Until my baby is vaccinated, I don’t feel comfortable taking them out of the house or exposing them to anyone but my partner and me. Am I being paranoid?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I don’t think you’re being paranoid. But let’s peel back the surface of your feelings by considering a few things. First, if your baby has a compromised immune system, it’s wise to be cautious about being around too many people until they’re less vulnerable. And if you’re in the thick of flu season or have family members who have been battling a “bug,” it’s best to avoid exposure for you and baby.

If you have a healthy baby, you’re likely fine to go out. This is especially true if you’re breastfeeding, as breastmilk fills your baby with antibodies and other goodies that work wonders at protecting them from harm, at least for a few months. The one “going out” caveat is that you might want to avoid incredibly crowded areas, like theme parks, malls, and cruise ships, for example, as these are the types of environments that can breed the spread of infection.

With that said, consider whether your hesitancy to leave the house or have people over also has to do with your need to integrate with all the changes you’re going through. Becoming a parent is one of the most massive, sudden transformations a human can go through, which makes it natural to want to pause interaction with the outside world until you get your bearings.

Whatever your reasoning, I recommend following your instincts. If you’re yearning to leave the house but guilt over exposing baby to a virus is holding you back, get creative about safe ways to go out. For example, you could go on walks, so long as you have a hard line with strangers trying to touch baby, which strangely happens more than you’d expect — people see something cute and want to touch. You could also meet friends for a picnic at the park or go to an uncrowded restaurant and sit on the patio. Essentially, choose activities that allow you to be outside, without having close contact with others.

If you want people to come over but worry about invisible dangers they might carry into your home, be strict about them washing their hands as soon as they arrive and holding off on coming over if they’re sick. Your pediatrician can also let you know if there are vaccinations you should confirm that others have before coming over. For example, whooping cough was a big problem when Hudson was born, so I and everyone who would be frequenting our house were vaccinated with Tdap before he was born. In addition to all that, you have every right to not allow anyone to hold the baby.

That’s my long way of saying that what you’re feeling is your maternal instincts giving you a strong signal that you should explore.

What to do

After contemplating where your hesitation to go out with baby or have people over is coming from, consider the following actions, as they can provide a welcome sense of security:

Get a recommendation from your pediatrician. If you’re raring to get out but fear keeps popping up, ask your baby’s pediatrician for their suggestion. They can guide you based on your baby’s unique health circumstances and any public health concerns you should be aware of.

For example, I’m writing this during the Covid-19 outbreak; for obvious reasons, this pandemic makes it easy to decide whether to go out or not. But even when we’re not in the midst of a pandemic, flu season and a flare-up of other viruses could cause the pediatrician to advise you to stay close to home for awhile. Regardless of their recommendation, you’ll likely have more clarity after the chat.

Breastfeed. While breastfeeding isn’t a substitute for vaccinations, the milk does give baby an extra layer of protection for about six months after birth. Breast milk does this by providing antibodies that support the immune system and protect against diseases you have had or have been vaccinated for. These antibodies can bind to potential pathogens and prevent their attachment to the baby’s cells. In addition, breastfeeding can enhance the baby’s response to certain vaccines.

Get vaccinated. Protecting yourself is one of the best ways to protect your baby. So confirm with your care provider that you’re up to date on vaccinations, and ask if they recommend any new ones. Many advise pregnant women to get a Tdap vaccine and a flu shot during pregnancy.

Don’t let others touch baby until they’ve washed their hands. Because close contact, touch in particular, is one of the main ways viruses spread, require anyone who wants to hold baby, or even just touch them, to wash their hands for at least twenty seconds first. And remember, you have every right to not allow others to hold or touch baby if you’re uncomfortable with it.

Verify the health standards of the day care facility you use. If your baby will need day care before they’re vaccinated, confirm the health standards of your preferred center by reading their health and safety inspection report. Many centers post these online, and you can also ask them for a copy. In addition, ask them about their hand-washing policy, vaccination requirements and records for those old enough to receive shots, guidelines for keeping a sick child home, and anything else you feel is important. The Child Care Aware website offers excellent resources for finding quality childcare: childcareaware.org/families /choosing-quality-child-care/starting-child-care-search/.

Avoid crowded spaces. As I mentioned before, crowded areas increase baby’s risk for contracting a virus. While the risk is probably pretty low when an outbreak isn’t occurring, if you’re feeling anxious you can enhance your peace of mind by avoiding crowded spaces until baby is vaccinated. For unavoidable sites like airports, minimize baby’s exposure by washing your hands as often as possible, not letting anyone touch them, and minimizing their contact with public surfaces.

Know that it’s okay to want to stay in. If baby’s health is only a portion of your hesitancy to interact with others, and all parts of you resist the idea of going out or socializing, trust that. Honor your need for time and space.

Create a loose script for when people hassle you about your need for space. Because it can be hard for others to understand your request for space — especially when they’re yearning to meet that adorable baby — come up with a go-to response for when you’re questioned. For example, “The pediatrician recommends we keep baby home and away from others for [insert your desired period of time here], and for baby’s safety we’re going to honor that.” Even if the pediatrician didn’t recommend this, I’m all about blaming it on them, as others are often loath to go against the word of a medical expert.

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I had a horrible childhood and am afraid I’ll replicate that with my child, as I have no good parenting role models. Am I destined to be a bad parent?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

The fact that you want to step away from the negative parenting patterns of your parents is amazing — you’ve already taken a huge leap away from those patterns. Many people grow up in dysfunctional households and never identify what they should try to do differently with their children. You’re in an eyes-wide-open position that’s filled with possibility.

I also invite you to consider that your horrible childhood can be a blessing as well as a curse when it comes to parenting your child. It’s a blessing because you get to start from scratch, and a curse because you have to start from scratch. Regarding the blessing, you have a clean slate you get to fill with your own way of parenting. You get to seek out parenting philosophies that resonate with you, then use pieces of these philosophies to craft your own. It can be an exciting, enlightening process. Regarding the curse, the idea of starting from square one can feel overwhelming. You don’t have positive parenting presets. You don’t have memories filled with happy parenting moments to lean on. You — and your partner, if you have one — are tasked with starting from the beginning. Again, a blessing and a curse.

What to do

Stand firm in the knowing that you’re in no way destined to be a bad parent. You are a wholly unique human who gets to make her own decisions. The dated belief that all women turn into their mothers is ridiculous — you get to choose who you become. You get to choose how you want to parent. The following ideas will help you get on the path that will shape you into the amazing parent you’re destined to be:

Get specific about parenting traits you don’t want to repeat. While you realize you don’t want to parent like your parents, it can be helpful to break down exactly what it is they did or didn’t do that you found damaging. For example, did they ignore you, talk down to you, use corporal punishment, withhold affection, leave you home alone before you were old enough to care for yourself, shame you?

As painful as it might be to dredge this all up, it can be liberating to explore what your parents did and how it impacted you, so you develop a clear picture of how you want to parent. And if you find this difficult to do on your own, seek out the support of a mental health specialist, especially if you experienced abuse.

Determine the type of parent you want to be. Once you pinpoint the parenting methods you don’t want to use, it’ll be easier to determine what methods you want to try. A good place to start is figuring out what the opposite of the negative parenting methods you listed would be. For example, you might list, “actively listening, building up the child’s confidence, using communication instead of physical force to discipline, being openly affectionate, never leaving the child alone (until they’re old enough) or with iffy childcare, supporting the child in navigating failure without shame,” and so on.

Research. The parenting methods you list in the previous step will probably reveal parenting topics you want to learn more about. For example, maybe you’re unsure what nonviolent communication is, are at a loss about compassionate ways to discipline, and want to discover how to be more comfortable with physical affection. Start researching the topics you’re drawn to, and take note of all the ideas and methods you want to try. This will be an ongoing activity, as what works for your family will shift over the years. But every minute of research adds to your base of knowledge and enhances your dedication to being a loving parent. There’s a list of helpful parenting classes and books in the “Recommended Resources” section on page xx to get you started.

In addition to this traditional research, you can research parents you respect. For example, if you appreciate the way your partner’s sister parents, you can spend time observing what she does and doesn’t do, and ask questions about her parenting philosophy. The more you’re around parents who show there’s a better way, the more you’ll develop confidence that you can also choose a better way.

Don’t forget about your intuition. While I’m all about that research, I’m also a big believer in your intuition. The fact that you recognize the damaging aspects of your childhood probably means you’re in tune with your emotions and gut instincts about what feels right and wrong to you. Lean on these instincts as you navigate parenting.

For example, when your child is a toddler and they become upset for no apparent reason, you’ll likely have an instinct about how you can support them. And sure, this instinct might be informed by the parenting research you’ve done, but it’s mainly coming from your inner knowing — your ability to tune into your child and support them in the way that works best for both of you. In some ways, the most important thing you can do as a parent is learn to trust your intuition, and take the time to listen to it when parenting decisions arise.

Stay aware of any impulses to emulate unwanted parenting habits passed on by your parents. As strong as your loving intuition is, it’s not perfect and will sometimes give way to subconscious habits learned from your parents. But all is not lost if that happens. It simply means you’re a human who — like every other human — inherited a few of your parent’s habits. The cool thing is, habits can be changed when they’re noticed. So whenever you have a parenting moment that makes you feel icky, analyze it. For example, if your child is being very persistent about their need for attention, and you snap at them in the way your mother used to snap at you, clock that. You might think, “Hmm, it’s interesting that I responded in that way. How can I stay more calm next time, and respond in a way I feel good about?”

The tricky thing is, it can be hard to have this insight when we’re stressed, as stress can automatically push us into ways of being and thinking we learned as a child. However, developing the habit of using stress-relieving tools like breathing or walking away from a situation until you’ve calmed down helps you step out of the responses your parents ingrained in you, and choose something else.

Essentially, managing stress and keeping your eyes open to the negative influences of your parents’ parenting are two of the best ways to prevent your parents’ unwanted influence from bleeding into your parenting experience.

Be wary of your parents’ current influence. If your parents are a regular fixture in your life, stay attuned to whether your parenting habits change when they’re around. For instance, I have a friend who had a painful childhood and spent years working through her issues with her parents. She eventually got to a place where she could have them in her home for visits — her children were four and eight when these visits began.

What she realized was that she changed the way she treated her children when her parents were around. She either reverted to parenting methods they had used, or went overboard with the new methods she’d learned. “It was like I left my rational mind and based my parenting on their reactions to my children,” she said. “I either wanted to please them, or show them I was a better parent than they were. My kids and husband started dreading visits from them because it changed me so much.”

It got so bad she had a sit-down with her parents. She told them how she felt when they were around and explained that if the visits were to continue, they had to hold their judgments and let her parent the way her children were used to. This didn’t immediately solve all the issues, but it set guidelines that helped prevent her parents’ influence from derailing her thoughtful parenting choices.

Know that you won’t be a perfect parent, and that’s okay. No matter how much effort you put into being an amazing parent, you will make mistakes. Your kids will yell at you, you might yell back, some doors will be slammed, and tears will be shed. This is an inevitable part of parenting, and something no one escapes. When this happens, I encourage you to not punish yourself with guilt and shame, but instead to chalk it up to one of those good ole learning moments and move on. The less time you spend lamenting your parenting mistakes, the more time you can spend loving on your children and yourself.

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Sometimes I fantasize about running away. Do I need help?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

When I was a new mom, I fantasized about running away to a beachside hotel and sleeping until I no longer felt like I was living underwater. I had it all planned. I would loot my savings so I could pay the hotel in cash and no one could track me through my credit card. I would leave my cell phone under my mattress with a note saying, “I’m alive, but barely, and I’ll return when I’m ready.” The closest I got to this was stopping at the beach parking lot on my way home from Target one day, rolling down the windows, and sleeping for thirty minutes. Most new moms, as well as veteran moms, admit similar fantasies. So we’re not alone.

But just because we’re not alone doesn’t mean it feels good to want to run away from our lives. Something that might help you feel better is knowing most moms that have the running-away fantasy don’t actually want to ditch their families forever; they’re just looking for a few hours (okay, maybe a few days) where they don’t have to take care of anyone’s needs but their own. They want some precious time to screw their head back on. To get so deeply asleep they’re facedown, drooling into a pillow in a pitch-black, airconditioned hotel room. To order room service. To remember what their dreams are. To take a shower, or a poop, without someone crying for them. I think this is a totally normal, valid fantasy.

With that said, if you feel like you want to run away because it seems you’re of no value to your family, you feel too sad or anxious to care for anyone, or you’ve become so obsessed with thoughts of running away it becomes hard to function, you might be experiencing postpartum depression, anxiety, or OCD. In that case, a perinatal mental health specialist is the person to see. They can help you figure out what’s going on and provide specialized support.

What to do

Recognize that this fantasy is a not a sign that you weren’t meant to be a mother; instead it’s trying to guide you toward a life where your needs are honored. Here’s how to listen to that guidance:

Let yourself feel entitled to help and alone time. Some women think they should thank their lucky stars when someone steps in to help with their baby. Or that they need to sing their partner’s praises when they offer to hold the baby while mama sleeps. While it’s fine to feel thankful and express that thanks, you should also expect this support, and even demand it. It shouldn’t be something you stumble upon as often as you find a leprechaun passing out Xanax at the end of a rainbow. You should stumble upon help and time for yourself as often as you throw a load of spit-up-stained shirts into the wash.

What I’m saying is, when you start fantasizing about running away, make a clear plan with your partner or your go-to baby-care person about when you need them to take baby, and for how long. Some women feel that in asking their partner for this support they’re asking for a favor, but no. You’re not asking for a favor. You’re asking your partner to provide something that is your right, not a privilege. So as uncomfortable as this might initially be, I encourage you to clearly let them know what you need, instead of asking if it’s something they’d be willing to do. Claim your right for support.

Fulfill your fantasy. Because the fantasy of playing hooky from your life is usually sparked by a need for alone time, grab it by the horns. When your baby is an infant and incredibly dependent on you, maybe the most you can hope for is a few hours out of the house. But you should take it! Use that time to get a massage; bring a blanket to the beach or a local park, lie down, and sleep in the fresh air; or take your journal or laptop to a coffee shop and write. Do that thing you really want to do but keep thinking, “Nah, I don’t have enough time.”

