Read an Excerpt
Pregnancy is a time of big changes for your family, your body, and your emotional equilibrium. Finding balance, keeping yourself healthy, and choosing a healthcare provider who will support you in this journey are crucial to creating the best possible environment for baby, both in and out of the womb.
So You're Pregnant …
You just found out you're pregnant. Perhaps you've been trying for just a few months, or maybe for a few years. There's also a good chance this baby has taken you by surprise; about half of all pregnancies among American women are unintended. Planned or unplanned, pregnancy stirs up a wide spectrum of emotions. You may be on cloud nine and picking out nursery patterns, or you may be in a state of shock wondering how you're going to handle it all. Relax. You're normal. Everyone reacts to the joys and jeopardies of pregnancy differently. Preparing yourself for the road ahead is the best way to overcome your fears and get a realistic picture of what pregnancy, and motherhood, is made of. So ask questions, read up, take classes, and talk to friends and family who have been there. There's no such thing as too much information when it comes to your (and baby's) health.
A Different Kind of Family Tree
Even if you and your mate are the poster people of perfect health, you may have a history of chronic illness or medical disorders further back in your lineage that could impact the health of your unborn child. Your healthcare provider will ask you questions about your ethnic and racial heritage and family background (and that of the baby's father) to screen for medical conditions your child may be at risk for. Having the most complete and accurate information possible will help her determine what screening tests, if any, you may require.
In addition to the medical history of you and your partner and any children you already have, you should gather known health information an additional two generations back (i.e., your parents and siblings and those of your partner, and your second-degree relatives including grandparents, aunts, and uncles). Any additional information you have about medical conditions further back in your family tree should also be brought to your provider's attention.
Parents-to-be who were adopted may have little to no information on their birth family. As of early 2002, only four states (i.e., Alabama, Alaska, Kansas, Oregon) provided open and unconditional access of original birth certificates to all adopted adults; other states provide access with birth parent consent or by court order only. If you'd like to pursue access to your health history, your first step, according to adoptee-rights advocate Nancy Ashe, is to know the law: "Request non-ID (non-identifying) information where the law allows from the state where the adoption was finalized. Non-ID is information about the adoption that excludes information that may allow identification of the actual people involved." In many cases, the non-ID information will include some medical and social history of the birth parents, but in some states it is only voluntary and may not be available.
If you have a history of health problems or miscarriage and your doctor feels more family background would be valuable, many states provide a system by which an adoptee can petition the court to get adoption records opened or unsealed. Ashe cautions however that "health history included in adoption records shouldn't be taken as the 'end all.' There are no guarantees that the healthy 20 year old who gave birth didn't develop major medical problems later in life or that the original adoption information even includes health history beyond a physical indicator at the time of the adoption (i.e., "appeared to be in good health")."
If you uncover a history of medical problems in your family you were unaware of, try to keep in mind that only 3 percent of American infants are born with a birth defect, and only a portion of those are thought to have a genetic component. In many cases of inherited diseases, a complex interaction of both genetic and environmental factors is required to trigger the condition. If your provider determines you are at risk for passing along a medical problem to your child, she may refer you to a genetic counselor for a further analysis of your risk factors and a discussion of options for further testing or another appropriate course of action.