What parents need to know from Joe Biden’s town hall
Joe Biden/Facebook.

It was supposed to be another debate, but Joe Biden stood alone on a stage in Philadelphia tonight, talking to the American people on ABC as his opponent, President Donald Trump, did the same on NBC.

If you were watching NBC (or didn't watch either of the candidates because you were busy getting children fed and to bed) don't worry, we were watching for you.

Biden took the stage just hours after the campaign announced that Kamala Harris' communications director and a member of the campaign's flight crew had tested positive for COVID-19. Biden and Harris both tested negative before tonight's event, which was held under strict health and safety measures to prevent any potential spreading of COVID-19.

Here's what you need to know about Vice President Biden's town hall:

Joe Biden on the pandemic 

With a small group of Pennsylvania voters in attendance—a mix of Democrats, Republicans and undecided voters—the first set of questions addressed the coronavirus pandemic, and the lack of coordinated federal action.

Asked what "following the science" means to him in terms of policy measures that could help contain the pandemic, Biden argued that the President was informed early on about what scientists said about the virus, but consistently played down its seriousness.

Biden, who said he meets several times per week with members of the scientific community for debriefings, said that he had created detailed plans for reopening schools and businesses that he published in a series of op-eds earlier this year.

"He missed enormous opportunities," Biden said, referring to President Trump's response to the pandemic, and to the lack of progress on testing and tracing nationwide. "It is a Presidential responsibility to lead, and he didn't do that," Biden says. "He kept worrying about the stock market."

Questioned about how he would contain the pandemic without crushing the economy, Biden said, "You can open businesses and schools if you provide them with the guidance that they need, and with the money that they need to do it."

Biden's response highlighted the importance of aid for schools during the pandemic. "We need more teachers in our schools to be able to open smaller pods. We need ventilation improvements. And we need them now."

Asked by a 2016 Trump voter if he would take a vaccine if it became available, Biden said, "If the body of scientists say that this is what is ready to be done, I would encourage people to take it." But Biden pointed out a lack of transparency within the current administration about a realistic timeline for a vaccine, and the lack of planning around vaccine distribution.

"There should be a plan for when we get the vaccine, how will we distribute it," Biden said.

Asked if he would mandate the vaccine, he said it would depend on the efficacy of the vaccine and how distributable it was, stating that he would work with local and state governments on encouraging and enforcing widespread vaccination.

Joe Biden on taxes 

Asked about extending tax cuts for the middle class—and whether tax cuts in a pandemic would be wise—Biden didn't explicitly say he would extend tax relief, but confirmed his plan not to raise taxes on anyone making under $400,000.

Under Biden's plan for the economy, corporations and taxpayers making over $400,000 per year would be taxed at a slightly higher rate, creating billions in tax revenue without needing to raise taxes for the middle class.

Joe Biden on racial equality

Asked by a young Black student what he would say to Black voters under the age of 30 who are conflicted about voting because they are reluctant to participate in a system that they feel doesn't represent or reflect them, Biden's response focused more on policy changes than addressing systemic racism or progressive reforms in the criminal justice system.

Biden's priorities included a range of policies from expanding health care to creating economic supports to funding educational programs, focusing on putting the African American community in a position to create wealth (seriously, he said "it's about accumulating wealth" like five or six times).

Among the policies Biden listed: Supporting public health programs that address mental health and addiction, funding early education programs, funding and supporting HBCUs in order to create career opportunities, support for first-time home buyers, support for Small Business Associations to create opportunities for Black entrepreneurs.

"Have you heard what you need to hear?" moderator George Stephanopolous asked the young voter.

"I think so," was the response—although the young man's expression was a bit dubious.

When asked about the 1994 crime bill he supported that resulted in disproportionate impacts on African Americans, Biden said, "We have to change the system," expressing his support for community policing, as opposed to "swarming in armored Humvees."

"Most cops don't like bad cops," Biden pointed out, but are reluctant to report systematic problems within departments. Biden pledged to create a task force composed of leaders in the BIPOC community along with law enforcement to address racial discrimination in law enforcement.

Joe Biden on the environment

Asked if he would ban fracking, and what environmentally sustainable energy sources he supports, Biden was clear that he is not in favor of banning fracking, but proposes regulation to make sure it's done within certain guidelines.

Biden set himself in contrast to the "Green New Deal" championed by Congresswoman Alexandria Ocasio-Cortez and others, instead proposing investing in technologies to create and distribute energy more efficiently, support agricultural innovations to reduce the environmental impact of industrialized farming, and stop subsidizing oil companies in favor of investing in sustainable energy.

