By Hilda Hutcherson| September 4, 2020
"Often misunderstood and misdiagnosed, PCOS can play havoc with your fertility. Here’s how to recognize the symptoms and take action to protect your reproductive health."
"Caroline’s mother was concerned when she turned 15 and hadn’t had her first period. It finally came, but it wasn’t until three months later that she’d get her second. Her gynecologist assured her that irregular periods were common for someone her age, so Caroline’s mother didn’t worry. Then, at 18, her periods disappeared for six months. This time, her college ob-gyn said that the stress of college often causes menstrual periods to wane, and that the best treatment was hormonal therapy to make her periods regular. So she started taking birth control pills.
Thirteen years later, she was ready to have a baby and stopped taking them, assuming that since she was older and not under as much stress, her periods would become more regular. But they didn’t. She also noticed increased acne and facial hair. After six months of trying unsuccessfully to conceive, she started taking her temperature and using an ovulation predictor kit. Both revealed that she was ovulating infrequently and irregularly. The question was why?
Many women with irregular periods are told it’s no big deal. Even her acne and facial hair didn’t throw up a red flag. Fortunately, tests eventually led to an accurate diagnosis: she had polycystic ovary syndrome (PCOS), a hormonal disorder that disrupts women’s fertility and may cause a host of other health issues. As many as 15 percent of women between 18 and 45 have PCOS, making it the most common hormonal disorder among women of childbearing age.
For this guide, I reviewed the current literature and interviewed Beth Rackow, M.D., a reproductive endocrinologist and director of the pediatric and adolescent gynecology program at Columbia University Irving Medical Center.
What to do:
Know the signs and symptoms
Polycystic ovary syndrome is a common hormonal disorder among women, yet often goes underdiagnosed by health care providers. Some women have few, if any, symptoms. Others have many — irregular or absent periods, excess facial or body hair growth (hirsutism), obesity and infertility — but they may be mistaken as signs of other health conditions.
Irregular, unpredictable periods are one important symptom. Periods may come twice a month, be infrequent (greater than 35 days apart) or disappear for months at a time. They may be light or they may be heavy enough to cause anemia. You may suspect PCOS if you also have acne that doesn’t respond to treatment or increased growth of facial or body hair. These are signs of excess androgen hormone. Eighty percent of women with hirsutism have PCOS.
PCOS may appear as early as adolescence. “Girls with PCOS typically present when they haven’t had their first period when they should have, their periods are very infrequent or they are having frequent, heavy periods,” said Dr. Rackow.
It’s common for menses to be irregular in girls during the first year or two after the first period. Acne is also common during adolescence. However, if menstrual periods continue to be abnormal after the first two years, or if bleeding is persistently heavy at any time, an evaluation is needed."
By: Ellen S. Glazer, LICSW| February 4, 2020
Most anyone who has struggled with secondary infertility knows that it is an incredibly lonely experience. You may be blessed with one or two children — possibly more — but struggling to expand or complete your family. Surrounded by families with young children, you find yourself alone and in pain.
If you are a veteran of primary infertility, you may remember strategies you developed for shielding yourself from the pregnancies of others. Not so this second time around: pregnant women and moms with babies and toddlers surround you at preschool.
If you had your first child with ease and are new to infertility, you may feel even less equipped to deal with seemingly limitless fecundity. Primary infertility prepared your fellow travelers for the envy, anger, sadness, isolation, and awkwardness it brings. For you these feelings are new, and along with them comes the guilt of secondary infertility: “Why can’t I be happy with the child I have?” Today we’ll focus on ways you can cope with secondary infertility.
The first few steps to coping with secondary infertility
Seek good medical care. If you went through primary infertility, you know the ropes of the world of reproductive medicine. However, if this is all new to you, do not delay in seeking expert help. There is a lot to learn in reproductive medicine. Beginning to understand it may help you feel that you have some control of your situation. Don’t be reluctant to seek a second and even a third opinion — you will learn from each consult, and talking with a few physicians can help land you in the right place.
Try to avoid self-blame. It is tempting to blame yourself. You are a likely target if you feel you waited too long to have a second child, or perhaps blame yourself for not having your first child sooner. If you have two or more children and are struggling to complete your family, you may accuse yourself of greed. Another form of self-blame comes when parents feel they are being punished for not fully appreciating or enjoying the child they have, or worse still, being “bad” parents.
Take charge of the message. Although many people choose to have one child and feel confident with “one and done,” there is often the assumption that a family means two or more children. As a parent of one child, you are likely to frequently encounter the following questions: “Is she your only child?” or “Are you going to have more?”
It helps to figure out a short, direct, and containable message to give anyone who asks about family size. Something like, “We’re hoping to have a larger family, but it’s not been easy for us.” Or “___ is our first child, but we are hoping he/she will have a sibling before too long.”
Additional ways to cope with secondary infertility
Try not to focus on age. Many parents think a lot about the spacing of their children. Secondary infertility derails plans for ideal spacing — whatever that may mean to you. My advice to people is blunt: let it go. I remind clients that close or distant relationships with siblings are not defined by spacing. All of us know adults who cherish their sister or brother 10 or 15 years their junior, but argue constantly with the sibling who is within two years of their age.
By Nina Lakhani in New York| Mon 17 Aug 2020 16.47 EDT
"Black babies have a greater chance of survival when the hospital doctor in charge of their care is also black, according to a new study.
In the US, babies of color face starkly worse clinical outcomes than white newborns.
Earlier research from the Centers for Disease Control and Prevention (CDC) published last year shows that black babies are more than twice as likely to die before reaching their first birthday than white babies, regardless of the mother’s income or education level.
While infant mortality has fallen overall in the past century thanks to improvements in hygiene, nutrition and healthcare, the black-white disparity has grown.
Multiple interrelated factors which contribute to these disparities include structural and societal racism, toxic stress and cumulative socioeconomic disadvantages.
The new study published in the Proceedings of the National Academy of Sciences suggests the race of the attending doctor also plays an important role.
Researchers reviewed 1.8m hospital birth records in Florida from 1992 to 2015, and established the race of the doctor in charge of each newborn’s care.
When cared for by white doctors, black babies are about three times more likely to die in the hospital than white newborns.
This disparity halves when black babies are cared for by a black doctor.
Strikingly, the biggest drop in deaths occurred in complex births and in hospitals that deliver relatively more black babies, suggesting institutional factors may play a role.
The study found no statistically significant link between the risk of maternal mortality – which is also much higher for black and brown women – and the race of the mother’s doctor.
Why race concordance is so important in black infant mortality requires further research, but it may enhance trust and communication between doctor and mother, and black doctors may be more attuned to social risk factors and cumulative disadvantages which can impact neonatal care, according to Brad Greenwood, lead author from George Mason University in Virginia.
Unconscious racism among white doctors towards black women and their babies may also be at play.
For white newborns, the race of their doctor makes little difference to their chances of survival.
Despite the stark findings, black women seeking a black doctor to minimize the risk to their babies will struggle as the medical workforce remains disproportionately white. Only 5% of doctors are black, according to the Association of American Medical Colleges."
