Heidi Murkoff - What to Expect Before Youre Expecting: The Complete Guide to Getting Pregnant

What to Expect

Before Youre Expecting

2nd EDITION

By Heidi Murkoff
and Sharon Mazel

Foreword by Charles J. Lockwood, MD
Professor of Obstetrics and Gynecology and Public Health
Dean, Morsani College of Medicine, University of South Florida

To Erik, my everything

To Emma and Wyatt, for making me a mom
and Lennox for making me a grandmom

To Arlene, my first partner in What to Expect and my most important one
youll always be loved and always be remembered

To moms, dads, and babies everywhere
and to all who care for and about them

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Copyright 2009, 2017 by What to Expect LLC

What to Expect is a registered trademark of What to Expect LLC.

All rights reserved. No portion of this book may be reproducedmechanically, electronically, or by any other means, including photocopyingwithout permission of the publisher. Published simultaneously in Canada by Thomas Allen & Son Limited.

Library of Congress Cataloging-in-Publication Data is available

Cover design: Vaughn Andrews

Cover photo: MattBeard.com

Cover quilt photo: Gregory Case, gregorycase.com

Cover quilt design: Anna Sutton, bunnyhilldesigns.com

Book design: Lisa Hollander and Barbara Peragine

Interior illustrations: Karen Kuchar

Workman books are available at special discounts when purchased in bulk for premiums and sales promotions as well as for fund-raising or educational use. Special editions or book excerpts can also be created to specification. For details, contact the Special Sales Director at the address below, or send an email to .

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New York, NY 10014-4381

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eISBN: 9781523501984

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So, here I am again, about to deliver a bookmore precisely, a new edition. As Ive pointed out once or twice before, books (whether new or new editions) and babies have a lot in commontheyre a lot of work, they keep you up at night and get you up way early in the morning, they bring both joy and stress. (One key difference being babies update themselves. Books, not so much.)

Needless to say, you cant create a bookor a babysolo, at least strictly speaking. My human babies, Emma and Wyatt, were created with the most wonderful man in the worldmy husband, best friend, soulmate, and partner in all things, Erik.

My book babies, well, that takes a team effort with a much bigger teamand this new baby is no exception. Some members are new to the What to Expect team, but many have been by my side since book one. With that, Id like to thank:

Suzanne Rafer, my forever editor (it may actually be longer than forever by now) and forever my favorite. Many xos.

Peter Workman, who created the house we live in, and Dan Reynolds, who preserves and improves our home. And everyone else at Workman who has contributed to this latest WTE baby, including the creative Vaughn Andrews and the artistic Lisa Hollander. Karen Kuchar, for clearly and beautifully illustrating the art and science of conception (and for making reproductive parts look so pretty!). Beth Levy, for coordinating all those editing passes. Barbara Peragine, for fitting in more boxes than ever. Julie Primavera and Monica McCready, for those phenomenal production values. Suzie Bolotin, David Schiller, Page Edmunds, Selina Meere, Moira Kerrigan, and Lily Kiralla. The women who make special markets so special (and are so special to me), Jenny Mandel and Emily Krasner. And everyone in digital, ebooks, and the entire book sales team. (Books dont sell themselves, after all!)

Phenomenal photographer and friend Matt Beard, for having us covered yet againwith beautiful cover photos of Emma and Lennox.

Sharon Mazel, who has been (virtually) by my side for pass after pass of edition after edition of book after book, surviving (no, thriving!) under deadline after deadline, and maintaining a type A+ personality to match my own, while somehow raising 4 girls (women!) and occasionally (hopefully) dating her husband, Jay.

Dr. Charles Lockwood, trusty and trusted medical adviser, for delivering the most accurate, up-to-date, and carefully curated information on all matters momand all matters that matter to moms (and their partners). Thanks for your wisdom, wit, insight, care, compassion, and the endlessly invaluable contributions youve made to What to Expect. Drs. Stephanie Romero, Shayne Plosker, and Anthony Imudiamany thanks for your RE expertise. And of course, Dr. Howie Mandel, for delivering compassionate careand Lennox.

ACOG, for being passionate advocates of women and their reproductive rights, and leaders in health care policy. And thanks to all the ob-gyns, fertility specialists, midwives, and nurses who believe that delivering preconception care can deliver a healthier future. To the CDC, for your dedication to the health and wellbeing of our global family, shared commitment to preconception health, and most recently, for the up-to-the-minute facts on Zika virus.

Our always awesome WhatToExpect.com team, lovingly led by Michael Rose, Kyle Humphries, and Siobhan Adcock, plus our new Ziff/Davis family, including Jimmy Yaffe, for being the web partners of our dreamsand believing in the power of moms, dads, babies, purple, and #BumpDay. And for helping create a truly amazing community of moms, Sara Stefanik.

International Medical Corps, first responders, humanitarian heroes and our passionate partners in maternal child health and #BumpDay, with extra love to Margaret Traub and to all the humanitarian health workers who care for the most vulnerable members of our human family, especially Amazing Grace Losio, my personal midwife hero in South Sudan.

The USO, our partners in the Special Delivery programand all the military moms, dads, and babies Ive gratefully hugged already, and those Ive yet to hug (cant wait).

Marc Chamlin, for always being there for me, always protecting me, always caring for me, and Alan Nevins, for managing the unmanageable (is there anything you cant put on a spreadsheet?), putting out fires, cleaning up messes, and picking up piecesin short, for being the best agent a girl could ever have.

Erik, the love of my lifeI cant remember having a life before you, and couldnt imagine one without you. Emma and Wyatt, for making me one very happy and proud mama. I love you both so much. And of course, the latest love of my life, Lennox.

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By Charles J. Lockwood, MD
_______
Professor of Obstetrics & Gynecology and Public Health
Dean, Morsani College of Medicine
Senior Vice President USF Health
University of South Florida

Would you undertake the most exhilarating, exhausting, and expensive trip of your life without knowing where you were going, how to get there, and how much it was going to cost? I thought not. Well having a baby is all of that and much more. What to Expect Before Youre Expecting is your tour-guide, travelogue, and guidebook to achieving a successful pregnancy. It provides solid, evidence-based recommendations that, if followed, should help you get pregnant, stay pregnant, and have a healthy baby.

The book begins, appropriately enough, with preconception carehow to get your body (and brain) ready to conceive and carry a pregnancy to term. It provides a practical set of steps to help ensure that you will start your pregnancy in the best possible shape for success. Information is provided on what your ideal body weight should be, and how to get there through diet, exercise and sleepyes, getting enough sleep will help optimize your reproductive potential (and general health). Practical advice is also provided on how to stop smoking, cut down on caffeine and alcohol, and ensure that the prescription, over-the-counter, and herbal medications you are taking are baby-safe. Critically important advice is provided on working with your physician to optimize management of any preexisting medical conditions you might have, what preventive care you should receive before your conceive (for example, vaccinations, Pap test, dental care, genetic testing), how to avoid work-related and environmental toxins, and even how to avoid Zika and other infection risks. The finances of establishing a family are also discusseda crucial but frequently overlooked topic by many couplesas well as vital information on health insurance and what it may cover (and not cover).