The Baby Decision
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Ashdown-Sharp, Patricia. A Guide to Pregnancy and Parenthood for Women on Their Own. New York: Random House, 1977.
Bolick, Kate. Spinster: Making a Life Of One’s Own. New York: Crown, 2015.
Greywolf, Elizabeth. The Single Mother’s Handbook. New York: Morrow, 1984.
Hertz, Rosanna. Single by Chance, Mothers by Choice: How Women are Choosing Parenthood Without Marriage and Creating the New American Family. New York: Oxford University Press, 2006.
Kennedy, Marge, and Janet Spencer King. The Single Parent Family: Living Happily in a Changing World. New York: Crown, 1994.
Lamott, Anne. Operating Instructions: A Journal of My Son’s First Year. New York: Pantheon, 1993.
Lehmann-Haupt, Rachel. In Her Own Sweet Time: Unexpected Adventures in Finding Love, Commitment, and Motherhood. New York: Basic, 2000.
Mattes, Jane. Single Mothers by Choice: A Guidebook for Single Women Who Are Considering or Who Have Chosen Motherhood. New York: Times Books, 1994.
Miller, Naomi. Singles Parents by Choice: A Growing Trend in Family Life. Insight Books, 1992.
Morrissette, Mikki. Choosing Single Motherhood. The Thinking Woman’s Guide. New York: Houghton-Mifflin 2008.
Schwartz, Pepper. “Para Dads and Para Moms.” New York Times, 9 November, 1995.
Traister, Rebecca. All the Single Ladies: Unmarried Women and the Rise of an Independent Nation. New York: Simon and Schuster, 2016.
Varon, Lee. Adopting on Your Own: The Complete Guide to Adopting as a Single Parent. New York: Farrar, Strauss, and Giroux, 2000.
Step-Parenting
Bernstein, Anne C. Yours, Mine and Ours: How Families Change When Remarried Parents Have a Child Together. New York: Norton, 1991.
Bray, James and John Kelly. Step Families: Love, Marriage and Parenting in the First Decade. New York: Broadway Books, 1998.
Burns, Cherie. Step motherhood: How to Survive Without Feeling Frustrated, Left Out, or Wicked. New York: Three Rivers, 2001.
Burt, Anne., ed. My Father Married Your Mother: Writers Talk About Stepparents, Stepchildren, and Everyone in Between. New York: W.W. Norton, 2006.
O’Connor, Anne. The Truth About Stepfamilies; Real American Stepfamilies Speak Out. New York: Marlowe and Company, 2003.
Oxhorn-Ringwood, Lynne Louise Oxhorn and Marjorie Vago Krausz. Stepwives; Ten Steps to Help Ex-Wives and Stepmothers End the Struggle and Put the Kids First. New York: Simon and Schuster, 2002.
Papernow, Patricia. Surviving and Thriving in Stepfamily Relationships: What Works and What Doesn’t. New York: Routledge, 2013.
Penton, John and Shona Welsh. Yours, Mine, and Hours. Relationship Skills for Blended Families. Charleston, SC: BookSurge, 2007.
Roosevelt, Ruth, and Jeannette Lofas. Living in Step. Briarcliff Manor, NY: Stein and Day, 1976.
Organizations & Websites
For more resources, please see the resources sections of the books in the bibliography as well as the websites listed here.
Childfree
Laura Carroll
https://www.lauracarroll.com
Author of Families of Two and The Baby Matrix offers support and information.
Childfree Meetup
http://www.meetup.com/topics/childfree
Meet locally with other childfree people.
Childfree.Net
http://www.childfree.net
This website connects you to many childfree websites and resources.
No Kidding!
http://www.nokidding.net
An international social club for childfree couples and singles.