By Tara Haelle| August 16, 2020
"It was the end of the world as we knew it, and I felt fine. That’s almost exactly what I told my psychiatrist at my March 16 appointment, a few days after our children’s school district extended spring break because of the coronavirus. I said the same at my April 27 appointment, several weeks after our state’s stay-at-home order.
Yes, it was exhausting having a kindergartener and fourth grader doing impromptu distance learning while I was barely keeping up with work. And it was frustrating to be stuck home nonstop, scrambling to get in grocery delivery orders before slots filled up, and tracking down toilet paper. But I was still doing well because I thrive in high-stress emergency situations. It’s exhilarating for my ADHD brain. As just one example, when my husband and I were stranded in Peru during an 8.0-magnitude earthquake that killed thousands, we walked around with a first aid kit helping who we could and tracking down water and food. Then I went out with my camera to document the devastation as a photojournalist and interview Peruvians in my broken Spanish for my hometown paper.
Now we were in a pandemic, and I’m a science journalist who has written about infectious disease and medical research for nearly a decade. I was on fire, cranking out stories, explaining epidemiological concepts in my social networks, trying to help everyone around me make sense of the frightening circumstances of a pandemic and the anxiety surrounding the virus.
I knew it wouldn’t last. It never does. But even knowing I would eventually crash, I didn’t appreciate how hard the crash would be, or how long it would last, or how hard it would be to try to get back up over and over again, or what getting up even looked like.
In those early months, I, along with most of the rest of the country, was using “surge capacity” to operate, as Ann Masten, PhD, a psychologist and professor of child development at the University of Minnesota, calls it. Surge capacity is a collection of adaptive systems — mental and physical — that humans draw on for short-term survival in acutely stressful situations, such as natural disasters. But natural disasters occur over a short period, even if recovery is long. Pandemics are different — the disaster itself stretches out indefinitely.
“The pandemic has demonstrated both what we can do with surge capacity and the limits of surge capacity,” says Masten. When it’s depleted, it has to be renewed. But what happens when you struggle to renew it because the emergency phase has now become chronic?"
Reviewed by: Lisa Hollier, MD, MPH, FACOG, Baylor College of Medicine, Houston, Texas
"Please note that while this is a page for patients, this page is not meant to give specific medical advice and is for informational reference only. Medical advice should be provided by your doctor or other health care professional."
"What is COVID-19?
COVID-19 is a new illness that affects the lungs and breathing. It is caused by a new coronavirus. Symptoms include fever, cough, and trouble breathing. It also may cause stomach problems, such as nausea and diarrhea, and a loss of your sense of smell or taste. Symptoms may appear 2 to 14 days after you are exposed to the virus. Some people with COVID-19 may have no symptoms or only mild symptoms.
How does COVID-19 affect pregnant women?
Researchers are still learning how COVID-19 affects pregnant women. A report released in June 2020 looked at whether pregnant women might be at increased risk of getting very sick from COVID-19. This report from the Centers for Disease Control and Prevention (CDC) notes that:
How can COVID-19 affect a fetus?
Remember that researchers are learning more about COVID-19 all the time. Some researchers are looking specifically at COVID-19 and its possible effects on a fetus. Here’s what they know now:
What should pregnant women do to avoid the coronavirus?
Pregnant women should take steps to stay healthy, including:
Should pregnant women wear a mask or face covering?
As of April 3, the CDC says all people, including pregnant women, can wear a cloth face covering when they are in public to slow the spread of COVID-19. Face coverings are recommended because studies have shown that people can spread the virus before showing any symptoms. See the CDC’s tips on making and wearing a face covering.
Wearing a cloth face covering is most important in places where you may not be able to stay 6 feet away from other people, like a grocery store or pharmacy. It also is important in parts of the country where COVID-19 is spreading quickly. But you should still try to stay at least 6 feet away from others whenever you leave home.
If you have COVID-19 or think you may have it, you should wear a mask while you are around other people. You also should wear a mask if you are taking care of someone who has COVID-19 or has symptoms. You do not need to wear a surgical mask or medical-grade mask (N95 mask).
How will COVID-19 affect prenatal and postpartum care visits?
It is important to keep your prenatal and postpartum care visits. Call your obstetrician–gynecologist (ob-gyn) or other health care professional to ask how your visits may be changed. Some women may have fewer or more spaced out in-person visits. You also may talk more with your health care team over the phone or through an online video call. This is called telemedicine or telehealth. It is a good way for you to get the care you need while preventing the spread of disease.
If you have a visit scheduled, your care team’s office may call you ahead of time. They may tell you about telemedicine or make sure you do not have symptoms of COVID-19 if you are going in to the office. You also can call them before your visits if you do not hear from them."
By Cassie Shortsleeve| July 14, 2020
"Six weeks after I gave birth to my first daughter, I found myself in my OB/GYN’s office for my postpartum checkup. After a quick conversation and a physical exam, my doctor told me that I was “cleared.” I could resume all regular pre-pregnancy activity.
I went home, fed my baby and went on a run — and had to stop after a half-mile. My pelvic floor felt like it was going to give out and — although once an avid runner — I felt clumsy. That night, I lay awake, milk-stained and sweaty. Nothing about me felt “cleared.”
Despite the fact that in 2018, the American College of Obstetricians and Gynecologists recommended that, to optimize women’s health, postpartum care should become more of a rolling process rather than a single encounter, for many new moms, the six-week postpartum appointment remains the only touch point with the health-care system that birthed her baby.
If Latin America has la cuarentena — a 40-day period when women take care of a new mom while she rests — and the ancient Indian medical system of ayurveda teaches us that we must nurture women for 42 days postpartum for the health of her next 42 years, the United States, traditionally, has this: one lone appointment that, in many senses, gives a message of closure to the fragile and monumental postpartum period.
"The four- to six-week time frame has historically been thought to be enough time for women to be able to go back to do more physically demanding jobs, like farming, without having any serious medical issues,” explains Heather Irobunda, a board-certified OB/GYN in New York. Your uterus has usually shrunk back to a pre-pregnancy size, lacerations have healed, soreness from birth has resolved.
But physical changes persist for longer — probably six months or so, says Kecia Gaither, director of perinatal services at NYC Health+Hospitals/Lincoln. Around then, pelvic floor and abdominal musculature tone returns, changes in hair normalize, and the menstrual cycle might become more regular (if it’s returned).
Some research even suggests women wait 12 months to conceive again. But how long does it take for the body to recover? It depends on where you look.
The Centers for Disease Control and Prevention, for one, says that a “pregnancy-related” death is a death of a woman while pregnant or within one year of the end of pregnancy, but “maternal mortality” is defined by the World Health Organization as the death of a woman while pregnant or within 42 days of the end of pregnancy.
The Diagnostic and Statistical Manual of Mental Disorders, often called the “bible” of psychiatric health conditions, defines postpartum depression as depression “with postpartum onset: defined as within four weeks of delivering a child.” But, says Cindy-Lee Dennis, a professor at the University of Toronto who studies the postpartum period, “it’s fairly standard in the research literature to consider postpartum depression up to one year postpartum.” (Take a landmark 2013 study published in JAMA Psychiatry of 10,000 mothers: It found that 1 in 7 women develop PPD within the first year postpartum.)
