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Salad Days

WHAT’S GOING ON WITH YOUR PARTNER

Physically

• Morning sickness (nausea, heartburn, vomiting)

• Food cravings or aversions

• Dizziness, irritability, headaches

• Fatigue

• Breast changes: tenderness, enlargement

Emotionally

• Thrilled, stunned, a little frightened, or even completely bummed out (not all pregnancies are planned) that she’s pregnant. Sometimes all of these at the same time.

• A heightened feeling of closeness to you

• Apprehension about the nine months ahead

• Mood swings and sudden, unexplained crying

WHAT’S GOING ON WITH THE BABY

It’s going to be a busy first month. About two hours after you had sex, one very lucky sperm will have fertilized the egg, and, voilà, you’ve got yourself a zygote. By the end of the day, the zygote will divide into two cells and is now, technically, an embryo. Your tiny bundle of cells will continue to divide, and four to seven days after conception it will implant itself comfortably into the wall of your partner’s uterus, where it’ll stay until birth. By the end of this month, your little embryo will be about one quarter-inch long—10,000 times bigger than when it was just a zygote—and will have a heart (but no brain), and tiny arm and leg buds.

WHAT’S GOING ON WITH YOU

Thrills

I still have the white bathrobe I was wearing the morning my wife and I found out we were expecting for the first time. I remember standing nervously in the kitchen, the countertop cluttered with vials of colored powders and liquids, droppers, and the small container filled with my wife’s “first morning urine.” (Fortunately, do-it-yourself pregnancy detection kits are a lot less complicated today than they used to be, but I’m not sure they’re anywhere near as much fun.) Feeling like a Nobel Prize–winning chemist on the edge of making a discovery that would alter the course of the entire world, I carefully dropped several drops of the urine into one of the vials of powder. I stirred the mixture with the specially provided swizzle stick, rinsed it, and slowly added the contents of the other vial.

In all honesty, the results we got twenty minutes later weren’t a complete surprise. But that didn’t make it any less thrilling. I’d always wanted to have children, and suddenly it seemed that all my dreams were finally going to come true. It was like hitting the million-dollar jackpot on the nickel slots.

“Young kids today don’t know how good they have it.… I remember the old days before home pregnancy tests.”

Fresh or Frozen

Whether your baby was conceived in a lab or a bed, your future child will develop in the same way. A few days after conception, the embryo—now about eight cells—may be implanted in your partner’s uterus. Some clinics wait a few more days, until the embryo develops into a blastocyst. The reason is that in the wild, fertilization usually takes place in the fallopian tubes and the embryo travels for a few days until arriving in the uterus, where it implants in the wall. Not all embryos, however, develop into blastocysts, so waiting until they do gives your fertility doc a better shot at implanting something that has a strong chance of survival.

If you’re doing IVF, the eggs you use will come either from your partner or another woman. And you can order them in one of two ways: fresh or frozen. Fresh embryos result in somewhat more pregnancies and live births than frozen ones. However, fresh isn’t always a possibility (the eggs may have been fertilized before you or your partner went through a medical procedure—like chemotherapy—that could potentially have damaged either her eggs or your sperm. Or the eggs may have been retrieved from a faraway donor). Interestingly, fresh may not always be better. In independent studies, researchers in Finland, the U.S., and Australia all found that while defrosted embryos result in fewer pregnancies, the babies that are produced that way are less likely to be born prematurely, be born underweight, or die soon after birth. No one has any idea why that is.

Relief … and Pride

The pregnancy test’s positive result filled me with an incredible feeling of relief. Secretly, I’d always been afraid that I was sterile and that I’d have to be satisfied with taking someone else’s kids to the circus or the baseball game. I also felt a surge of pride. After all, I was a man, a fully functional man—all right, a stud, even. And by getting my wife pregnant, I’d somehow lived up to my highest potential.

If you’re not the biological father of your child (your partner conceived using donor sperm), you probably won’t have these feelings. But that in no way means that you’re any less manly—or that you’re going to be any less of a dad—than the rest of us.

Many expectant ART dads feel a different kind of relief: all those months and years of infertility treatment—the emotional ups and downs, the optimism and disappointment—are now a thing of the past. Other dads take longer to get to this point, and some never completely shake the infertility mentality.

Morning Sickness

Somewhere between half and 90 percent of all pregnant women experience “morning sickness.” Despite the catchy name, the nausea, heartburn, and vomiting can strike at any hour of the day. No one’s quite sure what causes morning sickness. Some suggest that it’s the pregnant woman’s reaction to changing hormone levels, in particular human chorionic gonadotropin (hCG), which is produced by the placenta and is the same stuff that’s picked up by home pregnancy kits. Others, such as researchers Margie Profet, Samuel Flaxman, and Paul Sherman, contend that morning sickness is the body’s natural way of protecting the growing fetus from teratogens (toxins that cause birth defects) and abortifacients (toxins that induce miscarriage). Morning sickness seems to go hand in hand with food aversions, which a lot of pregnant women also have. The most common aversions are to meat, fish, poultry, and eggs—all foods that can spoil quickly and can carry disease.

Whatever the cause, for most women, morning sickness typically starts four to six weeks after conception and disappears by fourteen to fifteen weeks. Until then, here are a few things you can do to help your partner cope:

• Give her some good news. It turns out morning sickness may actually be a good thing. Women who don’t have nausea or vomit are three times more likely to miscarry than those who do have those symptoms, according to researcher Gideon Koren. And women over thirty-five (whose risk of miscarriage is higher) benefited the most. In addition, women with morning sickness are less likely to deliver too early, have very low-birth-weight babies, or have babies with birth defects. Oh, and those babies do have higher IQs. Knowing this probably won’t make your partner feel any better, but it might give her something to smile about as she’s leaning over the toilet bowl.

• Encourage her to drink a lot of fluids (although some women with morning sickness have trouble tolerating milk). You might also want to keep a large water bottle next to the bed. She should avoid caffeine, which tends to be dehydrating, and she might want to start the day with a small amount of nonacidic juice, such as apple or grape, or flat soda; the sweet flavor will probably encourage her to drink a little more than she might otherwise.