When baby is a bit older and can survive without you for a night, consider booking a hotel room (and using it). And yes, there will probably be guilt and hesitancy and all that other mom stuff when you prepare to leave, but if you can force yourself to get to that hotel and fully focus on you for twenty-four hours, you’ll return as You 2.0.

Learn from your fantasy. Do me a favor and take a minute to envision what you would do after running away. After you take care of the basics like sleeping, eating, bathing, and maybe having a good cry, what do you see yourself doing? What are the things you would do to make yourself happy if you had no one else to care for? Let yourself go there, then write down what you see.

I did this when Hudson was a newborn, and I saw myself going on sunrise beach runs, taking long showers, sipping coffee while getting absorbed in a writing project, napping, watching some good ole reality television, and eating dessert I didn’t have to share. It was pretty basic stuff. What I realized was that while I wasn’t at a place where I could check off all those activities every day, I could sprinkle them in. So from that point on I committed to doing at least one activity from my fantasy list each day, and it was life changing. I now have a seven-year-old and am thrilled to say I usually do some version of everything on my fantasy list every day. And I didn’t have to run away from my family to do it!

So use your fantasy, mama. Use it to inform how you start blending your fantasy world with your real world.

Let yourself do less. I’ll bet that when you envisioned your fantasy you saw yourself juggling way less than you are now. There’s a reason for that. Moms are taught to stretch ourselves so thin we’re transparent. Cook fresh, organic food. Exercise. Feed baby on demand. Never let them sit in a wet diaper for longer than 3.5 minutes. Maintain a clean, organized home. Call your mom. Keep a foot in your career. Nurture your romantic relationship. Shower. Brush hair. Have a bowel movement. Burp baby. Sleep. (Wait, no, scratch that.) Oy vey. It’s just so much. But here’s a wild idea. What if you let yourself just cross some of the stuff off the list? (At least for now, when baby is such a fresh human and so demanding.) What if you asked someone else to do the cleaning and grocery shopping? What if you let yourself do less and know that it’s not giving up, but getting smart? Try it out for a week and see how it feels.

Tell someone where you’re going. I know a few women who went to the grocery store and ended up at a local hotel. In all cases but one, the women called their partner to let them know where they were. While those were awkward conversations, the partners at least knew they were safe. In one situation, the mom did not inform anyone and turned her phone off. Her sister found her right before her husband called the police. Don’t let that happen to you — it will just cause more stress. Play hooky if you feel you have no other choice, but make sure the person caring for your baby knows what’s up.

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I have horrific thoughts about awful things happening to my baby. Sometimes I imagine being the person inflicting harm. Am I crazy? Am I a danger to my baby?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I would stop breathing whenever I let myself think about something horrible happening to my baby. Leukemia. A deadly car accident. SIDS. A kitchen accident. The list goes on. The thoughts would slam into me out of nowhere. One time, I was changing Hudson’s diaper and had a vision of him and Eric being in a lethal head-on collision. I froze. Diaper in mid-air. I was there. Feeling all the feelings I assume I would feel if that — the worst — happened. Then Hudson peed on me, and I snapped out of it. These thoughts didn’t come every day, but they came often enough that I had to build walls. I refused to let my mind go there. And if it tried, I would combat it with heavy-duty distraction.

When the distractions got too exhausting and less effective, I saw a therapist. She helped me find a balance between running from the nightmares and letting them swallow me. She also helped me recognize that feeling like something horrible was about to happen didn’t mean anything was actually going to happen. It was just a false thought triggered by the facts that my newborn was so vulnerable and I was almost entirely responsible for keeping him alive. She offered heaps of techniques, and I tried them all. The ones that worked are in the upcoming “What to do” section. But according to the therapist, what I experienced was pretty mild. Some women get so buried in nightmarish thoughts about their baby they can barely function.

One of the most frightening mental phenomena some new parents experience is thoughts of intentionally or accidentally harming, or even killing, their child — a type of something labeled “intrusive thoughts.” Most report that they don’t actually want to harm their baby but still have vivid thoughts of doing so. These thoughts can really become frightening for a parent when they’re doing something like bathing their baby, driving with them, or partaking in other activities that present obvious risks. It can cause an almost constant state of paranoia, and keeping things under control can take debilitating amounts of energy. For obvious reasons, this is a mental state parents rarely tell anyone about, out of fear their baby will be taken away. But what many don’t realize is that these thoughts are more common than you’d expect. A study published in BMC Psychiatry found that between 70 and 100 percent of new mothers report unwanted intrusive thoughts of infant-related harm, and half of all new mothers have intrusive thoughts about harming their infant on purpose. These thoughts don’t make you a monster, they’re just a sign you’re experiencing a very treatable psychological condition. Any mental health specialist worth their salt will not even think of reporting you, as long as you can honestly acknowledge that you find the intrusive thoughts disturbing.

When these intrusive thoughts become consistent and regularly impact your ability to function, they might be a sign of postpartum obsessive compulsive disorder (OCD). This can manifest as obsessive attempts to suppress the intrusive thoughts, partaking in obsessive rituals that you are convinced will prevent harm from befalling your baby (like constantly praying or checking on them), or avoiding triggering situations like bathing the baby or driving with them. Not surprisingly, OCD has been connected to issues with serotonin regulation and elevated levels of oxytocin — both of which are hormones impacted during pregnancy and the postpartum period.

Obsessions with intrusive thoughts can also be triggered by stressful situations and a rapid increase in responsibility, which are both major elements of early parenthood. Because of these factors, some mental health specialists believe slight OCD tendencies might be a normal byproduct of the postpartum experience.

The rarest but most serious cause of these violent thoughts is postpartum psychosis. This condition usually consists of an inclination to harm the baby, extreme paranoia, hallucinations and delusions, sleep disturbances, and disorientation. It typically presents within a week of the baby’s birth. Unlike moms with conditions like postpartum OCD, those with postpartum psychosis rarely realize that they shouldn’t be having thoughts of harming their baby — they don’t find the thoughts terrifying or appalling. This is a situation that requires immediate intervention.

What to do

If the thoughts you’re experiencing are limiting your ability to function, get support from a perinatal mental health specialist. They will likely recommend cognitive behavioral therapy, and they might recommend medication. Follow their advice before you try any of the other suggestions listed below, as you deserve the support of a mental health specialist who can take the unique circumstances you’re working with and help you craft a customized treatment plan. They can also help you normalize what you’re experiencing, which can be an immense relief.

With that said, I want to acknowledge that summoning the courage to tell someone about your intrusive thoughts can be one of the most challenging things you ever do. The good news is, a condition like postpartum OCD is no longer seen as a “scarlet letter.” Ongoing research is helping us understand that these conditions are not signs that someone is a dangerous miscreant, but rather they’re symptoms exhibited by a perfectly normal human experiencing a treatable psychological phenomenon. There’s no shame in speaking up and accepting help. And in the most extreme cases, speaking up might save the life of you or your baby. From there, consider the following:

Remember that the thoughts aren’t “real.” One of the only good things about horrific thoughts about your baby is that they’re likely a shocking contrast to your other thoughts. This contrast can make it easier to pinpoint when a thought is intrusive — aka, a thought that is produced not by the real you but by the condition you’re navigating (e.g., OCD, anxiety, or depression). This realization can help you separate from the thoughts and remember that they’re not indications of something you will do, or even want to do, and they aren’t markers of how you feel about your baby.

Write down what’s true. If you start getting lost in all the horrible things that could happen, home in on what’s actually real by writing it down. For example, you might write, “I grew and birthed my baby — that wasn’t easy; it took strength and courage. I provide a home and nourishment for my baby. I’m not broken. These thoughts aren’t me. These thoughts aren’t true. I love my baby. That’s true.” Keep writing until you feel firmly planted in your truth.

Bring yourself back to reality with your five senses. Another way to pull your mind out of a swirl of worst-case what-ifs is asking, “What do I see, smell, taste, hear, and feel?” Keep listing things your senses are experiencing until the intrusive thoughts loosen their grip.

Remind yourself that you’re not crazy. When you have intrusive thoughts you’re experiencing a symptom, just like someone with the flu experiences the symptom of a fever. And just as the flu can strike anyone, intrusive thoughts can strike anyone. So when you have the symptom of intrusive thoughts, continually remind yourself that you’re a whole, amazing person having an uncomfortable experience that will pass with the right support. And as long as you recognize that the thoughts are disturbing and are nothing you should act upon, you’re doing fine, as this is an indicator that you’re not experiencing postpartum psychosis. Of course, these thoughts aren’t fun, and they could be a sign of postpartum OCD, an anxiety disorder, or postpartum depression, so get that support, mama.

Find a support group. In addition to seeking support from a perinatal mental health specialist, it can be helpful to find an in-person or online support group composed of women having similar thoughts. This can help you feel less alone, normalize your experience, and help you develop a deeper understanding of what you’re going through. To ensure you find a quality group, ask your therapist for recommendations.

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The thought of sudden infant death syndrome (SIDS) keeps me up at night. Why does it happen, and how can I prevent it?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I was so afraid of SIDS, I couldn’t fall asleep the first night of Hudson’s life. When I couldn’t hear him breathing, I placed my hand under his nostrils, waiting for the small puff of warm air that would confirm he was still alive. The fear of SIDS would have kept me from sleeping all through the next few months if the bone-deep exhaustion of motherhood hadn’t pulled me under. While many people talk about how amazing life is when a baby sleeps, my baby sleeping was one of my biggest sources of anxiety. And really, how could we not be terrified of SIDS? Defined as the sudden, unexplained death of an infant under the age of one, SIDS usually occurs when the baby stops breathing during sleep. Understandably, we want to figure out why it happens, and how we can prevent it.

While there’s been significant research on the topic, there’s still not a clear understanding of why it happens. But there are many theories, and these have led to certain safeguards we can implement to minimize the risk of this heartbreak striking our families.

The common SIDS risk factors are listed in the sidebar below. But before we get into that, I want to note that rarely does one factor cause SIDS. Often, the following elements must be present for SIDS to occur — if just one is removed, SIDS is much less likely to occur:

Vulnerability: A defect or brain abnormality that impacts a baby’s heart or lung function (such as the serotonin condition described below) can make them more susceptible to SIDS. Essentially, this vulnerability makes it more difficult for the body of a baby faced with an environmental complication (see below) to trigger a protective response.

Environmental complication: While most babies can manage environmental complications like lying facedown on a mattress or overheating, babies who are vulnerable and are six months old or younger are less able to respond protectively and so are at higher risk for SIDS.

Developmental changes: Infants six months old and younger experience rapid growth and change. These changes could temporarily disrupt internal systems that impact breathing. This is one reason why SIDS is most common in babies between the ages of two and six months.

There’s not much you can do about baby’s vulnerability or age, but the “What to do” section (pages 224–26) helps you cancel out most environmental complications.

Common SIDS Risk Factors

Here are many of the most common risk factors for SIDS:

Issue with serotonin-producing neurons: Properly working serotonin neurons are needed to maintain the continued functioning of the heart and lungs. Here’s how it works: The brain facilitates the flow of oxygen to the heart and lungs. If someone has sleep apnea, for example, they stop breathing, and the brain gets alerted that there’s not enough oxygen and too much carbon dioxide. Then the brain triggers a protective process called autoresuscitation, which usually consists of big gasps.

The belief is that in some cases of SIDS this protective mechanism is not triggered. A study done by Harvard Medical School found that when serotonin-producing neurons are inhibited, the brain’s ability to autoresuscitate and save the body from apnea is impeded. Continued research could lead to screening that might help detect infants at higher risk for SIDS.

Sleeping facedown: According to the book SIDS Sudden Infant and Early Childhood Death: The Past, the Present, and the Future, the prone (facedown) position has been found to increase the risk of rebreathing expired gases, overheating, and accidental suffocation. Placing an infant on their side to sleep is also not recommended. In 1994, a campaign called “Back to Sleep” was launched, urging parents to lay babies on their back for sleep. This lowered the rate of SIDS by 50 percent.

Sleeping on a soft surface, or near soft objects: A soft sleep surface or objects that could cover a baby’s face (like blankets, pillows, or stuffed animals) increase the risk for accidental suffocation and overheating.

Rebreathing: This consists of a baby breathing in the air they just exhaled, which causes oxygen levels to drop and carbon dioxide to rise. Putting a baby to sleep on their stomach or having a blanket or other soft material in the crib that can cover their face can result in rebreathing.

Overheating: As overheating could cause respiratory issues or depress a baby’s ability to wake up, it’s been found to be a risk factor for SIDS.

Respiratory infection: An article published in the medical journal Hippokratia found that a mild degree of respiratory viral infection was observed in 80 percent of SIDS cases. In addition, a study published in Immunopharmacology and Immunotoxicology reported that common bacterial toxins found in the respiratory tract, in association with a viral infection, could contribute to SIDS in an infant during a developmentally vulnerable period. An infection can be especially dangerous for a baby sleeping on their stomach, as this prone position could increase airway temperature and stimulate bacterial colonization and bacterial toxin production.

Maternal smoking and secondhand smoke: Maternal smoking during pregnancy is considered one of the greatest risk factors for SIDS, as it can lead to premature birth and low birth weight (both risk factors for SIDS), diminish lung growth, increase the chance of developing respiratory infections, and impair the baby’s ability to wake themselves. And exposure to secondhand smoke after birth could impact the baby’s inflammatory response during an infection and limit their body’s ability to respond to threats to the heart caused by inflammation.

Being born prematurely: A study published in the journal Pediatrics found that many premature babies have impaired blood pressure control, meaning if they have a drop in blood pressure during sleep, their body wouldn’t be able to quickly respond. In addition, premature babies often have a higher risk of developing respiratory distress, do not have strong sucking and swallowing reflexes, and have a higher risk of infection because of an underdeveloped immune system.