Birdie Gunyon Meyer, a registered nurse and director of certification for Postpartum Support International, a nonprofit group that lobbied to extend the period following delivery in the definition of PPD, says: “I don’t think anybody really believes that the postpartum period is over at four or so weeks, but we give that impression when you come in for your four- or six-week checkup."
The truth is, the adjustment to parenthood takes time. It takes more than a couple of weeks and more than a couple of months. Researchers say Year 1 is critical for children and parents alike. “For the child, the brain is growing rapidly and the experiences that happen and the neurological pathways that are developed stay with the child for a lifetime,” says Dennis."
"When my wife miscarried, I was alone in my mourning"
By Charles Feng| July 22, 2020
"Three years ago, my wife, daughter and I took a photo shivering on a beach amid the howling autumnal wind. Last year, for 11 glorious, anticipatory weeks, while my wife was pregnant, I planned to update the picture at the same location with a new baby in tow.
But that plan was abruptly upended when we had a miscarriage. Now that picture that sits on our mantel would still be just the three of us, squinting into the camera, buttressing one another against the cold.
The miscarriage itself lasted only a few hours. But the self-recrimination lingered long afterward because I wasn’t sure how to grieve when my wife’s emotional response seemed more important. When I searched online, women’s perspectives abounded on websites, in YouTube videos and in news articles, but men’s perspectives were scarce. Academic research was little better. A pattern emerged: Although there is a spotlight on Mom’s emotions and well-being during a miscarriage, Dad’s experiences are rarely discussed.
The pregnancy for our first daughter went smoothly. So, when my wife found out about our second pregnancy, we told family members and friends immediately after finding out, around the two-month mark. This meant that when the miscarriage occurred, we had to backtrack and explain to everyone what had happened, in painful conversations.
My wife’s friends, mostly women, showered her with messages and flowers. On the other hand, for the few friends, all men, I contacted, the comments ranged from the trite (“Sorry, that sucks”) to the callous (“Gotta try again!”) to, well, silence. My best friend, with the best of intentions, emailed my wife his condolences but excluded me.
Eventually, another friend who had recently experienced two miscarriages carved out some time to chat over dinner.
“How are you feeling, buddy?” he asked.
“Okay,” I said.
“Tough as it seems right now, it does get better with time.”
“Good to know.” I felt like a sullen teenager.
“You know, while discussing miscarriages is in general taboo, for men it seems especially so,” he said.
The entire arc of the miscarriage, from conception to loss, occurs within the female body. Aside from contributing sperm, I felt like a bystander. I was traveling when my wife watched the double pink lines appear on the pregnancy test. She occasionally saw the obstetrician on her own and started organizing the baby’s room without my input. I had an ancillary role in the pregnancy, so I wasn’t sure I even had a right to feel devastated.
The event itself is permanently etched in my psyche. Throughout the night, my wife had unremitting abdominal pain. I was asleep when she barged through the door from the bathroom.
“The baby’s gone,” she said through tears.
“I’m so sorry,” I said. I got up and hugged her. “What should we do now?”
“I don’t know.”
My wife went to the obstetrician, while I stayed home with our 2-year-old daughter.
After a sushi lunch — no longer pregnant, my wife could eat raw fish again — we dropped our daughter off at my parents’ house. To distract ourselves, we caught an animated movie. That evening, we drove to a deserted parking lot at the local elementary school. I shut off the car ignition and let the jazz radio buzz in the background. I held my wife’s hand as we stared into the darkness. We talked about the movie but little else.
The next day I was back at work.
The best thing I could do was to just be with her. I felt like I didn’t have a right to express my despair, so I actively suppressed my emotions. My wife needed to lean on me, so I became a stoic, unperturbable oak tree for her. According to a study published this year, after a miscarriage, men have described themselves, in supporting their wives, as “rocks, guards and repair men.” We adhere to traditional notions of masculinity, of being steady and capable, and never, ever succumbing to emotions."
By Sneha Kohli Mathur, CNN| August 28, 2020
"Nima Bhakta was that college friend who everyone knew would be a great mother.
We met in 2006, and I could see that she was always at ease when she interacted with children.
Kind and confident, she was also the friend who talked about how excited she was to have children of her own.
That's why it was such a devastating loss to her family, friends and to me, when she lost her battle with postpartum depression and died by suicide on July 24. Suicide is one of the leading causes of death in women with postpartum depression.
In a letter to her family before she died, Nima wrote that she tried to tell her loved ones about her struggle with postpartum depression but she hadn't been able to find the words to explain the depth of her suffering. She wrote that she had a loving and supportive husband and that no one was at fault for her pain.
It started, she wrote, after her son was born in 2019. She felt completely changed as an individual, wife, sister, daughter and aunt, and she didn't understand how she couldn't even attempt cooking or other things that she once enjoyed.
Her constant worry about the future and self-blame for any difficulties with her son overwhelmed her. She got to the point that she believed that she was a complete failure as a mother and was scared that she would cause him harm in the future. Throughout her letter was a sense of shame for needing help taking care of her son, and guilt that she wasn't feeling better despite having an incredibly supportive husband, Deven Bhakta, and her sisters and family.
In her text messages to me she expressed she was experiencing postpartum depression. "Everything I do for Keshav just seems like a task for me, it's been hard to have that bond between me and him. Really didn't expect all this since I love kids but with Keshav I've been struggling. I haven't been out of the house either unless it's for a doctor appointment, it's pretty bad. Deven's been such a big help it's ridiculous."
She couldn't see what a wonderful mother she was to her beautiful baby boy. I saw her as a devoted mother diligently attending to all of his daily needs. I could see she loved him so much.
How did a mother who didn't have any of the risk factors for PPD -- factors that include a personal or family history of depression and lack of social support -- still succumb to it? It can be harder for Indian women like us to ask for psychological help because these issues are not always discussed in our community, but there are other reasons women suffer from this misunderstood condition.
What is postpartum depression?
During pregnancy and in the hours after childbirth, women experience a dramatic drop in their estrogen and progesterone hormone levels, and that fluctuation is thought to contribute to postpartum mental health problems, according to the American College of Obstetricians and Gynecologists.
In addition to the changes in hormones, emotional factors, fatigue and general life stressors may contribute to PPD, experts say. Postpartum depression may begin in the days or weeks following childbirth, or it may begin months later, and it can last weeks, months or years if untreated.
While the experience of PPD can look different for each woman, common symptoms include a loss of pleasure or interest in doing things she once enjoyed; eating and sleeping much more or much less than usual; experiencing panic attacks or anxiety most or all of the time; feelings of guilt, worthlessness and self-blame; sadness or crying uncontrollably; fear of not being a good mom; fear of being alone with the baby or disinterest in the baby; difficulty making decisions; and thoughts of hurting oneself or the baby.
Postpartum depression is not the so-called "baby blues," which 70% to 80% of all moms experience, according to the American Pregnancy Association.
While baby blues may begin soon after birth, its symptoms -- which can include crying for no apparent reason, anxiety, insomnia and mood changes -- should dissipate two weeks after childbirth. If they continue past two weeks, mothers should be examined for postpartum depression."
"Do you ever feel like you’re not doing enough as a parent? Like you might be totally screwing this up and maybe even making things worse for your kids? We’re right there with you. Parenting was already hard, and now we're navigating a pandemic on top of it.
