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Family Nudity Is All About Comfort Level, NOT Sexuality

By February 15, 2016 1 Comment
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Celebrity blogger Perez Hilton caused an online uproar back in October after he posted a partially obstructed picture of himself in the shower with his 2 year old son on Instagram, which you can see to the right. Comments and concerns raised by this situation ranged from positive and supportive of bathing with own’s own small children to outraged and accusations of child abuse. So, what is the “right” answer?

When parents ask me how to address nudity, I usually ask them to reflect on their own levels of comfort with nudity. The general rule with respect to parents’ and children’s nudity is that everyone needs to be comfortable with how much is bared. In particular, it is very important that parents agree on how much nudity they are comfortable with showing in front of their children. If parents have very different views about their comfort levels, I advise families to err on the side of modesty. That way no one feels uncomfortable.

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Categories: Ages + Stages, Mental, Emotional, + Behavioral Health, School-Aged Children, Toddlers + Preschoolers, Tweens + Teens

Ladies, Don’t Drink and Don’t Have Babies: When Public Health Messaging Fails

By and February 8, 2016 1 Comment
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We strive to be evidence-based communicators here at The Scientific Parent, and sometimes we collectively wring our hands at public health messaging by our counterparts at other organizations. After all, the public health nerd core tends to be made up of nerds, and while we love nerds (seeing as how we consider ourselves members of that tribe), sometimes nerds can get lost in health data and forget that it doesn’t exist in a vacuum. Data may be objective in the eyes of researchers and statisticians, but in the real world and life, those numbers have context.

That’s why over the last two weeks we’ve found ourselves squirming over recent public health campaigns. For example: common sense would suggest that telling women in Texas to simply not get pregnant due to the threat of catching the Zika virus is utterly unhelpful. First, because of the lack of universal access to free contraceptives for both sexes, and also because the messaging places an undue burden on women with no equivalent advisory (i.e.: ‘don’t get anyone pregnant’) for men. Also, family planning and expansion usually doesn’t stop because viral outbreaks, as public health officials in every other country on the planet can tell you (including those in Brazil who are seeing women avoid mosquitos that carry Zika, not pregnancy).

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Categories: Policy, Politics, + Pop Health, Pregnancy, Birth + Family Planning

None of Us Are Above the Placebo Effect

By December 15, 2015 No Comments
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This is Weber’s Vitamin E Cream.  I put this stuff on everything.  I use it on my lips, on dry skin, on minor cuts and abrasions, I use it instead of regular moisturizer on my hands and legs.  It’s only available in Canada and whenever I go home, I stock up, because I consider it a necessity.  I swear when my kids are grown and they’re reminiscing about all the weird stuff that mom used to do, Weber’s Vitamin E Cream will be at the top of the list.

Does it work better than other products on the market?  Probably not.

Is there some sort of magical ingredient?  Nope.  If you look at the ingredients, it’s essentially petroleum jelly and vitamin-E.

So why do I use it?  Because I think it works, even though there’s no evidence that it works any better or worse than anything else.  It is my placebo and I’m OK with that. 

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Categories: Faith + Beliefs, Science 101 + Mythbusting

How I Got H1N1 (the “Swine Flu”) and Changed My Mind About Vaccines  

By December 7, 2015 1 Comment
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About 10 years ago I thought vaccines caused autism. I didn’t believe this fallacy with any fervor or passion – in fact, I hadn’t researched it any sense of the word.  It was just something I’d picked up from what I call background noise, the kind of passive media consumption we all tend to do in this super-technical world we live in.

Then I was hospitalized with a vaccine preventable disease  – and I suddenly cared a lot about vaccines, autism and how one person’s decisions can impact a community.

I was in my mid-20s when it happened. I didn’t have any kids or plans for kids in my immediate future, so vaccines and autism were not things at the forefront of my mind. I’d had all my shots as a kid, I got an annual flu shot, but that was about as far as I went when it came to vaccinations.

It was during the height of the H1N1 media hysteria (or the “swine flu,” as it was dubbed, based on its common animal host) when my husband and I attended a party with some friends.  I was 27 and despite the excessive media coverage, catching that virus wasn’t something I was concerned about.  I was young and healthy with no major medical issues.  If I got it, I figured, it would just be a bad flu, and I’d survive. I was above the media hype.