Joe Biden on trans rights 

When a mother asked Biden what he would do to protect her transgender child and protect LGBTQ rights, the former vice president told her: "I will flat-out just change the law. Eliminate those executive orders, number one."

Biden discussed how trans women of color are especially at risk in the United States and how a high number of trans women have been killed just this year. Biden says trans rights are important to his family, noting that his late son Beau helped protect trans people through legislation.

A stark contrast to the Trump town hall 

The contrast between Joe Biden's conversation with ABC's George Stephanopoulos and President Trump's conversation with NBC's Savannah Guthrie was stark.

While Trump and Guthrie sparred on one feed, Biden and Stephanopoulos conversed on the other. The tone was gentler, kinder and less divisive. And that was no accident.

Joe Biden was as calm as the President was combative, telling the American people: "If I'm elected president, you will not hear me race-baiting, you will not hear me dividing, you'll hear me try to unify and unify with—bring people together."

[Editor's note: Motherly is committed to covering all relevant presidential candidate plans as we approach the 2020 election. We are making efforts to get information from all candidates. Motherly does not endorse any political party or candidate. We stand with and for mothers and advocate for solutions that will reduce maternal stress and benefit women, families and the country.]

<p> Siobhan Adcock is the Experts Editor at Motherly and the author of two novels about motherhood, <a href="https://www.siobhanadcock.com/" target="_blank">The Completionist</a> and <a href="https://www.siobhanadcock.com/the-barter" target="_blank">The Barter</a>. Her writing has also appeared in Romper, Bustle, Ms., McSweeney's, Slate, Salon, The Daily Beast, The Chicago Review of Books and elsewhere. She lives in Brooklyn with her husband and daughter. </p>

Kristen Bell and Jackie Tohn on how they’re ‘sneak teaching’ kids with their new show "Do, Re & Mi"

The best friends created a musical animated show that's just as educational as it is entertaining

Amazon Studios

This episode is sponsored by Tonies. Thank you for supporting the brands that support Motherly and mamas.

Kristen Bell and Jackie Tohn have been best friends since they met as young singers and actors more than 15 years ago, and now they're collaborating on a new Amazon Original animated kids series called Do, Re & Mi. The show, which follows best birds Do, Re and Mi as they navigate the world around them while also belting out catchy tunes, is just as educational as it is entertaining.

On the latest episode of The Motherly Podcast, Bell and Tohn talk to Motherly co-founder Liz Tenety about how they're "sneak teaching" kids with their new show and why music is such an important focal point.

"It was basically our mission from the very beginning to 'sneak music education' into kids' lives, hands, brains, all of it," Tohn admits.

"There's so much science and data to support that [music] helps kids, their brains grow with math, with social skills. It literally can change your neuroplasticity. You can put music of their favorite genre or timeframe on, in an Alzheimer's ward, and they will come back online for a couple minutes. I mean, it's crazy," Bell, who has two daughters of her own, adds. "You know, music can bind a lot of families together. It can bind friendships together. And it's just a show that you can feel really good about. We want to get it in front of as many kids as possible, because I don't like the fact that some kids won't have exposure to music. Their brains deserve to grow just as much as everyone else's."

The first season of Do, Re & Mi premiered on September 17th and its creators recorded 52 different songs for the show that range from reggae and pop to country, blues and jazz.

"That's what's so exciting about this show," Tohn gushes. "Not only are the lessons we're teaching for everyone, but every episode has a musical genre, a musical lesson and an emotional lesson. And so there really is so much to learn."

Elsewhere in the episode, Bell tells Tenety about how she made literal toolboxes that carry different regulation tools to help her kids calm down (one is "find a song you love and sing out loud") and why having a village is crucial to surviving motherhood, especially in a pandemic, while Tohn details her special friendship not only with Bell, but with her daughters, too.

To hear more about the show, Bell's experiences in motherhood, and her enduring friendship with Tohn, listen to The Motherly Podcast for the full interview.

Entertainment

12 baby registry essentials for family adventures

Eager to get out and go? Start here

Ashley Robertson / @ashleyrobertson

Parenthood: It's the greatest adventure of all. From those first few outings around the block to family trips at international destinations, there are new experiences to discover around every corner. As you begin the journey, an adventurous spirit can take you far—and the best baby travel gear can help you go even farther.

