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Heart failure is an issue for new moms, and doctors need to start listening

When Cathy was 41 weeks pregnant, medical professionals were sure she was developing preeclampsia. Fearful of the complications, they recommended inducing birth, which led to 57 hours in labor, a steady stream of fluids and an eventual C-section.


All of which likely exacerbated the real problem: Cathy had undiagnosed peripartum cardiomyopathy (PPCM), a rare but life-threatening form of heart failure that can develop in the last month of pregnancy or in the first five months postpartum, according to the American Heart Association.

Five days postpartum and unable to catch her breath, Cathy went to the emergency room where the doctor ruled out a heart attack, stroke and pulmonary embolism. Even though blood work revealed an elevated cardiac enzyme and her severely swollen lower extremities should have signaled a problem, Cathy says the doctor was dismissive.

"He looked at the CAT scan and he was like, 'Well maybe you have some mini lung collapses because of the C-section and all the fluid, so just try to take really deep breaths and try to walk more,'" Cathy recalls to Motherly.

During a follow-up with her general practitioner two days later, Cathy says it took just "30 seconds" of listening to her heart for her doctor to determine something was wrong. Back at the hospital, an echocardiogram confirmed the PPCM diagnosis and she was given prescriptions for medications that immediately began helping.

For hundreds of new mothers, the outcome is worse. According to a new study in the journal Circulation: Heart Failure, rising rates of heart failure among postpartum women is contributing to rising maternal mortality rates in the United States—with 26% of pregnancy-related deaths attributable to heart conditions.

Cathy's experience is representative of why this continues to occur: As multiple studies have shown, women are more likely to be misdiagnosed when they are having a cardiac event than men. Much of this is because men's cardiac symptoms often present in the more "typical" way with chest pain or shortness of breath. Meanwhile, women are more likely than men to have symptoms of nausea or to have pain in the neck or back.

"Doctors may be more likely to attribute those symptoms to anxiety than heart disease," said Kim Lavoie, a professor of psychology at the University of Quebec at Montreal and co-author of a 2016 study on the topic. "So, in other words, a diagnostic bias may occur."

This is true across the board for women and especially so among young women—including new mothers—who are not viewed as being at risk for cardiac incidents. But as the recent findings have shown, this is a dangerous assumption.

In her case, Cathy says it seemed medical professionals were too quickly satisfied with the explanation of preeclampsia. "I kept saying, 'We don't have this. It's not what I'm feeling, regardless of what they labs might be saying, this isn't what I'm experiencing,'" she says, explaining her elevated resting heart rate should have signaled there was more at play. "Even if someone just said, 'Let's do an echocardiogram just to check'… We could have left the hospital after the C-section with meds instead of having to figure it out."

Five months out from her diagnosis, Cathy continues to take medication to manage the condition and copes with daily side-effects of fatigue. Still, she says she considers herself lucky that her situation wasn't worse, especially after connecting with a community of PPCM survivors and learning just how dire it could have been if she hadn't advocated for more care.

That's why she's now passionate about raising awareness—and encouraging other families to stand up for themselves if they feel a diagnosis isn't right. Rare as a condition like PPCM may be, she says, "If you know someone who's pregnant, just tell them… this is actually a thing."

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We're a busy people, this family of mine. And we like it that way. But we're still always looking for simple ways to reconnect.

And most of the time, those moments happen around the dinner table.

I'm not embarrassed to admit we've become homebodies—we vastly prefer nights in watching movies and meals at home to the stress and cost of evenings out. While my husband and I still try to schedule a few legit date nights out now and then, by the end of our busy days, we like relaxing at the table as a family, then putting our daughter to bed to spend time together catching up on our shows or watching a movie. Most of our dates happen on the couch, and we're okay with that.

Dinner itself is a tradition I grew up valuing. As one of five kids, it seemed to be the only time our family was really all together, catching up on our days, making plans, or even just being physically present together. (This reminds me so much of the table we would gather around every night!)

Now that I'm my family's connector, I make sure to prioritize that time (even if most nights it's all I can do to get my wiggly toddler to sit still long enough to get a few bites of her dinner).

Whether we're relishing a home-cooked meal or simply noshing some pizza (because mama is tired, folks), nothing can replace the feeling of reconnecting—or leaving the table with satisfied bellies.

