By: Mikaela Kiner "Pre-pandemic, being a mom meant figuring out the tricky balance between parenting, home, career and self. What that meant in practice was that women in heterosexual relationships took on about two-thirds of domestic responsibilities.
The global coronavirus pandemic has resulted in dramatic shifts for everyone, especially for families, with parents working from home, school and day care closures and a general loss of stability and support. Now moms are homeschooling older kids, caring for little ones, feeding their families three meals a day, and sanitizing everything, all while trying to keep everyone healthy and keep up with their day jobs. While many partners have stepped up to take on more responsibilities at home during the pandemic, the workload balance has not shifted enough (despite nearly half of men claiming they do "all" the homeschooling, a claim that most women disagree with). Women are legitimately concerned that they will become the default caregivers and take on most or all of the household chores, leaving little or no time for their careers or their own well-being. Here's how to keep that from happening by coming to an agreement with your partner about sharing the workload at home. 1. Have the hard conversation. Many people avoid hard conversations out of a fear that things will become adversarial. But now more than ever, we need to talk about roles and expectations. Remember that your partner also wants what's best for you and the family. View this conversation as a collaborative conflict, one where the two of you are working together toward a win-win solution. Phrase to try: "Let's sit down for half an hour this evening and review both of our to-do lists," or "Can we find a time in the next day or two to go over everything we're both trying to get done?" 2. Start with your goals in mind.Your goal is to come up with a plan that works for both of you. The focus is you both teaming up against the problem. Phrase to try: "I'd like to talk about how we can both find a good balance between work and helping the kids," or, "So much has changed. Let's talk about how we're going to make this work for us both." 3. Share your hopes + fears. Tell your partner what you're worried about, and what's been most challenging. Be honest about your experience and what you're afraid of. You'll notice there are no assumptions, personal attacks, shaming or blaming, which is important. My friend Melissa Strawn was in the middle of launching a business when the virus hit. Her husband works full-time and they're raising five boys. Melissa suggests, "Communicate openly and honestly about what's working and not working. Sometimes, I am just looking to feel validated given how much I actually juggle with five kids and a startup. Other times, I need him to just #getitdone." Phrase to try: "I'm concerned that I've taken on all of the homeschooling and I don't have time to do my work," or, "I realize I'm trying to cook, clean and watch the baby. When I sit down to focus on my job, I'm already exhausted."
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"Surrogacy is an important family planning option, but be prepared for a lengthy, expensive and emotional process." By David Dodge| April 17, 2020 "This guide was originally on October 11th 2019 in NYT Parenting." "From the time they began dating as teenagers, Rita and Erikson Magsino, now 39 and 43, talked about the family they hoped to have together one day. Almost immediately after marrying in 2005, they tried to make that dream a reality.
But parenthood would have to wait — Magsino learned she had an aggressive form of endometriosis that made it difficult for her to become pregnant. For over a decade, the couple tried everything to conceive — including fertility drugs and advanced treatments like intrauterine insemination and in vitro fertilization. Twice, Magsino became pregnant, only to miscarry late in the second trimester. “After we lost twins at 20 weeks, we decided enough was enough,” she said. A generation ago, the couple’s attempts to have a biological child most likely would have ended there. Instead, thanks to improvements in reproductive medicine, they welcomed a baby boy into their home in May with the help of a gestational surrogate. Surrogacy has also created an avenue to biological parenthood for thousands of others who can’t conceive or carry children on their own, such as same-sex couples and single men. As a gay, H.I.V.-positive man, Brian Rosenberg, 54, figured biological fatherhood was forever out of reach. But thanks to surrogacy, and a technique known as “sperm washing,” which prevents H.I.V. transmission, he and his husband, Ferd van Gameren, 59, welcomed twins, biologically related to Rosenberg, in 2010. “It’s still hard to believe,” Rosenberg said. “I thought this was a door that was shut to me.” Still, would-be parents need to be prepared for a process that is far longer, more expensive and emotional than many people expect — it’s called a “surrogacy journey” for a reason. For this guide, I interviewed the types of experts you can expect to encounter during a surrogacy journey, including two fertility specialists, a lawyer, a psychologist and an agency caseworker." New CDC Report Shows 10-24% of Women Suffered From Maternal Mental Health Disorders in 20186/22/2020 May 19, 2020 in Policy "A new Center for Disease Control (CDC) study finds that around 1 in 8 women report experiencing symptoms of maternal depression. The analysis, which looked at 2018 Pregnancy Risk Assessment Monitoring Survey (PRAMS) data from 30 states and Puerto Rico, found that rates of “postpartum depression” symptoms ranged from a little under 10% in Illinois to almost 24% in Mississippi.
The majority of women reported making at least one visit to their physician after giving birth, and most reported being asked about their mental health during this visit. But this also varied by location: Women in Vermont were almost always asked about their mental health, while those in Puerto Rico were among the least likely to be asked. At the same time, women who were younger than 19, or white or Pacific Islander, or had a history of depression during prenatal visits were more likely to be asked about depression during a postpartum visit." "Miscarriage happens in up to 15 percent of pregnancies. Why aren’t we talking about it?" By Jyoti Madhusoodanan| April 16, 2020 Photo: Kit Agar "Lizette Galvan’s home pregnancy test was positive a few days after her expected period. But at her first ultrasound, she heard the words: “This is where the heartbeat should be.” Just six weeks into her first pregnancy, Galvan — like approximately one in 10 pregnant women — had miscarried.
