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What to Expect – The Frummer’s Guide 
B’Shaah Tovah! You’re expecting! What do you need to know? What books to get? When to tell people? What will you buy? What shouldn’t you buy?
This guide will hopefully give you some clues as to where to start to make the next 9 months easier and to enable a smooth transition into becoming parents.
Stage 1. The first 12 weeks.
So you just found out – the stick from the pharmacy or the doctor’s test. Your husband knows, you’re excited. Now what?
Find a Doctor
Usually the first thing you’ll do is start searching for a good doctor. In
You need someone who will be able to fit you in within a few days if you’re worried about something, and has a phone number he/she is available on for emergencies (this is important!). If you can’t find an obstetrician you like, some family doctors will see women for pregnancy, but not all. If your obstetrician isn’t available however, your family doctor will be able to deal with quibbles (such as blood forms) and emergencies.
Telling People
Most people wait to tell people until the first 12 weeks are over, sometimes excluding parents or siblings, maybe a best friend. The rule of thumb is, if G-d forbid something goes wrong, would the people that know make it harder for you, or easier? Would they be supportive or would you find telling them too hard?
It’s worth remembering that 1/3 of first pregnancies (and 1/5th of subsequent pregnancies) end in miscarriage before the first 12 weeks – so if this happens to you, you are NOT alone. Check out our miscarriage boards for other mothers that have been through the same thing for support and advice. We also have a “trying to conceive” board if this is not the first time for you and you could really do with some friends who are going through the same thing.
Some people have a minhag to not tell anyone until it’s blatantly obvious. Whilst this may work for some, some relatives may be upset if they live abroad and couldn’t guess from your growing tummy.
The majority tell after 12 weeks, or the 12 week scan (which is sometimes a bit late). Some tell when they know everything is ok (if there have been problems in the first trimester), whilst others tell everyone because they’re being sick all the time and need help at home. What ever you do, it’s up to you and your husband to decide, but make sure you have the support and advice you need in this sometimes difficult time.
Scans and Tests
The common dates for scans and tests are as follows.
- The pre-12 weeks or the dating scan. This is the most accurate scan for dating your pregnancy, and even if subsequent scans show a later/earlier estimated due date, this scan is still to be relied upon more.
- The 12 week scan. This checks everything is ok with the baby and the uterus, that the placenta is in a good place (not covering the cervix) and takes measurements of the foetal bones for dating. The nuchal scan is also offered at this time. This measures the quantity of liquid under the skin at the back of baby’s neck and gives a probability that your baby has Down’s Syndrome. Of course, a termination is usually not an option for frum women (if there are other family issues such as mental health, consult a Rav) but if knowing the baby has Down’s will prepare you and your family emotionally and practically, then maybe it’s something worth considering. Ask a Rav about this. Low risk gives a probability of less than 1:300. High risk is more than 1:150. About one in 20 women will be given a high risk, and the vast majority go on to have a normal baby. Even with a risk as high as 1:5, the baby has four out of five chances that he does NOT have Down's.
- There are other Down Syndrome tests available. CVS or chorionic villus sampling involves taking a sample of cells from the wall of your placenta by either passing a needle into your abdomen (with local anaesthetic) or a tube through your cervix. This test can be performed earlier than an amniocentesis and has a low risk of miscarriage (1%). Amniocentesis involves taking a sample of amniotic fluid with a needle passed into your abdomen, at the same time as an ultrasound (to determine where the needle should go). A full DNA profile is obtained with these tests which can check for genetic diseases such as Cystic Fibrosis and Tay Sachs, as well as Down’s and the sex of the baby. Again, a Rav must be consulted before getting these tests.
- Blood tests around this time include a regular blood work-up (CBC) to determine your blood type, iron level and other factors that could affect the baby, antibody testing to see if you are immune to foetal life and health threatening diseases such as rubella and other blood tests that look for risks of chromosomal abnormalities with the foetus. If you are Rh (Rhesus) positive and your husband is not, this could cause haemolytic disease of the newborn (when the mother’s body creates antibodies which destroy the baby’s blood cells) which is quite preventable nowadays with the right treatment, if forewarned.
What to buy
This trimester, mainly books as you probably won’t be showing yet.
- “What to Expect When You’re Expecting” is a big favourite and can be picked up in second-hand book stores or off eBay. Make sure you get a relatively recent edition though.
- B’Shaah Tova – a good guide to pregnancy and birth from a religious perspective. Contains halachic issues too, although you should consult your Rav for specific p’sakim as there are other opinions to the halachot stated in the book.
Food. If you’re having morning sickness (which is perfectly normal if it’s whole-day sickness, or afternoon sickness), certain things may help, for example ginger.
The healthier you can be in this trimester (sickness aside) the better in the long term for your iron levels and general well-being of you and the baby.
