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109: Tips for Expecting Dads

Jul 12, 2022

Being a new father can be pretty intimidating, even for an ER doctor like Dr. Madsen. As a guy, what are you to do during the pregnancy? During delivery? And beyond? Women's specialist Dr. Kirtly Jones talks to Troy and the guys about what men can do to be supportive partners during pregnancy and how to take the best first steps into fatherhood. To hear more from Dr. Jones, listen to her podcast The 7 Domains of Women's Health.

Episode Transcript

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Scot: Hey, Mitch. Troy's got an announcement that he wants to make, something he wants to tell us.

Mitch: Oh, really?

Scot: Are you excited about it?

Mitch: I'm quite excited. I always love surprise announcements.

Scot: All right, Troy. What's the big announcement?

Troy: Well, Mitch, I'm going to preface this by saying, do you remember that episode we did a while ago about Dr. Turok's male contraceptive gel?

Mitch: Yes.

Troy: It doesn't work.

Mitch: Oh, no.

Troy: I'm just kidding. I was not part of his study. But I'm having a baby. My wife and I are having a baby.

Dr. Jones: Yay. Congratulations.

Troy: This is our first child.

Dr. Jones: Congratulations. Oh, are you in for a ride.

Troy: Oh, I don't think I have any idea what I'm in for. I'm extremely excited. Yeah, honestly couldn't be more excited, but definitely a bit nervous. Baby is due in September. We are just super excited. And I have to tell you the way we announced this baby, and I think, Scot, the way you found out.

Scot: I mean, I'd kind of call it finding out. There were still a lot of questions.

Mitch: Exactly.

Troy: Like, "Really, is this a joke?" Yeah, so we ran . . . Laura had this all planned out. When she told me, I came home from this late shift at 3 in the morning, and she gave me this gift bag that had the positive pregnancy test, said, "Hey, it's an early birthday present." I opened it and was like, "You've got to be kidding me. Wow."

And so, anyway, she had planned this out. We had already planned a marathon. She ran in a shirt that said, "Baby's first marathon," and then sent the picture out to the family and it took them forever to figure it out. I had to then send a close-up of the picture, and still no one responded.

And then I had to say something that says, "I promise this is not a late April Fool's joke," because it was April 2nd. And finally my sister-in-law, not any blood relatives, my sister-in-law figured it out and said, "Wow, you're having a baby." So baby is on the way. We're super excited. Yeah, due in September.

Dr. Jones: Wow. That is going to be wonderful. It's wonderful.

Scot: Today on "Who Cares About Men's Health," we thought maybe you might be able to use a little bit of help. I think as guys . . . I don't know. I can only speak for myself and men that I've observed. It seems like during that nine months we are like, "Well, we don't really have much to do."

Troy: Yeah. "This is easy."

Scot: But maybe we should be looking for something to do. I don't know. So that's what we're going to talk about today. It's the "Soon to be Dad" episode. "Who Cares About Men's Health" is about information, inspiration, and a different interpretation of men's health. Today's crew, as usual, he brings the MD, Dr. Troy Madsen, and dad-to-be.

Troy: That's right. Bringing the MD and bringing the baby soon.

Scot: Bringing the MD and the D-A-D.

Troy: D-A-D.

Scot: I bring the BS. My name is Scot Singpiel. And Mitch Sears just generally makes the podcast better. Mitch, how you doing?

Mitch: I'm doing pretty good. I'm excited for Troy.

Scot: All right.

Troy: Thanks, Mitch.

Scot: And Dr. Kirtly Jones is an OBGYN. She is part of our family. She does the "7 Domains of Women's Health" podcast. And she is an expert on this sort of thing, not only the technical aspects, but also from maybe what your partner might want. Any dad-to-be support mechanism that you might be offering? I don't know. We're going to find that out.

So, Dr. Jones, do you find that the statement I made about guys during those nine months just kind of think, "Well, I really don't have much to do," true or not? Should we be thinking that? What's your take on that?

