I have a fascinating conversation with Pat Keating, a registered nurse and childbirth educator, about the trends she has seen over the last 37 years around childbirth, breastfeeding, and preparing for a baby. We discuss how women and couples prepare for a baby, through childbirth education, birth planning, and internet resources. About half of pregnancies in the United States are not planned, and we discuss how the optimal situation would allow women to begin thinking about their reproductive health plan far in advance of a pregnancy to prepare physically, emotionally, and financially for a baby.