In this webinar, we’ll talk about the self-doubt, anxiety, and uncertainty that has come with pandemic parenting. We’ll also share what the research says about “good enough’ parenting, especially in times of crisis. We’ll be joined by guest, Dr. Sharon Lamb, psychologist and author of The Not Good Enough Mother. Agata Freedle will serve as moderator to guide our conversation and pose questions that you submit.
Join us on Zoom at 9 p.m. Eastern Time for this free webinar."
By Josie Cox| July 30, 2020
"As the epicenter of Covid-19 continues to drift around the globe, leaving death and depression in its wake, it’s become increasingly difficult for even the most naive to defend a whimsical assertion favored by the privileged in the early days of the pandemic. Coronavirus is not a great leveller. It never was.
Data made available to The New York Times earlier this month shows that Latino and African-American residents of the U.S. are three times as likely to become infected as their white neighbors. Black and Latino people are almost twice as likely to die from it.
Other figures show that states with the highest level of income inequality have had a larger number of Covid-19-related deaths than states with lower inequality. And the gender divide is marked too.
As the epicenter of Covid-19 continues to drift around the globe, leaving death and depression in its wake, it’s become increasingly difficult for even the most naive to defend a whimsical assertion favored by the privileged in the early days of the pandemic. Coronavirus is not a great leveller. It never was.
Data made available to The New York Times earlier this month shows that Latino and African-American residents of the U.S. are three times as likely to become infected as their white neighbors. Black and Latino people are almost twice as likely to die from it.
Other figures show that states with the highest level of income inequality have had a larger number of Covid-19-related deaths than states with lower inequality. And the gender divide is marked too.
Almost half of all mothers surveyed felt “rushed and pressed for time” more than half of the time during the lockdown, and 46% felt nervous and stressed more than half of the time. Only 15% of mothers said they had managed to set clear boundaries between work and family, largely on account of the closure of schools and childcare facilities.
“It is clear that parents in particular need more support during school and childcare closures,” says Dr Heejung Chung of Kent’s School of Social Policy, Sociology and Social Research, who led the study.
“There are signs that the increased workload and conflict between work and family has negatively impacted parents’ mental wellbeing, especially mothers,” she adds. “We need a thorough gendered analysis on the economic impact of the lockdown and more resources and policies are needed to support parents especially mothers' labor market attachments.”
Biggest Setback in a Decade
This research adds to reams of existing evidence underscoring the extent to which the pandemic has chipped away at hard-earned progress towards both greater gender equality and women’s economic rights, while exacerbating an already terrifying mental health crisis.
Sofia Sprechmann, Secretary-General of humanitarian agency Care International, recently described Covid-19 as the biggest setback to gender equality in a decade. Research conducted by McKinsey has revealed that women’s jobs are 1.8 times more vulnerable to this crisis than men’s. The consultancy concluded that because of Coronavirus’ “regressive effect on gender equality”, global GDP growth could be $1 trillion lower in 2030 than it would be if women’s unemployment simply tracked that of men in each sector."
By: Catherine Pearson| July 14, 2020
"We're facing a year without precedent in modern parenthood. So why do we feel...so detached?"
"When the pandemic first hit New York City in March, abruptly closing my boys’ school and daycare, I was a wreck.
I was terrified of my kids getting sick. I was so anxious sitting in bed at night, listening to sirens scream past my window down the Brooklyn-Queens Expressway, I’d lose my breath. Then sometimes, I’d have moments of delirious happiness: My family was safe and hanging out together at, like, 11 a.m. on a Tuesday. We never do that! It was emotional and logistical chaos all day, every day.
Now, months into this mess, I move through my days feeling basically ... nothing. When I see friends and family (from a safe distance, outdoors, usually wearing a mask) and they ask how I’m doing, I say something like: “We’re good! We’ve kept our jobs, and no one’s been sick. Also, I’m dead inside.”
This is only a partial joke.
The everyday stresses parents are facing now are arguably worse than they were when the virus first emerged. Where I live in New York City, public schools recently announced they’ll likely open for in-person learning between one and three days a week — as though those are remotely similar. I have no idea if my husband and I are sending our older son in. I have zero idea what we’re doing for childcare for our younger kiddo, because I do not see a solution that feels relatively safe and is one we can actually afford. I have no idea how we are going to get through the fall or winter or any part of next year.
But I’m not freaking out; I’m numb.
And I’m not alone.
“After being on high alert for so long, it’s entirely understandable that numbness would set in. No one can sustain a state of emergency for any length of time. We weren’t built that way,” said Olivia Bergeron, who runs Mommy Groove Therapy & Parent Coaching in New York City. “Fight or flight is supposed to be a temporary state to ensure survival, not a permanent way of living.”
By Pooja Lakshmin|July 29, 2020
"While parents may be feeling unsure about school options this fall, there are ways to feel better as you make the tough decision."
"A combination of dread, panic and sheer exhaustion. This is what I see on the faces of patients (and friends and colleagues) when the conversation turns to the most pressing topic on every parent’s mind: what to do about school in the fall. I’m a psychiatrist specializing in women’s mental health, and I have yet to speak to anyone who feels satisfied with the options presented to them, or who feels particularly confident in the choices they’ve made.
The information on children and the coronavirus has been evolving since March, with the most recent data suggesting that children are less likely to become infected by the virus and less likely to have a severe course when infected. But, those words “less likely” suggest that children are at some, albeit smaller, risk. And, the United States still has not come up with an adequate solution to protect teachers, many of whom are high risk.
As I see it, school stress for parents boils down to two main points: Deciding what to do, and then what to do with the uncomfortable feelings that could arise after that decision. As a psychiatrist, I’m admittedly not so helpful when it comes to the decision of whether or not to send your kids to in-classroom learning this fall. Where I can help is how to deal with the uncertainty and difficult feelings that accompany this process.
A risk assessment system, like the one described by Emily Oster, Ph.D., a professor of economics and public policy at Brown University, can be a useful guide when making decisions with scarce data. Instead of focusing on the illusion of “one right answer,” this framework can give you a reliable process for making hard parenting decisions by focusing on evaluating and mitigating risks, and assessing benefits. While no parent is feeling particularly confident about the school options available to them, it is possible to feel good about the process you use to make those decisions.
In an interview, Dr. Oster wrote, “By making clear the choices, the costs and benefits, we can reason our way to better decisions. But I really think even more important is the fact that we can make our way to more confidence in these decisions by articulating a good process.”
Once you’ve delineated a plan, then you’re faced with the task of coping with the onslaught of feelings, like worry, guilt, fear and uncertainty. For this, here are some strategies, many of which come from acceptance and commitment therapy, a form of behavioral therapy that teaches people to accept their difficult thoughts and feelings as opposed to struggling against them, and to prioritize taking actions that are in line with their values."
Elliot Aronson and Carol Tavris|Social Psychologists| July 12, 2020
"The minute we make any decision--I think COVID-19 is serious; no, I’m sure it is a hoax—we begin to justify the wisdom of our choice and find reasons to dismiss the alternative."
