Pregnancy Countdown!
Susan Magee and Kara Nakisbendi, M.D., authors of The Pregnancy Countdown Book, help you count down the days until the big event - and help you understand what you'll experience during this incredible journey!
Commitment: The Pregnancy Countdown Book is an informative and fun guide for pregnant women from inception to (sometimes delayed) delivery. The book counts the days of a woman's pregnancy to her delivery. Do things really change that much from day to day?
Kara Nakisbendi, M.D.: Pregnant women can feel different from day to day as far as energy levels, appetite, sleep quality and physical sensations. The book addresses these changes but more importantly it gives women concrete information to help explain what is happening to their bodies and to their babies. It is a surreal experience knowing that inside your body a fetus is undergoing complex developmental changes while your outside everyday life is the same. Women need this information so they can feel connected to this new life and reconcile the wide range of emotions they are feeling.
Susan Magee: The countdown premise also stems from the LONGNESS of pregnancy and what can sometimes be, from home pregnancy test to ten toes, an agonizing wait. In the third trimester, which I call the Itchy, Bitchy, and Huge phase, waiting for your water to break on those swollen feet can seem like an eternity.
Commitment: In the introduction to The Pregnancy Countdown Book, you state that pregnancy is hard work, and that books and websites don't want to admit that. What makes pregnancy such hard work?
Dr. Kara: For so many reasons pregnancy is hard work. For one, women are inundated with medical information and have to make decisions about various tests offered to them. While this may not seem like a big deal, for us women we feel like we are playing God. Another reason pregnancy is hard is that everything you do (or not do) may have an impact on your future baby. That is a huge responsibility. “Morning sickness,” back pain, sleepless nights are just some of the physical challenges women experience. Combine all of the above with wildly changing hormones and you will see pregnancy is not for the faint of heart.
Susan: You’re growing a human being in your body! How can that be easy? Acknowledging the hugeness of the task of pregnancy doesn’t mean you’re whining or being a wimp or that you don’t want to be pregnant. Many worthwhile things we do and accomplish are hard work. I was just talking to a swollen pregnant mom the other day and I said something like, “It’s really hard work, isn’t it?” and she looked at me and said, “I had no idea!”
Commitment: Why do you think no one talks about the difficulties of being pregnant?
Dr. Kara: In our culture, we don’t talk about it because women feel like they have to make it look effortless. They try to convince themselves it isn’t a big deal and that women have always given birth. The difference in our culture today is that we don’t have the support women use to have. Instead of being supportive, people share delivery night mare stories with pregnant women. If problems develop along the way, women will blame themselves.
Susan: Women really talk about their pregnancies and birthing experiences, after they’re over, when they have time to reflect (this is when the baby is about four- to five-months old and you realize the baby is not breakable.) Often, new moms will talk about how hard it was to deal with their physical issues, like bleeding through three sanitary pads an hour, shooting milk all over the place, and frankly how sore your vagina is. Plus, the baby blues are very real and still a bit taboo to discuss. Women just don’t like to admit that having a new baby is not the totally swell experience they thought it would be. We worry something is wrong with us, that as a mom, we already stink at the job. We’re weepy and suddenly alone with a baby. Sometimes I just called my sister and cried. It can be a hard time, but if you get the right support—from your significant other, family, friends, or a professional, it really will get better.
Commitment: How important is the pregnant woman – OB/GYN relationship?
Dr. Kara: Your relationship with your OB/GYN or midwife plays an integral part of a healthy pregnancy and delivery. Women need to feel comfortable telling their health care provider everything so that they receive the best care. If women feel judged or are worried that they may appear overanxious they may not tell their healthcare provider that perhaps the baby isn’t moving as much as it had been. The OB/GYN or midwife‘s role includes providing women with all the necessary information they will need.
Susan: The relationship is huge. Despite the fact that three of my friends loved him, I discovered by my second trimester that I didn’t like my doctor. He didn’t listen, he didn’t answer my questions, and when I had a complicated post-delivery, he was unsupportive. He even gave my husband “the wink” at my last post-natal appointment, indicating that I was ready to have sex again. (Ummm….no, I wasn’t! That six week later and you’re good to go myth, is just that, a man-made myth.) If I had to do it all over again, I would have left his practice and found another doctor I felt more comfortable with.
Commitment: What is “advanced maternal age” and how does that affect pregnancy?
Dr. Kara: Advanced maternal age or AMA refers to a woman who will be 35 or older when she delivers. Women who are “AMA” have an increased risk for having a baby with a chromosomal abnormality such as Down’s Syndrome. Chorionic villi sampling and amniocentesis are procedures that can be done to confirm whether a fetus has a chromosomal abnormality. Unfortunately, these procedures carry a risk of miscarrying a normal pregnancy. Age thirty five was selected purely for statistical reasons; at that age the chances of a woman carrying a baby with a chromosomal abnormality is equivalent to her having a miscarriage from CVS or amniocentesis. These aren’t statistics we like to think of when we are pregnant but it can help some women decide what tests to get. Advanced maternal age also refers to some increased risks to a woman’s health that can occur during pregnancy such as pregnancy induced hypertension, preeclampsia or gestational diabetes.
