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class="css-1ve4ipt"><div class="css-1q9yuh6"><article class="css-1ut8x4k"><div class="css-zmj3b2"><div class="css-1ve4ipt"><div class="css-70lk7h"><a href="/web/20190621070458/https://parenting.nytimes.com/becoming-a-parent/two-moms-get-pregnant?module=editors-picks&action=click&region=1" class="css-js22it"><figure class="css-h5v5bo"><img class="css-1vmxokd" src="https://web.archive.org/web/20190621070458im_/https://static01.nyt.com/images/2019/06/20/multimedia/20-NikkiBA2-IUI2/20-NikkiBA2-IUI2-thumbWide-v2.jpg" alt="B.A. Williams holds a vial of sperm that she and her wife purchased for fertility treatments." srcset="https://web.archive.org/web/20190621070458im_/https://static01.nyt.com/images/2019/06/20/multimedia/20-NikkiBA2-IUI2/20-NikkiBA2-IUI2-videoThumb-v2.jpg 75w, https://web.archive.org/web/20190621070458im_/https://static01.nyt.com/images/2019/06/20/multimedia/20-NikkiBA2-IUI2/20-NikkiBA2-IUI2-thumbWide-v2.jpg 190w, 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Williams holds a vial of sperm that she and her wife purchased for fertility treatments.","__typename":"TextOnlyDocumentBlock"},"__typename":"Image"}},{"topics":[{"id":"e7a83c90-2637-11e9-97fe-7118154e1f70","parent":{"name":"health","displayName":"Health \u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2"},"name":"postpartum-health","displayName":"Postpartum Health"},{"name":"health","displayName":"Health \u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2"},{"name":"motherhood","displayName":"Motherhood","id":"7edd13b0-4a69-11e9-94b1-0b2f88530bb4","parent":{"id":"f9e8ab60-4a68-11e9-9578-d1996b70db7c","name":"parent-life","displayName":"Life as a Parent"}},{"name":"parent-life","displayName":"Life as a Parent","id":"f9e8ab60-4a68-11e9-9578-d1996b70db7c"}],"publishedStatus":"PUBLISHED","author":{"bio":"\u003cp\u003eAnna Nowogrodzki is a science journalist and mom in the Boston area.\u003c/p\u003e","name":"Anna Nowogrodzki"},"secondaryMediaScoopId":"100000006487350","promotionalMediaScoopId":"100000006565505","publishedAt":"2019-05-03T19:01:00.000Z","id":"10b2bb30-4cd3-11e9-8358-e109482e0d82","createdAt":"2019-03-22T19:01:46.308Z","headline":{"default":"Postpartum Body Changes You Should Know About"},"sources":"\u003cp\u003e\u003ca href=\"https://www.nursing.umaryland.edu/directory/debra-bingham-drph-rn-faan/\" target=\"_blank\"\u003eDebra Bingham\u003c/a\u003e, Dr.PH., R.N., professor of nursing at the University of Maryland and executive director of the Institute for Perinatal Quality Improvement, Aug. 23, 2018\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://www.medstarhealth.org/doctor/dr-tamika-auguste-md/\" target=\"_blank\"\u003eTamika Auguste\u003c/a\u003e, M.D., obstetrician-gynecologist at MedStar Washington Hospital Center, Aug. 27, 2018\u003c/p\u003e\u003cp\u003eAlison Colussi, D.P.T., physical therapist at Physical Therapy Center of Rocky Hill in Rocky Hill, Conn., Aug. 27, 2018\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://sph.unc.edu/adv_profile/alison-stuebe-md/\" target=\"_blank\"\u003eAlison Stuebe,\u003c/a\u003e M.D., M.Sc., associate professor of obstetrics and gynecology at the University of North Carolina School of Medicine, Aug. 27, 2018\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://hollyherman.com/\" target=\"_blank\"\u003eHolly Herman\u003c/a\u003e, D.P.T., physical therapist at HealthyWomen HealthyMen Physical Therapy, Aug. 27, 2018\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://cdn.ymaws.com/www.awhonn.org/resource/resmgr/pdfs/pbws/pbwssylhandoutenglish.pdf\" target=\"_blank\"\u003eSave Your Life: Get Care for These Post-birth Warning Signs,\u003c/a\u003e” the Association of Women’s Health, Obstetric, and Neonatal Nurses, 2016\u003c/p\u003e","promotionalHeadline":" All the Weird Things That Happen to Your Body After Baby","updatedAt":"2019-06-18T19:05:08.062Z","slug":"postpartum-body","hero":"","whatToDo":{"hed":"What To Do","content":[{"hed":"Don’t ignore concerning changes.","content":"\u003cp\u003ePeeing a little when you sneeze, laugh or exercise is such a classic postpartum symptom that many assume it can’t be fixed. Not so. It’s called stress incontinence, and it’s a symptom of a problem with your pelvic floor, a set of muscles that stretch, bowl-shaped, between the tailbone and the pubic bone. Urge incontinence, in which you feel the need to urinate very frequently, feel you have a very small bladder or feel you can’t hold it, is also due to pelvic floor muscle stress.\u003c/p\u003e\u003cp\u003eIf you have any kind of incontinence, a good first step is a referral to a physical therapist who specializes in pelvic floor issues. “Being pregnant puts stress on your pelvic muscles” because of the weight of the fetus, said Dr. Tamika Auguste, an ob-gyn at MedStar Washington Hospital Center in Washington, D.C. Vaginal delivery or a C-section can further stress your pelvic floor, especially if the C-section was unplanned and occurred after some amount of labor. “Oftentimes women don't always recognize immediately how much of a toll that still took on their vaginal canal and pelvic floor,” said Alison Colussi, D.P.T., a physical therapist specializing in pelvic health. Muscles that stretch during delivery can either remain too loose or over-tighten in response.\u003c/p\u003e"},{"content":"\u003cp\u003eWhen you think pelvic floor, you probably think Kegel exercises — in which you contract your pelvic floor muscles. But Kegels are not always helpful, and they’re hard to learn how to do properly on your own, Colussi said, so it’s best to visit a physical therapist if possible. Some women’s pelvic floors are overly tight, “in a constant state of mini-Kegel,” as Colussi puts it, which Kegels would only exacerbate. Even when pelvic floor muscles are weak and need strengthening, “the focus is much more on finding the full range of motion of those muscles, which includes both relax and contract,” Colussi said.\u003c/p\u003e\u003cp\u003eThe relaxing part is hard. I tried to do it while on the phone with Colussi. “I’m not entirely sure if they’re relaxed or not,” I told her. “Am I actually trying to contract something accidentally?” She laughed. “I hear that 10,000 times a day,” she said.\u003c/p\u003e\u003cp\u003eOften, Colussi said, patients come in looking for an exercise to do for 10 minutes every day. “But the question is not what's a good exercise,” she said. It’s more about how people move in every one of their daily activities, from getting out of bed to picking up mashed fruit off the floor to lifting babies out of their cribs. The \u003ca href=\"https://allsports-physicaltherapy.com/blog/quick-tips-proper-lifting-mechanics/\" target=\"_blank\"\u003eproper way to pick up\u003c/a\u003e that mashed fruit or a baby in a car seat is to squat down, keeping your center of gravity over your hips and not tilting forward. Then exhale, engage your abs and straighten up using your leg muscles, not your back.\u0026nbsp;\u003c/p\u003e","hed":"Do pelvic floor exercises — but not just Kegels."