What to Expect When You're Expecting

IF I’VE LEARNED TWO THINGS OVER the last 23 years, it’s that kids don’t raise themselves — and books don’t write themselves (no matter how long you look at a blank screen).

Fortunately, I haven’t had to take either job on by myself. For the kid raising (officially finished, though, let’s face it — does it really ever end?), I’ve had the best partner-in-parenting out there, my husband, Erik — who also happens to be my partner in What to Expect. For the book writing, I’ve had dozens of colleagues and friends pitch in — contributing support, insight, and ideas in the creation (and re-creation … and re-creation … and re-creation) of four editions of What to Expect^® When You’re Expecting.

Some of those helpers have come and gone — but others have stood by since day one, and edition one. Thanks a lot to:

Sandee Hathaway, for all your valuable contributions to What to Expect. You’re a great sister and an even greater friend.

Suzanne Rafer, editor and friend, who has faithfully guided What to Expect from conception through delivery four times over — dotting every ‘i,’ crossing every ‘t,’ deleting every misguided pun (and pair of parens). What’s in a name? When it comes to What to Expect, a lot — and we have Suzanne to thank for the memorable moniker that helped launch not only 29 million copies, but hundreds of headlines, cartoons, and parodies.

Peter Workman, a publisher of uncommon integrity and uncompromising commitment — who believed in our book when bookstores didn’t, who let What to Expect’s grass roots take their slow and steady time sprouting, who never gave up on the little series that could, and did.

Everyone else at Workman who’s helped with our latest delivery: David Matt, for believing in evolution (of Cover Mum), taking artistic chances, and overseeing our very challenging — and very successful — Extreme Makeover. John Gilman, for your extreme patience in this extreme makeover — and for making illustration magic happen. Lisa Hollander, for always being my favourite designing woman, as well as to Weiheng Tang. Tim O’Brien for bringing to life Cover Mum, The Next Generation — and for finally getting her off her rocker. Lynette Parmentier for re-creating as an actual quilt our iconic illustrated quilt. Karen Kuchar for inking our hot mamas (almost makes me want to run out and get pregnant again!) and Tom Newsom for our fabulous fetuses. Irene Demchyshyn for going with the flow and keeping the flow going. And my other phenomenal friends at Workman, including Suz2 (Suzie Bolotin), Helen Rosner, Beth Doty, Walter Weintz, Jenny Mandel, Kim Small, and Amy Corley.

My other partner, Sharon Mazel. You’re my mini-me, my other (better) half, my BFF — and I love you. To the beautiful Daniella, Arianne, Kira, and Sophia, for sharing your amazing mum with me (and for getting sick and breaking bones only when absolutely necessary). And to the doctor in the house, Jay, for his great biology lessons and his good nature — but mostly, for letting me be the other woman in Sharon’s life.

Dr Charles Lockwood, our remarkable medical advisor, for your concise and precise advice, your meticulous attention to detail (medical and otherwise), and your obvious compassion for mums and babies. It’s truly incredible how much you know, how much you do (I get exhausted just reading your CV), and how much you care.

Steven Petrow (MG), Mike Keriakos, Ben Wolin, Jim Curtis (CSOB), Sarah Hutter, and all my wonderful friends and partners at Waterfront Media, for making our vision of whattoexpect.com and My What to Expect a reality. Thanks, also, to the amazing community of mums — not only for making our site the special place that it is, but for sharing your bellies, babies, and toddlers with me every day.

The two other guys in my life (a girl could get spoiled): Marc Chamlin, for your keen legal eagle eye, your business smarts, your unflagging friendship and support; and Alan Nevins, for your masterful management, phenomenal finessing, endless patience, persistence, and hand-holding.

Jennifer Geddes and Fran Kritz, for helping us get our facts straight (check … check … check!). Dr Jessica Wu, for your impeccable pregnancy skin care counsel, and Dr Howie Mandel, for being such a good sport about the What to Expect questions I’m always sneaking in at my annuals. And always, to always-inspiring Lisa Bernstein, Executive Director of the What to Expect Foundation, for making miracles happen (plump, full-term miracles), and to Zoe, Oh-That-Teddy, and Dan Dubno.

To Erik, my partner in everything I do, always and forever, for all the reasons listed above, and more than I can list. There’s no one I’d rather mix business and pleasure with, and I love you forever. And speaking of love, to my pride and joy (I’m not saying who’s who), Emma (the baby who started it all) and Wyatt (the baby who followed). I love you guys — you’ve made me one lucky mama.