Birth and Postpartum
American College of Nurse-Midwives
8403 Colesville Rd. Suite 1550, Silver Spring, MD 20910 240.234.8068.
www.midwife.org
American College of Obstetricians and Gynecologists (ACOG)
www.acog.org
Birthing from Within
www.birthingfromwithin.com
Boston Women’s Health Book Collective
www.ourbodiesourselves.com
This website offers more resources than can be included in their wonderful Our Bodies, Ourselves books, plus a blog.
Childbirth and Postpartum Professionals Association
PO Box 491448, Lawrenceville, GA 30049
888.692.2772
www.cappa.net
Conceivable Future
http://conceivablefuture.org
A woman-led network bringing awareness to the threat of climate change to reproductive health and justice.
Doulas of North America
PO Box 626, Jaspar, IN 47547
888.788.3662
www.dona.org
Genetic Alliance, Inc.
http://www.geneticalliance.org
Genetic education.
March of Dimes
http://www.marchofdimes.com
Prevention of premature birth.
Mindfulness-Based Childbirth and Parenting Education Program
www.mindfulbirth.org
Postpartum Support International
6706 SW 54th Avenue, Portland, OR 97219
Support Helpline 800.894.9452
www.postpartum.net
Nationwide telephone support referral to local help
Vibrant Gene
http://www.vibrantgene.com
Kayla Sheets is a genetic consultant and genetic counselor who can help with planning and preconception care. Her website is full of information, including access to her talk shows. See my interview with her, Appendix 3.
Infertility and Pregnancy Loss
American Society of Reproductive Medicine (ASRM)
1209 Montgomery Highway, Birmingham, AL 35216
205.978.5000
e-mail asrm@asrm.com
patient/consumer website
www.fertilityfacts.org
Professional organization of reproductive endocrinologists and allied professionals. The patient consumer website above is useful. Referrals provided.
Kristen Darcy
http://www.kristendarcy.com
Life coaching blog often focused on infertility.
Domar Center
http://www.domarcenter.com
781-434-6578
Stress management services including mind/body workshops
Endometriosis Association
8585 N. 7th Place, Milwaukee, WI 53223
414.355.2200
http://www.endometriosisassociation.org
Support and information
Health Journeys
http://www.healthjourneys.com
Relaxation and visualization downloads for stress management, healthy pregnancy, other relaxation and health needs.
Hope After Loss (formerly Hygeia Foundation, Inc.)
PO Box 3943, 264 Amity Rd, Woodbridge, CT 06525
800.893.9198
www.hygeiafoundation.org.
Bereavement Support.
RESOLVE
7918 Jones Branch Rd. Ste. 300, McLean, VA 22102
703.556.7172
www.resolve.org
A national organization for consumer advocacy, education on medical and emotional aspects of infertility and pregnancy loss. Local chapters have support groups, meetings and conferences. (I used to be their Clinical Director.)
Organization of Parents Through Surrogacy
P.O. Box 611, Gurnee, IL 60031
847.782.0224
e-mail bzager@msn.com
www.opts.com
Non-profit educational, networking, and referral organization serving prospective parents, surrogate mothers, and professionals.
SHARE Pregnancy Loss Support/St. Joseph’s Health Center
402 Jackson St. St. Charles, MO 63301
800.821.6819
www.nationalshare.org
National support information, telephone support, chapters nationwide.
Stirrup Queens
http://stirrup-queens.com
Melissa Ford, author of Navigating the Land of If, off
ers insight and humor in her blog and gives you links to other infertility blogs.
Adoption
Adoption.Net
23161 Lake Center Drive, Ste. 209, Lake Forest, CA 92630
info@Adoption.NET
www.adoption.net
A goldmine of support of everyone involved in the adoption process including birthmothers and pregnant women. In addition to community sharing, social worker Kathy Brodsky contributes articles.
American Academy of Adoption Attorneys
PO Box 33053, Washington, DC 20053
202.832.2222
http://www.adoptionattorneys.org/aaaa-page/home
National organization of attorneys who specialize in adoption. In addition to referrals, the academy works on adoption reform.