Long QT syndrome: This heart rhythm condition can potentially cause fatal arrhythmia — when the heart beats too fast or slow or has an irregular pattern. According to a study in Journal of Biological Research, long QT syndrome accounts for 12 percent of SIDS cases.

Toxins from the mattress: While I want to be super clear that this theory hasn’t been thoroughly tested, I think it’s worth sharing. A New Zealand scientist and chemist, Dr. James Sprott, believes the phosphorous, arsenic, and antimony found in some fire retardants used on crib mattresses can mix with mold created from the baby’s urine, spit-up, and drool to create toxic gas. He believes the inhalation of this gas could contribute to SIDS. An additional theory is that body heat can contribute to the release of volatile organic compounds (VOCs) in mattresses.

Again, this theory hasn’t been conclusively proven, but I think it’s worth it to bypass this potential risk by purchasing an organic crib mattress from a company that’s Global Organic Textile Standard (GOTS) certified. If that’s too pricey, you may be able to prevent the release of these gases with a mattress cover specifically designed to block toxic gases. (If you’re wondering where the information about cosleeping is, go to question 97.)

As research continues, new potential causes of SIDS will likely be revealed. Your care provider can provide information about the most up-to-date SIDS research.

While there’s no foolproof way to prevent SIDS, the following can help you significantly reduce your baby’s risk:

Practice healthy habits during pregnancy. The American Academy of Pediatrics reports that babies of women who obtain regular prenatal care, do not smoke, and abstain from regular illicit drug and alcohol use during pregnancy have a lower risk for SIDS.

Put baby on their back for sleep. Even if your baby seems to be more soothed on their stomach, always put them to sleep on their back.

Breastfeed. The American Academy of Pediatrics states that babies who are exclusively breastfed have a 50 percent lower risk of SIDS, as breastfeeding provides the following benefits:

  • Supports the baby’s ability to arouse from sleep more easily
  • Decreases incidence of diarrhea, upper and lower respiratory infections, and other infectious diseases
  • Supports the overall immune system
  • Helps the brain systems that control breathing to mature
  • Minimizes allergies that could cause inflammation in air passageways
  • Reduces gastroesophageal reflux
  • Supports the development of the oral cavity and throat muscles, helping to keep the airway open
  • Enhances the mother’s awareness of the baby

Ensure that the crib is empty, and use a sleepsack. Have baby sleep on a firm mattress with a fitted sheet — there should be nothing else in the crib, not even crib bumpers. Regarding clothing, put baby in a breathable sleepsack, which is a “wearable blanket.” This allows them to stay warm without using a blanket that could bunch up around their face. If the weather is so warm that you yourself are using little more than a sheet for coverage, your baby will likely be fine in a onesie or a light sleepsack.

Create a cool environment. As it’s important to prevent overheating, keep the thermostat between sixty-eight and seventy-two degrees Fahrenheit, have a fan on in baby’s sleep area, and clothe them in the aforementioned sleepsack or onesie. In addition, it’s not advised to put them to sleep in a hat, as it can trap heat.

Open windows when weather permits. Fresh air helps keep the air in baby’s sleep environment cool and clean, minimizing SIDS risk factors. If the weather allows and you feel it’s safe, open the windows in your baby’s sleep zone, being sure to insert a window guard when they become mobile.

Cleanse air with plants and an air purifier. Enhance the cleanliness of the air in baby’s room by using an air purifier and placing one or two air-purifying plants in areas of the room they can’t reach. Plants that can cleanse the air of harmful toxins, like trichloroethylene, formaldehyde, benzene, and xylene, include the peace lily, Gerbera daisy, florist’s chrysanthemum, red-edged Dracaena, and English ivy.

Use a firm, GOTS-certified organic crib mattress or a toxin-resistant mattress cover. As the toxins in standard mattresses might increase the risk of SIDS, opt for a GOTS-certified organic crib mattress or wrap the mattress in a cover that’s a “toxic gas shield.”

Make sure baby’s bed adheres to Consumer Product Safety Commission (CPSC) guidelines. A government organization that oversees products sold in the United States, the CPSC provides recommendations for purchasing a safe infant bed; see “Safe Sleep — Cribs and Infant Products Information Center” at cpsc.gov/SafeSleep.

Skip swaddling. While the research is ongoing, a study published in Pediatrics found that swaddling might increase the risk for SIDS, as it could hinder a baby’s ability to wake up during cardiovascular stress.

Have baby sleep in your room for at least the first year of life. A report by the American Academy of Pediatrics recommends that babies sleep in their parents’ room for the first twelve months, as this can reduce SIDS by up to 50 percent. While there’s not a definitive reason for this outcome, it’s believed that a baby will arouse from sleep easier when sleeping in a room with others, and that parents are better able to monitor the baby when they’re in the same room.

Consider a bedside sleeper. These aptly named baby beds are essentially bassinets that can be pushed up next to your bed and readjusted so baby is level with you. Some also have a side that can fold down, allowing you to easily access baby. If you go this route, make sure you select a bed that meets CPSC safety standards. Ideally, it will have a thin and firm mattress that’s no more than an inch thick. In addition, net or mesh walls are preferred, as they increase air flow.

Stay away from cigarette smoke. As breathing in secondhand smoke can be incredibly harmful to infants, remove your baby from any area where someone is smoking. And because smoke can linger on furniture, carpet, and other material, it’s best to not have baby in the home of a smoker, which is why it’s strongly advised that any smoker who lives in the same home as an infant quit smoking. In addition, do not let anyone who smokes hold baby, as smoke can linger in hair and clothes.

Ensure that all babysitters and childcare facilities you utilize follow these safety guidelines. Whenever anyone else will be caring for baby, make sure they adhere to this sleeping protocol. If baby will be at a daycare, have someone there walk you through their protocol. You can also stop in during naptime to see them in action.

The same goes for a babysitter; walk them through your sleepy-time routine, ensuring they understand its importance by having them repeat it back to you. You can also provide a simple written reminder. For example, “Put baby to sleep on their back, in their designated, empty bed, without a blanket and in a sleepsack or onesie, depending on temperature. And turn on the fan.”

If a parent or in-law seems resistant, remind them that this is not a request. While they might have done things differently when their children were infants, it’s up to you how your child is put to sleep.

Contact your pediatrician if baby seems to have respiratory issues. As respiratory issues can be a SIDS risk factor, contact your care provider if baby has a cough, breathing issues, or any symptom that concerns you.

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My pet used to feel like my child, but now that I have a human child I never want my pet around because I’m nervous they’ll hurt the baby. Should I find my pet a new home?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Isn’t it wild how having a baby can change your perspective of almost everyone in your life? Especially your animals. It’s like one minute your pet is a constant companion and best friend, and then, bam, your baby’s born and that pet suddenly feels like a looming threat. This can feel jarring and heartbreaking. While you’re celebrating and savoring the new love that’s come into your life, you’re also mourning the relationship you’re losing. Because even if your pet is able to stay in your home, it’s unlikely your bond will ever be the same, as you now have a new creature to dote on. On the other hand, if you determine it’s safe to keep your pet, their life may become even richer as they develop their own bond with baby. Everyone can win.

Regarding your fear of your pet hurting the baby, there’s no guarantee either way. But there are ways to objectively look at the situation and make a decision that’s best for all involved. And luckily, it’s not very often that a family needs to remove a pet from their home for baby’s safety. In most cases, training, limiting and/or supervising your fur-baby’s contact with your human baby and taking other precautions can ensure your baby’s safety without the need to say goodbye to your pet.

What to do

Here are some ideas to keep your baby safe while also nurturing your pet’s well-being:

Consider whether your pet has ever been violent. One of the best ways to determine if your pet will cause harm to your baby is to review their history. Has your pet been aggressive toward other animals or humans? How do they react to children? Is there anything about their personality or history that would lead you to believe they might cause harm to your baby? Answering these questions honestly can be an important first step in making your final decision about rehoming.

Hire a trainer. A trainer can not only help your pet break bad habits but can also help you determine if they’re a threat to your baby, as animal trainers are often experts in the behaviors of their animal-of-choice and know the signs that indicate an animal could be a danger to others. If the trainer believes your pet is safe to stay in your home, and you agree, you can ask them to help your pet break certain habits to create a safer environment for baby. For example, if you have a dog that jumps on people, is used to sleeping on your bed and getting on other furniture, and normally goes into the room that is now the nursery, the trainer can help you teach them that those habits are no longer allowed. If you’re reading this during pregnancy, I recommend working with a trainer before baby is born.

Introduce your pet to baby’s scent. As most animals have a heightened sense of smell, prepare your pet for the array of new odors baby will supply by having them smell an article of clothing that the baby has worn, before they meet the baby. Pet them as they’re taking a whiff, as this can help them create positive associations with the baby’s scent.

Don’t leave your pet alone with the baby. Make sure you’re always present when your pet and baby are near one another. Both children and animals can be erratic, so you’ll want to monitor all interactions until your baby is much older. In addition, begin teaching your baby that it’s not okay to pull the dog or cat’s tail, for example, by gently removing their hand if such an action occurs.

Stay aware of your pet’s emotions. Keep an eye on how your pet responds when they hear baby cry, for example, or when they’re simply around baby. Is their personality unchanged? Are they acting more aggressive or skittish than usual? Do they seem depressed? Do they shake or show other signs of anxiety when baby cries? Are they indicating stress by averting their eyes or moving away when baby is around? Your observations can inform how you navigate their relationship with your baby. A trainer can also provide invaluable insight into what various behaviors indicate, and what, if anything, should be done.

Tip: You can prepare your pet for your baby’s cries and other noises by playing recordings of baby sounds when you’re pregnant. It can be telling to see how they respond to the recording.

Organize extra care for your pet. Because your pets will likely be dealing with emotions that range from irritation to depression as your attention shifts from them to the baby, ensure they still feel the love by asking friends or family members to spend time with them during the first few weeks postpartum. If you have a dog, find people who can take them for a walk or a romp at the dog park. If you have a cat, ask a fellow cat lover to come over and give them attention. And of course whenever possible, remind your pets they’re still important to you by carving out bits of time throughout the day to spend with them. In addition, when your pet is with you and baby, be sure to also pay attention to them so they don’t feel jealous of the baby.

Ease into baby-pet interactions. When you’ve determined it’s safe to allow your pet to meet your baby, take it slow. Start by having someone hold your pet while you hold the baby, and allow the pet to slowly move toward the baby. They’ll likely sniff them, and maybe give a little lick. During this initial interaction (and all the following) stay as calm as possible, as pets and babies are sensitive to our energy and will react accordingly. A tense mood makes everyone else tense. So take deep breaths, and trust that the meeting will go great.

Read Good Dog, Happy Baby. This excellent book by dog trainer Michael Wombacher provides an effective twelve-step process for preparing your dog and family for a new baby.

Know that you’re not a horrible person if you need to find your fur- baby a new home. As heartbreaking as it is to determine your baby really isn’t safe around your pet, the decision to find them a new home will be best for all involved. Not only will you be keeping your baby safe, but you’ll also be ensuring your pet doesn’t spend the rest of their life being scolded and shut off from the family, and you won’t have to suffer the distress of being the one to hand out that punishment. While it’s devastating to say goodbye, you’re ultimately doing right by all involved.

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Since giving birth to my second baby, I’ve been finding my first child kind of irritating. Am I a bad mom for not feeling equal favor for my children?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

While most parents swear they feel the same about all their children, that’s usually not true. A study published in the Journal of Family Psychology found that 74 percent of mothers and 70 percent of fathers reported preferential treatment toward one child. This isn’t surprising, as personalities, shifting life circumstances, and a slew of other factors impact how we feel about the people in our life, meaning there will be seasons when we enjoy spending time with some people more than others — and our children aren’t immune to this.

While you probably love all your children so much you’d die for them, that doesn’t mean you equally enjoy spending time with all of them. For example, you might have an adorable baby who can’t talk back, a four-year-old who worships the ground you walk on, and a teenager who primarily communicates with eye rolls. Not surprisingly, you’d probably prefer to hang with the little ones. Even if your children are close in age, you’ll likely still have your “favorite.” Like if the two-year-old has intense emotions that trigger you, and your baby is super mellow, you’ll probably favor the baby. There is nothing wrong with any of this. You can love all your children unconditionally while not liking them equally.

Something else to consider is that your older child might be feeling especially “needy” right now. They can sense that your focus has shifted, and they want your attention. Many children, even older ones, often seek this attention by acting out of character or creating disturbances. Essentially, they create circumstances that force you to pay attention to them. And because sleep deprivation and the endless needs of a newborn make it hard to recognize the deeper meaning of these outbursts, it’s easy to lash out and create even more of a divide between you and your child. This will probably resolve itself as your family settles into its new structure, but in the meantime, you can call on your partner or other adults close to your older child to spend more time with them. You can also ask these adults to take the baby for short stints so you can spend one-on-one time with your firstborn, even if it’s the last thing you want to do. (No judgment!)

It’s also important to remember that your favor may shift as you and your children change. As life continues molding your family, you might find that one child’s irritating traits are dissolving, while your “favorite” child begins getting under your skin. And remember, that preverbal baby will eventually find their voice, and it’s anyone’s guess how you’ll respond to what they have to say. Isn’t parenthood exciting?!

What to do

Keep reminding yourself that while it’s totally normal to like one child more than the other, it’s still important to not engage in differential treatment (aka treating one child better than the other) and to continually ensure that all your children know how loved they are. These activities can help you do that:

Examine what bugs you about the child you don’t like as much. It can feel really icky to not know why you don’t like one of your children as much as the other. This not-knowing can lead you to believe you’re a bad mom, cold hearted, or just destined to have a tumultuous relationship with that child. I don’t think any of that is true. I’ll bet there are specific reasons why certain things about your child trigger you. Let’s figure out what they are.

When you find yourself inwardly (or outwardly) rolling your eyes at this child or gritting your teeth, notice that. Press pause and objectively look at what’s happening. What about this moment is irritating you? Is your child responding to something in the same way your partner does, a way that you wish they didn’t? Are they responding in the opposite way that you would, and that’s triggering? Does their behavior remind you of someone you don’t like, and that dislike is being reflected onto your child? Does their behavior remind you of flaws in yourself you want to avoid? Is your child acting needy in a moment where you feel stretched thin? Unravel the situation until you figure out what the core source of your annoyance is.