The adorable Howard Eisenberg, father and friend (not necessarily in that order); Victor Shargai (and John Aniello) for your love and support; and to the world’s best (and newly trimmest) in-laws, Abby and Norman Murkoff. And to Rachel, Ethan, and Liz, Sandee’s fantastic three, and to Tim, her Numero Uno.

To ACOG, for being advocates for women and babies, and to all of the doctors, midwives, nurses, and nurse practitioners who work every day to make pregnancy safer and happier for expectant families. Most of all, to all the expectant, new, and old mums (and dads) who’ve helped make each edition of What to Expect better than the last. I’ve said it before, and I’ll say it again, parents are my most invaluable resource — so keep those cards, letters, and emails coming!

Thanks again, and again, everybody … and may all your greatest expectations come true!

THE OTHER DAY I RECEIVED A wonderful, heartfelt thank-you letter from a patient. Enclosed was a picture of a strapping college hockey player — whom I had delivered 19 years before! I have the best job on Earth. I get to share in the most joyful, exciting, and wondrous moment that human beings will ever experience — the birth of their child — only I get to experience it over and over and over. Sure, being an obstetrician has its share of tough moments — some very tiring ones at 3 a.m. and some very frustrating ones when the pace of a patient’s labour appears to be glacial. There is the occasional adrenaline rush, the patient with the challenging symptom, and the inevitable flood of complex emotions, but mostly it’s just plain fun.

In a way, my job is a lot like your pregnancy will probably be — every day will bring a little adventure, but most of them will be fun. What to Expect When You’re Expecting is like having a personal obstetrician to guide you through that adventure. I have been recommending this book for years and thoroughly enjoyed reading the fourth edition — because the best just got better. All new, it’s packed with information and useful advice, the kind you would hear from your favourite doctor or midwife — one who is wise but funny, thorough but practical, experienced but enthusiastic, and organised but empathetic.

The book starts you off before conception with solid recommendations on what to — and what not to — do before you are expecting. It then gently guides you through conception to your first visit to a health care provider. It explains what changes you’ll need to make in your lifestyle, job, and diet. One of the book’s best features is a month-by-month — in fact a week-by-week — guide to how your baby is developing and what she or he is doing in your uterus. This is accompanied by a description of how you are developing — and not just your belly but everywhere, from your hair to your toes — and what you may be feeling. It tells you what your health care provider will do at each visit and reviews what tests will be ordered and why. Toward the end, it prepares you for the big day, however you might be delivering — vaginally or by caesarean. You’ll learn about birthing plans, how to distinguish real labour from false labour, and which labouring positions work. Your questions about back labour, fetal monitoring, episiotomy, pain relief, and anaesthesia will be answered, even if you didn’t know to ask. Then What to Expect guides you through all aspects of the incredible process of birth.

The book also covers the postpartum period, providing tips for differentiating the ‘blues’ from depression. In an important chapter, it covers complications that you can read about if they occur or skip over if they don’t. It covers pregnancy in women with common medical conditions, such as asthma, high blood pressure, and diabetes — and how to maximise your chances of a normal pregnancy. It also covers what to do if you experience a pregnancy loss and does it with a wonderful mix of compassion and practicality. Partners are not forgotten: the book provides a very practical guide to being a great coach. And parents-to-be of multiples are included, too. An entire chapter is devoted to their undoubtedly doubled questions and concerns.

As a maternal – fetal medicine specialist, I am impressed by just how much is covered in this book. As an editor, I am impressed by the clear, cogent, and concise writing. As a husband and father, I am impressed that the authors know just what mums-to-be and their partners need to know. The best judges of this book, however, have been the hundreds of patients who have raved about it to me, my staff, and other patients in the waiting room.

If you are reading these words, it’s likely you are either newly pregnant or about to become so. Congratulations! My advice to you is lie back, get comfortable, and read on — you are about to embark on the adventure of a lifetime.

PREGNANCY BRINGS ABOUT GREAT excitement as well as anxiety for the majority of couples. From the first missed period until the six-week post-delivery check-up, the woman’s body and emotions undergo a myriad of change. It is at the start of this extraordinary journey that a trustworthy guidebook would be most welcome.

What to Expect When You’re Expecting is that comprehensive, easy-to-read guidebook. It clarifies and educates and addresses real concerns — both big and small — that affect real parents-to-be.

