DIY Baby! Your Essential Pregnancy Handbook

TABLE OF CONTENTS

Chapter 1: The Case of the Missing Period

• When am I due? Naegele’s Rule: An Easy Way to Find Your Due Date

• Early Ultrasound

• What Causes Twins?

• Sciences Notes: Fertilization to Implantation

• Pregnancy Dating

• Folic Acid and Early Nutrition: Alcohol, Tobacco,Drugs and Medications

• How Much Weight Should I Gain?, Body Mass Index, Exercise in Pregnancy

• Early Symptoms of Pregnancy: Breast Changes,Genital Changes,Cramping,Fatigue,Nausea,Spotting and Bleeding,Emotions

• Choosing Your Ob Provider

• Lay Midwives and Home Birth

• Choosing Where to Deliver: Hospital or Birth Center

• Your First Prenatal Visit

• For Dads: Mom’s Early Pregnancy Symptoms; How They Impact You

• Office Notes: Ambiguity About Pregnancy

Chapter 2: Miscarriage and Early Pregnancy Loss

• What is a Miscarriage?

• Incidence and Causes

• Diagnosing and Treating Miscarriage

• Ectopic Pregnancy

• Incomplete Miscarriage

• Second Trimester Pregnancy Loss

• Office Notes: Terry’s Twins

Chapter 3: Hormones and Optimism: Ten to Twenty Weeks

• Estrogens: Physical Effects, Mental and Emotional Effects

• Progesterone: Physical Effects, Mental and Emotional Effects

• Human Chorionic Gonadotropin (the Pregnancy hormone):Physical Effects, Mental and Emotional Effects

• Fetal Adrenal Glands and Hormones

• The Importance of Cholesterol

• Other Hormones, Relaxin

• Second Trimester Physical Symptoms: Bleeding and Spotting, Energy Level, Appetite Changes

• Science Notes: Fetal Movement

• Early Genetic Screening: Nuchal Translucency and Early Ultrasound, First Trimester Serum Screening, Second Trimester Serum Screening, Mid-Trimester Ultrasound, Amniocentesis,

• Chorionic Villus Sampling

• For Dads: Intercourse and Mood Changes

Chapter 4: Viability: Twenty to Twenty-Six Weeks

• Viability Defined

• Preterm Birth: Defined and Incidence

• Gestational Age and Survival

• Preterm Birth: Prevention and Recognition, Risk Factors

• Preterm Labor Symptoms

• Round Ligament Pain or Contractions?

• Diagnosis of Preterm Labor

• Early Symtpoms Change

• Treatments for Preterm Labor

• Medications to Stop Contractions: Terbutaline, Magnesium Sulfate, Nifedipine, Indocin, Sulindac

• Betamethasone

• Antibiotics

• Consequences for Newborns of Preterm Birth

• Science Notes: Cerebral Palsy

• Office Notes: Story of Mom to a Preemie

Chapter 5: Nesting: Twenty-Six to Thirty-Six Weeks

• Prenatal Visits: Tummy Checks and Heart Tones

• Gestational Diabetes

• Pre-Eclampsia

• Rhesus Facor (Rh)

• Group B Strep

• Physical Changes in the Third Trimester: Pelvic Pressure, Constipation, Sleep Changes, Braxton Hicks Contractions, Breast Leakage, Vaginal Discharge, Sex in the Third Trimester, Emotional Status

• Fetal Movement: Sleep Cycles, Breathing, Hiccups

• Prenatal Classes

• Perinatal Massage

• What to Pack

• Birth Plans

• For Dads: Pregnancy “Mania”

Chapter 6: It’s Time! Labor and Deliver Me

• Keys to Successful Vaginal Birth: Passenger, Pelvis, Power

• Condition Your Body for Labor: You Can Affect the Outcome

• Condition Your Mind: Abdominal Breathing and Progressive Muscle Relaxation

• Your Birth Plan

• When will IT happen?

• How long will IT take?

• Phases of Labor: Early, Active; First, Second Third

• Science Notes: What Causes Labor to Begin?

• Early, Prodromal, and False Labor

• Spontaneous Rupture of the Membranes

• Bloody Show

• The Delivery Center

• The Labor Nurse

• Other non-Ob-Provider Delivery Personnel: Baby Care Providers, Nursing and Medical Students

• The Labor Room (LDR)

• The Fetal Monitor

• Fetal Heart Rate During Labor

• Maternal Position Change and Oxygen Administration

• Cerebral Palsy and Intrapartum Hypoxia

• Internal Monitors: Fetal Scalp Electrode, Intra-Uterine Pressure Catheter

• What Will Labor Be Like?

• Admission and Early Labor, Wearing Your Own Clothes, Walking and Eating, Early Labor Contractions, Active Labor Contractions, Walking, Swiveling, “Doing the Ball”

• Science Notes: Rotation and Descent of the Baby in Labor

• Pictures: 20 pages of photos with detailed explanations of what happens inside the body during labor

• Positions of the Baby in the Uterus

• Important Diameters of the Fetal Head

• Pelvic Anatomy

• Fetal Monitors and Intra-Uterine Pressure Monitors

• The Faces of Labor

• Positions for Active Labor

• Positions for Pushing

• Supporting the Perineum

• Delivery Maneuvers

• Back Labor

• Asynclitism or “Tilted Head”

• “Transition”

• Pain Medication Options: Intravenous Narcotics, Regional Anesthetics

• Pushing

• The “C” Position

• Hips Flexed and Out

• Normal Duration of Second Stage

• Special Techniques for Delivering the Occiput Posterior or Asynclitic Baby: Pushing With a Towel, Hand and Knees

• Baby Delivers!

