Patricia Harman has spent more than thirty years caring for women as a midwife, first as a lay-midwife, delivering babies in cabins and on communal farms in West Virginia, and later as a nurse-midwife in teaching hospitals and in a community hospital birthing center. Her latest book, Arms Wide Open was released in April 2011.
When women come to my office for their first OB visit, they’re usually in shock. Maybe they have been trying for a long time. Maybe they were on the pill and only missed one. Maybe they thought, because they were older or had endometriosis, it would never happen. After we have a few laughs, we get down to business.
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“The most important thing is nutrition.” I stress. “A healthy baby doesn’t come out of thin air. It’s built out of what you eat.” I give them handouts on nutrition and what to eat when they’re too sick to eat anything. We also talk about foods to avoid. “Don’t go crazy about this, “ I caution. “If you’ve already had a hotdog or blue cheese, you don’t need to freak out. The main thing I worry about is fish. This is something that changes frequently so check out the latest on the Internet.”
I talk to them about avoiding alcohol and drugs, even marijuana. I want to make a big point of this, though most patients have heard it already. I talk to them about smoking, how it makes a woman more vulnerable to miscarriage, low birth weight, prematurity and certain birth defects.
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Most women know smoking is harmful, but if they’re smokers, quitting is easier said than done! We discuss strategies for stopping (nicotine patches and gum aren’t recommended). If they’re half-a-pack a day smokers, I try to get them to cut down one cigarette a day. In ten days they are down to one cig and then they stop. If they are a pack-a-day, it will take twenty days. “That doesn’t sound too hard does it?” I ask sympathetically. Most seem to think it’s possible.
“Oh, and by the way, sex is ok. In fact it’s good for you!” I inform…It’s the question on their minds, that they’re often embarrassed to ask. “The only times you shouldn’t are if you’re spotting, if it hurts or it causes contractions.”
The last thing I talk to them about is loving themselves. “You are a walking miracle,” I tell them, young or old, established in life or just a teenager. “You are carrying a new life. Be gentle with yourself.”
Q: What’s the one thing women are afraid to ask about?
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All the above information has been reviewed by this week’s expert.