},{"content":"\u003cp\u003eIt’s common to feel discomfort or pain the first few times you have penetrative sex after childbirth, but after that, don’t put up with it. The first step is of course to go slowly and be gentle with yourself. Often ob-gyns will advise using an over-the-counter lubrication product, because breastfeeding suppresses estrogen production, and estrogen produces lubrication, explained Dr. Alison Stuebe, associate professor of obstetrics and gynecology and chair of the taskforce that wrote the newest American College of Obstetricians and Gynecologists \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care\" target=\"_blank\"\u003eguidelines for postpartum care\u003c/a\u003e. But lube is just a beginning, our experts all agreed.\u003c/p\u003e\u003cp\u003eIn addition to dryness, pain during sex can be caused by pelvic floor dysfunction, other tight or stretched muscles or scar pain from a tear or episiotomy during a vaginal birth. Sex can hurt for patients who’ve had C-sections as well, because both C-sections and the process of pregnancy can stretch or tighten muscles. Ask your obstetric care provider for a referral to pelvic floor physical therapy.\u003c/p\u003e\u003cp\u003eDr. Stuebe also directs patients to “\u003ca href=\"https://longestshortesttime.com/podcast-48-the-parents-guide-to-doin-it/\" target=\"_blank\"\u003eThe Parents’ Guide to Doing It\u003c/a\u003e,” an episode of “The Longest Shortest Time” podcast with sex advice columnist Dan Savage as a guest. Savage discusses types of sex other than penetration. Unfortunately, some women experience pain with any kind of sex, usually from increased nerve sensitivity, said Colussi.\u003c/p\u003e","hed":"Don’t put up with painful sex."},{"hed":"Seek help if you feel pressure in your vagina.","content":"\u003cp\u003eSome women come to Colussi saying they feel pressure in their vagina, like something is obstructing their bowel movements, “or like a dry tampon is half falling out of me,” she said. Sensations like these could mean a pelvic organ prolapse, when an organ (uterus, bladder or urethra) shifts from its original position or presses against the vaginal wall. “Prolapse is probably the thing women are least prepared for,” said Colussi.\u003c/p\u003e\u003cp\u003eSevere prolapses can be fixed with surgery or alleviated with a pessary (a support in the vagina to prop up the prolapsing organ), but milder prolapses can be managed just by lying down more frequently and avoiding high levels of pressure in your abdomen, Colussi said. “Oftentimes for a woman it feels a lot worse than it actually is,” she said, but in other cases prolapse can be more severe than it feels, so it makes sense to see a health care provider. To better manage pressure levels in your abdomen, don’t bear down when pooping; and exhale instead of inhaling or holding your breath when you exert yourself. If you find yourself grunting and then holding your breath when you lift something heavy, try exhaling instead.\u0026nbsp;\u003c/p\u003e"},{"hed":"Ask your doctor about scar pain. ","content":"\u003cp\u003eIf you feel pain in your C-section scar or scar from a tear or episiotomy, see your medical provider. A doctor may recommend scar massage or scar mobility treatments from a postpartum physical therapist. However, be aware, scientific data on the effectiveness of scar massage is limited because it has barely been studied, Dr. Stuebe said. A 2011 paper concluded that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22093081\" target=\"_blank\"\u003escar massage\u003c/a\u003e is “anecdotally effective” but found that surgical scar massage of any kind had only been studied in a tiny sample size of 30 patients. Scar pain is common. A year after giving birth, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/19733050\" target=\"_blank\"\u003ea study found\u003c/a\u003e, 18 percent of women who had C-sections still had pain at the incision site, and 10 percent of women who had vaginal births still felt pain in the vagina or perineum (the area between the vagina and the anus).\u003c/p\u003e"},{"content":"\u003cp\u003eCarrying a baby, lifting a baby and holding a baby while breastfeeding are hard physical work, especially for women who were pregnant. Your posture and movement habits change during pregnancy from carrying around extra weight in new places, and your body also produces the hormones relaxin and progesterone, which loosen your ligaments and joints.\u003c/p\u003e\u003cp\u003eBaby product design doesn’t help. “Car seats and cribs have changed drastically” in recent years, said Colussi. They’re carefully designed for infant safety, but not for parent ergonomic safety. Infant or “bucket” car seats are heavy, and usually parents carry them in their nondominant arm, causing muscle imbalances. She recommends that parents practice early and often carrying their babies on both sides equally. “Cribs are hard because the rails can’t go up and down anymore,” she said. Colussi recommends that parents, especially shorter ones, place a step aerobics stepper next to the crib.\u003c/p\u003e\u003cp\u003eIf pain persists after making these changes, physical therapy is a good idea.\u003c/p\u003e","hed":"Learn to carry your baby on both sides."},{"content":"\u003cp\u003eIf you feel a gap in your abdominal muscles, you may have diastasis recti, in which all the layers of the abdominal muscles, the rectus abdominus, separate in the middle. This happens normally during the latter part of pregnancy to make room for the growing uterus, but if it persists at your six-week postpartum checkup, ask your provider, who may refer you to a physical therapist. To avoid putting too much pressure on these muscles, avoid crunches or sit-ups, and when you sit up, don’t sit straight up using just your abdominal muscles: Roll onto your side first and use your arms.\u003c/p\u003e\u003cp\u003e\u0026nbsp;\u003c/p\u003e","hed":"Use proper form for sitting up. "}]},"body":"\u003cp\u003eWhen I was pregnant, I read four books on pregnancy and two on childbirth. I read no books on what my body would be like during the first year postpartum, because I had never heard of any. During that first year, many people are underinformed about their own bodies, even as they learn vast amounts about their babies. Many of us are cleared for sex and exercise at six weeks postpartum, but a body that grew another human can take much longer than that to heal — and can be permanently changed in some ways.\u0026nbsp;\u003c/p\u003e\u003cp\u003eFor this piece, I discussed health in the first postpartum year with two ob-gyns, a nurse, two physical therapists who specialize in treating postpartum bodies and two mothers. All the experts said many people have questions about what is normal, and they recommended calling your obstetrician, midwife or primary care provider if you’re concerned about something specific. For many symptoms, a next step will be a referral to a physical therapist. The experts stressed that you don’t have to live with pain, discomfort or leaking urine, and that your health is as important as your baby’s.