Pregnancy without fear.

PREGNANCY WITHOUT FEAR

Understanding what happens during each stage of pregnancy can help you cope and prepare for the changes in your body and emotions.

You think about having a baby, and you're scared. Being pregnant means living a mysterious, uncontrolled life for about 266 days. Just yesterday your best friend endured 36 hours of labor and told you she couldn't have tolerated one more moment of pain. And more than once you've read in the newspapers about mothers who have had their babies in the back seat of taxicabs, and you're certain you would never have the fortitude to get through such an ordeal.

Fear of pregnancy is common, more common than many women admit. One reason for this denial is that women are praised and recognized positively as mature, responsible individuals when they decide to have children. Fear of pregnancy clashes with a selfless attitude, and so they try to keep this fear under wraps.

The association of pain with pregnancy is a valid fear, dating back to the time when Eve ate from the tree of the knowledge of good and evil. As part of her punishment, God told her she would suffer pain during childbirth. In more recent times Sir James Simpson, first doctor to use chloroform, was denounced when he used his discovery to lessen childbirth pain. Chloroform was a decoy of Satan, he was told; did not the Bible enjoin "In sorrow thou shalt bring forth children"?

Now researchers suggest that the strong contractions of labor, though painful, are necessary. They stimulate the baby's respiratory, circulatory, and digestive systems so the infant can function on its own after birth.

One way to alleviate misconceptions about childbirth is by discussing your fears with others who have had children. Be aware, however, says K.C. Cole, author of What Only a Mother Can Tell You About Having a Baby, that women like to heighten their stories. "Just as men tend to exaggerate war stories, mothers often embellish the perils and pains of labor for dramatic effect -- not to mention the hours. If there were as many 36-hour labors as some mothers claim, we'd all stop having babies." Also unlikely are instances in which mothers claim to have casually delivered their babies in the bathroom after five minutes of labor. "Two-hour labors are as rare as 36-hour labors," Cole concludes.

Doctors think of pregnancies in terms of trimesters, or three-month periods. Understanding what happens during each stage of pregnancy can help you cope with and prepare for the changes in your body and emotions.

Usually the first sign of pregnancy is the absence of menstruation. This first trimester is also the time when perhaps 75 percent of pregnant women suffer nausea ("morning sickness"). "The body is going through a complete hormonal change to prepare itself for the new arrival," says Cole, "and experts claim the alteration of your hormones is what causes the sickness." The reaction to this hormonal change differs with each person, however, and the upset can range from mild queasiness to overwhelming nausea and vomiting.

Other physical discomforts during this time are fatigue, fainting, dizziness, headaches, nosebleeds, heartburn, increased urination, constipation, backaches, leg aches, and varicose veins.

Just as hormonal changes can induce nausea, they can also generate mood swings. You might find yourself crying over the smallest dissatisfaction or annoyance. One study showed that 60 percent of the women questioned admitted to some depression. These mood fluctuations are controllable, or at least tolerable, when you understand their source.

The second trimester is the most comfortable. Many of the physical discomforts have subsided, and although you show obvious signs of being "with child," such as an expanding waistline, protrusion of the abdomen, and widening hips, you're able to complete your normal pursuits without much physical difficulty. According to Juanita H. Williams, director of the women's studies program at the University of South Florida, "many women experience feelings of serenity and well-being during this time, probably as a combination of attitude toward their condition and their high estrogen level."

Obviously the comfort can't last forever, and the third trimester may be the most difficult. During the ninth month the baby is reaching its maximum size and will begin to settle down into the pelvis, ready to be delivered.

Weight gain is a major concern during these last three months. Some women are terrified of entering this stage because they are afraid their partners won't love them or find them attractive. Ironically, the opposite often happens. Says Cole: "Almost every woman I interviewed mentioned how surprised she was that men seemed to be turned on to them sexually." In fact, many women receive more attention when they're pregnant. "Even the grocery baggers were careful to pack my bags lightly or even carried the bags to the car when I was pregnant," says 23-year-old Bonita.

There is not a mother around who hasn't had the fear of giving birth to an unhealthy baby. Because the risks increase with age, health-care professionals recommend becoming pregnant before age 35.

Here are some other do's and don'ts for a healthy pregnancy:

* Avoid chest and abdominal X-rays.

* Eliminate or minimize the use of environmental substances (teratogens) that directly affect the development of fetal organs. Examples include lead, alcohol, and certain medications. (Researchers at Johns Hopkins University devised a test in 1981 that shows how the liver breaks down drugs and determines the potential of certain drugs to cause birth defects. The safest measure, of course, is to take no drugs.)

Food and beverage teratogens, explains Dr. Hugh Drummond, a clinical psychiatrist and author of The Spirited Guide to Health Care in a Dying Empire, include coffee, tea, cola, decaffeinated drinks, artificial coloring, MSG, and food with additives. Occupational teratogens to be avoided are automobile exhaust fumes, dry-cleaning fluid, aerosol hair spray, and dyes. Also, avoid kitty litter and undercooked meat, both of which can cause toxoplasmosis.

* Stop smoking. Studies show that smoking mothers have a 30 percent greater chance of stillbirth and a 26 percent greater risk of prenatal death.

* Learn about the Rh factor. This is an inherited component in the blood that, if not treated, can cause miscarriage, stillbirth, or birth defects. Injections can be administered to prevent the mother's and the child's blood from fighting each other.

* Eat more. During pregnancy you need about 40 percent more of the 17 essential nutrients, or about 200 to 300 more calories a day. If you're unsure about a healthy diet, consult a nutritionist.

* Obtain sound prenatal care and take childbirth preparation classes. Ask your doctor about a safe exercise program.

* Ask your doctor if he recommends a drug--such as a tranquilizer, analgesic, or anethetic (spinal block or epidural block)--to help with the pain of labor and to alleviate your anxiety just prior to birth.

* Be prepared for the postpartum period, sometimes called the "baby blues." "Most women experience some kind of depressive blues immediately after the birth of their baby," says Leslie Feher, executive director of the Association for Birth Psychology in New York. These sad feelings last from one day to two weeks; only one out of every 10 women suffer from a debilitating psychosis known as postpartum depression (PPD).

Knowledge and information can help dispel pregnancy fears. There is nothing wrong with being afraid. It is only when fear becomes your master that you deprive yourself of what you want most--in this case, a baby.

Dianne-Jo Moore is a free-lance writer who specializes in health articles. She lives in Grand Rapids, Michigan.