"Members of Heaven’s Gate, a religious cult, believed that as the Hale-Bopp comet passed by Earth in 1997, a spaceship would be traveling in its wake—ready to take true believers aboard. Several members of the group bought an expensive, high-powered telescope so that they might get a clearer view of the comet. They quickly brought it back and asked for a refund. When the manager asked why, they complained that the telescope was defective, that it didn’t show the spaceship following the comet. A short time later, believing that they would be rescued once they had shed their “earthly containers” (their bodies), all 39 members killed themselves.
Heaven’s Gate followers had a tragically misguided conviction, but it is an example, albeit extreme, of cognitive dissonance, the motivational mechanism that underlies the reluctance to admit mistakes or accept scientific findings—even when those findings can save our lives. This dynamic is playing out during the pandemic among the many people who refuse to wear masks or practice social distancing. Human beings are deeply unwilling to change their minds. And when the facts clash with their preexisting convictions, some people would sooner jeopardize their health and everyone else’s than accept new information or admit to being wrong.
Cognitive dissonance, coined by Leon Festinger in the 1950s, describes the discomfort people feel when two cognitions, or a cognition and a behavior, contradict each other. I smoke is dissonant with the knowledge that Smoking can kill me. To reduce that dissonance, the smoker must either quit—or justify smoking (“It keeps me thin, and being overweight is a health risk too, you know”). At its core, Festinger’s theory is about how people strive to make sense out of contradictory ideas and lead lives that are, at least in their own minds, consistent and meaningful.
One of us (Aronson), who was a protégé of Festinger in the mid-’50s, advanced cognitive-dissonance theory by demonstrating the powerful, yet nonobvious, role it plays when the concept of self is involved. Dissonance is most painful when evidence strikes at the heart of how we see ourselves—when it threatens our belief that we are kind, ethical, competent, or smart. The minute we make any decision--I’ll buy this car; I will vote for this candidate; I think COVID-19 is serious; no, I’m sure it is a hoax—we will begin to justify the wisdom of our choice and find reasons to dismiss the alternative. Before long, any ambivalence we might have felt at the time of the original decision will have morphed into certainty. As people justify each step taken after the original decision, they will find it harder to admit they were wrong at the outset. Especially when the end result proves self-defeating, wrongheaded, or harmful.
The theory inspired more than 3,000 experiments that have transformed psychologists’ understanding of how the human mind works. One of Aronson’s most famous experiments showed that people who had to go through an unpleasant, embarrassing process in order to be admitted to a discussion group (designed to consist of boring, pompous participants) later reported liking that group far better than those who were allowed to join after putting in little or no effort. Going through hell and high water to attain something that turns out to be boring, vexatious, or a waste of time creates dissonance: I’m smart, so how did I end up in this stupid group?"
By: LULU GARCIA-NAVARRO
"So many of us do it: You get into bed, turn off the lights, and look at your phone to check Twitter one more time.
You see that coronavirus infections are up. Maybe your kids can't go back to school. The economy is cratering.
Still, you incessantly scroll though bottomless doom-and-gloom news for hours as you sink into a pool of despair.
This self-destructive behavior has become so common that a new word for it has entered our lexicon: "doomscrolling."
The recent onslaught of dystopian stories related to the coronavirus pandemic, combined with stay-at-home orders, have enabled our penchant for binging on bad news. But the habit is eroding our mental health, experts say.
Karen Ho, a finance reporter for Quartz, has been tweeting about doomscrolling every day over the past few months, often alongside a gentle nudge to stop and engage in healthier alternatives.
Ho first saw the term in a Twitter post from October 2018, although the word may very well have much earlier origins.
"The practice of doomscrolling is almost a normalized behavior for a lot of journalists, so once I saw the term I was like, 'Oh, this is a behavior I've been doing for several years,' " she says.
If Ho's daily reminders aren't enough to break the habit, clinical psychologist Dr. Amelia Aldao warns that doomscrolling traps us in a "vicious cycle of negativity" that fuels our anxiety.
"Our minds are wired to look out for threats," she says. "The more time we spend scrolling, the more we find those dangers, the more we get sucked into them, the more anxious we get."
By: Cassie Shortsleeve| July 07, 2020
"Black maternal health providers share the advice they give their own patients that any Black expectant or new mom can learn from."
"Pregnancy is a life-changing event. But for Black women, this time in their lives comes with uniquely concerning health issues and added layers of struggle.
In the U.S., Black women are two to three times more likely to die from pregnancy-related causes than white women. That figure is even larger in metro areas such as New York City where Black women are up to 12 times more likely to die during pregnancy and childbirth. And while about one in seven women in this country experience a perinatal mood and anxiety disorder (PMAD), Black women suffer at higher rates—and are less likely to receive treatment.
Black moms and moms-to-be also face the biases of a mostly-white medical field, not to mention systemic racism, and stigma in and out of doctors' offices, say experts. But there are ways to prioritize yourself and protect your mental wellness (or help an expectant friend) in the journey to motherhood.
Here, Black doctors, therapists, doulas, and other maternal health experts share the words of wisdom they'd give to Black moms everywhere.
1. Prioritize emotional wellness.
"Given that Black women are at higher risk for pregnancy-associated mortality when compared to non-Black pregnant women, it is important that Black women empower themselves with knowledge about the importance of maintaining emotional wellness so that they take the steps necessary to advocate for their mental health needs during their pregnancy. If you're experiencing significant anxiety, disclose your distress to friends and family. If social support is not sufficient, talk to your healthcare provider about different treatment options."—Christine Crawford, M.D., M.P.H., an assistant professor of psychiatry at Boston University School of Medicine and an adult, child, and adolescent psychiatrist at Boston Medical Center.
2. Find the mental health support you need (even if it's virtual).
"Mental health support during the prenatal period is important especially during a time like this when women have the extra stress of the consequences of COVID-19 and racial injustice and protests. Black women are less likely to receive care for depressive symptoms and are often under-diagnosed. If you have symptoms, find a provider that you feel comfortable with, whether on a mental health app, one-to-one talk-therapy, or group therapy. Another great tool I love for moms is meditation apps. They can help with grounding during times of great stress. If the new mother has access to mental health support during the prenatal period, the risks for postpartum depression decrease."—Latham Thomas, founder Mama"
By Juli Fraga and Karen Kleiman|July 5, 2020
"Soon after her first baby was born in 2014, Crystal McAuley started having catastrophic thoughts about her infant’s health. Throughout the day, random thoughts popped up like tiny speech balloons, each one filled with a newfound fear: “What if the baby overheats?” “What if he stops breathing?” “What if he falls out the window?”
McAuley, 38, shared her concerns with her husband, who told her the baby was healthy. His reassurance, however, didn’t shut down the worry-filled thoughts that looped over and over in her mind. “It was hard to make them stop,” McAuley recalled. And then they changed course: “I started having visions of pulling my car into the opposite lane of traffic, but I didn’t want to die or harm my infant.”
McAuley was experiencing intrusive thoughts, which are unwelcome, negative thoughts, or images that seem to come out of nowhere and are highly upsetting, psychologists say.
“Occasionally, everyone experiences senseless intrusive thoughts,” said Jonathan Abramowitz, Ph.D., a professor of clinical psychology and an anxiety researcher at the University of North Carolina at Chapel Hill. On a turbulent flight, for example, we may see images of the plane crashing, even if we’re not afraid of flying. If we’re driving a friend’s new car, we may have thoughts about getting into an accident.
