What to Expect When You’re Expecting

657 Pages·1990·10.7 MB·English

by  Heidi Murkoff

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everything you need to know—and
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and beyond. Featuring a week-by-week
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just for dads throughout.
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N ❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖❖
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M
U Heidi Murkoff
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O and Sharon Mazel
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Foreword by Charles J. Lockwood, MD, Professor of Obstetrics
and Gynecology and Public Health, Dean, Morsani College of
Medicine, University of South Florida
W
HAT TO
EXPECT®
WHEN YOU’RE
EXPECTING
5TH EDITION
Also Available from What to Expect®
What to Expect® the First Year
What to Expect® the Second Year
Eating Well When You’re Expecting
What to Expect® Before You’re Expecting
The What to Expect® When You’re Expecting
Pregnancy Journal & Organizer
Qué puedes esperar® cuando estás esperando
(What to Expect® When You’re Expecting—Spanish Edition)
Qué puedes esperar® en el primero año
(What to Expect® the First Year—Spanish Edition)
The What to Expect® Baby-Sitter’s Handbook
W
HAT TO

EXPECT
®
WHEN YOU’RE
EXPECTING
5TH 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
Workman Publishing • New York
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.
Your legacy of caring, compassion, and integrity lives on forever;
you’ll always be loved and always be remembered.
To moms, dads, and babies everywhere—
and to all those who care for and about them
Copyright © 1984, 1988, 1991, 1996, 2002, 2008, 2016 by What to Expect LLC
Design copyright © Workman Publishing Co., Inc.
All rights reserved. No portion of this book may be reproduced—mechanically, electronically,
or by other means, including photocopying—without written permission of the publisher.
Published simultaneously in Canada by Thomas Allen & Son Limited.
Library of Congress Cataloging-in-Publication Data
Names: Murkoff, Heidi Eisenberg, author. | Mazel, Sharon, author.
Title: What to expect when you're expecting / by Heidi Murkoff and Sharon
Mazel ; foreword by Charles J. Lockwood, MD, Senior Vice President, USF
Health, and Dean of the Morsani College of Medicine.
Description: Fifth edition. | New York : Workman Publishing, [2016]
Identifiers: LCCN 2015044527 | ISBN 978-0-7611-8748-6 (alk. paper)
Subjects: LCSH: Pregnancy. | Childbirth. | Postnatal care.
Classification: LCC RG525 .M87 2016 | DDC 618.2--dc23 LC record available at
http://lccn.loc.gov/2015044527
ISBN 978-0-7611-8748-6 (PB)
ISBN 978-0-7611-8924-4 (HC)
Book design: Lisa Hollander and Barbara Peragine
Interior illustrations: Karen Kuchar
Cover design: Vaughn Andrews
Cover photographs: © mattbeard.com
Cover quilt: Lynette Parmentier, Quilt Creations
Cover quilt photography: Davies + Starr
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Printed in the United States of America
First printing April 2016
10 9 8 7 6 5 4 3 2 1
Thanks and More Thanks
So, it’s time for another delivery. And if those perhaps best left on the fringe), to bring
delivering a book is anything like deliver- his enormous reserves of knowledge, experi-
ing a baby—and it is, in many ways (you ence, wisdom, caring, and compassion to help
nurture, nurture, nurture, stress, stress, stress, deliver our latest baby safe and sound (as in
try to breathe, breathe, breathe, and then you sound advice). Dr. Stephanie Romero for her
push, push, push)—I have a whole lot of birth incredibly insightful contributions. Dr. Howie
attendants to thank: Mandel, for delivering compassionate care—
First, always and forever, the father of and Lennox.
What to Expect, Erik—the man who made ACOG, for being tireless advocates for
me a mom to Emma and Wyatt, a mom to moms and babies everywhere, and to all the
What to Expect, and the happiest woman on doctors, midwives, nurses, childbirth educa-
the planet. My 24/7 partner in life, love, work, tors, doulas, and lactation consultants around
parenting, and (best of all) grandparenting. the world who literally nurture the nurtur-
Suzanne Rafer, editor and friend, who ers among us, helping deliver the healthiest
has helped me birth more baby books than I start in life for every baby and the healthiest
can count, and has been there since What to future for all of us. The experts and advocates
Expect was first conceived (and who actu- at the CDC—an organization passionately
ally named our first baby): tirelessly coaching, devoted to the health and wellbeing of our
cheering, and policing my puns (with limited global family, especially when it comes to our
success—that’s what erasers were made for). most vulnerable—for your shared mission and
Peter Workman, who created the house commitment, for being an invaluable partner
I’ve delivered all my babies in, and whose in spreading important health messages (and
legacy lives on in them. preventing the spread of disease!).
Everyone else at Workman who con- Our other partners in mom and baby
tributed to this baby: Jenny Mandel, Emily health and #BumpDay: International Medical
Krasner, Suzie Bolotin, Dan Reynolds, Page Corps (internationalmedicalcorps.org),
Edmunds, Selina Meere, Jessica Wiener, and humanitarians, first responders, and trainers
Sarah Brady. of healthcare heroes (like my personal mid-
Matt Beard, who had us covered, cover- wife hero from South Sudan, Tindilo Grace
to-cover, bringing beautiful images of Lennox Losio, aka Amazing Grace). 1,000 Days™,
before and after. Karen Kuchar for bringing for believing that a healthy future depends
moms and babies to life with her lovely illus- on a healthy (and well-fed) beginning. The
trations. Lisa Hollander and Vaughn Andrews UN Foundation’s Universal Access Program,
for putting it altogether artfully in such a pretty for their passionate support of women and
package, Beth Levy, Claire McKean, Barbara girls and their reproductive rights, health, and
Peragine, and Julie Primavera for master- wellbeing.
fully producing and managing the seamless Our partners in Special Delivery, the
sausage-making. USO, and the amazing military mamas around
Sharon Mazel, who has nurtured, stressed, the world I’ve had the honor to hug and have
breathed (and reminded me to breathe), and yet to hug (more hugs coming!).
pushed alongside me for the last 15 years of Our incredible WhatToExpect.com
birthing What to Expect babies—without ever team, fearlessly led by Michael Rose, Diane
asking for an epidural—while somehow man- Otter, and Kyle Humphries, for their endless
aging to raise 4 amazing daughters and staying energy, enthusiasm, innovation, integrity, cre-
happily married to the second most patient ativity, conviction, passion, and shared purpose
man on earth, Jay. (and for believing in the power of purple).
Dr. Charles Lockwood (who appropri- For inspiration and love, our beautiful