• Be sensitive to the sights and smells that make her queasy—and keep them away from her. Fatty or spicy foods are frequent offenders.

• Encourage her to eat a lot of small meals throughout the day—every two or three hours, if possible—and to eat before she starts feeling nauseated. Low blood sugar can make the nausea worse. A high-protein, high-carbohydrate diet may help. And basic, bland foods like rice and yogurt are particularly good because they’re less likely to cause nausea than greasy foods.

• Go for a walk. Some women find that exercise reduces nausea.

• Make sure she takes her prenatal vitamins—with food—if her doctor says to do so. He may also suggest that she take some additional vitamin B and K. For some women, the prenatal vitamins may actually be making the morning sickness worse. OB Lissa Rankin often switches her patients to a chewable vitamin. If that doesn’t work, she takes them off the vitamins altogether for a few months. “It’s more important to stay hydrated and take in some nutrients than to take a vitamin,” she says.

• Put some pretzels, crackers, or rice cakes by the bed—she’ll need something to start and end the day with, and these are low in fat and calories and easy to digest.

• Explore alternative treatments. Acupressure bands that press on the inside of the wrist have reduced symptoms in some women, and so has eating or drinking ginger or taking vitamin B6 supplements. In addition, some research indicates that sniffing peppermint oil and isopropyl alcohol (the stuff they rub on your arm before giving you a shot) can shorten the duration of symptoms. But be sure to check with her practitioner before she starts sniffing or eating or pressing on anything.

• Be aware that she needs plenty of rest and encourage her to get it.

Irrational Fears

At some point after the initial excitement passes, a surprising number of men find themselves experiencing an irrational fear that the child their partner is carrying is not theirs. Psychologist Jerrold Lee Shapiro interviewed more than two hundred men whose partners were pregnant, and found that 60 percent “acknowledged fleeting thoughts, fantasies, or nagging doubts that they might not really be the biological father of the child.” The majority of these men don’t actually believe their partners are having affairs. Rather, Shapiro writes, these feelings are symptoms of a common type of insecurity: the fear many men have that they simply aren’t capable of doing anything as incredible as creating life, and that someone more potent must have done the job. Most guys get over these feelings pretty quickly.

Dads whose baby was conceived using donor sperm and aren’t biologically connected have their own kind of irrational fears. A lot of guys worry that they won’t be able to bond with their baby or that sperm samples have been switched and that they’ll end up with a child of a different race. Actually, the issue isn’t so much race as physical similarity. Most IVF couples don’t feel the need to make the circumstances of the pregnancy public. And, like any other dads, they hope their children will look like them—at least enough so that they won’t have to deal with the inevitable “Gee, the baby doesn’t look anything like you” comments. They may choose to tell the kids the true story of their birth later on. But that’s a topic we’ll tackle in the sequel to this book, The New Father: A Dad’s Guide to the First Year.

STAYING INVOLVED

Exercise

If your partner was already working out regularly before the pregnancy, she probably won’t need any extra encouragement to exercise. And if her doctor approves, she can continue her regular fitness routine, and do pretty much any kind of working out she wants to (see “Workout No-Nos” on page 34 for some exceptions). Be aware, though, that some health clubs—out of fear of getting sued—may ask a pregnant woman to provide a letter from her doctor. If your partner wasn’t physically active before pregnancy, this isn’t the time for her to take up rock climbing or start training for a marathon. That doesn’t mean, however, that she should spend the entire pregnancy on the sofa. Getting exercise is critical (the Centers for Disease Control and Prevention—CDC—recommends thirty minutes per day of moderate exercise). It will help improve her circulation and keep her energy level high.

Exercising during pregnancy may also help your partner keep her weight gain steady and reasonable, help her sleep better, improve her mood, and reduce some of the normal pregnancy-related discomforts. Plus, it will improve her strength and endurance, both of which will come in very handy during labor and delivery. Researchers James Clapp and Elizabeth Noble found that women who exercise during the pregnancy have shorter labors and give birth to healthier babies. Others, including Bradley Price, have found that exercise may even lessen the chance that your partner will deliver prematurely, have complications during labor, or need a Cesarean section.

Finally, there’s Canadian neuroscientist Dave Ellemberg, who found that compared to couch-potato expectant moms, pregnant women who did twenty minutes of moderate exercise (leading to slight shortness of breath by the end) three times per week had babies with “more mature cerebral activation.” Translation: their brains developed more quickly. Ellemberg believes that those babies could “acquire speech more rapidly” and reach developmental milestones sooner.

But because pregnancy can make even the buffest woman feel a little run down, she may not always feel like working out. One way to help motivate her to get the exercise she needs is to work out with her. (See below for a list of good activities you can do together.) The most important thing is to start easy and not push her if you see she’s feeling tired or winded. If your budget doesn’t permit joining a gym or a health club, you can always buy pregnancy workout DVDs or even download pregnancy exercise apps to your phone.

Workout No-Nos

• High-impact sports. I’ve spoken with dozens of OB/GYNs over the years and have yet to find one who seriously believes that it’s possible to induce a miscarriage by ordinary falling—especially in the first trimester. Severe, sudden impacts such as car crashes can sometimes cause a miscarriage, though. Same with sudden starts and stops, such as might occur on a roller coaster. That said, it’s a good idea to limit or avoid high-contact sports, like boxing, hockey, or roller derby.

• Any sport that might cause her to take a hard fall. This includes horseback riding, in-line skating, ice skating, and, starting in about the seventh month, bicycling. For a nonpregnant person, taking a tumble doing one of these sports could be dangerous. For someone who’s having balance issues, the risks are even greater.

• Downhill skiing. Unless you’re an expert, don’t, and even then take it easy. My wife skied when she was seven months pregnant but avoided the most challenging runs, where she’d have risked a serious fall. Unless your partner’s doctor prohibits it, cross-country skiing should be fine.

• Scuba diving. The fetus can’t decompress like adults can.