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Categories: Faith + Beliefs, Infectious Disease + Vaccines, Science 101 + Mythbusting

It’s Official: We Can All Calm Down About Screen Time

By October 6, 2015 4 Comments
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Pediatric use of screen time is something I’m a little sensitive about. I spent six months of my life working on it and for six months of my life it was all screen time, all the time. Once my portion of the project was over I swore I would never talk about screen time again, that’s how exhausted of the topic I was.

But frankly, I’m tired of seeing parents shamed for allowing their kids watch an episode or two of Daniel Tiger’s Neighborhood while they fold the laundry or make dinner. The science doesn’t support the level of derision that parents receive for even minimal uses of screen time. So when the American Academy of Pediatrics (AAP) issued new working group recommendations on screen time last week, I decided to make an exception and talk about the subject one more time.

I like to refer to subjects like exclusive breastfeeding, screen time, and the amount of time parents spend with their kids as “Modern Mom Guilt.” I think I and just about every other interested parent in America breathed a sigh of relief when the AAP let us know that screen time was one less thing parents had to feel guilty about.

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Categories: Ages + Stages, Mental, Emotional, + Behavioral Health, School-Aged Children, Science 101 + Mythbusting, Toddlers + Preschoolers

It’s Time to Stop Judging Mothers for How They Gave Birth

By September 7, 2015 3 Comments
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 I have sat down to write this particular post several times. Each time I’ve spent more than half of the post justifying why I had an emergency c-section, and the steps I took to avoid a c-section in the first place. But that’s not the point I actually want to make. I think it says a lot that in a post that I’ve intended to be about how we can support mothers no matter how their children came into the world, I felt the need to justify that I really wasn’t “too posh to push.”

First, I’d like to take the entire concept of “too posh to push” off the table, because statistically it’s not a thing. If anything it’s “I’m posh, therefore I push,” with white women of higher socioeconomic status having a significantly lower c-section rate than other groups. *

But, again, that isn’t the point of this post.

Having an emergency c-section was the single worst experience of my life. It was physically and mentally traumatic. After having an epidural administered approximately 20 hours earlier, its effects had started to wear off by the time the decision was made. For the safety of my son they couldn’t give me any more pain medication in the operating room. The anesthesiologist called a time out, concerned that I wasn’t adequately numb.  I remember the OB saying “we have to go” and then feeling the incision. Let me be clear, I was in pain. I felt everything. Once my son was safely out I asked to be completely knocked out, but not before the stitching began.   I don’t regret the decision to be completely sedated.  I would not wish an emergency c-section on anyone.

I did find it difficult to bond with my son after my c-section, but NOT because we’d been separated for the first 30 minutes of his life (we’d been separated when I requested to be completely sedated). It was because the trauma of his birth was so overwhelming that I had a hard time reconciling this round-headed, chubby-cheeked cherub with how he had come into the world, and that made it difficult for me to bond with him.

Leslie in labor.

Leslie in labor somewhere around hour 18.

What I’ve found since my son’s birth is that my experience was not unique. If you ask any woman who has had an emergency c-section, she will likely tell you that they wouldn’t wish the experience on anyone. An emergency c-section is not the easy way out as it is often characterized. It is traumatic, it is painful, and it is scary. It is an emergency life-saving procedure where the comfort of the mother is secondary to ensuring mother and baby survive.

In public health we’re all acutely aware that private decisions often have public consequences. When I told colleagues that I had an emergency c-section, I was typically reminded of the increasing c-section rate, and then asked to describe in minute detail what lead up to the procedure. They were trying to figure out if my emergency c-section was truly an emergency, or if my OB simply wanted to go home and catch The Daily Show at 11pm. I became another data point, which as a data nerd I understand to a certain extent, but sometimes in public health we can forget that our data points are people.

When I told friends how my son was born, I received one of two responses: 1. Empathy and commiseration from other women who experienced an emergency c-section or 2. Disdain from those who have given birth the old-fashioned way or who felt their c-sections were medically unnecessary. From the latter cohort, I’ve been told I did birth wrong, I gave up too soon, I wasn’t fully informed of the risks, I was taken advantage of by the medical profession. The most common and hurtful was that I took the easy way out. Let me assure you, after 26 hours of labor and feeling each individual stitch being made in each individual layer of my body, I can assure you that an emergency c-section is NOT the easy way out.

I have been in tears more than once after a well-meaning conversation with a friend or colleague who needed to tell me how badly I birthed my son. Something Julia and I say over and over again on this blog is that language matters. When we tell women that they didn’t do birth the right way, it breaks motherhood into two tiers: those who are “Mom Enough” and those who are not. The research shows that this judgment of mothers who have had c-sections is ripe among women, with mothers even judging themselves for giving birth the “wrong way.”

Perhaps the most stinging phrase I’ve heard since my son’s birth is one that mothers heap on themselves: their bodies failed them. This is usually accompanied by cries that their bodies let their babies down, fears that their children won’t love them as much because they weren’t able to birth them the “right way.” It breaks my heart when I hear women say it, because it says that their bodies were somehow less natural than other women. It says that at a base, biological level one woman is fundamentally less “female” than a woman who is able to give birth naturally.

This language cuts and we must stop using it against each other and ourselves.

Leslie and her son minutes after he was born.

Leslie and her son minutes after he was born.

It took me well over a year to mentally come to terms with my c-section.  I didn’t set out to do that.  In fact at one point I wasn’t sure I’d ever reconcile my birth experience, what others told me about it, and whether or not I had the mental fortitude to go through it again.  But several events eventually lead me to make peace with my son’s birth.

The first events were unfortunately tragic. A friend of a friend had a labor similar to mine, yet refused to consent to a c-section when it was recommended by the OB on-call. She was convinced the doctor was motivated to perform the c-section for selfish reasons. By the time she consented, her son was stillborn and couldn’t be revived. My friend reached to ask how she could support her friend who was wracked with guilt and grief. My only advice was to not judge her, because whatever my friend thought of her decisions, her friend’s own judgment would be ten times of what anyone could heap on her. The second event involved an acquaintance from high school who had a labor similar to mine. While she consented to a c-section promptly, the procedure was delayed and her son was also stillborn and could not be revived.

To be clear, these events were personally transformative, and that’s why I mention them here.  I don’t mention them to scare women into c-sections.  If you can safely push that baby out, then push that baby out! More power to you!  And it obviously goes without saying that c-sections and specifically emergency c-sections carry risks above and beyond a vaginal birth.  I say this because I know there is a contingency on the web that will be quick to accuse me sharing these two stories in an attempt to scare women into having unnecessary c-sections.  If that’s what you think, please re-read the third and fifth paragraphs of this post.

But, these two tragedies caused me to reframe my son’s birth from something I viewed as traumatic and less than ideal to “there but for the grace of god goes I.” These tragedies reframed birth in my mind from an end in itself, to a means to an end.

The next two events happened in close succession. I switched OBs during my current pregnancy and requested a copy of my medical records. When I read the c-section report it was like reading a hidden history. The first half read as I’d remembered the day progressing, but many of the details leading up to the procedure and the procedure itself I hadn’t been aware of. Those details made me realize the situation was much more serious than I’d been aware of at the time.  It also put my OB’s comment, “we have to go” into better context.  I’d always thought that his comment had more to do with wanting to keep to hospital policy and in/out times, but after reading the report I realized he meant that my son had to come out now, not five minutes from now.  Despite the trauma of the experience I’m grateful that he made that call.

Shortly after reading the report, and with the knowledge that I was pregnant again, a friend began to lecture me on how I couldn’t let my OB take advantage of me again in this delivery. She repeated the phrases I’d heard before, that I could do it right this time, that with more time and patience my body could do what came naturally.  This time, instead of focusing on the other person in the conversation and trying to validate what they were saying, I stood up for myself. I let them know how her language made me feel, how I felt about my birth, and that their judgment was extremely hurtful.

I expected the friend to get angry, to tell me how she was just trying to empower me to stand up to the medical profession, but what I got instead was a sincere apology. I think the moment was a bit of a wake-up for her as well.  I don’t think she’d realized how much the language she was using to encourage vaginal birth actually stigmatized women who’d had cesareans.

This issue around the language and ranking of birth doesn’t just extend to women who have had caesarian sections, but also to women who became mothers through surrogacy, adoption, or by step-parenting. We must stop defining each other by how we came to be mothers and instead value each other as partners in a shared, wonderful, maddening, frustrating but joyful journey.

Leslie, her husband and son when he was only a few months old.

Leslie, her husband and son when he was only a few months old.

* To be clear this is a vast overgeneralization of the issue. There are many, many factors that go into both an individual’s risk of having a c-section as well as traits and behaviors associated with demographic groups including access to prenatal care, nutrition and underlying medical conditions.

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Categories: Mental, Emotional, + Behavioral Health, Pregnancy, Birth + Family Planning

Surviving Your Family Summer Vacation: Your Parental Permission Slip

By August 9, 2015 No Comments
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It’s been 6 days since I’ve slept in my bed and over a week since I’ve had any time to myself uninterrupted. Not a huge deal really, but for you fellow introverts and creatures of comfort like myself, you probably understand me when I say that I’m in the “wits end” zone of wanting to willfully play dead when the kids or my fiance approach me to socialize. No more socializing! No! I need a vacation to recover from this vacation!

Here’s the thing about family time for me. I LOVE my family. And my family also drives me crazy at times as families do on vacations all together, especially on vacations in remote places because we invade each other’s space and do a lot of activities together. That applies to my family of origin and the one I’m in the process of creating.  Add on the fact that this new family of mine includes a man and two teenage boys who already have their own collective patterns and quirks and habits (read: manly behaviors), and it’s a recipe for a woman like me wanting to barricade myself in my vacation bedroom on day two with the furniture and wave a flag above it all like Jean Val Jean in the Broadway finale of Les Miserables. Do you hear the Julia sing? It is the song of cranky men! 

So let me summarize so I can get us to the point: Introvert. 3 members of the male species. 4 flights, 10 hours of flying, 10 hours of driving, remote cabin in the Wisconsin woods. Nervous about meeting my future mother-in-law for the first time and staying in her home. Surprise revival of hayfever. Ah-choo.

Survival for me in this case was pretty simple if I chose to be literal.

Step 1: Don’t die.

Step 2: Return home.

Since that was clearly not enough for the quality of life I preferred for this trip, I discovered a few sanity savers along the way. These things, like my To-Don’t List, are obvious when you think about them but something I’m going to articulate here to both remind you of them, and also to give you explicit permission to do this on summer vacation with your kids. Why? Why not, I say! So consider this your parental permission slip for:

  1. Saying no. Legitimately. Unabashedly saying no and not getting twisted over how upset anyone might get for it. Sad faces because I won’t do something? Ok. Sad faces then. That’s life, right? That might sound cruel on first read, but also consider that being miserable and going along with things is obvious to those around you, especially with kids who can smell a phony a mile a way. They notice when you’re maxed out or agitated even if you think you’re hiding it brilliantly, and oftentimes they internalize your emotions to mean something about themselves. I know I did as a child.Our youngest always gives me lots of hugs when he knows I’m getting tired or frustrated, and asks me what’s wrong – and that keeps me authentic and in the moment, checking in with my own feelings. For more on this, refer to my earlier post on the To-Don’t List. No means no, it doesn’t mean you’re being a jerk. Example: No, I don’t want to chop logs. Have fun though! Nope! I don’t like wolf spiders the size of my head! I don’t want to see it! Bad or wrong? Nope.
  2. Skipping traditions that precede you if they’re really not your thing. It’s ok to participate in what traditions you want to do, and choose to skip what you don’t. The guys went into town for a candy run at a place with the best cashew brittle I’ve ever had. They chopped down trees and built fires. They did their annual man-bonding fix-it work in loud voices while I took a page out of the family matriarch’s book.
    Our gorgeous view while fishing.

    Our gorgeous view while fishing.

    I stayed home with my future mama-in-law and enjoyed our own quiet time together. The sparkly silver lining? She is an introvert too so we had a great time connecting, reading, relaxing at will in harmony with one another. Later we all took a power boat out on the lake and had a blast, and even did some fishing. Plus, I caught a fish, apologized to it and let it go (I didn’t have the heart to kill it and eat it).  A new tradition to add to the pile! The boys were thrilled.