\u003c/p\u003e\u003cp\u003e\u003cem\u003ePostpartum \u003c/em\u003e\u003ca href=\"https://parenting.nytimes.com/health/postpartum-depression\" target=\"_blank\"\u003e\u003cem\u003edepression\u003c/em\u003e\u003c/a\u003e\u003cem\u003e and \u003c/em\u003e\u003ca href=\"https://parenting.nytimes.com/health/what-does-postpartum-anxiety-feel-like\" target=\"_blank\"\u003e\u003cem\u003eanxiety\u003c/em\u003e\u003c/a\u003e\u003cem\u003e are part of overall health but merit their own space, so see our guides for those topics.\u0026nbsp;\u003c/em\u003e\u003c/p\u003e","topic":{"displayName":"Health \u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2","name":"health"},"type":"GUIDE","isSensitiveContent":false,"theGist":{"content":"\u003cul\u003e\u003cli\u003eMany women who’ve given birth have postpartum pelvic floor issues that can require physical therapy. Look out for peeing when you laugh, sneeze or exercise, or for very frequent urges to pee.\u003c/li\u003e\u003cli\u003eTreatment for pelvic floor issues isn’t just Kegels (and a lot of people do Kegels wrong).\u003c/li\u003e\u003cli\u003eIf penetrative sex hurts after the first few times, go slow, use lube and try non-intercourse forms of sex. If it still hurts, see a pelvic floor physical therapist.\u003c/li\u003e\u003cli\u003eIf you feel like something is falling out of your vagina, you may have prolapse. Consult your doctor for a referral to a pelvic floor physical therapist.\u003c/li\u003e\u003cli\u003eScar pain is common after both C-sections and vaginal births even up to a year postpartum. Scar massage may help.\u003c/li\u003e\u003cli\u003eIf your back, shoulders or hips hurt, make sure you’re carrying your baby and baby gear on both sides of your body equally, and see a physical therapist.\u003c/li\u003e\u003c/ul\u003e","hed":"The Gist"},"summary":"From separated abs to pelvic floor issues, what to look out for after having a baby.","ignoreInProgramming":false,"whenToWorry":{"quickLinkContent":"Here are some signs you may need additional support or medical care.","quickLinkSubhead":"When to ask for help","content":"\u003cul\u003e\u003cli\u003eIf you have shortness of breath, pain in your chest or seizures, call 911.\u003c/li\u003e\u003cli\u003eIf you have an incision that does not heal, a temperature above 100.4F, too much bleeding (soaking one pad per hour or a blood clot the size of an egg or larger), a red or swollen leg that feels painful or hot, or a headache that does not get better with medication or is accompanied by vision changes, call your medical provider.\u003c/li\u003e\u003cli\u003eIf you had gestational diabetes, make sure you get screened for diabetes according to your medical provider’s advice.\u003c/li\u003e\u003cli\u003eIf you had high blood pressure (\u003ca href=\"https://parenting.nytimes.com/pregnancy/preeclampsia-symptoms\" target=\"_blank\"\u003epre-eclampsia\u003c/a\u003e) during pregnancy, make sure your blood pressure is monitored according to your medical provider’s advice. (You are still at risk for pre-eclampsia up to six weeks postpartum.)\u003c/li\u003e\u003cli\u003eIf you quit or tapered smoking or other drugs during pregnancy, see your medical provider for a postpartum support plan. The stresses of life with a baby can lead to relapse.\u0026nbsp;\u003c/li\u003e\u003c/ul\u003e","hed":"When to Worry"},"editorsPick":true,"promotionalMedia":{"__typename":"Image","id":"SW1hZ2U6bnl0Oi8vaW1hZ2UvNmYyNDk2MDItMDJjMC01NDc2LTk2ZjUtMmNkZGIxMGYyN2E1","imageType":"photo","url":"/imagepages/2019/06/18/multimedia/postpartum-body.html","uri":"nyt://image/6f249602-02c0-5476-96f5-2cddb10f27a5","credit":"Hye Jin 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\u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2"},{"name":"parent-life","displayName":"Life as a Parent","id":"f9e8ab60-4a68-11e9-9578-d1996b70db7c"},{"displayName":"Fatherhood","id":"a92d4a90-4a69-11e9-88c6-8b5c240877dc","parent":{"name":"parent-life","displayName":"Life as a Parent","id":"f9e8ab60-4a68-11e9-9578-d1996b70db7c"},"name":"fatherhood"},{"name":"newborn","displayName":"Newborn","id":"b4808080-29c4-11e9-9987-55724655059c"},{"id":"a513bed0-29a8-11e9-875f-a3eaeb387614","name":"baby","displayName":"Baby"}],"timesTags":[],"publishedStatus":"PUBLISHED","previouslyPublished":false,"section":{"__typename":"Section","name":"parenting","displayName":"Parenting"},"publishedAt":"2019-06-13T10:00:00.000Z","id":"080383a0-8e1b-11e9-8613-477347f8852f","createdAt":"2019-06-13T20:49:57.785Z","creators":["Anna Machin"],"headline":{"default":"How Men’s Bodies Change When they Become Fathers","subHeadline":"","__typename":"CreativeWorkHeadline"},"previouslyPublishedUrl":"https://web.archive.org/web/20190621070458/https://www.nytimes.com/2019/06/13/parenting/fatherhood-mens-bodies.html","updatedAt":"2019-06-20T14:11:30.548Z","slug":"fatherhood-mens-bodies","bylines":[{"__typename":"Byline","creators":[{"__typename":"Person","displayName":"Anna Machin"}]}],"topic":{"id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2","name":"health","displayName":"Health \u0026 Wellness"},"type":"ARTICLE","scoopId":"100000006557519","isSensitiveContent":false,"summary":"Hint: They don’t just get ‘dad bods.’","ignoreInProgramming":false,"__typename":"ParentingArticle","promotionalHeadline":"How Men’s Bodies Change When they Become 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","__typename":"TextOnlyDocumentBlock"},"__typename":"Image"}},{"topics":[{"displayName":"Baby","id":"a513bed0-29a8-11e9-875f-a3eaeb387614","name":"baby"},{"name":"newborn","displayName":"Newborn","id":"b4808080-29c4-11e9-9987-55724655059c"},{"id":"f848bfa0-2ee0-11e9-a849-15882c36d4e0","parent":{"name":"newborn","displayName":"Newborn","id":"b4808080-29c4-11e9-9987-55724655059c"},"name":"colic-and-crying","displayName":"Colic and Crying"}],"author":{"bio":"\u003cp\u003ePatricia Waldron, M.S., is a science journalist in upstate New York.\u003c/p\u003e","name":"Patricia Waldron"},"publishedStatus":"PUBLISHED","secondaryMediaScoopId":"100000006487350","promotionalMediaScoopId":"100000006555269","publishedAt":"2019-06-13T10:00:00.000Z","id":"a25da310-892d-11e9-ba24-a9cba574f2a9","createdAt":"2019-06-07T14:20:37.523Z","headline":{"default":"All Babies Cry, but How Much Is Too Much?"},"sources":"\u003cp\u003e\u003ca href=\"https://www.chop.edu/doctors/slack-kristen-n\" target=\"_blank\"\u003eKristen Slack,\u003cstrong\u003e \u003c/strong\u003eM.D.\u003c/a\u003e, pediatrician at the Children’s Hospital of Philadelphia, April 9, 2019\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://profiles.ucsf.edu/amy.gelfand\" target=\"_blank\"\u003eAmy Gelfand, M.D.\u003c/a\u003e, child neurologist and director of pediatric headache at University of California San Francisco, April 15, 2019\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://www.utphysicians.com/provider/j-marc-rhoads/\" target=\"_blank\"\u003eJ. Marc Rhoads, M.D.\u003c/a\u003e, pediatric gastroenterologist at the University of Texas at Houston, April 15, 2019\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://www.cincinnatichildrens.org/bio/d/nick-deblasio\" target=\"_blank\"\u003eNick DeBlasio, M.D.