Dr. Jones: Well, it can be, but you shouldn't be thinking that. So in the first trimester, and we don't know exactly where Troy and his partner are in their trimesters, it can be pretty rocky because there can be a lot of nausea. And so, when someone is throwing up all the time and they can't eat, there are things . . . First of all, you feel a little guilty because you are half of this creation, but not the part that throws up all the time.

There is something called couvade syndrome where men experience all the symptoms of the pregnancy. They even go into labor. There's a special hut for them. So in some cultures, the men act out all the symptoms of nausea, and vomiting, and back pain, and you name it, and then labor. And then the women just go on about their lives and work in the fields, etc., and raise the kids.

So men can walk away and we know all over the world men walk away from a pregnancy, leaving the pregnant person to deal with all of it. But if you're a pair, and if you're listening to someone throw up all morning, it would be, "What kinds of things can I bring to you? What kinds of things can we have in the house that might make your tummy settle a little bit better?" That's kind of helpful. "I heard that ginger worked for you. I've been reading up about this. Can I bring you some ginger?"

Scot: Troy, would you like to practice that? I'd like to hear you say that.

Troy: I'm just fascinated by this couvade syndrome. So these are men who are actually experiencing all the symptoms of pregnancy? And they're not doing this consciously, it sounds like. They're actually experiencing this.

Dr. Jones: Yeah. It's not a common thing. It's in some cultures and not in others. So clearly there are issues. Some partners want to go over the top and order everything by the time they're 12 weeks, and you've got hundreds of dollars of baby carriers. Guess who gets to pay for it, maybe?

So how much are you going to be in the physical domain? And in the physical domain, your partner is probably going to be experiencing whatever she might be experiencing, but being supportive, like, "Can I help you lift that? I know your back has been really sore. This is getting farther in pregnancy."

If she says, "Gee, I want to go skydiving," you're not going to say, "Is that the best idea?" There are some things that she won't do with you or she won't feel like doing with you.

So by trimester, first trimester is nausea, vomiting, the things that happen physically that you could be helpful with in terms of just saying, "Oh, gosh, that's so awful," and maybe, "Tell me what I can do to help."

Scot: Let me jump in quickly. So we also sent an email around to some women who just recently had babies in the office. And the thing you just said was one of the answers that came back. It said, "I think, for me, it's knowing how . . ." This is what they wish that their husbands knew.

"I think, for me, it's knowing how difficult pregnancy can actually be for women. There were some days I couldn't get out of bed because I was so tired or sick, and my husband didn't really understand at first what was going on. He thought I could just do the same things I did before pregnancy. Eventually, he got it, but pregnancy can do wild things to your body that I think a lot of men don't understand."

Dr. Jones: And it can do wild things to your emotional life as well. So people can feel overwhelmed. They can cry easily. Things about mommy hormones. So just being understanding that things are not going to be the same, and the pregnancy is just the first nine months of the rest of your life that's not going to be the same.

Troy: That's encouraging.

Scot: I was going to say we're like three minutes in. How do you feel now?

Troy: I know. I'm kind of speechless really. But we are in the second trimester now, so things . . .

Dr. Jones: Things are pretty good now.

Troy: Yeah. Laura really had a great first trimester. Definitely the fatigue and nausea. I tried to offer what I could. I'll tell you, just being the very independent person that she is, she did go out and buy all of those things for nausea herself, and I should've done that for her, but . . .

Dr. Jones: No, no, no.

Troy: Yeah, she had her stockpile.

Dr. Jones: You can just say, "Wow, good for you. You're doing an amazing job."

Troy: Right. But yeah, certainly she had plenty of nights where she was just very, very tired, and just fatigued, and didn't have a lot of energy, and just needed a lot of sleep.

It is definitely a process, though, of understanding that and really trying to kind of understand exactly what the other person is feeling, and the emotional impact of this as well. Like you said, definitely a process of trying to figure that out, especially for someone who's going through this for the first time.

Dr. Jones: Women lose their entire sense of their bodies, and some people relish this whole transformation of their body, but some people don't. "Gee, does this baby make me look fat?" So I think it's how do you approach the change in your beloved's body? And mostly you just say, "I think you look strong. I think you look wonderful."

