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

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

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

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

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

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

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

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

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)

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)

Pregnancy - Hers• Typical discomforts

– Nausea– Fatigue– Mood swings– Anxiety– Frequent urination /

hunger– Trouble sleeping

Pregnancy - His• Much anxiety, no

support or sympathy

• Couvade syndrome – some expectant fathers are nauseous, gain weight, moody and anxious

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

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.

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

Common interventions used during labor and birth in hospital

• Forceps

• Vacuum

• Pitocin

• Episiotomy

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

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

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

Informed Labor and Delivery - Epidurals

• Pain relief (usually an epidural) is a “no brainer” (T or F)

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

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

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

Mothers – Negative Stereotypes

“Placenta brain” – Pregnancy and lactation make you dumb

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)

Brain Undergoes Permanent Enhancement

• Estrogen – memory, attention, complex tasks

• Oxytocin – sociability, calm (“tend and befriend”)

• Prolactin - bravery

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

Mothers Outperform Nonmothers

• Perception– Smell

– Hearing

– Sight

– Touch

• Longevity• Social awareness

• Faster learning– Motivation

– Perception

– Attention

– Memory

Breastfeeding Benefits for Baby

• Immune system• Supply meets demand

(no overfeed)• Easier to digest• Healthy, straight teeth• IQ • Promotes bonding

US Fertility Trends

• Women having fewer children– 1957- average was 3.6

children– 1990 – average was 2

children

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

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

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