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Spoiler alert: This article refers to plot points in the film Tully.


To some, it's a great piece of cinema, but to others, the portrayal of postpartum depression in Tully isn't entertaining, it's worrisome.

The resulting controversy may do what the film does not: Educate the public about maternal mental health. The recent New York Times coverage proves people are talking about Tully, and that's a good thing, even if the movie didn't live up to some film-goers expectations.

When the Tully trailer came out we at Motherly covered it with excitement. The promotional images seemed to portray the day-to-day struggles of motherhood accurately, in a way we'd never seen on the big screen.

But when Motherly's Digital Education Editor Diana Spalding went to an advanced screening, the tone of our Tully coverage changed. A midwife and pediatric nurse, Spalding had some real concerns about the problematic way the film mislabels postpartum psychosis as the more common postpartum depression. Her review of the film spread beyond our community and went viral, as reported in the New York Times.

"I love that people are talking about it as much as they are. That's a big step towards reducing the silence and stigma around postpartum mood disorders for sure. We need to be able to have open conversations, so this is a great start," says Spalding.

In her review Spalding wrote about how she wished Marlo (a mom of three played by Charlize Theron) got treatment for her postpartum psychosis after experiencing hallucinations and delusions.

In the film, Marlo is diagnosed with postpartum depression, but as Spalding pointed out in her review, the symptoms of that common condition do not include the kind of hallucinations Theron's character experiences. Film-goers see Marlo being (incorrectly) diagnosed with PPD, but they do not ever see her getting help for it. For Spalding, that—and the film's surprise reveal of Marlo's mental illness—are troubling. "I still wish that the movie had shown her receiving treatment and that the trailers alluded to her psychosis- it's potential to be triggering for people is huge and unfair," Spalding says.

Filmmaker Diablo Cody tells the New York Times she made a conscious decision to not consult with any maternal mental health experts before writing the script, which may explain why the mental illness the character experiences is described as depression when it is actually psychosis.

The controversy around the film is amplifying opinions and statements from the kinds of experts Cody did not consult, and that's a good thing. While Spalding is happy to see maternal mental health being talked about on a national level, she says it's important to also remember the smaller, more intimate discussions that aren't being had. "I also worry about the women who don't have the opportunity to have conversations about this topic. I worry that the movie will make them feel like this is just 'how it is' and they have to suffer alone," she says.

If you are suffering from postpartum depression, psychosis, or any kind of perinatal mood disorder, know that you are not alone and you don't have to suffer.

The film ends with a diagnosis, but in real life, a diagnosis is just the beginning of a healing journey. Film-goers are left to assume Marlo gets some help with her mental health, but in real life, we need to make sure mamas do. That's a conversation worth having.

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It's messy, it's fun, and it's a powerful way to teach kids a lesson that will serve them well this school year and all the way into adulthood.

Two years ago mom of two Amy Beth Gardner was preparing her oldest daughter Breonna, now 13, to start middle school the next day when she decided to create a memorable moment for Breonna that has since been replicated by parents all over the world.

"I gave her a tube of toothpaste and asked her to squirt it out onto a plate. When she finished, I calmly asked her to put all the toothpaste back in the tube," Gardner wrote in a Facebook post that has since been shared millions of times.

Of course, Breonna couldn't get the toothpaste back in the tube when her mother surprised her by asking her to. The visual, tactile lesson was her mother's metaphor for something else.

"Just like this toothpaste, once the words leave your mouth, you can't take them back," Gardner wrote.

It's been two years since Gardner posted her plate full of toothpaste to Facebook and went viral, and she's still hearing from fellow parents who are using the lesson to help teach their kids about kindness, sometimes years before middle school even. Gardner often hears from other parents who do the toothpaste ritual with kids much younger than her own and some have wondered why she didn't do it earlier. She says she absolutely would have incorporated this lesson into her daughters' earlier years if she'd had that chance.