  3. Setting some ground rules with your partner. This is particularly important for situations with stepkids, but try to set some parameters that allow you to connect with your partners’ family in a natural way, or allow you the space to bond with your family or family of origin in these situations in a way that works for you. Reminder: you’re an individual and decide what works best for your needs, and if you don’t speak up, no one can support you. To get ahead of roadblocks, the fiance and I sat and discussed a couple of basics that we stuck closely to this week: this trip would be a complaining-free zone (ahem, teenagers), everyone would do their same chores as they do at home (us included), and we would balance our time between kid-focused activities and grandparent-focused activities. Not too scheduled, not too lax. The only thing I’d recommend is adding in some couple time too – that’s one thing we didn’t do. Next time we’ll be better prepared and go out on our own.

I’m pretty simple to please on vacation – I love my quiet time and I need a mix of activity and some reading and writing every day to stay content. I’m guessing you probably can dig around and think of exactly what would make you happy to do for a week with the family, too, regardless of where, when, and whom is involved.

What are your essential needs and how can you make them happen within your trip parameters? Often it’s easier than we think – we just tend to create self-imposed limits with thoughts of we “should do this” or we “have to do that.” That’s the anthem of any parent who is trying their best, really. But without the shoulds and have-tos, what would you do? Aim for that the best you can and cut yourself some slack along the way. After all, it IS vacation, and you deserve time to both enjoy yourself and the people around you.

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Categories: Mental, Emotional, + Behavioral Health

Parents Matter. We Need to Stop Telling Them They Don’t.

By July 30, 2015 2 Comments
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At my 22-week checkup my Obstetrician had a frank discussion with me about “how I’m doing.” This wasn’t a discussion I ever had with my previous OB during my first pregnancy so I was a little surprised when it happened.

Before having been pregnant, I had expectations of loving the experience. Friends had said the time had some “uncomfortable” aspects, but that they felt better, healthier, and more in touch with their bodies during pregnancy. Meanwhile I was all of eight weeks pregnant with my first when I sobbed to my husband, “I don’t know if I can do this for another seven months!”

I went into this pregnancy expecting it to be different.  I knew what to expect this time and how to work around it, or so I thought.  And while the first few weeks were much better than my first pregnancy, I soon experienced terrible morning sickness that lasted until week 17 and have never really bounced back from it.

So, when my OB asked me how I was doing my response was, “I’m pregnant. I’ve been better.”

He broke the news to me that I was anemic, which didn’t shock me as anemia runs in my family. “So, iron supplements?” I asked, thinking this would be a simple solution. He said yes, but he also wanted me to take vitamin C and take care of myself because he could tell I wasn’t. How could he tell I wasn’t taking care of myself? I was showered, my hair was combed, I had on clean clothes, I was gaining weight, my prenatal tests were all normal.

What I realize now is that he was trying to tell me that I looked like I’d been hit in the face with a frying pan, and while I wasn’t aware of it at the time, I felt like I had too. He ordered that I get more sleep, eat healthier, and that my in-laws take my son for the weekend so I could fully rest. He even offered to write the last order down on a prescription pad.

Our conversation completely threw me. It was not a conversation I was expecting to have with my OB and for sure one I hadn’t come prepared to have that day.  I thought I had been taking care of myself. I took my prenatal vitamins, I was going to the gym whenever I could, and I was sleeping better than I had in my first pregnancy. My husband had taken on a huge chunk of the child care and housework, and my in-laws even watched my toddler son once a week, sometimes twice.

I told him that I had a lot more help than many women do. His response was that having help wasn’t the same as having enough help.

How Leslie usually spends her evenings.

How Leslie usually spends her evenings.

He asked me what I thought at the time were a series of unrelated questions.  What did I usually eat for breakfast? If I got breakfast it was usually a granola bar. How often did I eat? Three times a day, usually a snack before bed. What did I eat for dinner? Lean protein. What did I do when my in-laws took my son? Client work. Why was I still doing cardio at the gym despite ligament pain? It was best for the baby. How often did I wake up at night? How many fingers do you have? How was my energy level? I’m pregnant, I’m tired all the time. Did I ever have dizzy spells? Yes, a few times a day but I’m pregnant, that’s par for the course. When was the last time I did something for myself like take a long bath, read a book or have dinner with friends? I’m a parent and pregnant again, those aren’t things I have time for.