\u003c/a\u003e, pediatrician and medical director, pediatric primary care at Cincinnati Children's Hospital, April 16, 2019\u0026nbsp;\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Obstetric-Care-Consensus-Series/Safe-Prevention-of-the-Primary-Cesarean-Delivery?IsMobileSet=false\" target=\"_blank\"\u003eInfant Colic—What works: A Systematic Review of Interventions for Breast-fed Infants\u003c/a\u003e,” Journal of Pediatric Gastroenterology and Nutrition, May 2016\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://link.springer.com/article/10.1007%252Fs11916-016-0558-8\" target=\"_blank\"\u003eThe Link Between Infantile Colic and Migraine\u003c/a\u003e,” Current Pain and Headache Reports, May 2016\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://pediatrics.aappublications.org/content/141/1/e20171811\" target=\"_blank\"\u003e\u003cem\u003eLactobacillus reuteri\u003c/em\u003e to Treat Infant Colic: A Meta-analysis\u003c/a\u003e,” Pediatrics, January 2018\u003c/p\u003e","updatedAt":"2019-06-19T15:57:48.657Z","slug":"baby-colic","hero":"","body":"\u003cp\u003eThe best part of having friends and family with a new baby is the chance to hold the adorable infant as he sleeps and then hand him off as soon as he starts to cry. Of course, parents don’t have this option and must become adept at deciphering what’s wrong and learning how to soothe their child.\u0026nbsp;\u003c/p\u003e\u003cp\u003eInfants typically cry \u003ca href=\"https://www.jpeds.com/article/S0022-3476(17)30218-4/abstract\" target=\"_blank\"\u003eabout two hours each day\u003c/a\u003e, but around 20 percent of babies are colicky. These champion criers spend three or more hours each day fussing and wailing inconsolably. For mothers and fathers, being unable to comfort your child is extremely frustrating, making the first few months of parenthood even more challenging.\u003c/p\u003e\u003cp\u003eI searched through the scientific research and spoke with two pediatricians, a pediatric gastroenterologist and a child neurologist to learn how to comfort a crying infant and to examine some of the factors that may contribute to colic.\u003c/p\u003e","whatToDo":{"hed":"What To Do","content":[{"hed":"Try out different strategies to soothe your baby.","content":"\u003cp\u003eCrying is the only way that babies can communicate with the world, so they do it a lot. Hunger, gas and wet diapers are obvious reasons for crying, but sometimes a baby might be overstimulated, bored or just naturally fussy. “Don’t drive yourself crazy trying to figure out why your baby is crying every single time,” said \u003ca href=\"https://www.cincinnatichildrens.org/bio/d/nick-deblasio\" target=\"_blank\"\u003eDr. Nick DeBlasio, M.D.\u003c/a\u003e, a pediatrician at Cincinnati Children’s Hospital. “Babies cry. That’s just part of being a baby.”\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf you’ve tried the usual remedies and your baby is still crying, there are several strategies to pursue. Pediatricians recommend creating a womb-like environment through white noise or heartbeat sounds, tucking the baby into a swaddle and gently rocking the child. There’s also “\u003ca href=\"https://www.youtube.com/watch?v=j2C8MkY7Co8\" target=\"_blank\"\u003ethe Hold\u003c/a\u003e,” a procedure publicized by pediatrician Robert Hamilton that involves tucking the baby’s arms across the chest with one hand while holding the baby’s bottom in the other and gently bouncing the baby around the room. Or, just try a change of scenery. Bring your child out of a crowded room, take a warm bath or go out for a walk. Some babies will even self-soothe with the help of a pacifier.\u0026nbsp;\u003c/p\u003e"},{"content":"\u003cp\u003eIf these soothing strategies don’t work for long and your baby seems to be crying and fussing excessively, then you might have a colicky baby. Traditionally, colic is identified using the “Rule of Three” — inconsolable crying that lasts more than three hours a day and occurs more than three days a week for at least three weeks. Often the crying occurs late in the day, around the same time — some doctors call it “the witching hour” — though crying can occur at other times. \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/colic/symptoms-causes/syc-20371074\" target=\"_blank\"\u003eColicky\u003c/a\u003e cries sound urgent and painful and are often accompanied by clenched fists, a red face and excess gas. The crying usually starts around three weeks of age, peaks at six weeks and improves by three months, though it can last up to six months in some babies.\u003c/p\u003e\u003cp\u003eIf you think you have a colicky baby, then be sure to discuss the problem with your pediatrician. By definition, colic is crying for an unknown reason, but several conditions look like colic and should be ruled out. Constant crying could also be a sign of a minor or more serious injury, or even child abuse.\u0026nbsp;\u003c/p\u003e\u003cp\u003eCommon conditions that can be mistaken for colic are \u003ca href=\"https://medlineplus.gov/refluxininfants.html\" target=\"_blank\"\u003eacid reflux\u003c/a\u003e, when stomach acid comes up into the esophagus or mouth, and protein allergies. Acid reflux typically causes crying several times a day after feedings and frequent spitting up. Protein allergies cause babies to be fussy all the time, and result in blood or mucus in the stool, which can be detected with lab tests.\u003c/p\u003e","hed":"Learn the signs of colic."},{"hed":"Remember: It’s not you fault, and it will eventually go away.","content":"\u003cp\u003eIf your baby receives a diagnosis of colic, then your pediatrician is likely to reassure you that you’re doing a great job and things will improve with time. “It doesn’t mean you’re a bad parent, and it doesn’t mean that your kid doesn’t like you,” counseled Dr. DeBlasio. He tells parents that it’s natural to feel frustrated and reminds them that colicky kids won’t be this difficult forever.\u0026nbsp;\u003c/p\u003e\u003cp\u003eThere are no generally accepted treatments for colic, so Dr. DeBlasio recommends simple changes to help with the gas, such as frequent burping and switching to bottles that reduce air swallowing, such as ones with angled tips or bottles with collapsible plastic bags. He tells parents, however, not to spend a lot of time and money trying different formulas or other supposed treatments.\u003c/p\u003e\u003cp\u003eThere are many alternative and herbal remedies marketed for colic, like \u003ca href=\"https://journals.sagepub.com/doi/pdf/10.1177/014107680009300404\" target=\"_blank\"\u003egripe water\u003c/a\u003e, but parents should be wary. Gripe water no longer contains alcohol, like it did in the 1800s, but there is also no evidence it works. “There have been some small studies that have looked at anything from acupuncture and chiropracty to a huge variety of herbal supplements,” said \u003ca href=\"https://www.chop.edu/doctors/slack-kristen-n\" target=\"_blank\"\u003eDr. Kristen Slack, M.D.\u003c/a\u003e, a pediatrician at the Children’s Hospital of Philadelphia. “Really, there’s no consistent evidence to suggest that any of that is helpful.