The basal body temperature (BBT): The BBT can help to pinpoint more accurately the
period of ovulation during which unprotected intercourse is riskiest. To get the BBT, the woman takes her temperature with a special basal body thermometer every morning immediately on awakening, before speaking or sitting up, etc. (the thermometer should be shaken down and left next to the bed the night before). In most women the temperature will drop and then rise abruptly at the time of ovulation as seen above. Three full days after ovulation, intercourse can be resumed. See next page for more on natural family planning.
EMERGENCY CONTRACEPTION
The emergency contraception pill (ECP) is the only method of birth control that can be used after unprotected intercourse (or as backup when your contraceptive method has failed, as with a broken condom, slipped diaphragm, or missed oral contraceptive pills) but before a pregnancy is
established.4 Both Preven and Plan B reduce a woman’s risk of pregnancy by 75 percent when taken within seventy-two hours of unprotected sex. The sooner ECPs are taken after unprotected sex, the more effective they are. (Your doctor might also recommend using ordinary birth control pills as emergency contraception, but check with him or her first to confirm the dose you should use.)
ECPs work by temporarily stopping ovulation, or by preventing fertilization. They may also work by preventing a fertilized egg from attaching to the uterus.
Like combination pills, Preven contains estrogen and progestin. Side effects are similar to those associated with combination oral contraceptive pills and are usually mild. Plan B contains only progestin and may cause fewer side effects.
Presently, emergency contraceptive pills are available by prescription in some states, over-the- counter in others.
STERILIZATION
Sterilization is frequently the choice of couples who feel that their families are complete, don’t have a problem with closing (and locking) the door to conception, and are anxious to dispense with
contraception altogether. It’s increasingly safe (with no known long-term health effects) and virtually foolproof. The occasional failure can be attributed to a slip-up in surgery or, in the case of
vasectomy, not using alternative birth control until all viable sperm have been ejaculated. Though sterilization is sometimes reversible, it should be considered permanent.
Tubal ligation is a procedure done under general or epidural anesthesia in which a small incision is made in the abdomen and the fallopian tubes are either cut, tied, or blocked. It does require some down time, usually two days (sometimes more) of only light activity. A vasectomy (the tying or cutting of the vasa deferentia, the tubes that transport sperm from testicles to penis) is a much easier, in-office procedure done with local anesthesia, and it carries far fewer risks than tubal ligation. It doesn’t (as some men fear) affect the ability to achieve erection or ejaculate. Research has also shown that there is no increased risk of prostate cancer for men with vasectomies.
A newer permanent birth-control option for women is called Essure. An alternative to tubal ligation, this type of sterilization requires neither an abdominal incision (as does tubal ligation) nor general anesthesia. A soft, flexible microinsert is placed into each fallopian tube via a catheter (tube) inserted through the cervix. Over the course of three months, new tissue grows in the fallopian tube (inside the insert), blocking the tubes completely. Another method of birth control must be used until
the doctor can confirm through testing that your tubes are effectively blocked (usually after three months).
FERTILITY AWARENESS
Women who prefer not to use hormonal or mechanical contraception can opt for a “natural” form of birth control (also called “natural family planning”). This approach relies on the woman becoming aware of a number of body signs or symptoms to determine the time of ovulation. If done perfectly correctly, couples using the NFP approach can be just as successful avoiding pregnancy as those couples using birth control methods.
The more factors a couple takes into consideration, the better the success rate. These factors include keeping track of mucus changes in that vagina (the mucus is clear, copious, thin, has an egg white consistency, and can be pulled into a long string at ovulation); basal body temperature changes (the baseline temperature, measured first thing in the morning, drops slightly just before ovulation, reaches its lowest point at ovulation, and then immediately rises to a high point before returning to the baseline for the rest of the cycle; see diagram, page 700); and cervical changes (the normally firm cervix becomes a little softer; it is also slightly higher and more open than normal during ovulation).
Ovulation predictor kits can also help to pinpoint ovulation (though using them every month to
prevent pregnancy can get very costly). Saliva tests for ovulation can also help some women predict when ovulation is imminent and are more cost effective. Intercourse is avoided from the first sign that ovulation is about to occur until three days after.
DIAGNOSING A NEW PREGNANCY
“I had a baby about twelve weeks ago, and I started feeling a little queasy yesterday. How soon can you get pregnant again, and if you’re breastfeeding, how can you tell?”
