by insurance, so if you’re interested, check with your partner’s doc.
PERCUTANEOUS UMBILICAL BLOOD SAMPLING (PUBS)
No, PUBS has nothing to do with bars, although you may need one after thinking about all this. The PUBS test is usually conducted at 17–36 weeks and is sometimes ordered to confirm possible genetic and blood disorders detected through amnio or CVS. The procedure is virtually the same as an amnio, except that the needle is inserted into a blood vessel in the umbilical cord; some practitioners believe this makes the test more accurate. Later in the pregnancy, PUBS may be used to determine whether the fetus has chicken pox, Toxoplasma gondii (see page 42), or other dangerous infections. Preliminary results are available within about three days. In addition to the risk of complications or miscarriage resulting from the procedure, PUBS may also slightly increase the likelihood of premature labor or clotting of the umbilical cord, and because it can’t be performed any earlier than 17 weeks, it’s not nearly as popular as amnio or CVS.
Dealing with the Unexpected
For me, pregnancy was the proverbial emotional roller-coaster ride. One minute I’d find myself wildly excited and dreaming about the new baby, and the next I was filled with feelings of impending doom. I knew I wanted our babies, but I also knew that if I got too emotionally attached and anything unexpected happened—like an ectopic pregnancy, a miscarriage, or a birth defect—I’d be crushed. So, instead of allowing myself to enjoy the pregnancy fully, I ended up spending a lot of time torturing myself by reading and worrying about the bad things that could happen.
ECTOPIC PREGNANCY
About 1–2 percent of all embryos don’t embed in the uterus but begin to grow outside the womb, usually in the fallopian tube, which is unable to expand sufficiently to accommodate the growing fetus. Undiagnosed, an ectopic pregnancy would eventually cause the fallopian tube to burst, resulting in severe bleeding. Fortunately, the vast majority of ectopic pregnancies are caught and removed by the eighth week of pregnancy—long before they become dangerous. Unfortunately, there is no way to transplant the embryo from the fallopian tube into the uterus, so there’s no choice but to terminate the pregnancy. As quickly as technology is advancing, though, I’m sure transplantation will be possible in the not-too-distant future.
PREECLAMPSIA
This is one of the most common pregnancy complications—about 10 percent of pregnant women, most between the ages of eighteen and thirty, suffer from it, although the highest risk groups are very young teens and women in their forties. Preeclampsia is sometimes referred to as toxemia or PIH—protein-induced hypertension—because one of the symptoms is high protein in the urine. Basically, it’s an increase in the mother’s blood pressure late in the pregnancy. This can deprive the fetus of blood and other nutrients and put the mother at risk of a stroke or seizure. Women who have a history of high blood pressure or blood vessel abnormalities are especially prone, as are daughters of women who had preeclampsia when they were pregnant. And Norwegian researchers Rolv Skjærven and Lars J. Vatten found that “men born after a preeclampsia-complicated pregnancy had a moderately increased risk of fathering a preeclamptic pregnancy.” But most of the time it comes as an unpleasant surprise to everyone.
In its early stages there usually aren’t any symptoms, but it can be detected by a routine blood pressure check. If the condition worsens, the woman may develop headaches, water retention, vomiting, pain in the abdomen, blurred vision, and seizures. Interestingly, researchers now suspect that preeclampsia is actually a disorder in which the mother’s immune system rejects some of the father’s genes that are in the fetus’s cells. They suspect that women may be able to “immunize” themselves before getting pregnant if they build up a tolerance by exposing themselves to their partner’s semen as often as possible. This explains why preeclampsia is far more common during first pregnancies, or at least the first pregnancy with a new partner. It also explains why fewer women over thirty develop this condition. (Still, it can happen to older moms or those who have multiple children.)
There’s no guaranteed way to prevent preeclampsia, but there are a few things that could reduce the risk. Staying well hydrated, cutting back on salt, and getting enough exercise may help your partner keep her blood pressure under control. So can increasing her fiber intake. One study found that women who ate over 25 grams of fiber every day cut their risk by 50 percent. And in one of the greatest pieces of good news for pregnant women, Elizabeth Triche and her colleagues found that “women who had five or more servings of chocolate each week in their third trimester were 40 percent less likely to develop preeclampsia than those who ate chocolate less than once a week.” Apparently, there’s a chemical in chocolate, theobromine, that dilates blood vessels and reduces blood pressure. But do you really think your partner needs an excuse to eat more chocolate?
MISCARRIAGES
The sad fact—especially for pessimists like me—is that miscarriages happen fairly frequently. Some experts estimate that between a fifth and a third of all pregnancies end in miscarriage (sometimes also called “spontaneous abortion”). In fact, almost every sexually active woman not on birth control will have one at some point in her life. (In most cases the miscarriage occurs before the woman ever knows she’s pregnant—whatever there was of the tiny embryo is swept away with her regular menstrual flow.)
Before you start to panic, there are a few things to remember: First, over 90 percent of couples who experience a single miscarriage get pregnant and have a healthy baby later. Second, many people believe that miscarriages—most of which happen within the first three months of the pregnancy—are a kind of Darwinian natural selection. Some have even called them “a blessing in disguise.” In the vast majority of cases, the embryo or fetus had some kind of catastrophic defect that would have made it incompatible with life. Still, if you and your partner have a miscarriage, you probably won’t find any of this particularly reassuring. And it won’t make it hurt any less.
Until very recently, miscarriage, like the pregnancy it ends, had been considered the exclusive emotional domain of women. Truth is, it isn’t. While men don’t have to endure the physical pain or discomfort of a miscarriage, their emotional pain can be just as severe as their partner’s. They still have the same hopes and dreams about their unborn children, and they still feel a profound sense of grief when those hopes and dreams are dashed. And many men, just like their partners, feel tremendous guilt and inadequacy when a pregnancy ends prematurely.
Some good friends of mine, Philip and Elaine, had a miscarriage several years ago, after about twelve weeks of pregnancy. For both of them, the experience was devastating, and for months after the miscarriage they were besieged by sympathetic friends and relatives, many of whom had found out about the pregnancy only after it had so abruptly ended. They asked how Elaine was feeling, offered to visit her, expressed their sympathy, and often shared their own miscarriage stories. But no one—not even his wife—ever asked Philip what he was feeling, expressed any sympathy for what he was going through, or offered him a shoulder to cry on.
If You’re Expecting Twins
If your partner was carrying twins (or more), miscarrying one “does not seem to have negative implications regarding the health or genetic integrity of the surviving fetus,” say doctors Connie Agnew and Alan Klein. Miscarrying a twin may, however, put your partner at a slightly higher risk of going into preterm labor.
If your partner is carrying three or more fetuses, you may have to deal with the question of “selective reduction.” Basically, the more fetuses in the uterus, the greater the risk of premature birth, low birth weight, and other potential health hazards. Simply—and gruesomely—put, all these risks can be reduced by reducing the number of fetuses. It’s an agonizing decision that only you and your partner can make. Since 1980, the number of twin births has doubled, and the number of unplanned triplets, quads, and
