What to expect when you're expecting (130 page)

Even once you’re in labor and the mucous plug is dislodged, you can still spend time in the bath. In fact, hydrotherapy during labor can provide welcome pain relief. You can even opt to give birth in a tub (see
page 24
).

One caveat when you’re tubbing for two, especially this late in the pregnancy game: Make sure the tub has a nonslip surface or mat on the bottom so you don’t take a tumble. And as always, avoid irritating bubble baths—as well as too-warm ones.

“I can barely fit behind the wheel. Should I still be driving?”

You can stay in the driver’s seat as long as you fit there; moving the seat back and tilting the wheel up will help with that. Assuming you’ve got the room—and you’re feeling up to it—driving short distances is fine up until delivery day.

Car trips lasting more than an hour, however, might be too exhausting late in pregnancy, no matter who’s driving. If you must take a longer trip, be sure to shift around in your seat frequently and to stop every hour or two to get up and walk around. Doing some neck and back stretches may also keep you more comfortable.

Don’t, however, try to drive yourself to the hospital while in labor (a really strong contraction may prove dangerous on the road). And don’t forget the most important road rule on any car trip, whether you are driver or passenger (and even if you’re a passenger being driven to the hospital or birthing center in labor): Buckle up.

“I may have to make an important business trip this month. Is it safe for me to travel this late in pregnancy, or should I cancel?”

Before you schedule your trip, schedule a call or visit to your practitioner. Different practitioners have differing points of view on last-trimester travel. Whether yours will encourage you or discourage you from hitting the road—or the rails or the skies—at this point in your pregnancy will probably depend on that point of view, as well as on several other factors. Most important is the kind of pregnancy you’ve been having: You’re more likely to get the green light if yours has been uncomplicated. How far along you are (most practitioners advise against flying after the 36th week) and whether you are at any increased risk at all for premature labor will weigh into the recommendation, too. Also very important is how you’ve been feeling. Pregnancy symptoms that multiply as the months pass also tend to multiply as the miles pass; traveling can lead to increased backache and fatigue, aggravated varicose veins and hemorrhoids, and added emotional and physical stress. Other considerations include how far and for how long you will be traveling (and how long you will actually be in transit), how demanding the trip will be physically and emotionally, as well as how necessary the trip is (optional trips or trips that can be easily postponed until well after delivery may not be worth making now). If you’re traveling by air, you’ll also need to factor in the restrictions—if any—of the airline you choose. Some will not let you travel in the ninth month without a letter from your practitioner affirming that you are not in imminent danger of going into labor while in flight; others are more lenient.

If your practitioner gives you the go-ahead, there are still plenty of other arrangements you’ll need to make besides the travel ones. See
page 250
for tips to ensure happy (and safer and more comfortable) trails for the pregnant you. Getting plenty of rest will be especially important. But most critical will be making sure you have the name, phone number, and address of a recommended practitioner (and the hospital or birthing center where he or she delivers) at your destination—one, of course, whose services will be covered by your insurance plan should you end up requiring them. If you’re traveling a long distance, you may also want to consider the possibility of bringing along your spouse on the remote chance that if you do end up going into labor at your destination, at least you won’t have to deliver without him.

“I’m confused. I hear a lot of contradictory information about whether sex in the last weeks of pregnancy is safe—and whether it triggers labor.”

It’s not like there hasn’t been a lot of research done about sex in late pregnancy. It’s just that most of it is conflicting, leaving you and all your very pregnant peers unsure of how to proceed—that is, if you’re still in the mood to proceed. It is widely believed that neither intercourse nor orgasm alone triggers labor unless conditions are ripe, though many impatient-to-deliver couples have enjoyed trying to prove otherwise. If conditions are ripe, it’s been theorized, the prostaglandins in semen might be able to help get the labor party started. But even that’s not a sure thing—or a theory you can necessarily bank on taking you to the birthing room, even under the right, ripe conditions. In fact, one study found that low-risk women who had sex in the final weeks of pregnancy actually carried their babies slightly longer than those who abstained from sex during that time. Are you confused yet?

Based on what’s known, most physicians and midwives allow patients with normal pregnancies to make love right up until delivery day. And most couples apparently can do so without any problems arising, so to speak.

Check with your practitioner to see what the latest consensus is and what’s safe in your situation. If you get a green light (chances are, you will), then by all means hit the sheets—if you have the will and the energy (and the gymnastic skills that might be necessary at this point). If the light is red (and it probably will be if you are at high risk for premature delivery, have placenta previa, or are experiencing unexplained bleeding), try getting intimate in other ways. While you still have some evenings to yourselves, rendezvous for a romantic candlelit dinner or a starlit stroll. Cuddle while you watch TV, or soap each other in the shower. Or use massage as the medium. Or do everything but—use your hands and your mouths to your heart’s content, assuming your practitioner hasn’t red-lighted orgasm for you. This may not quite satisfy like the real thing, but try to remember you have a whole lifetime of lovemaking ahead—though the pickings may continue to be slim in that department at least until baby’s sleeping through the night.

“The baby isn’t even born yet, and already my relationship with my husband seems to be changing. We’re both so wrapped up in the birth and the baby, instead of in each other, the way we used to be.”

