Kids A2Z - How to: Tell your boss you're pregnant, make a birth plan & more

how to... tell your boss you’re pregnant

Your boss may not make the top 10 list of people you want to tell about your pregnancy, but maybe she should.

“Everyone agrees: Your boss should not be the last to know,” advises Dr. Marjorie Greenfield of University Hospitals and author of The Working Woman’s Pregnancy Book.

When to share the news is another question.

Women who encounter dangerous situations or toxic substances, think police officers and veterinarians, may wish to speak up immediately, advises Greenfield. Others, like the ad exec Greenfield interviewed who was excluded from new projects after revealing her pregnancy, might want to wait as long as possible.

When you’re ready, schedule a meeting with your boss, but be prepared. “You might not get a totally happy reaction,” says Greenfield. “They’re looking through the lens of what it means to the company.”

You should be ready to discuss how you’ll fit in doctor’s appointments, what will happen during your maternity leave, and — the kicker — whether you’re coming back.

“If you’re not sure, say ‘I intend to come back,’ ” says Greenfield. “But when you lie by saying you’re coming back, you do a terrible disservice to the women who will come behind you.”

how to... make a birth plan

Entering the hospital in active labor is not the time to start making your birthing preferences known to your delivery team. Instead, take the time early in your pregnancy to create a birth plan that expresses the experience you want and discuss it with your doctor or midwife, suggests Dr. Elisa Ross, an ob-gyn at Hillcrest Hospital.

Ross points her patients to the worksheet available at, which walks expectant parents through such choices as:
  • Who should be in the delivery room
  • What pain relief, interventions or monitoring frequency you prefer (46 percent of respondents to Cleveland Magazine’s pregnancy poll planned for a natural birth, even if they kept their options open)
  • How you’re planning to feed
“The birth plans that work well have the words ‘if possible’ in them a lot,” Ross says.

Even if natural childbirth is your preference, Ross recommends including a code word in your birth plan to use during delivery if your pain preferences change.

how to... kick-start successful breast-feeding

The groundwork for successful breast-feeding is laid immediately after delivery, says Dr. Ann Witt of Breastfeeding Medicine of Northeast Ohio. But moms may have to speak up to take

“Often, in that first hour after birth, babies are taken away for pictures or to be cleaned,” says Witt, the region’s only lactation-focused pediatrician. “Moms have to be protective of that time and spend as much of it as they can skin-to-skin.”

There’s a move afoot nationally to make hospitals more “baby friendly,” says Witt, led by the Baby Friendly Hospital Initiative, which certifies hospitals according to criteria such as initiating breast-feeding in the first hour of life and restricting use of pacifiers.

No Northeast Ohio hospitals have achieved the certification, but Witt advises selecting a breast-feeding-supportive ob-gyn, family physician and pediatrician to increase your odds of success.

“The more educated and aware you are, the better,” Witt says.

how to... survive the baby (and pre-baby) blues

Plenty of new moms and their partners watch for signs of postpartum depression.

But according to Dr. Sheryl Kingsberg, chief of behavior medicine at University Hospitals Case Medical Center, depression during pregnancy is just as common.

“All the hormones that occur with pregnancy and postpartum put women at risk,” Kingsberg says. “Since many women haven’t heard of pregnancy-related depression, they either ignore it, or they feel guilty about being a ‘bad mom.’ ”

To distinguish between true depression and a bad mood, Kingsberg recommends new or expectant moms score themselves on the Edinburgh Postnatal Depression Scale, easily found online
(, and talk to their ob-gyn about how they’re feeling.

Gone untreated, says Kingsberg, pregnancy-related depression and postpartum depression can have negative consequences for mother and child. “Untreated depression has a huge impact on the long-term development of babies and children,” she says. “These women don’t necessarily cry all day, but they’re flat, and it’s critical that infants have that eye contact, cooing, smiling, that attachment with a positive primary caretaker.”

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