Browsing Tag

Postpartum

Recent Reports of Skin-to-Skin Benefits Fail to Mention Key Infant Safety Risks

By January 5, 2016 1 Comment
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Last week, news of a recent study trickled  across my newsfeed, touting the benefits of skin-to-skin contact with infants. That study, published online by the American Association of Pediatrics,  presented evidence in support of Kangaroo Mother Care (KMC), which is a method that involves infants being carried and held with prolonged skin-to-skin contact (S2S).

As is often the case, though, the mainstream media picked up the story and ran with it, touting the potential benefits of the practices, while making no mention of any risk. But there are risks – and I believe a parent needs to be aware before putting the practices into place.

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Categories: Accidents, Injuries, + Abuse, Ages + Stages, Newborns + Infants, Science 101 + Mythbusting

The Best Science-Based Pregnancy + Parenting Books

By November 30, 2015 4 Comments
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I’m enjoying my first few weeks of maternity leave after the birth of my daughter, and I have to say, it’s been a different experience than the last time I was pregnant. Between being more aware and educated on what to do with a newborn, and the wonderful lack of colic this time around, I have actually had time to rest and reflect on things.

One of those things (and veteran parents know this) is that when you or the mother of your child becomes pregnant, one of the first things people will do – besides terrify you with horrifying birth stories – is recommend pregnancy and baby books for you to read.  When this happened to me, I started to read some of these books, but each one seemed to have a specific parenting angle they were working.  Not to mention that there were usually a plethora of products endorsed by the authors that were hawked for sale. It started to be a red flag to me if someone passed along a book and at the front or end were instructions to go to a website in order to buy products to use to carry out the advice in the book (slings, oils, creams, CDs, cosleepers, you name it!).

Midway through my first pregnancy I’d finally found a set of books that worked for me.  They were no-nonsense, based on science, and backed by recognized health and medical organizations.  So for you, dear readers, I’m passing along my recommendations for the best baby books that will give you the facts, only the facts, and won’t lead you down the rabbit hole to huckster products and new parent guilt:

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Categories: Pregnancy, Birth + Family Planning, Science 101 + Mythbusting

8 Awesome Baby Gifts That Aren’t Onesies

By September 28, 2015 1 Comment
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Baby showers and baby gifts often present a unique gifting hurdle for people without children or people who haven’t had infants in a while: what the heck do you get someone who is about to have a baby? Before my son was born I defaulted to the standard gift, one which we received a boatload of when we were expecting: adorable onesies.

Who can resist the urge when perusing the aisles at Target, that siren song of the onesie with a bow-tie and suspenders applique or little ducky feet? They are bleeping adorable, they’re also less awkward than gifting breast pads or a snot sucker.

While 99% of the onesies we received as gifts were adorable and I appreciated all of them, once my son arrived we had more baby clothes than he’d ever wear and not a lot of things to actually help us survive his first colicky few weeks of life.

So to those of you who are scratching your heads wondering what to gift the couple that’s expecting, though I don’t formally endorse the following products, I offer you these options:

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Categories: Pregnancy, Birth + Family Planning

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

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

What Are We Telling Mothers When We Say “Breast is Best”?

By June 3, 2015 20 Comments
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When my baby boy arrived, he weighed 4 pounds, 13 ounces. He entered the world 8 weeks early and spent 29 days in the Neonatal Intensive Care Unit (NICU).

When your baby is in the NICU, there is enormous pressure to breastfeed. The nurses rolled a hospital grade pump to my bed side just hours after delivery and minutes after my first visit to my baby’s incubator in the NICU. “Breast milk is like medicine for preemies,” I was told.

Every day I pumped around the clock and delivered milk to the NICU in the insulated bags they provided … like I was packing his lunch for school. Every milliliter was carefully inventoried and measured by the NICU nurses. I always knew from the looks on their faces if I had made enough to feed him for the day. Like I said- ENORMOUS pressure.

Things were going okay until about 10 days after delivery. I developed mastitis on the right breast. For those unfamiliar, mastitis is an infection of the breast tissue. I had pain, high fever, and chills. After two antibiotics it resolved. Then I developed a second mastitis infection on the other side. The pain was excruciating. The infections did a number on my body, my sleep, and my milk production (and yes we worked with lactation consultants and did all sorts of tricks to try and increase production).

