tag:theconversation.com,2011:/au/topics/baby-9321/articles
Baby – The Conversation
2024-01-24T23:40:59Z
tag:theconversation.com,2011:article/217368
2024-01-24T23:40:59Z
2024-01-24T23:40:59Z
Extreme heat can be risky during pregnancy. How to look after yourself and your baby
<figure><img src="https://images.theconversation.com/files/570779/original/file-20240123-25-6rr05.jpg?ixlib=rb-1.1.0&rect=0%2C20%2C6709%2C4446&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/kid-kissing-belly-her-mom-633713483">Shutterstock</a></span></figcaption></figure><p>As we face the continued effects of <a href="https://www.lancetcountdown.org/2023-report/">climate change</a>, the frequency and intensity of heatwaves is increasing. We’ve recently learnt 2023 was <a href="https://www.climatecouncil.org.au/resources/2023-named-hottest-year-record-scorching-temps-sweep-australia/">the hottest year</a> on record.</p>
<p>Extreme heat presents a major public health threat. It can be <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01208-3/fulltext">especially dangerous</a> for people who are socioeconomically disadvantaged, and people who have reduced physiological ability to adapt, such as older adults and those with certain medical conditions.</p>
<p>Pregnant people are also more vulnerable, with evidence showing exposure to extreme heat <a href="https://pubmed.ncbi.nlm.nih.gov/37501633/">is associated with</a> increased risks for the baby.</p>
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Read more:
<a href="https://theconversation.com/health-check-can-stress-during-pregnancy-harm-my-baby-81825">Health Check: can stress during pregnancy harm my baby?</a>
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</em>
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<h2>What are the risks?</h2>
<p>Globally one stillbirth occurs <a href="https://www.unicef.org/reports/neglected-tragedy-global-burden-of-stillbirths-2020">every 16 seconds</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/30389451/">15 million babies</a> are born preterm (before 37 complete weeks of pregnancy) every year. Complications of preterm birth are the leading cause of death and disability for children aged under five years old. </p>
<p>A <a href="https://pubmed.ncbi.nlm.nih.gov/33148618/">systematic review</a> which included studies from 27 countries showed that for every 1˚C increase in ambient (environmental) temperature, the risk for preterm birth and stillbirth increased by 5%.</p>
<p>The risk of stillbirth and preterm birth attributed to heat is greater in lower- and middle-income countries where women are often employed in agriculture or other manual labour positions, and their work continues until <a href="https://pubmed.ncbi.nlm.nih.gov/35237548/">the end of their pregnancy</a>. </p>
<p>Within high-income countries the risk <a href="https://pubmed.ncbi.nlm.nih.gov/34951022/">is greater</a> in <a href="https://pubmed.ncbi.nlm.nih.gov/35710419/">disadvantaged populations</a>.</p>
<p>Recent Australian research has also suggested a mother’s exposure to extreme temperatures may <a href="https://ehp.niehs.nih.gov/doi/10.1289/EHP12660">influence a baby’s birth weight</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman drinks glass of water" src="https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570781/original/file-20240123-17-77i0s4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Make sure you stay hydrated while pregnant.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pregnant-water-drinking-woman-young-pregnancy-2177419759">Shutterstock</a></span>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/5-expert-tips-on-how-to-look-after-your-baby-in-a-heatwave-216906">5 expert tips on how to look after your baby in a heatwave</a>
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<p>Pregnant people are thought to be at increased risk of heat stress due to changes in their body’s capacity to <a href="https://pubmed.ncbi.nlm.nih.gov/37501633/">regulate temperature</a>. These changes include:</p>
<ul>
<li><p>increased body mass and body fat which reduces a pregnant woman’s ability to dissipate heat to the environment </p></li>
<li><p>decreased ratio of surface area to body mass can make sweating less effective</p></li>
<li><p>additional energy produced from the baby increases the mother’s core body temperature. </p></li>
</ul>
<h2>The effects on the body and baby</h2>
<p>When the ambient environment is hotter than the pregnant woman’s core body temperature (that is when the air temperature reaches around 38 degrees or above) blood flow is diverted to the skin to allow sweating. This can decrease blood flow to the placenta, meaning less nutrition and oxygen to the baby.</p>
<p>If dehydration occurs, hormonal changes can include the release of prostaglandin and oxytocin, potentially triggering labour prematurely. </p>
<p>Heat exposure can also release heat-shock protein (a family of proteins produced by cells secondary to stressful conditions) which can damage placental cells and placental function. This can contribute to poor fetal nutrition, leading to <a href="https://pubmed.ncbi.nlm.nih.gov/30594173/">low birth weight</a>. </p>
<p>However, actual thermo-physiological data from pregnant women during heat exposure is sparse. Our <a href="https://pubmed.ncbi.nlm.nih.gov/29496695/">recent review</a> showed no study has assessed thermoregulatory function in pregnant women at temperatures higher than 25˚C. </p>
<p>Our subsequent <a href="https://pubmed.ncbi.nlm.nih.gov/34165763/">climate chamber study</a> with pregnant women showed their bodies regulate temperature up to 32˚C as well as non-pregnant women.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Woman in sun hat sits with legs in swimming pool. She appears pregnant." src="https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/570775/original/file-20240123-15-zkxgxo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dipping your feet into a cool pool can help you and your baby cool off.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/beautiful-young-pregnant-woman-sitting-near-422267806">Tanya Yatsenko/Shutterstock</a></span>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">Don’t like drinking plain water? 10 healthy ideas for staying hydrated this summer</a>
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<h2>5 ways to beat the heat while pregnant</h2>
<p>Evidence of the effectiveness of interventions that address acute heat exposure during pregnancy specifically are limited. Air-conditioning is exceptionally protective, however it is unaffordable for many in Australia and globally. </p>
<p>More evidence of the effect of extreme heat on pregnancy outcomes at a population level in both low and high income countries will help us develop ways to protect pregnant people and the community. </p>
<p>In the meantime, with the threat of more very hot summer days, simple strategies to <a href="https://www.health.nsw.gov.au/environment/beattheheat/pages/default.aspx">beat the heat</a> when pregnant include:</p>
<p><strong>1) Drink enough water</strong> – take a water bottle with you when out and about</p>
<p><strong>2) Plan your day</strong> – avoid the hottest part of the day if you can. Take a hat or umbrella with you for shade</p>
<p><strong>3) Stay cool</strong> – use fans or air-conditioning if possible, close blinds and curtains, visit a cooled public environment </p>
<p><strong>4) Dress down</strong> – wear lightweight, long-sleeved, light-coloured, loose-fitting clothes made from natural fibres, such as cotton or linen</p>
<p><strong>5) Go to sleep on your side</strong> – at night and for daytime naps to allow the <a href="https://theconversation.com/five-ways-to-reduce-the-risk-of-stillbirth-108253">best blood flow to the baby</a>.</p>
<p>These strategies need to be adapted to personal circumstances, and of course seek medical advice if you feel unwell. Signs of heat exhaustion that can lead to <a href="https://www.healthdirect.gov.au/heatstroke">heat stroke</a> if not treated early include:</p>
<ul>
<li>sweating and pale, cool, damp skin</li>
<li>dizziness and weakness</li>
<li>a headache</li>
<li>nausea or vomiting</li>
<li>a rapid pulse and fast, shallow breathing</li>
<li>muscle cramps </li>
<li>fainting</li>
<li>feeling restless and anxious</li>
<li>heat rash.</li>
</ul>
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Read more:
<a href="https://theconversation.com/its-extremely-hot-and-im-feeling-weak-and-dizzy-could-i-have-heat-stroke-215084">It's extremely hot and I'm feeling weak and dizzy. Could I have heat stroke?</a>
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<p>If you have these symptoms, find a cool place to rest, drink cool water or a rehydration drink, remove excess clothing, have a cool shower or bath, or sit for a while with your feet in cool water.</p>
<p>More severe symptoms indicating heatstroke include intense thirst, slurred speech, lack of coordination or confusion, and aggressive or strange behaviour. Heatstroke is a medical emergency, so call triple 0.</p>
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Read more:
<a href="https://theconversation.com/five-ways-to-reduce-the-risk-of-stillbirth-108253">Five ways to reduce the risk of stillbirth</a>
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</em>
</p>
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<img src="https://counter.theconversation.com/content/217368/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adrienne Gordon receives funding from MRFF, NHMRC and Wellcome Trust. She is affiliated with the International Stillbirth Alliance, the NHMRC Stillbirth Centre of Research Excellence, The Perinatal Society of Australia and New Zealand, The Sydney Institute for Women, Children and their Families, Womens Healthcare Australasia and RedNose Australia. </span></em></p><p class="fine-print"><em><span>Camille Raynes-Greenow receives funding from NHMRC, Wellcome Trust, ERLA, UK. </span></em></p><p class="fine-print"><em><span>Ollie Jay receives funding from National Health and Medical Research Council, Wellcome Trust, NSW Health, NSW Dept of Planning, Industry and Environment, and the NSW Reconstruction Authority (formerly Resilience NSW), Tennis Australia.</span></em></p>
During pregnancy, the body’s capacity to regulate temperature changes. Here’s how to cool down and the overheating red flags to watch out for.
Adrienne Gordon, Neonatal Staff Specialist, NHMRC Early Career Research Fellow, University of Sydney
Camille Raynes-Greenow, Professor and Deputy Head of School, Sydney School of Public Health, University of Sydney
Ollie Jay, Professor of Heat & Health; Director of Heat & Health Research Incubator; Director of Thermal Ergonomics Laboratory, University of Sydney
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/219005
2023-12-14T19:19:48Z
2023-12-14T19:19:48Z
Eggs from men, sperm from women: how stem cell science may change how we reproduce
<figure><img src="https://images.theconversation.com/files/564442/original/file-20231208-17-22yb4u.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C748&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/morula-early-stage-embryo-consisting-cells-776035219">nobeastsofierce/Shutterstock</a></span></figcaption></figure><p>It may soon be possible to coax human skin cells into becoming functional eggs and sperm using a technique known as “in vitro gametogenesis”. This involves the creation (genesis) of eggs and sperm (gametes) outside the human body (in vitro). </p>
<p>In theory, a skin cell from a man could be turned into an egg and a skin cell from a woman can become a sperm. Then there’s the possibility of a child having multiple genetically-related parents, or only one.</p>
<p>Some scientists believe human applications of in vitro gametogenesis are a <a href="https://www.statnews.com/2023/10/02/ivg-ivf-replacement-reproductive-technology-hype/">long way off</a>. </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1708819232077533218"}"></div></p>
<p>However, scientists who work on human stem cells are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579208/">actively working</a> on overcoming the barriers. <a href="https://www.statnews.com/2023/04/08/ivf-eggs-hormones-gameto-reproductive-fertilo/">New</a> <a href="https://www.technologyreview.com/2021/10/28/1038172/conception-eggs-reproduction-vitro-gametogenesis/">biotechnology</a> <a href="https://www.newyorker.com/magazine/2023/04/24/the-future-of-fertility">start-ups</a> are also seeking to commercialise this technology.</p>
<p>Here’s what we know about the prospect of human in vitro gametogenesis and why we need to start talking about this now.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-what-are-stem-cells-14391">Explainer: what are stem cells?</a>
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<hr>
<h2>Is the technology available?</h2>
<p>In vitro gametogenesis begins with “pluripotent stem cells”, a kind of cell that can develop into many different cell types. The aim is to persuade these stem cells to become eggs or sperm.</p>
<p>These techniques could use stem cells taken from early embryos. But scientists have also worked out how to <a href="https://www.eurostemcell.org/stemcellshorts-what-are-induced-pluripotent-stem-cells">revert adult cells</a> to a pluripotent state. This opens up the possibility of creating eggs or sperm that “belong to” an existing human adult.</p>
<p>Animal studies have been promising. In <a href="https://www.nature.com/articles/490146b">2012</a>, scientists created live-born baby mice using eggs that began their life as skin cells on a mouse tail.</p>
<p>More recently, the technique has been used to facilitate same-sex reproduction. Earlier this year, scientists created mouse pups with <a href="https://www.nature.com/articles/d41586-023-00717-7">two genetic fathers</a> after transforming skin cells from male mice into eggs. Mouse pups with <a href="https://www.nature.com/articles/d41586-018-06999-6">two genetic mothers</a> have also been created.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/1ocWjHJgKcc?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">How scientists bred mice with two fathers.</span></figcaption>
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<p>Scientists have not yet managed to adapt these techniques to create human gametes. Perhaps because the technology is still in its infancy, Australia’s legal and regulatory systems do not address whether and how the technology should be used. </p>
<p>For example, the National Health and Medical Research Council’s <a href="https://www.nhmrc.gov.au/about-us/publications/art">assisted reproduction guidelines</a>, which were updated in 2023, do not include specific guidance for in vitro-derived gametes. These guidelines will need to be updated if in vitro gametogenesis becomes viable in humans.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/the-future-of-stem-cells-tackling-hype-versus-hope-72052">The future of stem cells: tackling hype versus hope</a>
</strong>
</em>
</p>
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<h2>The potential</h2>
<p>There are three distinct clinical applications of this technology.</p>
<p>First, in vitro gametogenesis could streamline IVF. Egg retrieval currently involves repeated hormone injections, a minor surgical procedure, and the <a href="https://www.mayoclinic.org/diseases-conditions/ovarian-hyperstimulation-syndrome-ohss/symptoms-causes/syc-20354697">risk</a> of overstimulating the ovaries. In vitro gametogenesis could eliminate these problems.</p>
<p>Second, the technology could circumvent some forms of medical infertility. For example, it could be used to generate eggs for women born without functioning ovaries or following early menopause.</p>
<p>Third, the technology could allow same-sex couples to have children who are genetically related to both parents.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/promising-assisted-reproductive-technologies-come-with-ethical-legal-and-social-challenges-a-developmental-biologist-and-a-bioethicist-discuss-ivf-abortion-and-the-mice-with-two-dads-208276">Promising assisted reproductive technologies come with ethical, legal and social challenges – a developmental biologist and a bioethicist discuss IVF, abortion and the mice with two dads</a>
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<h2>Legal, regulatory and ethical issues</h2>
<p>If the technology becomes viable, in vitro gametogenesis will alter the dynamics of how we create families in unprecedented ways. How we should respond requires careful consideration.</p>
<p><strong>1. Is it safe?</strong></p>
<p>Careful trials, rigorous monitoring, and follow-up of any children born will be essential – as it has been for other <a href="https://theconversation.com/maeves-law-would-let-ivf-parents-access-technology-to-prevent-mitochondrial-disease-heres-what-the-senate-is-debating-176668">reproductive</a> <a href="https://theconversation.com/rest-assured-ivf-babies-grow-into-healthy-adults-23432">technologies</a>, including IVF.</p>
<p><strong>2. Is it equitable?</strong></p>
<p>Other issues relate to access. It might seem unjust if the technology is only available to the wealthy. Public funding could help – but whether this is appropriate depends on whether the state <a href="https://theconversation.com/ideas-for-australia-rethinking-funding-and-priorities-in-ivf-should-the-state-pay-for-people-to-have-babies-57036">ought to support</a> people’s reproductive projects.</p>
<p><strong>3. Should we restrict access?</strong></p>
<p>For instance, pregnancy is rare in older women, largely because egg count and quality <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/age-and-fertility">decline with age</a>. In vitro gametogenesis would theoretically provide “fresh” eggs for women of any age. But helping older women become parents is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566409/">controversial</a>, due to physical, psychological and other factors associated with having babies later in life.</p>
<p><strong>4. We’d still need surrogates</strong></p>
<p>If we took skin cells from each male partner and created an embryo, that embryo would still need a surrogate to carry the pregnancy. Unfortunately, Australia has a shortfall of surrogates. International surrogacy provides an alternative, but carries <a href="https://theconversation.com/its-hard-to-find-a-surrogate-in-australia-but-heading-overseas-comes-with-risks-206182">legal, ethical and practical difficulties</a>. Unless access to surrogacy is improved domestically, benefits to male couples will be limited. </p>
<p><strong>5. Who are the legal parents?</strong></p>
<p>In vitro gametogenesis also raises questions about who are the future child’s legal parents. We already see related legal debates surrounding non-traditional families formed through surrogacy, egg donation and sperm donation. </p>
<p>In vitro gametogenesis could theoretically also be used to create children with more than two genetic parents, or with only one. These possibilities likewise require us to update our current understandings of parenthood.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-may-one-day-grow-babies-outside-the-womb-but-there-are-many-things-to-consider-first-125709">We may one day grow babies outside the womb, but there are many things to consider first</a>
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<h2>How far is too far?</h2>
<p>Of the potential uses already mentioned, same-sex reproduction is the most controversial. The reproductive limitations imposed by being in a same-sex relationship are sometimes seen as a “social” form of infertility the medical profession is not obligated to fix.</p>
<p>The moral stakes, however, are virtually identical regardless of whether in vitro gametogenesis is used by same-sex or opposite-sex couples. Both uses of the technology fulfil exactly the same goal: helping couples fulfil their desire to have a child genetically related to both parents. It would be unjust to deny access to only one of these groups.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Same-sex female couple cooking in kitchen, one feeding the other fruit" src="https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/564457/original/file-20231208-21-83z5z9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Who should have access to this technology? How about same-sex couples?</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/lesbian-couple-cooking-kitchen-together-1071305168">Rawpixel.com/Shutterstock</a></span>
</figcaption>
</figure>
<p>But same-sex reproduction is only the tip of the iceberg. In vitro gametogenesis could theoretically facilitate “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973109/">solo reproduction</a>” by deriving both eggs and sperm from the same individual. Interestingly, a child created this way would not be a clone of its parent, since the process of gamete formation would shuffle the parent’s genetic material and create a genetically distinct individual.</p>
<p>Or people could engage in “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215291/">multiplex parenting</a>” combining genetic material from more than two individuals. Imagine, for example, that two couples create embryos via IVF. In vitro gametogenesis could then be used to derive eggs and sperm from each of these two separate embryos, which could subsequently be used to conceive a single child that is genetically related to all four adults.</p>
<p>Finally, in vitro gametogenesis could revolutionise prenatal genetic selection. We’d have <a href="https://rmanetwork.com/blog/number-of-eggs-good-ivf-in-vitro-fertilization/">many more embryos</a> than available during regular IVF to screen for genetic diseases and traits.</p>
<p>So it would be urgent to discuss “designer babies”, eugenics, and whether we have a <a href="https://bioedge.org/bioethics-d75/savulescu-interviewed-on-procreative-beneficence/">moral obligation</a> to conceive children with the best chance of a good life.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/worlds-first-synthetic-embryo-why-this-research-is-more-important-than-you-think-188217">World's first 'synthetic embryo': why this research is more important than you think</a>
</strong>
</em>
</p>
<hr>
<h2>We need to start talking about this now</h2>
<p>Both law and ethics can lag behind new technologies, particularly when their implications are as profound and far-reaching as the implications of in vitro gametogenesis.</p>
<p>We need to discuss how this technology should be regulated before it is rolled out. Given how rapidly the science is developing, we should begin this discussion now. </p>
<hr>
<p><em>Laura Smith, a masters student from Monash University, contributed to this article.</em></p><img src="https://counter.theconversation.com/content/219005/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julian Koplin receives research funding from Ferring Pharmaceuticals for an unrelated project.</span></em></p><p class="fine-print"><em><span>Neera Bhatia receives funding from UKRI Arts and Humanities Research Council for an unrelated project.</span></em></p>
The technology may be here sooner than we think. But we have so much to discuss first.
Julian Koplin, Lecturer in Bioethics, Monash University & Honorary fellow, Melbourne Law School, Monash University
Neera Bhatia, Associate Professor in Law, Deakin University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/207360
2023-08-29T15:34:41Z
2023-08-29T15:34:41Z
When being a new mum feels overwhelming, here’s some expert advice on what you need to know
<figure><img src="https://images.theconversation.com/files/542176/original/file-20230810-11401-f0k38u.jpg?ixlib=rb-1.1.0&rect=11%2C15%2C2544%2C1686&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Being a new mother can take a lot of adjustment. </span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/parents-looking-at-their-baby-3584088/">pexels?nappy</a></span></figcaption></figure><p>We are sold the idea that becoming a new mother is the <a href="https://psycnet.apa.org/record/2016-38769-001">happiest time of your life</a>. But for many women, the reality doesn’t fit that perfect picture. Yes, they may love their baby very much but the broader impact of having a baby and becoming a mother can feel far more complex. </p>
<p>Research shows that when we look at happiness over our lifetime, the year after having a baby can be one of our <a href="https://psycnet.apa.org/record/2013-15090-008">lowest points</a>. It’s not about our relationship with our baby but rather the other parts of our lives that have changed so much. Social media hasn’t helped any of this. We are all tempted to just share the best bits, thinking we need to hide our feelings because we think <a href="https://psycnet.apa.org/record/2018-45585-002">everyone else is so happy</a>. But speaking out helps everyone. </p>
<p><a href="https://www.independent.co.uk/news/health/negative-thoughts-new-parents-baby-pregnant-children-parenting-b694300.html">It’s normal</a> to experience some challenging emotions when you become a new parent. You might not immediately bond with your baby, wondering why that flash of love didn’t appear. You might grieve for your old life and identity. You might feel trapped, wanting to escape yet at the same time feeling you can’t leave your baby. </p>
<p>Worries about not being “good enough” for your baby are also common. But honestly, you don’t need to get it right all the time. You are more than enough for your baby. None of these very normal reactions to change mean that you don’t love your baby.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>This article is part of <a href="https://theconversation.com/uk/topics/womens-health-matters-143335">Women’s Health Matters</a>, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/science-experiments-traditionally-only-used-male-mice-heres-why-thats-a-problem-for-womens-health-205963">Science experiments traditionally only used male mice – here’s why that’s a problem for women’s health</a></em></p>
<p><em><a href="https://theconversation.com/five-old-contraception-methods-that-show-why-the-pill-was-a-medical-breakthrough-207572">Five old contraception methods that show why the pill was a medical breakthrough
</a></em></p>
<p><em><a href="https://theconversation.com/the-orgasm-gap-and-why-women-climax-less-than-men-208614">The orgasm gap and why women climax less than men</a></em></p>
<hr>
<p>But knowing when these are normal feelings and when you might need support is important. At least <a href="https://maternalmentalhealthalliance.org/about/perinatal-mental-health/">one in five</a> new mothers will experience a mental health issue after birth. Though this is likely an underestimation because many hide these feelings. But hiding them just prevents you from getting the support you need. So here are some signs to look out for:</p>
<p><strong>Postnatal depression:</strong> <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/postnatal-and-antenatal-depression/">Depression</a> isn’t simply feelings of sadness. In fact, anxiety, about something specific or a general feeling of dread is common. You might lose pleasure in doing things, feel hopeless about the future, or feel very low about yourself. </p>
<p><strong>Anxiety and intrusive thoughts:</strong> We all have moments where we imagine ourselves dropping our baby. Sometimes however these thoughts become <a href="https://www.verywellfamily.com/overcoming-postpartum-ocd-and-intrusive-thoughts-5187982">repetitive, frequent</a> and we can’t make them go away. You might find yourself <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/perinatal-anxiety/">unable to sleep</a> or waking too early. You might feel restless, overwhelmed in public or feel shaky. </p>
<figure class="align-center ">
<img alt="Woman lying in bed with baby." src="https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542180/original/file-20230810-12281-ellk87.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s normal for life to seem radically altered and to feel a loss of identity.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/a-woman-resting-on-the-bed-with-her-baby-on-top-6849528/">pexels rdne stock project</a></span>
</figcaption>
</figure>
<p><strong>Postnatal rage:</strong> We often don’t talk about rage when it comes to mothers but it’s <a href="https://www.irishtimes.com/life-and-style/health-family/i-was-a-charging-brutal-half-animal-the-ugly-truth-about-postnatal-rage-1.2950662">more common</a> that you think. You might find yourself feeling on edge or irritable and then snap when something small goes wrong. Hormonal fluctuations and a lack of sleep might exacerbate this but more often it’s a reaction to feeling overwhelmed, powerless and unsupported. </p>
<p><strong>Birth or breastfeeding trauma:</strong> Many women have some difficult memories of birth but sometimes, even if you are able to talk them over with friends afterwards, <a href="https://www.youtube.com/watch?v=A43qlYkSMyU">these don’t go away</a>. You might find yourself having flashbacks, feel unable to go near the hospital or anything that reminds you of the birth, or feel very angry about your experience, or blame yourself. </p>
<p>Your sleep or appetite might be affected, or you might feel very jumpy or on edge. Sometimes these feelings are linked to physical events during the birth, but often they’re more about how you felt or were treated.</p>
<p>Increasingly similar feelings of trauma or grief are being recognised around <a href="https://welldoing.org/article/why-breastfeeding-grief-trauma-matter">infant feeding experiences</a>. If you experienced breastfeeding difficulties or had to stop before you were ready, you might be feeling guilt, anger or loss about that, despite your baby thriving. </p>
<h2>Getting support</h2>
<p>If you’re feeling overwhelmed by the emotions you are experiencing or find your sleep, energy or appetite is affected, here are some things to try:</p>
<figure class="align-center ">
<img alt="Woman with baby and laptop." src="https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542183/original/file-20230810-24-a9mnpk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Don’t suffer in silence, get as much support and help as you can.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/young-working-mother-cuddling-baby-and-using-laptop-at-home-7282818/">Pexels/sarah chai</a></span>
</figcaption>
</figure>
<p><strong>Talk to friends:</strong> Sometimes just sharing how we feel and realising that others feel this way can help us realise we are not alone </p>
<p><strong>Discuss with your health visitor or GP:</strong> They can help you understand how you are feeling and discuss different treatments such as counselling and medication</p>
<p><strong>Contact one of the many organisations that can help:</strong> The <a href="https://maternalmentalhealthalliance.org/resources/mums-and-families/">Maternal Mental Health Alliance</a> has a list of contacts. You can talk through difficult infant feeding experiences with a <a href="https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/help-and-support/">breastfeeding charity</a>. Many doulas (a person who can support you through pregnancy, labour and birth) also offer help to explore <a href="https://doula.org.uk">how you are feeling</a> about your birth and caring for your baby. </p>
<p><strong>Focus on looking after yourself, too:</strong> Your diet, activity levels and time outdoors can all affect how you feel. Do not be afraid to ask others for help or to use sources such as childcare to get some time for you to be able to do this. Explain to them how you feel and what you need. </p>
<p><strong>Creativity is good:</strong> The <a href="https://www.maternaljournal.org/">Maternal Journal</a> project holds in-person and online group sessions supporting you to explore how art can help, while also caring for your baby. </p>
<p><strong>Try baby massage:</strong> It can help you to slow down and connect with your baby. And it can help increase <a href="https://pubmed.ncbi.nlm.nih.gov/11246096/">oxytocin levels</a> in you both, calming your system.</p>
<p><strong>Explore some grounding techniques:</strong> <a href="https://www.healthline.com/health/grounding-techniques#physical-techniques">These can help you</a> to manage your anxiety. When you feel symptoms of anxiety, look for things in the environment around you. Try and find five things that are blue. Or five things that are soft. Count them and say them out loud. </p>
<p>Most of all remember that none of these feelings are anything to do with how much you love your baby or how well you care for them. Often mothers experiencing mental health difficulties are highly attuned to their baby’s needs because they are so worried about not getting it right. Your baby will be fine, but it’s important that you are too.</p><img src="https://counter.theconversation.com/content/207360/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Brown has received funding from the ESRC, MRC, NIHR, HEFCW, UKRI, Infant feeding charities and Public Health Wales. She is a trustee for First Steps Nutrition Trust.</span></em></p>
New motherhood is often portrayed as a time of joy but it can also be filled with fears and complicated feelings. Here’s how you can get help and support.