Common Symptoms
Symptoms are funny things. They can range from so little that you don’t believe you’re pregnant until you see the foetus wriggling on the screen, to so severe that you wish it were over already and everyone can tell you’re pregnant even if you didn’t want them to.
- Tiredness. This is often the first symptom women notice and can be quite debilitating during the first trimester. Rest as much as you can and look forward to the break between 3 and 6 months!
- Sickness. Mild for some, awful for others, there are herbal ‘remedies’ that don’t always work. If you lose weight due to it, don’t worry, the foetus will get what it needs. Watch out for dehydration however – keep drinking!
- Headaches. Some women find their occasional headache becomes an all-out war. Remember you can take Tylenol/Acamol/Paracetamol in pregnancy, and if you need something stronger, consult your doctor.
- Tender breasts. This can occur even before you’ve missed your period, or take weeks to manifest, if at all. They can be extremely painful for some women. Leaving your bra on at night when sleeping can help.
- Lower abdominal cramping. When only mild, without bleeding or other symptoms, this is usually just the uterus stretching to accommodate the new baby. If you are worried, always get checked by your doctor.
- Lower abdominal sharp pains. These are usually caused by the ligaments (round ligaments) holding the uterus being stretched. If the pain is severe and/or doesn’t let up upon change in position, see your doctor.
- Others. There are lots! If there is any bleeding, or any pain that worries you in any way, see/call your doctor. If he/she is good, he/she won’t mind at all.
The Second Stage – 3 to 6 months.
Congratulations! You made it through the scary time. Now you can start planning properly.
What to Buy
This depends on your personal hashkafa regarding planning in general. You can definitely start researching how much things cost e.g. cot/crib, pram/stroller, redecorating the spare room, and some women may have an entire baby shower right now.
Most good furniture places have an option where you can order what you like but it’s not delivered until you call them to tell them the baby has arrived, and is fully cancellable until then. It’s worth using this option.
Again, a rule of thumb when buying is, if chas v’shalom anything went wrong and you returned from the hospital with no baby lo aleinu, would seeing the stuff make things worse or are you the kind of person that could put it away for the next one? This is why most women don’t buy.
Scans and Tests
- 20 week scan. This can be performed anywhere between 18 and 25 weeks and is a detailed ultrasound that examines all the organs of the baby to make sure they are functioning correctly. Most women go for this scan, and it is worth remembering that if there are any problems, modern surgical techniques are very successful in newborns and the more forewarned, the better. This can also check for correctable defects such as cleft-lip and club foot. This scan can also tell you the sex of your baby with a high degree of accuracy.
- Glucose Tolerance Test/Challenge Test. The Tolerance test is when a quantity of glucose (mixed in a drink) is drunk (non-fasting) and an hour later a blood test is taken to see how much glucose is in the blood. A high level indicates not enough insulin is being made (causing the cells to absorb the glucose) and is a risk-factor for gestational diabetes. The doctor will then order a Glucose Challenge test, where smaller quantities of glucose are drunk over a longer period of time (usually 3 hours) and a number of blood tests are taken to confirm or deny the diagnosis. Gestational diabetes is not a reflection on your general health (although obese and older women are at higher risk for it) as slim and fit women can also have this syndrome. It requires monitoring throughout your pregnancy for excessive weight gain by you or the foetus, medication if severe and sometimes warrants an induction pre-term if there is a worry about the health of the foetus. If well taken care of, there is usually little worry. If you ignore your doctor’s advice and eat unhealthily, don’t exercise etc, there are significant health risks to both you and your baby.
- 3D/4D Scans. These are incredible, and sometimes, incredibly expensive too. In
Common Symptoms
The second trimester tends to be a bit of a relief. Sickness usually subsides, tiredness also. However you are getting bigger and will notice aches and pains that you didn’t have before.
Watch out for puffiness of the face or body (normal swollen ankles are fine) as they can be a sign of high blood pressure that needs to be seen immediately.
Constipation and associated haemorrhoids do not have to be suffered – there are things that can be taken in pregnancy that can provide some relief.
Find a childbirth class
This is really important. Studies show that women who know about labour have 25% less intervention such as caesareans, forceps and even pain medications (which can sometimes have negative side-effects).
Ask your Rav about whether or not your husband should come with. There are many classes in all major Jewish populations that are suitable for both parents, sometimes the husband only comes to one class, sometimes the instructor will do a one-to-one class for anything she deems inappropriate to be taught together.
For classes that are with both parents, you can usually find a quiet corner to practise labouring positions together, and the instructor will pull the women together for more intimate topics of instruction or videos etc.
I think it’s definitely better to get someone who understands the religious sensitivities as opposed to public classes that could offend/make you uncomfortable. A religious instructor will also be able to tell you more specifically what to bring to the hospital, tehillim and segulot, when you are likely to be niddah from according to the psak you’ve been given from your Rav. A religious group will also help you make friends with women from your area due at the same time as you, and these friends are worth keeping if you feel more isolated or your current friends aren’t at the same stage of life as you.