I was exhausted, emotionally raw and in extreme pain.  My husband and I made the decision to switch my son to formula at 3 weeks old. We did it for his health, my health, and my ability to care for him when he was discharged. I can easily say it was the best decision we could have made. My sweet boy absolutely thrived on his special preemie formula. He tolerated it very well, grew, and got stronger. We are incredibly grateful for formula. We consider it an amazing public health innovation. Formula fed our baby when I could not.

I’m a public health practitioner, so I’ve known for years that “breast is best,” but I’m also now a proud formula-feeding mom so I think this gives me a unique view on how we, in public health, talk about breastfeeding.  A recurring theme for me is concern about the language being used in these campaigns. Somehow public health has not found an effective way to promote breastfeeding without stigmatizing formula feeding.

For example:

  • Memes like this can make women unable to breastfeed feel like failures, when, in fact, breastfeeding isn't possible for all women.

    Memes like this can make women unable to breastfeed feel like failures, when, in fact, breastfeeding isn’t possible for all women.

    All birthing hospitals in Philadelphia (where we live) have officially discontinued the practice of giving free formula to new mothers. While I understand that this strategy is supported by evidence, it is part of a larger international initiative to make hospitals “Baby Friendly”. So using that logic, providing formula is “unfriendly” to babies? This message was reinforced by Nurse McGinn who was interviewed for the philly.com story. She reports that she “was given free formula and threw it out”. Quotes like these reinforce the message that feeding with formula is equivalent to giving your kid something bad. Every mother wants to do what’s best for their child, no mother wants to harm their child.

  • A friend sent me a link to a wonderful story about supporting formula feeding moms during World Breastfeeding Week. This article does a great job of examining the language being used in their recent campaign. The terms connect breastfeeding with “winning” and achieving “goals.” So is the flip side “losing” and “falling short of your goals”? This can be a rough reminder for formula-feeding moms. For many women, the switch to formula was made after extreme pain, guilt, and feelings of failure. Around the same time a public health colleague tweeted that we should use the language “breastfeeding is normal” instead of “breast is best” Although it was not her intention, I read that as meaning that anything other than breastfeeding is abnormal. So formula feeding is abnormal?!
Model Nicole Trunfio graced the cover of Elle Magazine last month breastfeeding her son.

Model Nicole Trunfio graced the cover of Elle Magazine last month breastfeeding her son.

We also see many efforts promoting the message that “breastfeeding is natural”. In the Olivia Wilde photo spread for Glamour Magazine which includes a photo of her feeding her son, she says “Breastfeeding is the most natural thing…” In the June 2015 issue of Australian Elle, we see model Nicole Trunfio breastfeeding her son on the cover.  According to US Magazine, “the powerful cover shot by Georges Antoni captures the natural moment between mom and child.” And while of course breastfeeding is natural…we have to think about the flip side of this message- are we telling parents that formula feeding is an unnatural act?

When thinking about health communication, we need to not only test the key terms for our campaigns but we need to consider their antonyms. Normal-Abnormal. Natural-Unnatural. Public health practitioners are (or should be) familiar with the theory of unintended consequences, but it seems that when it comes to infant feeding we aren’t thinking about the unintended consequences of our messaging.
So I ask readers

(1) While these breastfeeding and baby-friendly campaigns have well-intentioned public health goals (which I support):

  • What are the unintended consequences of their language and communication choices?
  • Do they help reinforce the divide between formula feeding and breastfeeding mothers?
  • What about the women who both formula feed and breastfeed? Where do they fit in?

(2) What are your suggestions for more effective language? How can we simultaneously promote breastfeeding without stigmatizing formula feeding?

Readers can comment below! 

*An earlier version of this post was published on Pop Health on August 7, 2014.

 

 

 

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Categories: Food, Nutrition, + Infant Feeding, Mental, Emotional, + Behavioral Health

What in the Bloody Bleep Can’t This $2,000 Dress Hide?

By and May 6, 2015 1 Comment
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Let’s talk about The Duchess of Cambridge’s body, because she just had a baby so of course we’ve got to get on the chatter bandwagon.  Let us state for the record: we think Duchess Kate is gorgeous. We look at her photos and videos of her interacting with others, and we think she’s just lovely, and we’re not talking just about her styled hair, or makeup, or impeccably chosen clothing. We’d also like to state that we’re not an avid fans of following celebrities, save for Alan Rickman, with whom Julia is slightly obsessed, or Ryan Gosling, Leslie’s favorite.