• Heavy lifting. This can put unnecessary pressure on internal organs.

• Overdoing it. If she can’t carry on a normal conversation while exercising, she’s working too hard.

• Overheating. Your partner shouldn’t overdress, and she should keep her workouts moderate. Remind her to take plenty of breaks and drink lots of water before, during, and after the workout.

• Hot tubs / steam baths / saunas. During the first six to eight weeks of the pregnancy, it’s best to stay away from anything that could raise your partner’s body temperature above 102°F (39°C). To cool itself, the body moves blood away from the internal organs—including the uterus and the fetus that’s inhabiting it—and toward the skin. After eight weeks, she should be okay. But even then, if she does decide to slip into the hot tub, make sure she drinks plenty of water.

One final word of advice: Do not panic if your partner did any of these things before you found out she was pregnant. First of all, there’s nothing you can do about it now, and torturing yourselves won’t undo it. Second, the chances are slim that anything she did will have an impact on the baby in any significant way. Just be careful from here on out.

Whatever you do, remember that you and your partner will get the greatest benefit and least chance of injury if you exercise regularly—thirty minutes on as many days as you can—rather than sporadically. Here are some great ways of exercising together:

• Walking—doesn’t matter whether it’s fast or slow, through your neighborhood, on a trail, or on a treadmill.

• Running—but do yourselves and your knees a favor: get good shoes and run on a soft surface.

• Low-impact aerobics and low-impact exercise machines such as stair-steppers, treadmills, and bicycles.

• Swimming, water aerobics, or snorkeling.

• Cycling—stationary or street is fine, but you should probably skip those bumpy dirt-bike rides.

• Tennis or golf.

• Light weight-lifting.

• Yoga—but avoid extreme stretches; this can cause damage to your partner’s connective tissues, which are somewhat weakened during pregnancy.

Before starting any kind of workout program, discuss the details with your provider and get his or her approval. If you’re doing anything that will work up a sweat, be sure to get enough fluids. Both of you should drink a glass or so of water an hour before starting and another four to eight ounces every fifteen to twenty minutes while you’re working out.

Nutrition

Although the names keep changing (once upon a time it was the Four Basic Food Groups, then came the Food Guide Pyramid, then MyPyramid, then MyPlate), the principles of good nutrition haven’t changed all that much since you learned about them back in sixth grade. And a healthy pregnancy diet looks pretty much like a healthy nonpregnancy diet: eat plenty of fruits and veggies, whole grains, and lean protein, limit fats and salt, and drink a lot of water. There are a few differences, though. Now that your partner is pregnant, she’ll need more calcium, folate, iron, and protein (we’ll talk about this in detail below). Overall, after the first trimester, she should get about 300 more calories a day than before (more if she’s carrying twins or better). Of course, if she was underweight before the pregnancy or is pregnant with multiples, she might need a little more than that. Defer to her doctor on this one.

If she was overweight before getting pregnant, this is not the time to go on a diet. At the same time, the fact that she’s “eating for two” is not a license to eat anything she wants. In fact, a growing body of solid research is finding that what a woman eats while she’s pregnant can directly—and permanently—affect the baby’s long-term health and risk of developing diabetes, heart disease, obesity, and other diseases. Her practitioner will undoubtedly suggest a diet for her to follow, but here are a few important nutritional basics to keep in mind:

CALCIUM

Calcium is critical to the manufacture of the baby’s bones. And because so much of your partner’s calcium intake goes directly to the baby, she needs to make sure there’s enough left over for herself—1,200–1,500 mg per day. If not, the growing fetus will leach it from your partner’s bones, potentially increasing her risk of developing osteoporosis later in life. The best sources of calcium are milk and other dairy products. But if your partner is allergic to milk or is lactose intolerant (a condition that affects as many as fifty million Americans), many doctors will advise her to stay away from it—especially if she’s planning to breastfeed (her milk allergy could be passed to the baby). Good alternate sources of calcium include pink salmon (canned, with soft bones, is okay), tofu, broccoli, calcium-fortified orange juice, eggs, and oyster-shell calcium tablets.

FOLATE

Folate (or folic acid) is a B vitamin that plays an important role in preventing neural tube defects, which are major defects of the brain and/or spine. These defects happen in the first few weeks of pregnancy—often before a woman knows she’s pregnant. Since about half of all pregnancies are unplanned, experts recommend that every woman of childbearing age take a folate supplement, just in case. Your partner should get around 600 micrograms per day during the pregnancy. Some docs bump that to 800 micrograms per day for the first trimester. Folate is so important that many grain products, including some flours, pastas, and cereals, are fortified with it. Additional good sources of folate include asparagus, avocados, bananas, beans, beets, broccoli, citrus fruits, dark green veggies, eggs, lentils, seeds and nuts, and yogurt.

IRON

Your pregnant partner needs 27 mg of iron per day—nearly twice as much as before. If she doesn’t get enough, she may become anemic and begin to feel exhausted. She should try to get three servings of iron-rich foods per day. Spinach, dried fruits, lean beef or poultry, fortified cereals, and legumes are all good sources, but since a lot of your partner’s iron intake is being used to manufacture the fetus’s blood, she may need still more than she can possibly get from food alone. If so, her doctor will prescribe some over-the-counter supplements, but probably not until sometime after the third month. If possible, your partner should take the tablets with a glass of orange juice—it (along with other sources of vitamin C) will help her body absorb the iron. One warning: iron supplements frequently cause constipation.

PROTEIN

The average woman needs 45 grams of protein a day, but your pregnant partner should take in about 70 grams per day. If she’s pregnant with twins, however, she’ll need to up her protein intake by another 20–25 grams a day, but not until she’s in the fourth or fifth month. When the fetus is eight weeks old, it has about 125,000 brain-cell neurons. But then production goes into hyperdrive—one thousand new neurons every second—so by the end of the nineteenth week, there are more than twenty-five billion, the most your child will ever have.

