From DadLabs™ Guide to Fatherhood: Pregnancy and Year One  by Clay Nichols, Brad Powell, Troy Lanier, and Owen Egerton
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Probably, you are enlightened and mature. You’re secure in your sexuality. The mechanics of childbirth are a beautiful and natural process worthy of respect and celebration. You can say “vagina,” no problem. Good for you. You can probably skip this chapter.

On the other hand, somewhere in you may be lurking a fifteen year-old boy. Find that boy. Introduce yourself to him. Reacquaint yourself for a moment, then bring up the subject of a gynecologist’s office. An obstetrician/gynecologist, more specifically. Toss in a reference to stirrups, and step back for a minute. 

What’s that boy doing?

If the kid is cringing, changing the subject, or blowing milk out his nose, you may be feeling a bit uncomfortable about your wife’s first visit to the OB/GYN. That’s because you are going, too. 

That’s right, my friend. You are going to the OB/GYN office. And not just once, either. In the course of a normal pregnancy, an expecting mom may visit the doctor as many as a dozen times. It should be your goal to be at every single one of those appointments (especially for a first-time dad). 

REMEMBER THOSE “OPTIONAL” PRACTICES?

Historically, men have not been encouraged to go to gynecologists’ offices. Ask your dad how many visits he has made to the OB/GYN’s office. When he finally stops laughing, it may be useful to remind yourself that this is a sign of progress. It is a privilege to accompany your wife on these appointments; to be present and participatory, a witness to a miracle. That turning back the clock is not something to be desired, or even possible. 

Being bitter at this point is going to be counter-productive. Men did not really become regulars at OB/GYN appointments until the 1990s. Doctors estimate that fathers are now present for about 30 percent of all appointments, up from only 5 percent a generation ago. The trend points to a tectonic shift that has taken place in the space of just a few years—men becoming full partners in the business of raising kids. 

There are many possible explanations for guys showing up at the Home of the Pap Smear:

1. That this is some kind of echo boom from the change in roles that women have been undergoing for generations. If women can be expected to be in the boardroom, then guys should be in the exam room.

2. That the fragmentation of the American family—with expecting moms miles from their own mothers—has forced dads to sub or missing female relatives.

3. That maybe we’ve just wised up. Maybe guys just figured out hat being shown the door when it comes to pregnancy, labor and delivery, and raising kids was a bad deal. That men should have equal access to the experiences and relationships everyone knows are the most important in life. How much do you really like your boss? Is more time with him or her really that important? More guys than ever define success as “spending more time with the family.” If that is the case, then the ground floor of success is a gynecologist’s office. 

WHERE DID ALL THE BROWNIE POINTS GO?

The truth is that in the last few years, attending OB/GYN appointments (along with about a million other parenting responsibilities) has become a societal assumption. Sorry, Dad, we kind of volunteered you for this shit—which means you don’t really get much credit for going. What was cause for comment and praise just a few years ago has become a simple expectation. You’re probably not even going to get a nice, approving smile from the cute receptionist. But that doesn’t mean there isn’t a wealth of really good reasons why you should be present: 

1. The PR angle.

These appointments are an opportunity to make an early bid for full partnership status. Attendance at even the most mundane appointment lets Mom know that you support her and that you want to contribute to the process to the extent that you can. You should also remember that she’s nervous, too. Not about the OB/GYN office, like you, but about all the information and unknowns that lie ahead. You will be a reassuring presence. Holding her hand is important.

2. The live-feed angle.

The doctor is a very efficient source of information. Rather than getting lots of info secondhand from Mom or from books/videos/Web (present authorship excluded), go to the source. Your doctor has practice presenting the information you need in a way that is digestible. Attending doctors’ appointments is actually the most time-efficient way of staying informed. 

3. The entertainment value angle.

Some doctor visits are amazing. Many of the most jaw-dropping, touching, heart-pounding moments of pregnancy happen in the doctor’s office. Think about hearing the baby’s heartbeat for the very first time or seeing an ultrasound reveal the image of a baby’s hand. Is there really anything at the office that can match that? 