Nowadays, with one click of the ‘Enter’ button, couples are bombarded with facts, figures, opinions, truths, theories, anecdotes, speculation and often propaganda. What do you read? What do you believe? Is the information presented credible?

What to Expect When You’re Expecting cuts through the confusion. It starts with preconception, talks through every aspect of pregnancy week-by-week, and finishes with the postpartum stage. It explains all the physical, hormonal and emotional changes in a clear, reassuring and accurate manner. All topics are covered: normal pregnancy; minor spotting to placenta praevia; mild increases in blood pressure to the rare but potentially dangerous eclampsia and other possible complications. This is a book that is in touch with today’s women. It gives down-to-earth information about optimal nutrition goals, lifestyle adaptations, fluid intake and covers issues from belly piercing to domestic violence. Pain relief in labour is often an anxiety-provoking subject: this is well covered in the book, and all the pain-relieving options available are presented.

The 21st century is the safest time in our history to bear a child. Couples who in years gone by would have remained childless are now bearing children.

Women with chronic medical conditions that were once contra-indications to pregnancy are now safely having babies.

What to Expect When You’re Expecting is an essential resource for expectant couples, their parents, medical students, midwives and all those involved in maternity care alike.

We live in an era where there are many choices open to us, which means we also need to make many decisions. With knowledge comes the power to make informed choices. Couples who have read this text will be empowered to better understand the remarkable processes of pregnancy, labour and delivery.

TWENTY-FOUR YEARS AGO, I DELIVERED a daughter and conceived a book within a few hours of each other (it was a busy day). Nurturing both those babies, Emma Bing and What to Expect When You’re Expecting (as well as the next baby, my son, Wyatt — and the other What to Expect offspring) as they’ve grown and evolved over the years has been at once exhilarating and exhausting, fulfiling and frustrating, heartwarming and nerve-racking. And like any parent, I wouldn’t trade a day of it. (Though there was that week when Emma was thirteen … okay, make that a year. Maybe two.)

And now I’m thrilled to announce yet another delivery. A brand-new book that I couldn’t be prouder to start showing off and sharing: the fourth edition of What to Expect When You’re Expecting. A cover-to-cover, front-to-back revision that’s been completely rewritten from start to finish — a new book for a new generation of expectant parents (you!), featuring a fresh look, a fresh perspective, and a friendlier-than-ever voice.

What’s new in the new What to Expect? So much that I’m excited about. Week-by-week updates on your little one’s transformation from microscopic bundle of cells to cuddly newborn — the incredible development of your baby-to-be that will make all that heartburn, all those trips to the bathroom, all that wind, all those pains, and all the sleep deprivation more than worth it. And (speaking of heartburn and wind), more symptoms and more solutions than ever before — and more of your questions answered (even the ones you didn’t know you had yet). There’s an expanded section on working during pregnancy (as if being pregnant wasn’t hard enough work!). And going from the practical to the pampered, a brand-new section on expectant beauty: how to love — or at least cope with — the expectant skin you’re in, even when it’s blotchy, pimply, rashy, itchy, too oily, or too dry; which skin, hair, nail, and make-up regimens you can stick with and which you’ll have to ditch until delivery. Lots on your pregnant lifestyle (from sex to travel to exercise to fashion), your pregnancy profile (how your obstetric, medical, and gynaecological history may — or may not — affect your pregnancy), your relationships, and your emotions. A more realistic than ever chapter on expectant eating that responds to every eating style, from at-the-desk to on-the-run, from vegan to low-carb, caffeine-addicted to junk-food dependent. An expanded section on preconception, a new chapter for all you many mums of multiples. Lots more for that very important (but too often neglected) partner in parenting, the dad-to-be. And, of course, the very latest on all things pregnancy (news you can use, on everything from prenatal diagnosis to labour and delivery and beyond).

As always, just as important as what’s different in this fourth edition is what’s the same. When What to Expect When You’re Expecting was first conceived, it was with a single mission in mind: to help parents-to-be worry less and enjoy their pregnancies more. That mission has grown but it hasn’t changed. Like the first three editions, this fourth one was written to answer your questions, reassure you, relate to you, empathise with you, and help you get a better night’s sleep (at least as good a night’s sleep as you can get when you’re busy running to the bathroom or fighting off leg cramps and backaches).

I hope you enjoy my new baby as much as I enjoyed creating it and that it helps you as you go about creating that new baby of yours. Wishing you the healthiest of pregnancies and a lifetime of happy parenting. May all your greatest expectations come true!