That being said, with all of the coverage on our blog, it’s hard for us to avoid (and not be baffled by) the recent photos taken outside of St. Mary’s hospital, with Duchess Kate, Prince William, and wee Princess Charlotte, a mere 12 hours after giving birth. Kate looks gorgeous, well-pulled together as always in a sundress, nude pumps, and full hair and makeup – about 12 hours after pushing another human being out of her body. Baby. Human. Out. Of. Her. Body. At breakfast time. In front of the press at dinner time.(!!!). Think about it. (Julia here: I can’t even pull myself that awake and together 12 hours after running a 5k, naps and spandex be damned!)

It seems we’re not alone as our Facebook and Twitter feeds have blown up with women from all backgrounds asking, “Where does this bleep get off looking like that, 12 hours after giving birth.”  We’re inclined to agree with them, except we think Kate’s dress and heels belie the same physical changes (and horrors) that every woman who has given birth have to deal with.

Most mothers leave the hospital still looking five months pregnant, wearing maternity clothes, hair in a messy knot and walking gingerly.  Forget about makeup and high heels.  But in this case appearances are deceiving. Beneath that $2,000 bespoke sun dress are likely the unifying bane of every postpartum mother’s existence: The mesh underwear and mega pad.  If you look at the photos Kate’s dress is loose fitting, easily hiding the pad that would even make your grandmother recoil in horror. We’re recoiling just looking at that thing in the photo to the right.

Why the giant pad?  After giving birth women can expect to experience lochia for days to weeks after giving birth.  This discharge resembles a heavy period and is about as fun as one too.  Women are given disposable underwear for two reasons: 1. To protect their own underwear from blood stains and 2. Regular underwear doesn’t tend to accommodate the girth of the postnatal pads. Girth!

The dreaded postpartum pad and mesh underwear. As thick as it is long, not even The Duchess of Cambridge could likely escape this.

The dreaded postpartum pad and mesh underwear. As thick as it is long, not even The Duchess of Cambridge could likely escape this.

The last time Duchess Kate was seen in public before giving birth was just a few days before going into labor when she took Prince George to swim in the Queen’s pool.  Can we just stop for a moment and acknowledge that might be the most British sentence ever written on the subject of pregnancy?  Anyway, you’ll note in the paparazzi photos her face looks the same as it has for most of her pregnancy.  But in the now famous photos outside of St. Mary’s hospital, her face and legs look noticeably puffy.   Which, come on, let’s cut her a break, she’d just given birth.

But this is yet another postpartum side effect.  As we’ve mentioned here before, a woman’s blood volume increases by 50% during pregnancy, and her body retains much more fluid.  This fluid helps, in part, the joints and tissues expand to make room for the growing baby.  But once the baby is born, all this extra fluid no longer has a purpose and escapes into the face and extremities, leaving most new mothers feeling like a float in the Macy’s Thanksgiving Day Parade.  Despite her dress and always gorgeous hair, it looks like Kate’s face and legs did not escape this post-pregnancy side effect.

And let’s talk about that dress one last time.  Gorgeous, loose fitting, but still it can’t hide that post-pregnancy belly. That’s right, as Kate showed the world after she gave birth to Prince George, your stomach doesn’t go back to six-pack flat once you give birth.  Your uterus can take six to eight weeks to contract to it’s normal size, during that time, you still kind of look pregnant – which is not a surprise because with baby, fluids, and placenta, it’s the volume equivalent of having a small watermelon stretching out your insides.  And if you ignore Princess Charlotte in those photos outside of St. Mary’s (we know it’s hard, she’s so little and perfect) you can clearly see Kate’s rounded belly, $2,000 bspoke dress or $20 gap maternity dress.

Now the heels, we have no earthly explanation for those, except princesses being princesses.

Let us be clear: We’re not criticizing her. How could we? She’s under constant scrutiny, has an immense amount of pressure on her shoulders in terms of parenting, navigating royal politics, and trying to carve a life out within that framework –  AND she owns the image fabulously. We’re proud of her, in fact, for whatever that’s worth. We’re just incredibly concerned that society as a whole has created an expectation of perfection from women, that it no one expects any less than it.

Come on, people. We complain and whine when we have to fast for a blood test, mope and dress down in practically potato sacks when we get a small biopsy. Someone needs to give this woman an award, and convince the Royal press team to release some laid-back pictures of the Duchess looking as real as any woman would right now. We’re sure her feet would thank them.

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Categories: Policy, Politics, + Pop Health, Pregnancy, Birth + Family Planning, Science 101 + Mythbusting

Royal Baby 2.0 – What We Got Right and What We Got Wrong

By May 4, 2015 1 Comment
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“Her Royal Highness The Duchess of Cambridge was safely delivered of a daughter” – they were the words the media and bookies across the world were waiting to hear. Last week we wrote about what the Duchess of Cambridge (aka Kate Middleton) could expect in her second labor based on what we knew about her labor with Prince George. Now that the blessed event has occurred, let’s double back and see if our predictions were right.

  1. PREDICTION 1: Royal Baby #2 would be late: CONFIRMED
    The Duke and Duchess of Cambridge with the new Princess. Image c/o Kensington Palace/The Press Association

    The Duke and Duchess of Cambridge with the new Princess. Image c/o Kensington Palace/Press Association

    Based on her rumored due date, the newest Windsor Princess is estimated to be about 1 week late. According to rumors with Prince George, he was estimated to have arrived about a week and a half late. While this isn’t abnormal for first pregnancies (first babies are 66% more likely to be late than subsequent babies) we know that late babies tend to recur with subsequent pregnancies. The science isn’t clear on why first babies tend to be late or why late babies tend to recur, but there are lots of theories, most of which have to do with babies taking the time they need until they’re ready to make their appearance.

  2. PREDICTION #2: Royal Baby #2 wouldn’t be as late as Prince George: CONFIRMED
    While we’ve established that first babies are notoriously late and that late babies tent to recur, we predicted that Kate would likely be a little late with this baby as well, but she wouldn’t be nearly as late as Prince George. . The same aforementioned study that found that late pregnancies tend to recur,  also found that subsequent pregnancies tend to not extend as late as those of the first babies. George’s rumored due date was July 13, 2013 and he arrived on July 22, 2013, making him approximately 10 days overdue. The new yet-to-be-named Princess’ due date was rumored to be April 25, and she arrived May 2 making her only about a week overdue.
  3. PREDICTION #3: Kate’s second labor would be much faster than her first: CONFIRMED
    Again, while details are sketchy, the consensus seems to be that Kate was in active labor with Prince George for about 11 hours. Anyone who has gone through labor and delivery knows that’s nothing to sneeze at. This time around, Kate was admitted to hospital at 6am and gave birth at 8:34am, making her second labor a whopping 154 minutes. That’s right, we’re measuring this one in minutes. Second labors tend to be faster as both a woman’s abdominal and vaginal muscles have lost tone they are unlikely regain. This is why Benito Alvarez, MD, formerly the codirector of obstetrics and gynecology at the Cleveland Clinic told Parents.com “Which is why we have a rule here: never turn your back on a woman who’s already had a baby or two.”

Pregnancy Bell CurveSo what does all this mean? In short, not a whole lot. We know that one woman’s pregnancy (on that just so happened to be of the royal variety) conformed to the ever-present statistical bell curve. For those of us who have willed ourselves to forget the dreaded bell curve, might I offer a quick refresher: a bell curve is a statistical distribution of data points, which shows the “normal” range of probabilities for a set of statistics (statistics like, those surrounding giving birth). What we know is that Kate Middleton’s second pregnancy and delivery statistics fell into the “average” distribution of the curve…nothing unusual about any of it. As most OBs and midwives know, every pregnancy is different, but different can be, and often is, still captured under the vast array of what’s considered normal. And that’s science, folks!

 

Resources:

National Survey of Family Growth. 2011-2013 NSFG: Public Use Data Files, Codebooks, and Documentation. Centers for Disease Control and Prevention. Last Updated January 25, 2015. Retrieved May 3, 2015.

Kortekaas, J., Kazemier, B., Ravellia, A et al. Recurrence rate of postterm delivery, a national cohort study. Journal of Obstetrics and Gynecology. Supplement to January 2013. pp S298

Institute for Quality and Efficiency in Health Care. Pregnancy and Birth: When Your Baby’s Due Date Has Passed. PubMed Health. Last update March 1, 2014. Retrieved May 3, 2015.

Nicole Caccavo Kear. Pregnancy, Take Two. Parents.com January 2008. Retrieved May 3, 2015.

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