bookmark_borderReview: Mayo Clinic Guide to a Healthy Pregnancy

I recently finished the Mayo Clinic Guide to a Healthy Pregnancy. Of the books I’ve read, it is most comparable to Our Bodies, Ourselves: Pregnancy and Birth. I’m not sure which I like better. The Mayo Clinic guide contains more details about pregnancy, including more information about the development of the fetus itself and useful information on gentle exercises to perform during pregnancy.

However, it is missing the key things I appreciated from the Our Bodies, Ourselves book: the sense of educating the reader about the various options available to her and empowering the reader to make the choices that are best for her situation. The Mayo Clinic guide is much more prescriptive, and it spends a lot less detail helping women decide why they might want to follow or deviate from standard practices.

I’m glad I read the Mayo Clinic guide; I did learn some things. But if I had to recommend just one or two books, I’d still go with Out Bodies, Ourselves: Pregnancy and Birth, and Expecting Better combined with an app like I’m Expecting (Android) to provide more details about the week by week development of the baby.

bookmark_borderReview: A Baby At Last

It was just as I finished reading A Baby at Last!: The Couple’s Complete Guide to Getting Pregnant–from Cutting-Edge Treatments to Commonsense Wisdom by Zev Rosenwaks, M.D., Marc Goldstein, M.D. and Mark L. Fuerst that we discovered we were pregnant. However, before that point, I was thinking that background in dealing with infertility might be something very valuable for us.

Generally, doctors say that a couple is infertile if they have been trying to get pregnant for a year and have not yet succeeded. We’d been trying for nearly a year and a half, and during that time, we had observed that I had extremely irregular menstrual cycles — the shortest were about 40 days and the longest over 100 [1]. Even though we weren’t planning jumping straight from there to high tech fertility treatments, we did want to understand what the different options were before we started talking to our doctor about fertility issues.

A Baby At Last seems quite thorough. It is generally optimistic about a couple’s chances of conceiving through fertility treatments, but it is also realistic about the risk factors involved, especially age. The book is rather technical at times, but that’s overall a good thing, since it helps the reader understand when different options are applicable. The book also has a number of chapters on specialized subjects — e.g., fertility issues for cancer patients — which I just skimmed but which seem like they would be valuable for those in the specific situation.

The book contained a chapter on alternative medicine techniques. The authors managed to say, in a way that wasn’t too condescending toward those considering such techniques, that there is little evidence that they work and that when they do show some positive effect, it seems like it’s more or less due to general stress reduction. This seems much more useful than the insulting and condescending attitudes adopted by many folks speaking up against alternate techniques. Yes, they are pseudoscience, but rudeness isn’t going to convince the people who don’t realize that.

Although I don’t have other books to compare this too, overall, this seems like a good resource for a couple who wants to understand their options for fertility treatments.

[1] As an aside, one thing that was frustrating on our journey to pregnancy was that our doctor encouraged us to wait a year before coming back and talking about fertility, even though, at that point, I had only had one period in the six months since I went off the pill, and I probably (based on temperatures) hadn’t ovulated. Statistics are hard to come by, but such a pattern generally indicates some sort of issue.

bookmark_borderWe’re pregnant!

Temperature above the coverline for 17 days, and things are looking suspicious. However, my ovulation pattern has always been a bit unpredictable, so that doesn’t necessarily mean anything. However, a positive home pregnancy test and a follow-up confirmation test with my doctor (at an appointment I initially scheduled to discuss next steps on our potential fertility issues), have confirmed what we have been waiting for: we’re pregnant!

The downside of tracking my temperature and home pregnancy tests is that I strongly suspected I was pregnant before I even was sure I missed my period. Why is this problematic? Well, the risk of miscarriage is still pretty high in week 5 of pregnancy[1]. Estimates vary because gathering the data is a bit tricky, but a common number is that at this point 10% — 1 in 10 —pregnancies will still end in miscarriage.

That said, we are excited, and cautiously optimistic.

[1] For those doing some confused math, yes, I can divide by 17. Pregnancy is counted from the time of your last menstrual cycle — or if you’re like me and have extremely irregular cycles but do track other fertility signs, pregnancy is counted from two weeks before ovulation.

bookmark_borderWaiting

Based on my temperature shift, I ovulated nearly 2 weeks ago. Am I or am I not pregnant?

One of the hardest parts of trying to conceive is the waiting. Every single menstrual cycle, there is a small window of fertility, then we need to wait a couple weeks before we can tell whether or not we succeeded. When you have irregular cycles — mine ranged anywhere from 35 to 100 days, compared to the regular 28 — this is even harder, because you don’t know when that window of fertility will happen, and you don’t know how long it will be before you have another.

Even the early pregnancy tests become vastly more accurate if you wait until you would have missed your period to take them, so all you can do is wait and wonder — even a negative test doesn’t mean you’re definitely not pregnant. You start analyzing every little twinge and feeling. Some women start getting breast tenderness as early as the end of the first week after fertilization, my breasts might be tender. Is that maybe a bit of spotting from implantation? I feel funny, I think, maybe that’s because I’m pregnant? Or maybe I’m just paying more attention than usual.

So we wait, and we check, and we hope. Because that is all we can do until we succeed or find it’s time to try again.

(Note: I could have written this post nearly anytime in the year and a third we spent trying to conceive — in fact, I did write various parts of it over time. I’ve chosen to date it relative to when we actually conceived because I had all these feelings then just as much as other times.)

bookmark_borderA room for many

Whether it’s two or three friends over for dinner or 20 for board games, we entertain frequently. We designed our home to support groups of many sizes. Much of what makes a room work for two also contributes to how well it functions for larger gatherings. In this post we want to focus on some of the things that are especially important in making a space work for entertaining.