Women often feel quite insecure about the changes in their body, and it's appropriate because they've been invaded, and just being supportive in how they may not feel quite themselves. "What can I do? What can I do to help?"

And then, of course, in the third trimester, when someone is carrying 20 . . . It's like carrying a fanny pack that's got 25 or 30 pounds on your . . . not on your fanny, but in front of you. So you could imagine carrying a 30-pound pack on your waist in front of you. It puts you off balance, and your back can get sore, and you have reflux, and you have heartburn. Some people have problems with carpal tunnel and other things. It's just saying, "What can I do to help? What can make it better?"

Scot: Troy, practice that. Let's hear you.

Mitch: Right now, I want to hear it.

Troy: Yeah. What can I do to help, and what can make it better?

Scot: Yeah. There you go.

Troy: There you go. Yeah. And I think for me, too, a lot of it has been trying to just even identify those things without having to even ask that question. Just looking around and saying . . . As we've talked about before on this podcast, we tend to have a lot of animals at our house. We foster a lot of animals. It's her job. She's the director of an animal rescue group. So just trying to say, "Hey, I'm just going to clean up after these animals and do what I can here to help out."

I find it's a little bit of a tough balance because, like I said, Laura is a very strong, independent woman, and I don't want to come off as patronizing in any way either, like saying, "Well, you're pregnant. You really shouldn't be lifting that," things like that. She's going to lift these animal crates, and she's going to do this stuff. So I do find it is a little bit of a balance there too of . . .

Dr. Jones: Oh, absolutely. And if someone is getting cranky, all you need is someone telling you what you should be doing or shouldn't be doing. By the way, do you foster cats?

Troy: We do.

Dr. Jones: Great. Do I need to give you the toxo talk?

Troy: We're well aware. Yes. I've been cleaning all the litter boxes and . . .

Dr. Jones: There you go.

Troy: Yeah. I am the designated poop scooper in this home. Litter boxes, dog poop, you name it. That's my specialty.

Scot: Troy, we brought Dr. Jones on not just so we could tell you what we think you should do, but so you could also ask questions. I mean, why have a podcast if you're not going to utilize it to your own benefit once in a while? Lord knows we've done it with this one, so . . .

Troy: Oh, I know.

Scot: Did you have anything that you wanted to ask Dr. Jones about? She is really the expert on all of this.

Troy: So many questions. As I've read about pregnancy, I kind of feel like we're in the eye of the storm right now. It sounds like the first trimester obviously can be pretty rocky, and Laura did great and did not really have any significant vomiting, but some nausea, fatigue. And now everything just feels good, and everything is going well. What's coming up next? What's the third trimester going to be like?

Dr. Jones: Oh, it's that 30-pound pack that's hanging off your belt. So, number one, if everything is going well, and her blood pressure stays wonderful, and she doesn't have any leaking of her amniotic fluid, and it's a perfectly healthy pregnancy, it still is . . . people tend to feel a little bit more fatigued. It's hard to find a nice place in bed, because you're kind of rocking and rolling trying to find a nice place.

And of course, she's going to be very pregnant in the hottest months of the summer, and so finding a cool space in your bedroom is going to be important if she wants it.

And then when it gets to lifting the 30 pounds that's on her waist, and then anything else, just say, "How can I help? What can I do?"

So I think probably she's strong. Anybody who just ran a marathon in pregnancy is very strong, and she's probably going to cruise through her third trimester really well. Not all women do that. For some women, they have back pain, headaches, carpal tunnel, swelling feet, things that make them feel enormously uncomfortable, and then there's labor.

Troy: Probably the most intimidating part to me is thinking about that process, labor, and what to expect there, and how do you deal if there are complications. And again, the challenge for me is I just see everything that goes wrong with everybody's lives.

Scot: In the ER, yeah.