Most early pregnancy losses occur within the first 12 weeks. Although the risk drops with each passing week, a miscarriage can occur any time until the 20-week mark. (Later losses are considered stillbirths.) About 10 to 15 percent of all pregnancies end in such an early loss, according to the American College of Obstetricians and Gynecologists. “Miscarriage is the most common complication in pregnancy,” said Dr. Courtney Schreiber, M.D., an associate professor of obstetrics and gynecology at the University of Pennsylvania. “Many occur even before a woman has connected with a prenatal care provider.” Thanks to improved home tests, women like then 38-year-old Galvan learn sooner than ever if they’re expecting. “In the past, women would not even have known about a lot of pregnancies that would’ve ended in a miscarriage,” said Dr. Pamela Geller, Ph.D., an associate professor of psychology, ob-gyn and public health at Drexel University in Philadelphia. “They might have had a bit of pain and bleeding but would have just thought of it as a heavy menstrual cycle.” This early knowledge also means more women grapple with the emotional consequences of early pregnancy loss — which are often no different than the grief of losing a loved one. For this guide, I read through the science, and spoke with three practicing ob-gyns and a researcher who studies miscarriages to help you understand early pregnancy loss, treatment options and ways to optimize recovery." By: Karen Kleiman "The awesome responsibility of caring for a newborn naturally warrants a heightened sense of vigilance. Sometimes this necessary state of watchfulness can be confusing. At every turn, a new mother believes a crisis is looming. Afraid of slipping and dropping the baby, she holds them extra tightly while she goes down the stairs. Afraid of a disaster in the night, she keeps herself awake to hear the silent sounds of breathing. If she falls asleep from sheer fatigue, she dreams of causing the baby harm through her own negligence.
Here are some reasons why postpartum women don't share these scary thoughts: 1. The ambiguity factor One reason why postpartum women don't talk about the thoughts that are having is that they are not sure what is "normal" and what may be problematic. This is due to the overlapping experiences between women with postpartum anxiety or depression and women with no such diagnosis. For example: fatigue, loss of libido, moodiness, weepiness, changes in weight, sleep disturbance, and low energy can all be attributed to anxiety and depression, yet they are also considered to be within normal expectations for postpartum adjustment. Because moods and other internal experiences are expected to fluctuate following childbirth, women sometimes decide it is best to brave any discomfort and hope it goes away by itself. Unfortunately, scary thoughts are not easy to ride out. What's more, without proper assessment, a woman's worry about these thoughts can rapidly disintegrate from initial concern to panic. 2. The critical inner voice The shame that can accompany upsetting thoughts is unbearable. What is wrong with me? How can I be thinking these things? Good mothers don't think such terrible thoughts. Often, the only explanation that makes sense to a mother who is trying to reconcile this disturbing experience is that there is something profoundly wrong with her, something is broken inside. Maybe she is close to insanity. Or maybe she is not fit to be a mother. Either option, or anything in between, is a nightmare. This nightmare stuns many women into silence. They hope that if they can just hold their breath and carry off this role-play, their awful thoughts will somehow go away. In some instances, the thoughts actually do go away. Usually, they do not. Other women tirelessly try to push the thoughts out of their minds, but are distraught when the thoughts return in full force. Some women can express the horror of their thoughts along with the abysmal shame that accompanies them, but, for many, the actual articulation of the specific thoughts, the words they fear would somehow make the thoughts come alive, remain locked inside. Women say they are embarrassed, ashamed, mortified, humiliated and guilty beyond description. They say they feel hideously exposed, naked, repulsive, raw, nauseous, ugly and sickened by their own thoughts. Some say they feel so appalled by the nature of their thoughts that they feel inhuman, as if only a monster could possess and admit such atrocities. An important point here is that high level of distress indicates that the scary thoughts are ego-dystonic, or incompatible with the woman's sense of herself. Although it is never easy to experience such high levels of distress, there is considerably more concern when a woman expresses no such distress or displays no strong affect attached to this worry. Thus, a woman's agitation is often a signal that anxiety is the mechanism at work and not something more worrisome, like psychosis. Knowing this can reassure both the distressed mother and her healthcare provider. Shame-based barriers to disclosing one's thoughts can be fueled by the critic inside one's own head. With regard to the critical inner voice, mothers report they are reluctant to reveal scary thoughts because they:
"The pain of pregnancy loss lingers and can take a toll on your relationship." By: Mira Ptacin| April 19, 2020 Photo: Mira Ptacin and her husband, Andrew, wed one month after a pregnancy loss.Credit...via Mira Ptacin "Five months into my pregnancy and moments after we went in for a sonogram, a deafening silence filled the air. The image on the ultrasound screen revealed the child in my womb had a constellation of birth defects and no chance of survival outside of my body.
Right after doctors gave me the diagnosis — holoprosencephaly — I was given three options: terminate the pregnancy, induce and deliver a doomed fetus or wait for the tragedy to unfold on its own terms. Ten days later, I was no longer pregnant. One month after that, my fiancé, Andrew, and I got married. My breasts were leaking milk, I was wearing a trampoline-sized maxi pad and still bleeding when I said the words “I do.” Since this loss 12 years ago, I’ve seen my share of therapists and bereavement experts. As Andrew and I waded through the bleary stages of our sorrow, many of these professionals warned us that divorce rates after experiencing child loss are staggeringly high. “Up to 90 percent” was the common refrain — a statistic most likely drawn from one of the earliest books on grief and child loss, Harriet Schiff’s groundbreaking “The Bereaved Parent.” But this book was published in 1977, and Schiff’s study is hardly conclusive. First of all, she cites little empirical evidence. Also, it’s hard to statistically control for all the variables in a relationship; separating the influence of child loss from other causes of marital problems in bereaved couples is essentially impossible. Still, professional therapists, grief counselors and couples can agree on this: Marriage is difficult, and managing to stay married after the death of your child is incredibly, incredibly difficult. “You’re the only two people who have shared the loss of your child, and it feels like you can get lost in the pain,” said Anne Belden, M.S., a family planning coach who runs a private practice that focuses on women and couples who are going through infertility, adoption and child loss. “To look in the eyes of your partner and see equally deep despair — it magnifies your pain and can almost be too much to bear.” Being with your own grief is hard enough, Belden explained, but sometimes, sharing our sorrow with the person who has experienced the loss with us fails to promote healing. Quite often, the opposite occurs." By Jennie Agg| May 5, 2020 "After losing four pregnancies, Jennie Agg set out to unravel the science of miscarriage. Then, a few months in, she found out she was pregnant again – just as the coronavirus pandemic hit"
"I stepped out of Oxford Circus tube into mid-morning crowds and cold, bright sunshine. The consultant’s words were still ringing in my ears. “Nothing.” How could the answer be nothing? This was January 2018, six months since my third miscarriage, a symptomless, rather businesslike affair, diagnosed at an early scan. The previous November, I’d undergone a series of investigations into possible reasons why I’d lost this baby and the two before it. That morning, we had gone to discuss the results at the specialist NHS clinic we’d been referred to after officially joining the one in 100 couples who lose three or more pregnancies. I had barely removed my coat before the doctor started rattling off the things I had tested negative for: antiphospholipid antibodies, lupus anticoagulant, Factor V Leiden, prothrombin gene mutation. “I know it doesn’t feel like it, but this is good news,” he said, while the hopeful part of me crumpled. We were not going to get a magic wand, a cure, a different-coloured pill to try next time. Now, my husband, Dan, was back at work and, for reasons I can’t really explain, I had decided to take myself shopping rather than go home after the appointment. I stood staring down the flat, grey frontages of Topshop and NikeTown and willed my feet to unstick themselves from the pavement. I ended up wandering the beauty hall of one of London’s more famous department stores. I let myself be persuaded to try a new facial, which uses “medical-grade lasers” to evaporate pollution and dead skin cells from pores to “rejuvenate” and “transform” your complexion. Upstairs in the treatment room, the form I was handed asked if I’d had any surgery in the past year. I wrote in tight, cramped letters that six months ago I had an operation to remove the remains of a pregnancy, under general anaesthetic. When I handed the clipboard back to the beautician, she didn’t mention it. I wished that she would. As I lay back and felt the hot ping of the laser dotting across my forehead, I thought how ridiculous this all was; that this laser-facial is something humans have figured out how to do. How has someone, somewhere, in a lab or the boardroom of a cosmetics conglomerate, conceived of this – a solution to a problem that barely exists – and yet no one can tell me why I can’t carry a baby? There is no doctor who can reverse a miscarriage. Generally, according to medical literature, once one starts, it cannot be prevented. When I read these words for the first time, three years ago, after Googling “bleeding in early pregnancy”, a few days before what should have been our 12-week scan, I felt cheated. Cheated, because when you’re pregnant you are bombarded with instructions that are supposed to prevent this very thing. No soft cheese for you. No drinking, either. Don’t smoke, limit your caffeine intake, no cleaning out the cat’s litter tray. I had assumed, naively, that this meant we knew how to prevent miscarriage these days, that we understood why it happened and what caused it; that it could be avoided if you followed the rules. You learn very quickly that the truth is more complicated. After a miscarriage, no medic asks you how much coffee you drank or if you accidentally ate any under-cooked meat. Instead you find that miscarriage is judged to be largely unavoidable. An estimated one in five pregnancies ends in miscarriage, with the majority occurring before the 12-week mark. Seventy-one per cent of people who lose a pregnancy aren’t given a reason, according to a 2019 survey by the baby charity Tommy’s. You are told – repeatedly – that it’s “just bad luck”, “just one of those things”, “just nature’s way”. Just, just, just. A fatalistic shrug of a word. But this is not the whole story. “There is this myth out there that every miscarriage that occurs is because there’s some profound problem with the pregnancy, that there’s nothing that can be done,” says Arri Coomarasamy, a professor of gynaecology and reproductive medicine, and director of the UK’s National Centre for Miscarriage Research, which was set up by Tommy’s in 2016. “Science is trying to unpick that myth.” Unfortunately, the roots of this myth run deep. It’s an idea reinforced by the social convention that you shouldn’t reveal a pregnancy until after 12 weeks, once the highest risk of miscarriage has passed. It goes unchallenged thanks to age-old squeamishness and shame around women’s bodies, and our collective ineloquence on matters of grief. The bloody, untimely end of a pregnancy sits at the centre of a perfect Venn diagram of things that make us uncomfortable: sex, death and periods. An impression persists that, while unfortunate, miscarriages are soon forgotten once another baby arrives – that you’ll get there eventually. It’s true that the majority of people who have a miscarriage will go on to have a successful pregnancy when they next conceive (about 80%, one study carried out in the 1980s found). Even among couples who have had three miscarriages in a row, for more than half, the next pregnancy will be successful. Accordingly, the prevailing logic seems to be that not only is miscarriage something that cannot be fixed – it doesn’t need to be fixed. There is little research or funding for trials, and only glancing attention from the healthcare system. What is not being heard, in all this, is that miscarriage matters." By: Megan Richardson, LMFT, NCC "There is no doubt that COVID is putting a strain on a lot of aspects of our life, one of them being our relationships. While some couples may find that spending extra time with their spouse is creating additional problems in the relationship that once did not exist, many couples are also finding prior relationship concerns are now being placed into a spotlight that may have been easy to avoid or ignore before.I am a strong believer in the fact that the goal of relationships is surprisingly not to feel happy all the time, as it can be easy to blame unhappiness on a partner when there may be other contributing factors. Instead, it is important to acknowledge what you may be feeling in your relationship so that you can take action to address your emotional reactions.
Aside from being in a relationship where you or your children’s safety is at risk, unhappiness may not actually be a good reason to end a relationship. Our partners were not created to make us happy, just like we should not be expected to make our partners happy. Couples often find relief in learning most relationships go through seasons where they do not necessarily feel happy but can still have a satisfying experience in the long term if they remain committed and work on their relationship concerns. Happiness can be worked on. Couples who end relationships because they are unhappy often continue to find themselves unhappy outside of the relationship, as well. So while it can be easy to blame your unhappiness on your partner, it may not be all of their fault. If you find yourself feeling especially irritated with your spouse since the start of the quarantine, you are not alone. But it also may not be their fault." By Meghan Holohan| April 20, 2020 "After experiencing infertility for almost four years, Sarah and Brian Piett felt thrilled to welcome their new son, Brooks, on February 26. Soon after, the COVID-19 pandemic dramatically changed life. Now friends and family can’t meet the baby or offer to babysit. As the quarantine lingers, Sarah feels more listless, worried and frustrated. “Our whole family has really been waiting for Brooks forever and have been on this journey with us. We finally have our baby and nobody can even see him,” the 29-year-old recovery room nurse from Canonsburg, Pennsylvania, told TODAY Parents. “I’ve cried a lot.” "After facing infertility for almost four years, the Pietts were excited to finally welcome a baby. But that feeling lessened as stay-at-home orders means Sarah feels isolated." -- Courtesy of the Piett family "Sarah struggled to breastfeed and a phone call with the lactation consultant made her feel guilty about pumping and supplementing with formula. She wishes she had a little more help around the house or could even go to a moms group or walk around a mall.
“I love my baby and I love holding him,” she said. “Sometimes you wish that somebody was here just to hold him for like five minutes to give you a break.” At her six-week follow up appointment, she scored high on a diagnostic test for postpartum depression. Her doctor gave her a prescription and a therapist recommendation. She feels like being isolated is making her depression and anxiety more severe. “It sounds so selfish but I keep thinking this isn’t the maternity leave I envisioned. I thought I’d be able to see friends and they’d be able to see my baby and enjoy him,” Piett said. “It just totally all around completely sucks.” By Anne Miller| April 15, 2020 "When the first pregnancy arrives with little effort, struggling to conceive again can come as a shock." "The doctor sketched a rough outline of my reproductive organs and nearby anatomy as she talked. The black lines on white paper seemed so sparse, when in reality they represented our hopes for the future. My husband and I had a healthy, smart, sassy, thriving preschooler; but we wanted another child. And with the relative ease of our first pregnancy — three months of trying followed by a clockwork 40 weeks (and three days) of pregnancy — we assumed the second would come easily.
Instead, it took us a little more than two years to conceive. The process hit us like a shock wave, draining our savings and deflating our dreams. The doctors called it secondary infertility, a sometimes nebulous term that’s often given to women (or couples) who have successfully given birth but are struggling to get or stay pregnant again. As with regular infertility, it’s diagnosed in women who can’t seem to conceive after trying for a year or more (if they’re under 35); or for six months or more (if they’re 35 or older). For many women, a secondary infertility diagnosis can come as a shock — if you’ve had a baby once, why shouldn’t you be able to have another? “I had heard that secondary infertility was possible, but I never thought it would happen to us,” said Shannon Stockton, a mom of two girls who are more than eight years apart. “I had gotten pregnant so easily the first time.” Stockton, who works as an executive assistant for a medical nonprofit, had her first daughter at 28, and hoped to have a second child four or five years later. She and her husband started trying again when she was 33, but she didn’t give birth until she was 37. “Why couldn’t we figure out the timing? Why wouldn’t our bodies do what they were supposed to do?” they wondered. Their diagnosis: unexplained secondary infertility." Sixteen women on their personal transformations. "I Started Saying Yes to No" By Casey Wilson "I am a yes person. Shonda Rhimes lived a “Year of Yes” and I have lived a lifetime of yes. In fact, I prided myself on coming from a place of yes, emotionally, whatever that means? Yes, I'll take a red eye to be at your bachelorette party. Yes, I'll help the male stripper round up his lose clothes after the music has stopped and everyone else stands around in horrified silence. Yes, I'll co-lead a self-help retreat for friends in Joshua Tree, despite the fact my own life is in utter shambles. Yes, I'll hurt when no one wants to attend! Yes, I'll go to couples therapy with a boyfriend for a year after we stop dating to "tie up loose ends." Yes, I'll suport your pyramid scheme and buy your chalky shakes and bad jewelry and Flat Earth pamphlets. Yes, I'll sell those items myself, to little success. Yes, I'll host. Yes, I'll speak. Yes, I'll march. Yes, I'll give. Yes, I'll be there. And here. And everywhere. And perhaps most upsetting: Yes, I'll go to your one-person show. And then I had children. Two spirited little boys. Suddenly I was barely getting to or even halfway doing the things I cared about most: working, deepening my marriage, tending to my precious female friendships, fighting for change and watching every episode of "The Real Housewives." Something had to give, and it wasn't gonna be The Housewives. It became clear I had to drill down on what was truly necessary. That meant only doing the things it felt (as a friend puts it) "joyful for my spirit to do." I imposed a Marie Kondo-like approach to social commitments and anything that extended beyond the rewarding (yet relentless!) work of motherhood. It's still hard for me to say no. It's simply not in my nature. I hate to disappoint people, be they a boss or a male stripper. But nothing forces you to create boundaries like having kids. We have only so much energy. I have, maybe, almost...none? Because that sound we have always been aware of, that dim hum that has been running under our entire lives, grows louder as children are ushered in. It's the hum of mortality. There's only so much time. We must say no in order to say yes to what is most essential. Until the time comes to say goodbye." "I Started to Worry About Failure" By Nikole Hannah-Jones "I grew up in a dysfunctional household because my father was an alcoholic, and when I was young, I would lie in my twin bed next to the window and write out the life I planned to lead when I grew up and gained control. I still have the battered, sunshine-colored notebook in which I plotted my future.
Our family was working class. We had no wealth and no family connections to open doors, but the one advantage I can claim was unwavering confidence in my ability to change my circumstance. I did not trust many people, but I trusted myself absolutely. Even as a young child, I believed in my mind, my work ethic and my ambition. And so, my journal did not record my hopes for the future. It recorded what would be. I have been afraid of many things in my life, but failure was not one of the. Until I had my daughter. Because of my childhood, I have spent an inordinate amount of time thinking about all the things I would never do as a parent, all the ways I would be better. I had a determination to create the home life for my dhild that I wished I had growing up. Yet before she breathed her first breath, when she was just a flutter in my stomach, I began to feel a tightness in my chest driven by a fear that I would not be up to the task. That no matter how much I loved her, I would make so many mistakes, mistakes I likely would not even know I was making, mistakes that would somehow scar my child the way that I feel scarred.I likely would not even know I was making mistakes that would somehow scar my child the way that I feel scarred. The confident control I have exercised over my entire life feels so tenuous now that I am in charge of raising another human being who is witnessing me and all my flaws while her personhood is being formed. Even now as I now have more empathy for my own parents, I am consumed by the fear that in the most important venture in my life, I will fail. So when my daughter was just a baby, I started writing a journal to her. Over the pages, I tell her how much I love her, how much she means to me, how she has changed my life, and own up when I make mistakes. My hope is that one day when she is grown up, this journal will allow her to extend me some grace for the failures I know I will make. It is a strange conversion. As a child, I did not find hope a useful thing. But now that I have my own, I often feel as if hope is all that I have." By Alexander Sacks, MD + Catherine Birndorf, MD| May 9, 2019 Photo: Michelle Kondrich"Thoughts like these are completely normal, but many new moms feel ashamed of having them. Here’s how to let go of self-judgment and too-high expectations, from reproductive psychiatrists Alexandra Sacks and Catherine Birndorf.
I’ve have been working in women’s mental health for the past decade and my mission has been to educate people about the identity shift that occurs with motherhood, a phase called “matrescence.” Like adolescence, this developmental transition is hormonal, physical and emotional — all at the same time. But unlike adolescence, this transition hasn’t been part of the public discourse, and new mothers often end up judging themselves for these natural feelings. Of course, this conversation also includes the transitions of fathers, partners, and non-birthing parents. To cover the experience of matrescence from pregnancy through motherhood, I coauthored (with reproductive psychiatrist Catherine Birndorf, MD) the new book What No One Tells You; below is an excerpt. If you’re interested in learning more about the subject and hearing real women’s stories, I invite you to listen to my new podcast “Motherhood Sessions,” where I sit down with mothers and share therapeutic conversations about guilt, perfectionism and many other human struggles. My hope is that by reducing stigma and shame around these topics we can all start to better understand the mothers in our lives — whether it’s yourself or someone you know and love. —Alexandra Sacks, MD We often hear moms whisper in hushed tones something they’d never tell their friends or partner: “Sometimes I wish I had my old life back.” Or they wonder, “Am I a bad mother because sometimes I’d rather take a nap than nurse my baby?” These ambivalent thoughts are completely natural, yet many moms feel ashamed of them. We call this the push and pull of motherhood — sometimes you’ll feel pulled toward your baby’s needs and your identity as a mother, and sometimes you’ll want to push it all away. Motherhood, like all complex experiences, is a mix of both positive and negative. Loving your child doesn’t change the fact that sometimes the work of caretaking is not fun. Yet for many moms, admitting that there are moments, days or weeks when you want a break is scary, because it can make you ask yourself: “Am I trapped with this feeling forever? What if I made a mistake? Does this mean I don’t love my baby?” Ambivalence comes up when you find your attention is pushed away from your baby to care for yourself and others in your life, and you don’t know how to make it all work. With every choice, someone gets shortchanged. How are you not going to feel guilty about leaving a meeting at work to go to the pediatrician? Or sleeping an extra 15 minutes while your baby is fussing, only to find him lying in spit-up? And what about when you’re with the baby but really thinking about returning a friend’s call, replying to a work email, eating dinner with your partner, or sleeping?" How to shift your mind-set from giving so much of yourself to others. By Pooja Lakshmin| May 5, 2020 Photo: Dadu Shin"I was teaching a group of new mothers a few years ago how to recognize postpartum depression and anxiety when a woman raised her hand. “My work is letting me take an extra two weeks of paid maternity leave. I don’t know what to do. I feel bad if I take it. My team will have to pick up the slack. I feel bad if I don’t. I’d be giving up precious time with my daughter.” I responded, “Is there any option you wouldn’t feel bad about taking?”
As a perinatal psychiatrist who takes care of women coping with the transition to motherhood, I meet mothers who lean into their guilt like it’s a security blanket and hold up their self-sacrifice as a badge of honor. Adopting a martyr identity doesn’t always correlate to clinical depression or anxiety. It’s a role that women can inhabit even without a diagnosable mental health condition. I don’t blame those mothers for shielding themselves under a cloak of suffering. Appearing too well adjusted can be a liability. Leaving your kids in the car for three minutes to get a coffee can be grounds for a call to Child Protective Services and daring to bottle-feed your baby without trying to breastfeed can lead to criticism from strangers. In 1996 Sharon Hays, Ph.D., a sociologist, coined the term “intensive mothering” to describe parenting that is “child-centered, expert-guided, emotionally absorbing, labor-intensive and financially expensive.” Two decades later, the mental load describes the invisible labor that goes into running a family. We still find ourselves living in a world where most mothers, even while working outside the home, bear the brunt of household work. The coronavirus pandemic only seems to be intensifying that pressure." Postpartum is already changing. What about during COVID-19? By Margaret M. Quinlan, Ph.D., Bethany Johnson, MPhil, M.A.| April 22,2020 "Maggie and I are both fascinated by social media discourse, and particularly any conversations that center around bodies and health crises. We've researched the infertility community on Instagram (Bethany never thought to turn to Instagram during treatment), and then we had to make an account for work. This was a very awkward endeavor for us (trained academics who don't have experience marketing our research), but the upside is we've met some incredible people. Today we are interviewing Chelsea Skaggs of Postpartum Together. Not only does she have an excellent Instagram account with relatable, vulnerable images, but she fosters necessary dialogue about the difficulties of the postpartum period, and she runs an online group for newly postpartum folks. We began by discussing COVID-19 and the postpartum experience, then we asked about her work. As someone who works with postpartum women, how do you think COVID-19 is changing postpartum experiences right now? We are seeing a lot of changes for women who are entering postpartum during this season. First of all, many women are grieving the loss of a picture they had in their mind—from the birth experience to bringing baby home to meet the family to have more in-person support. We must have permission and space to grieve that loss while also holding the gratitude women have for this time of their lives. (I remind people that grief and gratitude are not mutually exclusive!) We have to get more creative with support—how do we stay connected to friends and family and other aspects that make women feel like themselves? Postpartum can be an isolating time already, so adding on social distancing means women need, more than ever, more access to virtual supports and resources to keep them connected. On the flip side, some women have the chance to embrace the slow-down of postpartum. So many other cultures prioritize a slow transition, and in America, we are typically more fast-paced. With COVID-19, many women have the chance to step back, slow down, and have that time to rest and restore while having intimate time with the immediate family." "How are you and your family doing in all this?
Every day is different for us. I know personally having things I can't control is an anxiety trigger, so I have been extra mindful to carve out time for joy and being present. I am also tempted to measure my value in how productive I am, and right now, my brain needs a lot more time to restore (more sleep and downtime), and I've had to challenge the belief I've held all my life about productivity. It has been very introspective. Some days feel heavy—seeing the impact on our family, our friends, and extended family, but it also feels so refreshing to be living with fewer complications. The pandemic allows us to remove some of the stressors our family was falling into that aren't part of our values; ultimately, we have "sifted out" things, and I appreciate that. I wish it weren't because of such tough circumstances." By Dr. Pragya Agarwal| March 8, 2020 Photo: Getty"Fertility treatment is on the increase in the U.K., approaching 68,000 treatment cycles carried out every year and approximately 1 in 6 couples (3.5 million people) affected. One in 8 women of reproductive age may face problems when trying to conceive a child, which makes infertility more common than Type 2 diabetes. In 2015, 73,000 babies were born using assisted reproductive technologies, a number that has doubled in the last decade. But, it is still being treated as a niche issue.
Michelle Obama, upon the release of her memoir in late 2018, revealed that she and her husband Barack Obama had used IVF to conceive their daughters and opened up the public discourse around infertility. However, there are no clear workplace policy guidelines on the kind of support that individuals undergoing fertility treatments should expect to receive. Paid paternity and maternity leave has been a subject of discussion and debate in recent years, therefore aiming to make workplaces more inclusive for parents, and women in general. But, fertility treatments have been largely seen as a private matter, and not the subject of robust policy discussions. In most cases, infertility is surrounded by silence and stigma and women, in particular, are reluctant to share this in the workplace, for fear of being stereotyped. In general, women already face a number of barriers and biases in the workplace. Mothers specifically face a motherhood penalty even before they have a child. In a study published in the American Psychological Association, Eden King shows that discrimination starts the moment a woman announces that she is pregnant. Women encountered more subtle discrimination in the form of rudeness, hostility, decreased eye contact and attempts to cut off the interaction when they appeared to be pregnant (wearing a pregnancy prosthesis) while applying for jobs in retail stores than when the same women did not appear to be pregnant. Implicit unconscious biases and stereotypes are at play here, as women are being penalized for acting out of their feminine stereotype. The study shows that these acts of subtle sexism and microaggressions starting when a woman announces their pregnancy puts her firmly on the "mommy track" and can have a huge impact on her decision to leave the workforce. Women who become mothers also earn less than their childless peers." By Karen Kleima| April 28,2020 "What if I get sick and can't take care of my baby?
What if my baby gets sick? What if my partner gets sick? How do I do this all alone? Being a new mother is hard. Being a new mother during a pandemic is almost unimaginable. One of the things we have learned-thanks to the increased awareness and circulation of good, accurate information about maternal mental health-is scary, negative intrusive thoughts about harm coming to the baby are a stressful but common expression of normal anxiety. Almost every single new mother and most new fathers experience the presence of scary thoughts that can range from mildly annoying to excruciatingly painful and debilitating. It may be hard to distinguish between "normal and scary thoughts" and those triggered by the current extraordinary stressors associated with sheltering in, isolation, quarantining, social distancing and all the other mandates that are imposing gut-wrenching restrictions. It stands to reason new mothers today are bombarded on a moment-to-moment basis with negative thoughts that may feel out of control, never-ending and often shame-inducing. After all, we often hear, "How can a good mother think these thoughts?" But good mothers do have these scary thoughts. Awful thoughts. Terrifying thoughts. Indescribable and unfathomable thoughts. And if these moms do not find the support and validation they need, the thoughts can swirl around in their heads, gaining momentum from fear. Anxiety is at an all time high right now, for good reason. It's scary outside and some new moms understandably feel out of control with anxiety. When the anxiety emerges within the context of having a new baby, it often manifests as specific thoughts about something horrible happening to the baby. By accident, or by intent. The guilt and worry can be excruciating." By Allana Akhtar| February 7, 2020 Photo: Finland Prime Minister Sanna Marin just approved 7 months of parental leave for both parents. Reuters. "Finland may have made a significant move in reducing postpartum depression among new moms.
The country's government, led by 34-year-old Prime Minister Sanna Marin, will give both new parents seven months of parental leave after childbirth. Pregnant women get an additional month of leave before giving birth. The updates will replace the country's current policy that provides gender-based pay for four months for new mothers and two months for new fathers, according to NPR. The new policy will go into effect in 2021. Marin says the move will improve gender equality and is part of her government's plan to pass wide-sweeping social reforms. Marin is the youngest female prime minister in the world, and a majority of her cabinet members are women. Along with giving fathers more time with their newborns, the progressive policy can improve new mothers' physical and mental health, research suggests, and prevent postpartum depression. Research finds that having both partners at home after childbirth improves a new mom's anxiety and wellbeing. While everybody is focused on the baby after it's born, mothers are acutely at risk. Worldwide, 17.7% of new mothers experience postpartum depression. While the potential causes of maternal distress are many, new research on Sweden suggests that simply having fathers more available to help out with the newborn can lead to huge gains in mental health for mothers. Sweden has Europe's most generous parental leave, NPR reported, at 240 days per parent. Mothers are 14% less likely to visit a doctor for childbirth-related complications when fathers are present for the first few of a baby's life. They are also 11% less likely to require antibiotic prescriptions, and 26% less likely to need anti-anxiety medication. The new National Bureau of Economics working paper, authored by Stanford economists Petra Persson and Maya Rossin-Slater, focused on the impact of parental leave policies in the Nordic country, which offers some of the world's most generous parental leave." No, lying flat after sex won't increase your chances of conception. By Jen Gunter, MD| April 15, 2020 Photo: Armando Veve"As an ob-gyn, I’ve personally encountered many fertility myths in my office or online — some of them even during my training. Why do they persist? Sex education, particularly about the physiology of reproduction, is typically incomplete and subpar. And when we do talk about fertility and reproduction, we don’t talk about it directly — euphemisms for the uterus, menstruation, the vagina and the vulva are still common, and when you can’t use a word, the implication is that the body part is shameful. And, of course, many myths persist simply because they’re alluringly fantastical, and we’re inclined to believe these tall tales over the stodgy facts. Here are seven fertility myths that need to be forgotten.
1. Phases of the moon affect menstruation This is not an uncommon belief-some women even refer to menstruation as their "moon time." The confusion is understandable: The 29.5-day lunar cycle (from new moon to new moon) is very close to the average 28-day menstrual cycle. But studies show no connection between the moon and menses. Moreover, it is hard to envision how a moon-menstruation would be biologically beneficial to human reproduction. 2. Reproductive hormones need to be ‘in balance’ This is a common modern myth in gynecology exam rooms all across North America-and it results in a lot of unnecessary testing of hormone levels. The truth is that, for women of reproductive age, the hormone levels for FSH, LH, estrogen and progesterone change not only day to day, but also often hour to hour. When a women has certain symptoms-for example, an irregular menstrual cycle or infertility-hormone testing may be recommended to make a diagnosis. But in these situations, doctors will look at individual levels in conjunction with symptoms, rather than comparing levels with some mythical "balance." Being "in balance" may sound natural, like a person who is "in tune" with her body. But it is simply not a factual statement, or even a good analogy, for what happens biologically." By Kristen Rogers, CNN April 22, 2020 "(CNN)Becoming a mother is a variable experience, fluctuating in its joys and challenges before, during and after birth.
These phases are of equal importance, but the postnatal period (post-birth) is key to a mother's well-being, her adaptation to changes and the formation of a positive relationship with her baby. The postnatal period is also an underserved aspect of maternity care, receiving less funding, service and attention from health providers, according to a new review on what matters most to women after giving birth, published Wednesday in the journal PLOS ONE. Add to that a worrisome pandemic, and it becomes even more crucial to prioritize a woman's well-being during this time of adjustment. "Once the baby's out healthy, then people are kind of less bothered," said co-author Soo Downe, a professor in midwifery studies at the University of Central Lancashire in England. And commercial hospital systems may not see as much profit in keeping up with the wellness of the mother after birth, she added. "There's all this intense focus on women's health during the three trimesters of pregnancy and then women deliver and there's really very little support after that," said Dr. Denise Jamieson, chair of the Department of Gynecology and Obstetrics at Emory University and chief of gynecology and obstetrics at Emory Healthcare. Jamieson wasn't involved in the study." By Al Donato| 4/15/2020 6:48pm EDT "If you’re an exhausted parent at home right now, you have a friend in Elmo’s dad, Louie. In the latest pandemic programming from “Sesame Street,” the children’s series has released a PSA for parents starring the famous Muppet’s father.
In the PSA, Louie reveals that, like many kids cooped up at home, Elmo won’t leave his parents alone. “It is wonderful to spend so much time with our children, but it can also be a bit ...” the older Muppet pauses, before letting out the world’s most relatable sigh. “Overwhelming.” By Carmela K Baeza, MD, IBCLC| Art By Ken Tackett "Some dyads (mother-infant pair) start their breastfeeding relationship in harsh circumstances. Frequently, due to medicalized births and unfavorable hospital routines, there are so many interferences to initiate breastfeeding that by the time mother and baby arrive home they are already using bottles and formula – despite mother having desired to exclusively breastfeed.
These mothers often feel that they do not make enough milk and that their babies prefer the bottle. They will make comments like “my baby doesn't like my breast”, “I cannot make enough milk”, “the more bottles I give my baby, the less she likes me”, and so on. This can become the road into postpartum depression. Those mothers who are intent on breastfeeding will often look for support, and may find it in a midwife, a lactation consultant or a breastfeeding support group. These health care professionals or counselors may offer the mother to work on her milk production by expressing milk from her breasts (either with her hands or with a pump) and feeding that milk to the baby, as well as putting baby on the breast. And this is what we call triple breastfeeding. Imagine: mother puts baby at her breast. Baby suckles for an hour and a half, falling asleep frequently. Mother will tickle him, speak to him, encourage, often to little avail. After an hour and a half, mother will unlatch the baby (he never seems to come off on his own), put him in the crib, set up her breast pump and begin pumping, going for at least 15 minutes on each breast. Halfway through, the baby wakes up and cries – he´s hungry. But he was just on the breast for almost two hours! Mother turns off the pump (and so little milk has come out!) and feeds her baby a bottle of formula. She cries. She feels exhausted, useless, and unable to meet her baby´s needs. She has not left the house for days, because she is immersed in a never-ending cycle of breast-pumping-feeding." Facing parental burnout? Use the magic word. By Pooja Lakshmin|October 18, 2019 "While swapping horror stories of PTA wars, overscheduling and toddler meltdowns, parents these days will inevitably ask one another, “But, are you taking care of yourself?”
Self-care has become the panacea for an over-exhausted, workaholic American culture. And if there’s one job that spells constant fatigue, it’s being a parent. But how does self-care happen in a country where more than half of married couples with children have two parents working full time, and mothers are not only spending more time at work but also more time taking care of children? It doesn’t help that the images we’re sold of self-care include meditation apps and Peloton binges. For mothers in particular, with self-care just an app click or exercise class away, there is a haunting sense that if you feel burnt out, you must not be taking care of yourself. Cue more stress and guilt." By Penny Simkin| October 27, 2009 "Author/lecturer, doula, childbirth educator, Penny Simkin, PT, talks about pain in labor and the concept of "when pain becomes suffering."
By Penny Simkin| Oct 30, 2015 "Author and educator, Penny Simkin offers an introduction to the serious topic of traumatic childbirth including symptoms of PTSD and suggestions for facilitating postpartum recovery from a traumatic birth experience.
Traumatic childbirth occurs in as many as 25-34 percent of all births. Approximately one-third of those women may develop Posttraumatic Stress Disorder (PTSD). For more information, visit pattch.org. Penny is one of the founders of PATTCh, Prevention and Treatment of Traumatic childbirth, whose vision is "a world where women, infants and families, experience optimal physical and mental health in pregnancy, childbirth, and the postpartum period." Research on this condition is only about 10 years in the making. By Julie Revelant "When I had my first child six years ago, I was grateful breastfeeding turned out to be, for the most part, a smooth ride.
After a visit with the hospital lactation consultants, who showed me the best breastfeeding positions and gave me the support I needed, I was on my way, and continued to breastfeed exclusively for the next 12 months. In those early months, though, I'd experience something odd-and often frightening-that I never told anyone about. When my daughter latched on and my milk let down, an intense feeling of anxiety, panic, and doom would wash over my entire body. For a brief moment-about 20 to 30 seconds-I had a sudden irrational fear that something bad was going to happen. And as quickly as the feelings came, they went. It was always unsettling and, at times, scary, but becuase I had struggled with anxiety for as long as I could remeber, I chalked it up to biology and hormones. When I gave birth to my second child two years later, I wasn't surprised those same feelings surfaced once again. It was still unsettling, but thankfully, it didn't affect my ability to breasfeed her for 13 months. Yet it continued to nag at me, and as a health journalist, I wanted to know why I'd often write about breastfeeding, and when I asked my sources if this was common, most of them had no idea what I was talking about. Then one day, I spoke with a lactation consultant and she told me what I had experienced was real and it had a name: D-MER: Dysphoric Milk Ejection Reflex. |
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