GYNECOLOGICAL ENVIRONS

You’ve done it. You’re in. OB/GYN—the whole deal. You hold the door of the office open for the pregnant mom and step in. You have a moment of being proud of yourself, then you begin to wonder what exactly you got yourself into. You wonder: Is there any place less appropriate for me to be? Women’s Lingerie section at Sears? Why not spend your spare time at the hairdresser? What business has a guy got in a gynecologist’s office? 

A glance around reveals that the place is pretty much generic Doctor’s Office, though like women’s restrooms they tend to be a lot nicer than the male equivalent. The waiting room may have a few more plants and pastel colors than the proctologist’s, but the basic layout is likely to be the same. 

Stand with your wife in the line to sign in, and take in the scene. There will be moms with new babies, women in for checkups, women in various stages of pregnancy, and probably even a smattering of other dudes. Take some comfort in observing their discomfort. As your wife signs in, you may begin to suspect that the staff is genuinely glad that you are there. No alarms triggered by testosterone-sensing devices linked to Chick Central have sounded. The seats are quite comfy. No SI, but take this as an opportunity to check out Modern Pregnancy without fear of wiseass comments. You might even want to take a copy with you into the exam room when Mom is called back. It can provide handy cover. 

The mom’s name is called, and you get a little jolt. Time to go behind the curtain. 

INTERNAL EXAM FOR EXTRA CREDIT

Given the situation, you have clearly accomplished a level of intimacy with your partner. Well done. But you are about to embark on a journey of discovery that will take your relationship to new depths. 

Allow us to rephrase. The miracle of pregnancy, labor, and delivery will almost certainly instill in the expecting dad an appreciation of the miraculous potential of a woman’s body. An appreciation of miraculous potential is not, however, all that sexy. As a modern due dad, you are likely to be issued an invitation to a wide variety of gynecological procedures employing a number of tools, both technological and mechanical. Some dads will readily accept every invitation, while others will attempt gracefully to decline in an effort to “preserve the magic” (good luck). 

What follows are some highlights from the OB/GYN playbook, so you can decide if you want a seat on the 50-yard line or a partially obscured view in the upper deck. 

1. Backless gown and tumbler.

Each appointment begins with the same ritual:
• While Dad waits in the exam room, Mom visits the small but clinically well-appointed bathroom to slip into something less comfortable, and to make a deposit.

• She emerges in a surgical gown and bearing a urine sample in a cup.

• Some dads are tempted to comment: “Everything come out all right?” etc., etc. Others find conversation with a woman holding a cup of pee to be awkward. 

Why the ritual? These aren’t mere formalities. The gown makes examining the expecting mom easier for the doc, and the pee in the cup will be tested for indications of complications like gestational diabetes. 

2. Vitals information.

The nurse handles some preliminaries including taking vitals, asking a few questions, and noting Mom’s weight. The latter is a fraught moment--some moms will elect to turn away from the scale while the measurement is taken. This is really the perfect moment for dads to Shut the Hell Up. Things can only go bad for you. Almost no comment, regardless how well intentioned or supportive, will have the desired effect. 

Why the weigh-in? If moms gain too much weight, they are at increased risk of birth complications, and bigger moms make bigger babies. We often equate big with healthy when it comes to newborns, but overweight babies are as likely as underweight babies to have postnatal issues. 

3. Assuming your positions.

With the arrival of the doctor or midwife comes the main event— the “internal” or pelvic exam.

• Mom sits on the exam table.

• The doc whangs the bare metal stirrups from their hiding spot in the table, snaps on gloves, and drops on a little lube—keeping the patter going the whole time.

• About the time Mom gets her feet in the stirrups, you have made a decision about where in the room (or not) you want to be. If you are feeling uncertain, bring a magazine just in case you need the distraction. 

4. Responses across the speculum.

The exam is usually very quick:

• One hand palpates the lower abdomen while the other goes under the gown. The doc inserts two fingers into the vagina, checking the condition of the cervix.

• If the doctor requires a look at the cervix, he or she may opt to use a speculum. This tool looks like two chrome spatulas attached to a caulking gun. The doc lubes and inserts this tool and clicks the trigger a few times, retracting the walls of the vagina to allow an unobstructed view of the cervix.

• Then it’s over. The gloves are popped off and the Q&A continues. 

