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We've seen Tully—and we've got some real concerns

Spoiler alert: This is about the entire movie, not just the trailer. Additionally, this article contains information and opinion about maternal mental health and may be upsetting for some individuals.


When the trailer for Tully first came out, I was beside myself. Finally, a movie about what motherhood is really like. I couldn't wait to see it.

In Tully, Charlize Theron plays Marlo, a mom of three who hesitantly accepts the help of a night nanny to get through the famously rough fourth trimester, after her youngest daughter is born. The movie is named for the night nanny, Tully, who is played by Mackenzie Davis.

Tully depicts an image of motherhood never before seen in a movie like this. Marlo has leaking breasts, a postpartum belly and a messy house—definitely not the glamorized version of motherhood we are used to seeing. We also see a lot of very familiar scenes, such as when Marlo accidentally spills a bag of freshly pumped breast milk, and the pure heartache that ensues from that.

Marlo's husband, played by Ron Livingston, is a fine husband and dad—definitely present and "trying" but certainly not as engaged or aware as we'd like him to be.

So far, I was on board with the plot.

Enter the night nanny, who comes into Marlo's life and starts making everything better. She connects with the baby right away, helps Marlo get her house organized and eventually becomes her confidant and friend.

Things take a turn for the huh? though, when Tully sleeps with Marlo's husband—while Marlo is watching and "telling her what he likes."

The climax of the movie comes when Tully and Marlo go out for a night and find themselves drunk in a bar in Brooklyn. Tully tells Marlo she can't work for her anymore, which greatly upsets Marlo. They end up driving back home together, but Marlo is drunk and falls asleep at the wheel—and they get into an awful car accident.

When Marlo regains consciousness, she is in the hospital, with her husband by her side. We learn from a doctor that Marlo has been suffering from postpartum depression.

We also learn that Tully is not real. Tully is actually Marlo's younger-self, who Marlo has imagined into an actual walking-talking person. The movie ends with Marlo's husband stepping up and helping around the house a bit more, and it is unclear if Marlo receives treatment—the movie definitely does not show her doing so.

I am not a movie critic, so I can't speak to the cinematography and acting—though from a non-expert POV I thought that was all really good. The actors all did tremendous work, and I was really impressed.

I am, however, a midwife. And as a maternal health provider, I have some very real concerns about Tully.

Postpartum depression is mentioned in the movie (once when we find out Marlo had it after her first baby was born, and once at the end when the emergency room doctor asks her husband if she's had a history of mental health issues).

The problem is that Marlo does not have postpartum depression—she has postpartum psychosis.

Postpartum psychosis (PPP) is rare, impacting about one or two out of 1000 women. Symptoms include:

  • Delusions
  • Hallucinations
  • Periods of extreme activity
  • Anger
  • Paranoia
  • Trouble communicating

As with all mental illness, it's essential that we do not make any blanket statements about women with PPP because everyone's story is different. That said, postpartum psychosis "can lead to devastating consequences in which the safety and well-being of the affected mother and her offspring are jeopardized," according to Dr. Dorothy Sit and colleagues.

From hallucinating a personified version of her younger self (including "helping" her have sex with her own husband), to nights filled with frantic cleaning and cupcake baking, to a spontaneous night out where she ends up driving home drunk, Marlo exhibits many of the signs of PPP.

I am not sure if this was intentional, or if the film-makers did not realize that the character they created had PPP. Since they acknowledge that she has postpartum depression, though, I am surprised that they seem not to have consulted with a therapist to ensure that the topic was handled appropriately, whatever their intention was.

My issue with the movie is not that it is about a woman with postpartum mental illness—indeed we need many, many more movie about postpartum mental illness.

My issue is that in not addressing the fact that Marlo has a postpartum psychosis, the rampant problem of unaddressed maternal mental health concerns is perpetuated.

The reason that people are so excited about Tully is because they feel like it is the first time that true motherhood is being portrayed on the big screen—but this is not true motherhood. Motherhood is hard, yes, but it is not this. This is mental illness. Brushing aside her mental illness again refuses to give it the attention it deserves.

Marlo needs immediate mental health treatment, and there is no direct acknowledgment in the film that she is getting it. Yes, a doctor tells her husband that she has PPD. Perhaps we can assume that means she's getting help?

Here's the thing though—all too often in mental health we assume that someone is fine and getting the care they need. So we don't do anything or say anything.

We need to create a culture that is done assuming and starts ensuring.

My strong concern here is that this movie which presents itself as validating the experience of motherhood is sending the message that these symptoms are normal. They are common yes. But they deserve to be respected and attended to, not dismissed.

Twice in the movie, Marlo talks about suicide. Once in the beginning when she says (to her entire family), "I want to kill myself," and her husband tells the kids that she's only joking, "like a clown." And then later Tully jokes that Marlo wants to murder her—since Tully is really Marlo, murdering her means killing herself.

In neither of these instances does anyone do anything to help her. Yes, this is a movie—but real women are suffering from this very real problem. Normalizing suicidal ideation is simply not okay.

Carolyn Wagner, a maternal mental health therapist based in Chicago told us: "The reality of postpartum psychosis is that it is extremely serious and presents a grave danger to mom and infant. It does not involve fantastical imagined friend and caregiver, and it is certainly nothing to be made into a plot twist.

"Additionally, I am concerned about the impact the storyline will have on postpartum mood disorder survivors who are not aware before going into the movie what they are going to see. The promos do not even hint at the twist, so moms are likely to be caught totally unaware which can be really upsetting and potentially damaging."

I find myself wondering about responsibility. Does the film industry have a responsibility to address mental illness appropriately? I'm not sure that they do.

But I see such a missed opportunity in Tully. Had the movie been just a bit longer, perhaps they could have shown Marlo receiving help—how amazing would it have been to see Hollywood take on the stigma of maternal mental health and turn it on its head? Instead, we leave with the notion that this is just "how it is" for moms.

So for what it's worth, to anyone out there suffering, please know it doesn't have to be like this. You have done absolutely nothing wrong, and you are not alone. There is very real help available to you.

You are so worth it.

If you're experiencing feelings or thoughts that concern you, contact your medical provider or a therapist who can help you find the right treatment plan. If you want to hurt yourself or your child, please call 911 or go to the emergency room where they can help you. For a description of postpartum mental illness symptoms, please visit Postpartum Progress.

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Unstructured play is play without predetermined rules of the game. There are no organized teams, uniforms, coaches or trainers. It is spontaneous, often made-up on the spot, and changeable as the day goes on. It is the kind of play you see when puppies chase each other around a yard in endless circles or a group of kids play for hours in a fort they created out of old packing boxes.

Unstructured play is fun—no question about it—but research also tells us that it is critically important for the development of children's bodies and brains.

One of the best ways to encourage unstructured play in young children is by providing open-ended toys, or toys that can be used multiple ways. People Toy Company knows all about that. Since 1977, they've created toys and products designed to naturally encourage developmental milestones—but to kids, it all just feels like play.

Here are five reasons why unstructured play is crucial for your children—

1. It changes brain structure in important ways

In a recent interview on NPR's Morning Edition, Sergio Pellis, Ph.D., an expert on the neuroscience of play noted that play actually changes the structure of the developing brain in important ways, strengthening the connections of the neurons (nerve cells) in the prefrontal cortex, the area of the brain considered to be the executive control center responsible for solving problems, making plans and regulating emotions.

Because unstructured play involves trying out different strategies without particular goals or serious consequences, children and other animals get to practice different activities during play and see what happens. When Dr. Pellis compared rats who played as pups with rats that did not, he found that although the play-deprived rats could perform the same actions, the play-experienced rats were able to react to their circumstances in a more flexible, fluid and swift fashion.

Their brains seemed more "plastic" and better able to rewire as they encountered new experiences.

Hod Lipson, a computer scientist at Cornell sums it up by saying the gift of play is that it teaches us how to deal with the unexpected—a critically important skill in today's uncertain world.

2. Play activates the entire neocortex

We now know that gene expression (whether a gene is active or not) is affected by many different things in our lives, including our environment and the activities we participate in. Jaak Panksepp, Ph.D., a Professor at the University of Washington studied play in rats earning him the nickname of the "rat tickler."

He found that even a half hour of play affected the activity of many different genes and activated the outer part of the rats' brains known as the neocortex, the area of the brain used in higher functions such as thinking, language and spatial reasoning. We don't know for sure that this happens in humans, but some researchers believe that it probably does.

3. It teaches children to have positive interaction with others

It used to be thought that animal play was simply practice so that they could become more effective hunters. However, Dr. Panksepp's study of play in rats led him to the conclusion that play served an entirely different function: teaching young animals how to interact with others in positive ways. He believed that play helps build pro-social brains.

4. Children who play are often better students

The social skills acquired through play may help children become better students. Research has found that the best predictor of academic performance in the eighth grade was a child's social skills in the third grade. Dr. Pellis notes that "countries where they actually have more recess tend to have higher academic performance than countries where recess is less."

5. Unstructured play gets kids moving

We all worry that our kids are getting too little physical activity as they spend large chunks of their time glued to their electronic devices with only their thumbs getting any exercise. Unstructured play, whether running around in the yard, climbing trees or playing on commercial play structures in schools or public parks, means moving the whole body around.

Physical activity helps children maintain a healthy weight and combats the development of Type 2 diabetes—a condition all too common in American children—by increasing the body's sensitivity to the hormone insulin.

It is tempting in today's busy world for parents and kids to fill every minute of their day with structured activities—ranging from Spanish classes before school to soccer and basketball practice after and a full range of special classes and camps on the weekends and summer vacation. We don't remember to carve out time for unstructured play, time for kids to get together with absolutely nothing planned and no particular goals in mind except having fun.

The growing body of research on the benefits of unstructured play suggests that perhaps we should rethink our priorities.

Not sure where to get started? Here are four People Toy Company products that encourage hours of unstructured play.

1. People Blocks Zoo Animals

These colorful, magnetic building blocks are perfect for encouraging unstructured play in children one year and beyond. The small pieces fit easily in the hands of smaller children, and older children will love creating their own shapes and designs with the magnetic pieces.

People Blocks Zoo Animals 17 Piece Set, People Toy Company, $34.99

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

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If you've got hamburger in your freezer you might want to check it before making dinner.

According to the United States Department of Agriculture, Cargill Meat Solutions is recalling approximately 132,606 pounds of ground beef products for possible Escherichia coli O26 (aka E.coli).

The beef was sold at various retailers, including Target, Meijer, Safeway and Sam's Club, as well as Save Mart in California. This comes after a previous recall involving ground beef sold at Publix.

The USDA's Food Safety and Inspection Service notes the recalls are the result of an investigation into 17 illnesses and one death in recent months, and that children under 5, older adults and people with weakened immune systems are the most at risk for a type of kidney failure common in people with E.coli infections.

"It is marked by easy bruising, pallor and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately," the agency notes.


Cargill has issued a statement on its website that reads, in part: "We were distressed to learn a fatality may be related to an E.coli contamination of one of our products. Our hearts go out to the families and individuals affected by this issue."

The recalled beef products were produced and packaged on June 21, 2018. They have a use or freeze by date of July 11.


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In the moments after we give birth, we desperately want to hear our baby cry. In the middle of the night a few months later it's no longer exactly music to our ears, but those cries aren't just telling us that baby needs a night feeding: They're also giving us a hint at what our children may sound like as kindergarteners, and adults.

New research published in the journal Biology Letters suggests the pitch of a 4-month-old's cry predicts the pitch they'll use to ask for more cookies at age five and maybe even later on as adults.

The study saw 2 to 5-month olds recorded while crying. Five years later, the researchers hit record again and chatted with the now speaking children. Their findings, combined with previous work on the subject, suggest it's possible to figure out what a baby's voice will sound like later in life, and that the pitch of our adult voices may be traceable back to the time we spend in utero. Further studies are needed, but scientists are very interested in how factors before birth can impact decades later.

"In utero, you have a lot of different things that can alter and impact your life — not only as a baby, but also at an adult stage," one of the authors of the study, Nicolas Mathevon, told the New York Times.

The New York Times also spoke with Carolyn Hodges, an assistant professor of anthropology at Boston University who was not involved in the study. According to Hodges, while voice pitch may not seem like a big deal, it impacts how we perceive people in very real ways.

Voice pitch is a factor in how attractive we think people are, how trustworthy. But why we find certain pitches more or less appealing isn't known. "There aren't many studies that address these questions, so that makes this research especially intriguing," Hodges said, adding that it "suggests that individual differences in voice pitch may have their origins very, very early in development."

So the pitch of that midnight cry may have been determined months ago, and it may determine part of your child's future, too. There are still so many things we don't know, but as parents we do know one thing: Our babies cries (as much as we don't want to hear them all the time) really are something special.

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To my firstborn baby,
We were overjoyed when we found out we were pregnant with your brother. We were so excited to give you a sibling to play with; someone to love and grow up with. Someone who will be your buddy for life.