Developing this deeper understanding about your child and how you respond to them will support you with the upcoming activities, and help you realize that neither of you have a fatal flaw or are intentionally trying to irritate one another. You’re both just doing your best to feel loved, seen, and heard as your family adapts to the big changes brought on by a new baby.

Create intentional opportunities to bond with your not-the-favorite child. Now that you’ve started pinpointing why your child irks you, brainstorm activities you can do together that have the lowest potential for irritation. For example, snuggling on the couch and watching a movie, making a smoothie, or building a LEGO tower might be situations that allow you to be together without getting peeved with each other. When it’s time to do activities like cleaning up, brushing teeth, getting dressed, or other tasks that typically find you and your child clashing, you could tap out and call in your partner, at least while you have a newborn. While this won’t always be possible, being aware of situations that typically cause you to get frustrated with your child, having another adult take on these situations, and investing time in the activities that are usually harmonious can begin shifting your parent-child relationship.

Talk with your partner. If you have a partner in this parenting thing, they can help you see your relationships with your children more clearly. They likely witness your interactions with the kids more than any other adult and can support you in identifying dynamics you’re not aware of, or easing up when you’re too hard on yourself. For example, they can let you know if your actions make your favoritism clear, and if you’re overly harsh with the child that’s bugging you. They can also help you make a plan for how the two of you can provide all the children equal care and attention, which might look like them picking up the slack with the child who’s frustrating you, making sure they don’t feel neglected.

Help your kids feel emotionally safe. If you sense the child you don’t favor as much is picking up on your energy, remind them how much you love them and let them know what’s going on — in an age-appropriate way. For example, my friend Amy has an eleven-year-old son who really irritates her. “He is me in a little boy’s body,” she said. “He’s constantly showing me all the things I don’t like about myself, and I have no patience for it.” Her daughter, on the other hand, has a temperament similar to Amy’s husband’s. “She’s so easy to be with,” Amy said. “Sometimes when I’m spending time with her in the morning and her brother wakes up, I feel angry. I feel like he’s going to ruin my mood before he even does anything.”

Needless to say, Amy was wracked with guilt about this, especially when her son straight up asked, “Mom, why don’t you like me?” Amy was inclined to tell him all the things that would make him feel better, but she decided that would only mask the problem. Instead, she told him that because he was so much like her, he sometimes reminded her of things in herself she wanted to change. She told him it wasn’t fair to take this out on him, and asked him to let her know when she was being unkind. He now says, “Mom, are you seeing you in me?” when he senses that he’s bugging her.

If Amy’s son had been younger, she probably wouldn’t have gone into the whole “You remind me of me” thing, as he might not have been able to process that. Instead, she could have acknowledged his feelings, asked questions to get more insight into what was making him feel unliked, and then assured him that things would change.

Above all, stay aware of how you’re treating each child so you can avoid hurting anyone, glean insights into how to improve these relationships, and tune into your children so you can tell when they are in need of reassurance that you love them deeply.

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I have a loved one who had a miscarriage and seems to have a hard time being around my baby. How should I navigate this relationship?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Very gently, and without your defenses up. The reaction your loved one is having has nothing to do with how they feel about you or your baby, and everything to do with their emotions about their pregnancy loss. They are probably navigating immense grief, and being around someone that has the one thing they want most can feel heartbreaking. I learned this the hard way.

One of my closest friends — we’ll call her Zoe — had a miscarriage when my son Hudson was two. Zoe and Hudson had an amazing bond that evaporated as soon as she lost her baby. She would tense when Hudson ran to her for a hug, and she avoided his requests to play. He was heartbroken, and I was irritated. “Can’t she see that she’s hurting his feelings?” I would think. I never said anything, but I’m sure I was giving off a vibe.

I didn’t get it until I went out to lunch with her one day. Every time we neared a pregnant woman or small child, Zoe would stiffen and look away. When a woman with a stroller sat near us at the restaurant, I noticed her bite her cheek, resisting tears. She was suffering. I had been so wrapped up in how Hudson was responding to her standoffishness that I hadn’t really seen her pain. From that point forward, I planned meetups that didn’t involve Hudson or the high potential of running into any of her other triggers. I would go over to her house, take her out for a drink, go to a belly dancing class, or do anything that distracted her from motherhood, even if it was only for a few hours. And you can be sure I didn’t bring up mom life when we were together.

After Zoe eventually gave birth to a healthy baby girl, she brought up her postmiscarriage reaction to children. “It killed me to not hang out with Hudson, and my sister’s kids,” she said. “But it all made me angry, and so sad I felt like I couldn’t breathe. I wasn’t angry at any of you, I was just mad at life, and my body, and how unfair everything felt. You and my sister were my safe places, but when your kids were around, being with either of you sucked.” She told me how the situation with her sister was especially complicated because all family gatherings involved her kids. “Of course I didn’t expect her to not bring her kids to, like, Easter dinner, but I kind of wish my family would’ve given me an out for some of those things. I just wanted permission to be sad, and disgruntled, and not show up for a while.”

And there it is. She wanted permission from the people who loved her to navigate the miscarriage in whatever way she needed. She didn’t want people trying to cheer her up or saying, “That will be you soon enough” when watching kids running around. She wanted people to tell her that everything she was feeling was okay, and they’d be there for her no matter how much or little she needed them. She wanted people to check in, without forcing a hangout.

While every woman handles the loss of a pregnancy in a different way, almost every woman I’ve known who has navigated miscarriage relates to this story, myself included. They want you to be there for them without unknowingly subjecting them to more pain. Sound tricky? It doesn’t have to be.

What to do

Here’s how to show up for your loved one during her journey through pain and loss, without sacrificing joy for your journey into motherhood:

Let her lead the way. The person best able to provide insight into how you can support your friend is your friend. Request one-on-one time with her, and ask how you can best support her. You can throw her a major bone by letting her know up front that you’re cool hanging without your baby and will do your best to not talk about motherhood, unless she brings it up. This will likely make her feel relieved, as she might have been nervous about making these requests. Letting her know that she can’t offend you with her requests will make her feel safe to share and spend time with you.

Give her an out. While you don’t want to withhold invitations to gatherings, it’s compassionate to let her know you totally get it if she doesn’t feel comfortable attending. This helps her feel included, without the pressure. And while it’s tempting to say something along the lines of, “You totally don’t have to come, but I really hope you do,” I would cut out the second half of that sentence. We mean well when letting someone know how much we’d love them to show up, but all it does is put social pressure on them. Instead, convey a message along the lines of, “If you want to come, please do. But I also completely understand if you don’t feel up for it. Whatever you want is the best decision.”

Regularly send a “thinking of you” text. I have a client who experienced a miscarriage, divorce, and cancer diagnosis in the same year. “I felt a big need to go within,” she said, reflecting about that year. “I told my people I needed space, and everyone listened. They listened so much that I completely stopped hearing from them. I didn’t blame them, because I had pretty much told them to do that — but it made me feel isolated. Then my cousin started sending short texts. She’d write, ‘Hey! You don’t need to respond but I just wanted to let you know I love you and am thinking of you.’ She would send some variation of that a few times a week. I usually didn’t respond, but I appreciated those notes so much. It made me feel like even though I was in a space where I needed solitude, I hadn’t been forgotten.”

You can be like this cousin, sending loving, no-strings-attached messages to let your friend know she’s not alone, even if she wants to physically be alone. If you don’t receive a response, it doesn’t mean she didn’t appreciate the thought. Don’t give up on her; just keep letting her know you care.

Tip: Add to your thoughtful texts by occasionally having your friend’s favorite treats or flowers sent to her house. You could also send a comfort box from an infant loss support program like Three Little Birds (threelittlebirdsperinatal.org) or a card from the #IHadAMiscarriage line (shop.drjessicazucker.com).

Don’t bring up your baby unless she does. Baby-brain tries to wipe the memory of everything but baby topics, which might be the last thing your friend wants to talk about. I used to prepare for meet-ups with friends I assumed didn’t want to talk baby by making a list of interests we shared. My overpreparing tendencies would then lead me to Google those topics to come up with interesting stuff to talk about. You obviously don’t have to do that, but you might prep yourself to keep anything pregnancy or parenting related from slipping out of your mouth. And of course, your friend may straight up ask you about, or bring up, baby or parenting topics — if so, share openly, while being careful not to go overboard. Pay attention to her nonverbal cues, slyly shifting the conversation if you notice she is becoming uncomfortable. While the first few conversations with her might feel forced and awkward, you’ll eventually become comfortable with the new unspoken guidelines of your relationship.

Let her know you’re comfortable hearing about what she’s going through. Sadly, some women feel like a pariah after a miscarriage. They feel like people are tiptoeing around them, trying to ignore the death-colored elephant in the room. You can minimize this discomfort and make your friend feel safe to share by asking if she wants to talk about how she’s feeling. She might not, but just knowing you’re not afraid of the topic might help her feel like she’s not an island no boat wants to stop at.

Call her baby by name. If your friend shared the name of her baby, use it when talking with her. This helps convey that you don’t think of the miscarriage as trivial, that you understand a child she was deeply connected to passed.

Don’t feel guilty for your joy. You have nothing to feel guilty about. You have every right to have a beautiful, healthy baby — and to be happy about that. While you don’t have to talk about that beautiful baby with your friend, you do get to feel shame-free gratitude for motherhood.

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I know there’s a whole movement about not judging mothers, but I’m still afraid I’ll be judged. How can I feel secure in my parenting decisions and manage the judgment when it comes?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

There sure is a movement to stop judging mothers. And for good reason! Us poor mamas have everything from side-eye to full-on trolling thrown at us for putting even a finger out of line. But where to put “the line” is the biggest problem. What’s the definition of that line? Where the heck does it live? Each parenting camp (and there are many) will give you a different answer to those questions. And all of those camps are certain their way of parenting is The Way to parent. It’s a dangerous recipe for excessive judgment that sadly causes mothers to feel unsure and shamed about their parenting choices.

I wish I could tell you the movement to let moms be has resulted in a rosy world where all parenting trolls say, “You know what, I don’t agree with you, but that’s okay! I’m sure you have your reasons.” But it hasn’t. The judgment still exists, and not just on the internet. Family gatherings, mommy-and-me groups, preschools, parks, and all the other places where mothers and offspring congregate can be ground zero for judgment, even from people who know better and mean well. And it will probably always be that way.

So what to do? Luckily, I’ve developed this fairy dust that you blow in the face of anyone who starts judging your parenting, and they suddenly understand where you’re coming from. Or no…maybe I haven’t. But wouldn’t that be cool?

What’s actually cooler is the realization that the only person we need to convince to stop judging us is ourselves. When we figure out how to be solid in our unique parenting choices and realize it’s not the right way, or the wrong way, but our way, we’re free to stop caring (at least as much) about the judgments that come from external sources. It’s like my mom said for the entirety of my teen years and was annoyingly right about, “What other people think and say about you has nothing to do with you.” You just need to get right with you.

The main reason people judge another’s parenting decision is because that decision is different from what they’re doing, and they process it as that person implying that they’re doing it wrong. Their judgments are essentially saying, “Nah-ah, I’m not doing it wrong, you’re doing it wrong.” So ultimately, the judgment comes down to that person’s own stuff. I know this because I used to be a big-time judger. I wouldn’t do it openly; I would do it behind people’s backs like a civilized person. When I finally started looking at why I did that, I realized that every time I judged someone’s parenting choice it was because that choice ignited my own insecurity. For example, I had a friend who shared how they no longer let their toddler have screen time because he got too obsessed with it. I was so triggered by this. I immediately went to my husband and was like, “There’s no way they’re actually doing that. They have to be lying. And if they’re not lying, they’re just going to make their kid obsessed with screens when they’re older because they were deprived as a child.” My judgments completely came from the fact that I was feeling guilty about how much screen time I let our son have. But I didn’t want to give it up because it made life so much easier. I was fighting hard to feel okay about my choice, even though I didn’t. As you can see, those harsh judgments were all about me and my stuff.

What to do

Keep reminding yourself that judgments aren’t personal and that you can trust yourself — then try the following:

Above all, listen to feedback from your intuition. You already know the best way to parent your unique child, in the unique circumstances you live in. Deep down, it’s all there. But the opinions of others, books by the experts, how we were parented, and various other factors muddy the waters, making us second guess our decisions.

To step out of that muddiness and make decisions that feel intuitively right, get into a quiet space and ask yourself about the parenting decision you’ve been conflicted about. For example, “Where should my baby sleep?” When the voice of your mother or that expert or whomever starts babbling, push them away. Seek the answer that makes your insides happy. When you find the right answer for you, your stomach will unclench, your chest will feel light, and your heart will say, “Yes! That feels right!” And you don’t have to ask permission to listen to these feelings. You can just do what feels right.

And the cool thing with decisions is, you can always change them. If you decide cosleeping is right for your family, but then circumstances change and it no longer seems like the best option, you can edit what you’re doing. And while many parenting decisions might have to be made with a partner, you’ll be able to discuss the options with more clarity when you first determine what decision makes your insides happy.

Caveat: Some of your decisions will come more from that place in your brain that’s craving ease than your deep wells of wisdom — and that’s okay. We will never be perfect parents. We will sometimes be like, “Yeah, I know I shouldn’t let my kid watch so much SpongeBob, but it’s saving my sanity right now, so oh well.” We’ve all been there. Heck, I’m there while I type this.

If someone’s disapproval triggers you, explore that. When my mom gently insinuates that I might try something different with Hudson, I. Get. So. Angry. Irrationally angry. When I started looking at where that came from, I noticed that the angrier I got over a suggestion, the more my insides (those traitors!) thought she was right. She knows me so well. She knows when I’m not honoring my instincts. And I hate when she’s right, because obviously we all hate when our moms are right, right?

