Every time there is a shift in our culture, it usually means that women have to manage more tasks to keep the household running. And so it follows, women are working harder during this pandemic.

“More Work For Mother: The Ironies of Household Technology From The Open Hearth To The Microwave,” by Ruth Schwartz Cowan is one of those iconic writings that remains relevant, even in the midst of a pandemic. Women, even those who have partners, but especially those who are heads of households have been left strung out by the dizzying amount of house work that they alone must do.

Food preparation—breakfast, snack, lunch, snack, dinner, snack, and finally dishes—swallows swaths of time. Remote learning means that paid work or needed rest is often interrupted. And let’s not forget about the damn laundry! Social isolation means that caretakers or help from family is not available. And, even when a partner is available, the “homemaker” is still targeted for these additional chores.

A recent New York Times article described the results of a survey about housework and outlined what we already knew—-men believe that they contribute more that they actually do!

Before this is further cemented as the norm, delegate specific tasks to everybody in the house.

To start, never confuse self-care with selfishness. Second, delegating effectively means giving up on the notion of perfection.

Children, six and above, can expertly navigate the Ipad, Nintendo switch, and Zoom. Also, they can’t wait to get back to soccer practice and swim meets. Which means they can run down the stairs to put clothes in the washer and press a few buttons. There are lots of tools on how to assign chores to children, including verywellfamily.com and parents.com, for example. Make a chart, assign age appropriate tasks, and dedicate a period of time to do the chores together before cutting the umbilical cord.

The same thing follows with the dishes, someone else can load and press buttons, it doesn’t always have to be you. But don’t sit, pout and stew in resentment. Ask for what you need and be specific, “I need you to load the dishwasher, turn on the machine, wipe down the counter, and sweep the floors.”

For this to work, let go of the Superwoman Syndrome. Resolve to let go of bad stress. Send the teenager or partner to the grocery store with a list, and don’t freak out if they buy the wrong brand. It really does not make a difference if they buy Prego instead of Ragu.

In the long run, everybody will appreciate what it takes to keep a house running. They will wonder how you have managed to do it all by yourself. More importantly, you will have acted to preserve your health and peace of mind.

There you have it. Spread the word.

~Juliet_MD~

The post Women Are Working Harder During This Pandemic appeared first on Below The Belly Button.

We will not weather the pandemic, or this period of social unrest, unless we sleep. Without sleep, we will eat more unhealthy foods, drink too much alcohol, and will be persistently irritable and angry.

1 of 3 Americans do not get enough sleep.

The average person needs 7 hours of sleep. There are many ill effects of not getting enough rest. Without enough rest, heart disease, diabetes, and stroke will lurk in your future. Also, depression and psychosis are two other illnesses that are caused by sleep debt. And if you’re not worried about going crazy, you should worry about gaining weight. We eat more when we are tired. The hunger hormone, ghrelin, is released when we don’t sleep, leading to overeating. That craving for ice-cream may just be a call to get some rest! And, let’s not forget that tired people do not have good sex.

Take action. Take sleep seriously. 

“Sleep is about the preservation of life itself.”

Start with these tips:

Avoid alcohol. Besides the dehydration that is shaken into any good cocktail, alcohol interferes with the ability to sleep deeply.

Turn off the lights. Our culture of always being “on” is a major disruptor of our circadian rhythm, our natural sleep cycle. Our bodies should ideally rest and wake in tandem with sunrise and sunset. When its dark, Melatonin, the “hormone of darkness,” is released. This biochemical signals the body to relax. The bright lights, the television, the computer, and the phones, all interfere with how the body naturally prepares for sleep.

Exercise. Exercise is one of the best ways to release stress from the body, and movement also releases endorphins, “feel good” hormones that will help you to relax.

Why We SLEEP

Practice good sleep hygiene. Go to bed! You’re are better able to problem-solve and concentrate if you have had a good nights’ sleep. If you are totally exhausted, it’s better to get up early to finish that project, than to stay up late in an attempt to force your brain to work.

The American Academy of Sleep Medicine sponsors a great website: Sleep Education. This is a great resource to learn about specific sleep issues like shift work, sleep apnea, snoring, jet lag, etc.

We are living in what is, for many of us, the most tumultuous period of our lives. Sleep right, eat right, and exercise. We will get through this, in one piece, if you take care of yourself.

There you have it. Now spread the word.

~Juliet_MD~

1.“The Science of Sleep”, National Geographic, August 2018

The post Good Sleep, Better Health appeared first on Below The Belly Button.