\" Unregulated supplements and spinal manipulation may also carry risks to the baby.\u0026nbsp;\u003c/p\u003e"},{"content":"\u003cp\u003eResearchers are still trying to nail down a definitive cause for colic.\u0026nbsp;\u003c/p\u003e\u003cp\u003eOne theory is that a contributing factor is inflammation in the gut from a less-than-ideal collection of microbes that first colonize the infant’s intestines. \u003ca href=\"https://www.utphysicians.com/provider/j-marc-rhoads/\" target=\"_blank\"\u003eDr. Marc Rhoads, M.D.\u003c/a\u003e, a pediatric gastroenterologist at the University of Texas at Houston, has looked for \u003ca href=\"https://www.jpeds.com/article/S0022-3476(18)30947-8/fulltext\" target=\"_blank\"\u003esigns of inflammation in babies’ stools\u003c/a\u003e, measuring a biomarker called calprotectin that signals irritable bowel syndrome in adults. His research group found much higher levels of calprotectin in infants with colic than in infants without it, suggesting inflammation, and also found differences in the microbial communities in their guts.\u003c/p\u003e\u003cp\u003eTo help correct this microbial imbalance, research groups in several countries have tested a strain of the bacterium \u003cem\u003eLactobacillus reuteri\u003c/em\u003e, isolated from the breast milk of a \u003ca href=\"https://www.biogaia.com/about-us/biogaias-history/\" target=\"_blank\"\u003ePeruvian woman\u003c/a\u003e. \u003ca href=\"https://pediatrics.aappublications.org/content/141/1/e20171811.full\" target=\"_blank\"\u003eA meta-analysis\u003c/a\u003e that combined multiple smaller studies reports that colicky babies who were breastfed and received the strain as a probiotic cried about 46 fewer minutes per day than babies who received a placebo. Dr. Rhoads conducted \u003ca href=\"http://www.jpeds.com/article/S0022-3476(17)31039-9/abstract\" target=\"_blank\"\u003ea small trial that established the safety of the probiotic\u003c/a\u003e, which can be purchased as \u003ca href=\"https://www.gerber.com/gerber-soothe-probiotic-colic-drops\" target=\"_blank\"\u003eGerber Soothe Probiotic Colic Drops\u003c/a\u003e or \u003ca href=\"https://www.biogaia.com/product-country/biogaia-protectis-drops-usa-44/\" target=\"_blank\"\u003eBioGaia ProTectis Baby\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eWhile Dr. Rhoads is confident that gut inflammation plays a role in colic, he said many questions remain. “We know that those drops can help,” he said. “We don’t know that there wouldn’t be better results if they were combined with another probiotic, or if there are strains that might even be better than the ones we’re using now.”\u0026nbsp;\u003c/p\u003e","hed":"If you breastfeed, consider probiotics."},{"content":"\u003cp\u003eSome cases of colic may also be the earliest symptom of migraine, a heritable neurological disorder that makes the brain hypersensitive and is best known for causing painful headaches.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://profiles.ucsf.edu/amy.gelfand\" target=\"_blank\"\u003eDr. Amy Gelfand, M.D.\u003c/a\u003e, a child neurologist at the University of California San Francisco, discovered that \u003ca href=\"https://n.neurology.org/content/79/13/1392.long\" target=\"_blank\"\u003emothers with migraine were 2.5 times more likely to have a colicky baby\u003c/a\u003e than mothers without the disorder. Other research groups have reported additional links between \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/1679399\" target=\"_blank\"\u003ebeing a colicky baby and having migraine headaches as an adolescent\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\u003cp\u003eWhile colicky babies probably don’t have headaches, they may be more sensitive to their environment. “For fussy infants who have a family history of migraine, it may be that by the end of a long day of new and varied stimulation, they have just had it and are expressing that through inconsolable crying,” said Dr. Gelfand. “If this is the case, then doing some of the things that we would do to help a child with migraine could potentially also help a baby with colic,” such as bringing the baby into a quiet, dimly lit room. She also counsels that parents with migraine and a colicky baby may want to keep an eye out for headaches later on, which should prompt a visit to a doctor.\u003c/p\u003e","hed":"If you have migraine headaches, monitor your baby."}]},"topic":{"id":"a513bed0-29a8-11e9-875f-a3eaeb387614","name":"baby","displayName":"Baby"},"type":"GUIDE","isSensitiveContent":false,"theGist":{"hed":"The Gist","content":"\u003cul\u003e\u003cli\u003e\u0026nbsp;All babies cry. If a bottle or a diaper change doesn’t fix the problem, then swaddling, white noise, gentle bouncing or a pacifier may help.\u003c/li\u003e\u003cli\u003eColic is a diagnosis for an otherwise healthy baby with excessive, inconsolable crying, and its cause is not well-understood.\u0026nbsp;\u003c/li\u003e\u003cli\u003eThere are no generally accepted treatments for colic, but limited evidence suggests probiotic drops may work for breastfed babies.\u0026nbsp;\u003c/li\u003e\u003cli\u003eHaving a colicky baby doesn’t mean that you are a bad parent, or that something is wrong with your child. Most babies grow out of it by around 4 months of age.\u0026nbsp;\u003c/li\u003e\u003cli\u003eIf the crying has you at your wits’ end, ask friends or family to give you a break, or leave the infant in a secure place for 20 to 30 minutes while you cool off.\u003c/li\u003e\u003cli\u003eNew research suggests that cases of colic may be related to the bacteria that first colonize the infant’s gut or to having a family history of migraine.\u003c/li\u003e\u003c/ul\u003e"},"summary":"Babies with colic can be incredibly challenging, but thankfully the condition ends on its own.","ignoreInProgramming":false,"whenToWorry":{"hed":"When to Worry","quickLinkContent":"Here are some signs you may need additional support or medical care.","quickLinkSubhead":"When to ask for help","content":"\u003cp\u003eWhatever the reasons for colic, it’s an incredibly stressful time, and parents should monitor their own mental health. Parents of colicky babies have higher rates of anxiety, \u003ca href=\"https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1651-2227.2009.01317.x\" target=\"_blank\"\u003epostpartum depression\u003c/a\u003e and sleep deprivation, and are more likely to abuse or \u003ca href=\"https://www.pnas.org/content/109/Supplement_2/17294.long\" target=\"_blank\"\u003eshake their babies\u003c/a\u003e. Relatives, friends and babysitters can provide a much-needed mental break, and postpartum specialists can offer additional therapy and emotional support for struggling parents.\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf you’re about to reach a breaking point, however, it’s O.K. to secure the child in a safe place, like a crib or bassinet, and step out of the room. “I always try to reassure parents that no baby ever died of crying for 20 or 30 minutes,” said Dr. Slack.