Pay attention to diet and nutrition. What your partner eats immediately before conception and in the first days and weeks of the pregnancy can have a big impact on fetal development and the baby’s long-term health. See pages 35–44 for details on her diet and nutritional needs.
• Quit smoking and drinking. Both decrease fertility and increase the chances of a premature or low-birth-weight birth, or pregnancy loss.
• Stay out of hot tubs. A recent study by health-care giant Kaiser Permanente found that women who used a hot tub after conception were twice as likely to miscarry as women who didn’t. Other studies haven’t found much of a connection, but Kaiser’s lead researcher, De-Kun Li, recommends that “women in the early stages of pregnancy—and those who may have conceived but aren’t sure—might want to play it safe for the first few months and avoid hot tubs” as a way of reducing “unnecessary risk of miscarriage.”
WHAT YOU SHOULD DO
• Talk to your doctor. Give him your medical history and tell him about your plans to do the dad thing. You want to find out whether there are any issues that you need to address before you start planning those romantic, candlelit, birth-control-free evenings. One especially important topic you’ll want to discuss is how to make sure your sperm is healthy. Here are some ways to do that:
• Keep your balls cool. Sperm is very sensitive to heat, which is why your testicles—where those little swimmers of yours live—hang outside your body, where it’s a few degrees cooler. Heating them up by a couple of degrees (say, by spending any more than five minutes in a hot tub or hot bath, sitting with your legs crossed for extended periods of time, or wearing tight underwear that keeps your testicles up against your body) could reduce sperm production or cause abnormalities. We all know that women have fertility cycles, but were you aware that we do too? Turns out that sperm are on a ninety-day cycle, meaning that whatever happens to them today won’t show up for three months or so.
• Call in the vice squad. Smoking, using illegal drugs (or misusing legal ones), and drinking alcohol have all been linked to lowered fertility, miscarriage, and birth defects.
• Watch the toxins. Hazardous chemicals, pesticides, and even noxious fumes could damage sperm and, if you inadvertently bring them home (for example, on your clothes), they could hurt your partner too.
• Lose some weight. Dr. A. Ghiyath Shayeb, from the University of Aberdeen, Scotland, found that obese men produce lower volumes of seminal fluid (the liquid that carries the sperm) and have a higher proportion of abnormal sperm. “[M]en who are trying for a baby with their partners should first try to achieve an ideal body weight,” writes Shayeb.
• Have a little more fun. Traditional thinking has it that if you want to improve your chances of getting your partner pregnant, you should not ejaculate for at least a couple of days before trying. But Australian OB David Greening disagrees. Greening studied men with DNA-damaged sperm. After seven days of ejaculating daily (no, it didn’t matter how), the percentage of damaged sperm dropped significantly. And motility—a measure of how straight and how quickly sperm swim toward those ever-elusive eggs—increased.
• Hang out with some dads. Talk to other guys about what it’s like to be a dad, the challenges they’ve faced, and how they overcame them. Ask a ton of questions.
WHAT BOTH OF YOU SHOULD DO
• Make sure you’ve discussed any possible medical issues with a qualified health-care provider. If you haven’t already, talk over any and all pregnancy-related risk factors. These include:
• Her age. Getting pregnant at thirty-five or older increases the risk of certain genetic abnormalities, such as Down syndrome.
• Your age. (See pages 296–297 for more).
• Family history. Could either of you be a carrier of any genetic disorders, birth defects, or conditions such as cystic fibrosis or hemophilia?
• Belonging to a high-risk ethnic group. African Americans may want to be tested for sickle-cell anemia. Individuals of African or Mediterranean descent may want to be tested for thalassemia; Jews of Ashkenazi (Eastern European) descent may want to be tested for Tay-Sachs and/or Canavan disease.
• Take a quick look at your HR manual and investigate your family leave options. We’ll talk about this more on pages 136–42. But the more time you have to prepare yourself and your employer, the better.
• Look at your finances. How are you going to pay for all this? Do you have insurance? If so, check your deductibles and copays—and whether you have maternity coverage at all. If you or she just started a job, does the policy have a waiting period before benefits kick in? If you don’t have insurance, what are your options? Could you qualify for Medicaid?
• Sit down with your partner and have some serious discussions about your plans. Hopefully she’ll get pregnant at the perfect time. But if that doesn’t happen, how do you feel about fertility treatments? Would you consider artificial insemination using your sperm? Would you consider using donor sperm? How about in vitro (test tube) fertilization? What about using donor eggs? And if you do use any kind of technology, are you prepared to parent twins or more? Don’t try to resolve anything in a single conversation.
Birth Defects
If one of the tests discussed earlier in this chapter indicates that your baby will be born deformed or with any kind of serious disorder, you and your partner have some serious discussions ahead of you. There are two basic options for dealing with birth defects in an unborn child: keep the baby or terminate the pregnancy. Fortunately, you and your partner won’t have to make this decision on your own; every hospital that administers diagnostic tests has specially trained genetic counselors who will help you sort through the options.
There’s no question that the availability of genetic testing has changed the landscape with regard to birth defects. Two recent studies analyzed birth data from a fifteen- to twenty-year period. One found a slight increase in the number of Down syndrome births, the other a slight decrease. As we’ve discussed, more and more women are putting off childbirth. And since women over thirty-five are about five times more likely than those in their twenties to have a Down syndrome baby, researchers would have expected the number of births to double. The reason that didn’t happen is quite simple: with genetic testing able to identify Down syndrome babies very early in the pregnancy, many couples are choosing abortion. If you’re considering terminating the pregnancy for genetic reasons, remember that communicating clearly and effectively with your partner is probably the most important thing you can do during this stressful time. The decision you make should not be taken lightly—it’s a choice that will last a lifetime—and you and your partner must fully agree before proceeding with either option. But ultimately, your partner should make the final decision.
Coping with Your Grief
If you and your partner choose to terminate your pregnancy or reduce the number of fetuses, or if the pregnancy ends in miscarriage, the emotional toll can be devastating. That’s why it’s critical for the two of you to seek out the emotional support you’re entitled to as soon as possible. While there’s nothing that can be done to prepare for or prevent a miscarriage, telling your partner how you feel—either alone or with a member of the clergy, a therapist, or a close friend—is
