On parenthood…

1. On parenthood… • Parentage is a very important profession, but no test of fitness for it is ever imposed in the interest of the children – George Bernard Shaw • The value of marriage is not that adults produce children but that children produce adults – Peter de Vries • Families with babies and families without babies are sorry for each other – E.W. Howe

2. Deciding to Parent • Decision because of availability of contraception and abortion • 60% pregnancies unplanned • Realities to consider: • Actual and opportunity costs ($200,000 on average) • Life changes • Restricts freedom, spontaneity • More work, less rest & sleep • Marriage changes

3. Pregnancy – Is it Wanted? • Pregnancy is 12th most stressful life events • Domestic violence can increase • High levels of maternal stress associated with lower birth weight of baby (Van den Bergh, 1990) • Low birth weight predicts poor school achievement, emotional and behavior problems • Women with less-than-positive attitudes about pregnancy have longer, more complicated deliveries (Yang et al, 1976) • These types of deliveries predict behavioral problems and poor academic performance

4. Transition to Parenthood • New role more difficult than any other (wife/husband; college student; employee) • PERMANENT • Abrupt change in lifestyle and relationships with no “off-duty” • Unrealistic expectations can lead to depression, guilt, anger

5. Becoming a mom – “The Good Side” • Great investment leads most mothers to form immediate intense bond to infant • Pregnancy, childbirth, nursing • Socialization has prepared women for caregiving to infant • Play with dolls, babysitting

6. Becoming a mom – “The Not So Good Side” • Sacrifice more than fathers (Daniels & Weingarten (1988) • Drastically readjust lives post motherhood • Shift to traditional roles (Hawkins et al, 1995) • Shift in marital power (Emery & Tuer 1993) • Women’s domain = family matters • Men’s domain = outside world

7. Becoming a Father – “Odd Man Out” at First • Treated as mom’s helper at first • Resist sharing household tasks • Resent mother’s “overinvolvement” with baby and decrease in sex and companionship

8. Children’s Effect On Marriage • Couples with children are less likely to divorce (Belsky & Pensky, 1988) • Most couples feel lower marital satisfaction (Glenn, 1990) • Happiest before kids and after kids • Less happy than childfree couples

9. Children’s Effect on Marriage • Decrease in satisfaction greatest for unhappiest marriages (Lewis, 1988) • Decrease in satisfaction less if very happy before marriage and if actively planned for child (Cowan & Cowan, 1992)

10. Children’s Effect on Marriage • Decrease in marital satisfaction more likely for mothers (Belsky & Rovine, 1990) • Feel like men do not live up to end of the bargain • Most women view partner involvement in domestic work as a sign of love (Levy-Shiff, 1994)

11. Pregnancy - Hers • Typical discomforts • Nausea • Fatigue • Mood swings • Anxiety • Frequent urination / hunger • Trouble sleeping

12. Pregnancy - His • Much anxiety, no support or sympathy • Couvade syndrome – some expectant fathers are nauseous, gain weight, moody and anxious

13. Informed Labor & Birth - Hospitals • The hospital is the safest place to give birth (T or F) • FALSE . No safer for infant than birth centers. • Arguably less safe for mother. C section rate is twice as high in hospital (about 30% of births in hospital) • 95% women in USA today give birth in hospital

14. What is a C – section? • Cesarean section, or c-section, is a major surgical procedure used to deliver a baby through incisions in the walls of the abdomen and uterus.

15. Informed Labor and Birth – C Sections • C Sections are as safe as vaginal births (T or F) • No. 1 unnecessary major surgery • FALSE. 3 times more likely to be fatal to mother • 7 times more likely to have complications to mother • Other countries with equal or better perinatal results have C section rates below 10% • Bonding may be affected because mother is drugged up or in pain; more difficult to begin breastfeeding

16. Common interventions used during labor and birth in hospital • Forceps • Vacuum • Pitocin • Episiotomy

17. Informed Labor and Delivery – Birth Position • The “normal” birth position (lithomy) is conducive to labor and delivery (T or F) • FALSE Upright delivery uses gravity = less pain, more efficient pushing, fewer episiotomies

18. Informed Labor & Birth – Electronic Fetal Monitoring • It’s good to have an electronic fetal monitor during birth to make sure baby is OK (T or F) • FALSE No difference in infant outcome between those monitored and unmonitored • Monitored were 3 times as likely to have C section, also more likely to have interventions • External ones are inaccurate 50% of the time

19. Informed Labor and Delivery – Arrested Labor • Once contractions start they shouldn’t slow down or stop (T or F) • “Friedman curve” applies = In active labor cervix dilates 1 cm per hour • FALSE 20% low risk women do not progress at this rate • Urged to accept interventions

20. Informed Labor and Delivery - Epidurals • Pain relief (usually an epidural) is a “no brainer” (T or F)

21. Informed Labor and Delivery - Epidurals • FALSE. Sharply limits mobility and less efficient pushing • Much greater chance of interventions • Chances for maternal fever increases • Leads to baby tested for and/or treated for problems • Most women report feeling they weren’t informed about risks and side effects and many report feeling pressured to take the drugs

22. Informed Labor and Delivery - Episiotomies • Routine episiotomies should be part of standard care (T or F) • FALSE. Painful, infection risk, slower healing, slower to resume sex, decreased sexual responsiveness, painful sex. • Women who do not have episiotomies are more satisfied with birth experience. • 50 - 80% of first time mothers have them if under OB care, 20 - 30% if midwife

23. Breastfeeding Prevalence • Recommended 6 mo exclusive, 1 year staple by AAP • 60% after 1 week • 27% after 6 months* • 12% after 1 year* *non exclusive

24. Mothers – Negative Stereotypes “Placenta brain” – Pregnancy and lactation make you dumb

25. Are pregnant women’s memories impaired? • Comparing pregnant women to non mothers, findings are mixed • Most research agree they are more distracted • Comparing pregnant women at different times of pregnancy, performance during the last few weeks before delivery on memory tasks is the lowest • Blamed on the peak of estrogen (10 times normal levels)

26. Brain Undergoes Permanent Enhancement • Estrogen – memory, attention, complex tasks • Oxytocin – sociability, calm (“tend and befriend”) • Prolactin - bravery

27. Neurons in Certain Areas are Growing at a Much Faster Rate • The hippocampus, the memory center, has an enormous amount of new neurons and synapses • Rapid growth could lead to “noise” partly accounting for temporary memory deficits • Overall brain size actually decreases usually just a few ounces • Neurogenesis temporarily slows down

28. Perception Smell Hearing Sight Touch Longevity Social awareness Faster learning Motivation Perception Attention Memory Mothers Outperform Nonmothers

29. Breastfeeding Benefits for Baby • Immune system • Supply meets demand (no overfeed) • Easier to digest • Healthy, straight teeth • IQ • Promotes bonding

30. US Fertility Trends • Women having fewer children • 1957- average was 3.6 children • 1990 – average was 2 children

31. 1 Child Families • Pros • More quality time w/ parents • Greater competency in conversation w/ adults • Higher IQ & GPA • Enriched childhood activities • More independent & confident • Cons • Pressure to achieve • More scrutiny • Sibs teach more quickly empathy & cooperation

32. Postponing Parenthood Until 30’s and 40’s • Pros • Financial Stability • Education & Career Achievement • No regrets • Fathers more involved. This correlated with better adjustment and achievement • Less chance of divorce • Greater enjoyment of parenting • Cons • Risk of miscarriage, birth defect • Harder to conceive • Generation gap

33. Non-Marital Pregnancy Trends • 30% of all births are to single mothers • Percentage increasing since 1970’s, but actual numbers are about the same • Birthrates to single moms in 30’s doubled last 15 years • Birthrates to teenage single mom’s is decreasing last 10 yrs • More married women having fewer babies