With car seats, strollers and travel systems designed to help you confidently get out and go on family adventures, Maxi-Cosi gives you the support you need to make the memories you want.

As a mom of two, Ashley Robertson says she appreciates how Maxi-Cosi products can grow with her growing family. "For baby gear, safety and ease are always at the top of our list, but I also love how aesthetically pleasing the Maxi Cosi products are," she says. "The Pria Car Seat was our first purchase and it's been so nice to have a car seat that 'grows' with your child. It's also easy to clean—major bonus!"

If you have big dreams for family adventures, start by exploring these 12 baby registry essentials.

Tayla™️ XP Travel System

Flexibility is key for successful family adventures. This reversible, adjustable, all-terrain travel system delivers great versatility. With the included Coral XP Infant Car Seat that fits securely in the nesting system, you can use this stroller from birth.


Add to Babylist

$849.99

Iora Bedside Bassinet

Great for use at home or for adventures that involve a night away, the collapsible Iora Bedside Bassinet gives your baby a comfortable, safe place to snooze. With five different height positions and three slide positions, this bassinet can fit right by your bedside. The travel bag also makes it easy to take on the go.


Add to Babylist

$249.99

Kori 2-in-1 Rocker

Made with high-quality, soft materials, the foldable Kori Rocker offers 2-in-1 action by being a rocker or stationary seat. It's easy to move around the home, so you can keep your baby comfortable wherever you go. With a slim folded profile, it's also easy to take along on adventures so your baby always has a seat of their own.


Add to Babylist

$119.99

Minla 6-in-1 High Chair

A high chair may not come to mind when you're planning ahead for family adventures. But, as the safest spot for your growing baby to eat meals, it's worth bringing along for the ride. With compact folding ability and multiple modes of use that will grow with your little one, it makes for easy cargo.


Add to Babylist

$219.99

Coral XP Infant Car Seat

With the inner carrier weighing in at just 5 lbs., this incredibly lightweight infant car seat means every outing isn't also an arm workout for you. Another feature you won't find with other infant car seats? In addition to the standard carry bar, the Coral XP can be carried with a flexible handle or cross-body strap.


Add to Babylist

$399.99

Pria™️ All-in-One Convertible Car Seat

From birth through 10 years, this is the one and only car seat you need. It works in rear-facing, forward-facing and, finally, booster mode. Comfortable and secure for every mile of the journey ahead, you can feel good about hitting the road for family fun.


Add to Babylist

$289.99

Pria™️ Max All-in-One Convertible Car Seat

Want to skip the wrestling match with car seat buckles? The brilliant Out-of-the-Way harness system and magnetic chest clip make getting your child in and out of their buckles as cinch. This fully convertible car seat is suitable for babies from 4 lbs. through big kids up to 100 lbs. With washer-and-dryer safe cushions and dishwasher safe cup holders, you don't need to stress the mess either.


Add to Babylist

$329.99

Tayla Modular Lightweight Stroller

With four reclining positions, your little ones can stay content—whether they want to lay back for a little shut-eye or sit up and take in the view. Also reversible, the seat can be turned outward or inward if you want to keep an eye on your adventure buddy. Need to pop it in the trunk or take it on the plane? The stroller easily and compactly folds shut.


Add to Babylist
$499.99

Tayla Travel System

This car seat and stroller combo is the baby travel system that will help make your travel dreams possible from Day 1. The Mico XP infant seat is quick and easy to install into the stroller or car. Skipping the car seat? The reversible stroller seat is a comfortable way to take in the scenery.


Add to Babylist
$699.99

Modern Diaper Bag

When you need to change a diaper during an outing, the last thing you'll want to do is scramble to find one. The Modern Diaper Bag will help you stay organized for brief outings or week-long family vacations. In addition to the pockets and easy-carry strap, we love the wipeable diaper changing pad, insulated diaper bag and hanging toiletry bag.


Add to Babylist

$129.99

Mico XP Max Infant Car Seat

Designed for maximum safety and comfort from the very first day, this infant car seat securely locks into the car seat base or compatible strollers. With a comfy infant pillow and luxe materials, it also feels as good for your baby as it looks to you. Not to mention the cushions are all machine washable and dryable, which is a major win for you.


Add to Babylist
$299.99

Adorra™️ 5-in-1 Modular Travel System

From carriage mode for newborn through world-view seated mode for bigger kids, this 5-in-1 children's travel system truly will help make travel possible. We appreciate the adjustable handlebar, extended canopy with UV protection and locking abilities when it's folded. Your child will appreciate the plush cushions, reclining seat and smooth ride.