Amy Brown, Professor of Child Public Health, Swansea University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/206815
2023-08-29T15:34:39Z
2023-08-29T15:34:39Z
Women still feel like they aren’t listened to when they give birth – here’s what could help change things
<figure><img src="https://images.theconversation.com/files/529567/original/file-20230601-21-fbfne2.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C5800%2C3846&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/new-born-baby-hand-hold-mum-1968250909">Ratchat/Shutterstock</a></span></figcaption></figure><p>Women often report that they are <a href="https://www.sciencedirect.com/science/article/pii/S0266613815002302?casa_token=Y3U5qP_CLgkAAAAA:X8XttGQrojxZWapFx7YeRifVidoBXfmfGV32ocbTW7Fjoe2IttRprpfSeUB5khvaBAHArawbaXjT#bib3">not listened to or given choices</a> about what happens during their own labour. But studies have long shown that <a href="https://www.gov.uk/government/publications/womens-health-strategy-for-england">feeling heard and having choice</a> during childbirth enhances women’s wellbeing.</p>
<p>These findings led to changes in NHS policy and guidelines beginning with the landmark report <a href="https://www.sciencedirect.com/science/article/pii/S0266613813003537?casa_token=0w-T3zF3BcoAAAAA:v9TE8QFF0IugEcSaQI6_run7w420zDhU3LzN1qg7hk1fsUr6-sfR00wEvvJQExwNFiFaLgTsby31#bib4">Changing Childbirth in the 1990s</a>.</p>
<p>However, our recent research has revealed a disconnect between policy and the reality of how decision making happens. This could help explain why women <a href="https://www.theguardian.com/lifeandstyle/2023/mar/16/i-kept-begging-for-pain-relief-the-women-forced-to-give-birth-without-gas-and-air">still say they feel ignored</a> when they ask for pain relief during labour. </p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>This article is part of <a href="https://theconversation.com/uk/topics/womens-health-matters-143335">Women’s Health Matters</a>, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/five-old-contraception-methods-that-show-why-the-pill-was-a-medical-breakthrough-207572">Five old contraception methods that show why the pill was a medical breakthrough
</a></em></p>
<p><em><a href="https://theconversation.com/the-orgasm-gap-and-why-women-climax-less-than-men-208614">The orgasm gap and why women climax less than men</a></em></p>
<p><em><a href="https://theconversation.com/science-experiments-traditionally-only-used-male-mice-heres-why-thats-a-problem-for-womens-health-205963">Science experiments traditionally only used male mice – here’s why that’s a problem for women’s health</a></em></p>
<hr>
<p>Our team of sociologists and midwives examined 37 video or audio recordings of labour and birth in <a href="https://www.journalslibrary.nihr.ac.uk/hsdr/FPFP4621/#/abstract">English midwife-led units</a> (where midwives support low risk births). </p>
<p>Although the women wrote that they expected and wanted to be involved in decision making when they went into labour in pre-birth questionnaires, this generally didn’t happen on the day. Nevertheless, when many of the mothers filled in follow-up questionnaires about six weeks after birth, they mostly reported being satisfied with their experience. </p>
<p>However, some women faced various forms of resistance from midwives about pain relief over a long period of time and were less pleased with how things went.</p>
<p>A key limitation of our study is that the 36 of the 37 mothers in the study were white. This is important to note beacuse black and Asian women in the UK are <a href="https://www.npeu.ox.ac.uk/assets/downloads/mbrrace-uk/reports/maternal-report-2022/MBRRACE-UK_Maternal_MAIN_Report_2022_UPDATE.pdf">more likely to die</a> in childbirth than white women. </p>
<h2>Complexity of pain relief decisions</h2>
<p>No one <a href="https://www.spectator.co.uk/article/why-is-the-nhs-denying-women-pain-relief-in-childbirth/">should be denied pain relief</a> without explanation, but our study findings show how complex decisions about pain actually are.</p>
<p>For example, increased pain is a sign the woman may be close to delivering her baby. If women <a href="https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/the-stages-of-labour-and-birth/">take opiates during the second</a>, “pushing” stage of labour, there is a chance the baby could be born with opiates in their system, which sometimes means <a href="https://www.nhsinform.scot/ready-steady-baby/labour-and-birth/labour/pain-relief-in-labour">newborns need help to start breathing</a>. It can also interfere with breastfeeding. </p>
<p>One woman, who we called Fiona, requested opiate pain relief 18 times over an hour and a half. A key issue for Fiona was a shift change, shortly after an agreement to administer pain relief depending on the outcome of a vaginal examination (to check that Fiona was not “ready to push baby out”). </p>
<p>The outgoing midwife left before conducting the examination and Fiona reissued her request for opiates almost as soon as the new midwife entered the room. The midwife asked what form of pain relief Fiona had in her previous labour and the nature of her current pains. Then she asserted a need to conduct clinical observations (such as blood pressure). </p>
<p>Nevertheless, the midwife kept the matter open by saying: “Bear with me and then we’ll keep having a bit more of a chat about your options.” The situation continued to unfold in this way, with Fiona requesting opiates and the midwife deferring the decision. </p>
<p>It was some time before the midwife outlined the risks involved with opiates. </p>
<p>Fiona hesitated but agreed to forgo opiates and delivered her baby around ten minutes later. In her post-birth questionnaire, Fiona said she did not regret going without opiates but added:</p>
<blockquote>
<p>I don’t feel that the midwife in the later stages of my labour listened to what I was saying. All in all the experience was positive. However, I asked for increased pain relief around 6.30am and repeatedly after that, and the midwife did not have a discussion with me about why it would be advisable not to have the pain relief until around 8.20am. In the meantime I was very frustrated that no one was listening.</p>
</blockquote>
<h2>Midwives lead most decisions</h2>
<p>The way a person initiates a conversation can open up or close the opportunity for the other person to participate. For example, a pronouncement – <a href="https://www.tandfonline.com/doi/abs/10.1080/10410236.2017.1350913?journalCode=hhth20">saying that something is going to or needs to happen</a> – conveys that the decision has already been made unilaterally. </p>
<p>When midwives made an offer (such as “do you want me to give you a bit of a massage?” and gave <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/1467-9566.12766">option-lists</a>, on the other hand, they set up an opportunity for women to make a choice. When we examined how midwives initiated decisions, the majority (57%) were unilateral. But this is not necessarily a bad thing. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Mother with her newborn baby at the hospital" src="https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529568/original/file-20230601-25-xaxev9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Birth is one of the most intense experiences a person can have.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mother-her-newborn-baby-hospital-day-1839847582">Lopolo/Shutterstock</a></span>
</figcaption>
</figure>
<p>Pronouncements occurred a lot in <a href="https://www.nice.org.uk/guidance/cg190">relation to fetal monitoring</a>. For example, midwives saying “I’m just going to listen to baby, lovely.” These declarations place little pressure on women to respond, and the frequent use of “just” conveys that monitoring will involve minimal disruption. </p>
<p>The value of <a href="https://www.cochrane.org/CD010088/PREG_routine-vaginal-examinations-labour">routine vaginal examinations</a> is contested among researchers. However, <a href="https://www.nice.org.uk/guidance/cg190/chapter/Recommendations#first-stage-of-labour">NHS guidelines</a> state they should be offered every four hours in the first stage of labour. </p>
<p>Midwives did occasionally offer explicit choice about whether a vaginal examination should take place, but only in early labour when they suspected there was no progress. Otherwise, decisions about examinations tended to be pronounced, but always involved an explicit consent check beforehand.</p>
<p>Overall in our recordings, birth partners typically deferred to midwives and confined themselves to providing support for their partners.</p>
<p>In the third stage of labour (the time between the baby’s birth and delivery of the placenta), the cutting of the cord is the only moment where birth partners – fathers in our dataset – were treated as decision makers. </p>
<p>Midwives routinely offered birth partners the opportunity to cut the cord. While women in our study did not seem to mind, <a href="https://academic.oup.com/shm/article/30/2/389/2669697?login=false/j.1365-2648.2012.05978.x?casa_token=POTutaB_2GUAAAAA:-T5NiJ1y-eQmrytMGJ4Q9O8no4HJPSvmbjLR48coTYezz5M2JaHClzuUxjoylEhDpZbA3EfNmZe6eB4">there are potential conflicts</a> between involving fathers in pregnancy and birth and maintaining women’s bodily autonomy. </p>
<h2>The difficulty of providing choice</h2>
<p>Our findings illustrate how difficult it is for midwives to promote patient involvement in a context where guidelines and clinical knowledge indicate particular things should happen. </p>
<p>The fact that the length of labour is inherently uncertain does not help. We suggest that midwives would benefit from better support and training to manage these tensions and that it would be helpful if these conflicts were recognised more explicitly within policy.</p>
<p>Our findings also highlight the need to improve communication during decisions about pain relief. Delaying or deferring decisions can leave women feeling unheard during one of the most, if not the most, vulnerable times of their lives.</p><img src="https://counter.theconversation.com/content/206815/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Clare Jackson receives funding from National Institute for Health and Care Research. </span></em></p><p class="fine-print"><em><span>Ellen Annandale receives funding from the National Institute for Health Research. She is Chair of Trustees for the Foundation for the Sociology of Health and Illness. </span></em></p><p class="fine-print"><em><span>Sian Beynon-Jones receives funding from National Institute for Health and Care Research.</span></em></p>
Midwives get blamed but contradictions in policy sometimes tie their hands.
Clare Jackson, Senior Lecturer in Sociology, University of York
Ellen Annandale, Professor of Sociology, University of York
Sian Beynon-jones, Senior Lecturer in Sociology, University of York
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/203828
2023-06-05T12:06:11Z
2023-06-05T12:06:11Z
Birth of a story: How new parents find meaning after childbirth hints at how they will adjust
<figure><img src="https://images.theconversation.com/files/529856/original/file-20230602-19-u8qb1f.jpg?ixlib=rb-1.1.0&rect=94%2C549%2C4418%2C2943&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Having a new baby can upend everything about your old life.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/newborn-baby-boy-being-cradled-by-new-parents-in-royalty-free-image/1307728623">Cavan Images/Cavan via Getty Images</a></span></figcaption></figure><p>Gather a group of new parents and the conversation will likely turn to their childbirth stories – ranging from the joyful to the gnarly to the positively traumatic. <a href="https://slate.com/human-interest/2022/01/birth-stories-feminist-history-internet-sharing.html">Birth story podcasts and websites</a> feature a curated range of birth experiences, and you can buy embossed leather “birth story” journals as a baby shower gift. People are fascinated by this pivotal, emotionally complex and literally life-and-death experience.</p>
<p>Birth narratives might also contain clues about how the adjustment to parenthood will go.</p>
<p><a href="https://www.penguinrandomhouse.com/books/203434/the-uses-of-enchantment-by-bruno-bettelheim/">People have long used stories</a> to understand difficult experiences. Stories may be particularly valuable as a source of “meaning-making,” the process of finding order in chaos by making sense of unexpected events, identifying silver linings and discovering the patterns and connections that thread seemingly random events together into a coherent narrative.</p>
<p>In a new study led by <a href="https://scholar.google.com/citations?user=YRIcV6YAAAAJ&hl=en&oi=ao">Geoffrey Corner</a>, a former graduate student in <a href="https://dornsife.usc.edu/nestlab/">my lab</a>, we found that the levels of meaning-making in the stories new parents told about their baby’s birth <a href="https://doi.org/10.1037/fam0001062">predicted their relationship quality and parenting stress</a> in the child’s first months.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three moms with infants on mats facing an instructor with a doll in a baby yoga class" src="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When new moms come together, the talk often turns to their childbirth stories.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/baby-massage-class-switzerland-new-mothers-learn-how-to-news-photo/629429057">BSIP/Universal Images Group via Getty Images</a></span>
</figcaption>
</figure>
<h2>Constructing meaning in your own life</h2>
<p>Finding meaningful themes and patterns in life’s seeming randomness is a fundamentally human activity. As writer Joan Didion put it, “<a href="https://www.penguinrandomhouse.com/books/40775/we-tell-ourselves-stories-in-order-to-live-by-joan-didion-introduction-by-john-leonard/">we tell ourselves stories in order to live</a>.”</p>
<p>“Meaning-making” can buffer despair in the wake of tragedy. Holocaust survivor Victor Frankl’s memoir, “<a href="http://www.beacon.org/Mans-Search-for-Meaning-P602.aspx">Man’s Search for Meaning</a>,” argued that meaning and purpose can prevent the bitterness and disillusionment that can otherwise fester after great loss. Research on what psychologists call <a href="https://doi.org/10.1207/s15327965pli1501_01">post-traumatic growth</a> has found that the level of “meaning-making” in people’s narratives about a difficult event predicts their mental health over time.</p>
<p>For example, studies have found <a href="https://doi.org/10.1037/a0018301">links between meaning-making and resilience</a> in cancer patients, bereaved parents and caregivers. Cancer survivors might discover that their chemo ordeal brought them closer to friends and family, or helped them step back from the hustle of everyday life and embrace a slower pace.</p>
<p>Although childbirth is typically experienced as a joyful rather than a tragic event, it can still be unpredictable, frightening and even life-threatening. Indeed, psychologists have begun to recognize that particularly difficult labors <a href="https://doi.org/10.1080/02646838.2015.1031646">can trigger post-traumatic stress symptoms</a>, not just in mothers but in their partners as well. Even normal, nontraumatic births require parents to cope with hours, sometimes days, of pain and discomfort. Therefore, we hypothesized that meaning-making might be an important part of couples’ birth narratives, potentially promoting resilience in new parents.</p>
<p>To test these hypotheses, we collected birth stories from 77 couples who were participating in our lab’s <a href="https://dornsife.usc.edu/nestlab/research/">longitudinal study of the transition to parenthood</a>. We visited couples at the hospital within a day or two of their infant’s birth, and audio-recorded them sharing their stories together. We told couples, “We’d like to hear you tell the story of your birth experience. Start from the beginning and tell us as much as you remember.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three masked medical workers hold newborn above mother's body during C-section operation" src="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=443&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=443&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=443&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=557&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=557&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=557&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parents may need to process even a normal childbirth with healthy outcomes.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/caesarian-babys-first-breath-royalty-free-image/125951777">Peter Dazeley/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<h2>Listening for meaning-making in birth stories</h2>
<p>A team of coders listened to each story and recorded examples of meaning-making, using three categories established in the research literature:</p>
<ul>
<li><p>Sense-making: Identifying reasons that an event might have unfolded the way it did or making connections that show why an event was meaningful. For example, one mother in our sample found meaning in her long labor, describing her baby as “very brave and tough” because she survived hours of pushing. </p></li>
<li><p>Benefit-finding: Pointing out silver linings or unexpected positive effects of a difficult experience. For example, after a difficult birth, one parent in our sample stated, “It was scary, but the nurses and the doctors were so nice to us.”</p></li>
<li><p>Change in identity: Describing how an event has transformed one’s sense of self. As a parent in our sample said, “I feel like my life has changed completely with the baby now here.”</p></li>
</ul>
<p>Although couples told their story together, we tracked meaning-making separately for each partner. We also rated how much each partner participated in telling their story so we could adjust for their levels of engagement in sharing their birth narrative.</p>
<p>The couples in our <a href="https://doi.org/10.1037/fam0001062">sample were avid “meaning makers”</a>: Almost all the participants made at least some meaning-making statements in their birth stories. Of the three categories of meaning-making, “change in identity” language surfaced least often, appearing in about 37% of the birth stories. Mothers tended to use more “sense-making” and “benefit-finding” language than fathers. And both members of a couple tended to use similar amounts of meaning-making language. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="infant on mother's chest in hospital bed with father smiling down at baby" src="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=487&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=487&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=487&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=612&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=612&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=612&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A new parent’s meaning-making can affect them and their partner.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mixed-race-family-admiring-their-newborn-baby-at-royalty-free-image/1248789907">SelectStock/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>Becoming mom or dad</h2>
<p>After we had coded all of the narratives, we next looked to see whether “meaning-making” predicted relationship satisfaction and parenting stress in our couples. The transition to parenthood can be a “<a href="https://doi.org/10.2307/347802">crisis event” for the couple relationship</a> and is often linked with <a href="https://theconversation.com/have-children-heres-how-kids-ruin-your-romantic-relationship-57944">declines in relationship quality</a>.</p>
<p>But when mothers used more “sense-making” and “benefit-finding” language, they showed a smaller drop in their relationship satisfaction than moms who used less. Fathers who used more “sense-making” and “benefit-finding” language reported lower parenting stress at six months postpartum than dads who used less.</p>
<p>And partners of fathers who used more “change in identity” language also reported lower parenting stress later on, suggesting that dads who experience the transition to parenthood as transformative may be able to help mothers cope better with new parenthood. On the flip side, though, when mothers showed more meaning-making, their partners actually reported more parenting stress at six months postpartum. It may be that when mothers find the birth experience to be more personally meaningful, partners feel left out or pressured to step up their own parenting.</p>
<p>Overall, these results supported our initial hunch that meaning-making might be detectable in birth narratives and forecast parents’ psychological adjustment after birth. Greater meaning-making language seemed to benefit the couple relationship and largely buffer parenting stress.</p>
<p>This study was limited by a fairly small sample of cohabiting heterosexual parents. Nevertheless, it highlights the value of stories in shaping family transitions. For therapists working with new parents in the wake of a difficult birth, encouraging couples to seek meaning in their birth story may help ease their transition to parenthood. Journaling and storytelling exercises may help couples process their feelings about their childbirth experiences. After all, the birth of a baby is also the birth of a story – and that story is well worth telling.</p><img src="https://counter.theconversation.com/content/203828/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Institutes of Health and the National Science Foundation. </span></em></p>
How you tell the story of a momentous event can help you make sense of what happened. Research finds new moms’ and dads’ narratives around childbirth held clues about their transition to parenthood.