Adoptive Families Magazine and Website.
http://www.adoptivefamilies.com/faq.php
In addition to the magazine, the website offers referrals to agencies, attorneys and parent groups, online community, blogs.
Building Your Family
New Hope Media LLC
39 West 37th St. 15th Fl., New York, NY 10018
646.366.0842
www.buildingyourfamily.com.
Online information and a guidebook for adopting or pregnancy.
Creating a Family
www.creatingafamily.com
Offers online adoption courses, information and referral for adoption and infertility and a radio show. Principal contributor is Dawn Davenport, author of The Complete Book of International Adoption (see bibliography section, Appendix A).
Families for Private Adoption
202.722.0338
http://ffpa.org
Mission is to serve prospective parents who are interested in adoption outside of traditional agencies. Volunteers are adoptive parents.
National Adoption Center
1500 Walnut Street, Philadelphia, PA 19192
215.735.9988
800.TO-ADOPT
e-mail: nac@adopt.org
www.adopt.org
Mission is to find homes for children in foster care, providing information and referral to prospective parents.
Treehouse
http://www.resca.net
This is a community of foster families living together along with elderly people. An exciting new model in which the children enjoy emotional and academic success. New communities are opening in a number of cities.
Parenting
Brain, Child: The Magazine for Thinking Mothers
888.304.6667
www.brainchildmag.com
The Fatherhood Project
http://www.fatherhoodproject.org
Research, education, and support, empowerment.
Literary Mama
www.literarymama.com
Mamazine
www.mamazine.com
Feminist mothering.
Mocha Moms, Inc
http://mochamoms.org
Local and online support for women of color in any stage of motherhood.
Lauren Sandler
http://www.psychologytoday.com/blog/one-and-only
Blogs about the one child family.
Single Mothers by Choice
http://www.singlemothersbychoice.com
National organization with local meetings for those considering or trying to be single mothers or already mothers.
Sister Song Women of Color Reproductive Health Collective
http://www.sistersong.net
A network of many organizations.
Well Family
http://well.blogs.nytimes.com/
This is the new name for the popular The Motherlode parenting blog. columns by New York Times journalists and lively comments from readers.
Breastfeeding
KellyMom
www.kellymom.com
A nurse/mother offers insights on nursing, parenting, and baby sleep patterns.
La Leche League International
957 N. Plum Grove Rd., Schaumburg, IL 60173
800.525.3243
www.llli.org
Step-Families
National Stepfamilies Resource Center
www.stepfamilies.info
Clearinghouse of information and support for stepfamilies and professionals.
StepMom Magazine
http://www.stepmommag.com
Online information and blog, as well as a monthly online paid subscription.
Gay Resources
Family Pride Coalition
http://www.familypride.org.
Advocacy for gay families.
GLAD
http://www.glad.org
Legal defenders and advocates.
Proud Parenting
http://proudparenting.com
Advocacy.
Our Family Coalition
http://www.ourfamily.org
Advocacy, support groups, education and parenting resources.
Kayla Mandel Sheets, LCGC, is a board-certified and licensed genetic counselor and founder of Vibrant Gene Consulting. She specializes in preconception genetic care for individuals and couples who desire guidance in having a healthy pregnancy.
Much of the information in this interview is medical or scientific and therefore will change rapidly. Readers should consult experts for current information and use the information here only as a starting point in thinking about these important issues.
1. What self-care should people be considering before they try to get pregnant? How far ahead of trying for pregnancy should genetic counseling start? What if you want to have a baby, but don’t think you’ll start trying for a year or two? Should you start all this preventive stuff now because it’s good for your health anyway?
a. There are many things that women and their partners can do to prepare for a healthy pregnancy. It is a little known fact that ACOG (American College of OB/Gyn) recommends every woman take time to create a reproductive health plan. I recommend that couples spend 3–6 months (or however long it takes) to get themselves into optimal health. Even if they are not planning on having a baby for a while, these health guidelines can help them get into healthy habits and with the luxury of having time on their side.