Many nutritionists believe that a high-protein diet—especially during the first nineteen weeks of pregnancy—supports this surge in brain-cell growth in the baby. Fortunately, most women already eat plenty of protein, so your partner won’t need any encouragement to eat more. But if you feel you need to be involved, lean proteins are always the best bet.

Low-fat milk is one of the easiest sources of protein: one glass has about 8 grams. Drinking milk may have other benefits as well. Dr. Fariba Mirzaei of the Harvard School of Public Health found that daughters of mothers who drank four glasses of milk per day while pregnant were 56 percent less likely to develop multiple sclerosis than daughters of women who drank less than three glass per month. Other researchers have found a positive connection between an expectant mother’s milk drinking and her children’s height (they’re taller) and IQ (they’re smarter). If your partner can’t drink milk, high doses of vitamin D produced similar results. But check with her practitioner before she takes any supplements. Other good sources are skinless chicken, lean meats, low-fat cheese, tofu, peanut butter, and cooked fish (but be careful with fish; see “Nutritional and Chemical No-Nos” on pages 40–43). Eggs (cooked, not raw) are another excellent choice; hard-boiled, they travel well and make a handy between-meal snack.

FRUITS AND VEGGIES

Eat a rainbow. Well, not really. But your partner (and you, for that matter) should try to eat fruits and vegetables in as wide a variety of colors as you can. Besides helping form red blood cells, green and yellow vegetables (which, strangely enough, include cantaloupe and mango) are excellent sources of iron and vitamins A and B, which will help your partner’s body absorb all that extra protein she’ll be eating. Vitamin A may also help prevent bladder and kidney infections. In addition, these vegetables are an excellent source of folic acid, which we discussed above. The darker the green, the better it is for your partner.

When it comes to fruit, the more-colorful-the-better rule holds true. Fruits are bursting with all sorts of vitamins and minerals, including antioxidants, which can protect against a variety of diseases and illnesses. Vitamin C is critical to the body’s manufacture of collagen, the stuff that holds tissue together. It also helps ensure the baby’s bone and tooth development. Vitamin D is involved in an amazing number of body functions and not getting enough of it can cause all sorts of problems, including increasing the likelihood that your partner will give birth early, have a C-section, develop gestational diabetes or preeclampsia, or give birth to a baby with skeletal problems. One of the best sources of Vitamin D is sunlight, but talk to her OB about whether she needs a supplement.

Overall, your partner should have a total of at least seven servings a day of fruits and vegetables.

CARBS

Grains (including breads and cereals) are basically fuel for your partner’s body, and she should have at least four servings a day. Since her body will burn the fuel first, if she doesn’t get enough there may not be enough for the baby. Grains are generally low in calories and high in zinc, selenium, chromium, and magnesium—all essential nutrients. They’re also high in fiber, which will help your partner combat the constipating effect of iron supplements. Good sources include whole-grain breads (keep her away from white bread and white rice for a few months if you can), brown rice, fresh potatoes, peas, dried beans, and quinoa.

Going Organic

Grocery store shelves are filled with organic everything. But how much of this craze is hype, just another excuse to raise prices? Well, there’s no way to give you an exact statistic, but it seems to make sense that we should try to minimize the amount of pesticides, hormones, antibiotics, and other nasty-sounding gunk that shows up in our food. The Environmental Working Group has a complete list (ewg.org/foodnews/list.php) of the produce items that you and your partner might want to avoid, as well as the ones that pose little or no danger (meaning there’s no sense paying extra for organic). Generally speaking, foods with peels you don’t eat are okay—and the harder the peel, the better. I’ve included a dozen of the worst and the best below. If you can’t stay away from the bad ones, at least wash them very, very carefully.

NO NEED TO BUY ORGANIC	DEFINITELY BUY ORGANIC
Avocado	Asparagus	Apples	Bell peppers
Sweet Corn	Mango	Strawberries	Nectarines
Pineapple	Papaya	Grapes	Cucumbers
Cabbage	Kiwi	Celery	Cherry tomatoes
Onions	Eggplant	Peaches	Snap peas
Sweet Peas	Cantaloupe	Spinach	Potatoes

WATER

As if she doesn’t have enough to do already, your partner should try to drink at least eight 8-ounce glasses of water (or unsweetened, noncaffeinated fluids) a day—more if she’s doing a lot of exercise or if she’s pregnant during the summer. This will help her to replace the water she loses when she perspires (which she’ll do more during pregnancy) and to carry away waste products. Keep in mind that at any given moment, about half of the population is walking around somewhat dehydrated, which puts them at increased risk of developing a variety of problems, including kidney stones and urinary tract cancers.

FATS

Despite all the hype about low- or no-fat diets, the fact is that your partner, like everyone else in the world, needs to consume at least some fat. She’ll probably be getting most of what she needs in the other things she’s eating during the day. But no more than 30 percent of her total caloric intake should come from fat. A diet too rich in fatty foods isn’t good for her or your growing baby-to-be. Monounsaturated fats (avocado, peanuts, almonds, olive oil, canola oil) are best, followed by polyunsaturated fats (margarine, mayonnaise, walnuts). The worst kinds are saturated fats (bacon, lard, butter) and trans fats—basically anything that has the words partially hydrogenated or hydrogenated on the ingredients panel.

“Is it organic?”

NUTRITIONAL AND CHEMICAL NO-NOS

Here’s the deal. Generally speaking, if your partner eats it, drinks it, breathes it, or smells it, so does your growing baby.