A new pregnancy at twelve weeks post-partum is very unusual, particularly in a breastfeeding mother, though it has been known to happen. The fact is that unless you or your partner have been sterilized, you run the risk of conceiving any time you have intercourse, even if you use birth control and
especially if you don’t. A postpartum pregnancy, however, may be difficult to recognize. This is particularly true if you haven’t resumed menstruating, since the first tip-off most women get that they might be pregnant is a missed period. If you’re breastfeeding, another pregnancy clue many women rely on—tender and enlarged breasts with more noticeable veins—may be obscured. However, you may begin to notice other clues that you may have conceived once a new pregnancy is established: a diminished milk supply because different sets of hormones operate in pregnancy and lactation (but such a drop in production may also be due to exhaustion, not Breastfeeding enough, or other factors);
morning sickness or queasiness (which could also result from something you ate or a gastrointestinal virus); or frequent urination (this could instead be due to a urinary tract infection).
If you have any reason to suspect you are pregnant, or even if you’re just unreasonably nervous about the possibility, take a home-pregnancy test. In the unlikely event that you turn out to be pregnant, be sure to begin regular prenatal care as soon as possible. A new pregnancy so close to childbirth puts a tremendous strain on the body, and you’ll need close medical supervision, extra rest, and plenty of good nutrition.
As long as you feel up to it, you can continue breastfeeding your baby while expecting another. If you feel utterly exhausted, you may want to supplement with formula or even wean completely.
Discuss the options with your practitioner. If you do breastfeed while pregnant, it will be extremely important to consume enough extra calories (about 300 for the fetus and another 200 to 500 for milk production), protein (four servings a day), and calcium (the equivalent of six servings a day), as well as to get plenty of rest.
PASSING GERMS ON TO BABY
“I have a really bad cold. Can my son catch it?”
Germs have a way of making rounds through the family, and later on, when your son is in school, he’ll be bringing plenty your way. For now (unless he’s already in day care), chances are much better that you or other family members will pass germs on to him.
To minimize the possibility that your baby will catch your cold—or any other infection you or another family member comes down with—wash your hands very thoroughly before handling him or anything that goes into his mouth (including his hands, bottle, or pacifier, and your nipples), and avoid drinking from the same cup. Keep baby from touching any cold sore or other contagious rash, and steer clear of kissing (as hard as it will be to keep your lips off that yummy face) while you have symptoms of infection. Make sure other family members follow the same rules. By the way, it’s fine to continue nursing your baby while you’re sick; in fact, breastfeeding strengthens your baby’s
immune system.
All that said, you’ll also have to resign yourself to the fact that few babies escape their first year cold free. Even with all the above precautions, he’s likely to succumb to the sniffles at some point—
and, because you spend so much close time together and share susceptibility (he receives only immunities from you that you already have), he’s actually more liable to catch a cold from you than from a passing sneezer on the street.
FINDING TIME FOR YOURSELF
“I’m so busy taking care of my new daughter’s needs that I never have time to take care of my own. Sometimes I don’t even have a chance to take a shower.”
Little things can mean a lot to the parent of a young baby. And often these little things that others take for granted—going to the bathroom when you feel the urge, having a cup of coffee while it’s still hot, sitting down for lunch—become luxuries you can no longer afford.
Still, it’s important to make time you can call your own. Not only so that you (and your spouse) will remember that your needs count, but so that your baby, as she grows in awareness, will
recognize this, too. “Mother” needn’t be (and really shouldn’t be) synonymous with “martyr.” You don’t have to suffer frequent urinary tract infections or constipation from infrequent trips to the bathroom, or indigestion from eating on the go, or depressingly dirty hair from postponing showers.
Though it will, indeed, take a lot of judicious juggling to meet your own needs without neglecting your baby’s, it will be well worth it for both of you. After all, a happier parent is a better parent.
How to best make time for yourself will depend on such factors as your schedule, your priorities, and just what it is you want to find time for. But the following tips can help put a little more personal time in your life:
Let baby cry. Not for half an hour, but certainly it won’t hurt if you put her safely in her crib and let her fuss while you brush your teeth or go to the bathroom.
Include baby. Sit down to lunch with your baby. If she’s not yet on solids, put her in a baby seat on the table (only while you’re sitting right next to her) and chat with her as you eat. Or take your lunch to the park if she’s more content in her stroller and if weather permits. Place her in her baby seat on the bathroom floor while you attend to personal needs—she’ll be getting early potty training while you get relief. Or play peekaboo with her from behind the curtain while you shower.
Depend on daddy. Shower while he breakfasts with her in the morning, or give yourself a facial while he takes her for a walk on Saturday afternoon. Don’t feel guilty about turning baby over to him in his spare time; a mother’s work (whether full- or part-time) is more consuming and demanding than any paid job. Parenthood is a partnership, and when two parents are on the scene, all the
responsibilities of baby care should be shared equally.
Exchange favors. Trade baby-sitting services with other parents who also need to free up some time.
Sit for a friend’s baby and your own one afternoon or morning a week while she does whatever it is she needs to get done; she reciprocates another day.
