Tag Archives: opinion

Doulas should be covered by health insurance.

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Yet another research study has come out showing that having a doula improves women’s birth experiences and reduces their risk of complications during birth. This is the first study, though, to show that health insurance companies are likely to save money overall by covering doula care. The original study was published by Birth, and you can access it here.

NPR has an excellent write-up on the study and some of its implications here.

We had doula support for each of my births, and I will always strongly recommend a birth doula (and a postpartum doula, if at all possible), for all parents, especially first-timers. Our daughter’s birth doula barely made her birth because it happened so quickly, but she was still a hugely important presence in the pre-birth planning, and talking with her about some of my anxieties and getting her feedback made my daughter’s birth easier both mentally and physically. I’m confident that the doula who supported us during my son’s birth was instrumental in helping us avoid an unnecessary Cesarean, and she provided empathetic and careful counseling when I had trouble breastfeeding him after we were discharged from the hospital.

Doulas are worth it, insurance should cover their services, end of story.

Some days are rough.

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I have been working myself pretty hard the past few weeks, and this week, it finally caught up with me. I am tired, sore, low-energy, constantly on the verge of grumpy. My 7 month-old sleeps well for her age, but the night feedings are starting to wear on me, and her naps have been a challenge this week. And I hurt my back from constantly picking up my anxiety-riddled toddler to soothe his fits. And I forgot, once again, how terrible periods can be, since I haven’t had one in a while. Sometimes they are pretty terrible.

I have been trying to compensate for my lack of energy. We have been eating leftovers for days. I’ve been spending every second I can snatch napping on the couch. I tried to take a bath yesterday to relax and help my back, but my daughter decided that her traditional hours-long afternoon nap should instead be only twenty minutes, so that bath was aborted. I have since decided that having to get out in the middle of a relaxing bath makes me feel approximately five times worse than not having a bath at all, which is good information to have for the future, I guess.

I hesitated to write this post, but I feel like one of my goals with this blog is to point out all the places that motherhood/parenthood/family life is not like in the magazines, and this is one of them. Sometimes you are tired and grumpy and in pain, and you could really use a sick day, but the baby does not care. The baby cannot care, because the baby needs to eat and be clean and sleep, just like you, and she can’t do any of those things on her own. It can be tough. I am lucky to have a good support network, but I’ve also worked really hard to create a support network, because I know that I’m prone to depression and anxiety, and having babies is hard. I cannot be a good parent in a vacuum. I need help.

Today I am proud of myself for getting my toddler to his daycare on time, for loading the dishwasher even though I really didn’t want to, and for smiling at my daughter even though she does not want to sleep. Those are good things to be proud of, I think.

Further thoughts on the 4 month regression.

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As predicted, I fell off the face of the internet for a little while, but my daughter seems to have figured out how to sleep with her fancy new brain with remarkably little intervention from me. The 4 month sleep regression is unpredictable, and this might be the eye of the storm rather than the end of it, but she has slept from 8PM-5AM for two nights in a row, and has been putting herself to sleep for bedtime and naps with no or very little fussing. I am ridiculously proud of her, and also relieved. Even if this is just a respite, my back and shoulders deserve the rest – rocking a 15lb baby to sleep 5-6 times a day is a lot of work!

This is also completely different from our experience of our son’s 4 month sleep regression, which lasted for months, and our son required significant intervention from us to learn to handle his new sleep patterns. I have vivid memories of rocking in a dark room for what seemed like hours, counting to myself to determine when it might be safe to try to put him down in his crib. As a second-time mother, I wonder how much of the trouble was really his different personality and temperament, and how much of it was just me getting in the way of him teaching himself sooner, but I really do think he was just a very different kind of baby from his sister.

Anyway, in my efforts to get through this regression with my sanity intact, I have been reading a lot about this age, and there are two articles I found in particular that I want to recommend strongly for any parents going through this period.

First, Ask Moxie has a great, lucid post explaining what the heck is going on during the 4 and 9 month sleep regressions, and reminds us all that it’s normal for these regressions to leave you feeling defeated and frustrated, even though they’re normal developmentally for your baby. The comments are good reading to help you feel like you’re not alone! A reminder about sleep regressions

(I do feel like I want to mention that, though she’s right that lots of babies seem to only take 20-40 minute naps as newborns, my daughter was the unicorn baby that would take 3 hour naps and always needed to be woken up to eat. So, these babies do exist, and are just as normal as the 20-40 minute nappers!)

Second, I love this article from KellyMom: Wakeful 4 month-olds

It addresses the supremely problematic advice a lot of parents get from their pediatricians, families, and an unfortunately large percentage of books on parenting and sleep, to resort to cry-it-out when their 4 month-old suddenly stops sleeping at night.

“Has NO ONE stopped to consider the developmental stage of the breastfeeding baby that begins at about four months and can go on to 6 or 7 months? Think about your four month old breastfeeding — what are they doing? This baby is on and off the breast — so interested in the world around him he can hardly stand it. “Oh look! There’s the dog! Hi, Mommy, I love you SOOOO much! The phone?! A car went by. The TV is on. Big sister comes into the room….hey, there’s just too much going on for me to concentrate on eating. I think I’m full now. I’ll see you later…..” – Jan Barger, RN, MA, IBCLC

Of course, of course, of course a baby distracted from breastfeeding during the day is going to be more hungry at night! I am moderately conservative when it comes to sleep training – I think there are a lot of gentle, limited-cry methods that are a great help in teaching babies how to sleep independently, but I don’t think cry-it-out is the Devil when used appropriately. The problem is that, in my experience, cry-it-out is almost never used appropriately. You do not wean a baby by leaving them to cry in the dark by themselves. You alter their daytime schedule to make sure they’re eating enough, you feed them in a quiet place so they can concentrate on eating, and then, only if needed, you work on night weaning in a gentle, supportive way. A lot of babies will drop night feedings on their own once parents ensure that they’re getting full feedings during the day, so why not try that before leaving them to cry at night?