• Cigarettes. When a mother-to-be inhales cigarette smoke, her womb fills with carbon monoxide, nicotine, tar, and resins that inhibit oxygen and nutrient delivery to the baby. Maternal cigarette smoking increases the risk of low-birth-weight babies and miscarriage. There’s also some evidence that paternal smoking (exposing your partner and your baby to secondhand smoke) is just as bad. If you think the baby is somehow protected from your smoke by being inside your partner, or if you think that smoking doesn’t matter this early in the pregnancy, you’re dangerously wrong. Bottom line: if you’re a smoker, quit now. If she is, encourage her to quit and help her any way you can. Interestingly, a lot of men put off quitting—or asking their partners to quit—out of fear that withdrawal might lead to some marital tension. Bad choice. The potential danger to your baby far outweighs the danger to your relationship. Oh, and if you’re thinking of e-cigarettes (and why not? Everything else in our lives seems to have an “e” or an “i” in front of it), think again. While they’re less toxic than tobacco cigarettes, and they cut down on secondhand smoke, they’re hardly safe. Most e-cigs use liquid nicotine, which, besides being addictive, can cause high blood pressure and other heart-related issues in your wife, and can reduce blood flow to the placenta, potentially doing permanent damage to your baby. E-cigs may also contain propylene glycol, which, when heated, can turn into a powerful carcinogen. They also produce nanoparticles, which can irritate the lungs and aggravate asthma and other lung issues.

Here’s a great example of what happens when people get something only half right. Remember what I said about smoking causing low-birth-weight babies? Well, in Great Britain, smoking during pregnancy—especially among teen girls—is disturbingly common. These young girls somehow got the idea into their head that having a smaller baby would make labor and delivery less painful. What they didn’t understand was that low birth weight is only the beginning. Smoking also increases the odds of miscarriage, birth defects, stillbirth, and premature birth. Babies born too soon have a higher risk of all sorts of problems later in life: respiratory illness, cerebral palsy, mental retardation, and heart problems, just to name a few. And they often go through nicotine withdrawal right after birth, just like crack babies. It also affects the mom, by increasing her risk of developing placental previa (where the placenta covers the opening to the uterus) and placenta abruption (where the placenta separates from the wall of the uterus before delivery), as well as of going into labor prematurely. Am I scaring you? I sure as hell hope so.

• Alcohol. Complete abstinence is the safest choice (although your partner’s practitioner may sanction a glass of wine once in a while to induce relaxation). Regular, high-dose alcohol consumption can cause Fetal Alcohol Syndrome, a set of irreversible mental and physical impairments and abnormalities. Even moderate social drinking has been linked to low-birth-weight babies, learning impairments, and miscarriages in the early stages of pregnancy. “[I]f you have a glass of chardonnay here and there, you do so at your own risk,” writes OB Lissa Rankin in her book, What’s Up Down There? Questions You’d Only Ask Your Gynecologist If She Was Your Best Friend. “It’s probably just fine to enjoy the occasional glass of wine. There’s a big difference between being reckless (a definite no-no) and having one drink at dinner. But there’s just no data to help us make safe recommendations.” If you’re worried about any drinking your partner may have done before you found out you were pregnant, talk to her practitioner about it.

• Fasting. Unless she has a doctor’s approval, your partner should never, ever go twenty-four hours without eating. This is especially important in the first nineteen weeks of pregnancy, when the baby’s brain is developing.

• Over-the-counter or prescription drugs. Your partner should talk with her doctor before taking any medication, including aspirin, ibuprofen, and cold medicines—especially anything that contains alcohol or codeine. Antidepressants in particular have come under a lot of scrutiny lately. Several recent studies have linked one class of antidepressants, SSRIs (which include Prozac, Zoloft, Celexa, and Paxil), with increased risk of several fetal abnormalities. Others haven’t found any connection. But as you might expect, untreated depression can cause plenty of problems too. So if your partner has struggled with depression, talk with her doctor about whether the risks of taking antidepressants are outweighed by the risks of not taking them.

• Caffeine. Avoiding an excessive amount of caffeine is especially important in the early months. Some studies have shown that pregnant women who drink more than three or four good-sized cups of coffee per day have a greater risk of having a miscarriage, delivering prematurely, or having a low-birth-weight baby than women who can walk by a Starbucks and keep their wallet in their purse. Most studies seem to indicate that a cup or two a day is okay, but check with her practitioner to get the final word.

• Recreational drugs. Abstain during pregnancy—unborn children can be born addicted.

• Certain foods. Raw meats and fish may contain Toxoplasma gondii, which can blind the fetus or damage its nervous system. Unpasteurized milk and soft cheeses such as Brie may contain Listeria, another dangerous bacterium. Raw eggs and chicken may contain salmonella. Practitioners do disagree, however, on the magnitude of the risk involved. My wife’s first OB/GYN was Japanese and had absolutely no problem with her eating sushi. Some fish you do need to watch out for, though. The FDA recommends that pregnant women stay away from shark, swordfish, mackerel, and tilefish, all of which contain high levels of mercury. Limit albacore tuna to a serving or two per week. If she wants fish or seafood, salmon, pollock, and shrimp are low-mercury choices.

• Cat feces. Okay, cat feces don’t have much to do with nutrition, but they do contain high quantities of the same parasite found in some raw meats. So if you have a cat and you want to be chivalrous, take over the duty of cleaning the litter box for the duration of the pregnancy. Actually, litter boxes don’t pose much of a problem for most women. She’s got a much better chance of coming into contact with cat poop when she’s outside, digging in the garden (which, in many cats’ view, is nothing more than a giant litter box anyway).

• Insecticides, weed killers, and the like. As long as you’re taking over the gardening, put on your gloves and take a load of chemical fertilizer and pesticides to the nearest toxic waste disposal place (your regular trash company won’t take it if they know it’s there). Prolonged and repeated exposure to those toxic substances has been linked to birth defects. If you really need pesticides and fertilizers, now’s the time to switch to organics. Also, keep your partner far away from other potential chemical contaminants, such as diazinon (a common cockroach killer), as well as no-pest strips, flea sprays and collars, and pesticide bombs. Two chemicals in particular—PCBS and DDE (an insecticide byproduct)—can have some very negative effects. Kids exposed to those chemicals in utero tend to be taller (about two inches) and weigh more (an average of eleven to fifteen pounds) as teens than kids who weren’t exposed, and they often enter puberty too early.