Most spec homes have entries that are, at best, mediocre. The townhouse we rented while this house was under construction had a terribly entry. It was narrow, dark, and led you up stairs into the middle of the dining room. There was no coat closet. Even a moderate size group filled the entry with shoes and left coats scattered everywhere. People coming would collide with those going. It was a mess.

Entrance Room (130)

  • Problem: Arriving in a building, or leaving it, you need a room to pass through, both inside the building and outside it. This is the entrance room.
  • Therefore: At the main entrance to a building, make a light-filled room which marks the entrance and straddles the boundary between indoors and outdoors, covering some space outdoors and some space indoors. The outside part may be like an old-fashioned porch; the inside like a hall or sitting room.

The entrance room to our home is everything that was not. Outside we have a generous covered area where we will soon have a bench for setting parcels on. We don’t have a window in the entry — this was one of the few times where we let style override substance — but we plan to install a video camera. The interior entrance room is large and has a bench, shoe cubbies, a full sized closet for hanging coats, and a storage console. Guests can hang their coat and take off their shoes while easing into the activities going on inside. There is room for those last bits of conversation that slow the departure of good friends.

Eating Atmosphere (182)

  • Problem: When people eat together, they may actually be together in spirit — or they may be far apart. Some rooms invite people to eat leisurely and comfortably and feel together, while others force people to eat as quickly as possible so they can go somewhere else to relax.
  • Therefore: Put a heavy table in the center of the eating space — large enough for the whole family or the group of people using it. Put a light over the table to create a pool of light over the group, and enclose the space with walls or with contrasting darkness. Make the space large enough so the chairs can be pulled back comfortably, and provide shelves and counters close at hand for things related to the meal.
  • In our home: This pattern defines our dining room in all but one respect. We have a large, heavy table that can bring a group of people together. It has a pendant which defines the table as its own space. The counter is nearby for keeping things close at hand. Because we have an open floor plan with lots of windows, the space is not really enclosed by walls or darkness. Instead, we captured the essence of that contrast by making the table a comfortable, attractive place to continue conversation. (We have a mat for under the table on order; this should increase the contrast between the table and its surroundings and encourage more pulling back of the chairs.)

As mentioned in the previous post, the heart of our home is a single large space. The space is dominated by our dining table. To accommodate our varying needs, we commissioned a custom table that consists of two 5’x5′ tables which we generally leave pushed together. We seat 12 comfortably (more when we don’t mind getting a little cozy). When the tables are apart, we can fit 10 at each table. Apart, the tables are good for games, although a bit large to reach across. The 5’x10′ default configuration of the table is surprisingly intimate. The table is wide enough to fit two people on each end, and the width allows greater visibility of those at the other end of the table. The distance is still large, but the wider table does help reduce fragmentation common to long, rectangular tables.

Sitting Circle (185)

  • Problem: A group of chairs, a sofa and a chair, a pile of cushions — these are the most obvious things in everybody’s life — and yet to make them work, so people become animated and alive in them, is a very subtle business. Most seating arrangements are sterile, people avoid them, nothing ever happens there. Others seem somehow to gather life around them, to concentrate and liberate energy. What is the difference between the two?
  • Therefore: Place each sitting space in a position which is protected, not cut by paths or movement, roughly circular, made so that the room itself helps to suggest the circle — not too strongly — with paths and activities around it, so that people naturally gravitate toward the chairs when they get into the mood to sit. Place the chairs and cushions loosely in the circle, and have a few too many.

The table acts as a sitting circle when it’s not being used for food or games, but the usual place for conversation is the living room. It opens to the main area on one side, but is enclosed by two outer walls and a staircase. Being ever-so-slightly separated allows the living room to act as a natural sitting circle. Couches, an arm chair, and the bench around the fireplace provide seating for about 8, and pulling in chairs from the dining room or utilizing the floor raises that number to 15. Even when the group is small, the space is compact enough to make conversation comfortable.

Large groups, like we have for our game days, naturally divide into smaller groups. We can support a couple groups at the two dining tables and another in the living room. Another crowd always gathers around the food on the kitchen island. Folks taking some time alone or talking in pairs can use the alcoves created by the fireplace bench. When the weather is nice, the deck increases the variety of spaces available for interacting with others.

Alcoves (179)

  • Problem: No homogeneous room, of homogeneous height, can serve a group of people well. To give a group a chance to be together, as a group, a room must also give them the chance to be alone, in one’s and two’s in the same space.
  • Therefore: Make small places at the edge of any common room, usually no more than 6 feet wide and 3 to 6 feet deep and possibly much smaller. These alcoves should be large enough for two people to sit, chat, or play and sometimes large enough to contain a desk or table.

Of course, not all is perfect. In a large, open space noise can be an issue. It can get painfully loud as voices gradually increase in volume to be heard over the general din. So far, the best solution we’ve found is occasionally reminding people to be more quiet (having some folks go to the up- or downstairs game space also helps). Most of the noise comes from people who are chatting between games, so from a volume perspective, having the spaces that attract conversation — the kitchen and living room — adjacent to the place where most of the games are played is less than ideal. To balance that, the adjacency allows people to easily drift in and out of games and allows more social mixing. Perhaps we’ll find a better solution in time.

Overall, we’ve been quite happy with how the space performs. Despite its shortcomings, we can entertain here more easily, more comfortably, and on a larger scale than we could in any place we’ve lived before. All-in-all, success!