His words rung in my head as he said them, “pregnancy is not just about the baby. You matter too.”

During my first pregnancy when I’d brought up complaints of feeling excessively tired or not having the capacity to eat as healthily as I’d like, my previous OB’s response was that pregnancy was hard, nothing was out of the ordinary, and it was all about doing what was necessary to have a healthy baby at the end. After my son was born, family joked, “nobody cares about you now, we’re all here for the baby.” It took a week for my milk to come in and in the hospital when I fed my hungry son some formula to supplement what I couldn’t produce, a nurse admonished me, “you’re doing what’s easiest for you, not what’s best for him.”

The message was clear: You don’t matter.

I didn’t realize how closely I’d taken that message to heart until my new OB pointed out that much of what I’d categorized as taking care of myself was actually taking care of others.

I held back tears long enough to get out of the office and into my car, and bawled the entire way home. A blubbering mess, I arrived home to a very confused but concerned husband.

“But it’s just anemia, you can take a pill for it, right?” he asked,

“It’s so much more than that!” I sobbed.

Until that day I don’t think I’d processed how much the overt and implied messaging from those around me had truly impacted how I viewed myself. I really didn’t think that I mattered and trying to make myself matter to me involved a significant mental shift.

Since surviving my son’s first colicky few weeks I have said repeatedly that Western society does a terrible job of supporting new parents, but I hadn’t taken my own message to heart. From healthcare infrastructure to family structure, to societal expectations, we essentially give new parents a pamphlet on swimming, throw them into the deep end, and act confused when they start to drown or annoyed when they ask for a life raft.

When I asked other friends if they felt like they didn’t matter after having had a child the response was overwhelmingly in the affirmative. Many mentioned family that offered to help initially didn’t come through, or had nothing but ‘helpful advice’ about what was best for the baby, watched while they were struggling. Others mentioned how specific language made the feel like non-persons:

“I felt like a cow.  My family thought it was a joke to hand [my daughter] to me when she was hungry and say ‘this is your job now.’ Even when I had pumped milk in the fridge my mom refused to use it because she only wanted the best for her granddaughter.  What about her daughter?”  said one friend.

Another confided, “we had this big family dinner the night we brought [my son] home from the hospital. Everyone was there and it was this running gag for everyone to ask ‘oh are you still here?’ to my husband and I. Yes, I’m still here, cleaning up the dishes because everyone is cooing over the baby and I can’t sit down because I pushed another human out of my body 48 hours ago. Thanks for asking.”

The general state of Leslie's home office and living room over the last two weeks.

The general state of Leslie’s home office and living room over the last two weeks.  This is the definition of confessional blogging.

While these may seem like awkward jokes from friends, study after study after study has shown that new and expectant parents feel unsupported ,and that lack of support leads to poorer outcomes for the parent(s) and baby. Yet we as a society seem to persist in the mentality that in order for a baby to thrive the mother’s well-being has to be sacrificed.

The last two weeks has been a learning experience for me. I have been slowly re-learning how to take care of myself, while still working and caring for my family. It has not been easy and at times self-care has felt like one more thing on my to-do list. But I’ve noticed a difference.

Mentally, I’m more focused and my mood has improved. I have more energy and I no longer feel like I’ve been hit in the face with a frying pan. I’ve gone back to the gym, but I’ve traded in the treadmill and elliptical for the recumbent bike and am focusing on strengthening the muscles in my back and shoulders which will help me survive the impending third trimester.

Some things have had to be sacrificed. Our living room and basement perpetually look like they’ve been hit by a tornado. The laundry is washed, but hasn’t been folded and put away in two weeks and the stairs haven’t been vacuumed for the same amount of time. I’ve learned that these are signs that I am a good mother, actually. Because when I’m ok, it supports my family. Today, I feel better.

 

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Categories: Mental, Emotional, + Behavioral Health