DAD RANT

“If you’ll step over here, you can see where the cervix is irritated.”

This is not a statement I had even imagined I would ever hear. My wife is on a table with her feet in the air, and a doctor is waving me over to have a look at her cervix. I froze and stammered. What’s the protocol here? Should you ask your wife’s permission? “Honey, can I look at your cervix?” Should I play it cool like I look at her cervix all the time? Go all clinical and doctor-like? 

My grip on the copy of Fit Pregnancy I had been hiding behind tightened. My policy was always to remain in the exam room during these appointments, but to stay engrossed in periodicals during the actual exam. 

Is declining really an option? “No thanks, dude, I’m all good for cervix right now.” Is it more embarrassing to my wife for me to look, or to act like it would be gross for me to look? It’s a no-win, and I’m getting a little pissed at the OB/GYN for putting me in this position. And by hesitating, I’ve clearly blown it. Eventually I decide that I’ll try to recover and look casual and mature, that the doctor is a woman makes a difference somehow, and that she’s trying to explain something that is of concern. So I ask my wife later if that was the right thing to do. She said that it didn’t much matter—my look of panic made it all worth it. 

DADDY CLAY

Why the cervical exam? The cervix ensures that everything and everyone stays where it/he is supposed to until the big birth day. The medical types monitor the cervix because any changes in thickness or aperture may be cause for concern. At the end of each appointment the doctor, nurse, or midwife who has conducted the exam will ask if you have any questions (if he or she doesn’t, you might want to look into changing your care). Have a canned question or two ready to go. Ask about nutrition, ask about fetal development, ask about the safety of household cleaners. Don’t ask if you can have sex. You should know the answer to that. 

LABOR INTENSIVE: DITCHING WORK FOR OBSTETRICS

Okay, going to all the OB/GYN appointments is a beautiful ideal, but this is the real world and somebody has got to pay the Babies- R-Us bill. If work is an unavoidable reality, and you have to prioritize, go 1-3-2. 

1. The doctors appointments in the first trimester are a must, with highlights like Doppler (not just for weather anymore) and ultrasound. (More on those in a minute.) 3. In the third trimester you are developing your game plan for the birth. 

2. The appointments in the second trimester are primarily about tracking progress. 

So in terms of prioritizing, it’s a good idea to go ahead and cash in your chips in the first trimester, see if you can build up a stack in the second, and go for broke in the third. 

STRATEGY IS THE BEST POLICY

If you have an option when asking to miss work for an OB/GYN appointment, always go to a colleague with kids: the ones with just a little bit of white gunk on the left shoulder just a bit of crusty stuff on the lapel—these people are in the club. They get it. You may even make a positive impression on a female supervisor for leaving the office early. (Warning: Don’t abuse this technique. It can really backfire. A buddy got caught coming off the golf course by a supervisor when he said he would be helping his pregnant wife into the stirrups. He got to attend all the rest of the appointments, no problem, given all his free time.) 

It’s also good to remember that although, to you, the birth of a child is a sacred rite requiring the attention of the known universe, your childless colleagues may not see it exactly the same way.

• They may wonder why they can’t stay home for six weeks when their cat has kittens (no shit).

• They may wonder why they have to spend so much time covering for the breeders going to doctor appointments, squeezing out pups, staying home with the snot noses, or off playing Santa Claus.

• And they may have a point. 

Try to be sympathetic to your coworkers’ point of view. Ten years ago, did you want kids? Did you want to spend a great deal of time covering for those who did? Why does someone deserve special treatment, even benefits, at work just because they have kids at home? The more you get that your childless colleagues may be feeling this way, the less likely you are to piss them off by being entitled. And the more likely you are to get your ass bailed out when the doctor orders another test, and you’re running just a bit late, and would you mind Bill/Judy/whoever just watching the front for a few minutes more? 

FUTURE CLOUDS AND RADAR: DOPPLER AND ULTRASOUND/SONOGRAM

A couple of tests that take place in the OB/GYN’s office involve futuristic medical gear. Get ready to be amazed: Beyond the gear, you’re going to be getting your first sounds and sights of your future offspring. 