So if someone’s judgment really ticks you off, explore whether you’re being triggered because what they’re suggesting is what you actually feel is best deep down, or because it just doesn’t feel good to be judged. If it’s the latter, remember that their response to your choices has way more to do with them than you, and go on your merry way.

Find soothing tools for when you’re triggered. When I feel judged I immediately get defensive. I want to lash out. Sometimes I do lash out. But when I catch myself, I keep my ego from raging by saying, “I hear you, but I really have to pee. Let’s press pause on this, and I’ll be right back.” It sounds ridiculous, but it works like a charm. This protocol gives me the opportunity to be alone and get hold of my emotions. I’m able to step away from what was said and figure out if the person was being hostile, trying to be helpful, or just making an offhand comment they didn’t intend as a judgment. Usually, I’m able to come back to the conversation with some perspective and more self-control.

You certainly don’t have to use my “I gotta pee” trick, but I encourage you to make a plan for how you’ll respond when judgment causes an ego flare-up.

Feel free to not share your parenting philosophy. If you’re with someone you know won’t understand your parenting choices, you have every right to not discuss them. For example, if your judgy in-laws are constantly asking why you do this or that with your child, you don’t have to explain yourself. You can simply say, “It’s just something that works for our family. We’re not saying it’s the way everyone needs to parent, but it’s the way we’re choosing to parent.” If they harp on about what they think you should do or how kids were parented “in their day,” feel free to just smile and nod while using your brain power to figure out which Netflix show to watch tonight, or tell them your tampon is leaking and walk away.

Steer clear of toxic parenting spaces, online and IRL. Certain Facebook groups, some parenting forums, get-togethers with parents you know you aren’t aligned with . . . these are all environments where toxic judgments run amok. While of course there are exceptions, you’d be wise to avoid gatherings you believe will be saturated with strong, maybe even hurtful opinions, especially when you’re still trying to figure out how you want to mother. There’s nothing wrong with guarding your heart.

Broaden your perspective on judgment from loved ones. The potential exception to my “stay away from toxic environments” spiel is family gatherings. While certain familial situations are definitely toxic and should be avoided, there are others that are uncomfortable just because a family member is having an awkward time being involved in your child’s life.

For example, let’s say one of your child’s grandparents gets to see them only twice a year. Every time you see that grandparent, they might be full of suggestions for how to parent. You would be within your right to be incredibly irritated by this. But riddle me this — what if the unsolicited advice was the family member’s misguided way of feeling more connected to your child? What if they feel that sharing their “wisdom” is a gift that will enhance your family’s life? If you suspect this is where a judgy family member is coming from, you might help them find other ways of feeling connected — for example, taking on some feedings or diaper changes or, in the case of older kids, having a few one-on-one outings. If this doesn’t stop the “Maybe you should try. . .” comments, feel free to straight-up tell them that while you respect their insight, you’ll let them know if it’s needed.

Resist the urge to make your own judgments. While placing judgment can feel so juicy in the moment, the “high” never lasts. Moral of the story: If we don’t want others to judge us, we shouldn’t judge them. We’re all doing the best we can, and we all deserve more under- standing and “you do you” from our fellow parents.

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I get really defensive when I receive unsolicited parenting advice. It’s so bad I’ve been snapping at strangers and find it hard to be around friends and family members who have kids. How can I navigate this advice without creating tension?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Unsolicited advice is composed of an interesting mix of motivations and emotions, as the advice-giver is usually trying to make themselves feel important and helpful, while the advice-receiver often feels like they’re being told they don’t know what they’re doing. For the most part, the only kind of advice that doesn’t cause tension is the solicited kind. So yup, it’s perfectly natural for your hackles to rise when someone starts preaching

about sleep training, insists you’ll kill the planet if you use disposable diapers, or shares some other opinion that primarily serves to pump up their ego. And while you have every right to be annoyed or defensive, remember that you and the advice-giver likely have two completely different perceptions of the conversation. They think the two of you are bonding over their knowledge and helpfulness, while you feel like they’re judging your parenting and putting their opinions where they don’t belong. Keeping that in mind can significantly reduce your defensiveness.

Something else that could be happening is that you’re feeling insecure about your parenting knowledge and choices, and need space to figure out what feels best for you. People telling you what you should do can make you feel rushed to make decisions and even more insecure about your base of knowledge. If you’re feeling this way, I encourage you to remember that you’re the expert on your child. You’re the guru of your family, even if you haven’t consumed as much parenting literature as the other person or haven’t found all the answers. (And spoiler alert: no one ever finds all the answers.) So instead of letting the advice get to you, take it as a sign that it might feel good to take some alone time to meditate on what’s going on with your baby, yourself, or your family and what solution intuitively feels right. If you don’t know where to start, use that alone time to research the issue and make a list of potential solutions that resonate with you.

It’s also common to feel the urge to tell the advice-giver why certain advice wouldn’t work for your family and, in the case of something like corporal punishment, why you think it’s wrong. But the fact is, they don’t want to hear it, and you don’t want to waste your breath. You don’t have to convince them their advice is misguided, or the way you’re doing something is working fine, or you’re confident you can come up with a solution on your own. You don’t owe them any explanation, and you don’t have to get sucked into a parenting debate — save your energy for something enjoyable. Here are some tips for slipping away from advice sessions with minimal effort and emotion.

What to do

Scream “No!” when someone tries to give you advice. Just kidding. Try this:

Keep parenting challenges to yourself when you’re with chronic advice-givers. Minimize the chance of receiving advice that might activate your defensiveness and anger by dodging parenting conversations with people prone to offering advice.

Compose go-to responses. When most people give advice, the response they want is an unsarcastic version of, “Oh my gosh, thank you! I never would have thought of that. You’re a genius! What would I do without your superior insights?” But you don’t have to give them that. You get to think of a response that allows you to shut down the outpouring of advice without getting into an argument. I usually say something like, “Hmm. That’s interesting. I’ll think about it.” If they continue with the advice, I’ll interrupt with an, “I’m so sorry but I think my baby just pooped. I’ll be right back.” And then I’m not right back.

Here are additional responses you can tinker with:

  • “[Insert the parenting choice here] is working just fine for us. No need to fix what isn’t broken.”
  • “It sounds like that worked great for your family. I love how there’s so many unique ways to raise a child, and that every family gets to make their own decisions.”
  • “I’m sure that’s an ideal option for some families. We’re going to keep doing what feels right for us.”
  • “We tried that, but it didn’t work for us. Just shows that each child is different!”
  • “I’m doing what the pediatrician advised.” And it doesn’t matter if this is a lie — it will likely shut down the advice or judgment, as people are often loath to go against the word of an expert.
  • “Luckily, we don’t have to agree on the right way to [insert parenting topic here]. We can each do it our own way.”
  • “Thanks for your concern.”
  • “I’ll keep that in mind. Anyways, tell me about that book club you joined.”

Check in with yourself after receiving advice. After you’ve gotten out of an unwanted-advice conversation, take a pause and look objectively at the advice. Do you instinctually know it won’t work for your family? Does it go against your parenting philosophy? If so, fuggedaboutit. But if the advice sparked some interest, file it away for later use.

Remember that the advice-giver is (probably) coming from a good place. Most people aren’t trying to insult or annoy when they give advice — usually, they’re genuinely trying to help. Hold on to this belief when they blast you with their counsel. While you don’t have to agree, or even listen to it, remembering that they’re probably not intending to insult you can help you stay calm enough to gently extract yourself from the conversation, instead of raging.

Avoid being the advice-giver. I like to preach about how annoying unsolicited advice is, but I myself give it all the time. And I’m working on this. Be better than me and swallow your advice when it tiptoes to the tip of your tongue. I can almost guarantee that people would prefer your empathy or your questions about what they think they should do over your wisdom (as wise as it might be). And of course, if they ask for your opinion, you can let it rip.

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I don’t feel connected to my baby. I don’t even like to look at them. Am I a monster?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

You’re not a monster. Not even a little bit. You’re one of the many women facing postpartum blues or postpartum depression. According to a study published in Morbidity and Mortality Weekly Report, one in nine women experience symptoms of postpartum depression. But some believe the number is actually much higher, as many mothers don’t feel comfortable talking about their depressive symptoms.

While it’s easy to convince yourself that the lack of connection with your baby is a sign you’re lacking some essential “good mother” chip, it probably just means that wonky hormones, plus the ingredients of exhaustion and extreme change, are impacting your ability to bond. However, just because the causes of what you’re experiencing aren’t dark and sinister doesn’t mean you’re not feeling like this is the end of the world. Many of us are given the consistent message — especially during pregnancy — that the bond between a mother and child is unbreakable. That it’s the greatest love story we’ll ever experience. When that’s not our reality, it can feel life shattering.

Something important to remember as you navigate this likely heartbreaking experience is that it’s temporary. While any form of anxiety or depression can easily trick us into thinking we’ll never feel better, that’s rarely the case.

If you’re sad and unable to develop a bond in the two weeks following baby’s birth, you might be facing the common phenomenon of postpartum blues, which is believed to be caused by a combination of your hormone levels plunging and a struggle to adapt to the abrupt changes of motherhood. If the feelings of sadness and disconnection don’t lift after two weeks, you might be experiencing postpartum depression.

It’s also important to realize that you’re not scarring your child, or your future bond with them, by not feeling connected now. The mother-child bond develops over a lifetime, and it will happen for you, even if you first have to navigate medical and emotional support. And it’s wise to seek that support. Sadly, about 60 percent of women with symptoms of depression do not receive a clinical diagnosis, and 50 percent of women with a diagnosis do not receive treatment. As added incentive to seek support, consider this: studies have shown that while postpartum depression can have short-term impacts on infants, there are rarely long-term emotional effects if the mother receives treatment early-on.

What to do

Get help, as you should not have to navigate this pain alone. While I totally get the resistance to being open about your depression (I waited two years before I asked for help!), I can almost guarantee that your care provider won’t judge you. They’ll probably be relieved you were brave enough to speak up. And I want to remind you again that postpartum blues or depression is not a fatal character flaw, it’s a very common by-product of going through the intense physical and mental shifts of pregnancy, childbirth, and early motherhood. It doesn’t mean you’re a bad mother, or that you’ll never bond with your baby. Asking for help is actually one of the best things you can do for your baby.

Here are a few support-steps you’ll likely need to take:

See your primary care provider. The first stop on the path to moving past postpartum blues or depression is your care provider. They can help evaluate what’s going on and refer you to a mental health specialist. They might also prescribe medication, like an antidepressant. For many women, medication is a key player in getting out of the grips of postpartum depression.

Be consistent with counseling. After you find a mental health specialist you resonate with, commit to showing up. When I was depressed, I cancelled on my therapist all the time because I felt too listless to leave the house. Needless to say, I didn’t get much out of the relationship. Years later I faced another bout of depression and forced myself to see my therapist once a week. If I couldn’t get out of bed, I would FaceTime her. I always felt lighter after our sessions and gleaned serious benefits from our time together — and I also needed medication.

As hard as it can be to keep showing up for counseling, it’s one of the most potent ways you can nurture yourself through depression. Even if some days you’re sure you have nothing to say to your therapist, you’ll benefit from simply arriving at the appointment.

Find quality care for baby. As you navigate this challenging time, it will be essential to ask trusted loved ones for help with your baby. Being their sole caregiver while trying to get through depression might feel impossible, which is why calling in reinforcements can ensure that you and baby get the care you deserve.

You might resist this because you don’t want to tell people about your depression. This is normal, but you’ll probably be amazed by how supportive friends and family are when you trust them with your vulnerability. (And you might also be surprised to learn that some of your loved ones have been through the same thing.)

Continue to spend time with baby. While being with your baby might be a painful reminder of how disconnected you feel, it’s important to continue being with them, even if you have to fake affection. Because “faking it ‘til you make it” might just help you develop an authentic bond with baby, and it will definitely support them in feeling bonded to you. If you don’t trust yourself to adequately care for your baby on your own, ask an adult to be with you when you’re spending time together.

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I find it really boring to take care of a baby all day. Does that make me a bad mom? Is there a way to make it more entertaining?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Girl, I feel you. When Hudson was a baby I felt like I was on a hamster wheel of feeding, butt cleaning, spit-up dodging, cooking, not showering, and walking around in circles saying, “Shh.” I felt like my life had been drained of creative, thought-provoking stimulation. I was mega-bored hanging with a person who didn’t talk and cared only about my boobs. And I was pretty sure I was missing crucial mothering pieces.

It’s no wonder we feel like there’s something wrong with our boredom when we’re constantly told how magical it should be to interact, bond, and help baby learn about the world. These are all essential tasks that plant seeds for the emergence of independent, vibrant humans. So shouldn’t we feel inspired and excited by them? I suppose some women are, but I wasn’t.

If you relate, let me start by saying how super-duper normal you are for feeling this way. You’re not an evil Grinch incapable of connecting with your child. You’re an adult who craves activities that challenge your mind and awaken your creativity. At first glance, caring for a baby does none of these things, and often it just makes us feel incompetent and frustrated. But when we dive deeper into the nuances of baby care, there is something to be done about baby-care boredom.

What to do

Toy around with these ideas:

Incorporate your interests into baby care. For example, it’s important to talk to baby so they’re exposed to language, but who said you have to talk to them about mundane topics or read to them from cardboard books? Give your babe language exposure by reading aloud from a magazine or that book you’ve wanted to read. And music — scrap the Mozart (unless that’s your jam!), strap baby to your chest, and get a workout by shaking your butt to nineties hip-hop while making funny faces at baby.

Think of innovative ways to make baby tasks more interesting. Do this by listing your daily baby-care activities on one side of a sheet of paper and writing your interests and talents on the other half. Then, start brainstorming how you can fuse the lists, mixing and matching your interests and talents with baby-care obligations.

For me, diaper changes became more compelling when I used the time to challenge my writer’s brain to come up with new lyrics to favorite songs. Breastfeeding was made way less boring by putting a TV tray and my laptop by my nursing chair and writing weird poetry while Hudson ate. And I made sure I still interacted with him by asking questions about how I should get around tricky prose.

Remember that you don’t have to parent the way others do. Bringing your unique self into motherhood is one of the best ways you can quell boredom and foster an authentic bond with your baby — it will help them get to know the real you. And if your way doesn’t look anything like the way of your sister or the ladies in your mom group, that’s okay. We all get to forge our own path.

While life with baby will eventually become less boring, regardless of what you do, liven up your mama-baby relationship now by injecting motherhood with the stuff that makes your mind do a happy dance.

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I resent my baby for getting all the attention, and I feel invisible. How can I start feeling like I matter?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Isn’t it a wild emotional shift to go from getting ample help and compliments when the baby is inside you, to suddenly being seen as their leaky accessory after going through all the work of getting them out? And sure, there are folks who ask about the birth and tell you how great you look (bless them), but really, most people are all about the baby. This can be nice at times, as you may score much-needed down time while others coo and ooh over the baby, but then there are the times when you crave to be seen as more than a mother — as more than the lady carrying around that adorable creation everyone wants to hold. You crave conversation about that book you’re writing, or that cat-grooming workshop you went to… or whatever your thing is. You want to be honored for being the power-house who grew and birthed a baby while also having all of these other amazing qualities. You’re not selfish for feeling this way.

For the first six months of Hudson’s life I felt completely invisible. When people came up to us, their eyes would immediately lock onto him. If they engaged me in conversation, their eyes would stay on him, and the topic would almost always be his eating, pooping, or weight-gaining habits. I felt like I was his personal assistant. Or PR rep.

A big part of my frustration was that these interactions were a physical manifestation of what was going on in my own head. Almost every thought I had, every action I took, involved Hudson. I could barely remember what made me an individual. While I loved him deeply, I also felt twinges of resentment that he had robbed me of my individuality. Luckily, these feelings began to fade as he grew and became less dependent on me. And of course, because motherhood is crazy like this, him needing me less made me have moments where I missed him needing me all the time. Geesh.

What to do

Remember that in the early days of motherhood it’s so normal for your life and identity to feel fully wrapped up in baby. However, you can create a lifeline to your unique self by making a list:

1. Create a list of all the things that make you feel like you. This list can contain anything, from something as simple as taking a shower or organizing the closet to tasks as complex as creating a graphic novel or starting that business you’ve been dreaming of.

2. Put the items on the list into three categories. The first category will contain the actions that are absolute essentials and should be prioritized immediately (for example, taking a shower every day, and going on a walk three times a week). These are the things you’ll bring to your support system and say, “Let’s figure out who can watch baby during these times so I can do these things.”

The second category will consist of actions that are incredibly important to you but can be put on hold for six months, as month six is often when baby is a tad less dependent and able to be with others for longer periods. My top two items in this category were meditating for fifteen minutes and writing for one hour, every day.

Finally, move the remaining actions on your list into category three, which consists of the things that will come back into your life after baby’s first birthday. By this time, you’ll likely be in your groove with motherhood, sleeping fairly regularly, and feeling comfortable setting up consistent childcare. This is around the time I started teaching HypnoBirthing classes and amped up my writing career.

3. Use the list. Pull out your categorized list whenever you’re forgetting who you are or wondering if you’ll ever get back to that person. After a day of feeling invisible, this list helps you breathe and remember that there will come a time when life settles back into a more balanced rhythm. And no, life will never go back to feeling exactly like it did before baby was born, but it will start being more layered and consisting of people seeing you as a unique woman, not just the person that baby is clinging to. Things will get better.

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My partner is showing signs they’re going to leave. Should I address these concerns, or try to ignore it? Can I do this alone if they do leave?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

I first want to acknowledge that regardless of whether or not your partner actually leaves, the fact that you’re feeling this way must be so hard. Parenting a newborn is stressful enough when all is well between the parents, but when you’re worried about your baby-raising partner skipping town, you’re forced to grapple with a mess of emotions no new mother should have to deal with. For example, you might feel scared, angry, sad, and a range of other emotions that could come with the major uncertainty you’re facing. Some might tell you to “just try to be strong, push the concerns aside, and power forward,” but I think bottling these emotions and ignoring your concerns just delays resolution. One of the strongest things you can do is feel the emotions and express those concerns. And don’t worry about trying to be strong, because you already are — your strength is a bright light at your core that can never be extinguished, no matter who enters or exits your life.

Regarding the path of parenting alone, you can absolutely walk it if you must. While it might feel like your world would end if your partner left, it wouldn’t break you. You are just as capable as the millions of single mothers out there, and you would find your footing even if it feels like the hardest thing you could ever do. I’m hands-down more impressed with the single mothers of the world than the Olympians, Academy Award winners, and Nobel Laureates, because these women are constantly summoning their courage, resilience, and dedication. They don’t get to clock out or take a sabbatical. They’re all-in, all the time. That might sound overwhelming, but you can do it if that’s how life unfolds.

What to do

Take small steps to figure out what’s going on, and build up your confidence and autonomy, which will be valuable even if your partner stays. Here are some ideas to get you started:

Address your fear. Instead of stewing in fear over whether your partner is planning to leave, tell them what you’re thinking. You’ll likely be met with one of two reactions. One: they’re shocked you’ve been thinking that and make moves to help you feel better. Two: they squirm because you’ve hit on something they’ve been considering. Either way, you’ve stepped out of the unknown and got the conversation started.

If they’re not planning on leaving but something about them is still making you uneasy, you can begin addressing their behavior and what you’d like them to change. If they are thinking of leaving, you can dive into why they’re feeling that way, if it’s something that can be resolved, and if you even want to resolve it.

As tempting as it can be to live in limbo, asking the question that’s probably been driving you crazy can untangle those knots in your stomach and give you something real to work with.

Consider whether you want them to stay. It might seem unfathomable that life could be better without your partner, but it’s worth considering. Once you move aside from the very natural fear of being alone, how do you feel about your relationship? Does your partner nurture your emotional, mental, and physical well-being? Or do they threaten or ignore it? Do you feel safe and cared-for when they’re with you? Or tense? Are you relieved when they’re out of the house for a few hours? Continue exploring your interpretations of the relation- ship until you get a hold on how you really feel about it. This deeper understanding can guide your feelings and actions moving forward.

Seek counseling. If you determine that you’re dedicated to keeping your partner in your life, and they’re willing to put in the work to mend the relationship, discuss the possibility of seeing a couple’s counselor. This objective support can give both of you an outlet for your emotions and healing strategies tailored to your unique situation. While some associate counseling with high costs, many mental health specialists accept insurance or provide pro bono services through family support centers.

Make a loose plan for what you’ll do if they leave. Many major changes seem insurmountable until we break them down into smaller steps. So to help yourself realize that you will make it through if your partner leaves, make a list of all the challenges that will erupt after they leave. For example, “Less income to pay rent. No one but me to watch the baby. A fear of being the only adult in the house at night. A loss of companionship.” Then start listing potential solutions to the changes. For example, “Find a new living situation. Ask friends and family members for help with childcare. Install a security system to enhance my sense of safety, or ask a family member to move in. Re- connect with my friends.” While this list won’t magically dissolve your challenges, it will at least show you that there’s a way forward.

Shift your focus to yourself. When we believe that much of our safety and happiness is based on our romantic partner, it’s easy to be terrified of the idea of them leaving. It can be crazy making to put so much stock in the actions of a person you can’t control.

Take back your sense of power and calm by shifting your focus from making sure your partner will stay to nurturing yourself — committing to actions that make you feel more whole and capable of caring for yourself and baby. Understandably, this is much easier when not navigating the fatigue, hormonal upheaval, and uncertainty of life with a newborn. But taking small actions like going on a morning walk with baby, drinking more water, making a list of career goals you’d like to pursue when you’ve gotten through the haze of early motherhood, calling a friend or family member who lifts you up, and doing anything else that makes you feel good, and isn’t based on your partner’s actions, can make a powerful difference.

The key to getting these small actions to actually help is that you’re doing them to support yourself, not to change into a person you think your partner will be more likely to stay with. Do it for you, the person you’ll always be in a relationship with.

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My partner and I fight all the time about how to care for our baby. It’s exhausting. What should we do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

How to care for tiny, defenseless offspring can stir up major beef between parents — even parents who didn’t think they even had strong opinions about how to care for a baby. What some of us don’t realize is that we’re carrying all sorts of baggage into parenthood. Either we consciously or subconsciously believe that the way our parents parented is the way to go, or we want to do things the exact opposite of the way our parents did it, or we are somewhere in between. And of course, life experience sprinkles more baggage into the mix. If the baggage your partner brings to parenting conflicts with your own, major disagreements can arise. And these disagreements can get really heated, as you’re both fighting for what you think is best for your baby — a precious person you’ve likely fallen head over heels for. The stakes can feel unreasonably high. Ceding to the will of your partner might seem like an unimaginable scenario, much more so than when you’re arguing about less-precious topics.

Here’s an example: From day one, my mother-in-law has stood firm in the belief that babies should sleep in a crib, ideally in their own room. She is the leader of team “Let Them Cry It Out.” Because my husband treasures his parents, who have raised six kids, he believes they know what’s best in most realms of parenting. I also treasure my parents, who are not cry-it-out advocates and slept with my brother and I when we were infants, putting us either in their bed or in a crib in their room.

None of this initially seemed to be a problem. For the first few weeks of our son’s life, my husband didn’t argue when I decided to bed-share. Things were going great. Our son happily fed and snoozed by my side, we were all getting adequate sleep, and we were adhering to all the safety guidelines for bed-sharing. But then Eric’s mom started peppering us with questions about where the baby was sleeping. And next came the assertions that if he didn’t get used to sleeping on his own, he would be in our bed until college. The result: my previously “let the baby sleep wherever you want him to sleep” husband was suddenly pushing me to change the sleep plan.

I immediately bristled. Not only was this arrangement the only one that allowed Hudson and I to sleep more than three hours a night and facilitated ample night-time feedings, but also it felt intuitively right to me. The thought of being pushed to not have my baby beside me at night triggered all my Mama Bear instincts. Intense arguing ensued. We would go at it. And honestly, we never really reached a resolution. It was a parenting stalemate. I just kept doing what felt right, and he stopped challenging me as much. This particular argument would flair up every now and again, but other baby care issues eventually took its place.

I’ve retrospectively discovered the suggestions in the “What to do” section, and I hope to use them with our second baby. For now, I hope I can help you do better than I did.

You see, you and your partner aren’t arguing because your relationship is broken, or because one of you is a bad parent. You’re arguing because you both feel like it’s your duty to protect the well-being of your offspring and you might believe your partner has a seriously misguided parenting point of view. Without intentional strategies and a mega-dose of active listening and understanding, it might be tricky to pull out of the cycle of baby-care arguments. So putting in the work to implement these positive changes is worth it, because ultimately, finding peace with your significant other and figuring out ways to parent as a team will likely benefit your baby more than any decision in all the topics you’re fighting about.

What to do

Just yell, “Mama knows best!” when your partner questions your parenting….Sigh. If only it were that easy. Because it’s not, try these strategies instead:

Get other people out of the mix. Regardless of how wise your parents, in-laws, siblings, friends, or whoever are about parenting, they shouldn’t get a say in how you care for your baby. I would get furious when I felt like my husband was parroting parenting views I knew he’d gotten from his mom. And I’m sure he felt the same. We both wanted to communicate with our partner, not with a proxy for our mothers-in-law. You can kick those people out of your conversations by mutually agreeing to ask your parents (or whoever is in your ear) to stop providing parenting opinions unless you ask for them. Let them know you respect their point of view but need to go at it without their input.

Get the right person in the mix. While I just told you to get other people out of your baby care decisions, the one exception could be a pediatrician you both resonate with. This neutral party can ideally provide information that guides your parenting decisions and resolves discord. But the key here is that your partner goes with you to these appointments, as they’ll likely be more open to the guidance if it’s received firsthand. This will also give them the chance to ask illuminating questions.

Determine the root of your parenting opinions. It can be wild to discover what our true beliefs are after unraveling ourselves from the parenting influences of our past. To start that unraveling, ask yourself the following questions about any belief you and your partner are in conflict about:

  • Is this a parenting method I came to believe in because it’s what my parents, siblings, or other loved ones did and insist on as the way to go?
  • Did I do extensive research that led me to believe this was the right choice for my family?
  • Does this instinctually feel right? Or does it feel wrong, but
    the idea of finding a new way feels scary and unknown?

Keep digging into the layers of the belief until you discover where it came from. From there, you can determine if this is a belief that truly feels like the best choice for your family, or begin building a new belief based on fresh experiences and research.

Write each other letters. As you probably know, it can be really hard to get your point across, or absorb your partner’s point of view, when you’re in a heated argument. You can bypass that distracting, unwanted heat by both composing letters about how you’re feeling, explaining your beliefs about the baby-care situation in question.

This letter allows you to really explore where you’re coming from and communicate in a way that’s fueled by a desire to help your partner understand you, rather than to make them agree that you’re right and they’re wrong. In turn, reading your partner’s letter can open your mind and heart to where they’re coming from, and help you move forward with the decision-making process with enhanced understanding for the “other side.”

Agree to not discuss the letters until you’ve both had time to process them and can talk without strong emotions distracting from the main objective: finding a solution that’s best for your baby.

Try out your partner’s baby-care wishes on a trial basis. If the baby-care strategy your partner is suggesting is not something you believe would be damaging to your child, you could agree to try it their way for a few days. For example, if they’re all for cloth diapers and you’re a disposable devotee, you might agree to give cloth diapers a go for a week. At the end of that trial you might still loathe cloth diapers, but your partner will at least feel like you heard them and gave their preference a whirl. And maybe some of these trials could transform a few of your parenting views. At the very least they’ll bring more harmony and respect into your relationship.

Create a safe word. Help prevent your arguments from getting into damaging territory by creating a safe word or phrase. This is a word or phrase that can be used when one of you realizes the conversation has taken a turn for the worse and is no longer productive.

Because Eric and I usually argue in the evening, our phrase is, “We need to go to bed” — and not in a sexy way. This phrase helps us realize fatigue and short fuses are making us mean and irrational. It doesn’t always stop the argument, but it at least makes us check ourselves.

Research together. When you can’t find common ground on a certain baby-care issue, research solutions together. Skim the same parenting books, peruse articles and studies about the baby-care topic, speak with your pediatrician, or engage in any other activity that allows you to absorb the same information. This joint research gets you on the same page (or at least in the same chapter), so you can find a solution without too much arguing.

Write down your joint parenting philosophy. Once you’ve worked through most of your disputes about baby care, work together to create a shared parenting philosophy. As you create it, consider questions like these:

  • What type of parents do we want to be?
  • What values are important to us?
  • How do we want to nurture our baby?
  • What type of emotional climate do we want to create in our family?
  • How do we want to handle disputes and discipline when our baby is older?
  • What do we hope to get out of parenting?
  • In what ways do we hope parenting helps us change and grow?
  • What aspects of our childhoods do we want to infuse in to our child’s life?
  • What aspects of our childhoods do we want to leave behind?

Keep riffing, exploring, and taking notes until you’ve created a document that can inform your parenting decisions moving forward. And of course, this document can be adapted as your family evolves.

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My partner seems resentful of my relationship with our baby. I don’t want my romantic relationship to suffer, but I also think my partner should understand how important it is for me to bond with our baby. What should I do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

“I laughed at him when he told me he was jealous of my connection with the baby,” Madison said. “I seriously thought he was joking. I had blood leaking out of the pad attached to my disposable underwear, our baby was latched on to one nipple, and milk was leaking out the other. When I realized he wasn’t joking, I yelled at him. I was so mad. Then he started crying, and I walked away.” Madison, a past doula client, called me the day after this went down with her husband. Insulted by how he was feeling, she got a little pissed when I suggested we try to see things from his side. I don’t blame her; I would’ve also been miffed if someone tried to make me see my husband’s point of view if he even insinuated that anything was hard for him when our son was a newborn. However, staying in the space of anger and defensiveness only blocks us from strengthening our relationship with the person who’s supposed to be our biggest supporter in early parenthood.

This is such a tricky situation because many of the emotions being triggered in you and your partner are likely coming from subconscious programming. For example, your partner’s inbuilt fears of abandonment or inadequacy could be sparked when you begin to devote time to baby that used to be reserved for them. And then there’s your emotions: if the primal instinct to care for your infant feels threatened, you could easily lose empathy for your partner’s emotions.

In addition to those subconscious responses, the resentment your partner feels about your relationship with baby could stem from circumstances that developed during pregnancy. For example, your partner probably wasn’t able to experience the same level of connection you might have fostered with the baby when pregnant — and that might have been hard on them. And now you’re nine months ahead of them when it comes to bonding with the baby. In addition, if you decide to breastfeed, there’s another significant bonding activity your partner can’t participate in. It’s understandable that they might feel left out. But of course, you’ve done nothing wrong by growing your child and choosing to breastfeed. Like I said, it’s tricky.

Both of you might find it near impossible to fully understand where the other is coming from, as each person’s point of view will feel so completely “right” to them. But strangely, that’s a great place to start — realizing you’re both just doing and expressing what feels true for you. Neither of you intends to hurt the other (I assume). From the base of that understanding you can start to build resolution.

What to do

Work through the following strategies while constantly reminding yourself that this isn’t a “win or lose” situation. There’s not one party that gets to be the righteous victor. The only “winning” comes when you both develop some empathy about what the other is feeling, and you start working together instead of apart.

Talk it out. Create the ideal environment for a productive conversation by setting a communication ground rule: you each get the opportunity to share without interruption. As hard as it is, don’t let yourself get bogged down in rebuttals and thoughts about that thing you feel like you really, really have to say right this second. Because then you don’t hear anything your partner says, because you’re just trying to remember that thing you wanted to say. Let that inclination go in favor of truly hearing what your partner is trying to express. If something really needs to be said, you’ll remember it when your turn comes.

Then, when your partner lets you know they’re done sharing, resist the urge to immediately jump into what you disagree with. Instead, first repeat the key messages you feel they’re trying to express. They can then let you know if you interpreted it correctly, or if there’s something important you misperceived. This will help them feel heard and give you an opportunity to objectively review what they shared. Then, take a beat before getting into how you feel, as the pause can help you get into a thoughtful space, instead of a defensive one.

This process might feel super frustrating at first, and it can be really hard to stick with, but by doing your best to follow it you’ll set yourself up for a productive conversation that doesn’t spiral into hurt feelings and a fractured relationship.

Create more opportunities for your partner to bond with baby. A great way to help your partner release jealously over your relationship with baby is to help them foster their own relationship with baby. Once they get to see what all the fuss is about, they’ll be less inclined to judge you for wanting to spend all your time with that adorable little nugget. You can support this bonding by giving them alone time with baby. This is important because when you’re near, baby will likely only have eyes for you. They can start with small activities like short walks, bottle feedings, and diaper changes. It’s simple stuff that can make a big difference.

Accept your partner’s help, even if they don’t do things your way. I’ve talked to numerous partners (my husband included) who felt like they were more of a nuisance than a help after their baby was born. I get this. Us mamas usually develop routines and preferred methods for caring for our babies pretty early on. When our partner tries to take on some of those responsibilities but doesn’t do it in the way we’ve labeled as “best,” it can be easy to feel like it’s more efficient for us to just take care of all the baby business. But as hard as it is to cede control over a task you’re probably the master of, giving your partner more responsibility when it comes to baby will help them feel like a part of the team, instead of an outsider peering in.

Remember that your partner is also going through big emotional and physical shifts. While you definitely win the award for navigating the biggest changes, your partner is also working through sleep deprivation, an identity upheaval, and a slew of other shakeups that are likely enhancing their feelings of confusion over where they stand, and their need to talk to you about it. Under “normal” circumstances they might have more perspective about what’s going on and might even be able to move past it without discussion — but in the raw state they’re in, the shift in your relationship could feel like the end of the world. I say all of this to give you a frame of reference for where your partner is coming from. Remember that neither of you is doing anything wrong; you are both doing the best you can to navigate your brave new world.

Notice if you start pulling away from your baby. If your partner’s jealousy is severe enough that it’s impacting your bond with baby, consider seeking professional support to work out the most effective and safest way to move forward. While it’s normal for your partner to feel resistance to the changes in your relationship, you shouldn’t be made to feel like you have to choose between them or your baby.

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My friends are a huge part of my life, but none of them have kids. I’m starting to feel really isolated. What should I do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Let me paint you a picture. Lady gets pregnant with Baby. Lady’s friends are super excited for her and want to support her. They throw a baby shower. They do most of the same things they’ve always done, only Lady’s wine is replaced by mocktails. Everyone is confident their friendship will seamlessly flow into Lady’s life with Baby, but no one talks about what that will look like. And then Lady has Baby. The friends show up to ooh and aah, then everyone leaves. Friends want to invite Lady to this and that, but they don’t want to pressure her or make her feel bummed she’s missing out, so the invites dry up. Friends want to call, but they don’t want to bother Lady. “Maybe she’s trying to nurse? Or sleep? I should probably just let her call me when she’s ready.” Lady is elbow-deep in diapers and exhaustion and at first doesn’t notice the radio silence. But then the fog of the fourth trimester begins to fade, and she notices. She notices that she feels isolated. She wants to call Friends, but doesn’t. She thinks she’ll just bore them with mom-talk.

This is a classic case of Postpartum Friendship Dissolution. As you probably noticed, much of it is birthed from lack of communication.

While your relationships with your buddies will definitely change, they don’t have to end. Your life circumstances have been shaken up and turned upside down, but you’re still you — the you that loves your friends, and vice versa. There has to be a way to save those friendships. But how? How do you side-step Postpartum Friendship Dissolution and walk the path of Postpartum Friendship Evolution?

What to do

Talk to your friends, one at a time, about how you’re feeling. (If you’re reading this while pregnant, talk to them before you have the baby, so you can all prepare for the changes.) These conversations aren’t meant to cause guilt for either party — they’re opportunities for you to be vulnerable and to co-create a plan for how the relationship will look moving forward. After you let them know you value their friendship and need more of them in your life, the two of you can brainstorm ways you can connect. For example . . .

  • Maybe your friend loves talking on the phone, and you can schedule calls for times you’ll be on a walk with baby.
  • Or maybe this friend lives nearby and is often free to join you for those walks.
  • Maybe this is the friend you used to see live music with or take dance classes with. While it will likely be hard to meet up for your activity of choice as often as you used to, you could commit to doing it once a month — or whatever works best for your schedules.

After you’ve created the plan, forewarn your friend that you won’t be as reliable as you were before baby. Motherhood is predictably unpredictable, potentially causing you to cancel plans at the last minute because of a sick child, or an AWOL babysitter. Being forthright with this information will hopefully prevent your friend from being annoyed that you’re not able to show up for the friendship in the same way you used to.

In addition, ask them to reach out if they haven’t heard from you in awhile. As a foggy-brained new parent, it can feel near impossible to remember how many days you’ve been wearing those pajama bottoms, much less when you last contacted your friends. Remind them that radio silence doesn’t mean you don’t care, it just means you’re overwhelmed.

Here are some additional considerations when navigating friendships as a new mom:

Be thoughtful of conversation topics. While your non-mom friends probably won’t mind hearing a bit about motherhood, they won’t be able to relate to it and will likely tire of the topic if it’s not kept to a minimum. Ensure your time with friends is filled with connection by asking each one about their life, and bringing up topics you used to love gabbing about. If you’re worried you’re incapable of thinking of anything but mom-topics, keep a running list of conversation starters you think would be interesting to your friend. For example, if the two of you love celebrity gossip, write down juicy tidbits you can bring up. If you’re politics fanatics, list hot topics you want to get their opinion on. You won’t always have to put this much effort into talking points, but while you’re trying to find your footing on the balance beam of parenthood and friendship, this forethought will pay off.

Note: If your friend is not child-free by choice, it might be best to steer clear of all talk of baby, unless they ask. Hearing about you living the life they desperately want could be devastating, and it could drive a wedge in the friendship. For more on this, see question 7.

Know that you might need to let go of some friends. Not all friendships will stand the test of motherhood. While it might be painful to let those friends drift away, you can honor them by sitting with the idea that they were meant to be in your life for a certain period of time, and now it’s time to part. This parting will likely be made easier by the fact that your time is now seriously limited, and you have to be selective about who you spend time with.

After I had Hudson, only three of my prebaby friends were still standing. These were the friends who weren’t offended if I forgot to call or text back, or didn’t reach out for months at a time. These were the friends who would try to make a meetup happen if I randomly had a free hour and reached out to them last minute. These were the friends who would come to Hudson’s birthday parties, even when they were the only ones without kids. They understood the constraints of my new circumstances and didn’t fault me for them. They were free of drama (at least the not-fun kind) and always there when I needed them.

Find new friends. One of the most natural parts of parenthood is making new friends. The playgroups, time at the park or library, and other baby-centered gatherings all create organic opportunities for fostering fresh friendships. And many of these connections will feel refreshing as you can gab about the trials and triumphs of parenthood without feeling self-conscious.

While these new relationships will likely be easier to maintain and should absolutely be nurtured and enjoyed, you should still use the suggestions above to hold on to at least a few of your pre-parenthood friends. Those are the folks you probably feel most comfortable being your unfiltered self around, which is a dynamic that can feel like gold as you navigate the unsure footing of early motherhood.

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What if part of my placenta doesn’t come out of my uterus? What will my care provider do?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

If part of your placenta doesn’t vacate your uterus within around thirty minutes after baby is born (something called a retained placenta), it will be evicted. As a full or partial retained placenta could cause hemorrhage (excessive bleeding) or infection, your care provider will utilize various methods until the entire organ has been birthed or removed. But you don’t have to be too worried about this, as it’s pretty rare. According to an article in the International Journal of Women’s Health, a retained placenta occurs in only 1 to 3 percent of deliveries.

There are three types of retained placenta:

1. Placenta adherens occurs when contractions are too weak to push the placenta out and it remains loosely attached to the uterus. This is the most common type of retained placenta.

2. Trapped placenta is when the cervix begins to close before the placenta has been expelled.

3. Placenta accreta occurs when the placenta attaches to the muscular walls of the uterus, instead of the lining of the walls. This is sometimes diagnosed before birth and usually results in the care provider recommending a C-section.

You care provider will check your placenta after its birth to confirm that it’s fully intact. If they suspect part of it is missing, they may perform an ultrasound to confirm. From there, they’ll take steps to remove the remaining pieces. However, it’s possible for a care provider to miss that a portion of the placenta is still in the uterus. In that situation, you might experience a fever, excessive bleeding, constant pain, or stinky discharge.

How does my care provider get it out? One of the first things they’ll likely do is administer medication that encourages the uterus to continue contracting. (This is often done preemptively.) Breastfeeding can also trigger contractions. You might also be told to urinate, as a full bladder can impede the placenta’s expulsion. If these methods don’t work, they may have to move on to manual removal, or surgery. In the case of manual removal, the care provider administers anesthesia and/or analgesia, reaches their hand into your uterus, and “sweeps.” Essentially, they feel around and remove lingering placenta. This doesn’t feel great — but it usually works. Surgeries to remove the placenta include dilatation and curettage (aka D&C), hysteroscopy, and laparoscopy. A hysterectomy is needed in rare cases. Antibiotics are given after the treatment to reduce risk of infection.

What to do

While there’s not much you can do to avoid the rare occurrence of a retained placenta, there are a few ways to be proactive:

Avoid prolonged use of Pitocin. According to the article in International Journal of Women’s Health, prolonged use of Pitocin could increase the risk of a retained placenta. So use Pitocin only if it’s absolutely necessary — not just because a care provider thinks it would be cool to speed things up.

Pay attention to your postpartum symptoms. If your care provider believes the full placenta was birthed but you experience fever, excessive bleeding, constant pain, or stinky discharge, or you just feel that something is off, let your care provider know so they can confirm you don’t have pieces of retained placenta.