The Final Stage, 6-9 months
The home straight. You’ll be getting more excited and probably more frustrated as you feel more uncomfortable.
What to buy
Herbal tea is a great way to ensure you are hydrated. Nettle leaves contain many minerals that help your uterus tone up for labour and is totally safe in pregnancy. Make a cup with 1 tablespoon of dried leaves (obtainable from health food stores) and boiling water with honey, sugar or whatever you want to make it palatable, then dilute in a large bottle (1.5 liters) of water. Make sure you’ve finished the whole bottle by
Hopefully most of your research is done now and you can order things to be delivered for after the birth. You will need now, however, things to take the baby home in. This is usually a baby grow/onesie plus vest to go under and trousers to go over. The hospitals want baby to be in two layers (even if it’s 35C outside!) when you leave. You also need access to a car seat to leave the hospital in, even if you haven’t bought one yet so make sure you have a friend to borrow one from if you don’t want to buy in advance.
Having something to put the baby in to sleep when you get home is also very important – it’s not always so easy for your husband to find something while you’re in the hospital. It’s not good for the baby to have it in the car seat to sleep (as babies need to be flat on their backs to reduce risk of SIDS/cot death and enable proper spine growth) so again, if you can borrow something temporarily before your furniture arrives then plan this now.
Nursing paraphernalia such as pumps, bottles, breast pads, sterilisers (if you’re buying one), silicone nipple shields for emergency latching-on difficulties etc are also important to have ordered or bought.
Nappies/Diapers – baby will need changing approximately 10 times a day at the start so you need a few packs ready – husband can get this when you’re in the hospital.
Things for you for when you’re in the hospital such as food, drinks, appropriate and comfortable clothing and hair coverings, siddurim/books and magazines, music (and player), etc should be planned soon too. The pregnancy books have a comprehensive list and your childbirth class should help you too.
Scans and Tests
Sometimes women can request a third trimester scan just for fun or to follow up any problems. The normal blood tests for iron level are given now too.
Common Symptoms
The tiredness will be back with a vengeance now, and it’s important to rest as much as possible. Your aim is to make sure you are as healthy, rested and relaxed as you can be before labour and the inevitable new-baby sleeplessness.
Frequent need for the bathroom is very common, getting worse as the trimester progresses. Go before you leave and make sure you’re going somewhere with a bathroom. Take tissues with you wherever you go in case you end up in some horrid shop toilet without any toilet paper!
Again, keep an eye out for puffiness but remember slight swelling of hands and ankles is normal, especially in hot countries. Any pains or symptoms you are concerned about, call your doctor.
This trimester sees the start of Braxton-Hicks contractions which are usually painless but can be uncomfortable. Some women have been having them for months already whilst others won’t notice them until they are in labour. They are tightenings of the uterus as the uterus practises for labour.
Labour and Delivery
What to buy (seriously)
Things I’ve found useful (please comment to add things to this list!)
- a small, hard ball (like a tennis ball) for putting pressure on your lower back during contractions
- chewy oat bars for energy
- cans of still juice, straight from the freezer
- comfy snood/tichel that won’t fall off mid-labour.
- Almond oil for perineal massage during the pushing stage (the midwife will know what to do with it!)
Special religious requirements
I’m not going to go through the whole of labour here – the above books do a far better job than I could ever hope to do!
Always plan worst-case scenario – even if that means labour in the middle of Yom Kippur/Shabbos/the huge Shavuot meal your mother has prepared weeks ago/Seder night etc. Have cab numbers ready, a separate bag for mukzah items that you could do without (like the CD player), hospital registration details etc in case you do have to go to hospital on Shabbat/Yom Tov. Read up on the halachot involved so you (and more importantly, your husband as you probably won’t care that much) are prepared. Also, find out what the situation is in your chosen hospital. Some hospitals in
Remember to ask your Rav for a psak as to when you’ll be niddah. There are different opinions as to the colour of the mucous plug (pink, brown etc), waters breaking and the rate of contractions that may make you niddah even if you haven’t seen blood.
You also need to know how much your husband can be involved in the labour. There are opinions that prefer that the husband remains outside the labour room, although if you feel you need him he is permitted to be with you, at the head end of the bed.
As you are considered a sick person that there is a risk of life (choleh she’yesh bo sakanah), your husband is permitted to pass things to you directly (like glasses of water), and perhaps even push the ball into your back during contractions. Again, you must consult your Rav.
Although you may be a very tzanuah person, remember that the people dealing with your labour are professional and very accustomed to seeing it all before. They are there to help you and you should ask them if you need them. There is a certain level of distancing that occurs between mind and body during labour that will help you overcome embarrassment, for example, when you need to use the bathroom but can’t move from the waist down because of your epidural.
I hope this short guide helps you relax a bit!