ately played the role of ob in What to Expect “children”: Wyatt, Emma, and Russell, and
When You’re Expecting, 4th and 5th editions!), of course, Lennox. Howard Eisenberg, Abby
our intrepid medical advisor—always ready to and Norm Murkoff, Victor Shargai, and Craig
tackle any topic on the minds of moms (even Pascal.
Contents
Foreword to the Fifth Edition, by Charles J. Lockwood, MD . . . . . . . . . . . . . . . . . . . .x
Introduction to the Fifth Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
PA RT 1 :
F I R S T T H I N G S F I R S T
Chapter 1: Are You Pregnant? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
all about: Choosing and Working with Your Practitioner . . . . . . . . . . . . . 10
Chapter 2: Your Pregnancy Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Your Gynecological History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Your Obstetrical History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Your Medical History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38
all about: Prenatal Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Chapter 3: Your Pregnancy Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
all about: Complementary and Alternative Medicine . . . . . . . . . . . . . . . . . 78
Chapter 4: Nine Months of Eating Well . . . . . . . . . . . . . . . . . . . . . . . . . .84
Nine Basic Principles for Nine Months of Healthy Eating . . . . . . . . . . . . . . . . . 86
The Pregnancy Daily Dozen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
all about: Eating Safely for Two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
PA RT 2 :
NINE MONTHS & COUNTING FROM CONCEPTION TO DELIVERY
Chapter 5: The First Month Aproximately 1 to 4 Weeks . . . . . . . . .122
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
What You Can Expect at Your First Prenatal Visit . . . . . . . . . . . . . . . . . . . . . . . .125
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .128
all about: Your Pampered Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Chapter 6: The Second Month Approximately 5 to 8 Weeks . . . .156
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .159
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
all about: Weight Gain During Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
Chapter 7: The Third Month Approximately 9 to 13 Weeks . . . . . .182
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .185
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
all about: Pregnant on the Job . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199
Chapter 8: The Fourth Month Approximately 14 to 17 Weeks . . 211
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .214
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214
all about: Working Out When You’re Expecting . . . . . . . . . . . . . . . . . . . . . . .229
Chapter 9: The Fifth Month Approximately 18 to 22 Weeks . . . .246
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .246
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .249
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249
all about: Sex and the Pregnant Couple . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Chapter 10: The Sixth Month Approximately 23 to 27 Weeks . .281
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .283
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .284
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .284
all about: Childbirth Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301
Chapter 11: The Seventh Month Approximately 28 to 31 Weeks . .307
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .310
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
all about: Easing Labor Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .330
Chapter 12: The Eighth Month Approximately 32 to 35 Weeks . . .337
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .337
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .339
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .340
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .340
all about:Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .366
Chapter 13: The Ninth Month Approximately 36 to 40 Weeks . . . .372
Your Baby This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .372
Your Body This Month . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .374
What You Can Expect at This Month’s Checkup . . . . . . . . . . . . . . . . . . . . . . . . . . .376
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .376
all about: Prelabor, False Labor, Real Labor . . . . . . . . . . . . . . . . . . . . . . . . . . . .393
Chapter 14: Labor and Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396
Stage One: Labor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .419
Stage Two: Pushing and Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .430
Stage Three: Delivery of the Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .436
Cesarean Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .438
Chapter 15: Expecting Multiples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .441
all about: Multiple Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .454
PA RT 3 :
A F T E R T H E B A B Y I S B O R N
Chapter 16: Postpartum: The First Week . . . . . . . . . . . . . . . . . . . . . . .460
What You May Be Feeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .460
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .461
all about: Beginning Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .478
Chapter 17: Postpartum: The First 6 Weeks . . . . . . . . . . . . . . . . . . .488
What You May Be Feeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .488
What You Can Expect at Your Postpartum Checkup . . . . . . . . . . . . . . . . . . . . . .490
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .490
all about: Getting Back into Shape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .518
PA RT 4 :
S TAY I N G H E A LT H Y W H E N Y O U ’ R E E X P E C T I N G
Chapter 18: If You Get Sick . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 524
What You May Be Wondering About . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .524
all about: Medications During Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . .538
PA RT 5 :
T H E C O M P L I C AT E D P R E G N A N C Y
Chapter 19: Managing Complications . . . . . . . . . . . . . . . . . . . . . . . . . . .544
Pregnancy Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .544
Uncommon Pregnancy Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .563
Childbirth and Postpartum Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .567
all about: If You’re Put on Bed Rest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .573
Chapter 20: Pregnancy Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .582
Types of Pregnancy Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .582
all about: Coping with Pregnancy Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .592
INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .604