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Postpartum doulas are the support system all new mothers need

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When we look back through history it is rare to find cultures where a mother's extended family and community did not support her during the perinatal period, but the modern emphasis on independence and individualism has changed that.

Many of us do not have a built-in social support network to help us in those difficult days of early motherhood. A new mom in 2019 may find her close relatives live on the other side of the country, and she doesn't know her neighbor's names. Or, she may be surrounded by people who would love to support her—but simply don't have the experience or time to be of service to her.

This is why we need more postpartum doulas and why more women should have access to them.

Like birth doulas, who help a mother during birth, postpartum doulas aim to empower and support mothers during a vulnerable time in their lives.

They are part lactation consultant, part baby-whisperer, part parenting coach and part therapist, and they can help new parents feel less alone and more confident as their lives change so drastically. But getting a postpartum doula to help you through the fourth trimester can be expensive. As Today recently reported, in America, the cost of hiring a doula "varies from state to state and most people pay out of pocket." It can be thousands of dollars, a cost too high for many families.

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But in America and other western nations where mothers no longer have that built-in community, women are hoping to make doula services more accessible, and suggest we need to stop acting like hiring a doula is akin to hiring a housekeeper and incorporate the service into health care funding. "It seems like a luxury, but for many cultures it [postnatal care] was just a necessity, and I think we need to start looking at it like that too," Shelley McClure, a postnatal doula and educator in Australia tells ABC News.

One of McClure's clients, Taycee-Lee Jones, decided to pay for a postpartum doula after welcoming her fourth baby. Paying McClure to help her wasn't a luxury. It was what she needed to do to survive as her partner had to go back to work quickly. "We don't have that support that we used to have from our community. We don't have sisters and aunties all coming to provide that support," she says. "Shelley as a postpartum doula, came around, brought food, did my dishes, gave me a foot rub, checked in with how I was doing," she explains, suggesting that the kind of in-home care she received from Shelley could help prevent postpartum depression and should be standard.

Shannon Sproule, a postpartum doula with Full Circle Birth Collective in Edmonton, Canada, agrees. She tells Global News her packages start at $120 for one four-hour session of in-home postpartum care. She recognizes that not everyone can afford that, and believed the future of postpartum care needs to include access to doulas through public programs.

"I think as the medical community starts to awaken to the idea that this is a really vulnerable time for parents and we need to support them better and more frequently during the 12 weeks postpartum, it will become more accessible," Sproule explains.

Access to postpartum doulas in America by state

If postpartum doulas are seen as a luxurious out-of-pocket expense in countries like Australia and Canada (both of which have universal healthcare schemes) can American parents hope to see these practitioners become more accessible?

Actually, yes. Some parts of America have seen real momentum when it comes to giving more women access to doulas.

This is really good news because research shows that the women who would most benefit from having a doula are often those who can least afford it. Oregon and Minnesota already permit Medicaid coverage for doula services, New York has a pilot program in action, Milwaukee is planning to provide doulas to 100 vulnerable new mothers and a bill has been submitted in Rhode Island to get the ball rolling in that state.

"Doula services are needed more than ever given that the experience of childbirth in the U.S. is increasingly lonely and medicalized," Helen Kim, a perinatal psychiatrist and director of the Mother-Baby Program at Hennepin County Medical Center told the Star Tribune. "In our current system, with more isolated families, distant extended families, and more fragmented communities, pregnant and postpartum mothers and fathers can easily feel isolated and overwhelmed with the task of caring for their baby."

The Dutch model of postpartum care

In America (and other western nations including Canada and Australia) most women who have one are paying out of pocket for postpartum doulas, but in the Netherlands, a remarkably similar service—with the added benefit of medical expertise—is standard, and as Quartz reports, costs families just over $5 USD per hour as the rest is covered by health insurance.

In the Netherlands parents aren't visited by a postpartum doula, but a kraamverzorgster, or home maternity nurse who comes by for a few hours each day for up to 10 days after the baby's birth. These nurses help parents with the basics of babies: feeding, changing, swaddling and bathing, but they can also help mom with lactation issues, screen for depression and do things like bring over food and do a load of laundry.

"All parents deserve support to get through that difficult first week," Linda Leijdekker, a Dutch pediatric nurse who specializes in child development tells Quartz.

American women are creating change

As the New York Times reports, back in America activists are changing mothers' lives by providing postpartum doula care at low or no cost. Doula collectives are popping up across America to connect low-income families and women of color to invaluable support in the most vulnerable season of life.

But these postpartum services are often provided by other low-income women who are basically volunteering their time, and as Collier Meyerson reports for New York Magazine, even when American doulas are being paid through programs like the ones in New York or Minnesota, they're often not being paid a living wage.

Bottom line: Mothers need postpartum care. It's not a luxury, and it also can't be provided at the expense of other working women. Our society has evolved in a way that removed mothers' support systems and now we have to figure out a way to build a new one.

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Sometimes it can feel like toys are a mama's frenemy. While we love the idea of entertaining our children and want to give them items that make them happy, toys can end up taking the joy out of our own motherhood experience. For every child begging for another plastic figurine, there's a mama who spends her post-bedtime hours digging toys out from under the couch, dining room table and probably her own bed.

Like so many other moms, I've often found myself between this rock and hard place in parenting. I want to encourage toys that help with developmental milestones, but struggle to control the mess. Is there a middle ground between clutter and creative play?

Enter: Lovevery.

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Lovevery Play Kits are like the care packages you wish your child's grandparent would send every month. Expertly curated by child development specialists, each kit is crafted to encourage your child's current developmental milestones with beautiful toys and insightful activity ideas for parents. A flip book of how-tos and recommendations accompanies each box, giving parents not only tips for making the most of each developmental stage, but also explaining how the games and activities benefit those growing brains.

Even better, the toys are legitimately beautiful. Made from eco-friendly, sustainable materials materials and artfully designed, I even find myself less bothered when my toddler leaves hers strewn across the living room floor.

What I really love, though, is that the kits are about so much more than toys. Each box is like a springboard of imaginative, open-ended play that starts with the included playthings and expands into daily activities we can do during breakfast or while driving to and from lessons. For the first time, I feel like a company isn't just trying to sell me more toys―they're providing expert guidance on how to engage in educational play with my child. And with baby kits that range from age 0 to 12 months and toddler kits for ages 13 to 24 months, the kits are there for me during every major step of development I'll encounter as a new mama.

So maybe I'll never love toys―but I will always love spending time with my children. And with Lovevery's unique products, mixing those worlds has become child's play.


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

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A lot of women are literally walking around in fashion mogul Jessica Simpson's shoes, but there was no way she was going to be getting her feet into any of the footwear with her name on while she was pregnant.

A few months ago, back when she was still super pregnant with her third child, Simpson posted a photo of her left foot on Instagram and honestly, just looking at it was painful.

"Any remedies?! Help!!!!" she captioned the pic of her incredibly swollen ankle and foot. Thankfully, now that she's in her fourth trimester and no longer pregnant, Simpson's feet have chilled out. She posted a new pic with the caption: "I spy....my ankles!!!!

Before + after

The commenters on Instagram are now as happy for Jessica as they were were as shocked back when she posted the first foot photo.

"Omg Jessica call your Dr. Keep feet up lower salt intake and no heels," one wrote (although the last bit seems like it probably wouldn't be an option even if she wanted to wear them).

Calling the doctor is not a bad idea if your foot look's like Simpson's before photo, because swelling during pregnancy can be a sign of preeclampsia, according to the Preeclampsia Foundation, which notes that "a certain amount of swelling is normal during pregnancy," but suggests that moms-to-be watch out for "pitting edema" (which means that when you press on the skin an indentation stays for a bit) and leg discoloration.

"If you suspect this kind of edema, notify your healthcare provider. You should also put your feet up every day, but avoid sitting for extended periods of time," the foundation states on its website.

What mamas need to know about swollen feet

Simpson took her swelling with a sense of humor, posting a before and after pic of some super high wedges and her swollen pregnancy foot with the caption #tenyearchallenge, but swelling can be serious in pregnancy.

It can be related peripartum cardiomyopathy a rare kind of heart failure that can develop in the last month of pregnancy or in the first five months postpartum, but, according to the the American Heart Association, isn't easy to diagnose as the symptoms (like swollen ankles) are also symptoms of third trimester pregnancy.

So swelling is something to watch and definitely talk to a health care provider about—but it also happens in many uncomplicated pregnancies, as a lot of Jessica's IG followers pointed out. "That happened to me with my 1st pregnancy. Lots of elevation for my feet and fluids. Watch the sodium intake. Hang in there," one mama wrote, throwing in a 💞 emoji.

Jessica Simpson just launched a collection of flats 

Another commenter offered a funny story to put Jessica at ease: "My feet looked like this the last month of my pregnancy (if not worse) and I had normal BP and didn't have preeclampsia. I'm 5'0" and retained so much water. My OB-GYN at the time (a 65 year old man) told me that I had what he called "Fiona feet"....yep, the ogre from Shrek. Yep. 🤦🏼♀️ Needless to say, I switched doctors after my daughter was born."

Jessica Simpson's shoe collection currently includes a wedges, booties and a gorgeous stacked stiletto, and she recently launched a collection of flats, which should be helpful to all the mamas-to-be who have swollen feet (although not as swollen as hers were, she should design an extra-wide slipper for that season of life).

[A version of this post was originally published January 11, 2019. It has been updated.]

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When Carrie Underwood and her husband, hockey player Mike Fisher, welcomed their second child, Jacob, back in January we were thrilled for her, because the road to motherhood hasn't been easy for the country singer.

"I put a lot of stress on myself — I feel like a lot of moms do, a lot of women do," she recently told People. According to Underwood, "the best moments in my life are when I say, 'Hey, I can't control everything, and that's okay."

There are so many things we can't control, including pregnancy loss. In a candid interview with CBS Sunday Morning, Underwood revealed that her second pregnancy wasn't really her second pregnancy. In the two years prior, Underwood had been pregnant three other times. She suffered multiple miscarriages in a short period of time, and it was hard.

She poured herself into her work 

"I'd kind of planned that 2017 was, you know, going to be the year that I work on new music, and I have a baby. We got pregnant early 2017, and didn't work out," she explains, adding that she got pregnant again in the spring of 2017 and again suffered a pregnancy loss. Another positive pregnancy test and another devastating loss followed in early 2018.

"So, at that point, it was just kind of like, 'Okay, like, what's the deal? What is all of this?'" Underwood recalls.

She says she poured herself into her work because she couldn't just sit around thinking about it.

"Literally right after finding out that I would lose a baby, I'd have a writing session," she explains. "I would literally have these horrible things going on in my life, and then have to go smile and, like, do some interviews or, like, do a photo shoot or something, you know? So it was just kind of, like, therapeutic, I guess."

It's okay to feel blessed and mad

Underwood says she recognizes that she has a pretty great life: "I have an incredible husband, incredible friends, an incredible job, an incredible kid."

And that's exactly why it was hard for her to allow herself to feel angry about the lost pregnancies. She feels so blessed in other parts of her life, but one night, when her husband Mike was away, the tears came while she was snuggling with her sleeping son, 3-year-old Isaiah.

"I don't know how I didn't wake him up, but I was just sobbing," Underwood recalled, noting that she prayed about the situation that night.

"That was like a Saturday – and the Monday I went to the doctor to, like, confirm, another miscarriage. And they told me everything was great!"

Underwood's story is one so many women can relate to. Miscarriages are really common, but they can feel so lonely because they're not talked about enough. It's okay to be angry is this happens to you, and it's okay to talk about it.

Underwood's experience is common

A recent review of scientific literature on the subject suggests miscarriage is the "the predominant outcome of fertilisation" and "a natural and inevitable part of human reproduction at all ages," ScienceAlert reports.

That research, written by evolutionary geneticist William Richard Rice of the University of California, follows other studies which suggest as many as 25% of pregnancies end in miscarriage.

"It is not an abnormality," Rice told New Scientist. "It's the norm."

Those kind of stats may not be comforting to those going through the kind experience Underwood had, but it is helpful to know we're not alone.

By speaking out about her experience, Underwood is helping other women who are going through the same thing. She's letting others know that it's okay to be angry, it's okay to cry, and it's also okay to have hope.

"They were hard. And it sucked so much! But things are looking better," she says.

Welcoming Jacob Bryan Fisher 

Finally, in January 2019, Underwood and Fisher welcomed baby Jacob to the family.

"Jacob Bryan Fisher entered the world in the wee hours of the morning on Monday," Underwood captioned several Instagram photos.

"[H]is mom, dad and big brother couldn't be happier for God to trust them with taking care of this little miracle! Our hearts are full, our eyes are tired and our lives are forever changed. Life is good..." she wrote.

"He's just this perfect little bundle of a smiley guy," she recently told People. Baby Jacob, big brother Isaiah and their dad have all joined Underwood on the bus for her Cry Pretty 360 arena tour. She decribes the chaos as "a big awesome mess," and explains that since she's busy prepping and performing, Fisher is on baby duty all the time, changing diapers and just being an amazing dad.

We are so happy for this family of four.


[A version of this story was originally published September 16, 2018. It has been updated.]

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Class Lessons

Need a way to make your kids really, really, really happy? Here's some news that just might do the trick: Every child's favorite song is hitting a stage near you for a 100-city live tour. Yes, we're talking about "Baby Shark."

Baby Shark Live! is coming to more than 100 U.S. and Canadian cities soon, with tour dates to be announced on July 9, 2019.

We know what you're thinking. How can a single song (epic as it may be) sustain a whole show? Well, there will be other songs performed too. Your kids can also rock out to favorites like "Five Little Monkeys," "Wheels on the Bus," "Jungle Boogie" and "Monkey Banana Dance."



The show will be produced by Pinkfong (which is the South Korean firm that brought us the tune in the first place) in partnership with Round Room Live. It promises to provide an immersive experience for kids like the live Pinkfong performances that are already happening in other parts of the world.


This represents the song's next step towards total world domination: In addition to becoming a total musical sensation among children everywhere, there's already a "Baby Shark" TV show in the works — chalk it all up the fact that there's a scientific reason why this song is always (always, always) stuck in your head.

Interested in taking your children to see this phenomenon come to life? You can buy tickets here.

The first leg on the tour will be announced on July 9, and we'd recommend acting fast. If through-the-roof YouTube views are any indication, this show is going to sell out faster than you can sing the iconic "doo-doo-doo-doo-doo-doo" line!

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News

In recent years lawmakers across America have been implementing policies meant to protect working mothers who breastfeed or pump at work. State by state, labor and building codes are changing to help pumping mothers get out of bathrooms, and at the federal level, the Fair Labor Standards Act (FLSA) covers basic accommodations and break times for working, nursing moms.

But not every working mother in America is covered by the FLSA's Break Time for Nursing Mothers law and even some who should be protected by the FLSA find their working environment is not complying with the law, and unfortunately, many Americans are unbothered by this.

According to a new survey from Aeroflow released this week, while 90% of Americans believe women should be allowed to pump at work, 46% of men and 24% of women don't think police and fire stations, construction sites and even schools should be required to have lactation rooms for first responders, teachers and the workers who are literally building society.

The survey suggests that while Americans support working, breastfeeding moms in theory, support is lacking in practice. In fact, in two-thirds of cases when breastfeeding mothers point out when they are being discriminated against they ultimately lose their jobs.

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This according to a report by the Pregnancy Accommodation Working Group, an initiative of the Center for WorkLife Law at the University of California, Hastings College of the Law, which tracked the outcomes of breastfeeding discrimination legal cases filed by workers over the last decade.

"Breastfeeding discrimination is widespread and can have devastating consequences for women and their families" says Liz Morris, a co-author of the report. "Despite a patchwork of laws giving legal rights to breastfeeding employees, millions still do not have the basic legal protections they need. Workers are losing their jobs to feed their babies," she continues.

The report highlights a few very concerning gaps in breastfeeding protections: Many workers in some predominantly female-professions, like nursing and teaching, find themselves exempt from the federal legal protections for breastfeeding workers. And things aren't necessarily easier if you're in one of the male-dominated professions.

Women are underrepresented in the ranks of law enforcement and other first responders, but women in these male-dominated fields are over represented in the number of breastfeeding discrimination claims, filing about 46% of them."Our community helpers, like first responders and teachers, have given so much to us–yet we haven't even given them the basic breastfeeding time and space they deserve" says Jessica Lee, a co-author of the report.

Moms let down by policy and employers

Simone Teagle is a New York City police officer who came back from a three month maternity leave with the intention of pumping for her son. She says pumping in a non-private break room was tough—a co-worker compared her to a cow—but often having to go for nine hours without pumping at all was tougher. She says she was harassed when she tried to take breaks to pump. Not pumping resulted in painful mastitis, and Teagle eventually took legal action and was reassigned to another precinct, according to news reports.

In many other cases, women who complain and raise the issue in the hopes of advocating for themselves and those who come after them don't get reassigned, they get terminated or forced out.

Kate Frederick was working at the New Hampshire Department of Health and Human Services when her son was born in 2012. He would not take a bottle, but she felt lucky to find a day care right across the street from her office. "I totally assumed that since it was Health and Human Services and all that it wouldn't be a problem to feed him at his daycare. I didn't anticipate any resistance," Frederick says.

But she did face resistance. Despite having a doctor's note (and despite the fact that other employees left the office during breaks to run to Dunkin' Donuts) she says her supervisor said no. She says she was also told she couldn't nurse her baby in the office lactation room, as it was intended for pumping, not nursing. Eventually Frederick was fired. She took legal action, and her case is scheduled to go before a jury in September 2019.

Susan Van Son, a correctional officer, couldn't even get her manual breast pump into her workplace legally. The New York Times explains how over the course of "two nights, she sneaked in every piece of the pump, save for one. Ms. Van Son's breasts weren't big enough to conceal the funnel, so she enlisted a better-endowed colleague to shuttle it in for her."

Understandably, Van Son left that job. So did a nurse who was bullied about her pumping breaks. So did a mother in the Air Force. So did an insurance company staffer who says her supervisor pressured her to quit and even dictated the resignation letter.

Finding a solution

Morris, Lee and their co-author, Joan C. Williams, compiled so many more stories like these in their report, but they also believe there is a solution that would protect moms from losing their jobs over pumping.

According to the trio, "robust breastfeeding laws already in effect in a number of states have been proven to work." They say workplace lactation policies need to offer universal coverage, with no employer exemption, recognize diverse physical needs and circumstances and reasonable accommodations, include functional space requirements and strong enforcement mechanisms and be economically realistic.

It's a tall order, to be sure, but San Fransisco got pretty close with its new law, one policy makers at all levels of government might want to check out, because it's time to recognize that the Break Time for Working Mothers provision to the FLSA leaves a lot of workers out. This is because it was passed as an amendment to an existing law regarding overtime pay, and so workers in certain professions (hello, teachers pumping in cars) aren't covered.

When it comes to protecting breastfeeding parents at work, America has certainly made some great strides in the last decade, but there is more work to be done to protect mothers who are just trying to feed their babies.

[A version of this post was originally published on January 25, 2019.]

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