But our excitement quickly turned to worry as we thought about how this would affect you. You were the only grandchild, on both sides. The only nephew, on both sides. Basically, the king of the castle. And you relished in that title.

We took special care to wait as long as possible to tell you. We waited until 20 weeks when we knew you were going to be getting a brother. We felt it would be easier for you to wrap your head around and also shorter for you to wait for his arrival.

I still watch the video of you cutting into the gender reveal cake. You were SO excited to see blue—because that meant you were getting a brother. You were overjoyed with telling everyone the news because you were the first to know.

From there your love for him grew every day. YOU too had a baby in your belly. I was carrying YOUR baby. You told everyone who would listen that you were going to be a big brother. We wondered if your love for him would quickly fade when he was actually here. When you realized that you would have to share time and attention...

But we were wrong. Your heart grew a million times bigger the day your brother arrived.

You came to visit me in the hospital wearing your doctor uniform, to check on both of us. You made friends with the nurses. You wanted to make sure I was okay. You wanted to take care of me and were so proud to wear your "Big Brother" shirt your aunt made you.

You were such a trooper during his two-week stay in the NICU. You were too young to go in to visit him. So, for you, it meant you had this mysterious brother you could only see in pictures and videos.

You drew him cards and colored pictures for his isolette (which you so playfully called his aquarium). You told everyone at school you had a new brother and that he would be home soon—even though you didn't know when exactly. Your heart ached as much as ours did. You wanted him home as much, if not more, than we did. You wanted your new family of four.

Sometimes I feel like you are wise beyond your years. A little old man trapped in a pint-sized body.

You were the best helper for Mom and Dad in those first days and months of welcoming your baby brother into our family. You would tell everyone to use hand sanitizer, and check to see if anyone was sick before they walked through the door to our house.

You would tell everyone how to hold your baby. And then them the proper way. You would tell everyone to line up their shoes at the door. You just wanted to keep your brother healthy and safe, ever the protector.

I worried the honeymoon period would wear off, that you would wonder how long he was staying here.

But, I was wrong. It's almost a year later and you are still so in love with your brother. Truly in love. On your obligatory "first day of school sign" you listed your favorite things as: Star Wars, basketball and my brother.

You tell everyone that you love him more than anyone. The way you both laugh hysterically together during peek-a-boo in the back seat of the car literally makes my heart explode into a million pieces, in the best way possible. It is a joy and an admiration I never knew possible as I watch my two precious boys interact and love each other.

My wish is that you will always be best friends. That you always look out for each other. Continue to be each other's biggest fans. Root each other on, even when it's hard, or you don't want to. Because, my sweet, sweet boy, I want you to remember—your brother looks up to you. You are his role model for life. And I thank you for taking that role so seriously.

Love,
Your Mommy

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If there's anyone who needs a nice spa day, it's parents. But booking a day at the spa isn't so easy when you also have to find and pay a babysitter.

A business owner in Los Angeles came up with a solution: Trina Renea, the founder of Spa Lé La, added free childcare (by a CPR-certified nanny) to her spa's menu, offering the service to any parent who needs a massage or a facial, or any of the spa's other stress-busting services.

If you've got more than one child at home, the first child is free, and each one after is just $6 for the whole duration of mom or dad's spa visit, HuffPo reports.

Renea recognized that for a lot of parents, a quick 15 or 30 minute appointment for a wax or a manicure just wouldn't be worth all the effort it would take to get the kids ready and then into and out of the car, so she added 30 minutes of "lounge time" that parents can take before or after their appointment, so mama can just chill for a bit.

If lounge time isn't relaxing enough for you, you can also spend an extra $40 for another 25 minutes in a totally comfortable nap room.

This kind of parent paradise could only have been thought up by a fellow parent. Renea is a mother herself, and she understands that a lot of parents feel guilty about prioritizing their own self-care. That's why she added cool classes to the childcare component: Kids can participate in art, music or yoga sessions while mom or dad is away. There's nothing to feel guilty about at all. "If they feel like their child is getting a class, then it makes them feel more comfortable," she told HuffPo.

The spa also offers services for expecting parents, like prenatal massage, belly facials, and even labor stimulating massage for those 40-week mamas-to-be who are understandably over being pregnant and just want to meet their little one.

Whether you have a child on the way or a couple of them keeping you up at night, this spa's menu sounds like the perfect way for mama to enjoy some me time.

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