10 Things Your Ob-Gyn Wants You to Know Before You Have a Baby

Whether you’re planning to have a baby or already pregnant, your ob-gyn is a valuable source of information (aka the voice of reason to pull you out of that Google rabbit hole).

Dr. Heather Johnson, a Washington, DC-based ob-gyn and author of What They Don’t Tell You About Having a Baby, has delivered over 3,500 babies in her 40-year career. She’s heard—and seen—it all. From preconception worries to navigating the emotions of postpartum life, she shares 10 key things she wishes people knew before having a baby to help them ease concerns and make planning ahead a little smoother.

1: Don’t panic about your body not knowing how to ovulate if you've been on the pill or other forms of hormonal birth control for a long time.

There is a common worry—and misconception—that being on birth control will make ovulating and getting pregnant more difficult. But when you stop taking hormonal birth control (such as the pill, a vaginal ring or progesterone shots), your body usually begins to ovulate almost immediately. Dr. Johnson asks her patients to consider this scenario: If a huge boulder is placed in a rushing stream, the water will run around it. Years later, if you remove the boulder, the water instantly rushes in to cover the area. Your body is like this. It wants to ovulate, so you have to use birth control to actively stop it from doing so.

But keep in mind: many people start birth control in their teens or early twenties due to irregular cycles. According to Dr. Johnson, “The pill covers up that irregularity, giving women the sense that everything is normal. You may forget about the irregularity because you’ve had years of clockwork periods. While most people outgrow that irregularity, sometimes the underlying issue still isn’t solved. Talk to your doctor if your cycle isn’t regular after two months of being off of birth control."

2: Age 35 really is considered a turning point for fertility.

Nope, your doc isn’t just trying to make you feel old by saying the words "Advanced Maternal Age." Thirty five is numerically the age when each year technically becomes more difficult to conceive. It may take longer or require some assisted reproductive technology. “Nature didn’t think cavewomen would be having kids at 35. Although we’ve fooled nature, some risks related to age can arise, such as higher rates of chromosomal abnormalities and medical complications during pregnancy,” Dr. Johnson explains.

Many women conceive without a problem in their mid-to-late 30s and into their 40s. But be prepared for more monitoring throughout your pregnancy. On the plus side, that means more frequent sonograms to put in the baby book!

3: It’s normal to be really exhausted during the first trimester.

Tired? That’s an understatement. “Binge watching” a Netflix show has taken you four weeks. And some days, the walk from the driveway to your front door feels like a trek up Mount Everest. The reason many women feel overwhelmingly fatigued during the first trimester is due to a surge in the human chorionic gonadotropin (HCG), or pregnancy hormone level.

“This is normal and will pass, along with the nausea, as hormone levels stabilize and your body adjusts,” says Dr. Johnson.

4: The idea of "eating for two” is a myth.

Despite the popular saying—and those insatiable carb cravings—being pregnant doesn’t mean you should actually eat for two. According to the American College of Obstetricians and Gynecologists, you should increase your caloric intake by 350 to 450 calories a day when you're pregnant, depending on your pre-pregnancy Body Mass Index (BMI). This doesn’t mean indulging is totally off limits (Chocolate peanut butter pie? Come to mama!).

Extra calories should come from nutritious foods that fuel your body (and your growing baby!). Think: an apple and cheese, Greek yogurt with berries or a handful of nuts. To keep your blood sugar in check and feel more satisfied, eat small meals throughout the day rather than just a few large meals.

Women of average weight should gain a total of 25 to 35 pounds by the end of their pregnancy. Even Dr. Johnson learned from experience. “When I had my first child at 28, I ate like an army—things I never would normally eat, in mass quantities. I stopped weighing myself after I gained 40 pounds. During my second pregnancy, I ate exactly what I was supposed to eat. I gained 26 pounds and felt so much better.”

5: Strangers will comment on your belly and/or your coffee intake.

• “Are you having twins?”

• “Is that decaf?”

• “You know what they say about soft cheese....”