• Hair dyes. Long-term use of hair dyes by adults has been linked to increased risk of several types of cancer. But could hair dye be absorbed through a pregnant woman’s scalp, enter her bloodstream, and harm her unborn baby? The jury’s out on that one. The American Pregnancy Association says that hair dyes (and other chemical-intensive products) are fine during pregnancy. After all, your partner isn’t planning to drink the stuff—she’s putting it in her hair, right? Other experts in reproductive health, including Joanne Perron, point to research that indicates that using hair dye may affect a growing fetus on the cellular level and could increase a child’s risk of developmental and reproductive disorders. May. Could. Big words. But why take the risk? The easiest solution is for your partner to avoid dyeing her hair while she’s pregnant—at the very least, during the first three months, when the baby’s organs and nervous system are forming. If you can’t convince her that her hair looks wonderful just the way it is, Google “nontoxic hair dye.”

A WORD ABOUT A VEGETARIAN DIET

If your partner is a vegetarian, there’s no reason why she and the baby can’t get the nutrition they need—especially if she eats eggs and milk. But if she’s a strict vegan, she’ll need to be especially sure that she’s getting enough protein and other nutrients. Check with her doctor or a good nutritionist for special guidance.

A FINAL NOTE ON NUTRITION

Helping your partner eat right is one of the best things you can do to ensure that you’ll have a healthy, happy baby (and a healthy, happy partner). But don’t be too hard on her. Being pregnant is tough enough without having someone standing over her shoulder criticizing every choice she makes. While she’d undoubtedly be better off eating nothing but healthy foods all the time, an occasional order of fries or a candy bar isn’t going to do any long-term damage. In fact, there’s some evidence that eating dark chocolate may actually be good for her. Several studies have found a correlation between dark chocolate and reduced heart attack risk, weight management, and stress relief. In one study, pregnant women who had five or more servings of chocolate every week (in the third trimester) were 40 percent less likely to develop preeclampsia (a very dangerous blood pressure condition; see pages 63–64 for more).

Finally, be supportive. This means that you should try to eat as healthily as she does. If you absolutely must have a banana split and you’re not planning to share, do it on your own time (and don’t brag about it).

The Hunger Campaign

One of the things I constantly underestimated while my wife was pregnant was how incredibly hungry she would get, and how quickly it would happen. Even though she might have had a snack before leaving the office, by the time she got home she’d be ravenous again.

If you’ve been doing most of the cooking at your house, things probably won’t change much during the pregnancy. But if your partner has been making the meals, there are a few things you can do to simplify her life significantly:

• Learn to cook simple, quick meals. There are plenty of cookbooks specializing in meals that can be made in less than thirty (or twenty or ten!) minutes. Easier yet, there are quite a few blogs and websites that can help. I like realfoodbydad.com, www.stayatstovedad.com, cookingfordads.net, and dadcooksdinner.com. You can also stock up on healthy microwavable dinners or order take-out meals, but that can get expensive pretty fast.

• Do some meal planning. This means you’ll have to spend some time reading cookbooks or surfing websites, looking for things that sound good. As you’re reading, be sure to write down the ingredients you’ll need. Although meal planning doesn’t sound all that difficult, it’s time-consuming—especially when you add in the extra time you’ll have to spend at the grocery store.

• Do the shopping. Even if your partner still plans the meals and makes out the shopping lists, your going to the store will spare her an hour or so a week of walking around on floors that are tough even on nonpregnant people’s feet. In addition, many women who have severe morning sickness find that being in a grocery store, surrounded by so much food, is just too much to stomach. If your partner did the shopping before the pregnancy, ask her to make a detailed list of the items she usually bought.

• Make her a nutritious breakfast shake. Let her spend a few more precious minutes relaxing in bed in the morning (see below for a good recipe).

• Keep some snacks in the glove compartment when you’re out together. Her energy can crash at any time, and a handful of nuts, some raisins, or a granola bar can really help.

A Special Note for Adoptive and ART Dads

If you’re one of the many expectant adoptive parents who has met your future baby’s birth mother, or you’ve hired a surrogate, do whatever you can to support her pregnancy without being annoying. Encourage her to exercise, stop smoking, eat right, take her prenatal vitamins, go to her regularly scheduled medical appointments, and so on.

“Why have you brought me here?”

RECIPES

Power Shake

¹/₂ cup skim milk

1 banana

12 strawberries

juice of 2 oranges

Combine ingredients in a blender or food processor and serve over crushed ice or straight up chilled.

Stocking Up

If you keep the following items on hand, you or your partner should be able to throw together a healthy meal or snack anytime.

• Unsweetened cereals

• Whole-wheat pasta

• Tomato or vegetable juice

• Whole-grain bread

• Skim milk

• Nonfat cottage cheese

• Low-fat, naturally sweetened yogurt

• Fresh eggs (and some hard-boiled ones too)

• Natural peanut butter

• Pure fruit jams

• Bottled water

• Crackers

• Fresh vegetables that can be eaten raw, including carrots, cucumbers, celery, and tomatoes

• Fresh fruit

• Frozen berries and grapes

• Raisins and other dried fruits

• Doughnuts (okay, not very often, but you’ve got to give yourselves a break once in a while)

Basic Quick Snacks

• Peel and slice carrots and celery the night before for your partner to take to work for lunch.

• Boil eggs: put a few eggs in a pot with enough water to cover them, cover the pot, bring to a boil. As soon as the water boils, turn off the heat and let the eggs sit in the pot for 20 minutes. Then rinse with cold water and shell.

• Mix up some GORP (dried fruits, nuts, raisins, sunflower seeds).

Chocolate Banana Pancakes

¹/₂ cup white flour

¹/₂ cup whole-wheat flour

2 teaspoons baking powder

¹/₄ teaspoon cinnamon

pinch salt

¹/₂ tablespoon white sugar

¹/₂ tablespoon brown sugar (if you’re missing either kind of sugar, just use a whole tablespoon of the one you have)

1 egg

1 teaspoon vanilla extract (optional, but great)

1 tablespoon vegetable oil

a bit less than 1 cup milk

¹/₂ cup chocolate chips

1 tablespoon butter or margarine

3 bananas, sliced

Mix the dry ingredients in a large bowl. Add the egg, vanilla, oil, and milk. Mix into a smooth batter. Add the chocolate chips and mix again. Melt the butter on a heated griddle. Pour the batter onto the griddle in large spoonfuls. Then quickly place several banana slices on each pancake. When the bubbles that form on the surface of the pancakes pop, flip them over. Cook until the second side is as brown as the first, and remove from griddle.

Open-Face Mexican Omelet

3 eggs

1 teaspoon cilantro, finely chopped

1 small tomato, chopped

¹/₄ cup green and/or red pepper, chopped

¹/₄ cup red onion, diced

black pepper to taste

If eating the egg yolks aggravates your partner’s morning sickness, use only the whites. Whisk eggs in a bowl or measuring cup and pour into a medium nonstick frying pan. Turn heat on low. As eggs begin to cook, add all other ingredients. Simmer until egg becomes firm, and slide omelet onto plate for serving.

Microwave Oatmeal

¹/₃ cup oats (you can use 1-minute, 5-minute, quick, or regular)

²/₃ cup water

¹/₂ banana, sliced

dash cinnamon

¹/₈ teaspoon vanilla extract

milk

1 tablespoon wheat germ

Put the oats in a 1-quart microwave-safe bowl. Stir in the water, banana, cinnamon, and vanilla. Microwave on high for 2 to 3 minutes, or until the concoction starts steaming or bubbling. Take out and stir again. Add milk to taste. Sprinkle with wheat germ for extra vitamins and protein.

Any of the following salads can be served as a main course for lunch or as a side dish for dinner.

Tomato and Basil Salad

The combination of these two ingredients makes a refreshing salad. When available, use fresh basil and local tomatoes for the best flavor.

2 vine-ripened tomatoes

6–8 basil leaves

4 tablespoons balsamic vinegar

4 tablespoons extra virgin olive oil

freshly ground black pepper to taste

Slice tomatoes and arrange on a serving plate. Shred basil leaves and sprinkle over tomatoes. Cover with the vinegar and oil. Add freshly ground pepper. Cover and refrigerate for at least 1 hour. Remove from refrigerator a half hour before serving.

Reading the Small Print

Getting healthy food isn’t always as easy as it might seem, and even though labeling requirements are getting more stringent, most food manufacturers aren’t about to do you any favors. So as you’re pushing your cart around the grocery store, be sure to read the labels carefully. In particular, watch out for the following:

• Ingredients. The first ingredient on the list is always the one there’s the most of—no matter what you’re buying. So, if that healthy ingredient (oat bran!!!) splashed all over the front of the box turns out to be at the bottom of the list, try something else.

• Sugar—and all the synonyms. Watch out for fructose, corn syrup, corn sweeteners, sucrose, dextrose, cane syrup, malt syrup, honey, and many more. They’re just fancy ways of saying “sugar.”

• Words like “drink,” “flavored,” or “cocktail.” Despite the healthy-looking label, most fruit “drinks” or fruit-“flavored” drinks contain less actual juice than you might guess—often as little as 10 percent, with the rest usually water and … wait for it … sugar.

• Servings. This is one of the most potentially deceptive areas in food labeling. In most cases, the number of calories, grams of fat and protein, and other nutritional information is given per serving. That’s all very nice, except that manufacturers don’t all use the same serving size. For example, I recently saw an eight-ounce package of fairly healthy frozen lasagna. The calories, protein, and fat all seemed okay—until I noticed that the serving size was actually only six ounces. This means that since one person would eat the entire eight ounces (I would, anyway), there was really 33 percent more fat and calories than expected.

• Percentage of calories from fat. Most nutritionists agree that pregnant women should limit their percentage of calories from fat to about 30 percent. Manufacturers are now required by law to make this calculation for you, so pay careful attention to the “nutrition facts” you’ll find on any packaged food.

• A word about additives. When it comes to ingredients, my rule of thumb has always been that if you can’t pronounce it, don’t eat it. In addition, even some easy-to-pronounce items don’t belong in your partner’s stomach. So while she’s pregnant, keep her away from artificial sweeteners (aspartame, Splenda, Saccharin, Truvia, and others), nitrates and nitrites (preservatives commonly found in lunch meats, hot dogs, and bacon), and monosodium glutamate (MSG, a flavor enhancer especially popular in Asian food and, for some odd reason, gefilte fish). All of these may have negative effects on your unborn child.

Mixed Green Salad with Balsamic Vinaigrette

Combining different types of greens, such as Boston lettuce, red leaf lettuce, radicchio, arugula, and endive, makes a green salad more interesting. Raw cucumbers, snow peas, French beans, shredded carrots, and cooked beets also add to the flavor, color, and nutrition of a mixed salad. Stay away from croutons, which are high in calories and low in nutrition.

Thoroughly wash and dry greens, place each serving on a plate, and arrange whatever selection of vegetables you like on top. Just before serving, pour about three tablespoons of balsamic vinaigrette dressing (see recipe below) over each salad.

BALSAMIC VINAIGRETTE

2 cloves garlic, crushed

²/₃ cup balsamic vinegar

1 teaspoon Dijon mustard

¹/₂ teaspoon parsley, chopped

¹/₂ teaspoon chives, chopped

¹/₂ teaspoon basil, chopped

²/₃ cup oil

salt and pepper

Mix garlic, vinegar, mustard, and herbs together. Whisk oil into the vinegar mixture. Add salt and pepper to taste.

Cucumber Salad

2 large cucumbers, sliced

1 medium Bermuda onion, diced

1 cup cider vinegar

¹/₂ cup nonfat plain yogurt

1 teaspoon fresh dill, chopped

If the cucumbers are not waxy, leave the skin on. Slice the cucumbers thinly (a food processor does the job best). Combine the diced onion with the cucumber slices in a large bowl that can be refrigerated. Pour the vinegar and yogurt over the mixture, cover, and leave in the refrigerator overnight. Serve cold as a side dish, garnished with the dill.

Low-Calorie Pizza

Create your own combination of toppings, including artichokes, olives, and squash, and use an assortment of cheeses, such as blue, cheddar, Swiss, and even low-fat cottage cheese.