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAs frustrating as these months can be, take heart: Eventually your wailing monster will turn back into a sweet baby. In the words of Dr. DeBlasio, “It does get better. All the colicky babies eventually calm down.”\u003c/p\u003e"},"promotionalMedia":{"__typename":"Image","id":"SW1hZ2U6bnl0Oi8vaW1hZ2UvMjE3ZTZjNDktYjMwZi01MTcxLTgzODctNjJhYzExNzYzNDkw","imageType":"photo","url":"/imagepages/2019/06/12/multimedia/colic.html","uri":"nyt://image/217e6c49-b30f-5171-8387-62ac11763490","credit":"Getty 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Baby?","subHeadline":"","__typename":"CreativeWorkHeadline"},"previouslyPublishedUrl":"https://web.archive.org/web/20190621070458/https://www.nytimes.com/2019/06/03/parenting/how-often-should-i-bathe-my-baby.html","updatedAt":"2019-06-12T17:30:24.994Z","slug":"how-often-should-i-bathe-my-baby","bylines":[{"__typename":"Byline","creators":[{"displayName":"Kristi Pahr","__typename":"Person"}]}],"topic":{"displayName":"Baby","id":"a513bed0-29a8-11e9-875f-a3eaeb387614","name":"baby"},"type":"ARTICLE","scoopId":"100000006538402","isSensitiveContent":false,"summary":"Giving baby a bath without harming that delicate skin is one more minefield for new parents to traverse. 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\u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2","name":"health"},"type":"ARTICLE","scoopId":"100000006556783","isSensitiveContent":false,"summary":"It’s not just a condition that affects pregnant women.","ignoreInProgramming":false,"tone":"FEATURE","subHeadline":"","isOak":true,"topics":[{"name":"health","displayName":"Health \u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2"},{"displayName":"Postpartum Health","id":"e7a83c90-2637-11e9-97fe-7118154e1f70","parent":{"name":"health","displayName":"Health \u0026 Wellness","id":"2018d290-29c3-11e9-9d29-fbc9f8b8f8b2"},"name":"postpartum-health"}],"timesTags":[],"publishedStatus":"PUBLISHED","previouslyPublished":false,"section":{"__typename":"Section","name":"parenting","displayName":"Parenting"},"publishedAt":"2019-06-20T10:00:00.000Z","id":"9cb1b040-92d9-11e9-9096-29d7b50a5680","createdAt":"2019-06-19T21:41:07.392Z","creators":["Katherine Zoepf"],"headline":{"default":"Postpartum Pre-eclampsia Can Be Deadly","subHeadline":"","__typename":"CreativeWorkHeadline"},"previouslyPublishedUrl":"https://web.archive.org/web/20190621070458/https://www.nytimes.com/2019/06/19/parenting/postpartum-preeclampsia.html","updatedAt":"2019-06-20T19:57:54.427Z","slug":"postpartum-preeclampsia","bylines":[{"__typename":"Byline","creators":[{"__typename":"Person","displayName":"Katherine Zoepf"}]}],"__typename":"ParentingArticle","promotionalHeadline":"Postpartum Pre-eclampsia Can Be Deadly","promotionalMedia":{"id":"SW1hZ2U6bnl0Oi8vaW1hZ2UvYzJlMjViYWItOGNiOC01OTg0LTg1Y2ItZGIzNWM5ZDgyNTRl","imageType":"photo","url":"/imagepages/2019/06/19/multimedia/20-parenting-preeclampsia-2.html","uri":"nyt://image/c2e25bab-8cb8-5984-85cb-db35c9d8254e","credit":"Ariel 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is Expensive. Here’s How to Bring Down the Cost."},"sources":"\u003cp\u003e\u003ca href=\"https://resolve.org/about-us/our-team/\" target=\"_blank\"\u003eBarbara Collura, president and C.E.O. of RESOLVE: The National Infertility Association\u003c/a\u003e, Dec. 12, 2018\u003c/p\u003e\u003cp\u003eDr. Lucie Schmidt, Ph.D., a professor of economics at\u0026nbsp;Williams College, Dec. 10, 2018\u003c/p\u003e\u003cp\u003eDr. Eric Forman, M.D., the medical and laboratory director of Columbia University’s Fertility Center, Dec. 14, 2018 and Jan. 9, 2019\u003c/p\u003e\u003cp\u003e\u003ca href=\"http://thebrokenbrownegg.org/about/regina/\" target=\"_blank\"\u003eRegina Townsend, blogger at The Broken Brown Egg\u003c/a\u003e and a mother who has used I.V.F., Dec. 12, 2018\u003c/p\u003e\u003cp\u003eJennifer “Jay” Palumbo, author of \u003ca href=\"https://wonderwomanwriter.com/the-2-week-wait-blog/\" target=\"_blank\"\u003eThe Two-Week Wait Blog\u003c/a\u003e and a mother who has used I.V.F., Dec. 14, 2018\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://www.fertstert.org/article/S0015-0282(16)62849-2/abstract\" target=\"_blank\"\u003eOptimizing Natural Fertility: A\u0026nbsp;Committee Opinion\u003c/a\u003e,” Fertility and Sterility, January 2017\u003c/p\u003e\u003cp\u003e\u0026nbsp;“\u003ca href=\"https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/ethics-committee-opinions/disparities_in_access_to_effective_treatment_for_infertility_in_the_us-pdfmembers.pdf\" target=\"_blank\"\u003eDisparities in Access To Effective Treatment For Infertility in the United States: An Ethics Committee Opinion\u003c/a\u003e,” American Society for Reproductive Medicine, September 2015\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0022534713053305\" target=\"_blank\"\u003eOut-of-Pocket Fertility Patient Expense: Data from a Multicenter Prospective Infertility Cohort\u003c/a\u003e,” The Journal of Urology, 2014\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://www.fertstert.org/article/S0015-0282(14)01367-3/pdf\" target=\"_blank\"\u003eAssisted Reproduction Policies in Israel: ARetrospective Analysis of In Vitro Fertilization–Embryo Transfer\u003c/a\u003e,” Fertility and Sterility, 2014\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2478204\" target=\"_blank\"\u003eLive-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles,\u003c/a\u003e” JAMA, 2015\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://journals.sagepub.com/doi/abs/10.1258/jhsrp.2012.011166\" target=\"_blank\"\u003eHow Long Should Women Persevere with I.V.F.?\u003c/a\u003e,” Journal of Health Services and Research Policy\u003cstrong\u003e, \u003c/strong\u003eApril 2012\u003c/p\u003e\u003cp\u003e\u003ca href=\"https://link.springer.com/article/10.1007/s13524-011-0078-4\" target=\"_blank\"\u003e\u003cstrong\u003e“\u003c/strong\u003eUtilization of Infertility Treatments: The Effects of Insurance Mandates,”\u003c/a\u003e Demography, 2012\u003c/p\u003e\u003cp\u003e“\u003ca href=\"https://www.aeaweb.org/articles?id=10.1257/aer.20161014\" target=\"_blank\"\u003eHealth Care Access, Costs, and Treatment Dynamics: Evidence from\u0026nbsp;In Vitro Fertilization\u003c/a\u003e,” American Economic Association, 2018\u003c/p\u003e","updatedAt":"2019-06-20T18:23:52.993Z","slug":"ivf-cost","hero":"","body":"\u003cp\u003eI always knew that raising a child would be expensive, but I never knew that trying to have one could be — until I discovered my husband and I needed fertility treatment.\u0026nbsp;\u003c/p\u003e\u003cp\u003eOne of the worst parts of \u003ca href=\"https://parenting.nytimes.com/becoming-a-parent/ivf-treatment?module=editors-picks\u0026amp;action=click\u0026amp;region=3\" target=\"_blank\"\u003ein vitro fertilization\u003c/a\u003e was dealing with the financial burdens it created.\u0026nbsp;\u003c/p\u003e\u003cp\u003eI had partial, limited fertility coverage, which seemed like the worst of both worlds: I had to deal with insurance, but it still did not cover everything. In the four years it took my husband and I to have a baby, I spent countless hours on the phone with insurance companies, pharmacies, doctor’s office billing departments and even shipping companies (“Where are my \u003cem\u003emeds\u003c/em\u003e!”) to understand my coverage, its cost and how to receive what I needed in time for treatment.