"Breonna did not come to us until she was 9 years old," Gardner tells Motherly, explaining that Breonna and her younger sister, Bridgett, now 9 years old herself, first came to live with Gardner and her husband Paul in 2014. The couple fostered the girls for 509 days before adopting them.

Gardner says she's grieved for the experiences she missed with her daughters, like late newborn nights, first steps and the first day of Kindergarten. She doesn't have as many years to prepare her daughters for adulthood as most mothers do, so she's doing her best to make her lessons as impactful as possible. That's where the toothpaste came in.

Amy Beth Gardner with her daughters, Breonna and Bridgett

"We've been really playing catch up to what other parents have been doing, and so, approaching middle school that whole summer we had been having lots of conversations about this transitional time in her life, and it had really come to me that day when I was brushing my teeth that morning," she explains. "I'm sure plenty of people had thought of this before I did, but not I had personally never seen it done. It really just came up."

It came up, and she wrote about the experience on Facebook. Soon, friends were asking her to change the post from private to public so that they could share it. Not long after that, Gardner's post was everywhere. She says she can't even put a number on the amount of messages she's received about that post, but she's thrilled to be helping other parents pass on this important lesson in kindness.

"I think most people can remember a time in their lives when either someone treated them unkindly or, if we're going to be really honest with ourselves, we can all remember a time when we didn't show kindness. So it's a good message I think, no matter what stage of life you're in. I think that's why it resonates with such a wide variety of people," she tells Motherly.

Not the least of which is her own daughter.

"She didn't know where I was going with the toothpaste when I had her squirt it out. And so, I saw the message hit her. I saw it actually take root. She actually had mentioned to me before we were done that 'I think you should do this with me every year before I start school, in case I forget'."

It's fun, it's messy, and it's a back-to-school tradition that's totally worth copying.

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It's a girl for Chanel Iman!

Iman and her husband, New York Giants football player Sterling Shepard, welcomed their daughter into the world on August 10 and called her Cali Clay Shepard. "You were worth every push [and] every contraction," the proud mama captioned an Instagram photo of the happy family.

The popularity of the name Cali has declined since the name peaked in 2014, when it was ranked 201 on the Social Security Administration's list of the most popular baby names. It's since fallen to 288. (The alternative spelling made popular by a character on Grey's Anatomy, Callie, ranks higher, at 188, but also peaked in 2014).

The popularity of her name may be waning, but little Cali herself is already very popular online. She's four days old and her Instagram account already has 7,600 followers.

It makes sense that Cali is already active on Instagram (well, her parents are active on her account) as her mama announced her pregnancy on the platform back on Mother's Day.

Congrats to Iman and Shepard on baby Cali's arrival! We can't wait to see more beautiful baby pictures on Instagram. 🎉

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In many ways, having a baby in Alaska is much the same as in Alabama: All babies need food, love and care. And all parents are responsible for navigating the life transition. But the expense associated with welcoming a baby? That sure does vary widely based on where in the United States the baby is born.

After assessing 26 key metrics—including infant care costs, child care centers per capita, delivery charges and more—data analysts from WalletHub determined Vermont is the most ideal state to welcome a baby in 2018.

On the other end of the spectrum, parents in Mississippi were disadvantaged by the state's higher infant-mortality rates and lower distribution of midwives or OB-GYNs per capita. (Although folks in southern states generally saved the most on average infant-care costs.)

"If local authorities want to attract families in their area—and for a host of societal reasons, it would behoove them—they should continue to strive for greater public safety and more family-friendly environments," Jeff Wallace, a business advisor and assistant professor at Snow College, tells WalletHub.

To make the rankings as credible as possible, the experts at WalletHub divided the 26 measures into four categories: cost, health care, baby-friendliness and family-friendliness. Then each metric was graded on a 100-point scale, with a score of 100 representing favorable conditions, such as low costs or better delivery outcomes.

While the list is focused on the best places to have a baby, experts who weighed in on the findings said there are much longer-term implications. "Children are more likely to be successful when they grow up in communities that feel safe, have families that are connected to each other, and offer support services if the family needs them," says Steven Meyers, Ph.D., Director of Undergraduate Psychology Programs and Initiative for Child and Family Studies at Roosevelt University. "Local authorities can establish these as priorities when they decide how to allocate resources."

Here are the 10 states we should look to for examples:

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As a pregnant mother, it's natural to want to get as much information as you can about anything you're going to put into your body while carrying your baby. Vaccines are one topic moms have a lot of questions about, and American Academy of Pediatrics just released a new study on the safety of the tetanus, diphtheria, and pertussis (Tdap) vaccination widely recommended for pregnant mothers.

The AAP's study found there is no association between a prenatal exposure to the Tdap vaccination and autism spectrum disorder (ASD).

This vaccine is recommended by the Centers for Disease Control for pregnant mothers as a means to protect babies against pertussis, also known as whooping cough, and the AAP backs up the CDC in the new study, recommending the vaccine for pregnant women to protect infants, who are at highest risk for fatal pertussis infection.

Dr. Heather Sankey, an obstetrician and gynecologist practicing at Massachusetts's Baystate Medical Center, previously told Newsweek, the Tdap vaccine is important in pregnancy because it's the only way to protect newborns. "You can't vaccinate children until they are a year old," she says, explaining the baby receives a healthy immunity from the mother's vaccination.

The AAP's retroactive cohort study involved 82,000 children born between 2011 and 2014 at Kaiser Permanente Southern California hospitals.

"Among this cohort of infants the prevalence of ASD was 1.6%, which is comparable to the U.S. autism rates," Tracy A. Becerra-Culqui, one of the study's authors, explains in a video abstract posted by the AAP. "Our results show that the Tdap vaccine administered in pregnancy is not associated with an increased risk of ASD in infants."

"You can see the results are consistent across birth years and among those who were first born," she continues.

One of two recommended immunizations for pregnant people

The Tdap vaccine is one of two immunizations recommended during every pregnancy, along with the inactivated influenza vaccination, according to the American Congress of Obstetricians and Gynecologists (ACOG).

The ACOG recently released a new, straightforward set of pregnancy immunization guidelines to to clarify the rules around which immunizations expecting mothers should get and when, noting that "there is no evidence of adverse fetal effects from vaccinating pregnant women with inactivated virus, bacterial vaccines or toxoids, and a growing body of data demonstrate the safety of such use."

"Our goal was to increase vaccination rates among pregnant women and make it easier for providers to routinely prescribe them," Dr. Laura Riley, one of the guide's authors and chair of the ACOG immunization work group, told Newsweek.

Beyond Tdap and the flu shot, other vaccines may be recommended at the discretion of the woman's health care provider on the basis on the mother's age, previous immunizations, disease risk factors or chronic conditions.

The immunizations for measles-mumps-rubella and varicella (which are live vaccines) are not to be administered during pregnancy, but may be given postpartum even among breastfeeding mothers.


Why Tdap is recommended

The AAP notes that cases of pertussis have risen over the last decade, and according to the Centers for Disease Control and Prevention (CDC), half of the babies infected with whooping cough must be treated in the hospital and there are fatalities every year.

The AAP says evidence has shown that when moms get the Tdap shot while pregnant, "antibodies are passed along to newborns and that the vaccine was 91.4 percent effective in providing some immunity until newborns reached 2 months of age."

Knowing that there is no association between a prenatal exposure to the Tdap vaccination and autism may mean more mothers get the shot, which could mean fewer newborns will be hospitalized.

[Update, August 14, 2018: This post was originally published July 9, 2018, but has been updated to reflect the American Academy of Pediatrics new study, "Prenatal Tetanus,Diphtheria, Acellular Pertussis Vaccination and Autism Spectrum Disorder," published online Aug. 13 ]

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