Darby Saxbe, Associate Professor of Psychology, USC Dornsife College of Letters, Arts and Sciences
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/198118
2023-04-13T15:17:09Z
2023-04-13T15:17:09Z
Planning for a baby? Why both men and women should consider quitting alcohol before and during pregnancy
<figure><img src="https://images.theconversation.com/files/520784/original/file-20230413-14-lfsl69.jpg?ixlib=rb-1.1.0&rect=65%2C57%2C5390%2C3571&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">You might want to make booze a thing of the past.</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/positive-multiethnic-couple-drinking-wine-with-guests-5876657/">pexels/monstera</a></span></figcaption></figure><p>When a couple is planning on having a baby, it’s often the woman who is seen as responsible for the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0749379716000660#bib8">health of the unborn child</a>. </p>
<p>In the UK, the chief medical officer’s <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545937/UK_CMOs__report.pdf">drinking guidelines</a> recommend that women should abstain from alcohol consumption during pregnancy. This is because it’s known to increase the risk of <a href="https://pubmed.ncbi.nlm.nih.gov/31194258/">miscarriage</a> and <a href="https://www.nhs.uk/conditions/foetal-alcohol-spectrum-disorder/">foetal alcohol spectrum disorders</a> (FASD). </p>
<p><a href="https://theconversation.com/how-foetal-alcohol-spectrum-disorders-could-be-a-hidden-epidemic-52835">FASD</a> is an umbrella term used to describe a range of emotional, behavioural, developmental and learning challenges that are linked to a baby’s <a href="https://theconversation.com/up-to-17-of-children-in-the-uk-could-have-symptoms-of-foetal-alcohol-spectrum-disorder-according-to-latest-estimates-107649">exposure to alcohol</a> while in the womb.</p>
<p>The guidelines also recommend that if you’re planning to become pregnant, the safest approach is <a href="https://theconversation.com/health-risks-of-light-drinking-in-pregnancy-confirms-that-abstention-is-the-safest-approach-83753">not to drink</a> at all to minimise the risks to your pregnancy.</p>
<p>But evidence from large surveys shows that not all women stop drinking before pregnancy – whether the pregnancy was intended or not. In a 2017 <a href="https://pubmed.ncbi.nlm.nih.gov/28277356/">study</a> of 5,036 women in the US, the prevalence of alcohol consumption before pregnancy was similar between those with intended (55%) and unintended pregnancies (56%). </p>
<hr>
<figure class="align-right ">
<img alt="Quarter life, a series by The Conversation" src="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/451343/original/file-20220310-13-1bj6csd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em><strong><a href="https://theconversation.com/uk/topics/quarter-life-117947?utm_source=TCUK&utm_medium=linkback&utm_campaign=UK+YP2022&utm_content=InArticleTop">This article is part of Quarter Life</a></strong>, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.</em></p>
<p><em>You may be interested in:</em></p>
<p><strong><em><a href="https://theconversation.com/five-important-things-you-should-have-learned-in-sex-ed-but-probably-didnt-202177">Five important things you should have learned in sex ed – but probably didn’t</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/mens-fertility-also-declines-with-age-heres-what-to-know-if-youre-planning-to-wait-to-have-kids-187498">Men’s fertility also declines with age — here’s what to know if you’re planning to wait to have kids</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/five-things-research-can-teach-us-about-having-better-sex-according-to-a-sex-therapist-199360">Five things research can teach us about having better sex, according to a sex therapist</a></em></strong></p>
<hr>
<p>In another 2015 <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1111/aogs.12816">study</a> of 3,390 Swedish women, weekly alcohol consumption was not significantly different between women with a “very planned pregnancy” (11%) compared with women with a “very unplanned pregnancy” (14%). </p>
<p>And a 2013 <a href="https://www.tandfonline.com/doi/full/10.3109/13625187.2013.851183">survey</a> of 258 Danish women found that although 77% of their pregnancies were “very” or “fairly well planned”, one out of five reported binge drinking early in the pregnancy. Among women with unplanned pregnancies, this rose to one out of three.</p>
<p>But while the focus tends to be on a woman’s relationship with alcohol before and during pregnancy, an increasing amount of evidence indicates that men’s alcohol use also <a href="https://www.sciencedirect.com/science/article/abs/pii/S0749379716000660#bib8">plays a role</a> when it comes to the health of the baby. </p>
<p>Indeed, alcohol can <a href="https://www.ajog.org/article/S0002-9378(08)02037-1/fulltext">affect sperm DNA</a>, in some cases reducing <a href="https://theconversation.com/how-mens-damaged-sperm-could-play-significant-role-in-recurrent-miscarriage-109683">fertility</a> and the potential to conceive. </p>
<h2>Why stop drinking?</h2>
<p>Better health outcomes for babies <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729018/Making_the_case_for_preconception_care.pdf">begin before conception</a>, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4293222/">clear links established</a> between the health of men and women before pregnancy and the health of their offspring. </p>
<p>Research shows that if couples are trying to conceive, it makes sense for them both to quit the booze <a href="https://edition.cnn.com/2019/10/03/health/dads-trying-to-conceive-stop-drinking-wellness/index.html">at least six months before pregnancy</a>. This helps to reduce the risk of potential negative outcomes for the baby such as <a href="https://journals.sagepub.com/doi/abs/10.1177/2047487319874530?journalCode=cprc">congenital heart disease</a>.</p>
<p>It also has <a href="https://www.drinkaware.co.uk/advice/how-to-reduce-your-drinking/the-benefits-of-drinking-less">benefits</a> for the <a href="https://www.drugsandalcohol.ie/32647/1/R-de-Visser-Dry-January-evaluation-2019.pdf">expectant parents</a>, such as better sleep quality, increased energy, and enhanced concentration levels.</p>
<p>Research has also <a href="https://www.sciencedirect.com/science/article/pii/S0749379716000660#bib8">found</a> that if a couple lives together and the male partner drinks, there is a higher chance that the woman will drink alcohol before and during the pregnancy.</p>
<p>One of the reasons why this might be the case is explored in <a href="https://journals.sagepub.com/doi/full/10.1177/1757975912441225">another study</a> where women said that drinking with a partner, whether before or during pregnancy, provided a sense of social connection.</p>
<figure class="align-center ">
<img alt="Pregnant woman holding belly." src="https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/515255/original/file-20230314-3238-lcctzb.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s best to avoid alcohol altogether if you are wanting to conceive.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/smiling-pregnant-woman-caressing-tummy-in-house-room-5427247/">Pexels/Amina Filkins</a></span>
</figcaption>
</figure>
<p>The period before pregnancy, known as preconception, is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975952/pdf/emss-77899.pdf">window of opportunity</a> for would-be parents to improve their health and increase their likelihood of conceiving. And <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729018/Making_the_case_for_preconception_care.pdf">alcohol consumption</a> should be thought about as part of this. </p>
<p>As part of our recent research, we <a href="https://www.sciencedirect.com/science/article/pii/S2772653322000405?via=ihub">reviewed the literature</a> exploring people’s and health professionals’ views about information and support for reducing drinking in the period before getting pregnant. </p>
<p>We found that women were aware that lifestyle factors such as smoking or drinking alcohol can affect their pregnancy and increase the risk of poor outcomes for the baby. But there was a notable lack of awareness of the importance of men reducing their alcohol consumption when planning for pregnancy, too. </p>
<p>Indeed, men <a href="https://www.jabfm.org/content/jabfp/26/2/196.full.pdf">don’t usually go to clinics</a> to get information about preconception health, as this is usually left to the woman. </p>
<h2>Quit together</h2>
<p>While there is some indication that men, as well as women, are open to changing their drinking behaviour when planning for pregnancy, our literature review found that <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">very few studies</a> have explored men’s or partners’ views on preconception health.</p>
<p>And while there are promising results from interventions and approaches aimed at enhancing preconception health in men and women, such as <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">alcohol screening</a> followed by counselling and health education on <a href="https://www.sciencedirect.com/science/article/pii/S1877575617300940?via=ihub">changing behaviour</a>, there’s still not enough emphasis placed on men’s health at the preconception stage. This needs to change because, as the research shows, a baby’s health is influenced by both mum and dad. </p>
<p>So if you are considering trying for a baby, now could be the time for both partners to set new goals and <a href="https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregnant/">cut down on drinking</a> together. And if you’re concerned about the amount you drink, or are dependent on alcohol, you should get <a href="https://www.nhs.uk/conditions/alcohol-misuse/treatment/">professional advice and support</a> on cutting down safely.</p>
<hr>
<p><em><strong>Other Quarter Life articles you may be interested in:</strong></em></p>
<p><strong><em><a href="https://theconversation.com/ivf-add-ons-why-you-should-be-cautious-of-these-expensive-procedures-if-youre-trying-to-conceive-180198">IVF add-ons: why you should be cautious of these expensive procedures if you’re trying to conceive</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/anxiety-can-lead-to-erection-problems-in-young-men-but-reaching-for-viagra-isnt-always-the-solution-191980">Anxiety can lead to erection problems in young men – but reaching for Viagra isn’t always the solution</a></em></strong></p>
<p><strong><em><a href="https://theconversation.com/young-people-are-drinking-less-heres-an-alternative-to-try-on-your-next-night-out-197465">Young people are drinking less – here’s an alternative to try on your next night out</a></em></strong></p><img src="https://counter.theconversation.com/content/198118/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>We would like to thank Lisa Schölin, Queens Medical Research Institute, University of Edinburgh; Andrea Hilton, Department of Paramedical, Perioperative and Advanced Practice, University of Hull and Anand Ahankari, Faculty of Health and Medical Sciences, University of Surrey who are part of the research team and helped with writing and reviewing this article.</span></em></p><p class="fine-print"><em><span>Lesley Smith received funding from the National Institute of Health Research, The Institute of Alcohol Studies, the former Alcohol Research UK (now Alcohol Change UK) and The Joseph Rowntree Foundation for alcohol-related research. </span></em></p><p class="fine-print"><em><span>Jayne Walker does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Cutting down on alcohol consumption before pregnancy can benefit the health of both men, women and their baby.
Lolita Alfred, Lecturer in Mental Health, School of Health and Psychological Sciences, City, University of London
Jayne Walker, Senior lecturer| Professional Lead. School of Paramedical, Peri-Operative and Advanced Practice. Faculty of Health Sciences., University of Hull
Lesley Smith, Professor of Women's Public Health, Institute of Clinical and Applied Health Research, University of Hull
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/202872
2023-03-30T16:28:22Z
2023-03-30T16:28:22Z
Surrogacy shake up in UK would create uneven treatment for birth mothers
<figure><img src="https://images.theconversation.com/files/518518/original/file-20230330-1068-4tislc.jpg?ixlib=rb-1.1.0&rect=39%2C39%2C4322%2C2857&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Proposed UK surrogacy law changes raise concerns over unequal treatment of birth mothers</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-pregnant-woman-holding-ultrasound-scan-132280757">Phil Jones/Shutterstock</a></span></figcaption></figure><p>Surrogacy, where a woman agrees to carry and give birth to a child for another person or couple to raise, is <a href="https://brilliantbeginnings.co.uk/new-data-family-court-350-percent-growth-surrogacy/">growing in popularity</a>. There aren’t any comprehensive figures on the number of cases (partly because some surrogacy arrangements are <a href="https://uk.practicallaw.thomsonreuters.com/8-560-0205?transitionType=Default&contextData=(sc.Default)">made informally</a>) but it’s clear it’s something more and more couples and individuals are considering.</p>
<p>In the UK, surrogacy laws go back to the 1980s – and are long overdue an update. This is why the Law Commission – which keeps the law under review and recommends reform where it’s needed – has proposed <a href="https://s3-eu-west-2.amazonaws.com/lawcom-prod-storage-11jsxou24uy7q/uploads/2023/03/3.-Surrogacy-draft-bill.pdf">changes to the law</a> that aim to make the process smoother and more secure for everyone involved. </p>
<p>Surrogacy laws vary from country to country, but <a href="https://www.legislation.gov.uk/ukpga/1985/49">under the law currently in the UK</a>, the woman who gives birth to a child is always the legal parent at first. However, under the new surrogacy bill, couples or individuals using a surrogate would be the child’s legal parents right from the moment of birth. This change would put UK surrogacy law out of line with UK adoption laws in a concerning way.</p>
<p>Currently, all women who give birth in the UK have the same default rights to the child. This is regardless of whether they’re planning to give the child up for adoption or surrogacy – and whether they’ve used their own egg, a donor’s, or the would-be mother’s egg. But the new bill would create a disparity in how we treat birth mothers in surrogacy cases. </p>
<h2>Here’s why</h2>
<p>Under the current system, the so-called intending parents – the ones using a surrogate to have a baby – apply for what’s known as a parental order six weeks after the child’s birth. This transfers legal parenthood from the surrogate (and her husband or civil partner, if she has one) to the intended parents. </p>
<p>This process can be lengthy: on average it’s around six months, but it can take up to a year <a href="https://www.independent.co.uk/news/uk/home-news/surrogacy-laws-uk-criticism-babies-health-risk-b2233078.html">in some cases</a>. And during this time, the surrogate remains the legal mother – which can cause issues in medical emergencies.</p>
<figure class="align-center ">
<img alt="Couple receiving ultrasound picture from surrogate expectant mother." src="https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/518514/original/file-20230330-26-tkkbre.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Surrogacy law changes in UK could deliver an uneven playing field for birth mothers.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/happy-married-couple-receiving-ultrasound-picture-1095110102">Olena Yakobchuk/Shutterstock</a></span>
</figcaption>
</figure>
<p>Under the proposed new system the need for a parental order is scrapped: the intending parents would have legal parental rights from the moment the child is born. If the surrogate changes her mind and wants to keep the baby, she would have up to six weeks after the birth to apply for a parental order herself. But the intending parents would still retain the legal status they gained when the child was born. </p>
<p>In such a case, the courts would then have to determine whether the intending parents should keep the child, or if the surrogate should be given parental status - so, the reverse of what the UK has at the moment. </p>
<h2>Adoption v surrogacy</h2>
<p>Pre-birth adoption contracts are illegal in the UK – and in fact, across most of the world. Even when a pregnant woman firmly intends to give up the child for adoption, she can only legally consent to this <a href="https://www.legislation.gov.uk/ukpga/2002/38/section/52/enacted?view=plain">six weeks</a> after the birth – just like surrogates under the current law. </p>
<p>The six-week period is an <a href="https://rm.coe.int/1680084823">international standard</a> which is meant to make sure that the birth mother’s consent to adoption is freely given. This allows some time to recover from childbirth and conditions like post-partum depression, which might make the decision more difficult. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/Rop3QyKh90k?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>Birth parents have a right to change their minds about adoption and legally this trumps the <a href="https://www.todaysparent.com/family/our-long-road-to-adoption/">grief and disappointment</a> prospective adoptive parents feel at being told the birth mother has decided to keep the baby. But in contrast, the new surrogacy proposals could make it harder for surrogate mothers who no longer want to give up their baby.</p>
<p>It seems that <a href="https://s3-eu-west-2.amazonaws.com/lawcom-prod-storage-11jsxou24uy7q/uploads/2019/06/Surrogacy-consultation-paper.pdf">very few</a> surrogates change their mind and want to keep the child. The same is true in adoption, where only a <a href="https://helpinggrowfamilies.com/can-a-birth-mother-change-her-mind-we-find-out/">small percentage</a> of women change their minds after giving birth. But their right to do so is fundamentally protected in both instances - for now. Under the proposed changes this may not still be the case. </p>
<h2>‘It’s not the same’</h2>
<p>A major difference between adoption and surrogacy is that in surrogacy, one or both of the intending parents are related to the child genetically. But it doesn’t make sense from an ethical perspective to think that this should change the legal rights of the birth mother. </p>
<p>Indeed, <a href="https://www.gov.uk/legal-rights-for-egg-and-sperm-donors#:%7E:text=Egg%20donors,when%20using%20a%20donated%20egg.">as it currently stands</a> if you give birth to a child, you’re always considered the legal mother in UK law – even when using a donated egg. The new proposals would change this blanket rule to make an exception in the case of surrogacy. </p>
<p>But if childbirth is an important enough connection to keep these default rights in the case of adoption, then why not in surrogacy? And if people who sign up to adopt a child accept the risk that a pregnant woman might change her mind about keeping the baby, why not in surrogacy?</p>
<p>Turning parenthood into a contractual agreement may seem like a common-sense fix to surrogacy dilemmas. But if surrogacy is made to be more about contracts, it might lead to risky situations with surrogates treated unfairly. And ethically, surely all birth mothers should have the same legal protection, regardless of their plans after the baby is born.</p><img src="https://counter.theconversation.com/content/202872/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Teresa Baron does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
UK surrogacy law reform: what you need to know about the proposed changes and how they could affect you.
Teresa Baron, Nottingham Research Fellow in the Department of Philosophy, University of Nottingham
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/174922
2022-06-28T11:57:04Z
2022-06-28T11:57:04Z
Anti-abortion pregnancy centers will likely outlast the age of Roe – here’s how they’re funded and the services they provide
<figure><img src="https://images.theconversation.com/files/470680/original/file-20220623-51933-jlif1n.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5982%2C3574&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A dozen states now provide a total of $89 million in funding to pregnancy centers.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/studio-portrait-of-pregnant-woman-royalty-free-image/1207238436?adppopup=true">Yuji Ozeki/Digital Vision via Getty Images</a></span></figcaption></figure><p>Experts predict <a href="https://www.brookings.edu/research/what-can-economic-research-tell-us-about-the-effect-of-abortion-access-on-womens-lives/">increased economic hardship</a> now that the U.S. Supreme Court has overturned <a href="https://www.oyez.org/cases/1971/70-18">Roe v. Wade</a> in its <a href="https://www.oyez.org/cases/2021/19-1392">Dobbs v. Jackson Women’s Health Organization</a> decision.</p>
<p>Three-quarters of abortion patients in the United States <a href="https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014">have incomes that place them below or just barely above the federal poverty line</a> of <a href="https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines/prior-hhs-poverty-guidelines-federal-register-references/2021-poverty-guidelines#threshholds">US$26,500 for a family of four</a> in 2021. The inability to afford a child ranks among the most common reasons women give when they explain <a href="https://doi.org/10.1186/1472-6874-13-29">why they are ending a pregnancy</a>.</p>
<p>The anti-abortion movement is often <a href="https://slate.com/news-and-politics/2021/12/dobbs-roe-abortion-poverty-statistics-republicans.html">criticized as caring little</a> about these matters. But as <a href="https://politicalscience.umbc.edu/faculty-1/dr-laura-hussey/">a political scientist</a> who has studied the intersections of abortion and social welfare issues, I became intrigued by a large but little-known subset of anti-abortion activists who claimed to support women during pregnancy and after childbirth. </p>
<p><a href="https://kansaspress.ku.edu/978-0-7006-2900-8.html">My 2020 book on this “pregnancy help” work</a> indicates that the anti-abortion movement does provide support to low-income families, even if not in the way its critics might prefer. </p>
<h2>The ‘pregnancy help’ movement</h2>
<p>This work mostly occurs within the anti-abortion movement’s own charitable organizations. Participants in this “pregnancy help movement,” <a href="https://www.heartbeatinternational.org/footsoldiers">according to Margaret Hartshorn</a>, the former president of one such organization, strive to make abortion “unwanted now and unthinkable in future generations” by ensuring “that no woman ever feels forced to have an abortion because of lack of support or practical alternatives.” </p>
<p>People in the movement run maternity homes, adoption and social service agencies, charitable medical practices, hotlines, support groups and aid networks. However, the core institutions of their movement are pregnancy centers. <a href="https://mobilizingideas.wordpress.com/2013/03/04/co-opting-choice-one-woman-at-a-time/">Pregnancy centers</a> <a href="https://doi.org/10.1086/665807">typically offer</a> free pregnancy tests, sonograms, counseling and promises of material support in the hopes of persuading women to carry unintended pregnancies to term. </p>
<p>The first ones began to open in the U.S. in the late 1960s. They outnumbered <a href="https://www.nytimes.com/2013/01/05/health/pregnancy-centers-gain-influence-in-anti-abortion-fight.html">abortion providers</a> at least as early as 2013. A July 2018 directory listed 2,740 U.S. pregnancy centers. Lehigh University <a href="https://press.uchicago.edu/ucp/books/book/chicago/M/bo5186375.html">sociologist Ziad Munson writes</a> that such outreach involves more people, volunteer hours and organizations than any other type of anti-abortion activism.</p>
<p>Based on my interviews of pregnancy center leaders and review of various movement communications, these organizations are mostly funded by individual donations, commonly raised through banquets, walks, races or church-based collections of money and goods. Some anti-abortion groups like <a href="https://www.focusonthefamily.com/pro-life/option-ultrasound-program-2/">Focus on the Family</a> and the <a href="https://www.kofc.org/en/what-we-do/faith-in-action-programs/life/pregnancy-center-support.html">Knights of Columbus</a> give them grants.</p>
<p>Pregnancy centers typically aren’t affiliated with specific churches, though they often frame themselves as ministries modeled on Jesus Christ’s love for people who are hurting and marginalized.</p>
<p>In 13 states as of 2021, pregnancy centers could apply for funding from state-run <a href="https://equityfwd.org/research/mapping-deception-closer-look-how-states-anti-abortion-center-programs-operate">Alternatives to Abortion programs</a>. As of March 2022, as many as 19 states may have directed a proportion of <a href="https://www.guttmacher.org/state-policy/explore/choose-life-license-plates">“Choose Life” license plate proceeds</a> to pregnancy centers. An Associated Press investigation of fiscal 2022 state budgets found that <a href="https://abcnews.go.com/Health/wireStory/millions-tax-dollars-flow-anti-abortion-centers-us-82692429">12 states funded pregnancy centers</a>, providing US$89 million. </p>
<p>Centers can also apply for select federal grants. According to a <a href="https://s27589.pcdn.co/wp-content/uploads/2020/10/Pregnancy-Center-Report-2020_FINAL.pdf">report on U.S. pregnancy center services</a> by the Charlotte Lozier Institute, an anti-abortion think tank, 17% of U.S. centers received some public money in 2019. </p>
<p>By comparison, the Planned Parenthood Federation of America, which provides abortions and other reproductive health care services, <a href="https://www.plannedparenthood.org/uploads/filer_public/67/30/67305ea1-8da2-4cee-9191-19228c1d6f70/210219-annual-report-2019-2020-web-final.pdf">reported receiving</a> about $618 million – or 38% of its revenue – in government grants and payments for services in the fiscal year ending June 30, 2020.</p>
<p>U.S. pregnancy centers in 2019, also according to the Lozier Institute, performed more than 730,000 pregnancy tests and met with nearly 1 million new clients. </p>
<p>For perspective, the U.S. recorded <a href="https://www.cdc.gov/nchs/data/vsrr/vsrr-8-508.pdf">3.75 million live births</a> that year. In 2017, the most recent data available, <a href="https://www.guttmacher.org/report/abortion-incidence-service-availability-us-2017">just over 860,000 abortions</a> were performed. A new <a href="https://doi.org/10.1371/journal.pone.0255152">peer-reviewed study</a> of pregnant women who were searching online for an abortion provider – suggesting they may be more internet-savvy, older and more socioeconomically advantaged than U.S. abortion-seekers generally – found that at least 13% of them visited a pregnancy center.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="An infant sleeps inside a crib." src="https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/470966/original/file-20220626-22-iwnvup.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Many pregnancy help centers provide low-income clients with cribs, baby clothes and diapers.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/cute-baby-sleeps-at-night-in-a-cradle-for-babies-royalty-free-image/1314727351?adppopup=true">Tatiana Kutina/EyeEm via Getty Images</a></span>
</figcaption>
</figure>
<h2>Pregnancy center aid</h2>
<p>Anti-abortion advocates paint pregnancy centers as <a href="https://clmagazine.org/topic/pro-life-champions/pro-life-pregnancy-centers-caring-for-mothers-and-their-preborn-babies/">the compassionate alternative to abortion</a>. Abortion-rights activists describe them as <a href="https://alliancestateadvocates.org/crisis-pregnancy-centers/">threats to public health</a> that advertise deceptively, offer few health care services and infuse their counseling with <a href="https://www.prochoiceamerica.org/wp-content/uploads/2017/04/cpc-report-2015.pdf">misinformation and emotional coercion</a>. </p>
<p>My research did not attempt to assess the quality of counseling provided by the centers. Rather, I focused on broadly understanding and describing the movement and measuring the extent of help they provide to needy families.</p>
<p>Similar to data I collected in 2012, a 2019 report by the Lozier Institute claimed that <a href="https://s27589.pcdn.co/wp-content/uploads/2020/10/Pregnancy-Center-Report-2020_FINAL.pdf">94% of centers provided material aid</a>. The report credited U.S. pregnancy centers with distributing about 1.3 million packages of diapers, 690,000 packages of wipes, 2 million baby outfits, 30,000 new car seats and 20,000 strollers. They valued these goods at nearly $27 million. I also found pregnancy centers provided personalized help in navigating community resources for housing, health care, creditor mediation and domestic violence recovery. </p>
<p>Activists told me that helping families meet their material needs was integral to their missions, greatly needed, and simply “Christian” or “pro-life.” <a href="http://www.ekyros.com/Pub/DesktopModules/ekyros/ViewStats.aspx?ItemId=13&mid=89&tabid=16">Available data suggests</a> that the women who use these centers tend to be under 30 and unmarried.</p>
<p>My research also noted that pregnancy centers were increasingly tying material aid to participation in their <a href="https://www.ewyl.com/curriculum.aspx?PackItemNumber=7601EWYL-EC&date=8/16/2021">parenting programs</a>. </p>
<p>Another trending service they offer is ultrasound imaging. Leaders I interviewed felt that offering a medical service could increase centers’ credibility and that viewing an image of their fetus would inspire clients to “choose life.” <a href="https://nifla.org/training/institute-limited-obstetric-ultrasound/">Trained nurses</a> overseen by an often off-site <a href="https://www.atcmag.com/Issues/ID/159/Staffing-the-Pregnancy-Medical-Clinic">physician “medical director”</a> usually perform the scans, but otherwise, <a href="https://sph.unc.edu/sph-news/crisis-pregnancy-centers-come-up-short-in-providing-access-to-information-on-pregnancy-options/">critics</a> correctly assert that most pregnancy center staff lack medical training.</p>
<p>Interviews of 21 pregnancy center clients over a period between 2015 and 2017 led medical sociologist Katrina Kimport of the University of California, San Francisco to <a href="https://doi.org/10.1363/psrh.12131">conclude</a> that “low-income women can find these centers to be meaningful and appreciated sources of free emotional support, pregnancy-related services and material goods,” even if the women ultimately needed more economic resources than centers could provide and sometimes struggled with program requirements. </p>
<p>Kimport continued: “Although these centers have been rightly criticized for disseminating scientifically inaccurate materials and employing potentially deceptive practices, the policy debate about their legitimacy needs to be more nuanced.” </p>
<h2>Pregnancy help in a post-Roe America</h2>
<p>Pregnancy center volunteers and employees I surveyed in 2012 overwhelmingly agreed that pregnancy centers would remain needed if the federal right to abortion was overturned. Centers are already most numerous, my statistical analysis of location data found, where public opposition to abortion is highest, abortion rates are lowest and abortion providers are the most scarce. Some anti-abortion leaders are calling the movement to follow the fall of Roe <a href="https://www.nytimes.com/2021/12/05/upshot/abortion-without-roe-wade.html">with increased aid to low-income people</a>, some of which would flow through pregnancy centers. </p>
<p>The kind of aid pregnancy help groups offer won’t begin to cover all costs of childbearing, or solve larger socioeconomic problems. Many women inclined toward abortion likely don’t see anti-abortion pregnancy centers as desirable service providers. </p>
<p>Still, they attract anti-abortion activists who appear to take seriously what one interviewee called the “consequences to a choice for life.” In my view, they could potentially participate constructively in a conversation about poverty and childbearing in a post-Roe America.</p><img src="https://counter.theconversation.com/content/174922/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>I am a member of Feminists for Life, an anti-abortion education and advocacy group that describes its mission as "systematically eliminating the root causes that drive women to abortion."</span></em></p>
Offering free pregnancy tests, sonograms and counseling, the pregnancy help movement maintains more than 2,700 resource centers throughout the United States.
Laura Antkowiak, Associate Professor of Political Science, University of Maryland, Baltimore County
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/182125
2022-05-26T20:39:17Z
2022-05-26T20:39:17Z
Can you use rapid antigen tests in children under 2 years old?
<figure><img src="https://images.theconversation.com/files/460487/original/file-20220429-17-drojpg.jpg?ixlib=rb-1.1.0&rect=2%2C0%2C995%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/brown-teddy-bear-sitting-on-sofa-2106255734">Shutterstock</a></span></figcaption></figure><p>As we head into winter, you may have a sniffly child under two years old at home. Is it just a cold? Or could it be COVID?</p>
<p>You may be tempted to reach into the cupboard for a rapid antigen test to find out. But some manufacturers say their COVID tests aren’t suitable for children under two.</p>
<p>Can you use a test intended for adults or older children? How do you test a wriggling or grumpy small child anyway? We’re infection control and child health researchers. Here are our tips.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-or-just-a-common-cold-what-to-do-when-your-child-gets-sick-this-winter-140727">Coronavirus or just a common cold? What to do when your child gets sick this winter</a>
</strong>
</em>
</p>
<hr>
<h2>Are there special tests for this age group?</h2>
<p>Of the 47 different rapid antigen tests <a href="https://www.tga.gov.au/covid-19-rapid-antigen-self-tests-are-approved-australia">authorised</a> for home use in Australia at the time of writing, most (57%) state they are not suitable for children under two. This leaves 20 tests that are.</p>
<p>You can <a href="https://www.tga.gov.au/covid-19-rapid-antigen-self-tests-are-approved-australia">check the list</a> on the Therapeutic Goods Administration (TGA) website to see if the test you have at home is one of them.</p>
<p>Just because a test isn’t approved for a particular age doesn’t necessarily mean it doesn’t work at all. It usually means the test has not been tested, or its use determined, for that age. But try to use a test approved for under twos if you can.</p>
<p>However, rapid antigen tests are generally not as accurate in children as they are in adults. They are: </p>
<ul>
<li><p><strong>highly specific</strong> – rapid antigen tests for children have <a href="https://ebm.bmj.com/content/early/2022/01/04/bmjebm-2021-111828">high specificity</a>. This means if the test is done correctly, it is unlikely to say your child is positive if it is not </p></li>
<li><p><strong>but not as sensitive</strong> – rapid antigen tests are less sensitive in children than adults. In other words, they’re not as good at detecting if a child has COVID. But tests are <a href="https://ebm.bmj.com/content/early/2022/01/04/bmjebm-2021-111828">more likely</a> to correctly detect COVID if the child has symptoms.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/15-things-not-to-do-when-using-a-rapid-antigen-test-from-storing-in-the-freezer-to-sampling-snot-176364">15 things not to do when using a rapid antigen test, from storing in the freezer to sampling snot</a>
</strong>
</em>
</p>
<hr>
<h2>Which type of test to use?</h2>
<p>Of the 20 tests approved for use in under twos, 16 use nasal swabs and four sample saliva. </p>
<p>The accuracy of different sampling methods in children differs by viral variant. While it was once thought nasal swabs were <a href="https://journals.lww.com/pidj/fulltext/2020/09000/nasal_swab_as_preferred_clinical_specimen_for.33.aspx">more accurate</a> in children, this may not necessarily be the case with the Omicron variant.</p>
<p>There’s <a href="https://www.medrxiv.org/content/10.1101/2021.12.22.21268246v1">preliminary evidence</a>, which has yet to be independently verified, saliva swabs may be better able to detect Omicron. So we’ll see how the evidence develops.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Rapid antigen test components with nasal swab" src="https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/462928/original/file-20220513-18-gc9eud.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Tests that use nasal swabs may be more accurate. But that may depend on the viral variant.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/covid19-nasal-swab-test-kits-saracov2-2027424992">Shutterstock</a></span>
</figcaption>
</figure>
<p>Taking a saliva sample may not be as straightforward as you think. </p>
<p>Depending on the test, your child may need to cough (several times, on demand) and spit into a tube. Or after you swab your child’s tongue and mouth, your child will need to keep the spongy tip of the swab in their mouth for a few minutes, without sucking or biting it. So getting an under two-year-old to cooperate is unlikely.</p>
<p>If you do go down this route you can use a <a href="https://www.rch.org.au/clinicalguide/guideline_index/COVID-19_swabbing/">tongue depressor</a> to flatten the tongue to take the sample. You can buy these from a pharmacy.</p>
<p>But with a bit of preparation (and an extra pair of hands) you should be able to use a nasal test on a young child. You should be able to do this without causing pain or distress, a <a href="https://www.rchpoll.org.au/polls/covid-19-testing-in-kids-what-concerns-parents/">common worry</a> for parents considering COVID testing their child.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-to-prepare-your-child-for-a-covid-test-165248">How to prepare your child for a COVID test</a>
</strong>
</em>
</p>
<hr>
<h2>How do I prepare?</h2>
<p>Understand what the <a href="https://www.rch.org.au/clinicalguide/guideline_index/COVID-19_swabbing/">COVID test</a> involves and plan to have the resources you need.</p>
<p>As you take the test components out of the packet, remember to keep them out of reach of your child. The chemicals can be toxic if swallowed, or can cause skin and eye irritation. Parents should also ensure small children don’t swallow test components, such as small bits of plastic.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Toddler holding security blanket in park or garden" src="https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=750&fit=crop&dpr=1 600w, https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=750&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=750&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=943&fit=crop&dpr=1 754w, https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=943&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/462932/original/file-20220513-13-onvo9u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=943&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Holding a favourite toy or blanket may help your child relax.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/toddler-boy-blue-eyes-overalls-outside-134286551">Shutterstock</a></span>
</figcaption>
</figure>
<p>It’s also helpful to have two adults: one to perform the test and the other to hold and support the child.</p>
<p><a href="https://www.rch.org.au/kidsinfo/fact_sheets/Reduce_childrens_discomfort_during_tests_and_procedures/">Distraction</a> helps take your child’s mind off the test by concentrating on something more pleasurable. Young children can be easily distracted by listening to a favourite song. So have a song ready on your phone.</p>
<p>For toddlers, it can help to have another adult to provide more engaging distraction such as watching a video on a phone or tablet, or switching on a light-up toy.</p>
<p>Holding a favourite toy or blanket may also help your child relax. </p>
<h2>How do I actually take the sample?</h2>
<p>One adult can use a <a href="https://www.rch.org.au/clinicalguide/guideline_index/COVID-19_swabbing/">secure hugging hold</a> to reduce movement during the test while the other adult takes the sample. </p>
<p>The adult holding the child sits the child upright on their lap and holds them close to make them feel secure. They cross one arm across the child’s body and place the other hand on the child’s forehead.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Sleeping baby wrapped tightly in checked blanket" src="https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1130&fit=crop&dpr=1 754w, https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1130&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/464418/original/file-20220520-13-ke69da.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1130&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Wrapping in a blanket can help.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/newborn-baby-boy-tightly-wrapped-blue-1142319218">Shutterstock</a></span>
</figcaption>
</figure>
<p>If you’re testing the child by yourself, you can wrap them in a blanket to hold them still while you take the sample. </p>
<p><a href="https://www.childrens.health.qld.gov.au/chq/information-for-families/helping-your-child-through-a-procedure/">Staying calm</a> yourself communicates to your child they are safe. Maintain a steady voice and breathe calmly during the test. </p>
<p>Slowly insert the tip of the swab inside the nose <a href="https://www.rch.org.au/clinicalguide/guideline_index/COVID-19_swabbing/">for about 1cm</a> or until you meet resistance. Angle it along the base of the inside of the nose horizontally rather than pointing it upwards as you insert it (<a href="https://www.rch.org.au/clinicalguide/guideline_index/COVID-19_swabbing/">go low</a>). </p>
<p>There is at least one nasal test that provides a smaller swab for young children so <a href="https://www.tga.gov.au/covid-19-rapid-antigen-self-tests-are-approved-australia">check the TGA site</a> if you wish to use it. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/go-low-go-slow-how-to-rapid-antigen-test-your-kid-for-covid-as-school-returns-175615">Go low, go slow: how to rapid antigen test your kid for COVID as school returns</a>
</strong>
</em>
</p>
<hr>
<h2>What do I do next?</h2>
<p>Children’s <a href="https://journals.lww.com/pain/Fulltext/2015/01000/Remembering_the_pain_of_childhood__applying_a.6.aspx">memories of medical tests</a> can influence how they respond next time. So, as your young child may need another rapid antigen test in the future, finish on a positive note. </p>
<p>Play with your child after the test and provide positive reinforcement. Give your toddler a simple reward, such as a stamp or sticker. </p>
<p>If the test is unsuccessful, give your child a chance to recover before trying again.</p>
<p>However, if you feel anxious about performing the test, or repeating it, seek the support of a health professional. Every test should be the best possible experience for your child to avoid unnecessary distress.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/covid-19-in-babies-heres-what-to-expect-181940">COVID-19 in babies – here's what to expect</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/182125/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thea van de Mortel teaches into the Graduate Infection Prevention and Control program at Griffith University. </span></em></p><p class="fine-print"><em><span>Karin Plummer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Can you use a test intended for adults or older children? How do you test a wriggling or grumpy small child anyway? We’re infection control and child health researchers. Here are our tips.
Thea van de Mortel, Professor, Nursing and Deputy Head (Learning & Teaching), School of Nursing and Midwifery, Griffith University
Karin Plummer, Research Fellow, Griffith University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/165355
2021-08-04T21:42:01Z
2021-08-04T21:42:01Z
Why your baby isn’t sleeping through the night yet … and how to teach them
<figure><img src="https://images.theconversation.com/files/413980/original/file-20210730-23-12zygdq.jpg?ixlib=rb-1.1.0&rect=7%2C7%2C4913%2C3268&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Babies and young children have different sleep patterns. Not every one sleeps through the night at the same age, but social pressure is strong on parents to make sure that their children get enough sleep.</span> <span class="attribution"><span class="source">(Shutterstock) </span></span></figcaption></figure><p>A baby’s arrival often means sleep deprivation for the parents during their child’s first five years of life. <a href="https://doi.org/10.1016/j.cppeds.2016.12.001">Between a quarter and a third of parents</a> report sleep problems in children under the age of five. It is one of the most frequent reasons parents consult a pediatrician.</p>
<p>Parents are eager to learn how to regulate their child’s sleep and how sleep affects their development. Social pressure encourages parents to look for answers to the problem of “getting a good night’s sleep” as quickly as possible – or face parental guilt! </p>
<p>But what does good quality sleep mean for a baby? What are the winning conditions for making the most of the benefits of sleep in a child’s development? And what are the consequences of not getting enough sleep?</p>
<p>The science of sleep gives us lots to think about and act on, despite ongoing debates within the scientific community and among early childhood professionals. There is a significant gap between what science knows about child development and sleep, and what is conveyed in our society. For example, the myth of sleeping through the night by a certain age creates <a href="https://doi.org/10.5664/jcsm.9188">unrealistic expectations</a> among parents that can shake their confidence.</p>
<p>Catherine Lord, the co-founder and president of <a href="https://immerscience.com/home/">Immerscience</a>, and I have <a href="https://www.apprendreadormir.com/">created a project on sleep</a> for children aged five and younger, called “Learning to sleep is like learning to walk.” The project aims to help parents who are caught in a whirlwind of information, intermingled with advice, testimonials and expert recommendations.</p>
<figure class="align-center ">
<img alt="A woman picks up a baby from her bed, in an apartment, in the middle of the night" src="https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/409143/original/file-20210630-17-1a141l9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A baby awake in the middle of the night. There’s no specific age a child should be able to sleep through the night, but many parents create unrealistic expectations.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<h2>Three realities about sleep</h2>
<ol>
<li><p><strong>Sleep is a pillar of health, just like healthy eating and exercise.</strong> <a href="https://doi.org/10.2147/NSS.S134864">A number of areas in a child’s development are linked to sleep</a>, including thinking (cognitive health), interacting with others (social skills), growing (physical health), feeling emotions (mental health) and healing (immune health). Sleep and health work in tandem, while the reverse is also true: being healthy promotes good sleep quality.</p></li>
<li><p><strong>Sleep development is specific to each child, just like learning to walk.</strong> Sleep needs vary with age and aren’t the same for everyone. <a href="https://sleeponitcanada.ca/all-about-sleep/sleep-a-personal-and-lifelong-natural-need/">A baby does not have the same needs for naps and night sleep as an adult</a>.</p>
<p>We grow at the same speed, on average, but we don’t all develop at exactly the same pace. Like walking, sleep develops at a different pace for each child. This period is called the sleep maturation stage. Sleep quality <a href="https://doi.org/10.1016/j.sleep.2020.01.009">varies greatly</a> until the age of two. Two studies that followed babies over time found that the time it takes to fall asleep decreases during the first six months of life, and that children wake less in the night during the second year of life.</p>
<p>By six months of age, a child <a href="https://doi.org/10.1016/j.sleep.2020.10.005">may experience variability in sleep</a>. And up to age three, <a href="https://doi.org/10.1542/peds.2017-4330">sleep varies from one child to the next</a>. To create the winning conditions to positively influence a child’s sleeping development, the important thing to consider is not their age, but where they are in their development.</p></li>
<li><p><strong>Falling asleep alone becomes possible with parental support if this is carried out one step at a time.</strong> There are a myriad of ways to raise children to support their development. The same is true for acquiring sleep autonomy, meaning a child’s ability to fall asleep and return to sleep alone with confidence.</p>
<p>This confidence can be acquired in different ways <a href="https://www.inspq.qc.ca/en/tiny-tot/baby/sleep/sleeping-safely">as long as safety</a> is respected: with or without crying, co-sleeping or not, with the breast or the bottle, with water or milk. Sleep is regulated by biology, but also by environmental factors, such as parental practices surrounding sleep.</p></li>
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<img alt="A mother and her young child in a bed" src="https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=756&fit=crop&dpr=1 600w, https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=756&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=756&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=951&fit=crop&dpr=1 754w, https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=951&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/409142/original/file-20210630-25-1u364y9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=951&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Sleep autonomy can be acquired in many ways, and co-sleeping is one of them.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>Two leading experts on child sleep, Avi Sadeh and Thomas Anders, <a href="https://doi.org/10.1002/1097-0355(199321)14:1%3C17::AID-IMHJ2280140103%3E3.0.CO;2-Q">have proposed a theoretical model of children’s sleep</a>. Based on a biopsychosocial approach, their perspective takes many factors into account including those associated with the child (such as temperament), the parents (such as mental health problems) and the parent-child relationship (such as parenting styles). All of these factors <a href="https://doi.org/10.1016/j.smrv.2008.12.001">influence a child’s sleep</a>.</p>
<p>Sleep is embedded in a <a href="https://doi.org/10.1016/j.appdev.2019.101057">social context</a> where parents play a crucial role in fostering sleep autonomy. An epidemiological study of preterm and full-term infants admitted to special baby care units after birth suggested that <a href="https://doi.org/10.1111/j.1469-7610.1995.tb01821.x">neurological immaturity is less important</a> in the development of sleeping problems than parental behaviours.</p>
<p><a href="https://www.doi.org/10.1001/archpedi.159.3.242">Studies have shown that parental actions</a>, such as staying near a preschooler until they fall asleep, can lead to more sleep problems. <a href="https://doi.org/10.1097/00004583-199701000-00012">A review of the studies on pediatric sleep</a> suggests that some types of interactions between parents and preschoolers at bedtime may predict sleep problems. Parents can support their child in learning to fall asleep and return to sleep on their own, as soon as the parent sees that the child is ready.</p>
<h2>Three ways to acquire sleep autonomy</h2>
<p><a href="https://doi.org/10.1016/j.infbeh.2017.02.002">A review of the scientific research literature</a> describes the advantages and disadvantages of different sleep intervention methods. Some are more appropriate than others, depending on the child’s age, development or the context of the child’s sleep difficulties.</p>
<ol>
<li><p><a href="https://doi.org/10.1016/j.psfr.2019.01.002">Behavioural sleep intervention methods</a> discourage parents from intervening when children wake in the night, so that the child can learn to fall asleep on their own. <a href="https://www.whattoexpect.com/first-year/sleep/ferber-method-sleep-training/">The three approaches — the standard “sleep extinction method” (“cry it out”)</a>, extinction with parental presence and gradual extinction technique (“camping out”) — include a pre-bedtime routine and putting the child to bed while awake. The parent leaves the child’s sleeping area so they can find sleep on their own.</p></li>
<li><p>Cognitive-behavioural sleep intervention methods change parents’ expectations, beliefs and perceptions about sleep. As the child gets older, additional components are added, such as relaxation techniques, thought modification related to worry and anxiety, positive imagery training and others.</p></li>
<li><p>Attachment-based methods are those that introduce a transitional object such as a blanket. In this category of sleep intervention methods, the key is to target “small steps” or “small goals” that are gentle and caring.</p></li>
</ol>
<h2>No magic method … but winning conditions</h2>
<p>There is no magic method, but parents can develop the winning conditions for sleep autonomy. Parents must make choices based on their child’s needs, which will vary over time, and their family context. Parents must be willing to adapt their methods but also be consistent in their individual interventions. <a href="https://doi.org/10.1016/j.sleep.2019.03.002">Parents must be consistent</a> so that the child will be confident.</p>
<p>The key message is to have confidence in your child and in yourself. Just like walking or potty training, falling asleep alone with confidence is a step toward autonomy. Helping your child in this learning process is helping them “grow up.”</p>
<p>Having realistic parental expectations about sleep is crucial. As a parent it is important to keep three things in mind: that your child sleeps enough for their stage of development, that your child’s sleep develops at their own pace, which can fluctuate, and that the parent must provide favourable and safe conditions to support their child in gaining sleep autonomy.</p><img src="https://counter.theconversation.com/content/165355/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Evelyne Touchette has received funding from the Fonds de recherche du Québec (DIALOGUE program).</span></em></p>
The sleep of young children varies a great deal. The myth of sleeping through the night at a specific age creates unrealistic expectations that can harm parents’ confidence.
Evelyne Touchette, Adjunct professor, département de psychoéducation, Université du Québec à Trois-Rivières (UQTR)
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/143989
2020-08-06T06:48:51Z
2020-08-06T06:48:51Z
COVID-19 pandemic shows why infant formula donations are dangerous and how breastfeeding protects infants
<figure><img src="https://images.theconversation.com/files/351212/original/file-20200805-503-n1ev2y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Breastfeeding is important at all times, but even more so in emergencies. </span> <span class="attribution"><a class="source" href="https://www.pexels.com/id-id/foto/cinta-kasih-rasa-sayang-tempat-tidur-3279208/">Pexels/Jonathan Borba</a></span></figcaption></figure><p><em>This article is published to celebrate <a href="https://www.who.int/news-room/detail/31-07-2020-world-breastfeeding-week-2020-message">World Breastfeeding Week 1-7 August</a>.</em></p>
<p>When emergencies occur, including in the current COVID-19 pandemic, people want to help mothers and babies. Sometimes they respond by making donations of infant formula. Baby milk companies can see emergencies as an opportunity to use <a href="https://www.opendemocracy.net/en/5050/infant-formula-companies-are-exploiting-covid-19-pandemic/">donations to market their products</a>.</p>
<p>Donations of infant formula in emergencies always <a href="https://www.worldnutritionjournal.org/index.php/wn/article/view/584">cause harm</a> because they reduce breastfeeding, increase rates of infection, and place infants in a food insecure situation. </p>
<p>After the <a href="https://www.ennonline.net/fex/34/special">Yogyakarta earthquake in 2006</a>, for instance, donations of infant formula doubled rates of <a href="https://www.cambridge.org/core/journals/public-health-nutrition/article/donated-breast-milk-substitutes-and-incidence-of-diarrhoea-among-infants-and-young-children-after-the-may-2006-earthquake-in-yogyakarta-and-central-java/7BC8079D2591050A0C25258EF2FAAF01">diarrhoea in babies</a>. The poorest families are worst affected. </p>
<p>During the COVID-19 pandemic all over the world, well-meaning donations from individuals and organisations have been harming infants. Infant formula manufacturers have sought to mislead parents and health workers about the safety of <a href="http://www.babymilkaction.org/archives/24341">breastfeeding during COVID-19</a> and <a href="https://twitter.com/DrKarleenG/status/1285404262814511106">have distributed infant formula against the WHO International Code</a>.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1285404262814511106"}"></div></p>
<p>The <a href="https://www.who.int/nutrition/publications/emergencies/operationalguidance-2017/en/">Infant and Young Child Feeding in Emergencies Operational Guidance</a> and the World Health Organization (WHO) state that breastfeeding is the safest and sustainable food source, and formula feeding should only be done when breastfeeding is not possible and with caution. </p>
<p>In normal situations, WHO only <a href="https://apps.who.int/iris/bitstream/handle/10665/69938/WHO_FCH_CAH_09.01_eng.pdf;jsessionid=E6DDD0E74718D61F15D764CB84765C41?sequence=1">recommends</a> infant formula when there are specific medical indications such as babies with galactosemia or with maple urine syrup disease.</p>
<p>WHO has said that <a href="https://www.who.int/news-room/detail/27-05-2020-countries-failing-to-stop-harmful-marketing-of-breast-milk-substitutes-warn-who-and-unicef">countries must act</a> to stop donations of infant formula in emergencies.</p>
<h2>Breastfeeding benefits in emergency situation</h2>
<p>Breastfeeding is important at all times, but even more so in emergencies. </p>
<p>Breastfeeding provides babies with safe food and water, and <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2901024-7/fulltext">protection from infection</a>. It also helps mothers who are stressed to bond with and provide good care to their babies. </p>
<p>Without breastfeeding, the ability of infants to fight infection is reduced, and formula-fed babies are more likely to need hospital treatment and, when conditions are poor, even to die. </p>
<p>It is for these reasons that <a href="https://www.who.int/publications/i/item/clinical-management-of-covid-19">WHO has said that women who are infected with COVID-19 should have</a> skin-to-skin contact with their babies after birth, keep their babies close to them day and night, and breastfeed.</p>
<h2>Infection rates are low when breastfed</h2>
<p>When babies are infected with COVID-19, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apa.15422">they rarely become seriously ill and many have no symptoms at all</a>. Even babies who are born prematurely <a href="https://www.thelancet.com/pdfs/journals/lanchi/PIIS2352-4642(20)30140-1.pdf">may not suffer serious illness</a> when infected with COVID-19. </p>
<p>There is now also research showing that babies are at little risk of infection with COVID-19 if they are kept with their mothers and breastfed. <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30235-2/fulltext">Research from New York</a> found that of 116 breastfed babies whose mothers had COVID-19 none became ill. </p>
<p>In another study, 666 babies were born to mothers who had COVID-19 and only 28 babies became infected. Babies who were breastfed were not more likely to be infected than those who <a href="https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16362">were formula fed</a> and it was concluded that separating babies from their mothers does not reduce infection rates. <a href="https://europepmc.org/article/ppr/ppr141432">Antibodies</a> to COVID-19 have been found in breastmilk which would help babies to fight COVID-19. </p>
<h2>Mothers have faced challenges in breastfeeding their babies in the pandemic</h2>
<p>Some government and medical organisation policies have said that mothers and babies should be separated and breastfeeding not allowed. These policies have been made without considering the importance of breastfeeding in protecting babies and have been <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/mcn.13033">criticised</a>.</p>
<p>Some organisations have now recognised their error and are reversing their recommendations and now support breastfeeding. As time goes on, it is becoming even clearer that even when mothers have COVID-19 they should be encouraged and supported to have skin-to-skin contact, to keep their babies close by them, and to breastfeed. </p>
<p>Other challenges that mothers have faced include the ongoing impact of the pandemic on health services. Pregnant women are having fewer health checks, many are having to give birth without a support partner. After the baby is born, face-to-face support for breastfeeding has been reduced. Grandmothers may not be able to visit and help their daughters with caring for the baby. </p>
<p>These challenges are happening in rich and poor countries. </p>
<p><a href="https://www.medrxiv.org/content/10.1101/2020.07.18.20152256v1.full.pdf">Australian research</a> found that many mothers found this situation very difficult and were stressed and anxious. When they experienced problems with breastfeeding they were reluctant to go to clinics because of fear of infection or were unable to seek support because services were shut. They often just wanted to have someone to talk to. </p>
<p>In response to the pandemic, some mothers placed a greater importance on breastfeeding because it could help protect their babies from infections including COVID-19. They also saw breastfeeding as protective because it was a secure food supply so they did not have to worry about whether they could buy infant formula. </p>
<p>The Australian Breastfeeding Association found that many women contacted their breastfeeding counsellors for <a href="https://www.who.int/maternal_child_adolescent/documents/who_chs_cah_98_14/en/#:%7E:text=This%20potentially%20life%2Dsaving%20measure%20is%20called%20relactation.&text='Relactation%3A%20A%20review%20of%20experience,wish%20to%20re%2Destablishing%20breastfeeding.">assistance with restarting</a> <a href="https://www.youtube.com/watch?v=V-EJ-T_KVcU">breastfeeding</a> because of the pandemic. Counsellors were also able to reassure mothers that it was usual for babies to want to feed more frequently in unsettled times and that stress has no impact on milk supply. </p>
<h2>Let’s support breastfeeding mothers to protect their babies health</h2>
<p><a href="https://worldbreastfeedingweek.org/">World Breastfeeding Week is celebrated every 1-7 August</a>, and this year’s theme is “Support Breastfeeding for a Healthier Planet”. This reminds us that breastfeeding protects not only the health of mothers and babies but also of the planet. </p>
<p>Formula feeding contributes to <a href="https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-019-0243-8">water and plastic pollution, land and waterways degradation as well as greenhouse gas emission such as methane (CH4), nitrous oxide (N2O) and carbon dioxide (CO2)</a>. In a world where natural as well as human made emergencies are ever increasing, we must support mothers to breastfeed so that they can protect their babies and protect the planet.</p><img src="https://counter.theconversation.com/content/143989/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andini Pramono menerima dana dari Lembaga Pengelola Dana Pendidikan dari Pemerintah Indonesia. Andini berafiliasi dengan Asosiasi Ibu Menyusui Indonesia (AIMI). </span></em></p><p class="fine-print"><em><span>Karleen Gribble tidak bekerja, menjadi konsultan, memiliki saham, atau menerima dana dari perusahaan atau organisasi mana pun yang akan mengambil untung dari artikel ini, dan telah mengungkapkan bahwa ia tidak memiliki afiliasi selain yang telah disebut di atas.</span></em></p>
WHO has said that countries must act to stop donations of infant formula in emergencies.
Karleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney University
Andini Pramono, PhD Candidate in Health Services Research and Policy Department, Research School of Population Health, Australian National University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/138825
2020-06-01T02:10:08Z
2020-06-01T02:10:08Z
Pregnant in a pandemic? If you’re stressed, there’s help
<figure><img src="https://images.theconversation.com/files/338440/original/file-20200529-51496-1u7d2op.jpg?ixlib=rb-1.1.0&rect=7%2C0%2C991%2C525&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pregnant-woman-feel-depression-standing-front-1731695446">Shutterstock</a></span></figcaption></figure><p>If you’re pregnant during the COVID-19 pandemic, you might be feeling a unique type of stress.</p>
<p>You might be uncertain about how an infection could affect your unborn baby. That’s over and above the stress you might be feeling about the pregnancy itself, and its impact on your relationship, job or lifestyle.</p>
<p>But there’s professional support to help you manage these stresses. And there’s lots you can do at home to ease your worries.</p>
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Read more:
<a href="https://theconversation.com/coronavirus-while-pregnant-or-giving-birth-heres-what-you-need-to-know-133619">Coronavirus while pregnant or giving birth: here's what you need to know</a>
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<h2>How will the coronavirus affect my unborn baby?</h2>
<p>One of the <a href="https://www.ncbi.nlm.nih.gov/pubmed/32220284">first studies</a> to look at the effect of coronavirus infection while pregnant found the health of unborn babies or newborns of women infected in their final trimester did not differ to those expected with uninfected pregnancies. </p>
<p>But this small study, from Wuhan in China, was rushed to publication and didn’t look at infection earlier in pregnancy.</p>
<p>A <a href="https://www.ncbi.nlm.nih.gov/pubmed/32292902">review</a> of 41 pregnancies complicated by COVID-19, as well as another 38 complicated by other coronaviruses (<a href="https://www.cdc.gov/sars/about/fs-sars.html">SARS</a>, severe acute respiratory syndrome and MERS, Middle East respiratory syndrome) gave us more information.</p>
<p>It found a small but significant increase in preterm birth (before 37 weeks’ gestation) in COVID-19 pregnancies. </p>
<p>However, the researchers couldn’t differentiate between spontaneous preterm birth and babies who were induced to arrive before 37 weeks.</p>
<p>So far, the evidence of harm to you or your unborn baby is limited, and should not cause concern.</p>
<h2>Pregnancy can be stressful anyway</h2>
<p>Separate to the fear of being infected with COVID-19 is the fear and stress related to simply living through the pandemic while pregnant. </p>
<p>Pregnancy can <a href="https://theconversation.com/health-check-can-stress-during-pregnancy-harm-my-baby-81825">often be stressful</a> as lifestyle, relationship and income changes create challenges for families.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/338438/original/file-20200529-51527-e90m0k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Pregnancy can be stressful at the best of times.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/worried-pregnant-woman-sitting-on-couch-557047597">Shutterstock</a></span>
</figcaption>
</figure>
<p>Worries about the baby’s health are present in any pregnancy, but adding concerns of what infection would mean for the unborn child can exacerbate feelings of anxiety.</p>
<p>Before the pandemic, <a href="https://www.ncbi.nlm.nih.gov/pubmed/31347796">about 20% of women</a> had a clinical anxiety disorder (for example, generalised anxiety, specific phobia) while pregnant. </p>
<p>We now have some early indicators of how the COVID-19 pandemic is affecting that statistic.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-can-stress-during-pregnancy-harm-my-baby-81825">Health Check: can stress during pregnancy harm my baby?</a>
</strong>
</em>
</p>
<hr>
<h2>And when you add the pandemic into the mix</h2>
<p>Canadian researchers <a href="https://psyarxiv.com/gdhkt/">surveyed</a> nearly 2,000 pregnant women in April 2020 (in research yet to be peer-reviewed). They found 57% of pregnant women showed anxiety symptoms but 68% reported an increase in pregnancy-specific anxiety.</p>
<p>Only one of the 1,987 participants had a confirmed case of COVID-19, with another 25 cases suspected but not confirmed. So, for most participants, just being pregnant during the pandemic (without being infected) led to three times as many women being anxious during the pandemic than before it.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-with-a-baby-what-you-need-to-know-to-prepare-and-respond-133078">Coronavirus with a baby: what you need to know to prepare and respond</a>
</strong>
</em>
</p>
<hr>
<p>Pregnant women are <a href="https://www.ncbi.nlm.nih.gov/pubmed/32317197">also concerned</a> about how the pandemic will affect their maternity care, including who can visit them in hospital and after the birth of their baby.</p>
<p>A <a href="https://www.medrxiv.org/content/10.1101/2020.04.16.20068031v1">review of pregnancy stress</a> during previous infectious disease outbreaks, including SARS, MERS, Ebola and Zika, found that as well as feeling vulnerable, pregnant women were anxious about disruption to pre- and postnatal care, and exposure to treatments not fully tested in pregnancy.</p>
<h2>We can’t avoid stress, but we can manage it</h2>
<p>We know stress during pregnancy has been linked to <a href="https://www.ncbi.nlm.nih.gov/pubmed/26372770">a range of</a> poor outcomes for the child, such as pre-term birth, being more susceptible to disease, and behavioural problems through childhood. </p>
<p>Post-traumatic stress symptoms in pregnant women following the <a href="https://www.ncbi.nlm.nih.gov/pubmed/16115284">September 11 attacks</a> and various <a href="https://www.ncbi.nlm.nih.gov/pubmed/24203917">natural disasters</a> have significantly affected both emotional and cognitive development in children later in childhood.</p>
<p>But there is good news. While we cannot avoid the stress that comes with the COVID-19 pandemic, we can manage it.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/coronavirus-is-stressful-here-are-some-ways-to-cope-with-the-anxiety-133146">Coronavirus is stressful. Here are some ways to cope with the anxiety</a>
</strong>
</em>
</p>
<hr>
<p>In fact, it’s not necessarily the stressful event itself that can lead to poor outcomes. It’s how a pregnant woman <a href="https://www.ncbi.nlm.nih.gov/pubmed/25710121">assesses the stress</a> of the event and how she chooses to move forward that might determine what happens to her child.</p>
<p>So, if we can manage our stress and not let it overwhelm us, we may be able to avoid the negative consequences of stress in pregnancy with benefits right through our children’s lives.</p>
<h2>Here’s what you can do</h2>
<p>Social support is key for managing stress, but social distancing makes it harder to gather with the friends and loved ones who might typically provide that support. </p>
<p>Still, there are many online pregnancy support and birth groups targeted to particular stages of pregnancy. These could provide reassurance and a sense of belonging while the outside world looks different.</p>
<p>You can still exercise outside. But if you prefer to exercise at home, there are many online pregnancy yoga and pilates classes.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/338439/original/file-20200529-51477-fe8t8c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Yoga and pilates classes for pregnant women are available online.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pregnant-woman-exercising-anticipation-child-birth-1023473263">Shutterstock</a></span>
</figcaption>
</figure>
<p>You can practise guided relaxation and meditation with an app. And if you can work from home, this might give you some much-needed flexibility.</p>
<p>You can also use local, evidence-based <a href="https://theconversation.com/coronavirus-has-boosted-telehealth-care-in-mental-health-so-lets-keep-it-up-137381">telehealth</a> to access mental health care. There are also many free, online programs providing <a href="https://www.cope.org.au/getting-help/self-help/">self-guided mental health support</a>.</p>
<p>As long as the COVID-19 pandemic is here, with its accompanying uncertainty, we can best focus on limiting the long-term effects of stress on our mothers, babies and families.</p><img src="https://counter.theconversation.com/content/138825/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Monique Robinson receives funding from the National Health and Medical Research Council (NHMRC).</span></em></p>
Pregnancy can be stressful at the best of times, let alone during a pandemic.
Monique Robinson, NHMRC Early Career Fellow, Telethon Kids Institute
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/130349
2020-05-05T12:46:15Z
2020-05-05T12:46:15Z
How does a baby ‘breathe’ while inside its mom?
<figure><img src="https://images.theconversation.com/files/332496/original/file-20200504-83721-wei11m.jpg?ixlib=rb-1.1.0&rect=1134%2C396%2C6214%2C4506&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Her deep breath has to get to the baby.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/pregnant-woman-sitting-outside-royalty-free-image/1132797740">electravk/Moment via Getty Images</a></span></figcaption></figure><p>“Mothering” is synonymous with “nurturing,” probably because moms start providing for their kids even before they’re born. </p>
<p>A fetus relies on its mother to provide all the essentials. The placenta is key here; this organ develops in the uterus and is like a gateway that lets mom pass baby everything it needs to support its development.</p>
<p>After the mother eats, her body breaks the food down into glucose, amino acids, fatty acids and cholesterol that travel through channels or <a href="https://doi.org/10.3390/ijms150916153">transporters in the placenta to the fetus</a>. They provide the energy and the building blocks that the growing fetus uses as it develops organs, tissues and bones.</p>
<p>Vital electrolytes like <a href="https://doi.org/10.1093/bjaceaccp/mku013">sodium, chloride, calcium and iron</a> pass through their own specific channels in the placenta or just diffuse from the mother’s side to the fetus’s.</p>
<p>Fetuses require oxygen for growth, too. Since their lungs are not exposed to air, they can’t breathe on their own. Instead they rely on their mothers to provide the required oxygen through a remarkable biochemical process. </p>
<p><a href="https://scholar.google.com/citations?user=DL4ZkpIAAAAJ&hl=en">I’m a biochemist</a>, and it’s this process that made me fall in love with the discipline when I was a student. It’s my favorite topic to present to my students today and helps explain why pregnant women can get so easily winded. </p>
<h2>Oxygen running through your veins</h2>
<p>Some ingenious biochemistry is at the root of how oxygen travels throughout the human body.</p>
<p>A protein called hemoglobin is responsible for picking up oxygen in your lungs and carrying it via your bloodstream to all of your tissues. <a href="https://www.acs.org/content/acs/en/education/resources/highschool/chemmatters/past-issues/archive-2009-2010/chemmatters-february-2010-issue.html">Hemoglobin contains iron</a>, and it’s responsible for <a href="https://theconversation.com/blood-in-your-veins-is-not-blue-heres-why-its-always-red-97064">blood’s red color</a>. It’s made up of four subunits, two each of two different types. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=307&fit=crop&dpr=1 600w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=307&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=307&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=386&fit=crop&dpr=1 754w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=386&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/326586/original/file-20200408-118674-h9npux.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=386&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Hemoglobin’s four subunits – two blue and two green in the illustration – can bind to one oxygen molecule each.</span>
<span class="attribution"><span class="source">Image generated from PBD ID 1C7B by Julie Pollock</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Each subunit contains one iron atom bound to a special compound called a heme that can interact with one oxygen molecule. It’s an all-or-nothing situation; for hemoglobins in the same vicinity, they’re either all holding onto oxygen or have all released their oxygen. It depends on the concentration of oxygen in the environment the hemoglobin finds itself in. </p>
<p>When you take a good breath, the concentration of oxygen is high in your lungs. Hemoglobin in the area automatically picks up oxygen. Then it travels via your blood to tissues with lower oxygen concentrations, where it gives up the oxygen.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=270&fit=crop&dpr=1 600w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=270&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=270&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=339&fit=crop&dpr=1 754w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=339&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/332492/original/file-20200504-83740-1j3brd.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=339&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">BPG binds to hemoglobin to facilitate the release of oxygen.</span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>A molecule called 2,3-bisphosphoglycerate, or BPG, facilitates oxygen’s release. It binds to the center cavity between the four subunits of hemoglobin to help the oxygen molecules pop free. </p>
<h2>Getting oxygen to the fetus</h2>
<p>Fetuses are not exposed to air, and their <a href="https://doi.org/10.1146/annurev.ph.46.030184.003153">lungs don’t fully develop until after they’re born</a>, so oxygen is another on the long list of things they must get through the placenta from their mothers.</p>
<p>Hemoglobin proteins are too big to cross the placenta. The maternal hemoglobins must give up their oxygen molecules on their side so the oxygen can cross over and be picked up by the fetal hemoglobins on the other side. The predicament is that since this is all happening in such close quarters, the hemoglobins should either all be holding on to oxygen or all be releasing it.</p>
<p>In order to circumvent this problem, <a href="https://www.wiley.com/en-us/Essential+Biochemistry%2C+3rd+Edition-p-9781118441688">fetal hemoglobin differs in structure</a> from maternal hemoglobin. With just a few changes to the amino acids in its protein sequence, fetal hemoglobin does not bind well to BPG, the molecule that helps oxygen get loose from adult hemoglobin. Fetal hemoglobin also has a stronger affinity for oxygen than the adult version does.</p>
<p>So at the placental interface, where there’s a lot of BPG, the maternal hemoglobin lets go of the oxygen and the fetal hemoglobin grabs ahold of it tightly. This process allows for effective and efficient transfer of oxygen from the mother to the fetus.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=359&fit=crop&dpr=1 600w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=359&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=359&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=451&fit=crop&dpr=1 754w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=451&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/332493/original/file-20200504-83740-101e5wu.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=451&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Effective transfer of oxygen from maternal hemoglobin (blue and green) to fetal hemoglobin (purple and green) is facilitated by BPG at the placenta.</span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Shortly before babies are born, they start making some adult hemoglobin so that when they are breathing on their own, they can perform appropriate oxygen transfer throughout their little bodies. <a href="https://doi.org/10.1016/j.ebiom.2016.11.032">Usually by the time a baby reaches six months of age</a>, the levels of fetal hemoglobin are very low, replaced almost completely by adult hemoglobin.</p>
<p>Academically, I knew about this remarkable biochemical process. But it wasn’t until I was pregnant with my son that I really understood it. My miles in spinning class decreased, I lagged behind my husband and dog on our daily walks, and I ran out of breath climbing the three flights of stairs to my office. My son’s hemoglobin was stealing my oxygen, so I had to breathe in more to complete routine tasks.</p>
<p>Once my baby was on the outside, breathing on his own with his mature hemoglobin functioning appropriately, I was more amazed than ever at the perfection of the science.</p>
<p>[<em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>.]</p><img src="https://counter.theconversation.com/content/130349/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julie Pollock has received research funding from the Virginia Academy of Sciences and the Jeffress Memorial Trust. </span></em></p>
A fetus needs oxygen long before its lungs work and it’s exposed to the air. Some ingenious biochemistry explains how the mother’s blood delivers it.
Julie Pollock, Associate Professor of Chemistry, University of Richmond
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/133412
2020-05-03T15:26:41Z
2020-05-03T15:26:41Z
Why a little baby talk is good for your toddler
<figure><img src="https://images.theconversation.com/files/331177/original/file-20200428-110761-1ky089m.jpg?ixlib=rb-1.1.0&rect=62%2C46%2C5126%2C3656&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Babies around the world love 'baby-talk' and it can help them learn language too. </span> <span class="attribution"><span class="source">(Richard Sagredo/Unsplash)</span></span></figcaption></figure><p>Has anyone ever told you: “Don’t baby talk to your baby?” Parents of young infants often tell us that they have heard this advice from friends, family and even health care professionals. </p>
<p>As the lead researchers in a <a href="https://doi.org/10.1177%2F2515245919900809">study of over 2,200 infants across 67 laboratories in 16 countries</a>, we have good reason to give you the opposite advice. Our findings confirm that babies around the world love baby talk — or what baby researchers call “infant-directed speech.” What’s more, because babies prefer to listen to infant-directed speech, baby talking to them is good for their language development.</p>
<p>What is infant-directed speech? Imagine saying “look at the ball” to a cute, cuddly six-month-old. Now think about how you would say that same phrase to a co-worker or friend. </p>
<p>What you are most likely to notice is that the melody of your speech when you are talking to a baby is very different from when you talk to other adults — <a href="https://doi.org/10.1017/S0305000900010679">your pitch is higher, and it’s also more animated, with lots of ups and downs</a>. The rhythm changes too — we speak in shorter bursts with longer pauses when talking with babies, and also <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.324.825&rep=rep1&type=pdf">exaggerate certain words, especially when naming things for them</a>. </p>
<p>People talking to babies also <a href="https://jstor.org/stable/1127699">use simpler words</a>, <a href="https://doi.org/10.1017/S0305000908008763">ask more questions</a>, and even <a href="https://doi.org/10.1111/lnc3.12015">change the way sounds in some words are pronounced</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=425&fit=crop&dpr=1 754w, https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=425&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/322984/original/file-20200325-168894-2b232l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=425&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A recent episode of the children’s show ‘Boss Baby,’ features a fictional ‘babblist,’ someone who can talk to and understand babies.</span>
<span class="attribution"><a class="source" href="https://whatsnewonnetflix.com/egypt/1846362/the-boss-baby-back-in-business-2018/season-3/episode-3/ga-ba-goo-ba-ga-the-babblist">(Netflix)</a></span>
</figcaption>
</figure>
<h2>Establishing a bond with your baby</h2>
<p>How does all the baby talk benefit your baby? The most obvious way is simply by getting your baby’s attention — all those melodic and rhythmic properties are great attention-getters for babies (and for adults too, for that matter, though they might give you a funny look). Getting a baby’s attention is good! </p>
<p>The more language a child hears directed towards them, <a href="https://doi.org/10.1177%2F0956797613488145">the more language they learn</a>, and <a href="https://doi.org/10.1207/s15327078in0701_5">the faster they process the language they hear</a>. Plus, infant-directed speech <a href="http://doi.org/10.1111/1467-9280.00240">communicates emotions effectively</a> and helps establish a bond between caregiver and infant. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331179/original/file-20200428-110761-p93rbk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Baby talk can get the attention of your baby — helping with parent-child bonding.</span>
<span class="attribution"><span class="source">(Thiago Cerqueira/Unsplash)</span></span>
</figcaption>
</figure>
<p>Other characteristics of infant-directed speech are argued to be more directly helpful for language development. Because it’s typically simpler than grown-up language, infant-directed speech gives babies a clear starting point from which to build up to more sophisticated vocabulary and grammatical structures.</p>
<h2>Global variations?</h2>
<p>The fact that North American caregivers use infant-directed speech, and that babies really like it, has been known for a long time. But while baby talk has been studied in dozens of languages, most of the research has been done on English speakers in North America. And we’ve had a nagging question about cultural variations. </p>
<p>Do babies around the world also love baby talk? Or have researchers been studying something that mostly applies to babies from college towns in North America? <a href="https://doi.org/10.1017/S0305000900010679">In one small study, North American parents were the biggest baby-talkers in the six languages tested</a>. We’ve even heard Europeans say that they find our North American baby talk downright embarrassing!</p>
<p>There are some communities where very little of the language infants hear is directed toward them, for example <a href="https://doi.org/10.1111/cdev.12974">Tsimane communities in Bolivia</a> and <a href="https://doi.org/10.1111/j.1467-7687.2012.01168.x">some Mayan communities in Mexico</a>. In those places, parents aren’t talking to babies much, let alone baby talking with them. Instead, most of what they hear comes from adults talking to each other. But these babies learn their language just fine.</p>
<p>Our project brought together researchers from 16 countries around the world to explore this question. Each lab ran the same study, using similar methods to measure infants’ preferences. Our first objective was to confirm, in a much larger sample than had ever been tested before, that the preference for infant-directed speech was real. </p>
<p>We found babies in our sample robustly preferred the clips of moms talking to their young infants compared with hearing that same women talking to another adult. </p>
<p>Moreover, this held true both for infants learning North American English and those learning other languages, telling us that this preference is not something unique to North American culture. </p>
<p>A companion study <a href="https://doi.org/10.31234/osf.io/sqh9d">that looked at bilingual infants</a>, headed by Krista Byers-Heinlein at Concordia University, found similar results. Even though they have richer, more diverse linguistic experiences, babies that grow up hearing multiple languages also preferred hearing baby talk.</p>
<h2>Talk to your baby</h2>
<p>Does this mean that caregivers should be encouraged to baby talk to their baby? Absolutely yes! Babies prefer baby talk in the many communities we tested, and other research robustly supports how this is beneficial for babies. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/331598/original/file-20200429-155215-3xykrk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There is not just one ‘right way’ to speak to your baby. Here a baby and mom play in Denmark.</span>
<span class="attribution"><span class="source">(Paul Hanaoka/Unsplash)</span></span>
</figcaption>
</figure>
<p>There is still more work to do. We couldn’t test babies in every community. Two continents weren’t represented in our study: South America and Africa. We are currently working on new projects, collaborating with labs in those places.</p>
<p>Our findings tell us a lot of different factors affect infants’ preferences for how we talk to them. Caregivers talk differently to babies in different communities and even different contexts in the same community. </p>
<p>There is no one “right way” to talk to your baby. But be assured that baby talk is a positive part of supporting your infant’s language development.</p><img src="https://counter.theconversation.com/content/133412/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melanie Soderstrom is supported in part by funding from the Social Sciences and Humanities Research Council of Canada and the Natural Sciences and Engineering Research Council of Canada.</span></em></p><p class="fine-print"><em><span>Michael C. Frank is supported in part by funding from the US National Science Foundation and the Jacobs Foundation.</span></em></p>
New research shows that babies around the world love baby talk — and when adults baby talk to them it is good for their language development.