Most times, we don’t give those thoughts much attention, but when stress arises and responsibilities mount, it can be harder to ignore them, Dr. Abramowitz explained. And with the added strain of the Covid-19 pandemic, many parents are preoccupied with worries about their children becoming ill and dying from the virus, he said.
McAuley said the pandemic has sent her anxiety into a tailspin. “I feel like a new mom again. At unpredictable times, I imagine one of my children falling down a steep ravine or dying in a violent accident.”
While intrusive thoughts can be a sign of a perinatal mood disorder, such as postpartum anxiety or postpartum obsessive-compulsive disorder, a 2006 study conducted by Dr. Abramowitz and his colleagues followed 85 participants (43 mothers and 42 fathers) from the second trimester of pregnancy to three months postpartum. Of those who participated in the study, 91 percent of mothers and 88 percent of fathers experienced upsetting intrusive thoughts about their newborn.
According to Dr. Abramowitz, it’s not uncommon for new parents to think of the baby falling down the stairs, choking or drowning in the bathtub. One parent told Dr. Abramowitz he imagined “sticking a pencil in the soft spot of his baby’s head.”
Disturbing thoughts and images like these can bewilder new parents. Not to mention, mothers who envision harming their babies may misinterpret their thoughts as ominous signs about their mothering abilities. “I felt like a prisoner inside my own mind,” said McAuley, who worried that if she told her doctor what she was thinking, her baby would be taken away.
While intrusive thoughts can be terrifying, the problem lies in how we interpret them, Dr. Abramowitz said. Labeling such notions as “negative” causes the brain to give them more weight, which is why parents who judge their invasive thoughts often struggle to let them go.
Dr. Abramowitz and his colleague, Nichole Fairbrother, Ph.D., a psychologist and researcher at the University of British Columbia, said intrusive thoughts pop up in new parenthood for a reason. In their research, the psychologists found that the immense responsibility parents feel for keeping their newborns alive can bring on disturbing thoughts about harm striking their babies, especially during the first six months of their children’s lives.
Dr. Fairbrother said: “I remember gazing at my baby’s delicate hands and thinking, ‘I could just cut those right off with the garden clippers,’ but because I’m an anxiety researcher, I wasn’t upset by it.”
Even though intrusive thoughts might seem puzzling, Dr. Fairbrother said, they’re often adaptive. “If a mother worries about the stroller rolling into traffic, she’s going to grip the handle more tightly,” she explained.
For parents bothered by their intrusive thoughts, certain exercises and steps can reduce the anxiety they create. A few suggestions:
Distance yourself from the emotions
One way to disarm intrusive thoughts is to recognize that they don’t define who you are. Repeating the bothersome thought in a singsong voice or saying it aloud, over and over again can help, said Stefan Hofmann, Ph.D., a clinical psychologist and anxiety researcher at Boston University. This behavioral technique, known as distancing, can unhook thoughts from emotions, helping the mind to change direction. No longer seeing the thoughts as a threat, parents begin to realize that “thoughts are nothing more than just thoughts,” Dr. Hofmann explained.
“A mother may think about pushing the stroller down the stairs, but that doesn’t mean she’ll act on it,” he said."
"Our struggle is not an emotional concern. We are not burned out. We are being crushed by an economy that has bafflingly declared working parents inessential."
By: Deb Perelman
"Last week, I received an email from my children’s principal, sharing some of the first details about plans to reopen New York City schools this fall. The message explained that the city’s Department of Education, following federal guidelines, will require each student to have 65 square feet of classroom space. Not everyone will be allowed in the building at once. The upshot is that my children will be able to physically attend school one out of every three weeks.At the same time, many adults — at least the lucky ones that have held onto their jobs — are supposed to be back at work as the economy reopens. What is confusing to me is that these two plans are moving forward apace without any consideration of the working parents who will be ground up in the gears when they collide.
Let me say the quiet part loud: In the Covid-19 economy, you’re allowed only a kid or a job.
Why isn’t anyone talking about this? Why are we not hearing a primal scream so deafening that no plodding policy can be implemented without addressing the people buried by it? Why am I, a food blogger best known for such hits as the All-Butter Really Flaky Pie Dough and The ‘I Want Chocolate Cake’ Cake, sounding the alarm on this? I think it’s because when you’re home schooling all day, and not performing the work you were hired to do until the wee hours of the morning, and do it on repeat for 106 days (not that anyone is counting), you might be a bit too fried to funnel your rage effectively.
For months, I’ve been muttering about this — in group texts, in secret Facebook groups for moms, in masked encounters when I bump into a parent friend on the street. We all ask one another why we aren’t making more noise. The consensus is that everyone agrees this is a catastrophe, but we are too bone-tired to raise our voices above a groan, let alone scream through a megaphone. Every single person confesses burnout, despair, feeling like they are losing their minds, knowing in their guts that this is untenable.
It should be obvious, but a nonnegotiable precondition of “getting back to normal” is that families need a normal to return to as well. But as soon as you express this, the conversation quickly gets clouded with tangential and irrelevant arguments that would get you kicked off any school debate team.
“But we don’t even know if it’s safe to send kids back to school,” is absolutely correct, but it’s not the central issue here. The sadder flip side — the friend who told me that if their school reopens, her children are going back whether it’s safe or not because she cannot afford to not work — edges closer.
Why do you want teachers to get sick?” isn’t my agenda either, but it’s hard to imagine that a system in which each child will spend two weeks out of every three being handed off among various caretakers only to reconvene in a classroom, infinitely increasing the number of potential virus-carrying interactions, protects a teacher more than a consistent pod of students week in and out with minimized external interactions.
“You shouldn’t have had kids if you can’t take care of them,” is comically troll-like, but has come up so often, one might wonder if you’re supposed to educate your children at night. Or perhaps you should have been paying for some all-age day care backup that sat empty while kids were at school in case the school you were paying taxes to keep open and that requires, by law, that your child attend abruptly closed for the year."
"The process of weaning involves hormonal, psychological, social, and physical changes."
By Cassie Shortsleeve| June 08, 2020
"Last month, one random morning while breastfeeding my 11-month-old daughter Sunday, she bit down (and laughed) then tried to latch back on. It was an unexpected snag in an otherwise smooth breastfeeding journey, but after some bleeding (ugh), a prescription antibiotic ointment, and shedding some tears, I decided it was also the end.
Not only did I beat myself up—I didn't make it to the (albeit self-imposed) one-year marker that I had set—but within days, those teary, dark moments that had been with me in the early postpartum period crept back up. I could almost feel my hormones changing.
If you just had a baby (or have new mom friends), you're likely aware of some of the mood changes that can accompany new parenthood, namely the "baby blues" (which impact some 80 percent of women in the weeks following delivery) and perinatal mood and anxiety disorders (PMADs), which impact some 1 in 7, according to Postpartum Support International. But mood issues related to weaning—or transitioning your baby from breastfeeding to formula or food—are less talked about.