I cringe at the mere mention of the words Home Birth. As much as I don’t want to offend the exceptional nurse midwives who provide this approach, and do not want to belittle the exercise of self-determination by mothers who choose this route, I worry about the risk. Multiple studies have clearly demonstrated that the baby is at greater risk of injury or death when delivered at home. That fact alone makes home births–scary. 

Home Births Pose Greater Risks

Between 2010 and 2017, almost 14 newborns for every 10,000 live births died following planned home births – that’s more than four times the rate for babies born in hospitals.

Last Friday I had what would have been considered the perfect home birth candidate–young, thin, no medical problems, and had a previous successful vaginal delivery with no problems. For the first 12 hours she labored with no intervention but she did not dilate. Still, we decided to give it more time–we were patient, counting on her pelvis to do what it did with her first baby, give way. But, at 6:30am in the morning, on day 2, when the baby’s heart rate slowed and did not recover, we got her into the operating room and got that baby out in 4 minutes. That’s the difference. When nature takes a turn for the worst, how far away are you from help?

Many people counter, “well women have been having babies for centuries.” Ah, did we forget about all the mothers and babies who died in childbirth? Childbirth can be dangerous, for both mother and child. As an obstetrician, my job is not just to stand there and watch the baby slide out–like poop. Women bleed, women get horrendous lacerations that have to be repaired in the operating room, babies get hurt, and babies die.

Birth Centers

Midwives have a different approach to birth and it is really beautiful. This is often not a question of who did the delivery. Ask the question: is the mid-wife certified? And, did that person undergo training to manage complications?It is always a question of where the delivery takes place. How far and how long will it take you to get help if you need it?  I have been on the receiving end of the drive-by-the-emergency-room-and-dump-the-patient-and-leave. It’s always sad, and usually lends to a devastating outcome.

Birthing centers offer the setting that allows women to feel “at home.” And, most of them (always check) have a tested system whereby they a) have a relationship with the doctors at the hospital, and b) have a tested, and efficient, way of getting mothers to the hospital, if it looks like there is going to be a problem. Check with the American Association of Birth Centers (AABC) for certified centers near you. 

Don’t hand over control of your birth experience to someone else, other than Mother Nature. (You should read “What you can do to avoid a c-section.”) Do be completely informed about the risks and benefits of a home birth by asking the critical questions.

There you have it. Spread the word

~Juliet_MD~

The post Home Births appeared first on Below The Belly Button.

Cesarean births dates back to the sixteenth century. Its use, then and now, has saved the lives of countless babies and mothers. But now, one in three babies are delivered via cesarean-section.

What one hospital is doing to reduce the number of cesareans was printed in the Chicago Tribune.

The procedure is considered major abdominal surgery with its attendant risks of bleeding and infection.  The procedure is an essential tool used by obstetricians, but the vaginal route offers a shorter recovery.

Here are three ways to exert some influence on how your baby comes into the world:

Wait for labor to ensue. In a recent study, Dr. Deborah B. Ehrenthal, et. al. cited that women who underwent an induction were twice as likely to end up with a cesarean-section than those who waited for active labor. And, for first time mothers who were induced, 1 in 5 landed on the operating table. Understandably, by the time women get to about 37 to 38 weeks, many doctors cave in to requests to “Please, get this baby out!” Instead of watching the pot boil, get a manicure, spend time with friends, go to the movies or get some sleep.

Schedule fun events for yourself that don’t include pints of ice cream. When you gain weight, your baby gains weight. If a baby is estimated to weigh close to or more than 9 lbs, most obstetricians will offer a c-section, and rightfully so. If there is concern that a vaginal birth cannot take place without significant injury to either party, a c-section is the best route. Too much weight gain also increases the chance of complications, like diabetes and pregnancy induced hypertension (PIH). Dr. Robert H. Debbs, Director of Pennsylvania Hospital Maternal Fetal Medicine Network, was asked to comment, “Weight is a major predictor of whether or not someone will have a cesarean-section. Patients who are overweight are simply at higher risk for adverse outcomes.”

Your obstetrician can provide these guidelines on how much weight you should gain. Although, genetics do play a role in how much the baby weighs, eating right and exercising before and during your pregnancy may just keep the scalpel at bay. Don’t diet. Instead, focus of developing a healthy lifestyle that you can pass on to your son or daughter.

Third, weigh your options, having had one cesarean-section does not mean that the next baby must be delivered the same way. Talk to your doctor about TOLAC (trial of labor after c-section). Sixty to eighty per cent of women who attempt VBAC (vaginal birth after c-section ) are successful! Speak up and ask questions.

There you have it. Now spread the word!

The post What You Can Do to Avoid a Cesarean appeared first on Below The Belly Button.