That parenthood is stressful is no surprise. Potty training, hospital visits, struggles in school, driver’s licenses, and first dates are just a few of the adventures that parents have to shoulder as their kids grow up.
Some of the earliest decisions can be among the most challenging. The choices that parents have to make leading up to and just after the birth of their children can have long-term implications. Should you to opt for a c-section, breastfeed, circumcise? These are some of the questions that face parents in the days leading up to and just after the birth of a child. Of course, the state of mind parents are in just before and after the birth of their child may not be the best for making these important decisions, some of which can affect a child for years to come.
The choices that parents have to make leading up to and just after the birth of their children can have long-term implications.
The months and weeks prior to parenthood – especially of a first child – are filled with uncertainly and conflicting information. Baby books can be hard to digest for many reasons, not the least of which is they can offer contradictory theories and advice about parenting
According to a new study by the CDC, circumcision rates are down in hospitals by 4-7% in the last 10 years. Why is this? The previous ten years had been marked by a significant increase in circumcisions, so that rates are now declining is a fairly new trend. There are mixed opinions of circumcision: on one hand, it’s been shown to decrease the risk of spreading certain STDs like HIV and HPV, while on the other it causes pain and stress for the tiny patient (and parents). Some groups across the country, such as the Whole Baby Revolution, are advocating banning circumcision in their areas, which underlines its changing status.
So how do parents feel about the practice when and if they have time to think about it? One mother we talked to, Francis*, told us, “I really wish I didn't circumcise my son - I was in the room when they did it, and afterwards couldn't even believe I had considered it.”
Another mother, Melissa, had attended a bris, the Jewish circumcision ritual, a year before her own son was born. She had heard the newborn cry in pain, so she told her husband (who is Jewish) that if he wanted their son circumcised, it would be up to him to secure a mohle and hold their son for the procedure. When the time actually came, her husband couldn’t bring himself to go through with it, so their tiny son was off the hook. Since the procedure can be stressful for a newborn, it’s understandable that parents would wish to avoid it altogether.
McAllister agrees that “the declining circumcision rates are a reflection of the increasing availability of information about this surgery. When parents have more knowledge and a greater understanding about the immediate and future impacts of circumcision, they’re better able to make a conscious, educated choice about whether they want their baby to be circumcised.”
Circumcision really is just a cultural and religious practice, not a medical one. '[O]ver time, that message is getting through. It’s simply not mandatory.'
She adds that people should read up and talk to friends about the decision, even though it can be a tricky conversation if you’re shy. “If the baby’s father is circumcised, it might be helpful to have a conversation with an adult man who wasn’t circumcised, to get another perspective. This might sound like a questionable topic for discussion, but it’s similar to asking a woman about her experience breastfeeding or having a Cesarean section... After parents have fully educated themselves and given very careful consideration to their options, I encourage them to do what they feel is best for their child.”
The bottom line is that circumcision is a personal decision, not a medical requirement. There may not be enough good evidence to warrant the practice for health reasons alone. On the other hand, if your cultural, religious, or personal beliefs encourage it, there is little evidence that it does a child any long term harm. Researching it though books, internet, friends, and of course your doctor, is always the best tack to take.
In almost 80% of hospitals surveyed, newborns were being given formula when they did not need it medically, which makes getting started breastfeeding more difficult. Only 4% of hospitals provide the full gamut of lactation support services available, and just 14% have a written policy on breastfeeding education.
*Names have been changed.
[Breastfeeding] education needs to start early in a woman’s pregnancy. It’s often too little, too late to see a lactation consultant the day after the delivery. I hear over and over from other mothers—even those who are physicians—that they didn’t feel that they had enough education about the 'how to’ of nursing prior to giving birth.
She ultimately stopped trying when her son was a few weeks old and switched exclusively to formula, which also has its benefits: Rebecca says its convenience and the fact that her husband could feed just as easily as she could with formula, with no pumping required, was quite a nice benefit. On the other hand, she was always slightly sad that she didn’t experience more of the mother-child bonding that comes with breastfeeding, and looks back on those early days of frustration with an inkling of regret.
New mothers are often emotionally quite delicate, not to mention exhausted. So the problems that can come up when learning to breastfeed (it is a skill that needs to be learned by mothers and babies) can feel overwhelming. Some babies have trouble latching on to the breast, mothers may find positioning their baby on one side or the other, awkward. All of these difficulties are easily overcome with a little help and practice, but too often, women don't receive the instruction they need to move the process along.
Dr. McAllister makes the point that the timing of breastfeeding education may be the root of the problem. “[Breastfeeding] education needs to start early in a woman’s pregnancy,” she says. “It’s often too little, too late to see a lactation consultant the day after the delivery. I hear over and over from other mothers—even those who are physicians—that they didn’t feel that they had enough education about the ‘how to’ of nursing prior to giving birth.”