I hope these two articles will be helpful to other parents going through this regression, especially if you’re going through it for the first time.

Book review: What to Expect the First Year by Heidi Murkoff

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Now that I have a few book reviews under my belt, it’s time to talk about a big one! Yes, I mean What to Expect the First Year by Heidi Murkoff et al. I got this book at the Good Will while I was pregnant with my first baby and read it slowly as he went through his first year. As you might expect considering What to Expect’s fame, it has a lot of good information about when babies hit milestones on average, ideas for games and toys that are appropriate by age, and it discusses some of the major concerns that parents run into in the first year. That said, I think there are a lot of better books out there for first-time parents, and I would not particularly recommend this one.

murkoff-expect-first-yearFirst of all, some of the health-related information is out of date even in the most recent edition, and doesn’t conform to the standards set by the American Academy of Pediatrics. Here, I am particularly thinking of their section on introducing solid foods. The current research and recommendation by the AAP is that it is not only safe to introduce highly-allergenic foods before age 1 to children whose parents have no history of food allergies, but that introducing these foods early may actually help prevent common food allergies.* I hope this kind of stuff will be updated in the next edition, but as of this moment, the book is out of date, as are a lot of the materials on the corresponding website.

Second, this book didn’t support breastfeeding to the extent that I was hoping. Murkoff repeats over and over that it’s best to breastfeed until at least age 1, but there’s also a lot of material about weaning to the bottle or formula. That’s fine, as it’s information many families will certainly want or need, but as a new mom who did have some difficulties with breastfeeding, I felt like I was constantly being told about how hard breastfeeding is without being offered any support structures to help. The book didn’t provide information for new mothers about continuing to breastfeed after the first year, and certainly didn’t touch at all on the health benefits (for mother and child) of doing so. Breastfeeding is hard and it’s important to acknowledge that, but I feel like its benefits are well-known enough that a book like this should really be supporting the breastfeeding relationship for as long as possible.

Obviously, some people will not be interested in breastfeeding or will not be able to breastfeed, and that’s okay, but there’s a way to support those decisions without constantly pressuring those of us who are breastfeeding to stop at age 1. Additionally, there is some outright wrong information about breastfeeding repeated over and over in the text, especially as concerns what’s normal/average in terms of weaning. Murkoff’s expectations for infant sleep also don’t line up with the books I’ve read on infant sleep that were grounded in scientific research.

Finally, I feel that this book spent too much time on a lot of very rare and uncommon illnesses. It’s great to have rare concerns listed briefly, and to provide resources for more information, but reading over and over about all the ways your baby could get sick is probably not a good idea for a new parent. It’s stressful enough to handle a healthy baby; spending your energy processing information that you’ll never need isn’t worth it, especially since that kind of worrying can create emotional issues you really don’t need. There is definitely such a thing as being too informed when it comes to certain topics. I say, give me information about the common cold, why vaccinations are important, what to do in a choking emergency or during a febrile seizure, and skip the several hundred pages on all the 1/10,000 ways my kid could get sick.

I feel like with What to Expect’s history as the “go to” pregnancy and child-rearing book series, it needs to be held to a high standard. People all over the world trust them to get it right and to provide information that is correct and reliable, and unfortunately, What to Expect the First Year just doesn’t deliver on those fronts.

*See http://aapnewsde.aap.org/aapnews-open/201302_o?pg=13#pg13 for one example.

Got a book you’d like me to review? Leave a comment with your suggestions or email me.

Link: “Mom Body” by Rebecca Roher

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So many of us don’t think very much about how pregnancy and birth work until we’re going through it ourselves. And pregnancy is so weird! You can describe it as a beautiful, miraculous process all you want, and it is, but it’s also a process full of discomfort. From the physical pain of your internal organs getting shoved around to the psychological discomfort of suddenly living in a body that looks different every day, pregnancy is bizarre and challenging work.

Huffington post has done a profile on a comic by cartoonist Rebecca Roher, created when one of her close friends was pregnant and birthed her first child. The cartoon highlights a lot of the strangeness of being pregnant, most of which you don’t usually encounter in popular culture. This is stuff I wish more people knew about. If you’re curious about what pregnant people are going through or the real experience of being pregnant, birthing, and suddenly being a parent (at least for some of us), I highly recommend you read it!
The entire cartoon is at GUTS here: Mom Body by Rebecca Roher

And the article on Huffington Post that I saw is here: ‘Mom Body’ Comic Nails The Emotional Exhaustion (And Eventual Joy) Of Pregnancy by Caroline Bologna

Working together

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I became pregnant with my first child the summer before my last semester of grad school, the summer I was supposed to be writing my Masters thesis. It wasn’t a hard pregnancy as pregnancies go, but that doesn’t mean it was easy. I was working part-time at a bed and breakfast and had to be on the bus to work by 5:30 in the morning. I was nauseous, I was exhausted, I was behind on everything, and it ended up taking me an extra semester to push my thesis through. I graduated four weeks to the day after my son was born, and standing up there with my baby and my degree was one of the proudest moments I’ve ever had.