In part, that's because they're less common than PMADs, such as postpartum depression. And not everyone experiences them. "All transitions in parenthood can be bittersweet and there is a wide array of experiences associated with weaning," explains Samantha Meltzer-Brody, M.D., M.P.H., director of the UNC Center for Women's Mood Disorders and a principal investigator in the Mom Genes Fight PPD research study on postpartum depression. "Some women find breastfeeding very satisfying and do experience emotional difficulty at the time of weaning," she says. "Other women do not experience emotional difficulty or they find weaning to be a relief." (See also: Serena Williams Opens Up About Her Difficult Decision to Stop Breastfeeding)
But mood changes related to weaning (and *everything* breastfeeding, TBH) make sense. After all, there are hormonal, social, physical, and psychological changes that take place when you stop nursing. If symptoms crop up, they can also be surprising, confusing, and occur at a time when you may have *just* thought that you were out of the woods with any postpartum woes.
Here, what's going on in your body and how to ease the transition for you.
The Physiological Effects of Breastfeeding
"There are basically three stages of hormonal and physiological changes that allow women to produce breastmilk," explains Lauren M. Osborne, M.D., assistant director of the Women's Mood Disorders Center at The Johns Hopkins University School of Medicine.
The first stage happens in the second half of pregnancy when the mammary glands in your breasts (which are responsible for lactation) begin to produce small amounts of milk. While you're pregnant, super high levels of a hormone called progesterone produced by the placenta inhibit the secretion of said milk. After delivery, when the placenta is removed, progesterone levels plummet and levels of three other hormones—prolactin, cortisol, and insulin—rise, stimulating milk secretion, she says. Then, as your baby eats, the stimulation on your nipples triggers the release of the hormones prolactin and oxytocin, explains Dr. Osborne.
"Prolactin brings a feeling of relaxation and calmness to mom and baby and oxytocin—known as 'the love hormone'—helps with attachment and connection," adds Robyn Alagona Cutler, a licensed marriage, and family therapist who specializes in perinatal mental health.
Of course, the feel-good effects of breastfeeding are not just physical. Nursing is an extremely emotional act in which attachment, connection, and bonding can be cultivated, says Alagona Cutler. It's an intimate act where you're likely snuggled up, skin-to-skin, making eye contact."
Pregnant women and new moms are experiencing 'shocking' rates of anxiety and depression during the pandemic
By Anna Medaris Miller| June 19, 2020
"Pregnant women and new moms are experiencing higher rates of depression and anxiety amid the coronavirus pandemic, a new study suggests.
In the study, researchers asked 900 women – 520 of whom were pregnant and 380 of whom had given birth in the past year – about their depression and anxiety symptoms before and during the pandemic. They found that the crisis elevated depression symptoms from 15% to 41%. Moderate- to high-anxiety symptoms went from 29% to 72%.
Pre-pandemic, about one in seven, or just under 15%, of women experienced such symptoms during the perinatal period.
"I was pretty shocked at the magnitude of the increases," said Margie Davenport, a co-author of the study and associate professor of the pregnancy and postpartum health program at the University of Alberta, Canada.
A number of factors – like physical isolation, increased household and childcare duties, and fears about the state of the world – have contributed to the higher rates of mental health issues among pregnant women and new mothers, a demographic that was already susceptible to developing perinatal and postpartum depression disorder.
Davenport suspects the rates are even higher in people who already face healthcare and social disparities.
"I'm worried that this [data] is potentially underestimating the effects on women who've lost their jobs, and women who don't have secure housing and secure healthcare," she said.
Most participants were white, employed, partnered, and living in a single-family home — in other words, had the types of supports that would typically put them at a lower risk for perinatal mental-health issues. Davenport fears the effects of the pandemic, and now racial justice issues, on pregnant women and new moms in more marginalized communities may be even worse."
"Women exposed to high temperatures or air pollution are more likely to have premature, underweight or stillborn babies, a look at 32 million U.S. births found."
By Christopher Flavelle| June 18, 2020
"WASHINGTON — Pregnant women exposed to high temperatures or air pollution are more likely to have children who are premature, underweight or stillborn, and African-American mothers and babies are harmed at a much higher rate than the population at large, according to sweeping new research examining more than 32 million births in the United States.
The research adds to a growing body of evidence that minorities bear a disproportionate share of the danger from pollution and global warming. Not only are minority communities in the United States far more likely to be hotter than the surrounding areas, a phenomenon known as the “heat island” effect, but they are also more likely to be located near polluting industries.
“We already know that these pregnancy outcomes are worse for black women,” said Rupa Basu, one of the paper’s authors and the chief of the air and climate epidemiological section for the Office of Environmental Health Hazard Assessment in California. “It’s even more exacerbated by these exposures.”
The research, published Thursday in JAMA Network Open, part of the Journal of the American Medical Association, presents some of the most sweeping evidence so far linking aspects of climate change with harm to newborn children. The project looked at 57 studies published since 2007 that found a relationship between heat or air pollution and birth outcomes in the United States.
The cumulative findings from the studies offer reason to be concerned that the toll on babies’ health will grow as climate change worsens.
Higher temperatures, which are an increasing issue as climate change causes more frequent and intense heat waves, were associated with more premature births. Four studies found that high temperatures were tied to an increased risk of premature birth ranging from 8.6 percent to 21 percent. Low birth weights were also more common as temperatures rose."
June 17, 2020| Produced by Meg Dalton| Hosted by Tanzina Vega
"As the coronavirus pandemic continues, some experts worry about the impact it will have on the mental health of new parents, especially those who have recently experienced childbirth. According to the American Psychological Association, one in seven people who have given birth experience symptoms of postpartum depression.
For more on this, The Takeaway spoke to Kelly Glass, a freelance journalist whose interests focus on the intersections of parenting, health, and race. She recently wrote about the mental health toll on new parents for The Washington Post.
Check out our ongoing coverage of the COVID-19 pandemic here.
Click on the 'Listen' button above to hear this segment. Don't have time to listen right now? Subscribe for free to our podcast via iTunes, TuneIn, Stitcher, or wherever you get your podcasts to take this segment with you on the go."
By Cassie Shortsleeve| May 6, 2020
"This is Real Women, Real Bodies: Your destination for trusted health and wellness advice, reflecting the untold experiences of people like you. This month, we’re exploring maternal mental health, including the myths and misconceptions surrounding motherhood.
As soon as she delivered her daughter in 1983, Shoshana Bennett, Ph.D., a clinical psychologist in Orange County, CA knew something was terribly wrong.
She started seeing horrifying images of someone stealing her newborn, a nurse suffocating her baby, or she envisioned herself dropping her baby, seeing the head smashed and blood on the ground.
When she returned home with her daughter, even innocuous objects around the house — the microwave, a vacuum cleaner cord, the dishwasher — seemed like potential weapons. Every 15 seconds or so, she’d imagine someone or something hurting her baby. Worse, with little, horrifying video clips on replay in her mind, she’d see that she was the perpetrator.
She didn’t tell her husband what was happening. She didn’t tell anyone what was happening. Instead, she spiraled into deeper, scarier thoughts. Her pain continued for years. “I missed the infancy and toddlerhood of my firstborn,” she tells InStyle. “It was just one long nightmare."
When she experienced similar symptoms after having her son a few years later, a psychologist made her feel even more scared and confused by making incorrect assumptions about her own childhood, predicting a negative bond for her and her baby. Her ob-gyn dismissed her experience as normal.
She gave up trying to find help. This would be the rest of her life, she assumed. She became suicidal.