4 soft tortillas (found in grocery freezer)

2 fresh plum tomatoes, sliced

3 cloves garlic, minced or crushed

1 cup mushrooms, sliced and sautéed

1 medium onion, chopped and sautéed

6 teaspoons fresh herbs (oregano, thyme, and basil), minced (or 2 teaspoons dried)

¹/₂ cup shredded cheese or low-fat cottage cheese

Preheat oven to 350°F. Place tortillas on a lightly greased cookie sheet. Cover with tomatoes, garlic, mushrooms, onions, and herbs. Add cheese. Bake for 20 minutes or until tortilla is crisp. Serve hot.

Quick and Easy Vegetarian Spaghetti Sauce

2 large onions, chopped

4 tablespoons olive oil

¹/₂ pound mushrooms, thinly sliced

2 16-ounce jars meatless spaghetti sauce

2 14.5-ounce cans stewed tomatoes

1 4-ounce can tomato paste

1 pound tofu, diced into ¹/₂-inch cubes

1¹/₂ teaspoons dried basil

a generous pinch of cayenne pepper

1 bay leaf

salt and pepper to taste

1 teaspoon sugar

¹/₂ teaspoon garlic powder

1 tablespoon rice vinegar

In a saucepan, sauté onions in the olive oil over medium heat until they’re translucent. Add mushrooms, and sauté for 5 more minutes (until the mushrooms begin to release their liquid). Add all the other ingredients and simmer for 40 minutes. If sauce won’t be used immediately, let cool, pour into two serving containers, and store in freezer. Defrost as needed.

Low-Calorie Cream of Zucchini Soup

This recipe can be varied by substituting carrots, potatoes, or celery for zucchini.

3 medium-size zucchini, seeded and cut into ¹/₄-inch slices

1 medium white onion, diced

1 small chicken bouillon cube (optional; bouillon cubes usually contain MSG)

1 cup nonfat plain yogurt

1 tablespoon fresh dill

salt and pepper

Put zucchini, onion, and bouillon cube in a saucepan. Add just enough water to cover. Bring to a boil and cook until soft (about 10 minutes). Let cool. Transfer to a blender or food processor, add yogurt and dill, and blend until smooth. Add salt and pepper to taste.

Spa Potato Chips

3 baking potatoes, peeled and thinly sliced

nonstick cooking spray

paprika to taste

Preheat oven to 350°F. Slice potatoes as thinly as possible (a food processor is best). Spray a cookie sheet with nonstick cooking spray. Spread out potatoes evenly in pan. Sprinkle with paprika and bake for about 15 minutes, or until crisp.

Spicy Peanut Butter Pasta

1 pound angel-hair pasta

1 tablespoon sesame oil

4 tablespoons peanut or safflower oil

6 cloves garlic, minced

1 generous pinch (¹/₈ teaspoon) red pepper flakes

10 scallions, thinly sliced

¹/₂ cup creamy peanut butter

6 tablespoons rice wine vinegar

6 tablespoons soy sauce

4 teaspoons white sugar

1 cucumber, peeled, seeded, and diced (optional)

cilantro to taste (optional)

Cook pasta according to directions on package. Drain and drizzle with the sesame oil. Set aside. Sauté garlic and pepper flakes in the peanut or safflower oil in a large frying pan. Add scallions. Turn heat to high and stir for one minute. Remove from heat. Add remaining ingredients and use a wire whisk to thoroughly mix into a thick sauce. Pour over pasta while sauce is still warm. Garnish with cucumber and/or cilantro, if desired.

Garlic Roasted Chicken

1 roasting chicken (3 to 4 pounds)

5 garlic cloves

1 carrot, sliced

2 celery stalks, sliced

4 small white onions

2 teaspoons olive oil

¹/₂ cup white wine (optional)

¹/₄ cup water

salt and pepper to taste

Preheat oven to 450°F. Clean chicken and rinse thoroughly with water. Pat dry. Sprinkle inside and out with salt and pepper. Using fingers, make pockets under skin and stuff with garlic cloves. Place chicken in a deep baking dish. Stuff cavity of chicken with carrot and celery slices and onions. Drizzle olive oil on top of chicken. Pour wine and water over chicken. Bake chicken at 450°F for ten minutes to sear. Then reduce heat to 350°F and cook for 30 to 40 minutes, or until the juices run clear when the thigh is pierced with a fork.

Rack of Lamb

A festive, delicious dish that is easy to prepare.

¹/₄ cup bread crumbs

3 cloves garlic, crushed

2 teaspoons parsley flakes

salt and pepper to taste

1 rack of lamb (ask the butcher to crack the rack, remove excess fat, and French-cut the ribs)

5 teaspoons Dijon mustard

Preheat oven to 450°F. In a small bowl, mix the bread crumbs, garlic, parsley, and salt and pepper. Place rack of lamb in a baking pan, meat side up. Spread mustard on top and bake for 10 minutes. Remove from oven. Using a fork, press the bread-crumb mixture into mustard, reduce heat to 350°F, and cook for about 20 more minutes, or until medium rare.

Fruit Salad with Creamy Yogurt Dressing

A refreshing, low-calorie dish for breakfast, lunch, or dessert. As a side dish or dessert, this recipe serves four. As a main course for lunch, it serves two.

1 green apple, cored and diced

1 banana, sliced

juice of 1 lime

1 small bunch of red or green seedless grapes

5 strawberries, halved

2 kiwis, peeled and sliced

1 seedless navel orange (or other citrus fruit), sectioned

1 cup low-fat vanilla yogurt (or nonfat plain yogurt)

1 teaspoon cinnamon

¹/₂ cup shredded coconut (optional)

4–8 fresh mint leaves (optional)

In a large mixing bowl, combine banana and apple, pour lime juice over them, and mix. Add remaining fruit and mix again. In a separate bowl combine yogurt and cinnamon. Just before serving, mix the yogurt dressing and coconut into the fruit. If fresh mint is available, garnish each serving with one or two leaves.