Hire help. You may not be able to afford even a part-time baby-sitter, but you probably can afford a responsible teenager to entertain your baby (when you are in the house), while you buy a little time for yourself.
FINDING OUTSIDE INTERESTS
“As much as I’m committed to being a full-time mother, I’m starting to feel suffocated by staying home with my new daughter. There’s got to be more to life than changing diapers.”
In the first few months of a baby’s life, when the demands of feeding and caring for her are round-the- clock and seemingly endless, about all a new mother has the time or inclination to crave is sleep. But once baby has settled into a routine and mom into a manageable rhythm, the dreary doldrums may settle over the frenetic fog of earlier weeks. Instead of finding yourself with too much to do and not enough time in which to do it, you may find yourself with too much time and not enough to do with it.
The challenge gone from getting through a day’s baby-care chores, you may well begin to feel like a wind-up mother going mechanically through the motions, and to crave the stimulations and
satisfactions of life beyond the four walls of home. Particularly if you were involved in many
activities before—a career, hobbies, school, athletics, community work—you may start to feel those four walls closing in, and start doubting your self-worth as well as your decision to stay home with your baby.
Yet a rich, full, satisfying lifestyle and life with baby are not, as they may seem now, mutually exclusive. The important first step toward achieving such a lifestyle is to recognize that woman (or man) cannot live by baby alone. Even if you adore every moment with your baby, you still need intellectual stimulation and the chance to communicate with someone who can say more than ah-goo, ahgoo (cute as that may be). There are a variety of ways of achieving these goals, and of reclaiming the sense of self you feel you’ve lost.
THROUGH YOUR BABY
You can look upon your baby as an obstacle to reentry into the grownup world—or as a ticket to it.
The following will give you a shot at finding adult interaction through your baby:
Play groups. Locate an existing group or seek out mothers interested in joining you to set up a new one up by putting up a notice at the baby’s doctor’s office; at your house of worship; on your building complex, supermarket, or community bulletin board. Try for a group with mothers whose interests match yours. See page 444 for more on setting up a play group.
Baby classes. Classes designed for babies are often more valuable for their parents. By signing up for such a class (first making sure it’s appropriate and safe for your baby; see page 447), you’ll have the weekly opportunity to meet and talk with other women, many of whom have chosen to stay home with their babies.
Parents’ discussion groups. Join an established one, or become involved in setting up a new one.
Invite guest speakers (a local pediatrician, a nurse, an author, and others who can address your needs as parents and/or as women); jointly hire a baby-sitter or sitters for the children. Meet in homes, school, a community center—or wherever there’s space available—weekly, every other week, or monthly. Joining online chats and discussion boards will also help you feel connected, provide you with valuable resources, give you a chance to vent, and most of all, remind you that you’re not alone in your situation.
The local playground or play area. Where babies play, parents can’t be far behind. The playground is not only a great place for infants (even when too young to be mobile, they find watching the
children and the activity fascinating) and older babies (when they can sit well, they usually love the swings, and many can tackle the slide and climbing areas before they are a year old), it is also an ideal place for mothers to meet other mothers and set up “play dates.” These dates, too, are more for the benefit of the parents at this point than they are for their babies, who aren’t yet capable of “playing together.”
THROUGH PERSONAL ENRICHMENT ACTIVITIES
Being a full-time mother doesn’t mean you can’t be anything else. Continue to pursue old interests, or find new ones, through any of the following:
A course at a local college. Take it for credit or just for fun or intellectual enrichment.
An adult education class. These are proliferating all over the country and offer everything from aerobics to Zen.
An exercise class. Challenging the body activates the mind. In addition, an exercise program, particularly one that offers child care or combines mother exercise with baby exercise, is a good place to meet other women with similar interests.
Active sports. Playing tennis or golf or another favorite sport regularly will help keep both body and mind well toned, as well as provide companionship.
A museum or art gallery. Become a member of a local museum and visit regularly, studying one
exhibit each time. (It will be even more fun if you go with another parent.) Added benefits for baby:
Early exposure to art and artifacts is visually and intellectually stimulating (infants are often fascinated by paintings and sculpture) and will help keep young minds open to them later.
Educational DVDs or CDs. Watch a DVD while doing household chores or breastfeeding; listen to CDs while driving; keep up with an old interest or explore a new one (learn a foreign language using computer software, for instance). Educational tapes are often available at no charge at the public library.
Books. They can take you anywhere, anytime. Read while you nurse, on a stationary bike, while baby naps, before bed. You’ll not only be entertaining and stimulating yourself by reading but, through your example, you nurture a life-long love of reading in your child. A great way to combine a love of literature and a need for adult companionship is to start or join a book club. If the club is made up of other new mothers and fathers, it can double as a parents’ group (where you talk books and babies).
Babies can be invited, or the club can hire a sitter or two to care for them while parents chat.