What Bennett didn’t know at the time — what she came to understand in years to come — is that she was suffering from postpartum obsessive-compulsive disorder (OCD), the most misunderstood and misdiagnosed of the perinatal mood and anxiety disorders (PMADs)."
By: Ash Spivak Natalia Hailes
"It's no secret that the postpartum period is just hard. After growing and carrying a human for almost 10 months, you perform what is likely one of the most challenging physical and emotional feats of your life—birthing that baby. And then you find out you're just getting started!
During postpartum, you're healing physically and emotionally while a new, adorable human is entirely reliant on you (and requires way more work than while you were passively growing them). Add in little sleep, changing hormones and doing this all during a pandemic.
Becoming a parent forces us to confront some of our biggest fears—loss, lack of control, change, the unknown. But here's the thing about being in the postpartum period during this pandemic. You are sharing those fears with a whole lot of people out there: all of us are being forced to confront them.
It's like we're arriving at a jungle with no paths and no maps. But whether you recognize it or not, you are already starting to pave your way.
We have no control over how long this pandemic will last or what the outcome will be. The only thing we do have some control over is how we move through it.
One guaranteed way to move through postpartum during a pandemic with more grace and ease is to prioritize your own well-being. Taking care of yourself is taking care of your baby. The actions we are being asked to take to minimize the spread of COVID-19 mimic those that are necessary in the early postpartum days: stay home and slow down (if you have the privilege); care for yourself so that you can care for others. Just like on the airplane, you need to put your mask on first.
For some, circumstances will make this even more challenging (those who have lost jobs, are working full-time and homeschooling and in the postpartum period, those needing to return to the frontlines, and those in essential jobs). While our capacity may be great, we are also only human. We never really know the path. We can only focus on how we move through.
Here are some ways to prioritize your postpartum well-being right now, even during a pandemic.
Ask for help
You can't do it all on your own. While the physical isolation from your support systems is no joke, it's important to remember that you are not isolated in this experience. Even during these times there are ways for others to pitch in. Have someone set up a meal train or set up a fundraising page if you are in a tough financial time. Therapists, postpartum doulas and lactation consultants are all working virtually. Book appointments and put it all on your new baby registry—way better than another onesie!"
By Alice Broster| June 10, 2020
"It’s likely that over the last few months you’ll have had to adapt almost every aspect of your life because of Covid-19. For new families and parents-to-be, this has been especially uncertain. The pandemic has dramatically transformed giving birth and the postpartum period. Virtual care and video consultations have stepped up to replace face to face appointments to cut down on the people entering hospitals. A neonatologist explains how postpartum care has changed because of Covid-19 and, while virtual medicine has been good for this period, it will never replace the emotional support that new parents need in person.
Over the last three months, people have faced going to the hospital to give birth alone. Families haven’t been able to introduce their newborns to their loved ones because of Covid-19 and for doctors on the frontline, it’s been an incredibly stressful time trying to deliver a high standard of care while keeping patients safe. An increase in virtual medicine has meant patients have been able to access their doctors without leaving the house. However, it’s also meant some new parents have been left behind. “For the vast majority of new parents, they need hands-on help. You need a hug and you need someone who is going to be there when you’re emotional. Sadly, that’s not something you can totally get through a computer,” says Medical Director of Aeroflow Breastpumps and board-certified pediatrician and neonatologist Dr. Jessica Madden.
With people entering hospitals alone to give birth and clinicians not being able to do at home check-ups Dr. Madden fears that some families have fallen through the net. The six week period after giving birth is key for the physical and mental health of both parents and babies. According to research conducted by Aeroflow Breastpumps, 90% of new mums believe educating parents about what to expect postpartum needs to be improved. Three out of four said they weren’t given enough guidance and 66% said they found the postpartum period more difficult than they thought it would be.
While some checks can be done over a video call, Dr. Madden highlighted that some services can’t adapt as effectively. “For the most part, lactation consultants can’t come into the room after birth to provide guidance and support. Breastfeeding clinics haven’t been open in the same way and that’s a massive loss,” says she says, “there’s an extra layer of fear right now for new parents. A lot of people aren’t bringing their babies to see pediatricians and women are scared to access postpartum care because they’re scared they’ll get Covid-19 from the doctor’s office.”
Not being able to access care and support postpartum can have massive implications for new parents. In the U.S. an estimated 70% to 80% of women will experience the ‘baby blues’ after giving birth, with many experiencing more severe postpartum depression. The reported rate of clinical postpartum depression among new mothers is between 10% to 20%. “When you look at how life is for pregnant people right now there are so many more risk factors. People are isolated and there’s excess stress and fear. I don’t think we will really know the effects Covid-19 has had on postpartum depression and anxiety until we look back on it next year,” says Dr. Madden."
By: Kelly Glass| June 10, 2020
"Asia Davis welcomed home her now two-month-old baby at the onset of the coronavirus pandemic. From the start, things didn’t go as planned. Davis was diagnosed with gestational diabetes, which black women are at a 63 percent higher risk of, and was required to get regular non-stress tests to monitor the health of her baby. Two weeks before her due date, her midwife explained the results of her recent non-stress test were “off,” and she needed to give birth right then.
“I cried and I begged to go home and get my stuff,” says Davis. “I had a birth plan. I wanted to labor at home before coming to the hospital, but now that wasn’t going to happen.”
A maternal-fetal specialist sent her immediately to labor and delivery, where a series of unexpected events continued. Davis’ baby’s heart rate was too high, and doctors and nurses rushed to get him out. He was fine after a frightening birth: When her son finally made his grand entrance, his umbilical cord was wrapped around his neck and body. “He wasn’t moving,” Davis said. “It was really scary, especially with nobody telling me anything.”
No visitors were allowed at the hospital where she gave birth, in Cleveland, Ohio’s COVID-19 epicenter, on March 26. So although her partner was with her for the birth, her mother and family weren’t able to visit for the three days she was there. Again, it wasn’t the scenario she had pictured, adding to her distress.
The postpartum period has been equally as isolated. It’s been just her and her partner and their new baby. Davis was diagnosed with postpartum depression, and with a lack of physical connection and a present support system because of social distancing guidelines, she’s struggling. Her partner, she says, is depressed too, so most of the child care burden falls on her. “I’m doing this alone, and it’s just too much. I need help.” On top of that, Davis is facing going back to work and finding childcare for her infant during a pandemic, which adds another huge set of worries.
According to a recently released report by Aeroflow Healthcare, 56 percent of new moms said they had family and friends stay with them to help out. Still, 48 percent said they struggled with postpartum depression and 39 percent with social support isolation. Postpartum depression, a serious mood disorder, affects 1 in 7 women and can last for months if left untreated, according to the American Psychological Association. Other postpartum mood disorders, namely postpartum post-traumatic stress disorder (PP-PTSD), can occur when childbirth is stressful and traumatic. To add to that, according to a 2018 study in Frontiers in Psychiatry, low social support is a significant risk factor for PP-PTSD. And those findings came during what now seems like a faraway time when baby showers, hospital visitors, and family coming over was the norm. Now, moms not only face postpartum depression and stressful birth experiences like Davis’, but are even more isolated than before — and the effects are yet unseen."