b. Research into the field of epigenetics (the expression of genes) shows that diet, exercise, and mental health are all important factors in the health and wellbeing of the baby, not just at birth but throughout his lifetime. Amazingly, the baby’s health in utero can impact its health well into adulthood, and some of these epigenetic markers are passed on to the next generation. So the lifestyle of the couple can affect not only their baby’s health, but the health of their grandchildren, too!
c. My recommendations depend on the client’s needs and situation, but on the whole I suggest people consider the following appointments:
i. Find and plan a meeting with your OB or care provider
ii. Consider meeting with a nutritionist or registered dietician to formulate a diet plan, or optimize your current plan. Request information regarding foods that can promote the health of your microbiome (i.e., pre-and probiotics). They can also help with clients who need to lose or gain weight in order to meet the ideal BMI range of 18.5–26. (I wouldn’t necessarily recommend speaking with your doctor about your diet because in the US, most are not formally trained in nutrition.) If you are unable to find a nutritionist, I recommend looking into web-based education, perhaps a web-based course such as Chris Kresser’s www.healthybabycode.com.
iii. Make an appointment with a dentist. I recommend getting your teeth cleaned, cavities fixed, and x-rays done (while you’re not pregnant!) These things are important to your oral health, which can have substantial impact on the health of your pregnancy. Poor oral health has been associated with preterm babies and other prenatal complications. We recently learned that the womb is not sterile (as once believed) and that the microbes that populate the placenta have the closest resemblance to the microbes of your mouth. We are still unclear about the process of how this happens, but for now suffice to
say keeping good oral hygiene is clearly important.
iv. If you have a long-term injury, this might be your chance to heal it before becoming pregnant and putting more stress on it. I had a slipped disc that was not fully resolved, and worried me that it would become crippling during pregnancy. With the help of a massage therapist and physical therapist, I now am pain free and stronger than before my injury.
v. Before you start taking prenatal vitamins, I recommend getting a baseline blood assessment for vitamin and iron deficiencies. Either your OB, PCP or naturopath can help with this.
• As for prenatal supplementation, I recommend one that contains a natural form of folate (“folate,” “5-methyl-tetrahydrofolate,” “L-methylfolate” or “Metfolin”) in lieu of the synthetic version, folic acid. Not everyone can metabolize folic acid well. There is a genetic test for how readily someone metabolizes folic acid into its active form of folate. The gene that encodes the enzyme is called methylenetetrahydrofolate reductase (MTHFR, for short). Some clients chose to be screened for this, while others choose to simply take the bioavailable form of the vitamin.
• You also get folate from foods such as dark leafy greens, chicken liver, and fruits. In total (food plus supplementation) aim for 800–1200 mcg per day. If you have a family history of birth defects (such as spina bifida or other open neural tube defects) or follow a vegetarian/vegan diet you should aim for the higher end of that range.
vi. Attempting pregnancy can be a stressful endeavor if it takes a while to conceive. Doing things that combat stress is essential to keeping your cortisol levels low (high cortisol levels can diminish fertility!). I recommend integrating yoga, tai chi, or meditation into your weekly schedule. Therapeutic massage and acupuncture can also help tremendously. If you have never meditated and want to learn, look into Mindful-Based Stress Reduction (MBSR) programs, notably ones that implement Jon Kabat-Zinn’s work because they have been scientifically validated.
2. Why do you recommend that everyone, not just those with known genetic disorders see a genetic counselor before trying for pregnancy?
a. Genetic testing is changing rapidly and not every prenatal healthcare provider is able to keep abreast of the latest in genetic testing, and few have formal training in genetics to begin with. It’s not their fault, it’s just simply not their specialty. If you want to know all of your testing options, it’s best you go to the source. Speak with a genetic counselor, ideally before you are pregnant so all of your options are on the table. Once you’re pregnant, it will be a race against the clock to get your genetic testing needs met. From years of experience, I can say it’s infinitely less stressful getting testing done without the pressure of time.