Melanie Soderstrom, Associate Professor in Psychology, University of Manitoba
Michael C. Frank, David and Lucile Packard Professor of Human Biology, Stanford University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/137202
2020-04-28T13:12:09Z
2020-04-28T13:12:09Z
Heartbreak of IVF cancellations and the desire to have genetically related children
<figure><img src="https://images.theconversation.com/files/331018/original/file-20200428-110738-wpph1.jpg?ixlib=rb-1.1.0&rect=0%2C34%2C5734%2C3794&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/baby-touching-woman-s-face-1257110/">Pexels</a></span></figcaption></figure><p>These are unsettling and uncertain times. Our lives have effectively been put on hold. And for some people, so too has the opportunity to become a parent – with <a href="https://www.bionews.org.uk/page_148694">fertility treatments suspended across a number of countries</a> due to the COVID-19 pandemic. This has left thousands of fertility patients in limbo, experiencing uncertainty and grief.</p>
<p>Following <a href="https://www.britishfertilitysociety.org.uk/2020/03/18/guidance-for-the-care-of-fertility-patients-during-the-coronavirus-covid-19-pandemic/">the guidance</a> of the British Fertility Society and the Association of Reproductive and Clinical Scientists, the Human Fertilisation and Embryology Authority has <a href="https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-professionals/">issued directions</a> requiring fertility clinics to suspend all treatments (with the exception of fertility preservation for cancer patients). </p>
<p>This is in part because the impact of COVID-19 on pregnant women is <a href="https://www.eshre.eu/Press-Room/ESHRE-News">still unclear</a>. Fertility treatments also entail close contact between patients and staff, making it impossible to respect social distancing measures. And as caring for COVID-19 patients takes priority in terms of the distribution of available medical resources, fertility treatments have fallen under the category of non-essential treatments and procedures – which have been halted across the UK.</p>
<p>This has had very severe consequences for fertility patients. For some, this suspension adds an undefined amount of time to the years trying to conceive before becoming eligible for treatment – and to the months on the waiting list for IVF. </p>
<p>For those who have been injecting hormonal medications, closely monitoring their sleep, diet, mental and physical health, all this seems to have been done in vain. The age cutoff to be eligible for IVF <a href="https://www.nhs.uk/conditions/ivf/availability/">varies across the UK</a>. This suspension might mean that women aged 35 in some areas, and 42 in others, will no longer be eligible for treatment.</p>
<h2>Essential vs non-essential</h2>
<p>This raises questions as to what should be considered “essential treatments”. It could be argued that fertility treatments are indeed non-essential. Trivially, no one is actually dying or missing out on <a href="https://www.bbc.co.uk/news/health-52382303">life-saving diagnoses</a> <a href="https://www.theguardian.com/world/2020/apr/04/coronavirus-crisis-is-stopping-vital-cancer-care-doctors-say">or treatments</a>. Indeed, thinking of having a child during a pandemic, might seem a “<a href="https://biblescripture.net/Ecclesiastes.html">vanity of vanities</a>”.</p>
<p>Within discussions on the ethics of reproductive technologies, some criticise fertility treatments for these reasons – especially when they involve <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/bioe.12332?casa_token=jJuix_W8YUAAAAAA%253AVljUJ4CUhc3h4I5K3635k40sEYMC36bj_xEnKgKc3szJUDIpgJeHQNydsHOzy-04K6Tij7BC_UdAmA">the development</a> and use of <a href="https://jme.bmj.com/content/44/12/835.info">new technologies</a>. They contend that state funding should be <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/japp.12091?casa_token=K1k7zLEzKNIAAAAA%253ABEToQURBo_qqkFAA3885Sru8mawWY4XIDo9SCT5jwYBwXCqyJHH1hsPCTBJ3YySRbYHR_FQmPUFPsQ">allocated elsewhere</a> and <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hast.594?casa_token=Oy3EghHloQcAAAAA%253AMFqfWIGO_EJBVmmltXpDh_5wTgww7Y7b4b9hXbcu17oHp9Kv1FCcZ5109hFVS5n4VXU_SfWANWbX7g">employed for more pressing medical issues</a>. Others also argue that there are many children <a href="https://brill.com/view/journals/jmp/13/6/article-p669_3.xml">in need of adoption</a> and that people can become parents in many other ways that do not entail costly and burdensome procedures. </p>
<p>Another critique of reproductive technologies stresses that the decision to undergo fertility treatments is not entirely autonomous and that oppressive <a href="https://www.utpjournals.press/doi/abs/10.3138/ijfab.10.1.119">societal norms shape people’s preferences</a>. These norms <a href="https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=4855&context=uclrev">emphasise the value of having genetically related children</a> over other forms of family formation – with women taking the biggest health risks.</p>
<p>The COVID-19 pandemic has put unprecedented strain on healthcare systems. So it would be easy to conclude that fertility treatments should not be a priority. But maybe instead, we should rethink their social value. </p>
<h2>Ethics of fertility treatment</h2>
<p>Infertility can have profound psychological implications and can lead to <a href="https://www.utpjournals.press/doi/abs/10.3138/ijfab.1.1.126">self-blame</a> <a href="https://www.sciencedirect.com/science/article/pii/S0022399902003987?casa_token=xoP1lcE1r-0AAAAA:9mbITP8NOThylUR36WTQF4QWP_hE5oCqUq8jex-jAP-qQtiHR-cNhUgpt7xSndHA0_tKoyB_">and distress</a>. Halting fertility treatments exacerbates all this. But it’s partly due to social norms that the experience of infertility is so psychologically devastating. </p>
<p>Making fertility treatments a priority during a pandemic and increasing funding in normal times may lend support to the view that a having a genetically related child is the only valuable way of becoming a parent.</p>
<p>This poses a dilemma: should people’s desire to have a genetically related child be fulfilled even if this might promote oppressive social norms? </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&rect=73%2C16%2C5390%2C3620&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/330778/original/file-20200427-145566-1fwf5tt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Biological families are still seen as the most attractive kind of families.</span>
<span class="attribution"><a class="source" href="https://www.pexels.com/photo/photo-of-family-walking-on-park-2880897/">Pexels</a></span>
</figcaption>
</figure>
<p>In her book <a href="https://books.google.co.uk/books/about/Resisting_Reality.html?id=UYHgUWlPMgUC&printsec=frontcover&source=kp_read_button&redir_esc=y#v=onepage&q&f=false">Resisting Reality: Social Construction and Social Critique</a>, the philosopher Sally Haslanger contends there are two ways to address this difficult problem. </p>
<p>One way is to satisfy people’s desires and bring them as close as possible to fitting social norms. Not halting fertility treatments during the pandemic and increasing funding would be a way to do this. Another way would be to combat the dominance of such social norms, even when there are negative consequences for those involved.</p>
<h2>Predominance of genetic ties</h2>
<p>In <a href="http://www.research.lancs.ac.uk/portal/en/people/giulia-cavaliere(9fcb3625-0daf-4ffd-8eba-6c1f93711970).html">my research</a>, I focus on the ethical and political questions raised by the development and use of reproductive technologies. My view is that neither of these approaches should be excluded when dealing with this dilemma. </p>
<p>Rather, people’s desire to have genetically related children must be respected, along with an understanding of the costs of not satisfying it. But there is also a need to critically engage with oppressive ideologies and the conditions that sustain them. </p>
<p>In this sense then, the predominance of genetic ties must be questioned along with the value it is attributed. But all this should be complementary to offering practical and moral support to people who are currently experiencing infertility. This is essential.</p><img src="https://counter.theconversation.com/content/137202/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Giulia Cavaliere has received funding from the Wellcome Trust Society & Ethics Studentship to support her doctoral research. </span></em></p>
Society shapes people’s preferences and emphasises the value of having genetically related children.
Giulia Cavaliere, Lecturer in Professional Practice, Values and Ethics, Lancaster University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/135554
2020-04-08T02:13:51Z
2020-04-08T02:13:51Z
Can mothers breastfeed during the COVID-19 pandemic?
<p>Even though, for reasons not yet yet known, the mortality rate of COVID-19 in infants is lower compared to older people, they are still at <a href="https://www.vox.com/2020/3/18/21181009/coronavirus-in-kids-symptoms-covid-19-risk">risk of getting the disease</a>. </p>
<p>During this pandemic, in which health practitioners recommend physical distancing to avoid virus transmission, mothers may wonder whether they should continue to breastfeed their children.</p>
<p>The World Health Organisation (<a href="https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected">WHO</a>), the US Centers for Disease Control and Prevention (<a href="https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/covid-19-and-breastfeeding.html">CDC</a>), the International Lactation Consultant Association (<a href="https://lactationmatters.org/2020/03/18/ilca-statement-on-breastfeeding-and-lactation-support-during-the-covid-19-pandemic/">ILCA</a>) and the United Nations International Children’s Emergency Fund (<a href="https://www.unicef.org/stories/novel-coronavirus-outbreak-what-parents-should-know">UNICEF</a>) recommend mothers continue breastfeeding during the COVID-19 pandemic. </p>
<p>Human milk has essential nutrients which support babies’ immune systems. The act of breastfeeding can also be a soothing activity that can relieve a mother’s stress and anxiety during this time of crisis. </p>
<h2>Breastfeeding is important to the baby</h2>
<p>At the time of writing, there has not yet been much published research regarding breastfeeding during the COVID-19 pandemic. Most research is still ongoing. </p>
<p>One <a href="https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)30360-3.pdf">published study</a> with a small number of participants, found no SARS-CoV-2 (the virus that causes COVID-19) in the breastmilk of infected mothers. This indicates the virus cannot be passed on through breastmilk.</p>
<p><a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public">Social distancing</a> measures and policies to <a href="https://www.thejakartapost.com/news/2020/03/16/stay-home-president-says.html">work and stay at home</a> have led to <a href="https://theconversation.com/no-work-no-money-how-self-isolation-due-to-covid-19-pandemic-punishes-the-poor-in-indonesia-134141">unemployment and a loss of income</a> for many people. </p>
<p>Reduction or loss of income can make it difficult to ensure quality nutrition, especially for parents with young children. </p>
<p>Breastfeeding is one way to ensure infants continue to get <a href="https://www.breastfeeding.asn.au/bfinfo/breastmilk-composition">quality nutrition</a> that can protect them from infectious diseases.</p>
<p>Breastfeeding can also benefit a mother’s health, including her <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6096620/">mental health</a>. </p>
<p>Breastfeeding can reduce stress, anxiety, negative emotions and increasing bonding between mother and baby. </p>
<h2>Breastfeeding safely</h2>
<p>To reduce the risk of COVID-19 transmission, health authorities recommend <a href="https://www.healthdirect.gov.au/personal-hygiene">good personal hygiene</a> such as frequent hand washing and covering the mouth with a sleeve or tissue when coughing and sneezing, as well as keeping a safe <a href="https://time.com/5800442/social-distancing-coronavirus/">social distance</a>. </p>
<p>If an infected mother still wants to and can breastfeed, she must be encouraged and <a href="https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected">supported</a> to do so.</p>
<p>She also needs to practice good personal hygiene, such as washing hands before and after breastfeeding. It is advised that she wears a surgical mask during breastfeeding to minimise the risk of transmission. </p>
<p>If an infected mother needs to be admitted to hospital, <a href="https://www.who.int/publications-detail/clinical-management-of-severe-acute-respiratory-infection-when-novel-coronavirus-(ncov)-infection-is-suspected">she should be encouraged and supported to express breastmilk</a>, which is squeezing milk out of the breasts for storage. This should be discussed with the father or other caregiver who can help the mother store expressed milk and feed it to the infant.</p>
<h2>Expressing and storing breastmilk safely</h2>
<p><a href="https://www.cdc.gov/healthywater/hygiene/healthychildcare/infantfeeding/breastpump.html">Expressing and storing breastmilk</a> during a pandemic is the same procedure as when done under normal conditions. But there is an additional focus on frequent hand washing before touching equipment, as well as sterilisation of breast-pumps, feeding bottles and other equipment.</p>
<p>If a mother’s condition doesn’t permit her to express breastmilk, the next option in Indonesia is to find <a href="https://www.abc.net.au/news/2019-06-24/wet-nurse-breastmilk-national-online-sharing-milk-bank/11238010">a wet nurse</a> or breastmilk donor. Currently, Indonesia doesn’t have a human milk bank. And in other countries human milk banks mostly only provide expressed breastmilk to <a href="https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/maternity/Pages/milk-bank.aspx">premature babies and other sick babies</a> in the neonatal intensive care units (NICUs).</p>
<p>Many mothers donate their breastmilk online. Before deciding to take breastmilk from a donor, parents need to assess the <a href="https://www.kemh.health.wa.gov.au/Our-services/Service-directory/Prem-Milk-Bank/Donor-Screening-Assessment-Introduction">donor’s health history</a>, such as whether they have tested positive for HIV or hepatitis, tuberculosis or have a history of cancer.</p>
<p>Once they receive the breastmilk, it’s wise to <a href="https://abm.memberclicks.net/assets/DOCUMENTS/ABM%27s%202017%20Position%20Statement%20on%20Informal%20Breast%20Milk%20Sharing%20for%20the%20Term%20Healthy%20Infant.pdf">perform flash heating or pasteurisation</a> (both are heating process that kill any harmful bacteria or viruses that may be in the milk) before feeding it to the baby. </p>
<h2>Formula is the last option</h2>
<p>Formula feeding is the last option to feed babies. Parents whose income has been reduced may not be able to purchase formula milk. Caregivers need to have access to clean water and electricity for safe formula making and equipment sterilisation. </p>
<p>It’s not recommended to donate formula milk as not all people have access to clean water and electricity during this period for safe formula making.</p>
<p>If the baby is more than six months old, parents can focus on <a href="https://www.who.int/nutrition/publications/guiding_principles_compfeeding_breastfed.pdf">complementary foods</a> – such as pureed, mashed or semi-solid food combinations of carbohydrate, meat, fruit and vegetables – to fulfil their baby’s nutritional needs. </p>
<p>WHO has <a href="https://www.ennonline.net/attachments/2671/Ops-G_2017_WEB.pdf">guidelines governments to help feed infants and young children</a> in emergencies, including during the COVID-19 pandemic. The government needs to assess and analyse the local conditions and available resources, including calculating the amount of babies and young infants in the country, as well as their health status. </p>
<p>Breastmilk is a safe and sustainable food source during an emergency. Therefore WHO recommends considering relactation, a process which may help women’s breasts produce milk again, in a mother who does not breastfeed their baby. </p>
<p>The government can allocate resources to ensuring skilled health providers (who have had training in breastfeeding counselling) are available, as well as other necessarily equipment to assist mothers to relactate or continue breastfeeding in this emergency situation.</p><img src="https://counter.theconversation.com/content/135554/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Andini Pramono tidak bekerja, menjadi konsultan, memiliki saham, atau menerima dana dari perusahaan atau organisasi mana pun yang akan mengambil untung dari artikel ini, dan telah mengungkapkan bahwa ia tidak memiliki afiliasi selain yang telah disebut di atas.</span></em></p>
At the time of writing, there have not been many published papers regarding breastfeeding during the COVID-19 pandemic. Most research is still ongoing.
Andini Pramono, PhD Candidate in Health Services Research and Policy Department, Research School of Population Health, Australian National University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/131300
2020-03-09T19:02:23Z
2020-03-09T19:02:23Z
Sad about having a boy not a girl? Your distress might be real but ‘gender disappointment’ is no mental illness
<figure><img src="https://images.theconversation.com/files/317742/original/file-20200228-24676-13lee3r.jpg?ixlib=rb-1.1.0&rect=0%2C4%2C1000%2C658&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sad-stressed-pregnant-woman-626813336">Shutterstock</a></span></figcaption></figure><p>In an age of <a href="https://www.theguardian.com/lifeandstyle/2019/oct/20/why-the-mother-who-started-gender-reveal-parties-regrets-them">gender-reveal parties</a>, <a href="https://www.instagram.com/explore/tags/babybumps/?hl=en">baby bumps on Instagram</a>, and <a href="https://www.bbc.com/news/world-us-canada-46613032">hyper-gendered</a> toys and clothing, learning about a baby’s sex is big news. </p>
<p>But having a boy rather than a girl, or vice versa, makes some people sad. Some label this “gender disappointment”.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1230949282557104128"}"></div></p>
<p><a href="https://link.springer.com/article/10.1007/s11019-019-09933-3">Our research</a> looked at what’s behind this sadness and whether gender disappointment is a mental illness, as some people say.</p>
<h2>What’s ‘gender disappointment’?</h2>
<p>In many societies, an ideal family is still a very gendered project. We see people <a href="https://www.kidspot.com.au/parenting/real-life/reader-stories/i-wanted-a-boy-so-badly-that-i-resented-my-newborn-girl/news-story/410534d6ecf0ca1e408b65e8938d7a0a">wanting the son</a> or <a href="https://www.abc.net.au/news/2019-08-10/ivf-australia-sex-selection-procedure/11387160">daughter</a> they’ve dreamed of or being congratulated for a “<a href="https://www.stuff.co.nz/life-style/parenting/71897562/a-pigeon-pair-why-is-having-one-boy-and-one-girl-seen-as-the-pinnacle-of-parenthood">gender balanced family</a>” with at least one boy and a girl.</p>
<p>Parents who do not achieve this ideal can feel they <a href="https://www.tandfonline.com/doi/abs/10.1080/14780887.2015.1008908?journalCode=uqrp20">failed at something important</a>. And some parents <a href="https://research.monash.edu/en/publications/gender-disappointment-and-cross-border-high-tech-sex-selection-a-">want to use IVF</a> to choose their child’s sex.</p>
<p>Gender disappointment is often portrayed as a mental illness, similar to depression, in <a href="https://www.dailymail.co.uk/news/article-2841999/When-having-boy-wasn-t-sure-Meet-mother-three-boys-spent-50-000-went-ensure-girl.html">the media</a> and on <a href="https://research.monash.edu/en/publications/gender-disappointment-and-cross-border-high-tech-sex-selection-a-">online forums</a>, where prospective parents discuss their desire for, or experience with, sex selection. </p>
<p>Parents who have <a href="https://utpjournals.press/doi/abs/10.3138/ijfab.10.2.4">been interviewed</a> about choosing the sex of their baby via IVF have also described gender disappointment as a mental illness.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/choosing-childrens-sex-is-an-exercise-in-sexism-45836">Choosing children's sex is an exercise in sexism</a>
</strong>
</em>
</p>
<hr>
<h2>What’s behind this phenomenon?</h2>
<p><a href="https://link.springer.com/article/10.1007/s11019-019-09933-3">Our research</a> found no evidence gender disappointment is a mental illness.</p>
<p>Instead, we argue that at the heart of many testimonies is the belief only children of a certain sex can do certain things, or have particular traits. The problem with such “gender essentialism” is there’s no strong evidence for it.</p>
<p>Contemporary research challenges the idea there are two distinctly different male or <a href="https://www.penguin.com.au/books/the-gendered-brain-9781847924766">female brains, personality types</a>, <a href="https://www.sciencedirect.com/science/article/abs/pii/S1364661313002015">behaviours</a> or “<a href="https://www.amazon.com.au/Testosterone-Rex-Myths-Science-Society/dp/0393082083">natural inclinations</a>” towards particular activities. </p>
<p>But there is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4147717/">mounting evidence</a> of how society creates, fixates on and reinforces gender differences.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/whats-the-point-of-sex-it-frames-gender-expression-and-identity-or-does-it-67849">What’s the point of sex? It frames gender expression and identity – or does it?</a>
</strong>
</em>
</p>
<hr>
<p>Parents reporting gender disappointment also seem to confuse sex with gender. </p>
<p>Sex refers to the various biological and physiological <a href="https://www.nature.com/news/sex-redefined-1.16943">bodily characteristics</a>, whereas gender relates to the <a href="https://www.palgrave.com/gp/book/9780230101814">socially constructed characteristics and roles</a> associated with individuals of a particular sex. And both <a href="https://journals.sagepub.com/doi/abs/10.1177/0891243215602102">sex</a> and <a href="https://www.bookdepository.com/Nonbinary-Micah-Rajunov/9780231185332?ref=grid-view&qid=1583335429632&sr=1-1">gender</a> are less binary, more diverse traits than commonly thought. </p>
<p>When parents speak about gender disappointment, they say they’re sad about missing out on particular activities, relationships or experiences with their child, not physical attributes associated with sex.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/317744/original/file-20200228-24685-1v50pm.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parents say they’re sad about missing out on particular activities, like playing soccer in the park.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-father-his-little-son-playing-196668920">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Yet, there is no guarantee an individual child will identify with the gender assigned to them at birth or develop the desired attributes. There are also no reasons to believe the parent couldn’t have the desired experiences with any child.</p>
<h2>Could parents be overreacting?</h2>
<p>Some people might argue parents’ anguish is an overreaction, a disproportionate response to the news of their baby’s sex, a failure in some sort of psychological process.</p>
<p>But is there a process specifically concerned with adjusting to the sex of your child that is somehow faulty in people who speak about gender disappointment? Not likely.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mondays-medical-myth-you-can-control-the-sex-of-your-baby-12896">Monday's medical myth: you can control the sex of your baby</a>
</strong>
</em>
</p>
<hr>
<p>What seems more plausible is the distress parents experience is a form of depression or adjustment disorder, which a psychological examination could address.</p>
<p>But if there is no unique cause of the “disease” or unique treatment for parents’ distress, it is hard to see the point of classifying it as a unique mental illness.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/were-overdosing-on-medicine-its-time-to-embrace-lifes-uncertainty-44715">We're overdosing on medicine – it's time to embrace life's uncertainty</a>
</strong>
</em>
</p>
<hr>
<h2>What can we do about it?</h2>
<p>So, we’re back to the issue of how parents who speak out about gender disappointment tend to overestimate the role of biology and underestimate the role of society in the process of acquiring gender roles and attributes.</p>
<p>With society being so gendered and gender essentialism so widely shared, such a view among parents is hardly surprising.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/its-not-just-the-toy-aisles-that-teach-children-about-gender-stereotypes-59005">It's not just the toy aisles that teach children about gender stereotypes</a>
</strong>
</em>
</p>
<hr>
<p>If society gave up those beliefs, parents might also stop assuming their parenting experience will be vastly different based on their child’s sex. The associated disappointment should then also disappear.</p>
<p>But overcoming ingrained societal beliefs is a long-term struggle. In the meantime, what can we do to help parents in distress?</p>
<p>Counselling to dispel some of the beliefs underlying their suffering would be a good start. Should parents have depression, or think they might have, their GP can help. But someone doesn’t need to be labelled with a mental illness for their distress to be addressed.</p>
<hr>
<p><em>If this article has raised issues for you, or if you’re concerned about someone
you know, call Lifeline on 13 11 14.</em></p><img src="https://counter.theconversation.com/content/131300/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tereza Hendl's PhD research was funded by the International Postgraduate Research Scholarships provided by the Australian Government.</span></em></p><p class="fine-print"><em><span>Tamara Kayali Browne does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
You don’t have to be labelled with a mental illness to seek help.