There is no evidence that formula-fed babies have any significant health or developmental problems in the long run.
Talk to your doctor or nurse while you are pregnant, and bring it up in your childbirth class if it isn’t mentioned. Of course, much of the learning process clearly has to do with the practice itself, which has to come after the birth of the baby, but there is still something to be said for absorbing as much as you can beforehand so you’ll be familiar with all the issues involved.
For some women and some babies, however, breastfeeding remains impractical or impossible. There is no evidence that formula-fed babies have any significant health or developmental problems in the long run. As Polin says, “if you don’t have breast milk it’s fine. There should be no sense of guilt.” So if breastfeeding doesn’t work for you – as it doesn’t for many women, for various reasons – don’t fret: your baby will turn out just fine.
C-section rates have reached an all time high in this country. Some of reasons for this, according a Healthgrades study, include the convenience (for doctors and parents) of choosing a delivery date and time; a lack of awareness of the complications associated with it; the rise in multiple births, which could require it; an increase in age-related risk factors in the mother; and a rising willingness of doctors to perform the surgery.
What’s particularly apparent is that more women are opting for scheduled c-sections, both for reasons of convenience and perhaps for physical or aesthetic reasons. But the surgery has its risks, including a longer recovery period for the mother and potential health risks to the baby – therefore, c-sections should not be viewed as a simpler alternative to the old-fashioned method.
It’s important to remember that c-sections are major surgeries and hard on the body in multiple ways. Allowing your body the time it needs to heal is ultimately the fastest way to recovery.
Had she just taken time to allow her body to recover slowly and steadily, she says, the recovery would have been a lot faster than it was when she tried to speed it up. “It took weeks for me to be able to move normally and get back to all my regular daily activities. Picking up the baby without a lot of pain took a number of weeks, too.” It’s important to remember that c-sections are major surgeries and hard on the body in multiple ways. Allowing your body the time it needs to heal is ultimately the fastest way to recovery.
That said, there’s an intense recovery involved with vaginal delivery as well. Sandy tells us that she wished someone had told her about the time that it takes to recover physically from childbirth. The stitches after a vaginal delivery, she said, were exponentially more painful than she’d anticipated, and it took her a very long time to feel normal again. Melissa, echoing Rebecca's experience but without the c-section, said, "It felt so great to feel lighter [after giving birth]; I was so excited to be a mom, that I did too much too soon and had extra heavy bleeding." Giving birth is a natural event, but it's a radical one. Treat yourself accordingly.
Beyond the seriousness of surgery for the mother, Polin tells us that what most people are unaware of are the risks to the child.
Even having a child a week before their natural due date can be hard on their little bodies developmentally. According to Polin, the risks to the infant that can come from planned c-sections include “respiratory disease, mortality and neurodevelopmental handicaps.” He also points out that the March of Dimes has launched a campaign to reduce unnecessary “late pre-term” c-sections (those done before week 39), because of the associated risks.
Of course, it’s clear that when c-sections are required, they can be life-saving, for both mother and child. But planned c-sections, particularly early ones, come with real concerns that should not be taken lightly. It is critically important to learn about all the issues associated with c-sections and vaginal births for your particular situation before making a decision.
Though the use of alternative locales and methods of giving birth seems to be on the rise, many women may still not be aware that there are other places to give birth besides hospital delivery rooms and that people other than doctors and nurses can assist in the delivery. Midwives are trained individuals who can do certain medical procedures, lab tests, and assist with the birth and the newborn. Doulas are not health professionals, but offer other types of services including emotional support for the parents leading up and after the birth of the child.
Theresa, said that she sincerely wished she’d known more about alternative birthing options before having her daughter. Her hospital experience was ok, but a birthing center or other environment that offered more personalized care would have made the process much more enjoyable in retrospect.
Birthing centers have a homier feel, some offering Jacuzzis, comfortable furniture, hardwood floors, rugs, and tasteful decoration. And while they typically don’t have doctors on staff, they offer nurses or midwives, who can handle a range of complications. According to the American Association of Birth Centers, more widespread use of birthing centers would save the country millions of dollars in healthcare costs per year, not to mention cutting down significantly on the number of c-sections.
Since most birthing centers foster “natural” births, many don’t offer epidurals, drugs to induce labor, or C-sections. For women who are concerned about this, some hospitals actually have their own birthing centers, which can put a mother’s mind at ease: The latest technology, doctors and specialists, and equipment can be only an elevator ride away should the need arise.