Babies bring a lot of things when they arrive in a couple’s lives—joy, excitement, and a lot of dirty diapers, for starters. But they also bring change—and considering they’re only pint-size, they bring a whole bunch of change.

Not surprisingly, your relationship with your spouse is one place where you’ll notice that change, and it sounds like you’ve glimpsed it already. And that’s actually a really good thing. When baby makes three, your twosome is bound to undergo some shifting of dynamics and reshuffling of priorities. But this predictable upheaval is usually less stressful—and easier to adapt to—when a couple begins the natural and inevitable evolution of their relationship during pregnancy. In other words, the changes to your relationship are more likely to represent a change for the better if they begin before baby’s arrival. Couples who don’t anticipate at least some disruption of romance-as-usual—who don’t realize that wine and roses will often give way to spit-up and strained carrots, that lovemaking marathons will place (well) behind baby-rocking marathons, that three’s not always as cozy as two, at least not in the same way—often find the reality of life with a demanding newborn harder to handle.

So think ahead, plan ahead—and be ready for change. But as you get yourselves into nurture mode, don’t forget that baby won’t be the only one who’ll need nurturing. As normal—and healthy—as it is to be wrapped up in the pregnancy and your expected extraspecial delivery, it’s also important to reserve some emotional energy for the relationship that created that bundle of joy in the first place. Now is the time to learn to combine the care and feeding of your baby with the care and feeding of your marriage. While you’re busily feathering your nest, make the effort to regularly reinforce romance. At least once a week, do something together that has nothing to do with childbirth or babies. See a movie, have dinner out, play miniature golf, hit the
flea market. While you’re out shopping for tiny onesies, buy a little something special (and unexpected) for your other special someone. Or surprise him with a pair of tickets for a show or a game you know he’d love to see. At dinner, spend at least some time asking about his day, talking about yours, discussing the day’s headlines, reminiscing about your first date, dreaming about a second honeymoon (even if it won’t be in the cards for many moons), all without mentioning the b-word. Bring massage oil to bed now and then, and rub each other the right way; even if you’re not in the mood for sex—or it’s seeming too much like hard work these days—any kind of touching can keep you close. None of this flame fanning will make the upcoming wonderful event any less anticipated, but it will remind you both that there’s more to life than Lamaze and layettes.

Considering Cord Blood Banking

As if you don’t have enough to think about before baby’s born, here’s another decision you’ll have to make: Should you save your baby’s umbilical cord blood—and if so, how?

Cord blood harvesting, a painless procedure that takes less than five minutes and is done after the cord has been clamped and cut, is completely safe for mother and child (as long as the cord is not clamped and cut prematurely). A newborn’s cord blood contains stem cells that in some cases can be used to treat certain immune system disorders or blood diseases. And research is under way to determine if these stem cells can also be useful in treating other conditions, such as diabetes, cerebral palsey, even heart disease.

There are two ways to store the blood: You can pay for private storage or you can donate the blood to a public storage bank. Private storage can be expensive, and the benefits for low-risk families—in other words, those who do not have any familial immune disorders—are not completely clear yet.

For these reasons, ACOG recommends doctors present the pros and cons of cord blood banking, and the American Academy of Pediatrics (AAP) doesn’t recommend
private
cord blood storage unless a family member has a medical condition that might be helped by a stem cell transplant now or in the near future. These conditions include leukemia, lymphoma, and neuroblastoma; sickle cell anemia, aplastic anemia, and thalassemia illness; Gaucher disease and Hurler syndrome; Wiskott-Aldrich syndrome; and severe hemoglobinopathy. The AAP does, however, support parents donating the cord blood to a bank for general use by the public. This costs the donor nothing and could save a life.

Investigate your family’s medical history to see if private cord blood banking makes sense for you. Or if you feel the potential future benefits are worth the cost, no matter what your family history, sign up for private banking (see below). You can also talk the cord blood options over with your practitioner.

For general information on cord blood banking, visit parentsguidecordblood.com. For information on donating cord blood, contact the International Cord Blood Registry at (650) 635-1452,
cordblooddonor.org
; or the National Marrow Donor Program at (800) MARROW2 (627-7692),
marrow.org
. For private banking options, contact the Cord Blood Registry at (888) 932-6568,
cordblood.com
; or ViaCord at (877) 535-4148,
viacord.com
.

Breastfeeding

For the past 30-odd weeks, you’ve likely seen (and felt) your breasts grow … and grow … and grow. If you’ve given any thought to what’s going on underneath those giant cups you’ve now traded up for, you probably know that your breasts aren’t growing randomly but are gearing up for one of nature’s most important jobs: baby feeding.

It’s clear that your breasts are already on board with breastfeeding. Whether you are, too, or whether you’re still weighing your baby-feeding options, you’ll probably want to learn more about this amazing process, a process that turns breasts (your breasts!) into the perfect purveyors of the world’s most perfect infant food. You’ll get some valuable highlights and insights here, but for much more on breastfeeding (from the why-to’s to the how-to’s), see
What to Expect the First Year.

Just as goat’s milk is the ideal food for kids (goat kids, that is), and cow’s milk is the best meal for young calves, your human breast milk is the perfect meal for your human newborn. Here are the reasons why: