The Doctor
Will See You Now

What’s Going On with Your Partner

Physically

Emotionally

What’s Going On with the Baby

During this month, the baby will officially change from an embryo to a fetus. By the end of the month, he or she (it’s way too early to tell which by looking) will have stubby little arms (with wrists but no fingers yet), sealed-shut eyes on the side of the face, ears, and a tiny, beating heart (on the outside of the body). If you bumped into a six-foot-tall version of your baby in a dark alley, you’d run the other way.

What’s Going On with You

The Struggle to Connect
Just about every study that’s ever been done on the subject has shown that women generally “connect” with their pregnancies sooner than men do. Although they can’t feel the baby kicking inside them yet, the physical changes they’re experiencing make the pregnancy more “real” for them. For most men, however, pregnancy at two months is still a pretty abstract concept. For me—as excited as I was—the idea that we were really expecting was so hard to grasp that I actually forgot about it for several days at a time.

Excitement vs. Fear
But when I remembered we were about to become parents, I found myself in the midst of a real conflict—one that would plague me for months. On the one hand, I was still so elated that I could barely contain myself; I had visions of walking with my child on the beach, playing catch, reading, helping him or her with homework, and I wanted to stop strangers on the street and tell them I was going to be a father. On the other hand, I made a conscious effort to stifle my fantasies and excitement and to keep myself from getting attached to the idea. That way, if we had a miscarriage or something else went wrong, I wouldn’t be devastated.

Dads who have been through a miscarriage on a previous pregnancy, or done several unsuccessful ART cycles, are especially susceptible to this kind of self-protective (and completely understandable) denial.

Increased or Decreased Sexual Desire
It was during the times when I let myself get excited about becoming a father that I noticed that my wife’s and my sex life was changing. Perhaps it was because I was still reveling in the recent confirmation of my masculinity, or perhaps it was because I felt a newer, closer connection to my wife. It may even have been the sense of freedom resulting from not having to worry about birth control. Whatever the reason, sex in the early months of the pregnancy became wilder and more passionate than before. But not all men experience an increase in sexual desire during pregnancy. Some are turned off by their partner’s changing figure; others are afraid of hurting the baby (a nearly impossible task at this stage of the game). Still others may feel that there’s no sense in having sex now that they’re pregnant.

Whatever your feelings—about sex or anything else for that matter—try to talk them over with your partner. Chances are she’s experiencing—or soon will be—very similar feelings. One thing you may not want to discuss with your partner is your dreams. According to Berkeley, California (where else?) psychologist Alan Siegel, a lot of expectant dads experience an increase in dreams about having sex—with their partner, old girlfriends, and even prostitutes. For some guys, these dreams are an expression of their concern that the pregnancy will mess with their sex life. The brain is probably saying to itself, “Well, big guy, if you can’t get any in the flesh, you can still have some pretty wild fantasies. . . . ” For other guys, sexual dreams are a way of reassuring themselves that fatherhood—and all those mushy, protective feelings that go with it—in no way detracts from their masculinity.

Looking for Validation
If you’re adopting, the time between your decision to adopt and the actual arrival of your child could be considered a “psychological pregnancy.” Unlike a biological pregnancy, you won’t, in most cases, know exactly how long it’s going to take from beginning to end. But what’s interesting is that most expectant adoptive parents go through an emotional progression similar to that of expectant biological parents, says adoption educator Carol Hallenbeck. The first step is what Hallenbeck calls “adoption validation,” which basically means coming to terms with the idea that you’re going to become a parent through adoption instead of through “normal” means.

If you and your partner have hired a surrogate, there’s a good chance that you’ll be going through a psychological pregnancy as well. Unlike an adoptive couple, you have a much better idea of when your baby will be born, but you may still go through what might be called “surrogacy validation.”

This may seem straightforward, but it’s usually not. For many parents, according to researcher Rachel Levy-Shiff, adoption (or surrogacy) is a second choice, a decision reached only after years of unsuccessfully trying to conceive on their own and after years of disappointments and intrusive, expensive medical procedures. Infertility can make you question your self-image, undermine your sense of masculinity (how can I be a man if I can’t get my partner pregnant?), force you to confront your shattered dreams, and can take a terrible toll on your relationship. If you’re having trouble accepting the fact that you won’t be having biologically related children, I urge you to talk to some other people about what you’re feeling. Your partner certainly has a right to know—and she might be feeling a lot of similar things. In addition, the adoption agency you’re working with will probably have a list of support resources for adoptive fathers. Give them a try.

Staying Involved

Going to the OB/GYN Appointments
The general rule that women connect with the pregnancy sooner than men has an exception: men who get involved early on and stay involved until the end have been shown to be as connected with the baby as their partners. And a surefire way to get involved is to go to as many of your partner’s OB/GYN appointments as possible.

Although I always love being told that I’m healthy as a horse, I’ve never really looked forward to going to the doctor. And going to someone else’s doctor is even less attractive. But over the course of three pregnancies, I think I missed only two OB medical appointments. Admittedly, some of the time I was bored out of my mind, but overall it was a great opportunity to have my questions answered and to satisfy my curiosity about just what was going on inside my wife’s womb.

There’s no doubt that you can get at least some basic questions answered by reading a couple of the hundreds of pregnancy and childbirth books written for women. But there are a number of other, more important reasons to go to the appointments:

If you’re planning to go to your partner’s checkups, you’d better get your calendar out. Here’s what a typical schedule looks like:

MONTHIF YOU’RE EXPECTING
ONE BABY		IF YOU’RE EXPECTING
MULTIPLES
1–5 MonthlyMonthly
6MonthlyEvery other week
7Every other weekEvery other week
8Every other weekWeekly
9WeeklyWeekly

Of course, taking time off from work for all these appointments may not be realistic. But before you write the whole thing off, check with the doctor—many offer early-morning or evening appointments.

Testing
Besides being a time of great emotional closeness between you and your partner, pregnancy is also a time for your partner to be poked and prodded. Most of the tests she’ll have to take, such as the monthly urine tests for blood sugar and the quarterly blood tests for other problems, are purely routine. Others, though, are less routine and sometimes can be scary.

The scariest of all are the ones to detect birth defects. One of the things you can expect your partner’s doctor to do is take a detailed medical history—from both of you. These medical histories will help the practitioner assess your risk of having a child with severe—or not so severe—problems (see pages 69–73 for more on this).

If you’re in one of the high-risk categories, your doctor may suggest some additional prenatal testing. Keep in mind that, with the exception of ultrasound, blood, and urine tests, each of the other prenatal diagnostics involves some potential risks either to your partner or to the baby. Ask your doctor about them and make sure the benefits of taking the test outweigh the potential risks.

If you did ART and PGD (preimplantation genetic diagnosis, see pages 334–35), you and your partner may not have to be tested at all—the lab was able to test the embryo itself for any potential abnormalities. If any were found, that particular embryo wouldn’t have been implanted. However, because there is a small risk of getting a false negative on the PGD, many fertility doctors will recommend additional testing once the pregnancy is underway.

ULTRASOUND (SONOGRAM)
This noninvasive test is painless to the mother, safe for the baby, and can be performed any time after the fifth week of pregnancy. By bouncing sound waves around the uterus and off the fetus, ultrasounds produce a picture of the baby and the placenta. To the untrained eye, standard, 2-D images look remarkably like Mr. Potato Head, without the glasses and mustache. 3-D ultra-sounds are able to generate a more complete image of the fetus. And 4-D ultra-sounds (sometimes called dynamic 3-D) can actually let you see your future baby in action, sucking his thumb, napping, swimming, and doing whatever else fetuses do to pass the time.

In the first trimester, your doctor will probably recommend an ultrasound only if there’s something going on that’s a little out of the ordinary. The most common reason is that the size of the uterus doesn’t correspond to the age of the fetus when measured from your partner’s last period. The doc may also order an ultrasound if your partner has experienced any bleeding, if there’s any doubt as to the number of fetuses, or if he or she suspects an ectopic pregnancy (a pregnancy that takes place outside the uterus). At this stage, the ultrasound can confirm that there’s a heartbeat, and can measure the baby (starting with the charmingly named Crown-Rump Length, which will give you a better due date estimate).

Second-trimester ultrasounds are usually the ones that low-risk couples see first. They’re used to determine the sex of the baby (this one is optional), to get a more accurate estimate of the due date, or just because you’re curious about what the baby looks like. If this is the first ultrasound, your practitioner will want to confirm the number of residents in the uterus, see how well they’re moving around, and make sure all the body parts and organs are the right size and in the right place. The test may also be used to firm up the due date and to confirm anything that may have come up in other prenatal testing, including the Triple or Quad Screen, amniocentesis, and CVS (see page 72).

During the last part of the pregnancy—and especially if the baby is overdue—your partner’s doctor may order additional ultrasounds to determine the baby’s position, to make sure the placenta is still functioning, or to confirm that there’s still enough amniotic fluid left to support the baby.

TRIPLE OR QUAD SCREENS
The Triple Screen measures three chemicals that may show up in your partner’s blood: AFP (Alpha-Fetoprotein), HCG (human chorionic gonadotropin), and estriol. The Quad includes one more substance, Inhibin A, to the screen, and there’s actually a Penta, which adds yet another substance, ITA (Invasive Trophoblast Antigen). Together they’re used to flag potential abdominal wall abnormalities and a variety of neural-tube defects (defects relating to the brain or spinal column), the most common of which are spina bifida and anencephaly (a completely or partially missing brain). Whether you have the triple, the quad, or the penta (is this is sounding like Olympic gymnastics judging, or is it just me?) will depend on what your doctor orders. Theoretically, the more things you test for, the lower the false-positive rate.

These simple blood tests are conducted when your partner is 15 to 18 weeks pregnant (some labs will do it as late as 20 weeks), and the results are usually available within a week, sometimes even the next day. It’s important to understand that a “positive” result is not necessarily an indication of the presence of an abnormality, just that there might be a problem. Most turn out perfectly fine, but if your partner does get a positive result, she’ll be asked to take additional tests, such as an ultrasound and amniocentesis, which should clear up any doubts you have. Since these screens are really designed to let your partner know whether she needs additional testing, she may not want to bother if she’s planning to have an amnio or an in-depth ultrasound test.

TESTS YOU MAY HAVE TO TAKE
No, you’re not pregnant, but there are still a few times when you may need to give a little blood to make sure all is well with your baby. A variety of genetically transmitted birth defects, for example, affect some ethnic groups more than others. So, based on your family histories, your partner’s doctor may order one or both of you to get additional blood tests. OB Saul Weinreb told me that “every person in the world is estimated to carry thousands of potentially harmful genetic mutations, which means that every couple has an approximately equal chance of having a baby with a random genetic disease they had no idea they carried.” The good news is that science has been able to identify certain diseases that occur more commonly in certain ethnic groups. So rather than think of these groups as somehow genetically worse off than others, think of them as being lucky that there are tests for conditions that may affect them. New tests are being developed every day. Among the most commonly identifiable conditions are:

Reasons Your Partner (or You) Might Consider Genetic Testing

Other Reasons for Prenatal Testing
Prenatal testing is also available to people who, while not considered at risk, have other reasons for wanting it done. Some of the most common reasons include:

You may also have to be tested if your partner has a negative Rh (for rhesus, like the monkey) factor in her blood. If you’re positive (and most of us are), your baby might be positive as well. If this is the case, your partner’s immune system might think the Rh-positive baby is some kind of intruder and try to fight it. This can lead to fetal brain damage or even death. Fortunately, this problem is preventable: your partner will have to get some anti-Rh injections, starting around the 28th week of the pregnancy.