Know how to stay calm if you experience a retained placenta. Stick a few of these retained-placenta-relaxation tools in your back pocket for the unlikelihood of this happening to you:

  1. If you’re told you have a retained placenta, immediately start taking deep breaths, helping to prevent panic from taking over.
  2. Have someone on hand to hold the baby, as pain medication may need to be administered. However, continue focusing solely on your baby until a recommendation is made and you make a decision. This can help your mind from spiraling into a place of fear.
  3. Keep reminding yourself that you’re being taken care of by trained professionals. While it’s not fun to have a retained placenta, they’ll take care of you, and you’ll be fine.
  4. If a manual removal or surgery is needed, close your eyes and envision your body filled with and surrounded by a warm, golden light that’s keeping you calm and safe.

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Will I be judged if I want to eat my placenta? And is it worth it?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

Maybe, to both questions. I believe that anyone who judges you for your birthing or parenting decisions isn’t worth your time. Sure, people close to you have every right to not understand your decision, but they don’t have a right to make you feel shame for the decision. And what’s the deal with some people having such a strong reaction to those wanting to ingest their placenta? Well…

Many believe that consuming the placenta is a dangerous, “hippie dippy” thing to do. They’re not entirely wrong. It can be dangerous in certain circumstances, and I know lots of hippies who are all about noshing on that placenta. But I believe what’s really behind these conceptions is that the idea of someone eating their placenta brings up visions of dicing up the organ and tossing it in the frying pan, or even throwing a few raw chunks in a smoothie. While that’s been known to happen, it’s not what placenta consumption usually looks like. Most women get the placenta encapsulated and take a few of the pills each day.

Before I get into the specifics of ingesting the placenta, know that it’s a controversial topic because very little research has been done on it. And the studies that have been done were limited, providing inconclusive results. Because of this, I think it’s important to talk to your care provider before making this decision. Then do what feels best to you.

To increase your knowledge of what it means to consume your placenta, let’s look at some facts:

How is it encapsulated? The placenta is washed, steamed (sometimes with herbs), dehydrated, and ground, and then the powder is encapsulated.

How could eating it help? Anecdotal evidence has suggested that ingesting the placenta can do the following:

  1. Increase energy
  2. Balance hormones
  3. Prevent anemia through restoration of iron levels (However, it’s been found that most placenta pills contain a very modest amount of iron.)
  4. Lower chances of developing postpartum depression

Some believe these benefits are caused by the placebo effect. As a big believer in the mind-body connection, I don’t think there’s anything wrong with that. But I’ve also heard from women who felt that their placenta pills dampened their mood and energy. In addition, there are potential risks to consider.

What are reasons I might not want to eat the placenta?

* Group B strep: If you have group B strep (GBS), there’s a possibility it could infect the placenta. The infection could then be passed to the baby through breastmilk after you ingest the pills. I’ve known plenty of women who tested positive for GBS, encapsulated their placenta, and had no issues with their baby being infected, but it’s important you’re aware of the risk before making the decision.

* Infection: In addition to GBS, it’s possible for the placenta to be contaminated by other intrauterine infections. There’s also the potential for contamination during the encapsulation process, if it’s not handled properly.

* Hormones: Estrogen in the placenta pills could increase the risk of blood clots. And the presence of progesterone could impede prolactin, which is responsible for milk production. Estrogen can also suppress prolactin.

What to do

Talk with your care provider. If they simply tell you not to encapsulate, ask them why. Ask questions until you get a clear view of where they’re coming from. If you feel that what they’re sharing is primarily based on personal beliefs instead of more solid evidence, consider talking with a few placenta encapsulating specialists to receive a more well-rounded perspective. After gathering information from numerous sources, sit with the decision until you’re clear on what you feel most comfortable with.

If you choose to move forward with placenta encapsulation, here are questions to ask the specialist:

Did you receive formal training and certification? What did that consist of? Do you engage in continuing education?

How many placentas have you encapsulated?

What are the risks of placenta encapsulation? Have your clients ever had adverse effects?

Are there certain STDs or infections that would rule me out as a candidate for encapsulation?

How do you handle and store the placenta before you’re ready to encapsulate?

Where do you encapsulate? What are the sanitation procedures for your equipment and workspace?

Would you be willing to encapsulate in my kitchen if that’s what I’m most comfortable with?

How do you make sure my placenta isn’t mixed up with someone else’s?

How do you encapsulate the placenta?

What temperature do you use to steam the placenta? Is it high enough to kill potential bloodborne pathogens?

What do you encapsulate the powder in?

Will you be immediately available to pick up my placenta? If not, how should I store it until you arrive?

How soon will you deliver my pills?

Will you provide a dosage recommendation?

When you start taking the pills, pay attention to how they make you feel. If you start feeling down or notice a drop in milk supply, consider not taking the pills for a few days to see if the negative symptoms go away. Because there isn’t much quality evidence about this, each woman taking these pills is essentially acting as a guinea pig, which ends up great for some, and not so much for others. Each body seems to respond a bit differently.

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What’s it really like to push a baby out?

Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood

It’s like pushing a flaming watermelon out a fleshy hole the size of a baseball. Just kidding. Actually, this experience is completely different for each woman. I’ll give you a couple of examples.

My client Chelsea had taken my HypnoBirthing class and was a devout believer in breathing her baby down (an alternative to pushing). For weeks beforehand, she practiced the birth breath every time she was having a bowel movement, and in her regular meditation practice she envisioned successfully helping her baby emerge in this gentle way. When she went into labor, the midwife and I were called to her house and she began a very long journey through labor.

Tired but determined, Chelsea worked her HypnoBirthing tools, continuously focusing on surrendering and expanding. Twenty-four hours later, the midwife said the head was almost out. Chelsea began doing her birth breathing, and ten minutes later the midwife said, “Give me one big push.” And just like that, her baby was born. I was shocked. Almost every birth I’ve attended consisted of a big announcement when the mom was fully dilated, and everyone getting in position to help her push. A nurse or midwife would then loudly coach the mom to press her chin to her chest and push like her life depended on it. It was usually a long process. But not this time.

My birth, on the other hand, was the epitome of the classic pushing you see in the movies. My feet were in those scary-looking metal stirrups, I had a spotlight on my vagina, a nurse was nervously watching the monitors, my husband looked like he was about to faint as screams, blood, and probably some poop came out of me, and the doctor kept telling me to “Push harder! Harder! Harder!”

I did as I was told. I wailed like a banshee and worked so hard I spiked a fever. I pushed for three hours before Hudson came out. When he arrived, his hand was pressed against his face (something called nuchal hand), which is likely what made the pushing such a long, hard process. But I don’t think that was the only reason. Even though I knew about the birth breathing technique I hadn’t really believed in the power of it , and I didn’t have a doctor who supported it. But who knows, even if I had Chelsea’s unwavering belief in breathing the baby down, I might still have needed to push harder harder harder, whether because of the nuchal hand or just the structure of my body.

I share these stories to make the point that the experience of pushing (or breathing) a baby out can range from gentle to super-duper intense. So much of it depends on the woman and the baby. And while how the pushing process unfolds is mostly out of your hands, there are ways you can prepare yourself for the experience, which I cover in the “What to do” section. Before we get to that, let’s look at the questions about pushing I get most often.

What does it feel like? For many women, pushing doesn’t feel nearly as uncomfortable as they think it will, even if they don’t have an epidural. Because of the pressure of baby’s head on nerves in the vagina, a numbing sensation is often present during pushing. This numbing is usually accompanied by intense pressure — essentially, it feels like you’re about to take the biggest poop of your life. Some women report a “ring of fire,” an intense burning sensation, when baby’s head is crowning. But most women I’ve worked with (myself included) said they never felt it. As strange as it sounds, I found pushing to be the most comfortable part of childbirth, albeit the most exhausting.

What can make it harder? A baby in the posterior, or “sunny-side up,” position is one of the most common situations that can make their emergence trickier. In this position, baby’s face is pointing toward the front of your body, which can make it challenging for them to get past your pubic bone. It doesn’t make vaginal birth impossible, just harder. There are tips for repositioning a posterior baby in the “What to do” section. You’ll also find a link for the video “How to Reposition a Posterior, or Sunny Side Up, Baby” in the book’s “Recommended Resources” section.

Numerous other circumstances can complicate pushing — here are the ones you can actually do something about:

􏰀 Lying on your back: This position doesn’t utilize gravity and can narrow the birth canal. Being on all fours, lying on your side, or squatting are all preferable for most women. If you have an epidural, ask if you can lie on your side while pushing.

􏰀 An epidural: As an epidural can make it difficult to feel and coordinate the birthing muscles, pushing when you have one can be tricky, but not impossible. I’ve witnessed many midwives tell moms with an epidural who had fully dilated to not push, and let contractions do the work instead. In many of these cases, the mom didn’t have to push until baby was almost out. Some call this delayed-pushing technique laboring down. You can also ask if the epidural can be turned down when you’re ready to push, so some sensation returns.

􏰀 A tired uterus: If you’ve had an incredibly long labor, your uterus might get tired, and tired uterine muscles can complicate baby’s descent because they may not be able to contract as effectively as needed to push baby out. Some care providers recommend Pitocin if they suspect the strength of contractions is waning, as it can give the uterus a much needed pick-me-up.

How long does it take? Unfortunately, there’s no answer for this one. Some women push for ten minutes and the baby is out, and others push for hours and still need the support of forceps or vacuum. Following the tips in the “What to do” section can increase your chance of shortening your push time.

What is it like for baby? While it’s impossible to know what baby is thinking during this process (I suspect it’s something along the lines of “WTF is happening?”), monitors tell us that many babies experience a dip in heart rate every time their mom engages in heavy-duty pushing, as there’s usually a drop in oxygen during this time. The heart rate usually bounces back up when the contraction and push are complete. This is another reason why the gentler pushing methods can be beneficial — they don’t require mom hold her breath. However, if there is a special circumstance requiring that baby come out as soon as possible, the more intense pushing could be worth it. Your care provider can help you determine what is safest for you and baby.

What to do

While there’s no way to know what type of pushing will be most effective for your body and baby, or how you’ll process that experience, these techniques will help you go into the event as prepared as possible.

Do the perineal tissue massage. This massage will prepare your perineum for baby’s head.

First, coat your pointer and middle finger, or your pointer and thumb, with an unscented, organic oil.

Then insert the fingers two inches into the vaginal opening, and move them in a U-shape along the inner edge of the perineum.

I recommend applying more pressure when you reach the tautest skin (area between the vagina and anus), as this is the skin most likely to tear during birth.

As you push to the point of discomfort, utilize pain-relieving techniques like deep breathing and facial relaxation. This makes the perineum become more elastic, and helps mentally prepare you for the vaginal stretching during crowning.

I recommend doing this nightly for about ten minutes, starting at around week thirty-four or thirty-five of gestation.

Get baby in the optimal position. Cephalic presentation (the best position for baby to be in) is when baby is head down, facing your back, with their chin tucked to their chest. Your care provider can help you determine if baby is in this position.

If they’re not facing your back, here are a few things you can do to give them the space to get into it, which they’ll usually instinctually do if they’re physically able.

Get into the yoga position called “child’s pose” and really stick your butt into the air. You can also gently sway your hips. Stay in this position for at least five minutes (unless you feel woozy), and practice once a day.

Get on your hands and knees and gyrate your hips.

As often as possible, sit in a position where your pelvis and belly are tilted forward. The easiest way to do this is to sit on a wedge cushion. If you’re sitting on a birth ball, make sure your knees are lower than your pelvis.

Sleep on your side instead of your back.

Avoid sitting in bucket seats, or leaning back into the sofa.

Prepare your pelvic structure. A deep squat (with the support of a spotter) or the yoga poses “child’s pose” and “cat-cow pose” can all help relax and lengthen your pelvic floor muscles.

Practice birth breathing while pooping. Because the “birth breath” stimulates the natural expulsive reflex, it can help you poop and get a baby out with minimal pushing. Many mamas don’t believe this until they experience its effectiveness while having a bowel movement. So . . .

While sitting on the toilet, take in a quick and strong inhalation through your nose.

As you slowly exhale, feel the power of the breath being pushed down the back of your throat, through the uterus, and out your vaginal opening.

While you exhale, you’ll organically create a low sound and gentle vibration in your throat. You’ll also feel your expulsive muscles bearing down.

Repeat until you expel that poo!

Ask your care provider how they typically guide women through baby’s emergence. Gaining an understanding of the instructions your care providers usually provide through this phase of birth helps you determine whether their process resonates with you. If it doesn’t, talk to them about how you’d prefer to navigate pushing.

Think of how you want to be guided through pushing, or breathing baby down, and add it to your birth preferences. After you’ve determined if you’d like to try birth breathing or want to go with more traditional pushing, add it to your birth preferences. I also recommend listing how you’d like to be guided through this experience. For example, women I work with often use the phrase, “I request calm prompts from only one person. No loud ‘cheerleading’ please.”

Utilize the “laboring down” technique. In laboring down, you allow the uterus to push baby out with only contractions, and not your pushing efforts, after you’ve fully dilated. This can conserve energy, reduce your chance of tearing, and provide a gentler experience for baby. Many women I’ve supported use this technique until they can no longer suppress the urge to push.

Choose a position that takes weight off the tailbone. Standing, kneeling, squatting, being on all fours, or lying on your side allow more expansion in the pelvis, potentially leading to an easier emergence for baby. Changing positions can also help if pushing progress seems to stall.

Apply a warm compress and oil. Help the perineum soften and expand (which minimizes tearing) by asking your care provider to place a warm washcloth on your perineum, in addition to massaging it with oil.

Go limp between contractions. Contractions and pushing can take a lot of energy. Allow yourself to recharge between push sessions by closing your eyes, going totally rag doll, and taking slow easy breaths. You can also ask that no one talk to you unless absolutely necessary.

Consider having a mirror held between your legs. Seeing the top of baby’s head between your legs can be an incredibly motivating visual. If you’re into this idea, bring a hand mirror to your birth, and ask someone to hold it between your legs when baby is crowning.

Get your copy today.