Troy: In the ER, yeah. I do, and I see the bad outcomes. I will tell you, I had a very emotional experience recently, and it's just crazy the timing of this, of caring for a baby who just was delivered right outside the door of the ER. With a baby on the way, that's something else. I mean, you try to push your emotions aside.

And fortunately, everything went beautifully, could not have gone better. But 6 a.m. on a night shift to have that happen. So I definitely have felt the impact of this emotionally where before I might not have felt that as much. I was like, "Oh, wow."

Dr. Jones: So you felt different?

Troy: Oh, yeah. No question about it.

Dr. Jones: So you already are emotionally a new guy. You're a new guy because of what's happening.

Troy: Oh, without a doubt.

Dr. Jones: And it wasn't a cognitive choice. It just happened.

Troy: Yeah, without question. So I guess in terms of when labor comes and when that time comes, what do we expect at that point? What do I expect as a father-to-be, and how can I be supportive through that process?

Dr. Jones: Well, I think that's another situation where you're going to need to take your partner's lead on this. For some women, they want to take classes, they want their husband there doing back massage, they want someone helping them do counting with them.

My husband actually, as a neurologist, had some experience in hypnosis. So he and I practiced hypnosis, and he did hypnosis through the first 20 hours of my labor until the 11.5-pound baby was really not going to fit, and we had the baby, had a C-section.

But he was right there for me. And it was hard watching someone who's completely in control all the time and needs to be in control lose it. So it's just being there. But let her ask you. Let her tell you.

The paradigm that you see on TV, which I've seen so many times, is the couple are working together, they're doing great, and then she gets in this magic situation called transition when it's just before she's ready to push, and she's screaming, "Get out of the room. I never want to see you again. Don't you dare touch me." You guys have seen that on TV, haven't you?

Scot: Oh, yeah.

Troy: I've seen it in person, yeah. In emergency medicine, I've had to deliver at least 10 babies. I spent a month on OB, and I've seen it all. So when I say I've been there . . . But it's so different as a healthcare provider, and then when you're there and seeing this person you love and you care about go through this, I think that's the challenging part.

Dr. Jones: It is.

Troy: How am I going approach this? And obviously, there's that part of me that can very easily switch into clinical mode and doctor mode, and I don't want to do that. I don't want to try and be the doctor in the room and trying to be very unemotional or clinical. But at the same time, I'm concerned that I will feel a little overwhelmed by this as well.

Dr. Jones: You will, and you should. It's overwhelming.

Scot: Overwhelming how?

Troy: I'm sure I'm going to experience a lot of anxiety going into this and, "Is everything going to go well? How are things going to turn out?" Certainly a lot of very deep empathy for Laura as she's going through the labor process, and just wanting to do anything I possibly can to ease that process for her, and wanting to be available to her to whatever I can offer.

Yeah, there's going to be that excitement leading up to it, just the anticipation of this new baby. I'm concerned about feeling overwhelmed with this. Like I said, I'm the kind of person who likes to keep my emotions in check, no doubt.

Scot: If you are moved to cry . . . Are you going to be in the room during the delivery?

Troy: Oh, I'm sure I will, yeah. I joked with Laura that I'm going to deliver the baby, but she didn't like that idea. I told her, "I'm an expert. I've done this. Trust me."

Dr. Jones: Ten times.

Scot: Is that because you want to save some money? Is that what you're trying to do?

Troy: Exactly. We're going to save a little cash on this kid, avoid the hospital copay.

Scot: That's right. Some guys do their own plumbing. Troy delivers his own kids.

Troy: "I got this. I got this."

Scot: If you find yourself emotional, like where you might cry because it's such a beautiful moment, are you going to fight that back, or are you going to let that happen? And, Dr. Jones, what do you think about that? Is that what a guy should do or not?

Troy: Scot, I would love to tell you I'm just going to let the tears flow, but I know myself too well, and I'm going to try and hold them back. I'm going to do the same thing I did when we first had our ultrasound at 14 weeks, and I saw that baby and that image of the baby. Laura looked over at me, and I sure tried to hold them back. And afterwards she said, "Were you crying?" I said, "No, I wasn't. Of course not. Why would I do that? Eh, maybe a little bit." So I'm sure I'll try and hold it back.

Dr. Jones: Well, even if you do, you can say, "Well, I'm overwhelmed." You don't have to let the tears fall if they're not right for you. I mean, we've seen it all. And sometimes the experience is totally scary. It is very scary. And of course, I'm a former OB, so I also think of all the things that can go wrong. And a first baby, it just never always goes as you hope. It's just a little different in some way than you hope.

But what you want is you want to be with a team that you completely trust, and that's the biggest thing. Whoever is there with you, wherever you choose to have this baby, you want to be with a team that's going to be there for you. So you don't have to be the doctor in the room.

Scot: Now we're going from Troy being DIY to Troy recruiting like he's the general contractor. He's recruiting his crew. Going around to his friends.

Troy: I've already done that. As soon as Laura told me that night, the next morning I emailed someone I know well who's done lectures for our residents, who has been the OB for several of my friends and colleagues, and I emailed her that first morning and said, "Please, I'm scared." I didn't say, "I'm scared," but I'm sure she could tell I was scared. I was like, "Will you be our OB?" And she was wonderful and got right back to me. Yeah, I'm very happy to be working with her and have her caring for us and for our baby.

Dr. Jones: Good. Well, I think that you are . . . you know what's going to happen. You're going to let her run the agenda as she's pregnant in terms of asking you for what you need, and letting her know that, within the limits of you taking weird hours and call, you're going to be there for her.

And then what happens is after the baby is born, the first couple of months, where there's a baby up all the time, do you help out with that? Does she help out with that? How much breastfeeding are you going to do?

Scot: Yeah, Troy, do you help out with that?

Troy: I'm planning to, trust me. I'm all in on this, and she's made it clear I'm helping out with this too.

Mitch: I mean, he's already a poop scooper.

Troy: I'm already a poop scooper. Diapers are going to be easy. That's going to be a piece of cake. That will be a relief from what I usually have to deal with.

Scot: Dr. Jones, I cut you off a little bit there. You were leading into breastfeeding. Where's Troy's involvement in that, though? He can't help there, can he?

Mitch: Yeah, that's actually one of the questions from our new moms, was how do men help during that process?

Dr. Jones: Well, they can bring the baby. So if they're not co-sleeping, and there are lots of opinions about whether babies should sleep in the bed, but if the baby is in a crib nearby, you go get the baby, you can change the diapers for the baby, the mom can breastfeed and put . . . How you work that out is a rhythm that every couple establishes.

Troy, you're used to sleep deprivation. And maybe your partner is really good at it, maybe she's not. So how you begin to juggle that is something that each couple finds their own way. I'm sure you're going to do great. That's the reality, is when there's love, you guys will do just fine.

Troy: Yeah. Again, for me going into this . . . And we've talked a bit about how this is going to look once the baby is born, and how all that works. That's kind of the approach I'm trying to take. I'm going to be available. I'm very fortunate that working through the university, I do get paternity leave. I'm absolutely taking it, and I want to do everything I can to help Laura, whatever it means in terms of sleep deprivation or getting up in the middle of the night.

And like you said, my hope is just that we can figure out how that works and how that looks exactly over those first couple of weeks. And I guess that'd be my question, too. Do most couples then . . .

Dr. Jones: Couple of months.

Troy: It's a couple of months to find that pattern? Okay.

Dr. Jones: Well, the baby is always changing. So they call the first three months of a baby's life who's born at term the fourth trimester, because they are still on truly autonomic phase. They just sleep, and poop, and eat, and that's about all they do. And then at about 2.5 to 3 months, they come up with a smile and then everything is perfect as soon as they smile at you.

But it's hard because just when you think you've got Plan A, the baby has changed, and then you have to say, "Oh, I guess we're going to work with Plan B." It's just being flexible.