Because something strange happens when you have kids. Suddenly, time seems to enter a warp. One day (usually the days when nap time is short and the tantrums are long), time will drag on endlessly, making each minute feel like an hour until my husband gets home and can help with the kids. But most of the time, when I stop and really think about where we are in this busy season of life, I feel like time is flying by.

I look at my daughter, and I feel like someone has snuck in during the night and replaced her with this big-little girl because I swear she was just born a few months ago. I hug my son, unsure where the time has possibly gone because didn't I just take that positive pregnancy test yesterday? And I marvel at this rapidly growing family my husband and I have built because, really, wasn't he just asking me to be his girlfriend a year or two ago? (Try 10, self. That was 10 years ago.)

As fast as time races by, I don't have any answers for how to slow it down. If anything, the pendulum seems to swing quicker and quicker as our days fill with new activities. With jobs and responsibilities, with more and more activities and play dates for the kids.

But at the dinner table, I feel like time slows down enough for me to pause and look at this little family. I imagine us two, five, 10 years down the road (gathering around a table just like one of these). More little (and then not so little) faces peering at me over the table, asking for another piece of bread or more milk as my husband makes them giggle with a silly face or story.

I imagine them as teenagers, telling me about an upcoming test or asking if they can borrow the car after dinner. I even see them as adults, coming back to visit with their own kids for the occasional family dinner. (Hey, a mom can dream, right?)


No matter where life takes us—or how quickly—I'm grateful for this time and this place where we can always come back together.

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It's on the walls of OB-GYN offices and maternity wards, and on the lips of friends, family and sometimes even strangers in the formula aisle. At times it's all a new mama can hear, even when she's sitting in silence with her thoughts.

When it comes to infant feeding, there is no phrase mothers hear more often than "breast is best" but new research, experts and moms who've lived a different truth say that while this message is amplified with the best intentions, new mamas need a lot more than those three words.

A recently published study, "The best of intentions: Prenatal breastfeeding intentions and infant health," suggests that there is a high societal cost to simplifying the the cultural conversation around infant feeding into a three-word slogan.

The study found that moms who intended to exclusively breastfeed but ended up using formula had children with health outcomes similar to exclusively breastfed infants. They also, in many cases, have a lot of undue guilt.

A mom's perspective

When Nicole Rivet-Barton welcomed her first child nearly four years ago she fully intended to breastfeed, but it was a struggle from the start.

"My expectation for myself was that my body would provide what it needed for my baby and when that didn't happen and I had to accept that and transition [to supplementing with formula] I felt like I was failing somehow," Rivet-Barton tells Motherly.

"I felt like less of a person," she explains, adding that whenever she had to have an encounter with a medical professional that wasn't her regular family doctor, she felt judged. On more than one occasion nurses chided her for bottle feeding, telling her "breast is best" without knowing those words were already never far from her thoughts.

"It wasn't the 'best' that I could give her. She was still hungry. My breast milk didn't have what she needed to grow properly," she says.

With the help of a breastfeeding support group and a lactation consultant, Rivet-Barton was eventually able to shift her mindset from "breast is best" to "you do you" and says she felt lighter for it.

"We went to a lactation consultant to help get my milk up and she basically said to me one day, 'You're going to pick your path and you're going to do what's right for your baby. Don't feel guilty.' And I guess I heard her that day, and I let it go," she recalls.

A lactation consultant who doesn't say "breast is best"

Leigh Anne O'Connor is an International Board Certified Lactation Consultant in private practice. She's not the lactation consultant Rivet-Barton turned to, but she certainly shares the same views when it comes to acknowledging that infant feeding can't be boiled down to three-word slogans.

"I've never embraced that phase, 'breast is best' or 'fed is best.' They're both divisive terms. It creates a division in parenting and it creates conflict," she says. In place of catchphrases, O'Connor advocates for a more nuanced, thoughtful conversation on the topic.

She believes we can have individual and cultural discussions that both normalize breastfeeding and encourage parents to get their baby fed in the way that works for them, whether it's through nursing, pumping, using donor milk or formula.

"It's complicated. It's not one size fits all," she says. "Breastfeeding isn't always all or nothing, and there's a place for supplementation."

When "you do you" is best

For Rivet-Barton, supplementing allowed her to keep breastfeeding as much as she could for six months after both of her daughters were born.

She says that by the time her second daughter came along, she felt more confident in her parenting choices, and gave herself a lot more grace when it came to her infant feeding choices.

"I got into my stride and got confident enough to listen to my gut and not other people," she tells Motherly, adding that she wishes medical professionals and society would use more than three words when trying to educate new parents about infant feeding. "Give them options without putting expectations on them," she suggests.

More research and more support needed 

There is a massive body of research suggesting that breastfeeding is great for babies. That's not in dispute at all. But the researchers behind that recently published study suggest that the link just isn't as simple as "breast is best."

"Our results suggest that formula offers similar health benefits for our relatively advantaged sample of infants, once we take prenatal intentions into account," the study's authors note.

The research suggests that moms like Rivet-Barton really have nothing to feel guilty about.

The authors—Kerri M. Raissian, an Assistant Professor in the Department of Public Policy at the University of Connecticut and Jessica Su, an assistant professor in University at Buffalo Department of Sociology—explain that it's not actually the intention to breastfeed that makes the health difference, but rather the fact that mothers who intended to breastfeed often have a certain kind of privilege: They're the mothers who have more access to medical care and therefore more access to information about infant health.

Raissian and Su suggest that instead of amplifying the phrase "breast is best" and potentially overstating the benefits of breastfeeding, society would do better to give mothers the support they need during pregnancy and beyond.

This means making sure that everyone has access to perinatal care, and the kind of parental leave that makes it possible to breastfeed in the first place.

"The U.S. is the only developed country with no federal paid parental leave, and only about 12 percent of mothers in the private sector have access to paid leave," Su explains. "Paid maternity leave likely increases breastfeeding success, and also seems to have additional health benefits for mothers and infants. If we have concerns about disparities in infant health we need social policies that support these recommendations and also go beyond simply encouraging breastfeeding over formula."

Breastfeeding is great, but maybe "support for mothers" would be a better three-word slogan.

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It happens to the best of us. Even to the GOAT. When you have a baby it's so easy for your home to just fill up with brightly colored plastic. Just ask Serena Williams.

Her 1-year-old daughter Alexis Olympia Ohanian Jr.'s things seem to be taking over the house, as Williams shared with her Instagram followers.


"Sometimes I have to throw my hands up in the air. #thismama used to have a living room. Now I just have a play room. When did that happen?" she captioned the relatable pic.

We've all been there, Serena. As Motherly's minimalism expert, Juli Williams, previously wrote, when so many kind family and friends gift your child with playthings, it's easy to forget where the toys taking over the living room even came from.

"By the time my daughter was 8 months old she had so many toys that we had filled two huge chests with them," she explains. "Plus the activity gym, bouncy seat, swing and walker that were sitting in our living room. Oh, and don't forget the bag of bath toys hanging to dry in our bathroom tub."

The clutter began to get to Williams, who was tired of picking up toys her daughter wasn't even playing with. When she got rid of almost all of her toys, she found herself "more at peace, with less to clean" and she noticed her daughter was playing more with the toys she did have.

Williams isn't the only one to notice this: Scientists have, too.

As Motherly reported last year, researchers at the University of Toledo found that toddlers play longer and more happily when there are fewer toys around. Their study involved setting toddlers up in a room with either four or 16 toys. It turned out, the kids with just four toys engaged "in longer periods of play with a single toy, allowing better focus to explore and play more creatively."

Bottom line: You don't have to sacrifice your living room (and your sanity) to bright bits of plastic when you become a mama. If you're overwhelmed by the number of toys in your space, your baby probably is, too.

If you are feeling the same way Serena is, consider Team Motherly's tips for keeping toys from taking over:

1. If you're moving soon, don't take all those toys 

When Motherly's co-founder, Elizabeth Tenety, packed up her playroom for an interstate move, she didn't bring 75% of the toys to her new house. She had the same problem as Serena, and didn't want to bring it with her.

"Our playroom was often unusable because—you guessed it!—the toys were E-V-E-R-Y-W-H-E-R-E and all over the floor, all the time. (No room to play.)," Tenety previously wrote.

Before the big move, she donated a ton of toys and found it has been "absolutely incredible to see the impact of living with radically less—on me, our home, and especially our kids."

2. Consider packing even if you're not moving 

Take a look at your living room or play room (wherever the toys replicate in your home) and consider what you would bring with you if you were moving (even if you're absolutely not).

Pack up anything you wouldn't take, and move it to Goodwill or another charity.

3. Prioritize experiences over material goods 

As our children grow, they're going to remember the memories we make together—not the toys cluttering up the house. If you can let grandparents and aunties in on this secret, you can keep your living room from looking like Serena's.

