The Expectant Father. Armin A. Brott

      Obstetrical Clinics

      If you live in a city where there is a large teaching hospital, your partner may be able to get prenatal care at its obstetrical clinic. If so, you’ll spend a lot less than you would for a private physician. The one drawback is that your baby will probably be delivered by an inexperienced—yet closely supervised—doctor or a medical student. This isn’t to say that you won’t be getting top-quality care. Clinics are often equipped with state-of-the-art facilities, and the young professionals who staff them are being taught all the latest methods by some of the best teachers in the country.

      Your Rights to Free and Subsidized Medical Care

      If worse comes to worst, hospital emergency rooms are required by federal law to give your partner an initial assessment—and any required emergency care—even if you can’t afford to pay. But that’s no substitute for the kind of ongoing prenatal care that will ensure a healthy pregnancy, healthy baby, and healthy mom.

      So if you’re uninsured or underinsured—according to the American Pregnancy Association (americanpregnancy.org/), that’s the case for 13 percent of pregnant women—or just need some help paying for that prenatal care your partner needs, your first step should be to find out what Medicaid benefits she’s eligible for. (If you’re in this category, don’t feel bad. Nearly half of all births in the U.S. are financed by Medicaid.) Since benefits vary by state, you should also make contact with your state’s health department as well. You’ll be able to get most of your questions answered at the Medicaid website (medicaid.gov).

      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.