It's being aware that moms don't always feel on top of their game emotionally after a baby is born. They can feel kind of overwhelmed. They can feel like their independence is gone. Some women have postpartum. Everybody gets baby blues. It's a period of a day, or two, or maybe even a week when they say, "Oh, this is really hard." But postpartum depression affects a lot of women, 20%, when Mom's mood isn't really enough, isn't up to the task, and she needs more support.

You just kind of have to be aware and ask her, "How are you feeling? Is there anything I could do for you today?" As long as you're talking, as long as you're emotionally available to each other, you'll do it fine. It's amazing. It's the last refuge of the rank amateur of this parenting thing.

Troy: The last refuge of the rank amateur.

Dr. Jones: Right. So do you know if you're having a boy or a girl?

Troy: This is a girl.

Dr. Jones: Congratulations.

Troy: A baby girl on the way.

Scot: Really?

Troy: Yeah, a baby girl.

Dr. Jones: Wow. Congratulations, It's just magical. It's going to be just magical. Not that boys aren't magical too. They both are.

Scot: Are you sure about that? I was wondering this morning, I was like, "I bet you they're going to have a boy."

Mitch: Yeah, same.

Scot: I mean, might want to double-check that.

Troy: We've got another ultrasound coming up shortly, so we'll have them take another look, make sure they got it right. They seem pretty confident.

Scot: Yeah. So there was one other one. It's "Should new dads go to the appointments during pregnancy and after?"

Dr. Jones: I think that's what the partner wants. My husband was a resident. I was not going to have him . . . This was in the old days when residents never, ever, ever . . . they didn't have an IV, and if they didn't have . . . straight out of the operating room. They did not miss a day. So I was not going to ask him to go to any of my appointments. I think you do what she wants.

Troy: Yeah. And she's asked me to go, and I've been able to go with her. So, again, yeah, you're right. I think it just depends on your situation.

Scot: And what's your role in those appointments then? Is it just to be there? Is it to remember things that have been talked about?

Troy: I mean, I think my role has been more just to be there with her, and I really have tried not to . . . Again, avoiding going into doctor role. I've been trying to just be there as husband and future father and just be there with her. I've tried not to ask a lot of questions or anything like that. Let her ask the questions she wants to ask. Let her OB talk to her, and not feel like she has to be talking to me because I'm the other doctor in the room or anything like that. But yeah, it's really been just being there. And that's what it's been so far, just being there with her and she . . .

Dr. Jones: Well, if you have a question, it's a good thing. I mean, I really liked it when husbands had questions. So if you have something to ask, then it's appropriate to ask.

Troy: Yeah, for sure. And the good news is everything has been so straightforward so far. I really haven't had to ask anything, and Laura has asked the questions I think that needed to be asked.

Scot: Oh, you're grading her now?

Mitch: That's what I was going to say, yeah.

Scot: She's asked the questions that she needed to ask.

Troy: I had my checklist in my mind and she passed.

Mitch: Backseat doctoring.

Troy: Not at all. I mean, I think they were just questions that we talked about beforehand that she had. And that's probably why I'm there too, because she may have had some questions in her mind. But yeah, we really have talked a lot about those things beforehand, and she's asked me questions.

And then in this case, I don't want to be the doctor to my baby or to my wife, so I've just provided my opinion but have tried not to steer the conversation when we're with the OB.

Dr. Jones: Of course. You're a natural already.

Troy: I wish. I feel far from it. Like I said, I feel inadequate. That's how we started this episode. That's probably a good summary.

Dr. Jones: Thank you for using your words.

Troy: Yes. I feel inadequate. That would be the absolute best word to describe how I feel.

Scot: Congratulations, Troy.

Troy: Thank you.

Scot: Yeah. On behalf of Mitch and myself, this is your baby present.

Dr. Jones: Oh, great.

Troy: I could not have asked for a better gift. This is my man shower. You guys just held a man shower for me. I couldn't have asked for a better man shower.

Scot: Yes. Dr. Jones, thank you so much for being on the podcast and talking to our nervous new dad, and thanks for caring about men's health.

Dr. Jones: What a treat. Talk to you soon.

Troy: Thank you.

Dr. Jones: Bye.

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