Add to Babylist
$599.99

Ready for some family adventures? Start by exploring Maxi-Cosi.

This article was sponsored by Maxi-Cosi. Thank you for supporting the brands that support Motherly and mamas.


Boost 1

This incredibly soft comforter from Sunday Citizen is like sleeping on a cloud

My only complaint? I've slept through my alarm twice.

When it comes to getting a good night's sleep, there are many factors that, as a mama, are hard to control. Who's going to wet the bed at 3 am, how many times a small person is going to need a sip of water, or the volume of your partner's snoring are total wildcards.

One thing you can control? Tricking out your bed to make it as downright cozy as possible. (And in these times, is there anywhere you want to be than your bed like 75% of the time?)

I've always been a down comforter sort of girl, but after a week of testing the ridiculously plush and aptly named Snug Comforter from Sunday Citizen, a brand that's run by "curators of soft, seekers of chill" who "believe in comfort over everything," it's safe to say I've been converted.


Honestly, it's no wonder. Originally designed as a better blanket for luxury hotels and engineered with textile experts to create this uniquely soft fabric, it has made my bed into the vacation I so desperately want these days.

The comforter is made up of two layers. On one side is their signature knit "snug" fabric which out-cozies even my most beloved (bought on sale) cashmere sweater. The other, a soft quilted microfiber. Together, it creates a weighty blanket that's as soothing to be under as it is to flop face-first into at the end of an exhausting day. Or at lunch. No judgement.

Miraculously, given the weight and construction, it stays totally breathable and hasn't left me feeling overheated even on these warm summer nights with just a fan in the window.

Beyond being the absolute most comfortable comforter I've found, it's also answered my minimalist bed making desires. Whether you opt to use it knit or quilted side up, it cleanly pulls the room together and doesn't wrinkle or look unkempt even if you steal a quick nap on top of it.

Also worth noting, while all that sounds super luxe and totally indulgent, the best part is, it's equally durable. It's made to be easily machine washed and come out the other side as radically soft as ever, forever, which totally helps take the sting out of the price tag.

My only complaint? I've slept through my alarm twice.

Here is my top pick from Sunday Citizen, along with the super-soft goods I'm coveting for future purchases.

Woodland Snug comforter

Sunday-Citizen-Woodland-Snug-comforter

The bedroom anchor I've been looking for— the Snug Comforter.

$249

Braided Pom Pom Throw

Because this degree of coziness needs portability, I'm totally putting the throw version on my list. It's washable, which is a must-have given my shedding dog and two spill-prone kiddos who are bound to fight over it during family movie night.

$145

Lumbar pillow

sunday-citizen-lumbar-pillow

What's a cozy bed without a pile of pillows?

$65

Crystal infused sleep mask

sunday citizen sleep mask

Promoting sleep by creating total darkness and relaxation, I've bookmarked as my go-to gift for fellow mamas.

$40

We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.

Shop

10 Montessori phrases for kids who are struggling with back to school

The first day of school can be hard for everyone, mama. Here's how to use the Montessori method to help your child adjust.

No matter how excited your child was to pick out a new lunchbox and backpack this year, there will likely be days when they just don't want to go to school. Whether they're saying "I don't like school" when you're home playing together or having a meltdown on the way to the classroom, there are things you can say to help ease their back-to-school nerves.

More than the exact words you use, the most important thing is your attitude, which your child is most definitely aware of. It's important to validate their feelings while conveying a calm confidence that school is the right place for them to be and that they can handle it.

Here are some phrases that will encourage your child to go to school.


1. "You're safe here."

If you have a young child, they may be genuinely frightened of leaving you and going to school. Tell them that school is a safe place full of people who care about them. If you say this with calm confidence, they'll believe you. No matter what words you say, if your child senses your hesitation, your own fear of leaving them, they will not feel safe. How can they be safe if you're clearly scared of leaving them? Try to work through your own feelings about dropping them off before the actual day so you can be a calm presence and support.

2. "I love you and I know you can do this."

It's best to keep your goodbye short, even if your child is crying or clinging to you, and trust that you have chosen a good place for them to be. Most children recover from hard goodbyes quickly after the parent leaves.

If your child is having a hard time saying goodbye, give one good strong hug and tell them that you love them and know they can do this. Saying something like, "It's just school, you'll be fine" belittles their feelings. Instead, acknowledge that this is hard, but that you're confident they're up to the task. This validates the anxiety they're feeling while ending on a positive note.

After a quick reassurance, make your exit, take a deep breath and trust that they will be okay.

3. "First you'll have circle time, then work time, and then you'll play on the playground."

Talk your child through the daily schedule at school, including as many details as possible. Talk about what will happen when you drop them off, what kinds of work they will do, when they will eat lunch and play outside, and who will come to get them in the afternoon.

It can help to do this many times so that they become comfortable with the new daily rhythm.

4. "I'll pick you up after playground time."

Give your child a frame of reference for when you will be returning.

If your child can tell time, you can tell them you'll see them at 3:30pm. If they're younger, tell them what will happen right before you pick them up. Perhaps you'll come get them right after lunch, or maybe it's after math class.

Giving this reference point can help reassure them you are indeed coming back and that there is a specific plan for when they will see you again. As the days pass, they'll realize that you come consistently every day when you said you would and their anxieties will ease.

5. "What book do you think your teacher will read when you get to school this morning?"

Find out what happens first in your child's school day and help them mentally transition to that task. In a Montessori school, the children choose their own work, so you might ask about which work your child plans to do first.

If they're in a more traditional school, find an aspect of the school morning they enjoy and talk about that.

Thinking about the whole school day can seem daunting, but helping your child focus on a specific thing that will happen can make it seem more manageable.

6. "Do you think Johnny will be there today?"

Remind your child of the friends they will see when they get to school.

If you're not sure who your child is bonding with, ask the teacher. On the way to school, talk about the children they can expect to see and try asking what they might do together.

If your child is new to the school, it might help to arrange a playdate with a child in their class to help them form strong relationships.

7. "That's a hard feeling. Tell me about it."

While school drop-off is not the time to wallow in the hard feelings of not wanting to go to school, if your child brings up concerns after school or on the weekend, take some time to listen to them.

Children can very easily be swayed by our leading questions, so keep your questions very general and neutral so that your child can tell you what they're really feeling.

They may reveal that they just miss you while they're gone, or may tell you that a certain person or kind of work is giving them anxiety.

Let them know that you empathize with how they feel, but try not to react too dramatically. If you think there is an issue of real concern, talk to the teacher about it, but your reaction can certainly impact the already tentative feelings about going to school.

8. "What can we do to help you feel better?"

Help your child brainstorm some solutions to make them more comfortable with going to school.

Choose a time at home when they are calm. Get out a pen and paper to show that you are serious about this.

If they miss you, would a special note in their pocket each morning help? If another child is bothering them, what could they say or who could they ask for help? If they're too tired in the morning, could an earlier bedtime make them feel better?

Make it a collaborative process, rather than a situation where you're rescuing them, to build their confidence.

9. "What was the best part of your school day?"

Choose a time when your child is not talking about school and start talking about your day. Tell them the best part of your day, then try asking about the best part of their day. Practice this every day.

It's easy to focus on the hardest parts of an experience because they tend to stick out in our minds. Help your child recognize that, even if they don't always want to go, there are likely parts of school they really enjoy.

10. "I can't wait to go to the park together when we get home."

If your child is having a hard time saying goodbye, remind them of what you will do together after you pick them up from school.

Even if this is just going home and making dinner, what your child likely craves is time together with you, so help them remember that it's coming.

It is totally normal for children to go through phases when they don't want to go to school. If you're concerned, talk to your child's teacher and ask if they seem happy and engaged once they're in the classroom.

To your child, be there to listen, to help when you can, and to reassure them that their feelings are natural and that they are so capable of facing the challenges of the school day, even when it seems hard.

Back to School

It’s Science: *Not* having postpartum sex is a sign of a great relationship

The more supportive your partner is while you are pregnant, the less sex you might have postpartum.

kirillvasilevcom/Twenty20

It's an understatement to say that being pregnant adds a whole new dimension to a relationship. Needs and desires develop and grow as fast as your belly. Supporting each other through all those changes and challenges can bring partners closer together. And then having a baby changes everything… including sex.

There can be a lot of pressure to bounce back postpartum, both physically and sexually. But it's more realistic—even adaptive—not to resume having sex as much as before.


Some couples might worry that a lack of sex after baby will take a toll on their relationship—especially since a having less sex before having kids might be an indication that something could be awry. But given the overwhelming lack of sleep and amount of fatigue involved in recovering, feeding your baby, adjusting to being parents, plus trying to avoid causing pain while your body heals, it can be seriously difficult to get in the mood.

The reality is that making and birthing a baby is such a transformative physical and emotional experience that it's bound to affect your sex life with your partner after birth. A recent study indicates that even when you have a strong bond with your partner before you deliver your baby, a decline in how often you have sex after baby arrives doesn't necessarily mean there's something wrong with your relationship—in fact, just the opposite.

Defining a 'healthy' relationship

Researchers at the University of Nebraska's Department of Psychology and Center for Brain, Biology and Behavior had a hunch that there may be something about being pregnant and becoming a parent that changes how you might typically associate your relationship quality and how often you have sex. So they set out to determine if having a healthy relationship while pregnant would predict less sex after postpartum.

To do this, they interviewed and observed changes in relationship quality and sexual frequency from pregnancy to 6 months postpartum among 159 heterosexual first-time-parent couples. The researchers measured four elements of a healthy relationship to determine the couples' relationship quality:

  • How well they cooperated in supporting each other
  • How well they communicated with each other
  • How well they responded to each other's stress
  • How well they demonstrated intimacy via love and affection toward each other

Turns out that when partners provided each other with emotional intimacy, mutual support, and effective communication during pregnancy, they actually did have less sex postpartum.

Although the study's findings may help to alleviate some postpartum relationship concerns, there are a few limitations to keep in mind:

  1. Participation in the study was limited to heterosexual couples who self-reported their reationship quality and sexual frequency.
  2. Changes in sexual frequency was limited to partnered sexual activity and did not include masturbation.
  3. Participants were mostly middle class couples, which could indicate that, if under greater stress or financial hardship, and independent of the quality of their relationship, there could be an even greater decline in sexual frequency postpartum because of the greater need to rebalance available resources.

It's about the trade-off in reproductive interests

Blame biology: By having less sex postpartum, you decrease the chances of getting pregnant again and avoid investing in a new baby while your current child is still so dependent, which improves your little one's chances for survival. Additionally, the potential costs of having postpartum sex—like pain or infection—are also reduced while you are healing.

In terms of evolution, having less sex postpartum might actually reflect a normal and healthy adjustment to the new realities of life after birth and indicate a successful adaptation to parenthood. Biologically, we are hardwired for these postpartum changes in sexuality as well. During pregnancy and postpartum, neural and cognitive adaptations of brain regions involved in reward and maternal motivation and behaviors can make you less responsive to sexual stimulation—and more responsive to your baby.

Less sex after birth is normal

It's normal for most couples to gradually have less sex during pregnancy and throughout the first year postpartum.

After birth, healing and adjustments to parenthood, it usually takes about a year to catch up to prepregnancy sexual frequency. The expectation to bounce back as quickly as possible after giving birth to sexual frequency at pre-pregnancy levels can add unnecessary stress to an already challenging time. It's time we end the internalized bounce-back pressure—and instead, normalize having less sex postpartum.

Sources:

Ahlborg T, Dahlöf LG, Hallberg LR. Quality of the intimate and sexual relationship in first‐time parents six months after delivery. Journal of Sex Research. 2005 May 1;42(2):167-74. doi:10.1080/00224490509552270

Geary DC. "Evolution of paternal investment" in The Evolutionary Psychology Handbook eds D. M. Buss. 2015. Hoboken, NJ: John Wiley & Sons, 483–505. doi: 10.1002/9780470939376.ch16

Gregory R, Cheng H, Rupp HA, Sengelaub D, Heiman JR. Oxytocin increases VTA activation to infant and sexual stimuli in nulliparous and postpartum women. Horm. Behav. 2015. 69, 82–88. doi: 10.1016/j.yhbeh.2014.12.009

Jawed-Wessel S, Sevick E. The impact of pregnancy and childbirth on sexual behaviors: A systematic review. The Journal of Sex Research. 2017 Jun 13;54(4-5):411-23. doi:10.1080/00224499.2016.1274715

Kim P, Leckman JF, Mayes LC, Feldman R, Wang X, Swain JE. The plasticity of human maternal brain: longitudinal changes in brain anatomy during the early postpartum period. Behavioral Neuroscience. 2010 Oct;124(5):695. doi: 10.1037/a0020884

Lehtonen J, Jennions MD, Kokko H. The many costs of sex. Trends Ecol. Evol. 2012. 27, 172–178. doi: 10.1016/j.tree.2011.09.016

Litzinger S, Gordon KC. Exploring relationships among communication, sexual satisfaction, and marital satisfaction. Journal of Sex & Marital Therapy. 2005 Oct 1;31(5):409-24. doi: 10.1080/00926230591006719

Lorenz TK, Ramsdell EL, Brock RL. A close and supportive interparental bond during pregnancy predicts greater decline in sexual activity from pregnancy to postpartum: Applying an evolutionary perspective. Frontiers in Psychology. 2020 Jan 10;10:2974. doi:10.3389/fpsyg.2019.02974

Mitnick DM, Heyman RE, Smith Slep AM. Changes in relationship satisfaction across the transition to parenthood: a meta-analysis. Journal of Family Psychology. 2009 Dec;23(6):848. doi:10.1037/a0017004

Muise A, Kim JJ, Impett EA, Rosen NO. Understanding when a partner is not in the mood: sexual communal strength in couples transitioning to parenthood. Arch. Sex. Behav. 2017. 46, 1993–2006. doi: 10.1007/s10508-016-0920-2

Schlagintweit HE, Bailey K, Rosen NO. A new baby in the bedroom: Frequency and severity of postpartum sexual concerns and their associations with relationship satisfaction in new parent couples. The Journal of Sexual Medicine. 2016 Oct 1;13(10):1455-65. doi: 10.1016/j.jsxm.2016.08.006

Its Science

Experts warn that acetaminophen is NOT considered safe in pregnancy

An international group of experts warn that the risks to the developing fetus may include reproductive and behavioral disorders.

Lordn/Getty Images

If you're pregnant and you have a headache or a fever, Tylenol (acetaminophen) has long been at the top of the already short list of over-the-counter medications generally regarded as safe for both mothers and fetuses.

However, according to a study published in September 2021 in the journal Nature Reviews Endocrinology, mounting research shows that "prenatal exposure to acetaminophen might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders."


Signed by 91 scientists from across the U.S., the U.K., Canada, Australia, Brazil, Scotland and Europe, a consensus statement published in the same journal draws a hard line, recommending that "pregnant women should forgo acetaminophen use unless medically indicated."

I've taken Tylenol during both my pregnancies. Many of my mom friends have taken it during their pregnancies. I'm sure my own mother took it when she was pregnant with me.

Doctors and midwives often fall back on Tylenol when pregnant women come to them looking for pain relief. But now, that's no longer a failsafe protocol.

Potential risks to the fetus from Tylenol in pregnancy

Performing a review of the most recent literature, the researchers found that acetaminophen exposure during pregnancy may be associated with reproductive and neurobehavioral abnormalities in both boys and girls.

In boys, exposure may increase the risk of reproductive abnormalities, including a higher risk of undescended testicles, and a reduced distance between the anus and the base of the penis, (termed the anogenital distance). Both of these factors may indicate "altered masculinization" and the potential for other reproductive disorders later in life.

In girls, prenatal acetaminophen exposure is associated with early puberty.

In both sexes, studies suggest exposure might increase the risk of attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, language delay and decreased intelligence quotient (IQ).

Figure 1 from Paracetamol use during pregnancy — a call for precautionary action.

More research is needed to assess the timing, duration and dosage of acetaminophen usage, but numerous animal studies also back up these findings.

In rats, fetal exposure to acetaminophen has been shown to also cause reproductive disorders, reduced fertility later in life and changes in cognitive function and behavior.

Figure 2 from Paracetamol use during pregnancy — a call for precautionary action.

It's unclear at what dosage Tylenol is harmful, but the strongest negative effects were observed with long-term use of acetaminophen (more than 2 weeks). If you happen to take it once or twice during your pregnancy at the minimum dose, you're much less likely to see such drastic repercussions.

Tylenol use is widespread

Acetaminophen is one of the most commonly used medications around the world—and it's often used in the general population without even a second thought. It's included in hundreds of other medications, including cough syrups, flu medicines, allergy medicines and sleep aids. It's often presumed benign, even though it's one of the major contributors to liver disease in the U.S. each year, writes doctor and midwife Aviva Romm, MD on a blog post about the safety of Tylenol in pregnancy.

Approximately 65% of pregnant women in the U.S. are estimated to have used Tylenol, and globally, more than 50% of pregnant women are expected to have used it (where it's widely known as paracetamol). Those statistics are also probably underreported. "One study showed that when asked about pharmaceutical use, many pregnant women did not report [acetaminophen] unless specifically asked," note the researchers.

The authors of the study acknowledge that acetaminophen "is widely considered to be the safest option for relief of pain and fever in pregnancy." And in fact, it's often the only option touted by healthcare professionals for their pregnant patients.

The researchers cite acetaminophen as an endocrine disruptor, saying it is known to "readily cross the placenta and blood-brain barrier," making its way to the fetus—with potentially harmful effects.

Now, given the growing body of evidence, it's time for increased awareness. The consensus statement calls on regulatory agencies, obstetrics and gynecological associations and healthcare providers to review the most recent research and reconsider their recommendations.

But where does that leave pregnant women dealing with pain in the meantime?

Pregnant women need pain management solutions

Clinical trials on the pregnant population are notoriously lacking (not without reason—performing studies on pregnant women can be ethically fraught), and pain during pregnancy is especially understudied. However, we do know that severe pain during pregnancy, left untreated, could have dangerous consequences for the mother, including an increased risk of anxiety, depression and high blood pressure.

And if you happen to get a fever above 100.4º during pregnancy, reducing it is your best course of action, as prenatal fever is associated with an increased risk of neural tube defects and cardiovascular disorders in the fetus.

But other pain management options are limited—or nonexistent. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen come with an increased potential risk of miscarriage in the first half of pregnancy, as well as birth defects. Aspirin carries a risk of bleeding risks, and opioids come with serious risks of birth defects in the brain, spine or spinal cord.

More research—and more options—are needed.

Pregnant women should avoid acetaminophen

The study's authors outlined a specific course of action, recommending that women be advised pre-pregnancy or early in pregnancy with the following guidance:

  • Pregnant women should forgo acetaminophen use unless medically indicated.
  • Pregnant women should consult with their physician or pharmacist if they are uncertain whether use is indicated and before using on a long-term basis.
  • Pregnant women should minimize risk by using the lowest effective acetaminophen dose for the shortest possible time.

This is a major departure from the previous guidance of acetaminophen as generally accepted as safe. But if you've used Tylenol in a previous pregnancy, don't lambast yourself with mom guilt—you did the best you could with the information you had at the time.

"The chances are, statistically speaking, still low that this will have any impact on your baby. And for fever and significant pain, it's still considered the safest prenatal option. But we can't just assume it's safe and it can have an impact, so the goal is to avoid it when you can and keep your duration of use as brief as possible," writes Dr. Romm on her blog.

What to take instead of Tylenol during pregnancy

If the idea of even taking one Tylenol pill gives you pause, know that there are a few alternative remedies safe for pregnancy that can be used for mild pain. For fever reduction, however, given the potentially dire consequences of high, prolonged fever itself during pregnancy, taking a Tylenol to reduce the fever is still probably your safest option—talk to your doctor to discuss details.

Headache reduction alternatives:

  • Hydration: In some cases, a headache is the body's way of signaling that you're dehydrated. Try upping your water intake, or sipping some cold coconut water, which packs in electrolytes.
  • Protein and fat: You could be missing key nutrients in your diet—try rounding out your meals and snacks with more protein and plant-based fats to balance blood sugar.
  • Magnesium: Taking 400 to 800 mg/day of magnesium glycinate or citrate can help relieve tension headaches and improve the stress response.
  • Massage: Neck and shoulder massage can help release tension and reduce the resulting headaches.
  • Stress management: Deep-breathing techniques may help reduce stress-based headaches.

Be sure to get your midwife or doctor's tips on headache management, too, and to discuss the frequency and duration of the headaches you're experiencing. If a headache comes on suddenly and severely, or you experience any vision changes, call your care provider right away.

But ultimately, as the study's authors state, "A balance must be struck between potential harm to pregnant people and/or their fetuses from untreated pain and fever, and the increased risks of harm to the fetus from medications." When thinking about using Tylenol or any other medication during pregnancy, it's all about the risk-benefit analysis. But being more informed about the risks can make a significant difference when you're weighing the scales.

Sources:

Bauer AZ, Swan SH, Kriebel D et al. Paracetamol use during pregnancy—a call for precautionary action. Nat Rev Endocrinol. 2021. doi:10.1038/s41574-021-00553-7

Caution needed: paracetamol use in pregnancy. Nat Rev Endocrinol. 2021. doi:10.1038/s41574-021-00567-1

F.D.A. Safety Announcement: Drug Safety Communications. FDA has reviewed possible risks of pain medicine use during pregnancy. January 9, 2015.

Womens Health