Tereza Hendl, Research Associate, Ludwig Maximilian University of Munich
Tamara Kayali Browne, Lecturer in Health Ethics and Professionalism, Deakin University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/132851
2020-03-04T21:20:32Z
2020-03-04T21:20:32Z
After a newborn was found in a recycling bin, a safe haven baby hatch may save lives
<figure><img src="https://images.theconversation.com/files/318696/original/file-20200304-66052-149xb24.jpg?ixlib=rb-1.1.0&rect=39%2C36%2C2005%2C1324&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although the United Nations has raised concerns about the rights of children, advocates say a baby hatch, like the one shown here in Karlsruhe, Germany, can save lives. </span> <span class="attribution"><a class="source" href="https://www.hardtstiftung.org/">(Hardt Foundation)</a></span></figcaption></figure><p>Tragedy struck in November <a href="https://www.cbc.ca/news/canada/saskatoon/baby-dead-saskatoon-bin-police-1.5361612">when an infant was found dead</a> in a recycling bin in Saskatoon. The death renewed concern that there is no way for women in Saskatchewan to safely and anonymously leave their babies if they feel they can’t care for them. </p>
<p>One proposed solution is a baby hatch, a heated, ventilated cabinet into which people can place their infant and leave. After a very short time, sensors inside trigger an alarm that notifies nurses or others to retrieve the child inside. </p>
<p>In October 2018, <a href="https://sanctumcaregroup.com/programs/sanctum-1-5">Sanctum 1.5</a>, a 10-bed home that supports high-risk and HIV-positive pregnant women and their babies, announced plans for a baby hatch. Within the month, these plans were <a href="https://www.cbc.ca/news/canada/saskatoon/saskatoon-sanctum-angel-cradle-idea-on-hold-1.4870498">put on hold</a> by the Ministry of Social Services, which said it wanted a chance to review the plans before proceeding.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318535/original/file-20200304-66089-obac8j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Katelyn Roberts, executive director of the Sanctum Care Group, stands next to the stalled construction site of a hatch meant to host an angel’s cradle, where newborns can be safely left for care.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Liam Richards</span></span>
</figcaption>
</figure>
<p>After the infant was found in the recycling bin, leadership at Sanctum 1.5 worked to move plans forward with the baby hatch. Executive Director Katelyn Roberts told the <a href="https://thestarphoenix.com/news/local-news/minister-does-not-commit-to-proposed-angels-cradle-in-saskatoon"><em>Saskatoon Star Phoenix</em></a> that “the tragedy … demonstrates a real need to push the initiative along in a more efficient way.” </p>
<p>Still, the province, and specifically the Department of Social Services, expresses reticence about moving ahead.</p>
<h2>Baby hatches: A place for abandoned babies</h2>
<p>Baby hatches can be traced back to <a href="https://www.nytimes.com/2007/02/28/world/europe/28rome.html">foundling wheels</a> built into the walls of convents and hospitals in the Middle Ages through to the late 1800s. These were barrels embedded in an outside wall of the institution — places women could leave a newborn. They turned a wheel to deliver the infant safely to others without venturing inside.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=821&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=821&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=821&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1031&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1031&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318524/original/file-20200304-66074-1h77ks6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1031&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Foundling wheel at the Ospedale degli Innocenti in Florence, Italy.</span>
<span class="attribution"><a class="source" href="https://en.wikipedia.org/wiki/Baby_hatch#/media/File:Ruota_Innocenti.jpg">(Wikipedia)</a></span>
</figcaption>
</figure>
<p>The use of foundling wheels declined over time as laws were introduced that allowed women to give birth to children and to safely and anonymously give them up.</p>
<p>In recent decades, foundling wheels have re-emerged in the form of baby hatches, with <a href="https://www.bbc.com/news/world-us-canada-46801838">iterations around the world</a>. The goal of these new, modern, heated, ventilated hatches is the same as their predecessors: to ensure that those who want to give up their babies safely have a way to do so. </p>
<p>In most of Canada, however, abandoning a baby safely and legally is not an option. There are no “<a href="https://www.theglobeandmail.com/news/toronto/safe-havens-needed-for-unwanted-babies-advocates-say-after-alleged-toronto-report/article37632550/">safe haven</a>” laws like those in the United States that allow for parents to “safely surrender” their child in a police station, hospital or fire station. </p>
<p>Instead, <a href="https://www.canlii.org/en/ca/laws/stat/rsc-1985-c-c-46/latest/rsc-1985-c-c-46.html#PART_VIII_Offences_Against_the_Person_and_Reputation_994092">Section 218 of the Criminal Code of Canada</a> prohibits abandoning any child under 10 “so that its life is or is likely to be endangered.” As a result, there is discretion in the law about what is considered a danger, and those who would abandon their child are always at risk of prosecution. </p>
<p>There are, however, a few places in the country where children can be left safely and anonymously. Since 2010, <a href="https://www.cbc.ca/news/canada/the-revival-of-baby-boxes-for-unwanted-infants-1.1357615">three baby hatches</a> have been established — one in Vancouver and two in Edmonton. </p>
<p>Because they are clearly identified as safe places, leaving a child in a baby hatch is one way to circumvent potential legal repercussions. In Vancouver, <a href="https://www.theglobeandmail.com/news/british-columbia/five-years-on-angels-cradle-program-a-safe-haven-for-abandoned-babies/article23400524/">police have agreed</a> not to pursue parents unless there is evidence that the child “was abused or otherwise endangered.” To date, three babies have been left in Canadian baby hatches. </p>
<h2>Women need access to more options</h2>
<p>Despite calls for more baby hatches across the country, there has been reluctance to move forward. One objection is that the children involved will not know their family background and health history. This issue is significant enough for the United Nations <a href="https://www.theguardian.com/world/2012/jun/10/unitednations-europe-news">to have expressed concern</a> that the proliferation of baby hatches around the world may violate human rights agreements about children’s rights to know where they come from. </p>
<p>As both donor-conceived people and adoptees have articulated, people have a right to know their origins. </p>
<p>There are other concerns. <a href="https://www.ctvnews.ca/health/health-headlines/european-parliament-urged-to-ban-boxes-for-unwanted-infants-1.1052814">Critics have suggested</a>, for example, that women might be coerced into leaving a child in a baby hatch against their will, or conversely, that women may give up a child without the knowledge of a father who may be willing or able to raise the child. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=419&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=419&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=419&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=526&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=526&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318531/original/file-20200304-66060-txksom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=526&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In this photo taken in February 2017, Francine Phago, manager at Doors of Hope, re-enacts how an abandoned baby would be taken from the drop box at the sanctuary in Johannesburg.</span>
<span class="attribution"><span class="source">AP Photo/Denis Farrell</span></span>
</figcaption>
</figure>
<p>Others suggest there is no evidence, or at least no evidence yet, that baby hatches do anything to reduce infanticide or the abandonment of children in precarious circumstances. </p>
<p>While these critics raise important objections, it’s unclear that their concerns are more important or more pressing than giving women the capacity to give up their child safely if they need to do so. </p>
<p>Further, there are ways to mitigate some of these issues and support women using baby hatches in their decision-making. In Germany, for example, there is an eight-week period where a woman can change her mind and come back to retrieve her child.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=457&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=457&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=457&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=574&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=574&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318532/original/file-20200304-66099-7os4q7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=574&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lt. Chuck Kohler, with the Coolspring Township Volunteer Fire Department, shows how a mother can relinquish her newborn anonymously, using the Safe Haven Baby Box, in Michigan City, Ind., in this 2018 photo.</span>
<span class="attribution"><span class="source">Jon Gard/The News Dispatch via AP</span></span>
</figcaption>
</figure>
<p>Baby hatches aren’t a perfect solution. They are no substitution for affordable housing, readily available mental health services, safe and accessible abortion, publicly funded childcare, and a minimum guaranteed income (among other social programs and services) that make it possible for more people to choose whether and when to raise children. </p>
<p>And there may always be some people, no matter what provisions are in place, who will <a href="https://globalnews.ca/news/6453992/christmas-eve-baby-found-calgary-charges/">abandon their baby in a dumpster</a>, a <a href="https://www.cbc.ca/news/canada/manitoba/abandoned-baby-found-at-winnipeg-hotel-1.1031542">stairwell</a> or a recycling bin. </p>
<p>Still, without safe haven laws or other sites where babies can safely be left without the risk of legal repercussions, baby hatches make a critical, potentially lifesaving option available to those faced with an impossible choice.</p>
<p>In Saskatoon, as elsewhere, baby hatches might just save both mother and child.</p><img src="https://counter.theconversation.com/content/132851/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alana Cattapan has received research funding from the Social Sciences and Humanities Research Council of Canada, the Canadian Institutes of Health Research, Canadian Blood Services, and the Saskatchewan Health Research Foundation. She currently has a grant to conduct a policy evaluation of Sanctum 1.5 in Saskatoon. She is on the Board of the Canadian Research Institute for the Advancement of Women.
</span></em></p>
Since an infant was found in a recycling bin last fall in Saskatoon, advocates have renewed their campaign for baby hatches, places mothers can leave newborns safely and anonymously.
Alana Cattapan, Assistant Professor, Department of Political Science, University of Waterloo, University of Waterloo
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/129825
2020-01-15T10:41:09Z
2020-01-15T10:41:09Z
Women who have more sex may enter the menopause later – new research
<figure><img src="https://images.theconversation.com/files/309705/original/file-20200113-103971-oy8ncz.jpg?ixlib=rb-1.1.0&rect=81%2C40%2C6690%2C4477&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mature-woman-experiencing-hot-flush-menopause-663392860">SpeedKingz/Shutterstock</a></span></figcaption></figure><p>Globally, on average, women experience the <a href="https://theconversation.com/the-menopause-dreaded-derided-and-seldom-discussed-85281">menopause</a> at around the <a href="https://www.ncbi.nlm.nih.gov/pubmed/30346539">age of 50</a>. But there’s a great deal of variation in this age both within and between countries. In recent years, scientists have begun to uncover factors that influence this variation, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285482/">increased smoking</a> and an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5850221/">early first period</a> being linked to an earlier age of natural menopause.</p>
<p>But our <a href="https://dx.doi.org/10.1098/rsos.191020">new study</a> has uncovered that women’s sexual behaviour is also connected with menopause timing. We found that women who had sex at least weekly or monthly were less likely to enter into the menopause throughout the duration of the 11-year study, compared to women who had engaged in sexual activity less than monthly. The women were, on average, 45 years-old at the start of the study and were mostly married or in a relationship.</p>
<p>We used 11 years of existing data collected from the US. Data collection began in 1996-97, from women between the ages of 42 and 52 who had not yet experienced the menopause. The women were grouped based on whether they typically engage in sexual activity weekly, monthly, or less than monthly. This measure of sexual activity included penetrative sex, oral sex, sexual touching and masturbation. </p>
<p>Our results were found to be significant even after taking into consideration other behavioural and physiological factors, such as the woman’s body mass index, the number of children she’s had, her educational attainment and oestrogen levels. </p>
<h2>Use it or lose it?</h2>
<p>We believe this link occurs because the body experiences a “trade-off” between continued <a href="https://theconversation.com/the-secret-to-ovulation-is-in-womens-faces-but-men-cant-see-it-44093">ovulation</a> and the termination of fertility. Trade-offs are important within biology, as the amount of energy the body has to have to expend on physiological processes is finite. In other words, energy used for one thing cannot be used for another, and once it has been used it is gone. </p>
<p>In terms of the menopause, it may be that there comes a point in life where energy invested into ovulation may be better off used elsewhere. Particularly if there’s no chance of an ovulation resulting in a pregnancy. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/309983/original/file-20200114-151848-1lrnctk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The findings indicate that women’s sexual behaviour can influence menopause timing.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/african-couple-bed-512874328">John Warner/Shutterstock</a></span>
</figcaption>
</figure>
<p>Ovulation is costly to the body. Not only does it take a lot of energy to maintain eggs and release them every month. But also, during ovulation, the body’s <a href="https://www.ncbi.nlm.nih.gov/pubmed/29161177">immune function is impaired</a>. </p>
<p>The whole point of ovulation is that the body is making itself ready for pregnancy, but if a woman is not having any sex, then there is no chance of conception. So if the body is not receiving the physical cues of a possible pregnancy, what’s the point of investing energy into the expensive bodily process of ovulation?</p>
<p>This is why we included different types of sexual activity in the analysis, as all are forms of vaginal stimulation, that could send cues to the body of a possible pregnancy.</p>
<p>In evolutionary terms, this means that age of <a href="https://theconversation.com/menopause-discrimination-is-a-real-thing-this-is-how-employers-can-help-108641">menopause</a> may be somewhat adaptive in response to the <a href="https://theconversation.com/can-the-menopause-really-be-reversed-62853">likelihood of becoming pregnant</a>. </p>
<h2>A positive trade-off</h2>
<p>Once ovulation has stopped, energy can be expended elsewhere – such as into grand-parenting activities. This ties in with <a href="https://theconversation.com/why-do-women-go-through-menopause-science-offers-new-solution-to-old-puzzle-54856">existing research</a> that suggests the menopause originally evolved in our evolutionary history to allow women to engage in <a href="https://www.pnas.org/content/95/3/1336.short">grand-mothering activities</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-you-experience-the-menopause-may-have-a-lot-to-do-with-your-family-123621">How you experience the menopause may have a lot to do with your family</a>
</strong>
</em>
</p>
<hr>
<p>It’s important to highlight that our research is purely showing that there is an association between sexual activity and age of menopause, and we are not suggesting that increased sexual activity definitely causes women to experience a later menopause. There are of course many contributing factors to the age of menopause – levels of sexual activity just being one of them.</p>
<p>But by providing women with the knowledge that behavioural factors can influence the timing at which menopause occurs, it’s hoped it will allow for more autonomy over the physiological process. Though of course there is no behavioural or medical intervention that can <a href="https://theconversation.com/can-the-menopause-really-be-reversed-62853">delay the menopause</a> completely – it is a biological inevitability at some point for all women.</p><img src="https://counter.theconversation.com/content/129825/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Megan Arnot receives funding from the Soc-B CDT (funded by the ESRC and BBSRC). </span></em></p>
We found that women who had sex at least weekly or monthly were less likely to enter into early menopause compared to women who engaged in sexual activity less often.
Megan Arnot, PhD Candidate, Evolutionary Anthropology and Behavioural Ecology, UCL
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/125701
2019-10-24T11:49:43Z
2019-10-24T11:49:43Z
How forceps permanently changed the way humans are born
<figure><img src="https://images.theconversation.com/files/298364/original/file-20191023-119414-620ytz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">James Young Simpson's Caesarian forceps, Hunterian Museum, Glasgow</span> <span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/3/3b/James_Young_Simpson%27s_Caesarian_forceps%2C_Hunterian_Museum%2C_Glasgow.jpg">Stephencdickson/Wikipedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Obstetric forceps look like ninja weapons. They come as a pair: 16 inches of solid steel for each hand with curved “blades” that taper into a set of molded grips. Designed for emergencies that require a quick delivery, they have a heftiness that conveys the weight of wielding them. </p>
<p>The first time I saw forceps used was also when <a href="https://scholar.harvard.edu/shah">I learned how to use them</a>. An experienced senior obstetrician and I did the emergency delivery in tandem. She showed me how to orient myself to the bony parts of the mother’s pelvis and guide each blade into the birth canal with my fingers while ensuring the curvature safely cradled the baby’s head. She clinked the shanks together so that both parts of the forceps locked definitively in place. As the frightened mother pushed, we pulled together so I could get a feel for the proper angles and necessary force. </p>
<p>We pulled so hard that I cringed. I saw the mother’s partner cringe as well. I could hear the depressed heart rate of the baby on the monitor. I could hear my own pulse pounding in my ears. But it worked. A baby girl was born and took her first breath of oxygen-rich air. Aside from matching bruises where the forceps pressed the baby’s cheeks, both she and her mother emerged from the delivery healthy. I was in awe of that power, the ability to step into a delivery room, avert a potential tragedy and preserve a moment of joy. </p>
<p>Once ubiquitous, the skill to use forceps is now rare. As cesarean deliveries and easier-to-perform “vacuum” deliveries became more common, the inclination of obstetricians to use forceps <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=22787679">waned</a>. Still, their introduction into birthing rooms permanently changed the way humans are born.</p>
<h2>The role of lived experience</h2>
<p>For most of human existence the risks of procreation were severe and terrifying. Everybody knew someone who died from a complicated pregnancy. Everybody knew someone whose baby was born dead. Not only did women face the prospect of birth and death simultaneously, in the absence of contraception, they did so again and again. Until the early 20th century, the probability of <a href="https://www.oxfordscholarship.com/view/10.1093/acprof:oso/9780198229971.001.0001/acprof-9780198229971">dying</a> from childbirth was similar to the probability of a woman dying of breast cancer or a heart attack today.</p>
<p>Women managed their understandable fear by drawing on the support of their community. They gave birth at home under the care of other women – family members, friends and neighbors who were also mothers. Families may have called upon a midwife, though back then there were no specific qualifications that distinguished the midwife’s professional skills beyond having attended a lot of births. For most of human existence, the most important form of expertise in childbirth was lived experience. </p>
<p>The capability to intervene in childbirth began to shift the balance of preferred expertise toward those who could wield surgical instruments. At first, the available options were limited and gruesome. Intervention only occurred under dire straits. If the baby appeared stuck in the birth canal, a physician could make more room by fracturing the mother’s pubic bone or by performing a vivisection – a cesarean without anesthesia, good lighting or the ability to stop bleeding. Or he could remove an obstructed fetus by whatever means necessary, potentially saving the life of the mother, but almost guaranteeing the mutilation and death of the baby. </p>
<p>Forceps were a game changer that made saving both possible. Sure, they resembled weaponry. But under the circumstances, the promise of delivering the baby alive and intact was widely welcomed. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=332&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=332&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=332&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=417&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=417&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298366/original/file-20191023-119423-n9v0bo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=417&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A late 18th-century illustration of forceps cradling the baby’s head.</span>
<span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/e/ee/Forceps.Smellie.jpg">http://en.wikipedia.org/wiki/User:Ekem</a></span>
</figcaption>
</figure>
<h2>The costs of technology and the need for balance</h2>
<p>Yet, this capability also came at a cost. </p>
<p>In the 19th century, as more women accepted medical intervention in childbirth, the composition of the birthing room began to change. The professionals who originally wielded forceps – both midwives and physicians – were men. They lacked lived experience in giving birth themselves. Gender roles and modesty standards also prevented practical opportunities to learn: men were discouraged from performing direct visual examinations of the female pelvis.</p>
<p>Most importantly, everyone – laboring mothers, their female caregivers and the male midwives themselves – recognized that what the male midwives had to offer was intervention with forceps. This led to a skewed perspective on when intervention was truly necessary. Rather than being performed during emergencies only, the ever-present specter of death made it compelling and common to use forceps preemptively. And as these professional male attendants grew in popularity in the later half of the 19th century, the role of family and community in providing support became increasingly marginalized. By the mid-20th century, intervention in childbirth was routine and nearly all women had their babies in hospitals under the care of male obstetricians.</p>
<p>Many of our modern norms resulted from the way these shifts propagated into the present. Today forceps deliveries are rare but intervention in childbirth is not. Today, 1 in 3 American mothers gets major surgery to give birth, despite <a href="https://www.ajog.org/article/S0002-9378(14)00055-6/fulltext">evidence</a> that this rate of intervention is excessive – and not only unhelpful but harmful. Today, the type of continuous labor support once provided by a mother’s community has largely fallen away, despite <a href="https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth">evidence</a> that it improves both birth experiences and outcomes. </p>
<p>The irony is that in our sharp focus on using technology to prevent harm, we appear to have lost sight of lived experience as its own complementary form of expertise. Valuing lived experience – what a mother is feeling, and what other mothers with similar experiences have felt – might not only make childbirth safer but also more dignified. It might provide better insight into when intervention in childbirth is truly helpful (and when it is not). It might help us support each other better when we are trying to start or grow our families. And it might help us adjust our collective goals to <a href="https://www.expectingmore.org/">expect more</a> from childbirth than simply emerging from the process unscathed. </p>
<p>[ <em>Insight, in your inbox each day.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=insight">You can get it with The Conversation’s email newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/125701/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Neel Shah receives funding from the Peterson Center on Healthcare, the Yellow Chair Foundation, the Rx Foundation, the Boston Foundation and the Harvard Risk Management Foundation. </span></em></p>
Childbirth used to be a terrifying ordeal. But women were surrounded by others – mothers, aunts, sisters – who brought love and experience. But midway through the 19th century, this changed.
Neel Shah, Assistant Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/124115
2019-09-25T17:39:13Z
2019-09-25T17:39:13Z
Discovery of prehistoric baby bottles shows infants were fed cow’s milk 5,000 years ago
<figure><img src="https://images.theconversation.com/files/294039/original/file-20190925-51410-ovs749.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C799%2C475&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Late Bronze Age baby bottles from Vösendorf, Austria. </span> <span class="attribution"><span class="source">Enver-Hirsch © Wien Museum</span>, <span class="license">Author provided</span></span></figcaption></figure><p>How did people look after their children in the Stone Age? It turns out that prehistoric parents may not have been so different to modern mums and dads. Clay vessels that have been found in Germany could have been used to supplement breast milk and wean children more than 5,000 years ago. They became more common across Bronze and Iron Age Europe and are thought to be some of the first-known baby bottles.</p>
<p><a href="https://www.tandfonline.com/doi/abs/10.1179/1758571615Z.00000000026?src=recsys&journalCode=ycip20">Analyses of child skeletons</a> from this period suggest that supplementary foods were given to babies at around six months and weaning was complete by two to three years of age. These bottles are often stray finds on dig sites of ancient settlements and come in all sorts of shapes, but are always very small and have a spout through which liquid could be poured or suckled. </p>
<p>Sometimes they take the form of very cute mythical animals with feet and heads, perhaps made by the parents to entertain their children. Archaeologists have suggested that they were used to feed infants, but they might also have fed the sick or elderly. Until now, no one knew their true purpose, or what types of food they might have contained. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=140&fit=crop&dpr=1 600w, https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=140&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=140&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=176&fit=crop&dpr=1 754w, https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=176&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/293894/original/file-20190924-51401-1v83vg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=176&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Feeding vessels of the late Bronze and early Iron Ages from Znojmo (Czech Republic), Harting (Bavaria, Germany), Franzhausen-Kokoron (Austria), Batina (Croatia) and Statzendorf (Austria), c. 1200-600 BC.</span>
<span class="attribution"><span class="source">Katharina Rebay-Salisbury</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>Parenting through the ages</h2>
<p><a href="https://nature.com/articles/s41586-019-1572-x">In our study</a>, we decided to investigate these objects using a technique called organic residue analysis. We found three in European child graves and two of them were complete. Normally we’d grind up broken pots, but we couldn’t possibly do this to these very small and precious vessels. </p>
<p>Instead, we did some very delicate drilling to produce enough ceramic powder and then treated it with a chemical technique that extracts molecules called lipids. These lipids come from the fats, oils and waxes of the natural world and are normally absorbed into the material of the prehistoric pots during cooking, or, in this case, through heating the milk. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-ancient-footprints-can-tell-us-about-what-it-was-like-to-be-a-child-in-prehistoric-times-91584">What ancient footprints can tell us about what it was like to be a child in prehistoric times</a>
</strong>
</em>
</p>
<hr>
<p>Luckily, these lipids often survive for thousands of years. We regularly use this technique to find out what sort of food people cooked in their ancient pots. It seems they ate many of the things we eat today, including various types of meat, dairy products, fish, vegetables and honey.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=845&fit=crop&dpr=1 600w, https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=845&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=845&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1062&fit=crop&dpr=1 754w, https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1062&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/293893/original/file-20190924-51414-yuwv1w.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1062&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A prehistoric family scene showing an infant being fed with a baby bottle similar to those we tested.</span>
<span class="attribution"><span class="source">Christian Bisig/Archäologie der Schweiz</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Our results showed that the three vessels contained ruminant animal milk, either from cows, sheep or goat. Their presence in child graves suggests they were used to feed babies animal milk, as a supplementary food during weaning.</p>
<p>This is interesting because animal milk would only have become available as humans changed their lifestyles and <a href="https://theconversation.com/why-some-humans-developed-a-taste-for-milk-and-some-didnt-56084">settled in farming communities</a>. It’s at that time – the dawn of agriculture – that people first domesticated cows, sheep, goats and pigs. This ultimately led to the “<a href="https://www.semanticscholar.org/paper/The-neolithic-demographic-transition-and-its-Bocquet-Appel-Bar-Yosef/25a36c84878d02df6b0eba8a6b5074555255f74e">Neolithic demographic transition</a>”, when the widespread use of animal milk to feed babies or as a supplementary weaning food in some parts of the world improved nutrition, contributing to an increased birth rate. The human population grew significantly as a result, and so did settlement sizes, which eventually became the towns and cities we know today. By holding these ancient baby bottles, we’re connected to the first generations of children who grew up in the transition from hunter-gatherer groups to communities based around agriculture.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=568&fit=crop&dpr=1 600w, https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=568&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=568&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=714&fit=crop&dpr=1 754w, https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=714&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/293891/original/file-20190924-51421-n2us8b.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=714&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A modern-day baby testing a replica of one of the ancient bottles.</span>
<span class="attribution"><span class="source">Helena Seidl da Fonseca</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>This research gives us a greater insight into the lives of mothers and babies in the past and how prehistoric families were dealing with infant feeding and nutrition at what would have been a very risky time in an infant’s life. Child mortality would have been high – there were no antibiotics in those days – and feeding babies with animal milk would have come with its own set of risks. Although it may have provided a valuable source of nutrition, today we know that unpasteurised milk carries the risk of contamination from bacteria and can transmit disease from the animal.</p>
<p>Like all good research, this begs a range of new questions. Both the ancient Greeks and the Romans used very similar vessels and we know of a small number in a prehistoric site in Sudan. It would be interesting to see how these generations of children were fed and raised elsewhere in the world. It’s perhaps comforting to know that despite the vast distance of time, these people loved and cared for their children in much the same way that we do today.</p><img src="https://counter.theconversation.com/content/124115/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julie Dunne receives funding from The Leverhulme Trust.</span></em></p>
Ancient farmers ensured their children were fed and entertained in a similar way to modern parents.