\u0026nbsp;\u003c/p\u003e\u003cp\u003eNow, after speaking with several fertility experts who deal with finances; an economist studying fertility and insurance; and parents, bloggers and advocates who’ve gone through I.V.F., I’ve discovered some ways to make the financial process a little less painful.\u003c/p\u003e","whatToDo":{"hed":"What To Do","content":[{"hed":"Call your insurance provider before visiting fertility clinics.","content":"\u003cp\u003eBefore you visit a fertility clinic, the first thing to know is whether you have any fertility coverage — and what kind.\u0026nbsp;\u003c/p\u003e\u003cp\u003e“If you have health insurance through your or your partner’s employer, talk to the benefits person and find out exactly what is covered from your health insurance,” said Barbara\u0026nbsp;Collura, president and C.E.O. of Resolve: The National Infertility Association. Collura noted that the exclusions on most full health benefits plan documents are “typically over 100 pages in teeny tiny font.”\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf you have an insurance plan through your state’s exchange, you might have coverage if \u003ca href=\"http://www.ncsl.org/research/health/insurance-coverage-for-infertility-laws.aspx\" target=\"_blank\"\u003eyour state\u003c/a\u003e has mandated fertility coverage. According to the National Conference of State Legislatures, only 14 states require insurance plans to cover infertility, and two — California and Texas — require insurers to \u003cem\u003eoffer\u003c/em\u003e coverage. Though typically, only a small fraction of the cost, such as that of medications, is covered.\u0026nbsp;\u003c/p\u003e\u003cp\u003eIf you do have fertility coverage, ask your insurance coordinator these questions:\u003c/p\u003e\u003cul\u003e\u003cli\u003eAre initial consultations covered — and if so, how many? (This may help you determine whether you can visit several clinics before choosing one.)\u0026nbsp;\u003c/li\u003e\u003cli\u003eDoes insurance cover diagnostic testing? While I.U.I. or I.V.F. procedures might not be covered, your blood work and ultrasound monitoring may be.\u003c/li\u003e\u003cli\u003eAre medications covered, and do they need to be from a special pharmacy?\u003c/li\u003e\u003cli\u003eWhich treatments are covered? Are both intrauterine insemination and I.V.F. included in coverage?\u0026nbsp;\u003c/li\u003e\u003cli\u003eIs there a waiting period before qualifying for I.V.F.? Do you first have to try certain treatments, such as I.U.I., for example? (Some insurance companies require a few months of trying to conceive or a number of I.U.I.s before beginning I.V.F.)\u003c/li\u003e\u003cli\u003eIs there a cap on your coverage? Is there a dollar amount, a cycle amount or a lifetime limit?\u003c/li\u003e\u003c/ul\u003e\u003cp\u003eIt may be challenging to get all the answers you need from your insurance company (take down the names of everyone you speak with so you’ll have a paper trail). Once you have chosen a clinic, another good resource is the billing coordinator there, who may be able to provide additional details.\u003c/p\u003e"},{"content":"\u003cp\u003eIt’s difficult to know what treatment will cost before you begin, and pricing can vary depending on where you live. According to the N.C.S.L., the average I.V.F. cycle can cost anywhere from $12,000 to $17,000 (not including medication). With medication, the cost can rise to closer to $25,000. Clinics define an I.V.F. cycle as one egg retrieval and all the embryo transfers that result from that retrieval.\u003c/p\u003e\u003cp\u003eThere are add-ons, including genetic testing of the embryos and surgical procedures (such as sperm extraction or laparoscopy), which can increase the cost of I.V.F. by thousands of dollars.\u003c/p\u003e\u003cp\u003eMost people will require more than one round of treatment, though exactly how \u003cem\u003emany \u003c/em\u003ecycles you’ll need is hard to predict. \u003ca href=\"https://www.fertstert.org/article/S0015-0282(14)01367-3/pdf\" target=\"_blank\"\u003eSome studies\u003c/a\u003e suggest that most women can get by with three; \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/2478204\" target=\"_blank\"\u003eothers \u003c/a\u003esuggest that number may be closer to six.\u003c/p\u003e\u003cp\u003eBut trying for more than one cycle isn’t financially feasible for everyone, said Dr. Lucie Schmidt, Ph.D., a professor of economics at Williams College in Massachusetts. “Some people can afford one cycle on their own, but not two or three,” said Dr. Schmidt, who studies how states’ insurance mandates affect I.V.F. treatment. “Lack of insurance (or less generous insurance) puts additional pressure on women to transfer multiple embryos, which can then lead to costly and risky \u003ca href=\"https://parenting.nytimes.com/pregnancy/twins-multiples\" target=\"_blank\"\u003emultiple births\u003c/a\u003e.”\u003c/p\u003e","hed":"Estimate how much you’ll have to spend."},{"hed":"When you have compiled information about cost, make a financial plan.","content":"\u003cp\u003eAt some point in the process, it’s helpful to set financial and treatment goals with your partner and your doctor. Discuss, for example, how many I.U.I.s you might try before you move on to I.V.F.; and how many I.V.F. cycles you will undergo before considering next steps, such as using an egg donor, a sperm donor or a surrogate. Would you pursue other family-building options, like fostering \u003ca href=\"https://parenting.nytimes.com/becoming-a-parent/adopting-a-child-guide\" target=\"_blank\"\u003eor adoption\u003c/a\u003e? Each progressive step can cost more money, so it’s important to budget for that.\u003c/p\u003e\u003cp\u003e“How will you know when enough is enough?” Collura suggested asking yourself, noting that you should create benchmarks to evaluate and decide on next steps. She said that financing family building is a huge issue for many couples, and if you’re not careful, it can derail your journey and your relationship.\u003c/p\u003e"},{"content":"\u003cp\u003eAlthough fertility treatment can be expensive, it isn’t just for the independently wealthy. People pay for I.V.F. in many different ways, from refinancing their homes to borrowing from family or putting payments on credit.\u003c/p\u003e\u003cp\u003eJennifer “Jay” Palumbo, author of \u003ca href=\"https://wonderwomanwriter.com/the-2-week-wait-blog/\" target=\"_blank\"\u003eThe Two-Week Wait Blog\u003c/a\u003e and a mother who had the first of her two children through I.V.F., won a free cycle from a clinic-sponsored contest. “I was someone who ran out of money to get pregnant. I don’t own a house now because we went through treatment,” said Palumbo. “We were in a very bad place; our whole savings account was empty, it was just … bad.”