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Issue Date: January 2011


Kids A to Z: Expert Insight


Jennifer Keirn

Prepared For Pregnancy

Ask Dr. Cynthia Austin for advice on preparing your body for pregnancy, and it will sound a lot like tips you'd get for healthy living: Get down to a healthy weight. Quit smoking. Moderate your alcohol and caffeine intake. Get regular exercise, four days a week for 30 to 45 minutes.

That's what Austin, a fertility expert at the Cleveland Clinic's Beachwood Family Health Center, tells her patients, along with one additional tip: Take 400 micrograms of folic acid a day to reduce the baby's risk of neural tube defects.

But it's not just women who should be getting ready for conception.

"Men should remember that the testicles are intended to be cooler than the rest of the body," Austin advises. That means staying away from tight pants and other things that reduce sperm counts, such as smoking, excessive drinking, marijuana and other drugs.

But often, she says, the biggest factor working against couples trying to conceive is overthinking the process. "They get these ovulation predictor kits that promise to help them pick their one best day," Austin says. "But there isn't one best day; there's one good week. That week ends when the test turns positive, so you're waiting until your last good day."

Austin usually suggests that couples consult a doctor after a year of trying without success, or sooner for women over 35.

"An assessment of fertility is looking at all the factors" from ovulation patterns and uterus shape to male sperm quality "and trying to find things that aren't working at their most optimal and trying to improve those things," she says.

Becoming 'Mom'

You may be a parent now, but delivery also marks your transformation from Sarah, Sue or Sally into Mom.

"Your ability to be selfish goes away; they are the priority," says Dr. Marcietta Wilson-Coleman, an obstetrician and gynecologist with Mercy Regional Medical Center in Lorain. "But you cannot lose yourself because then the people around you don't get the best of you."

Becoming Mom is a balance, says Wilson-Coleman, between who you were and who you're becoming. If you're a fun, vivacious person who gives up what you enjoy to focus on motherhood, she says, "your children never get to meet that person you used to be, and your husband loses that person in his life."

Take one big life adjustment, stir with raging hormones, and add a heaping measure of sleep deprivation "remember, we torture prisoners by taking away their sleep," Wilson-Coleman says and it's not surprising that nearly 15 percent of women suffer from postpartum depression.

Wilson-Coleman encourages new moms and their partners to respond quickly to signs of postpartum depression. "No joy is the biggest one," she says. "Your temper is short. You're crying for no reason. If it's persistent, even for a couple of days, that's too long."

Mothers who suffer in silence aren't just hurting themselves. Numerous studies have found evidence that maternal depression inhibits mother-child bonding and can cause behavioral and emotional problems later in life. Talk to your doctor, who may recommend medication or therapy.

"If you feel you're always trying to soothe but you're not soothed, it becomes a vicious cycle," Wilson-Coleman says. "That's when you need real help."

Welcome Home, Baby

Once your child enters the world, the parenting decisions that must be made come at you fast and furious.

Tops on many parents' list: the feeding decision. Nationally, three-fourths of women start out breast-feeding, but only 25 percent continue for one year.

"I believe 100 percent of mothers want to breast-feed, but many are afraid," says Tina Schulin, lactation consultant at EMH Regional Medical Center in Elyria. EMH's breast-feeding initiation rates match national averages while 80 percent of those women continue through the first year.

The key to successful breast-feeding, says Schulin, is support from family members, employers, and community resources such as support groups and lactation consultants. Women lacking that support network or who are unsuccessful at breast-feeding for other reasons, shouldn't judge themselves too harshly, says Dr. Alba Ortega of Mercy Pediatricians in Avon.

"It's the healthiest option for the baby, but it isn't the only option," she says. "When a mother is emotionally and physically drained, it makes it hard to raise her child in a healthy manner."

Ortega's prescription for healthy newborns? Wash hands religiously; avoid all exposure to cigarette smoke; put them to sleep on their backs; follow recommended 2-, 4- and 6-month immunization guidelines; and avoid crowds in those early weeks.

"A baby in the first three months of life tends to fall sicker than later in life," Ortega says. "What may only be a three-day illness in an older child can be weeks in a newborn."

Delivery Demystified

You've read the book. Now, here's what to really expect from delivery.

"Expect 12 to 18 hours of labor," says Colleen Brezine, director of nurse midwifery at St. John Medical Center's Holistic Birthing Center. "Contractions will be hard, and they will take your breath away."

Brezine caters to women seeking natural childbirth, for which she's seeing increased demand. She provides a birthing tub, soothing music and aromatherapy as alternatives to pain medication during labor, and helps moms avoid medical intervention such as fetal monitoring unless complications arise.

Sound appealing? Then put it writing in the form of a birth plan long before the delivery date arrives. And select a health care provider whose approach matches your values.

"If you just show up at the hospital to see how it goes, you'll get the hospital way of doing things," says Dr. Marjorie Greenfield, a University Hospitals' obstetrician and gynecologist. "If your experience matches your expectations, it's usually more positive."

Brezine walks her patients through important questions: Do you want pain medication? Would you like to move around, or are you OK with being attached to a monitor? Do you want medical intervention to speed labor? How do you feel about receiving an episiotomy?

"If you think of a birth plan like a contract, it doesn't work," Greenfield says. "It's more of a communication tool. Being flexible is the key thing. A healthy mom and a healthy baby that has to be everybody's goal."


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