Julie Dunne, Postdoctoral Researcher in Archaeology, University of Bristol
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/117606
2019-07-04T11:00:04Z
2019-07-04T11:00:04Z
Some baby care books are giving advice that goes against safe infant care guidelines
<figure><img src="https://images.theconversation.com/files/282654/original/file-20190704-51312-ud8rr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Parenting and baby care books may be unintentionally putting babies in danger.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-young-mom-reading-fairy-tales-716928106?src=JP9IIXRdI2lvHzDfJX2J6A-1-3&studio=1">Cookie Studio/Shutterstock</a></span></figcaption></figure><p>Becoming a new parent can be one of the most stressful things you ever do. It’s normal to feel blindsided between what you thought it would be like, and the reality. But it can lead to all sorts of emotions from <a href="http://oro.open.ac.uk/22943/">panic and anxiety</a>, through to <a href="https://www.theguardian.com/books/2001/sep/09/biography.features">grief</a> for your former existence, and even (often hidden) <a href="https://www.journals.uchicago.edu/doi/abs/10.1086/678145?mobileUi=0&journalCode=signs">regret at what you’ve got yourself into</a>. </p>
<p>This isn’t helped by how <a href="https://www.ncbi.nlm.nih.gov/pubmed/28795604">isolated many new parents now are</a>. Just a few decades ago, family, friendships and networks were far more localised, but now, many new mothers have babies many miles away from family, and may not know a single person close by who is going through the same thing. These connections are <a href="https://www.huffingtonpost.co.uk/entry/mums-feel-lonely-after-birth_uk_58bec088e4b09ab537d6bdf9">important socially</a>, but also in terms of <a href="https://www.rcog.org.uk/globalassets/documents/patients/information/maternalmental-healthwomens-voices.pdf">learning from others and sharing information</a>. </p>
<p>Without the advice of family and friends to hand, many new parents turn to baby books for advice. Parenting guides that suggest certain styles of caring have been around for many years. But recently there has been an explosion of these books, fuelled by the <a href="https://www.theguardian.com/news/2018/jan/16/baby-advice-books-industry-attachment-parenting">willing and waiting market of confused and isolated new parents</a>. Although a whole range of parenting books are available, books that promote getting babies into parent-led sleep and feeding routines, along with the idea of them being settled and more “independent” in between, have become particularly popular. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/DagfgMeMSXI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>We have previously shown that the more of this type of book that new mothers read, the higher their symptoms of depression and parenting stress, and <a href="https://theconversation.com/are-baby-advice-books-making-mothers-depressed-and-anxious-83992">lower their confidence in their own parenting abilities</a>. Although it could be that mothers who are feeling stressed and depressed choose to try and follow the advice in these books, for this study we also asked mothers directly how the books made them feel. A minority (15–20%) did like them and felt more confident, but far more said that they felt more stressed because they didn’t work for them. Some mothers reported that they were even left feeling “like a failure”.</p>
<p>More recently, we have been exploring <a href="https://onlinelibrary.wiley.com/doi/10.1111/mcn.12858">how these books are actually used</a> and the impact they have on baby care. Speaking to 354 mothers with a baby aged 0–12 months old, we found that several pieces of advice in these books are associated with a number of behaviours that go against the UK government’s recommendations for safe infant care, and research findings too. </p>
<p>For example, when mothers read these books, we found that 39% of babies were placed in their own room to sleep, <a href="https://www.lullabytrust.org.uk/safer-sleep-advice/">going against guidance</a> that the safest place is to share a room with their mother. Although thankfully rare, babies who sleep in a different room are <a href="https://www.sciencedirect.com/science/article/pii/S0140673603153238">at a higher risk</a> of Sudden Infant Death Syndrome (SIDS). This is <a href="https://www.sciencedirect.com/science/article/abs/pii/S0277953612002924">possibly because</a> parents are unaware of the temperature in that room, or that the baby has become unwell. While sleeping close to their baby can help parents regulate <a href="https://www.sciencedirect.com/science/article/abs/pii/S1526054205000230">the child’s breathing, temperature and heart rate</a>. </p>
<p>We also found that just 28% of mothers responded immediately if their baby cried at night, with 25.5% leaving a baby to cry themselves to sleep in the evening. Although occasionally leaving a baby to cry briefly is not going to cause harm, consistently leaving a baby to cry <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079210001322">can increase the level of stress hormones</a> circulating in a baby’s body, which could potentially programme their system to be overstimulated. </p>
<p>Breastfeeding rates were also lower, both in terms of starting and continuing breastfeeding. Breastfeeding <a href="https://www.sciencedirect.com/science/article/pii/S0140673615010247">protects maternal and infant health</a> and stopping breastfeeding before mothers are ready is associated with an <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/jan.12832">increased risk of depression</a>. The guidance in these books sets women up to not be able to breastfeed.</p>
<p>Breastfeeding works best when <a href="https://kellymom.com/ages/newborn/bf-basics/importance-responsive-feeding/">babies are kept close and fed responsively</a> whenever they want to. However, we found that mothers following the book guidance were more likely to try to feed to a mother-led routine, and as noted their babies were sleeping separately at night. </p>
<p>Of course, all this this might just be correlation – mothers who want to parent in this way may be more drawn to the books in the first place, rather than the books affecting their decisions. But we also asked mothers whether the books directly affected their behaviour in any way. Our findings showed that reading the books persuaded mothers to use a sleep and feeding routine (45%), sleep separately to their baby (23%), delay how quickly they responded to their baby’s cry (24%) and cuddle their baby less (15%).</p>
<p>Some advice books can promise a utopia to new parents desperate for a solution to a baby with frequent needs but such strict routines and separation behaviour often do not work and can place babies at <a href="https://www.lullabytrust.org.uk/safer-sleep-advice/">increased risk of SIDS</a>. We also know the importance of <a href="https://www.sciencedirect.com/science/article/pii/S0163638308001215">loving, responsive parenting interactions</a> in the early years for longer term social, emotional and health outcomes – which some books appear to promote the antithesis of. </p>
<p>Although some parents may make an informed decision to follow such advice, for many this guidance doesn’t work, leaving mothers feeling even more stressed. Rather than selling new parents a promise that they can “control” their baby, we need to focus on helping fewer new families <a href="https://www.huffingtonpost.co.uk/amy-brown/mothering-the-mother-the-_b_18317834.html">feel under such stress and anxiety</a> in the first place.</p><img src="https://counter.theconversation.com/content/117606/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Brown has previously received funding from the ESRC, NIHR and Public Health Wales. She is author of three books published by Pinter and Martin Ltd - 'Breastfeeding Uncovered: who really decides how we feed our babies', 'Why starting solids matters' and the 'The Positive Breastfeeding Book'.</span></em></p><p class="fine-print"><em><span>Victoria Harries does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
When there is no “village” to help raise a child, parents often turn to baby books for guidance — but they don’t always hold the best advice.
Amy Brown, Professor of Child Public Health, Swansea University
Victoria Harries, PhD Researcher in Biological Anthropology, Yale University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/115527
2019-05-07T09:30:42Z
2019-05-07T09:30:42Z
Teenage pregnancy doesn’t have to mean catastrophe – research shows it can be an opportunity
<figure><img src="https://images.theconversation.com/files/272481/original/file-20190503-103071-az9zb2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>The idea of having a baby as a teenager often is viewed as both a personal catastrophe and a social problem. This is probably why the continuing decline in teenage births in Britain – which is now at the <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthsummarytablesenglandandwales/2017">lowest level since records began</a> – is presented as a <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30589-X/fulltext">policy triumph</a>. But research tells a different story. </p>
<p>This is because having a baby as a teenager seems to have little effect on future social outcomes. Teenage mothers and fathers usually express positive attitudes about parenting and many transform their behaviour. As one teenage mother, interviewed as part of a <a href="https://www.researchgate.net/publication/230819532_Living_on_the_Edge_Sexual_Behaviour_and_Young_Parenthood_in_Seaside_and_Rural_Areas">research study</a>, put it:</p>
<blockquote>
<p>Just because you’ve got a baby doesn’t mean to say your life has ended at all. Me getting pregnant and me having a baby now has actually given me a bigger incentive to go and do something with my life instead of just getting a dead end job.</p>
</blockquote>
<h2>Disadvantage and teenage parents</h2>
<p>Statistically speaking, teenage motherhood correlates with low educational achievement, poor employment, low income, poor health and social disadvantage. This is the message in many “official” <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/796582/PHE_Young_Parents_Support_Framework_April2019.pdf">accounts</a>. But the reality is that rather than young motherhood causing poor outcomes, these outcomes are largely caused by preexisting social disadvantage.</p>
<p>This is an example of the “selection effect” so often found in social statistics. In this sense, social disadvantage has “selected” particular young women to become teenage mothers. And if statistical studies do not control for these selection effects, then they come to misleading conclusions about cause and effect. </p>
<p>In the US, a number of pioneering statistical studies attempted to control such selection effects. Researchers devised “natural experiments”, such as comparisons between twin sisters, where only one was a teenage mother, or between teenage mothers and other women who had conceived as a teenager but miscarried (who presumably would have gone on to become mothers). They found that mother’s age at birth had little effect on social outcome. As researcher Saul Hoffman put it in his systematic review, the effects of teenage parenthood were “<a href="https://cpb-us-w2.wpmucdn.com/sites.udel.edu/dist/4/415/files/2011/11/Hoffman-Teen-Births-FPP1999.pdf">often essentially zero</a>”. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=437&fit=crop&dpr=1 600w, https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=437&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=437&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=549&fit=crop&dpr=1 754w, https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=549&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/272492/original/file-20190503-103071-1ex74k2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=549&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many teenage couples spoke about the benefits gained from choosing to become parents.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p><a href="https://pdfs.semanticscholar.org/2a7c/6440a85446410cc944265aa30149e4155734.pdf">One study</a> found that teenage mothers in the US did better than miscarrying teenagers in employment and income by their mid- to late-20s. This implies that teenage parenting means lower state expenditure over the longer term. <a href="http://www.tpress.free-online.co.uk/teenpref.pdf">British studies</a> took up this “natural experiment” approach later, and came to similar conclusions. </p>
<p>Using large longitudinal data sets like the <a href="https://cls.ucl.ac.uk/cls-studies/1970-british-cohort-study/">British Cohort Study</a>, the <a href="https://www.iser.essex.ac.uk/bhps">British Household Panel</a>, and the <a href="https://cls.ucl.ac.uk/cls-studies/millennium-cohort-study/">Millennium Cohort Study</a>, researchers found that teen birth had little impact upon qualifications, employment or earnings for women by the age of 30. Similarly, having a teenage mother did not in itself significantly affect the chances of a preschool child experiencing poor health or doing poorly on cognitive tests.</p>
<p>Perhaps there can never be a completely accurate measurement of the effect of teenage motherhood. Nonetheless, these studies show that teenage childbearing can be seen as only a minor social problem in terms of economic outcomes. </p>
<h2>A positive experience</h2>
<p><a href="https://journals.sagepub.com/doi/abs/10.1177/0261018307078845">Previous research</a>, that focuses on teenage parents’ actual experiences, helps to explain these statistics. It shows how many teenage parents react positively and transform their behaviour for the better. Indeed, <a href="https://www.ncbi.nlm.nih.gov/pubmed/12629314">a review of studies</a> from around the world concluded that teenage mothers often experience motherhood as “positively transforming” and the baby to be a “stabilising influence”. </p>
<p><a href="https://journals.sagepub.com/doi/abs/10.1177/0193945905278190">A groundbreaking US study</a> that followed teenage mothers for over 12 years, found that for the most disadvantaged and alienated teens in the study, having a baby epitomised the hope of escaping a desolate past, but this proved illusory and eventually confirmed their pre-pregnancy despair.</p>
<p>At the other end of the spectrum, the more advantaged teens – with substantial family and social resources – found that their pre-pregnancy plans for education and employment were complicated by having a baby, but were also strengthened. For a “middle group”, motherhood provided a corrective experience. These mothers reported getting off drugs, returning to education, distancing themselves from risky friendships, and reevaluating earlier destructive behaviour. </p>
<p><a href="https://journals.sagepub.com/doi/10.1177/0261018307078845">Later British studies</a> came to similar conclusions: teenage motherhood increased self-esteem and provided a sense of security and stability. Mothers had “grown up”, they had found an added impetus in their lives, and were planning or embarking upon further education and employment. Far from a catastrophe, teenage pregnancy was more the turning point to maturity and developing a career. It provided resilience in the face of constraints and stigma – based on a belief in the moral worth of being a mother.</p>
<p>This shows how teenage parenting is more a part of social disadvantage, rather than its cause. And for some young people, it may even provide a way through and out of disadvantage. So rather than assuming the inadequacies of teenage parents, society would be better off supporting parents as a whole – while working to address wider issues of social injustice that make teenage pregnancy more likely to happen in the first place.</p><img src="https://counter.theconversation.com/content/115527/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Simon Duncan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Despite what the statistics suggest, many teenage parents say having a baby has transformed their lives.
Simon Duncan, Emeritus Professor in Social Policy, University of Bradford
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/115928
2019-04-26T10:03:56Z
2019-04-26T10:03:56Z
Meghan Markle reportedly seeks a private childbirth – medieval women really did have one
<figure><img src="https://images.theconversation.com/files/270961/original/file-20190425-121241-9hmupd.jpg?ixlib=rb-1.1.0&rect=0%2C146%2C3733%2C2667&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Privacy, please. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/london-uk-march-11-meghan-markle-1335905381?src=VZoR9y4qQcKwk378Z0fvmg-1-4">Mr Pics/Shutterstock.</a></span></figcaption></figure><p>The British royal family <a href="https://twitter.com/victoriaarbiter/status/1116273837082075136">has released a statement saying</a> that the Duke and Duchess of Sussex will keep plans for the arrival of their baby private. Other royal births have been announced almost immediately, with the new family posing for photographs soon afterwards on the steps of the Lindo Wing of St. Mary’s Hospital in London. Meghan and Harry, however, have chosen to “celebrate privately as a new family”, before placing their baby in the public eye. </p>
<p>As the London <a href="https://www.independent.co.uk/life-style/health-and-families/royal-baby-meghan-markle-prince-harry-pregnancy-birth-when-due-title-a8840136.html">media speculates</a> about when and where the birth will take place, the modern craving for instant information and “access-all-areas” insights has never been more apparent. Despite established <a href="https://www.gov.uk/data-protection">privacy laws</a>, information continues to spread, leak and diffuse – often without the subject’s consent. The fact that the Duchess had to make the request at all is, in itself, a telling sign. </p>
<p>Indeed, Meghan’s desire to retain privacy surrounding her impending birth has a historical precedent. The intimate – and largely lost – realm of the medieval “lying-in” room is a reminder that the modern predilection for publicising the deeply personal was not always the norm. </p>
<h2>A long lie-in</h2>
<p>Most pregnant women in the middle ages were tended to by other women, during an extended lying-in period of around two months, before and after childbirth. This private zone gave expectant women the time and space to prepare for, and recover from, childbirth, while awaiting the moment they were permitted to re-enter the church, in the ceremony of purification after childbirth. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=562&fit=crop&dpr=1 600w, https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=562&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=562&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=706&fit=crop&dpr=1 754w, https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=706&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/270699/original/file-20190424-19297-ulbfbd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=706&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The birth of St Edmund, from Lydgate’s Lives of SS Edmund and Fremund, England, 1434–1439.</span>
<span class="attribution"><span class="source">British Library</span></span>
</figcaption>
</figure>
<p>A 15th century manuscript miniature of the birth of St Edmund depicts the birthing chamber, midwives and female companions. The new mother rests in her bed as she is fed, made comfortable and soothed with aromatics by the women who care for her, while the baby is warmed before the fire.</p>
<p>The lying-in room was a womb-like space, adorned with tapestries for privacy and warmth, with daylight limited often to a single window, and herbs scattered across the floor to create a pleasant scent with therapeutic benefits. Women of higher social status were often bestowed with brooches, pendants and books depicting icons of healing saints, as well as jewelled girdles and statues of female saints. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=587&fit=crop&dpr=1 600w, https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=587&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=587&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=738&fit=crop&dpr=1 754w, https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=738&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/270705/original/file-20190424-121237-1n4yton.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=738&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A painted birth tray, depicting a mother lying-in, by Francesco di Michele c.1410.</span>
<span class="attribution"><span class="source">Harvard Art Museum</span></span>
</figcaption>
</figure>
<p>Painted birthing trays, or salvers – such as this <em>desco da parto</em> from Florence – were given to wealthy women after childbirth, to serve mulled wine and clean linens: a sign of the value bestowed on noble births. Though present in this depiction, men were rarely permitted to enter the lying-in room – entrance was by invite only, through the monitored doors. </p>
<h2>Wandering wombs</h2>
<p>Childbirth was a dangerous business for mother and child in medieval times, regardless of their social station. Of course, royal births in the middle ages were different to those of peasant women, whose return to the hard labour of everyday life would demand a less luxuriant recovery period. But while aristocratic households could afford the services of university-trained male physicians, hands-on care remained the job of the midwife. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=797&fit=crop&dpr=1 600w, https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=797&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=797&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1002&fit=crop&dpr=1 754w, https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1002&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/270843/original/file-20190424-121258-1is3oua.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1002&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Disembodied wombs with foetal positions and a pregnant female in Wellcome Apocalypse (MS 49), f. 38r, c.1420.</span>
<span class="attribution"><span class="source">Wellcome Library</span></span>
</figcaption>
</figure>
<p>The medieval gynaecological and obstetrical handbook known as <a href="http://www.upenn.edu/pennpress/book/13753.html">The Trotula ensemble</a> contains instructions for midwives on how to deliver a baby safely. Medieval understandings of the female body included the <a href="http://exhibits.hsl.virginia.edu/antiqua/gynecology/">ancient Hippocratic belief</a> that a woman’s womb was like a living creature that “wandered” around her body – a stereotype of “unruly” women which <a href="https://www.vogue.com/article/trump-women-hysteria-and-history">still lingers today</a>. The postpartum uterus was seen to be particularly disordered. The Trotula author notes: </p>
<blockquote>
<p>The womb, as though it were a wild beast of the forest, because of the sudden evacuation falls this way and that, as if it were wandering. Whence vehement pain is caused.</p>
</blockquote>
<p>Such notions of the “wandering womb” are manifest in images from medical manuscripts that show the uterus “floating” around the words on the page. These disembodied wombs show common foetal presentations, and a reasonably accurate knowledge of anatomy – surprising, in an age when human dissection was taboo and male physicians had limited access to women’s bodies. </p>
<h2>Dragons and divination</h2>
<p>The story of <a href="https://en.wikipedia.org/wiki/Margaret_the_Virgin">St Margaret</a>, the patron saint of childbirth, was well-known to women in the middle ages. Margaret was swallowed by a dragon but, after making the sign of the cross, was expelled quickly. Her popularity reveals how an uncomplicated birth was desired just as much throughout history.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=579&fit=crop&dpr=1 600w, https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=579&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=579&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=727&fit=crop&dpr=1 754w, https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=727&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/270713/original/file-20190424-121262-1do5fmn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=727&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">St. Margaret and the Dragon. From an illuminated medieval Book of Hours. Walters Manuscript.</span>
<span class="attribution"><span class="source">Walters Art Museum</span></span>
</figcaption>
</figure>
<p>Just as our modern fascination at guessing the sex of newborn babies remains, various medieval techniques for predicting the sex of a baby abounded. This one from The Trotula requires some careful orchestration: </p>
<blockquote>
<p>In order to know whether a woman is carrying a male or a female, take water from a spring and let the woman extract two or three drops of blood or milk from her right side and let these be dropped in the water. And if they fall to the bottom, she is carrying a male; if they float on top, a female.</p>
</blockquote>
<p>It’s safe to say that Meghan and Harry are unlikely to try this at home. But these medieval practices show that – unlike <a href="http://blog.catherinedelors.com/marie-antoinettes-first-laying-in/">Marie Antoinette’s hugely public birth</a> in the 18th century – watched by a plethora of spectators after her obstetrician called, “the Queen is going to give birth!” – childbirth need not always be a public spectacle.</p><img src="https://counter.theconversation.com/content/115928/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Kalas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The Duke and Duchess of Sussex wish to keep the arrival of their baby private – and it’s caused some consternation. But this was normal for most medieval women.
Laura Kalas, Lecturer in Medieval Literature, Swansea University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/111477
2019-02-20T10:00:28Z
2019-02-20T10:00:28Z
Miscarriage: why no one wants to talk about it in the workplace
<figure><img src="https://images.theconversation.com/files/259045/original/file-20190214-1717-rylpeu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>For many expectant parents, experiencing a miscarriage – whether it occurs early or late in pregnancy – can be devastating. Statistical <a href="https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1471-0528.2006.01193.x">evidence</a> suggests that one in three or four pregnancies results in a miscarriage. <a href="https://www.acog.org/?IsMobileSet=falsev">The American College of Obstetricians and Gynaecologists</a>, meanwhile, recognises miscarriage as the most common type of pregnancy loss, with anywhere from 10-25% of all clinically recognised pregnancies ending in miscarriage.</p>
<p>Although this life event is fairly frequent, it is rarely openly spoken about. In some cases, bereaved parents are even reluctant to discuss it with families and friends. And in many countries, people choose not to share their pregnancy news until the end of the first trimester when miscarriages are less <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741961/">frequent</a>.</p>
<p><a href="https://www.nhs.uk/conditions/miscarriage/">Miscarriage</a> is the loss of a child during the first 23 weeks of a pregnancy – and it can be highly traumatic for expectant parents. Added to the complications of dealing with such a unique type of loss, many people feel uncomfortable talking about personal issues within their workplace. </p>
<p>Organisations often shy away from dealing with personal circumstances that are linked to the body and its “dirty” processes, such as miscarriage, <a href="https://www.gov.uk/government/publications/menopause-transition-effects-on-womens-economic-participation">menopause</a> and <a href="https://www.theguardian.com/commentisfree/2018/jun/28/menstrual-leave-period-taboo-work-reform-women-health">menstruation</a>. People and organisations around the world regularly silence the physical experiences of workers out of shame, ignorance or discomfort. This is often down to the private nature of the topic and the lack of specific organisational support.</p>
<p>Part of the problem is that ideas of management and the workplace traditionally are deeply rooted in masculine norms that consider any personal experiences of loss, <a href="https://journals.sagepub.com/doi/10.1177/0018726712467380">the private world of reproduction</a> and intense emotional engagement as “weaknesses” or unprofessional. </p>
<h2>One body</h2>
<p><a href="https://journals.sagepub.com/doi/metrics/10.1177/1350507618784555">Our recent research</a> challenges the outdated patriarchal style of management that dehumanises workers and separates personal and professional lives. We advocate a more humanistic style of managing and behaving in organisations that is inclusive and supportive of employees, and which acknowledges that staff’s well-being inside and outside of the workplace is inevitably linked.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/SW0DD9nHOSM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>The research draws upon the first author’s (Ilaria) experience of miscarriage. We use personal narrative to show how difficult it can be to try and balance your personal life and work life when you are going through such a traumatic experience:</p>
<blockquote>
<p>I find a quiet space at the top of a staircase and cry my tears of love and lost motherhood. I open the gates of my loss and fragility. I am half aware of the possibility of being seen, half-unbothered about the experiential conflict between my personal and work lives, which are never separate, never manageable in organised compartments, never really balanced.</p>
</blockquote>
<p>Notwithstanding the impact on people and their ability to perform in the workplace, organisations often have no specific policies to support bereaved parents. There may be maternity or paternity policies, there may be a few days entitlement for bereavement, there may be sick leave, but usually there are no specific and targeted processes and policies in support of miscarriage. </p>
<blockquote>
<p>Maybe it shows on my face, as two colleagues I bump into ask me if I am okay. I am not feeling great. Headache? Something like that. Take care of yourself. I slide away. After all, a miscarriage is not really appropriate conference corridor chit-chat material.</p>
</blockquote>
<p>This lack of acknowledgement and support for miscarriage leaves people feeling alone, isolated and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468887/">may also lead to depression</a>. In the UK, mothers are assessed for this and supported by midwives or other healthcare professionals after giving birth. But following a miscarriage, women and their partners do not receive any post-miscarriage mental health or well-being support. Bereaved parents are left to their own devices or are expected to be proactive in seeking <a href="https://www.sands.org.uk/about-sands">external advice</a>.</p>
<h2>Shared stories</h2>
<p>When we began talking about miscarriage, people started coming forward with their own stories and shared their experiences. Colleagues reported feeling less lonely knowing that it was alright to discuss this, and acknowledged how miscarriage affected their lives and work. </p>
<p>By sharing narratives of miscarriage, individuals became part of a more intimate community of colleagues who feel valued and listened to as people – and not just workers.</p>
<p>Our research shows why it’s time for personal issues to be written and spoken about in a professional context. This needs to enter organisational discourses, policies and practices. Organisations must create places, networks and processes to legitimise miscarriage as a significant life event. This will enable people to discuss their experiences and feel more able to start talking about traumatic events with less shame and fear regarding other people’s reactions. </p>
<hr>
<p><em>Anyone affected by miscarriage can get help from the <a href="https://www.miscarriageassociation.org.uk/your-feelings/">Miscarriage Association</a> and <a href="https://www.sands.org.uk/about-sands">Sands</a>.</em></p><img src="https://counter.theconversation.com/content/111477/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Added to the complications of dealing with such a unique type of loss, is the fact that many people feel uncomfortable talking about personal issues with their colleagues.
Ilaria Boncori, Senior Lecturer in Management, Marketing and Entrepreneurship, University of Essex
Charlotte Smith, Lecturer in Management, University of Leicester
Licensed as Creative Commons – attribution, no derivatives.