In the same vein, Rebecca says that she was so terrified of the process, a birthing center could have made all the difference – if she’d only known that they existed. “In retrospect,” she says, “I would have used one. But knowing myself, because I was so scared of the birth process in general and its potential complications, I would have 100% chosen one offered by a hospital. A home birth was the only other option I knew of, and I wouldn’t have felt comfortable on that end of the spectrum.”
This is another decision that’s very much a matter of personal choice – and comfort level. In many cases, alternative options can work out problem-free.
“The vast majority of pregnancies are uneventful, and mom and baby do just fine," says McAllister. "Women have been delivering babies forever, and our bodies know just what to do!” If you are interested in other, less conventional options (and there are several), they may be worth looking into, by talking to doctors and friends, researching options on the internet, and the best method – touring the hospital or birthing center and talking to the staff yourself.
Given the almost comical amount of information out there on pregnancy, childbirth, and babyhood, finding the right sources can be challenging. Books, websites, and television shows can be informative, but they can also overwhelm. For a life event that is already stress-inducing by its very nature, it’s important to find clear, research-based information that serves to educate, not to scare.
the decisions you make regarding the birth and early care of your baby have a way of staying with you. They are life decisions, and you will be happier if you do your homework.
It may be tempting to just put off informing yourself, or to make a quick decision, but as the comments here suggest, the decisions you make regarding the birth and early care of your baby have a way of staying with you. They are life decisions, and you will be happier if you do your homework. Even if you end up deciding to do something differently the next time around, knowing why you made the choice you did is bound to produce more peace of mind.
Another mother, Sandy, said that she wished she hadn’t taken the hospital tour before going there in earnest to have the baby, because it only served to scare her. The equipment, the sterility of the place, and the sounds from the birthing rooms were not what this mother needed to experience prior to “D-day” itself. These parents agree that though it’s good to be prepared in some ways, there’s a fine line between awareness and anxiety.
It is important to pay attention to where the information comes from. That means the information you use has to have references (like this one!) or clearly state the source of the facts and figures mentioned in it so you can determine how valid the information is. Check who authored the health information you’re using. Articles written by doctors, nurses, and academics whose credentials are easily verified (do this) and substantial.
'I wish I knew to trust my instincts. I wish I knew all babies are not the same. Just because a book (or the internet) says a baby does X, doesn't mean your baby will.'
Go to trusted sources like the National Institutes of Health (NIH), CDC, the American Academy of Family Physicians, and the American Academy of Pediatrics. These are all excellent sources for information on pregnancy, childbirth, and baby’s health and behavior, says McAllister. Try to stay away from sites that have no author listed or no biographical information, or which don’t give references – cite journal articles, reputable websites or books -- for their information. Pay attention to who is behind any websites you use. Avoid sites sponsored by commercial enterprises that would appear to have a vested interest (such as a baby formula manufacturer) in the information.
Remember that the process of having a baby is not a one-size-fits-all situation – so it is helpful to seek out multiple takes on any issue and choose the one that fits you and your baby best. “Often, there’s more than one way to do things right, and there’s more than one good answer to any problem,” McAllister tells us. “The more you read and understand the facts, the better prepared you’ll be to make the decisions that are best for you and your baby. “
It’s important to keep in mind that women have been having babies for millennia, and in many ways, the female is well prepared for it, in body and mind. The idea behind educating yourself before having a baby is the same as it is for buying a car – so you can make a better informed decision you are more likely to be happy with.
Like anything else that is new and challenging, having a baby is bound to make you a little anxious. So be prepared for that.
Yes, there is a lot of information out there, and it can easily have the unwanted effect of making one feel as if she doesn’t know what she’s doing, or is ill-prepared. As Sarah told us, “I wish I knew to trust my instincts. I wish I knew all babies are not the same. Just because a book (or the internet) says a baby does X, doesn't mean your baby will. I was concerned if the book said babies drink 16 oz of milk and mine was drinking ‘only’ 13 oz., etc. I called La Leche for advice so many times, I finally could diagnose myself just by listing the answers to questions I knew ‘the experts’ would ask. After about a year, I realized I was doing it correctly!”
Polin agrees that keeping it simple and using your intuition is the way to go: “You don’t have to be perfect,” he says. “When I was growing up, mothers just did what they thought was best, and the kids turned out ok. Maybe we should do more of that these days.”
It’s true that the days and weeks before and after a baby is born can be overwhelming, draining, and full of questions. But relaxing into it as much as possible can help it along. Like anything else that is new and challenging, having a baby is bound to make you a little anxious. So be prepared for that.
Sarah adds, “My biggest thing is I wish I knew the BABY is the true EXPERT – only he or she knows what he or she wants, and it may be different (more or less, earlier or later...) than other babies; and that's OK.” The process can be overwhelming, but it can also be wonderful – though it’s easier said than done, worrying and comparing yourself to others less helps highlight the joys, so that the hardships can fade away.