DOPPLER EFFECTS

The Doppler has nothing to do with the seven-day forecast. As early as eight weeks’ gestation, the doc can use this small Mr. Microphone–looking device to eavesdrop on the baby’s heartbeat. 

This test is likely to happen at one of the mom’s first appointments, and is not to be missed. The fluttering sound (around 125 beats per minute is normal, but the range can vary) sounds a little like an AM broadcast from the surface of Mars, but you will never forget it. If the whole idea of being a father—having created a new life—hasn’t yet sunk in, this test will close the deal for you. There he or she is. It just gets more and more real from there. 

ULTRASOUNDS ARE CREEPY

Ultrasound (a.k.a. sonogram) tests will usually be prescribed by the doc starting at appointments scheduled around 12 to 14 weeks of gestation. Sometimes these sessions will happen in the doc’s office and may become a regular part of exams, especially in the third trimester. In some cases you may be asked to go to a clinic with the serious high end machines. When ultrasound is performed in the doctor’s office, the gizmo is about the size of your college fridge, with lots of buttons and an eight-inch black and- white monitor perched on top. 

1. The nurse wheels the thing in, pulls up the mom’s gown, and squishes conductive clear jelly all over her stomach—which seems sort of personal and forward, but you’re probably over all that at this point. 

2. The nurse will manipulate a microphone/garden hose diffuser– looking thingy over the mom’s lower abdomen, bouncing high-frequency sound waves off the contents. 

3. The grainy image that results has some things in common with an X-ray, but 3-D and underwater: Hard structures like bones show up very clearly, with shadows of soft tissues also visible. It takes a while to get oriented, but pretty quickly you will get used to what you are seeing. 

4. The nurse will take measurements of the skull and thighbone, which will help determine a more accurate due date. Along the way, the nurse may print screenshots as keepsakes for the prospective parents. 

While gazing on these images of the baby’s “face,” it may occur to you that your wife is going to give birth to an alien. With prominent eye sockets and oversize noodle, this is not the most flattering shot you will ever see of your youngster. 

BE AWARE: It’s important that, if you and the mom don’t want to know the sex of the child, you communicate this clearly and often to whoever sits down at the machine. If not knowing is important, you need to be persistent and repeat yourself often. Also heed warnings not to look at the screen when prompted. Once you’re oriented to the picture, it doesn’t take years of training to identify a twig and berries. It is easy to make an unwitting ID if you aren’t careful. 

TESTING, TESTING

Expecting is a time of intense optimism and looking forward to the future. But it’s also a time of lurking anxieties and fears, founded and unfounded, about what might go wrong. Nothing brings these anxieties to the surface more than the prenatal testing most couples undergo. The triple or quad screenings for Down syndrome and other congenital abnormalities, usually performed between 16 and 18 weeks, are particularly stress-inducing. You’re going to worry about it. She’s going to worry about it. We worried about it. The numbers are in your favor, but you are still going to worry about it. The best you can do is provide each other with distractions as you wait for the results. Welcome to the world of parenting. 

Care for Some Fries with That Ultrasound?

Evidence that the entrepreneurial spirit is alive and well: ultrasound “booths” at your local shopping mall. Advances in 3-D ultrasound imaging led some enterprising folks to come up with a great idea: We’ll sell sweet in-utero pics to pregnant moms and the dads who are willing to pay for anything to keep them happy. Ultrasound is a widely used procedure, and the medical community generally agrees that the risks are outweighed by the rewards, but it’s not for glossy eight-by-tens. Tissues are heated by the application of ultrasound, and some complications have been observed in animals. In the U.S., the Food and Drug Administration suggests that couples should avoid recreational ultrasound undertaken for keepsakes. Besides that, the blobby yellowish images produced by the 3-D ultrasound are hideously ugly, likely to horrify your friends and family. You’ll have plenty of time to have Kodak moments with the kid after he or she is born. Go with the FDA on this one.

From DadLabs™ Guide to Fatherhood: Pregnancy and Year One by Clay Nichols, Brad Powell, Troy Lanier, and Owen Egerton
© 2009 Quirk Productions, Inc. Used with permission. Visit us on the web at www.irreference.com.
DadLabs™ Guide to Fatherhood: Pregnancy and Year One  http://irreference.com/dadlabs-guide-to-fatherhood/