Susan: Though I understand the medical perspective, I truly hate that “advanced” label. It sounds like a soccer mom in menopause. I was 36 when I delivered my son and my doctor told me I was considered advanced. Yes, I was advanced—in knowing myself, in my career and in my mom-readiness. While there are medical reasons for the AMA label, we need to make it sound less like we’re going into labor and delivery with walkers. How about “more experienced maternally.”
Commitment: What kinds of aches and pains can a woman expect to experience during a normal pregnancy?
Dr. Kara: The hormone relaxin increases during pregnancy which relaxes the ligaments and tendons around joints, particularly in the pelvic bones. This puts a lot more stress on the muscles to hold everything together. Also, a woman’s center of gravity changes as her belly gets bigger, putting more strain on her back. Pressure from the baby’s head in the pelvis can cause discomfort. Pregnant women can often experience sciatica which is pain that radiates from the buttocks down the back of the leg.
Susan: As I say in our book, the only thing that doesn’t stretch, ache, pull, swell, or emit a liquid during pregnancy is your ears. Everything else is subject to the numerous aches and pains of pregnancy. It’s not that the aches and pains are so painful, but I was shocked at how varied they were—headaches, back pain, pulling sensations down my sides...even the arches of my feet hurt for a while. You think it’s just about the big bang at the end, but there are so many little bangs all throughout. It’s incredible how stretchy we are.
Commitment: Why do many pregnant women have strange dreams?
Dr. Kara: There are several causes for strange dreams. Changing hormones can affect the depth of sleep. Pregnant women also tend to wake up more frequently so they tend to remember their dreams more. Dreams can also be a way for the subconscious brain to play out unresolved issues and anxieties which pregnant women have many.
Susan: I had a lot of dreams that were definitely reflecting my anxiety about becoming a mom, like my baby was crying but I couldn’t find him or I forgot that I had given birth... But it’s not just moms to be who have vivid and unusual dreams. My husband had all sorts of vivid dreams about animals and talking fish while I was pregnant. He even dreamt a name that we almost named our son.
Commitment: What is the most important thing a woman should know about her pregnancy?
Dr. Kara: The most important thing a woman should know is that providing herself with good self-care will give her the greatest chances of a healthy pregnancy and delivery. Self care includes getting sufficient restful sleep, eating nutritiously dense whole foods, exercising and decreasing stress levels.
Susan: You probably won’t deliver on your due date, but know that within two weeks of it, one way or the other, you’ll have your beautiful baby.
Commitment: The Pregnancy Countdown Book features “Advice from the Trenches:” advice from women who have first hand experience with pregnancy and delivery. Should a first time mom seek advice from friends and family members or should she try to steer clear of unsolicited advice?
Dr. Kara: Unsolicited advice during pregnancy can be a minefield. People think they are being supportive by sharing their pregnancy stories but so many times they are “what can go wrong” stories. The last thing pregnant women need is more anxiety. I think first time moms should seek advice from friends and family whom they know to be supportive. The intention of “Advice from the Trenches” is to make pregnant women laugh and not feel so alone.
Susan: Once you bring home a new baby, you need the support and advice of other moms to stay same. Look for mom’s clubs (check your hospital or birthing center) or just look for other new moms on the playground or walking in the neighborhood. (You’ll be the two walking backwards to keep the sun out of the baby’s eyes.) But cut the new mom relationship short if she is too different from you philosophically. I was in a mom’s group where all the mom’s were making their own organic baby food and thought anyone who didn’t breast feed was negligent. I didn’t need that kind of pressure! I then joined a Gymboree group when Christopher was 6-months old and I met some awesome moms from whom I got lots of advice and support. We’re still friends, but now we do our playdates at night and leave the kids at home.
Susan Magee is an award-winning writer of fiction and non-fiction and the author/co-author of several books. She has an MFA from Bennington College and teaches writing at Chestnut Hill College in Philadelphia, PA. She lives near Philadelphia with her husband and son and is currently at work on her first novel.
Dr. Kara M. Nakisbendi is a Board Certified Obstetrician and Gynecologist, a Board Certified Nutrition Specialist and a Fellow of the American College of Obstetrics and Gynecology. Dr. Nakisbendi is a native of Philadelphia. She received her medical degree from Temple University School of Medicine and completed her internship and residency at Thomas Jefferson University Hospital. She practiced obstetrics and gynecology for four years in a busy practice at Lankenau and Paoli Hospitals. In January 2002, Dr. Nakisbendi left obstetrics and opened Nakisbendi & Associates for the sole purpose of providing comprehensive gynecological care throughout a women’s life cycle in a compassionate and supportive manner. In addition to routine gynecology, Dr. Nakisbendi incorporates a functional medicine approach which looks at the interactions among genetic, environmental and lifestyle factors that can influence long-term health and complex, chronic disease. She has special interests in menopausal changes, adolescent gynecology, sexual dysfunction and pelvic pain disorders.
Dr. Nakisbendi is affiliated with Lankenau, Bryn Mawr and Paoli Hospitals. She is on the medical advisory board of Living Beyond Breast Cancer. She is happily married and has two children.
To purchase The Pregnancy Countdown Book: Nine Months of Practical Tips, Useful Advice, and Uncensored Truths, click here.