When Tenety decluttered her kids' toy stash, she asked her family not to gift the kids with any more toys, suggesting a weekend at grandpa's house, some art supplies or swimming lessons would be more meaningful.

Minimalism expert Juli Williams did the same. "For my daughter's second Christmas, we asked our family to gift us a registration to a toddler class instead of toys—and my daughter loved it," she previously wrote. "I took photos at the class and sent them to our family every week to show them the exciting new things she was learning—and so they truly understood that it was a gift that kept on giving."

4. Consider a no-toy Christmas this year

For a lot of families, a pile of toys under the Christmas tree is a holiday tradition, but more and more parents (including Mila Kunis and Ashton Kutcher) are opting for no-toy Christmas celebrations.

Motherly's own Rachel Gorton has also opted for this minimalist tradition. "Christmas in our household represents so much more than toys under the tree. I don't want our children to be distracted from the real reason we celebrate this holiday by a shiny new toy they don't need," she previously wrote.

"I want them to learn about giving without the concept being tied only to possessions in their mind. I want them to understand that giving doesn't always come in the form of an object."

Like Kunis and Kutcher, (and Tenety and Williams) Gorton emphasizes meaningful gifts and gifts of experience in her family's holiday rituals. Serena might want to hop on this trend, too.

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As the royal tour of Australia continues, it seems the Duchess of Sussex is feeling some jet lag—but it's not necessarily from traveling.

During a visit to Bondi Beach to participate in an "anti-bad vibe circle" with members of the OneWave surf community mental health support group, Markle talked with circle participant Charlotte Connell who is also pregnant, about 23 weeks according to news reports.

Cornell says Markle told her that her own pregnancy has been making her tired, and keeping her up at odd hours. Mamas around the world are nodding in agreement.

"Meghan told me that pregnancy was like having jet lag," Sky News quotes Cornell. "She said she was up at 4:30 a.m. this morning doing yoga in her room as she couldn't sleep."

It's not surprising that (on a two-week tour with a mind-boggling 76 planned engagements) Markle is feeling a bit tired. Fatigue is so common in pregnancy, we hope someone on the tour is making sure Markle can sneak in a nap now and then (seriously, research suggests pregnant women who regularly nap are less likely to have a baby with a low birth weight).

As for being up at 4:30 in the morning doing yoga? Well, if you can't sleep (and so often pregnant mamas-to-be struggle with this) self-care though yoga may be the next best thing.

It's a great way to relax, and a recently published study found working out during pregnancy can cut your labor time down significantly.

Meghan may have pregnancy-induced jet lag, but it sounds like she knows how to take care of herself, something all pregnant mamas should remember to do.

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After one pregnancy, it's easy to be under the impression that you'll know what to expect the next time around. Only, for expectant mama Carrie Underwood, her current pregnancy has been "harder" than she anticipated—and many mamas of multiple kids can relate.

"It's definitely different than the first time," Underwood tells Entertainment Tonight. "When they say every pregnancy is different, it really is."

For Underwood, who recently revealed she experienced three miscarriages before this pregnancy, the new symptoms this time around have taken her off-guard. "I feel like this one is just a little harder on my body for some reason. But it's been really good."

Part of that, of course, may be influenced by the fact she's also spending her days keeping up with her 3-year-old son, Isaiah. Just as Chrissy Teigen also expressed, when you're expecting a baby with an older child in the house, it's simply harder to carve out downtime for yourself. That can make symptoms such as exhaustion and nausea feel that much more intense. (Pro friend tip: Offer to entertain the older child so mama can sneak an afternoon nap once in a while.

)As challenging as that can be, Underwood made the point that expecting a baby with an older sibling around can have perks—even if they still have to sell Isaiah on the idea. "He says he won't change any poopy diapers," Underwood says. "I understand, maybe I can change his mind."

Meanwhile, the family is keeping plenty busy with awards show appearances (and wins) and preparing for a move, which has put Underwood's buying habits on hold. "I haven't bought anything yet, we still have some of the stuff, cribs and stuff from my son, but we'll figure it out," she says. "It'd be pointless to buy it and then move it."

The family has been making plans, though, like deciding on a name for the baby that they are keeping private for now. And after a difficult road to expand the Fisher-Underwood family, she says they are really trying to enjoy the moment by keeping a positive outlook despite the less than positive symptoms.

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