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Written by:  Shannon McGinnis Koontz
Date: July 1, 2012

You've seen it all — stretch marks and morning sickness, sleepless nights and baby poop — and now you are thinking about doing it all over again. But are you really prepared to have another baby?

In the last several years, the baby business has drastically evolved, making even the most seasoned mom feel like a rookie. So we've done the research and now offer the scoop on baby trends and changes — to better prepare you for your next one.

Getting pregnant

This is no longer just a concern for older moms. With health advice easily available on the Internet, women are self-diagnosing their fertility issues. But this isn't necessarily a bad thing.

"Five years ago we were complaining that patients were coming too late with already established health problems," says Dr. Tamer Yalcinkaya, section head of reproductive endocrinology and infertility at Wake Forest Baptist Medical Center. "As a result of the information age, we are seeing younger patients in their 20s when infertility rates are at 10 percent, versus seeing these women over 35, when infertility rates are at 30 percent."

Technology has also become more advanced in the embryology lab. Yalcinkaya says at his clinic, miniature video cameras will be installed in embryo incubators for in vitro fertilization patients. The cameras are designed to monitor the embryos as cells divide, helping physicians select the strongest babies at their earliest stages for implantation in the mother.

At-home tests have evolved as well. In the last couple of years, over-the-counter tests have become available that check a woman's fertility. FertilCheck, for example, can detect the level of follicle stimulating hormone in a woman's urine. And for males, there is the discreet at-home sperm test, FertilCount.

Monitoring the pregnancy

Gone are the days of the scary, invasive amniocentesis as a first-stop for doctors to screen older moms for genetic abnormalities in their babies. Now through a blood draw called a maternal serum screening, combined with a method where doctors measure the fluid at the back of the baby's neck during a sonogram, doctors can determine if more invasive tests are necessary.

"This is far more precise than anything we've had before," says Dr. Kathryn Menard, vice chairman of obstetrics at the University of North Carolina School of Medicine.

Menard is also excited about a new prenatal test that has only been available during the last two years called Verifi. Using the mother's blood sample, doctors can test for certain chromosomal abnormalities as early as 10 weeks gestational age. This test is for women over age 38 or anyone who has a family history of genetic disorders. Menard says current research is investigating whether the results are as accurate in low-risk women, as they are in high-risk patients.

The delivery

Perhaps one of the biggest changes in the delivery room is the focus on mother-baby bonding. Hospitals are moving toward establishing skin-to-skin contact moments after the baby is born and, in some cases, for up to an hour.

Greensboro-based doula Jacqueline Messick says this is the case at Women's Hospital in Greensboro, where she assists with most of her deliveries. "We have seen incredible changes in the last two years. The baby stays with the mother for everything — bath, shots, weighing and warming," she says. "This helps with the mother and baby bonding — something we had lost over the last 50 years — as well as with the baby's heart rate, breathing and temperature."

Messick says hospitals are also becoming more receptive to nontraditional labor pain-control methods, including water births, acupuncture and hypnosis. "Doctors and nurses are really listening to the moms' intentions and trying to honor them," she says. "You don't see as much of a one-size-fits-all."

At hospitals across the state, nurseries are becoming more obsolete and moms keep their babies in the room during their entire hospital stay. This is especially helpful in promoting breast-feeding.

Another trend in North Carolina is taking place out of a delivery room — and in the home. According to the Centers for Disease Control, there was a 32 percent increase in home births in North Carolina from 2003-2004 to 2005-2006. And while legislation regarding home births is currently pending in North Carolina, midwives are assisting in more hospital deliveries.

"At our institution, we have a unique program where midwives train us," says Dr. Beverly Gray, assistant professor of obstetrics and gynecology at Duke University School of Medicine. "Patients want a less 'medical' experience, so by training through the midwives, we tend to have more of their values when we're taking care of our patients."

Sharing the news

With Facebook, Twitter and baby blogs, social media has opened new avenues for mothers to show their creativity in announcing their upcoming arrival.

Su Stone, Apex mother of three, announced two of her children's births on Facebook. "We've lived in New York, Washington and now North Carolina," Stone says. "Facebook was an easy way to reach all of our friends to share the news with everyone at once. It was a no-brainer."

Facebook is full of baby bump and sonogram profile pictures. And mommy blogs give women the opportunity to share pregnancy stories and exchange tips on how to beat morning sickness, back pain and other pregnancy woes.

There's also Pinterest, where parents can pin their favorite baby products and nursery décor. But where delivery is concerned, is social media lacking social graces?

"With social media, parents are definitely updating people endlessly while in labor — sharing the moment-by-moment activity," one doctor says.

Adjusting to life with baby

Parents don't have enough time to get it all done, especially if they already have children and are expecting another. As a result, more services are popping up that specialize in baby planning and care. Abby Stonewall Kapp, founder of Little Miracles Baby Planning in Charlotte, is a maternity concierge and one-stop shop, from nursery decorating and shower planning, to baby product research. Kapp says the International Baby Planners Association helps her track the latest trends.

"There's a big push in the baby world for eco-friendly and nontoxic baby products," she says.

Nannies and night nurses are also becoming more common. "I think we are seeing an increase in requests for night nurses and night nannies because there are so many parents who don't live near family, and they realize they can't do it all themselves," says Leah Warren, owner of Sweet Dreams Newborn Care in Charlotte. Warren says she also sees working moms and dads and parents of multiples who can use the extra hands.

"Working moms are at an all-time high and dads are more involved in caregiving than ever before," says Julie Wayne, a work-family balance researcher at Wake Forest University.

With so many dads taking a hands-on approach, it's no wonder classes for new dads are becoming popular. Teer House in Durham hosts one call New Tools for New Dads each month, and the Women's Health Information Center in Chapel Hill offers a monthly Boot Camp for New Dads at N.C. Women's Hospital, hosted by Ivan Weiskoff. At WakeMed Health &

Hospitals monthly Boot Camp for New Dads in Raleigh, dads-to-be learn from other experienced dads how to change diapers; care for umbilical cords and circumcisions; and hold, comfort and swaddle a baby.

"We teach them how to play an active role in their baby's lives," says Dave Jenkins, "coach" of the three-hour class in Raleigh. "One main concern from our dads is: 'I don't know if I will be a good dad.' We reassure them that they will be."

Shannon McGinnis Koontz is the associate editor of Piedmont Parent magazine in the Triad and a mother of two.



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