Susan J. Fisher - Taking Charge of Your Pregnancy: The New Science for a Safe Birth and a Healthy Baby

NEITHER THE PUBLISHER NOR THE AUTHOR IS ENGAGED IN RENDERING PROFESSIONAL ADVICE OR SERVICES TO THE INDIVIDUAL READER. THE IDEAS, PROCEDURES, AND SUGGESTIONS CONTAINED IN THIS BOOK ARE NOT INTENDED AS A SUBSTITUTE FOR CONSULTING WITH A HEALTH CARE PROFESSIONAL. ALL MATTERS REGARDING YOUR HEALTH REQUIRE MEDICAL SUPERVISION. NEITHER THE AUTHOR NOR THE PUBLISHER SHALL BE LIABLE OR RESPONSIBLE FOR ANY LOSS OR DAMAGE ALLEGEDLY ARISING DIRECTLY OR INDIRECTLY FROM ANY INFORMATION OR SUGGESTION IN THIS BOOK.

Copyright 2021 by Susan J. Fisher

Illustrations copyright 2021 by Nikola Kolundzic

All rights reserved

For information about permission to reproduce selections from this book, write to or to Permissions, Houghton Mifflin Harcourt Publishing Company, 3 Park Avenue, 19th Floor, New York, New York 10016.

hmhbooks.com

Library of Congress Cataloging-in-Publication Data

Names: Fisher, Susan J., author. | Cabaza, Becky.

Title: Taking charge of your pregnancy : the new science for a safe birth and a healthy baby / Susan J. Fisher, PhD with Becky Cabaza.

Description: Boston : Houghton Mifflin Harcourt, 2021. | Includes bibliographical references and index.

Identifiers: LCCN 2020050867 (print) | LCCN 2020050868 (ebook) | ISBN 9780544986640 (trade paperback) | ISBN 9780358409076 (hardcover) | ISBN 9780358611509 | ISBN 9780358611578 | ISBN 9780544986657 (ebook)

Subjects: LCSH : Pregnancy. | Childbirth. | Prenatal care.

Classification: LCC RG 551 . F 57 2021 (print) | LCC RG 551 (ebook) | DDC 618.2dc23

LC record available at https://lccn.loc.gov/2020050867

LC ebook record available at https://lccn.loc.gov/2020050868

Cover design by Amy C. King

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As a society, we teach our kids about a lot of things, but pregnancy isnt one of them.

I know this because my daughters were in the minority, thoroughly versed in all aspects of reproduction by the time they were teenagers. As they were growing up, my girls loved to talk about what they were learning, new ideas that were springing forth, and the life skills they were acquiring. My husband, who is a physician, and I also discussed our work lives with them. Because my research focuses on human development and pregnancy, these topics were a natural part of our conversations and the girls learned by osmosis.

But how do peopleespecially pregnant women or those contemplating the possibilitywho dont grow up in the home of a pregnancy professional acquire this knowledge? They dont. After raising two girls and meeting hundreds of their friends along the way, I know that most American children are not home-schooled on the topics of pregnancy and birth. This always seemed like an odd omission, since many are aware of the basics of reproduction before they enter kindergarten.

Today most children under age five have some sense of where babies come from. But the openness with which we now discuss the birds and the bees has not spilled over into what happens after conception: how a fertilized egg grows from an embryo into human form and how that fully developed baby is birthed into the world. You would think that learning about what really happens in pregnancy would stand side by side with sex education in our schools, but pregnancy and birth have yet to be granted a prominent position in our curricula. Its time for a change.

There is a growing understanding that some aspects of pregnancy, such as whether a baby will be born early or late, may be heritable. This means that details about how your mother carried and birthed you may be worth knowing as you embark on your own pregnancy. I was highly motivated to educate my daughters about my own pregnancies because my mother was not able to talk to me about any aspect of reproduction. She answered my first fumbling adolescent questions about my changing body by sending me to the dictionary to look up the definition of a single word: menstruation. Is it all clear now? Good.

Similarly, not a word was ever spoken about pregnancy. I was in the dark about the circumstances surrounding my own birth until I was an adult. I was deep into my twenties when my father told me, in passing, that my mother had been in labor for two days before I was born, at least three weeks early. The small-town doctor in attendance could do nothing but stand helplessly by as she struggled. I could tell by the expression on my fathers face and the tone of his voice that this had been a harrowing experience. His own birth, I eventually learned, had also been a protracted affairso difficult that my grandmother, a young woman when she gave birth to him in 1912, avoided ever repeating the experience, so my father remained an only child.

When I became a mother, I was determined to break the pattern of secrecy that seemed to surround pregnancy and birth. My work gave me the knowledge and confidence that are needed to pull these topics out of the dark corners and weave them into everyday conversations. I hope you will share what you learn in this book with friends and loved ones and eventually your own childrenwho may not yet be born.

What is there to say about the topic of pregnancy thats new? Every chapter youre about to read takes on that key question, and what you learn will influence your decisions in navigating pregnancy and birth. When youre armed with science-based information, youre in a position to take charge of your health care and your babys well-being before, during, and after pregnancy.

covers the explosive development of a fertilized egg into a miniature child, which happens during the mere first eight weeks following conception. Understanding the blinding speed at which pregnancy is launched provides an important rationale for preparing your body to take on its critical new role of being babys first home. There are numerous simple strategies for ensuring its a nurturing environment, which can up the odds that youll have a healthy child.

As placental mammals, baby humans develop within the safe confines of their mothers body, nurtured by the placenta. This remarkable temporary organ, the subject of , is the babys lifeline inside the womb. Placental structure and function are explored early in this book because the placenta steers the course of pregnancy, from implantation to birth. During the first month following conception, the placenta begins the process of extending its treelike branches deep into the uterus, a connection that plugs the baby into the mothers organ systems, which it shares for the duration of pregnancy. And after the baby is born, a mother can sustain this new life with her breast milk. Accordingly, we humans belong to the class of creatures known as Mammalia, or mammals, terms that derive from the Latin word for breast. These ancient biological processes, encoded in our genes, are immutable on a human timescale. Yet many other aspects of pregnancy are undergoing change.

Today the how and even the when of baby-making are shifting under our feet. Fifty years ago there were few options other than allowing nature to take its course. Now women and couples have more control than ever in determining when pregnancy will happen. The process involves a sea of choices and decisions, informed by significant cultural shifts in the way we navigate relationships and reproduction.

In 1980, just 18 percent of women who gave birth were unmarried. According to the Centers for Disease Control and Prevention (CDC), the proportion was 40 percent in 2018. The advent of in vitro fertilization in the 1970s, which made pregnancy possible for millions worldwide, also opened the doors to the development and widespread adoption of assisted reproductive technologies such as oocyte cryopreservation, more commonly known as egg freezing. In recent years, we have learned that the age-related decline in female fertility is largely due to a rapid deterioration in the quality of eggs. With the right hormonal treatment and a robust egg donated by a young woman, the childbearing years can be extended far beyond what anyone ever thought was possible. This has inspired more women, most often between the ages of thirty and forty, to hit the pause button on the biological clock by literally placing their eggs on ice, deep in a freezer. Technological advances now allow a woman who wants to delay pregnancy to be her own donor, utilizing her stored eggs for pregnancy when the time is right, rather than being bound to a schedule dictated by her biology. Egg freezing is accelerating the increase in age of mothers who are giving birth for the first time.