\u0026nbsp;\u003c/p\u003e\u003cp\u003eThere are other ways to pay for fertility without breaking the bank, though some options are more feasible than others:\u003c/p\u003e\u003cul\u003e\u003cli\u003eSome people start \u003ca href=\"https://www.indiegogo.com/projects/kirk-and-anthony-s-baby-fund--2#/\" target=\"_blank\"\u003esocial media fundraising campaigns\u003c/a\u003e.\u003c/li\u003e\u003cli\u003eOthers move to states with mandated health insurance to get coverage (or find a new job at a company that’s based in a state with mandated coverage).\u0026nbsp;\u003c/li\u003e\u003cli\u003eSome apply \u003ca href=\"https://babyquestfoundation.org/\" target=\"_blank\"\u003efor grants\u003c/a\u003e; which can be based on various factors, like location or income.\u003c/li\u003e\u003cli\u003eYou may also qualify for a clinical study, which you can peruse and sign up for on websites like \u003ca href=\"http://www.clinicaltrials.gov/\" target=\"_blank\"\u003eClinicalTrials.gov\u003c/a\u003e, \u003ca href=\"http://www.centerwatch.com/\" target=\"_blank\"\u003eCenter Watch\u003c/a\u003e\u0026nbsp;or \u003ca href=\"http://www.findmecure.com/\" target=\"_blank\"\u003eFind Me Cure\u003c/a\u003e.\u003c/li\u003e\u003cli\u003eSome clinics \u003ca href=\"https://www.nytimes.com/2017/04/27/nyregion/zhang-fertility-center-lottery.html\" target=\"_blank\"\u003eoffer lotteries\u003c/a\u003e for free cycles or money toward a cycle.\u003c/li\u003e\u003cli\u003eYou can join a \u003ca href=\"https://www.shadygrovefertility.com/affording-care/guarantee-programs/shared-risk-100-refund-program-faq\" target=\"_blank\"\u003eshared risk program\u003c/a\u003e, which offers a bulk number of cycles for a flat fee to qualifying patients – guaranteeing a baby or your money back. Your health and age will usually be considered to qualify for the program. Keep in mind, however, that shared risk programs are a gamble: Many people who qualify might not need the full number of cycles included in a bulk package, and end up spending more than they would have without it.\u003c/li\u003e\u003cli\u003eWith smaller clinics, you can try to negotiate with your doctor or billing department — especially if it’s not your first cycle.\u0026nbsp;\u003c/li\u003e\u003c/ul\u003e","hed":"Figure out how you will pay for treatment."},{"hed":"Acknowledge that you may need breaks.","content":"\u003cp\u003ePeople sometimes take breaks between treatments for financial, physical or emotional reasons.\u0026nbsp;While the quality of the eggs inside your body never improve with time, according to Dr. Eric Forman, M.D., the medical and laboratory director of Columbia University’s Fertility Center, a wait of six months or less can be “safe and reasonable” for many patients.\u003c/p\u003e\u003cp\u003e\"Sometimes insurance changes and it’s preferable to wait for a new plan to be in place,\" said Dr. Forman. Other people may need a break for medical reasons, or to take a vacation they planned before the embryo transfer. \"Sometimes people just need a break and can emotionally recharge for another attempt after a couple of months,” said Dr. Forman.\u003c/p\u003e\u003cp\u003eIt took Regina Townsend, a librarian in Chicago, more than seven years to have a baby. Townsend started trying to conceive at 25, but because of several health issues — including polycystic ovarian syndrome, hyperthyroidism, blocked fallopian tubes and Type 2 diabetes — her reproductive journey was complex. To make matters worse, her husband had his own suite of fertility issues, and their insurance coverage was spotty. She wrote about her experience on \u003ca href=\"http://thebrokenbrownegg.org/about/regina/\" target=\"_blank\"\u003eThe Broken Brown Egg\u003c/a\u003e, a website she founded to increase awareness of African-American infertility and reproductive health.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAccording to \u003ca href=\"https://www.fertstert.org/article/S0015-0282(18)31814-4/fulltext\" target=\"_blank\"\u003ea study\u003c/a\u003e published in the journal Fertility and Sterility in 2018, it can take African-American women a year longer to seek infertility treatment, and treatment can be 14 percent less successful than it is for white patients.\u003c/p\u003e\u003cp\u003eTownsend said that she and her husband would try I.V.F. for about six months, then something would come up that would force them to take a break. “I lost my job, or he lost his job, or we didn’t have insurance, then our clinic wouldn’t take our insurance,” Townsend said.\u003c/p\u003e\u003cp\u003eThey finally had their son. “This whole journey of trying to become parents is exhausting,” she said.\u003c/p\u003e"}]},"topic":{"name":"becoming-a-parent","displayName":"Becoming a Parent","id":"d5410970-29a6-11e9-855f-9f464a5733a7"},"type":"GUIDE","isSensitiveContent":false,"theGist":{"hed":"The Gist","content":"\u003cul\u003e\u003cli\u003eIn vitro fertilization is covered by some, but not all, insurance plans. Call your insurance provider right after you’ve been diagnosed with infertility to understand exactly what’s covered.\u003c/li\u003e\u003cli\u003eIt’s difficult to know at the outset how much your fertility treatments will cost. If you make a fertility plan, saying, we’d do X amount of intrauterine inseminations (when a doctor injects sperm directly into the uterus) and Y number of I.V.F. cycles, it can help you get a better sense of the cost from the start.\u003c/li\u003e\u003cli\u003eThere are ways to raise money for your treatment, including applying for grants, participating in research studies or even starting a social media campaign (if you’re comfortable). You can also try negotiating directly with your clinic to bring down costs.\u0026nbsp;\u003c/li\u003e\u003cli\u003eSome companies and consultants can deal with insurance on your behalf, and even offer monthly payment plans for treatment.\u0026nbsp;\u003c/li\u003e\u003cli\u003eLower-income families and women of color tend to have less access to fertility treatments than white women or those who are more affluent.\u003c/li\u003e\u003c/ul\u003e"},"summary":"Many insurance companies don’t cover I.V.F. But there are ways to ease the financial burden.","ignoreInProgramming":false,"whenToWorry":{"quickLinkSubhead":"When to ask for help","content":"","hed":"When to Ask for Help","quickLinkContent":"Here are some signs you may need additional support or medical care."},"topics":[{"name":"becoming-a-parent","displayName":"Becoming a Parent","id":"d5410970-29a6-11e9-855f-9f464a5733a7"},{"displayName":"Infertility","id":"fbca9b60-29a6-11e9-b7b3-2bcd82e5c220","parent":{"name":"becoming-a-parent","displayName":"Becoming a Parent","id":"d5410970-29a6-11e9-855f-9f464a5733a7"},"name":"infertility"}],"author":{"name":"Amy Klein","bio":"\u003cp\u003eAmy Klein wrote the \u003ca href=\"https://parenting.blogs.nytimes.com/author/amy-klein/?_r=0\" target=\"_blank\"\u003eFertility Diary\u003c/a\u003e column from 2013 to 2015 for Motherlode, a New York Times blog. She is the author of “\u003ca href=\"https://www.penguinrandomhouse.com/books/600470/the-trying-game-by-amy-klein/\" target=\"_blank\"\u003eThe Trying Game: How to Get Pregnant and Survive I.V.F. 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