• Tear vs. Episiotomy

• Science Notes: Anatomy of the Pelvic Floor

• “Shredding”

• “Caput Succedaneum” (Funny Looking Head)

• Science Notes: Baby’s First Breath

• Delivery of the Placenta

• For Dads: “Shock and Awe”

• Office Notes: Birth Plan Takes a Left Turn

Chapter 7: Help is On its Way: Medical Intervention at Term and During Birth

• Delivery Usually Uneventful: The Big Picture

• The National Cesarean Section Rate

• The Breech Position, Breech Delivery of a Second Twin

• Induction of Labor

• Some Reasons for Labor Inductions

• Prostaglandins Ripen the “Unfavorable” Cervix

• Augmentation of Labor with Amniotomy

• Induction of Labor With Oxytocin

• Augmentation of Labor with Oxytocin

• Labor Dysfunction

• Other Reasons for Intervention: Fetal Intolerance of Labor, Cord Compression, Placental Insufficiency

• Shoulder Dystocia

• Assisted Vaginal Delivery

• Safety Requirements for Vacuum/Forceps

• Vacuum

• Forceps

• Science Notes: Vacuum vs. Forceps Delivery

• Illustrations: Vacuum Delivery

• Cesarean Section

• Recovery from A C-Section

• VBAC versus Elective Repeat Section

• Patient Choice Cesarean Section

• Management of Third Stage (Delivery of Placenta) and Post-Partum Hemorrhage: Uterine Atony, Retained Placenta, Lacerations

• Birth Plans Revisited

• Home Births

• For Dads: Going to C-Section

• Office Notes: The Longest Labor

Chapter 8: DIY Baby! What You Need to Know if You’re Considering Home Birth

• Home Birth–Why: Personal, Financial, Spiritual/Religious, Access to Care

• Home Birth–Safer Than You Think??

• Are You a Good Physical Candidate to Attempt Home Birth?

• Are You a Good Mental/Emotional Candidate for Home Birth?

• Establish Relationships Prior to Delivery

• Contraindications to Attempting Home Birth

• Who Should Attend Your Birth?

• Preparation is Key: Supplies Necessary for Home Birth

• Managing Labor at Home

• Delivery of the Placenta

• Dealing With Heavy Bleeding

• Keep Your Eye on the Ball

Chapter 9: A Perfect Love, A Perfect Life: Newborn and Post-Partum Period

• A Love Like No Other

• The First Week Post-Partum

• Inconsolable Crying (Colic)

• Pacifiers and Artificial Nipples

• Breast-Feeding and Lactation: Latch-On, Inverted and Flat Nipples

• What is Breast Milk and When Does it “Come In”?

• Science Notes: Composition of Breast Milk: Why “Breast is Best”?

• Milk Let-Down

• Foremilk and Hindmilk: Empty One Breast Fully Before Switching

• Asymmetry in Production and Size

• Setting

• Nursing Holds

• Frequency of Nursing: How To Tell if Your Baby’s Getting Enough

• Duration of Nursing Sessions: Nourishment vs. Comfort Nursing

• Milk Supply, Breast Pumps

• Introducing a Bottle: Feeding the Baby Pumped Milk or Formula

• Storing Pumped Milk and Supplementing

• Formula Feeding

• Nipple Problems

• Mastitis

• Suppression of Milk Supply

• Neonatal Jaundice

• Baby Blues and Post-Partum Depression: Why They Occur and How to Tell the Difference: How to Know When You Need Help

• Feelings of Detachment

• Rehabilitating Your Pelvic Floor

• Kegels to the Rescue!

• Sex After Baby, Sex Drive Rebounds, Anatomic Changes

• Mile Markers: Six and Twelve Weeks

• Some Nuts and Bolts of Infant Care: Head Control, Car Seat, Pediatrician Visits, Circumcision, Preventing SIDS: Back to Sleep and No Smoking

• For Dads: Why the Breasts May be Off-Limits

Chapter 10: The Leading Man–Knight in Shining Armor: Tips for Dads

• “Shock and Awe”

• Fatherhood: Long-Term Commitment, Not a Rite of Passage

• Conquering Fear

• How to Be the Knight in Shining Armor

• You Will Be Ignored–It’s Nothing Personal

• Transform Setbacks Into Opportunities

• Ambiguity

• Breasts

• Sex After Baby–Patience–She’s Not There Yet

• How to Get Her Interested Again

• Work and Family Balance; Consistency

• How to Recognize Post-Partum Depression

• The Family Bed

• Dad’s Baby Blues: No Phase Lasts Forever

• Office Notes: Matthew’s Story (of Becoming a Father at 50)

Epilogue: What I Learned from My Own Pregnancies

Knowledge is Power

I want to empower you with knowledge and de-mystify pregnancy. Many of the questions I answer on cafemom.com and other pregnancy sites are thoroughly covered in DIY Baby. Many of my posts on pregnancy are excerpts from the book. I regularly add content to the book via this website.