Oftentimes, a pregnant belly might as well be an invitation for strangers to comment on the size of it and share (unwanted) advice. “It’s like walking around with crutches. People are compelled to say something. But they also embrace you. They’re mothering you, perhaps in a way you don’t want to be mothered,” says Dr. Johnson.

For your own sanity and well-being, try to take this part of pregnancy lightly and know it’s most likely coming from a good place (hopefully). But don’t be afraid to have a witty response at the ready, or to ask someone to keep their hands off of your stomach!

6: You may have to put aside your vision of the “ideal” labor and delivery.

Discussing a birth plan with your doctor during pregnancy is a great way to head into labor feeling confident that your preferences are being heard. However, things don’t always go according to that plan. Dr. Johnson explains, “The goal is the safe delivery of a healthy baby to a healthy mother.

Despite your plan, labor may take longer than expected. You may need to be induced for medical reasons. You may choose an epidural even if you swore you wouldn’t. Your doctor may determine a C-section is necessary. You haven’t “failed” if circumstances change and delivery wasn’t the experience you envisioned. Dr. Johnson hopes people will keep this in mind when setting their expectations.

"Whether you deliver naturally, with an epidural or by cesarean matters little when you are pushing your baby in a swing next to a mother who may have delivered in a different way."

7: Delivery is messy.

Things can get pretty messy in the delivery room. Beyond the blood, sweat, and tears, there’s also amniotic fluid, pee, poop and vomit to contend with. You may not want to look. Your partner may not want to look. But your doctor has seen it all and is totally unfazed by your range of bodily functions. Just keep your eye on the prize and you’ll be taking a precious (cleaned up!) post-delivery photo with your snuggly newborn before you know it.

8: Be prepared for mixed emotions if this isn’t your first child.

If you already have a child, you may be convinced it’s impossible to love anyone else just as much. You may even feel guilty about bringing a sibling into your firstborn’s little world. Being on the cusp of this huge transition brings all sorts of mixed emotions. (So don’t be surprised if you find yourself hugging your toddler while sobbing through a laundry detergent commercial.)

Spend some one-on-one time with your older child(ren) alone once you’re home from the hospital. “Anybody can hold or watch an infant sleep. Only you can spend that special quality time with your first or second. You’ll feel better and so will they,” Dr. Johnson says.

9: Remember these two words: good enough.

It’s inevitable: things are going to slip through the cracks when your new round-the-clock role is to care for a tiny human. Now is not the time to have an immaculate house, cook every meal from scratch or stay up late folding the laundry.

"It does take some stepping down and forgiveness of yourself to allow things to be just okay. That’s when it’s helpful to have parents or friends who quietly do what you need to have done,” Dr. Johnson says.

Hand your baby to your mother-in-law while you take a hot shower. Let friends drop off dinner. Sleep when the baby sleeps instead of unloading the dishwasher. They say it takes a village, so allow your village to help you get into the swing of your new normal.

10: Let go of what you think you’re “supposed” to feel after having a baby.

Adjusting to life with a newborn isn’t as picture-perfect as your Instagram feed. It’s exhausting (hence why you found your car keys in the fridge), overwhelming (so.many.diapers.) and anxiety-producing (WHERE’S THE BINKY??).

Dr. Johnson stresses that it’s totally normal not to feel elated at all times during this phase of life. Don’t be hard on yourself for your feelings, especially if you find yourself crying for no particular reason. These "baby blues" usually subside in a couple of weeks. However, if you’re experiencing persistent, intense sadness, it could be a sign of postpartum depression (PPD).

According to Dr. Johnson, “When you combine the hormonal changes, sleep deprivation, the physical discomforts and the realities of the first few weeks, the postpartum period is a perfect set-up for this disorder.”

For women who already have an existing predisposition for anxiety and/or depression, Dr. Johnson advises them to meet with their therapist before they have their baby so there is a plan in place. Any woman struggling with postpartum depression should immediately call their ob-gyn about their symptoms. She adds, "You may need to see a therapist or take medication. The biggest thing is not to be ashamed."