AMNIOCENTESIS
This extremely accurate test is usually performed at 15 to 18 weeks, and can identify nearly every possible chromosomal disorder, including Down syndrome. It can’t, however, detect deformities such as cleft palate. If your baby is at risk of any other genetic conditions, your partner’s doctor can order additional testing (but these tests are not done routinely). Amnio is also sometimes used in the third trimester of pregnancy to help doctors determine whether the fetus’s lungs are mature enough to survive an emergency premature delivery, if they’re worried about that. The test involves inserting a needle through the abdominal wall into the amniotic sac, where about an ounce of fluid is collected and analyzed. Results are usually available in one to three weeks. Unless your partner is considered at high risk (see page 70), or either of you needs to be reassured that your baby is healthy, there’s no real reason to have this test. The chances that a 25-year-old woman will give birth to a baby with a defect that an amnio can detect are about 1 in 500. The chances that the procedure will cause a miscarriage, however, are 1 in 200. For a woman over 35, though, amnio begins to make statistical sense: the chances she’ll have a baby with chromosomal abnormalities are roughly 1 in 190 and rise steadily as she ages. At 40, they’re about 1 in 65; at 45, 1 in 20.

CHORIONIC VILLI SAMPLING (CVS)
Generally this test is performed at 9 to 12 weeks to detect chromosomal abnormalities and genetically inherited diseases. The test can be done by inserting a needle through the abdominal wall or by threading a catheter through the vagina and cervix into the uterus. Either way, small pieces of the chorion—a membrane with genetic makeup identical to that of the fetus—are snipped off or suctioned into a syringe and analyzed. The risks are about the same as for amnio, and the two tests can identify pretty much the same potential abnormalities. The main advantage to CVS is that it can be done a lot earlier in the pregnancy, giving you and your partner more time to consider the alternatives. That’s why the number of amnios is falling, while CVSs are rising.

Location, Location, Location
If your partner is going to have an amnio or CVS and you have a choice as to where to get the test done, go with the lab (or clinic) that does the highest number of procedures. Researchers at Copenhagen University Hospital found that miscarriage rates at facilities that did fewer than 500 amnios over a ten-year period were twice as high as those that did 1,500 or more. And the miscarriage rates for CVS were much higher at facilities that did fewer than 1,500 procedures than those that did more than 1,500.

PERCUTANEOUS UMBILICAL BLOOD SAMPLING (PUBS)
No, PUBS has nothing to do with bars, although you may need one after thinking about all this. The PUBS test is usually conducted at 17 to 36 weeks and is sometimes ordered to confirm possible genetic and blood disorders detected through amnio or CVS. The procedure is virtually the same as an amnio, except that the needle is inserted into a blood vessel in the umbilical cord; some practitioners believe this makes the test more accurate. Later in the pregnancy, PUBS may be used to determine whether the fetus has chicken pox, Toxoplasma gondii (see page 50), or other dangerous infections. Preliminary results are available within about three days. In addition to the risk of complications or miscarriage resulting from the procedure, PUBS may also slightly increase the likelihood of premature labor or clotting of the umbilical cord, and since it can’t be performed any earlier than 17 weeks, it’s not nearly as popular as amnio or CVS.

Dealing with the Unexpected
For me, pregnancy was like an emotional roller-coaster ride. One minute I’d find myself wildly excited and dreaming about the new baby, and the next I was filled with feelings of impending doom. I knew I wanted our babies, but I also knew that if I got too emotionally attached and anything unexpected happened—like an ectopic pregnancy, a miscarriage, or a birth defect—I’d be crushed. So, instead of allowing myself to enjoy the pregnancy fully, I ended up spending a lot of time torturing myself by reading and worrying about the bad things that could happen.

ECTOPIC PREGNANCY
About 1–2 percent of all embryos don’t embed in the uterus but begin to grow outside the womb, usually in the fallopian tube, which is unable to expand sufficiently to accommodate the growing fetus. Undiagnosed, an ectopic pregnancy would eventually cause the fallopian tube to burst, resulting in severe bleeding. Fortunately, the vast majority of ectopic pregnancies are caught and removed by the eighth week of pregnancy—long before they become dangerous. Unfortunately, there is no way to transplant the embryo from the fallopian tube to the uterus, so there’s no choice but to terminate the pregnancy. As quickly as technology is advancing, though, I’m sure transplantation will be possible in the not-too-distant future.

PREECLAMPSIA
This is one of the most common pregnancy complications—about 10 percent of pregnant women, most between eighteen and thirty, suffer from it, although the highest risk groups are very young teens and women in their 40s. Preeclampsia is sometimes referred to as toxemia or PIH—protein-induced hypertension—because one of the symptoms is high protein in the urine. Basically, it’s an increase in the mother’s blood pressure late in the pregnancy. This can deprive the fetus of blood and other nutrients and put the mother at risk of a stroke or seizure. Women who have a history of high blood pressure or blood vessel abnormalities are especially prone, as are daughters of women who had preeclampsia when they were pregnant. And Norwegian researchers Rolv Skjærven and Lars J. Vatten found that “men born after a preeclampsiacomplicated pregnancy had a moderately increased risk of fathering a preeclamptic pregnancy.” But most of the time it comes as an unpleasant surprise to everyone.

In its early stages there usually aren’t any symptoms, but it can be detected by a routine blood pressure check. If the condition worsens, the woman may develop headaches, water retention, vomiting, pain in the abdomen, blurred vision, and seizures. Interestingly, researchers now suspect that preeclampsia is actually a disorder in which the mother’s immune system rejects some of the father’s genes that are in the fetus’s cells. They suspect that women may be able to “immunize” themselves before getting pregnant if they build up a tolerance by exposing themselves to their partner’s semen as often as possible. This explains why preeclampsia is far more common during first pregnancies, or at least the first pregnancy with a new partner. It also explains why fewer women over 30 develop this condition. (Still, it can happen to older moms or those who have multiple children.)

There’s no guaranteed way to prevent preeclampsia, but there are a few things that could reduce the risk. Staying well hydrated, cutting back on salt, and getting enough exercise may help your partner keep her blood pressure under control. So can increasing her fiber intake. One study found that women who ate over 25 grams of fiber every day cut their risk by 50 percent. And in one of the greatest pieces of good news for pregnant women, Elizabeth Triche and her colleagues found that “women who had five or more servings of chocolate each week in their third trimester were 40 percent less likely to develop preeclampsia than those who ate chocolate less than once a week.” Apparently, there’s a chemical in chocolate, theombromine, that dilates blood vessels and reduces blood pressure. But do you really think your partner needs an excuse to eat more chocolate?

MISCARRIAGES
The sad fact—especially for pessimists like me—is that miscarriages happen fairly frequently. Some experts estimate that between a fifth and a third of all pregnancies ends in miscarriage (sometimes also called “spontaneous abortion”). In fact, almost every sexually active woman not on birth control will have one at some point in her life. (In most cases the miscarriage occurs before the woman ever knows she’s pregnant—whatever there was of the tiny embryo is swept away with her regular menstrual flow.)

Before you start to panic, there are a few things to remember: first, over 90 percent of couples who experience a single miscarriage get pregnant and have a healthy baby later. Second, many people believe that miscarriages—most of which happen within the first three months of the pregnancy—are a kind of Darwinian natural selection. Some have even called them “a blessing in disguise.” In the vast majority of cases, the embryo or fetus had some kind of catastrophic defect that would have made it incompatible with life. Still, if you and your partner have a miscarriage, you probably won’t find any of this particularly reassuring. And it won’t make it hurt any less.

Until very recently, miscarriage, like the pregnancy it ends, has been considered the exclusive emotional domain of women. Truth is, it isn’t. While men don’t have to endure the physical pain or discomfort of a miscarriage, their emotional pain can be just as severe as their partner’s. They still have the same hopes and dreams about their unborn children, and they still feel a profound sense of grief when those hopes and dreams are dashed. And many men, just like their partners, feel tremendous guilt and inadequacy when a pregnancy ends prematurely.

Some good friends of mine, Philip and Elaine, had a miscarriage several years ago, after about twelve weeks of pregnancy. For both of them, the experience was devastating, and for months after the miscarriage they were besieged by sympathetic friends and relatives, many of whom had found out about the pregnancy only after it had so abruptly ended. They asked how Elaine was feeling, offered to visit her, expressed their sympathy, and often shared their own miscarriage stories. But no one—not even his wife—ever asked Philip what he was feeling, expressed any sympathy for what he was going through, or offered him a shoulder to cry on.

Psychologists and sociologists have conducted many studies on how people grieve at the loss of a fetus. But the vast majority of them have dealt only with women’s reactions. The ones that have included fathers’ feelings generally conclude that men and women grieve in different ways. Dr. Kristen Goldbach found that “women are more likely to express their grief openly, while men tend to be much less expressive, frequently coping with their grief in a more stoical manner.” This doesn’t mean that men don’t express their grief at all, or that they feel any less grief than women. Instead, it simply highlights the fact that in our society men, like my friend Philip, have virtually no opportunity to express their feelings—at least not in the “traditional” way. Many men respond to their grief by doing everything they can to get life back to normal. That often means going back to work, and putting in extra-long hours. It’s a way of getting away from the self-blame and feeling of helplessness at not knowing how to comfort their partner. It’s a way of avoiding the barrage of baby images that was probably always there but now seems much more pervasive. It’s a way of coping with their grief and, unfortunately, of ignoring it.

Trying Again
If you’ve suffered a miscarriage and have decided to try to get pregnant again, your goal is to prepare a healthy environment for the baby to swim around in, and to prevent birth defects or other complications.

One of the most crucial times of the pregnancy is between 17 and 56 days after conception. That’s when the organs start developing. But because this stage happens so early on, it’s entirely possible that your partner might not know she’s pregnant. And by the time she finds out, she may have already done all sorts of things that could affect the baby—things she’ll wish she hadn’t done.

For that reason, it’s important to prepare yourselves for the next pregnancy as far in advance as you can. Six to nine months would be great, but even a month or two can make a big difference.

If You’re Expecting Twins
If your partner was carrying twins (or more), miscarrying one “does not seem to have negative implications regarding the health or genetic integrity of the surviving fetus,” say doctors Connie Agnew and Alan Klein. Miscarrying a twin may, however, put your partner at a slightly higher risk of going into preterm labor.

If your partner is carrying three or more fetuses, you may have to deal with the question of “selective reduction.” Basically, the more fetuses in the uterus, the greater the risk of premature birth, low birth weight, and other potential health hazards. Simply—and gruesomely—put, all these risks can be reduced by reducing the number of fetuses. It’s an agonizing decision that only you and your partner can make. Since 1980, the number of twin births has doubled, and the number of unplanned triplets, quads, and so on has more than quadrupled. Fortunately, as ART methods improve, that trend will start to decline, which means that fewer and fewer couples will be faced with this heart-rending decision.

Pregnancy after a Miscarriage
Getting pregnant after having lost a baby can bring up a jumble of feelings for both you and your partner. For example, you’ll probably be feeling incredibly happy that you’re expecting again. But you may also be worried that this pregnancy will end the same way the last one did. That could keep you from allowing yourself to become truly engaged in and enjoy the pregnancy—at least until after you’re past the point when the miscarriage happened last time. If your partner is feeling this, she may deliberately keep herself from bonding with the baby, trying to save herself the grief if the worst happens again. If it’s been a while since the miscarriage, you might be angry—in an abstract sort of way—that you’re still expecting, when by all rights you should be holding a baby in your arms right now. But if your partner got pregnant right away, you might be feeling guilty at not having let an appropriate (whatever that means) amount of time pass.

Everyone deals with post-miscarriage pregnancy differently, but there are a few things that may make it a little easier:

Preconception

The rest of this book is devoted to how to have a healthy, safe pregnancy and a healthy mom and baby. But right now, we’re talking about steps you can take before your partner conceives again that can boost your chances of getting pregnant, make for a less-eventful pregnancy, and potentially help you reduce or avoid the expense and emotional ups and downs of fertility treatments.

You never know when your partner is going to burst out of the bathroom waving a little white stick and announce, “Honey, I’m pregnant!” So before the two of you hop in the sack, there are a few things that she should do, you should do, and the two of you should do together to get ready.

What She Should Do

What You Should Do

What Both of You Should Do

BIRTH DEFECTS
If one of the tests discussed earlier in this chapter indicates that your baby will be born deformed or with any kind of serious disorder, you and your partner have some serious discussions ahead of you. There are two basic options for dealing with birth defects in an unborn child: keep the baby or terminate the pregnancy. Fortunately, you and your partner won’t have to make this decision on your own; every hospital that administers diagnostic tests has specially trained genetic counselors who will help you sort through the options.

There’s no question that the availability of genetic testing has changed the landscape with regards to birth defects. Two recent studies analyzed birth data from a 15-20 year period. One found a slight increase in the number of Down syndrome births, the other a slight decrease. As we’ve discussed, more and more women are putting off childbirth. And since women over 35 are about five times more likely than those in their 20s to have a Down syndrome baby, researchers would have expected the number of births to double. The reason that didn’t happen is pretty simple: with genetic testing able to identify Down syndrome babies very early in the pregnancy, many couples are choosing abortion. If you’re considering terminating the pregnancy for genetic reasons, remember that communicating clearly and effectively with your partner is probably the most important thing you can do during this stressful time. The decision you make should not be taken lightly—it’s a choice that will last a lifetime—and you and your partner must fully agree before proceeding with either option. But ultimately, your partner should make the final decision.

COPING WITH YOUR GRIEF
If you and your partner choose to terminate your pregnancy or reduce the number of fetuses, or if the pregnancy ends in miscarriage, the emotional toll can be devastating. That’s why it’s critical for the two of you to seek out the emotional support you are entitled to as soon as possible. While there’s nothing that can be done to prepare for or prevent a miscarriage, telling your partner how you feel—either alone or with a member of the clergy, a therapist, or a close friend—is very important. And don’t just sit back and wait for her to tell you what she’s feeling. Take the initiative: be supportive and ask a lot of questions.

Avoid the temptation to try to “fix” things. You can’t. And don’t try to console your wife with statements like, “We can always have another one.” Your intentions are good, but it won’t go over well.

You and your partner do not have to handle your grief by yourselves: counseling and support are available to both women and men who have lost a fetus through miscarriage, genetic termination, or selective reduction. Going to a support group can be a particularly important experience for men—especially those who aren’t getting the support they need from their friends and families. Many men who attend support groups report that until they joined the group, no one had ever asked how they felt about their loss. The group setting can also give men the chance to escape the loneliness and isolation and stop being strong for their partners for a few minutes and grieve for themselves. If you’d like to find a support group, your doctor or the genetic counselors can refer you to the closest one—or the one that might be most sympathetic to men’s concerns.

Some men, however, are not at all interested in getting together with a large group of people who have little in common but tragedy. If you feel this way, be sure to explain your feelings tactfully to your partner—she may feel quite strongly that you should be there with her and might feel rejected if you aren’t. If you ultimately decide not to join a support group, don’t try to handle things alone; talk to your partner, your doctor, your cleric, or a sympathetic friend, or read—and maybe contribute to—some of the blogs that deal with grief from the dad’s perspective. One good one is at fathersgrievinginfantloss.blogspot.com. Keeping your grief bottled up will only hinder the healing process.





Notes: