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?"
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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." 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." By Diane Spalding "I am a midwife, and that means two things:
But we are in a pandemic, which means that the latter is impossible—and this makes me impossibly sad. You deserve hugs, love, recognition and so much more. So I will settle for the next best thing, which is to write you a little love letter. Darling new mama. Here are seven things you need to know: 1. This is hard Welcome to the mom club. It's a really awesome club, but there is a sad underlying truth you need to be aware of: Moms are notoriously hard on ourselves (often for things that we have no control over). Like, say, a pandemic. So many new mothers are wrought with guilt that they are doing this "wrong." Mama, there is no wrong here. Not even close. This is just hard. And it's okay to admit that. Saying that this is hard or disappointing does not diminish anything about your quality as a mother. This IS hard. And it's okay to say as much. But that brings me to my next point... 2. You can do hard things Motherly's co-founder and CEO, Jill Koziol, often says, "This is hard, but we can do hard things." I'm not sure it has ever rung more true than right now. You have a long history of doing (and rocking) hard things. Perhaps getting pregnant was hard. Perhaps you had a hard pregnancy. Then a baby came out of your body—um, hello! Or perhaps you became a mama through adoption, surrogacy or with a gestational carrier—that can be super hard, too. The point is, you have been met with challenges before, and you have overcome them. Yes, this is tough. But mama, so are you. 3. People are on your side On #TeamMotherly, we often remind each other of the Mr. Rogers quote that says, "When I was a boy, and I would see scary things in the news, my mother would say to me, 'Look for the helpers. You will always find people who are helping.' To this day, especially in times of disaster, I remember my mother's words and I am always comforted by realizing that there are still so many helpers—so many caring people in this world." Maybe it feels impossibly scary to be bringing a baby into the world, but there are so many helpers right now. Public health officials are figuring out policies to keep people safe. Scientists and doctors are researching treatments and vaccines. Activists and policy-makers are working to make the world a more just place for everyone. Remember that even when it feels helpless, people are working around the clock to make things better for you and your sweet baby." Sharon Oughton|Ted Talk "In this talk, Sharon will talk about the concept of infant mental health and how the overall wellbeing (emotional, physical) wellbeing of the baby in the context of his/her early relationships is very significant his/her lifecycle outcomes. “Seeing” the baby in every sense will ensure our future wealth in society.
Sharon is a Child & Adolescent Psychotherapist with over 15 years working with children and families. In that time she has gained an enormous sense of the importance of early relationships, especially in terms of emotional development, mental health and wellbeing. Degree in Social Work, MSc in Child & Adolescent Psychotherapy, including research on the impact of fairy tales and modern cartoons on emotional development and is a member of the Irish Council for Psychotherapy and a committee member of the Irish Association of Infant Mental Health. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at http://ted.com/tedx" "As we hide in our homes waiting out this virus, I’m worried about another, silent, pandemic." By Lindsay Springer| June 12, 2020 "On any given day, I make 17 snacks, change 12 diapers, listen to 957 complaints, constantly remind everyone to wash their hands, and burst into tears at least three times.
Yes, this is life with young kids. It’s what I signed up for and no, it’s not glamorous. Being a mom doesn’t come with “me” time. Showers are forever getting interrupted by preschoolers and their endless barrage of nonsensical questions. With three kids aged six and under, including a newborn, sleep is segmented, at best. Before COVID-19, the tantrum-filled, sleep-deprived whirlwind was mostly relegated to the weekends—but at least they were also filled with park visits, lunches with grandparents, playdates, dance, art and swimming classes. And back then, there was actually an end in sight—back to work/school/childcare on Monday, huzzah! But now, 82 days into the longest weekend ever lived, and I’m so, so tired. Tired of living the same day over and over again. Tired of making toilet paper binoculars and watching Paw Patrol. Tired of Lysol wiping the groceries and Amazon boxes. Tired of staying home. Tired of being scared of COVID-19. My four-year-old has developed a propensity for never-ending tantrums. My now feral six-year-old refuses to change out of his pyjamas or wear shoes. My husband has set up a home office in our basement storage room, the place least likely for a partially dressed child to wander in during a Zoom call (and literally the only other room in our house that is not occupied by the rest of us). The baby is oblivious, smiling and cooing at the chaos around him. Me? I’m quietly falling apart. How can I keep doing this? How can I get in the shower every night, wash off the spit up, the glitter glue, and the sandbox, only to crawl into bed, feed the baby, and wake up in the morning of this never-ending Groundhog Day and do it all again, without a break in sight? I, like many parents, am worn out and tired, and I fear this unsustainable hamster wheel we’re on is giving rise to a silent, mental health pandemic. A recent survey published by the Centre for Addiction and Mental Health (CAMH) in Toronto found that Canadian parents of children under 18, and mothers, in particular, were disproportionately more likely to report new or amplified symptoms of anxiety and depression related to COVID-19. These survey results are alarming, but not at all surprising since COVID-19 has changed parenting and redefined the landscape of motherhood." By Brooke Borel|April 17, 2020 "Here’s a primer on how to conceive, whatever your sexual orientation, gender identity or relationship status." "The early scenes of “Private Life,” a 2018 Netflix film about a New York City couple who are trying to conceive, present an unsettling scenario for anyone pondering their biological clock: A 40-something woman wakes up after an infertility procedure to find that things can’t progress as planned. Her doctors successfully extracted her eggs — but they also realized that her partner can’t produce any sperm. There might be a fix, but there’s a catch: It’ll cost another $10,000. Oh, and the doctors need the check today.
The scene, of course, is fictional and is meant to draw laughs, but it’s also a good reminder of how unpredictable and costly infertility treatments can be. If you’re thinking about having kids, what’s the best way to achieve that goal without unexpected and costly medical intervention? For most heterosexual couples, the first step is to try to conceive the traditional way, said Dr. Sherman Silber, M.D., director of the Infertility Center at St. Luke’s Hospital in St. Louis, Mo.: “I recommend, frankly, if they are young and fertile to make sure they have enough sex.” But intercourse isn’t always a sure-fire route to pregnancy; many couples struggle with infertility because of age, illness or reasons that aren’t yet known to science, said the two fertility doctors and one researcher I spoke to for this guide. Around one in 15 married American couples are infertile, according to the most recent published data from the Centers for Disease Control and Prevention. And there are special considerations for people who are transgender, single or in same-sex relationships. Then there’s the high cost, which “Private Life” got right: According to the Society for Assisted Reproductive Technology, as well as a fertility benefits expert I interviewed for this guide, treatments may run to thousands or tens of thousands of dollars and aren’t always covered by insurance. What to do?" By: Katelyn Denning "When was the last time you felt overwhelmed? Last week, yesterday, earlier today? My guess is, it probably wasn't that long ago. If your triggers are anything like the moms I work with, overwhelm can hit you at any point and in any situation.
Sometimes it's in the middle of the workday when the responsibilities and stresses of the job get to be so much that you think there's no way you'll ever climb out of this hole, let alone your inbox. Sometimes it's in the evenings when you look around at the mess in your house, a pile of laundry and no certain plan for dinner that you feel like you've let your family down and what you should really do is quit your job so you could actually stay on top of all of it. Sometimes overwhelm shows up when you're surrounded by two children who are wallowing in their own overwhelm of emotions, crying and whining, that you think life will be this way forever. And you're overwhelmed by the fact that you are the adult here. Or sometimes, overwhelm waits to hit you until the craziness of the day has ended and you have your first quiet moment to yourself. When you finally sit down, exhale a big sigh of relief, and think about doing it all over again tomorrow, the crushing weight of overwhelm sits on you making it hard to breathe. Can you relate? No matter how it shows up for you, overwhelm feels heavy. It creates the feeling of being out of control in terms of practically everything you can think of. And like the temper tantrums we often witness in our children, it can be hard to snap out of. Trust me—we have all been there and some of us probably more frequently than we would like to admit. But just like we're taught how to approach and calm a toddler who is stuck in an emotionally overwhelming moment which often manifests as a screaming fit, there are things that we can do to help ourselves snap out of it, too. Things that can help us stop spiraling into that feeling of being out of control, and instead, grounds us in the present moment. You will get through this. Everything is not lost. This is only temporary. You've got this. So the next time you feel that feeling, you know how it goes—your breath becomes short, your head starts to feel heavy, you can't see past your own nose and you just might break into tears if anyone asks you if you're okay—try one (or try all) of these things to catch your breath and reset." By Pooja Lakshmin|may 27, 2020 "New and expecting moms are facing pandemic-related fears on top of social isolation." Photo: Mikyung Lee "After going through a harrowing bout of postpartum depression with her first child, my patient, Emily, had done everything possible to prepare for the postpartum period with her second. She stayed in treatment with me, her perinatal psychiatrist, and together we made the decision for her to continue Zoloft during her pregnancy. With the combination of medication, psychotherapy and a significant amount of planning, she was feeling confident about her delivery in April. And then, the coronavirus hit.
Emily, whose name has been changed for privacy reasons, called me in late-March because she was having trouble sleeping. She was up half the night ruminating about whether she’d be able to have her husband with her for delivery and how to manage taking care of a toddler and a newborn without help. The cloud that we staved off for so long was returning, and Emily felt powerless to stop it. Postpartum depression and the larger group of maternal mental health conditions called perinatal mood and anxiety disorders are caused by neurobiological factors and environmental stressors. Pregnancy and the postpartum period are already vulnerable times for women due in part to the hormonal fluctuations accompanying pregnancy and delivery, as well as the sleep deprivation of the early postpartum period. Now, fears about the health of an unborn child or an infant and the consequences of preventive measures, like social distancing, have added more stress. As a psychiatrist who specializes in taking care of pregnant and postpartum women, I’ve seen an increase in intrusive worry, obsessions, compulsions, feelings of hopelessness and insomnia in my patients during the coronavirus pandemic. And I’m not alone in my observations: Worldwide, mental health professionals are concerned. A special editorial in a Scandinavian gynecological journal called attention to the psychological distress that pregnant women and new mothers will experience in a prolonged global pandemic. A report from Zhejiang University in China detailed the case of a woman who contracted Covid-19 late in her pregnancy and developed depressive symptoms. In the United States, maternal mental health experts have also described an increase in patients with clinical anxiety. In non-pandemic times, as many as 14 percent of women will suffer from pregnancy-related anxiety, which refers to fears that women have about their own health and their baby’s over the course of pregnancy and delivery, and up to 20 percent of women will experience postpartum depression. Samantha Meltzer-Brody, M.D., M.P.H., who is the chair of the department of psychiatry at the University of North Carolina at Chapel Hill and the director of the Center for Women’s Mood Disorders, said, “The natural vulnerability of this major life transition is exacerbated when you just have sort of global anxiety, and things like going to the grocery store to pick up diapers suddenly become a much more anxiety-producing event than it ever was before.” In my clinical practice and in a Covid-19 maternal well-being group I co-founded, women have voiced their fears about a number of possible distressing scenarios: delivering without a support person; being one of the 15 percent of pregnant women who is asymptomatic for Covid-19 and facing possible infant separation; and recovering during a postpartum period without the help of family or friends to provide support. There’s also grief about the loss of a hopeful time that was meant to be celebrated with loved ones." 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." "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." 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." |
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