some of their pregnancy weight, but there are ways to boost your odds of shedding every last pound: First, try to stay within the weight guidelines during your pregnancy (that's about 25 to 35 pounds for normal-weight women). Research shows that women who gain more than what's recommended are the least likely to melt it off afterward. Another biggie: breastfeeding. It's known to rev up metabolism (by hundreds of calories a day!) and helps a lot of moms naturally slim down. And once your doctor gives you the green light, get some exercise. Brazilian researchers found that women who dieted and worked out after delivering lost significantly more pregnancy weight than those who only cut calories. (But remember, breastfeeding moms shouldn't cut back too much -- you still need about 2,000 well-balanced calories a day to meet the nutritional demands of nursing.) And it's easier to slip in exercise than you think -- yes, even when you're a totally pooped new mom. Try going for long stroller walks or picking up some Pilates or cardio DVDs and slipping in a quick workout after you put baby down for the night. Finally, try the old "nap when the baby naps" advice. According to a recent Kaiser Permanente study, new moms who got five hours of sleep or less a day were three times more likely to keep on their extra baby pounds (11 of them, on average) a year later than those who got more zzz's.
THE (RELAX!) FACTS: The risk of developing dangerously high blood pressure (preeclampsia) is just between 5 and 8 percent. It's more common in women under 18 or over age 35 -- as well as in women who have borderline high blood pressure going into their pregnancy. "But if you had any of these factors, your doctor would be monitoring you closely from the very beginning -- and would likely catch the condition early," says Dr. Ashton. Preeclampsia also doesn't tend to develop until the second half of pregnancy, and in some cases, arises so late that there are few, if any, adverse health affects. There's no way to necessarily lower your risk for the condition. But making sure you get regular prenatal checkups (during which your blood pressure will be checked) and alerting your doctor to any symptoms of preeclampsia, such as swelling of your hands or face, blurry vision, or major headaches, will ensure it's caught in its earliest stages. As for gestational diabetes -- a condition where your body becomes unable to process sugar properly, so it accumulates in the bloodstream -- the risks are similarly low. Simple dietary changes, like limiting your intake of starchy carbs, are usually all it takes to get it under control. For healthy women with no history of diabetes, a routine blood glucose test between weeks 24 and 28 of pregnancy can spot the condition.
THE FEAR: Sex will never be the same again.
THE (RELAX!) FACTS: After baby makes her way out, it's hard to imagine how everything down there will get back to the way it was. But it will! You just need to give your body a little time to heal, and your libido a chance to fire back up again (breastfeeding may dampen your sex drive at first). During the first few months, odds are you and your hubby will crave sleep more than sex, anyway. Once your doctor does give you the green light to go for it, take it slow -- it may hurt or feel uncomfortable the first few times (lube will be your new best friend). But the human body is an amazing thing with an incredible ability to snap back and recover. In fact, nearly 70 percent of women report that things are back to business as usual by six months after delivery, according to one recent study in the journal Obstetrics & Gynecology. And once the initial ouch-ness passes and your muscles regain their strength, a lot of new moms actually find their sex lives improve post-baby. They crave it more often and find the intimacy more satisfying than before.
THE FEAR: Labor will be too tough or painful -- I'll never make it through.
THE (RELAX!) FACTS: It's easy to get so wrapped up in your pregnancy -- all the week-by-week developments, picking out baby names, decorating the nursery -- that it doesn't dawn on you until those last few weeks that your baby actually needs an exit strategy. So you start worrying about all the different things that can happen: How much will it hurt? How long will it last? First, take a step back and realize that women have been doing this since the dawn of time (so yes, you can handle it too) -- and these days, there's plenty you can do about pain. If you're the type of person who gets more nervous the more information you have, you might be better off talking with your doctor about a few specific issues, and then just waiting until it happens to get through it. And don't watch those real-life delivery room shows on TV! They're not indicative of what you'll go through, since they tend to show just the super-dramatic deliveries. And if you're the total opposite -- and really do feel better the more uber-prepared you are -- then go for the childbirth classes, poll all your friends for tips on how they got through it, and draw up a birth plan and discuss it with your doctor. "Regardless of your worrying style, it's most important to have a doctor you trust and can chat openly with about your fears and wishes in the delivery room, and who can talk you through what to really expect," says Dr. Morse. "That will go a long way toward putting your mind at ease."
THE FEAR: What if something really gross or embarrassing will happen during delivery?
THE (RELAX!) FACTS: You've likely heard all sorts of delivery room stories -- say, about the woman who pooped on the table, or threw up all over her doctor...or cursed her husband for "doing this to me" in front of everyone present. And yes, you will wind up with a team of doctors and nurses staring expectantly at your vagina for a loooong time -- and by your side for every grunt and groan. But you know what? They do this like five times a day and whatever happens, they've seen before. And in the moment, you won't care either. The only thing you'll be thinking about is getting that baby out and seeing her for the first time. "Honestly, nothing grosses us out," says Dr. Morse. "So put it out of your mind!" If it will help ease your nerves any, go ahead and get waxed before D-day, or institute a "stay north of my waist" rule for any family or friends keeping you company.
THE FEAR: I'll need an emergency c-section.
THE (RELAX!) FACTS: A third of all babies are born by c-section, but many of these surgeries are known in advance -- not the scary last-minute, rush-into-the-OR kind, says Dr. Morse. A c-section might be planned, for example, if the baby is breech or very large, if there are problems with the placenta, or if the mom has had a previous c-section. "I can tell you from my own experience that emergency c-sections are not common. But if something happens and you do need one? That's why you're in the hospital," she says. "And as scary as it may be to get whisked into surgery, mom and baby usually come out of it just fine."
THE FEAR: I won't make it to the hospital in time.
THE (RELAX!) FACTS: It doesn't happen every day, but when it does, it's all over the local news: the mom who delivered her baby in a cab on the way to the hospital, with a taxi driver standing in as obstetrician. In truth, you'd probably have enough time to fly across the country between your first contraction and hearing the baby's first cries. Official stats say that, on average, labor and delivery last between 12 and 21 hours. "It's usually toward the longer end of the range for firstborn children," Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom. Have a chat with your M.D. or childbirth-class instructor to make sure you're completely clear on when to head to the hospital. Doing a trial run, so you'll know exactly how long it takes to drive there, may also quell any lingering apprehension.
THE FEAR: I'm not going to be a good mom.
THE (RELAX!) FACTS: You know exactly who you are as an individual now, and perhaps as a partner, a professional, and even a pet owner. But what will happen when you throw a child into your established mix? Will you be able to balance the needs of your new life with your old one, not to mention figuring out how to teach your child, discipline her, and build her self-confidence? Gah! "I remember worrying whether I was capable of expanding my love enough for this new person," Dr. Northrup says. You'll be amazed. "Our ability as humans to bond is endless," says Steven R. Goldstein, M.D., a professor of obstetrics and gynecology at New York University School of Medicine. "If you're concerned about being a good parent," he adds, "it's a positive sign. It means you really, deeply care. And if you care, you are going to be a good mom."
Originally published in the October 2011 issue of American Baby magazine.
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