If I were only to give a few bits of advice to families preparing for a new baby, while physical health problems in the mother or child are the biggest concerns of prospective parents, my coaching also would be aimed at safeguarding relationships in the new family constellation.
I find that having a prenatal visit at least by 34 weeks’ gestation for first-time parents is invaluable to getting to know them so that you are not a stranger after delivery and you can communicate more effectively if there are difficulties.
Dr. Barbara Howard
As for other topics that may not seem like a topic to be raised with a pediatrician, pregnancy fears may need to be prompted. You might say, "Most mothers in the second trimester have scary dreams about their future baby. Has this happened to you?" This gives parents a chance to express concerns, often about birth defects, but sometimes about how they or their partner will be caring for the baby. This can be a chance to ask about how the pregnancy has affected their relationship so far, and how they hope it will change once the baby comes.
The prenatal visit is a time to inform parents about practical matters such as your office’s practices regarding on call, insurance, your website, and the expectation for previsit questionnaires. After taking pregnancy and family histories, the other main topics are plans for circumcision and breast-feeding. This is the time for recommending prenatal labor and delivery classes for both fathers and mothers.
Possibly the most important topic for prospective parents, however, is quite different from these issues so clearly related to health – it is about building relationships. Fathers can be easily engaged on the topic about whether to circumcise or not, but having fathers sign on to supporting breast-feeding may not seem as obviously important. Not only do some couples have low comfort in talking about or exposing the mother’s breasts, but some fathers are even possessive of them and unwilling to share with the baby. A discussion about how the father can be the one to bring the baby from the crib for the middle-of-the-night breast-feeding and then burp, change, and return the infant to the crib is a way to support the (exhausted) mother.
Fathers need to know how important their help and support are to the new mother. Mothers need to be heard by the father (and anyone else who will listen) about their fears and pain during delivery, for as many times as it takes. He needs to tell her how brave she was and how grateful he is. Our son bought his wife a "push present" to acknowledge this marathon achievement!
Fathers also need to understand that things don’t just go back to "normal" once the baby has arrived. The support of the father at this special time is symbolic to the mother of the future of their relationship. I can’t tell you how many mothers, disgruntled with their marriages years into parenting, will call up examples of lack of support in the newborn period as the beginning of the deterioration of their relationship. The mother is exhausted from the well-termed "labor," literally and figuratively "drained" by breast-feeding and the interrupted sleep of the first months. She needs her partner to step up with both hands to help – and express sympathy – to show that he is part of the new parenting team.
I think it is important to emphasize that relationships do change – have to change – when a baby arrives. This can be a coming-together in sharing the chores as well as joys of parenting, or a splintering from lack of the communications co-parenting requires. Egocentricity that sufficed in a marriage without children no longer works when the exponential increase in life demands begins. Lack of social support is the number one risk factor for marital discord and child behavior problems; the main social support in American families is the spouse/partner. A golden rule for each parent to follow is, "Ask what you can do to help."
Other supports in addition to the spouse/partner are important, too. To start this topic you might ask: "How are you going to involve others in and out of the family with this child?" There is a need for both engagement and sometimes limit-setting on others that can be a new kind of task and stress for the couple. The task may involve at first negotiating visits and time with grandparents from each side versus privacy for the parents, then later determining family dietary practices for the new child as she grows; compromising on cultural discipline styles; deciding on how religious practice will be conveyed or not; and even setting limits on toys and gifts.