When's the Right Time to Say the F Word to Your Doctor?

When's the Right Time to Say the F Word to Your Doctor?

"Are we on the brink of an infertility crisis?" That's the panic-inducing headline of a recent piece in The Lily, The Washington Post's new-ish digital "publication for women." The subtitle reads, "American women are having kids later. What's the impact of 'the new normal'?" 

The Lily's article mentions the declining fertility rates worldwide and cites, among many causes, the fact that more women are deciding to become parents after age 35, i.e. at advanced maternal age, when fertility starts declining.

The point of the piece isn't to make women feel guilty about postponing parenthood to a time in our lives when we actually feel ready for it. And it's not just to give a reality-check (if anyone even needed one) that delaying parenthood can mean missing out on having kids. Chances are,

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Here's How Pop Culture Can Handle the "Older Mom" Issue With Humor and Grace

Here's How Pop Culture Can Handle the "Older Mom" Issue With Humor and Grace

If you've been reading this site or checking out my posts elsewhere, then you know I've been preoccupied with the issue of how the pop culture media handles "advanced maternal age" pregnancies. I still believe every woman, celebrity or not, has a right to privacy about her pregnancy, childbirth, or anything else to do with her body. But I agree that the growing number of celebrities having kids at 40-plus might be creating the illusion that it's always an easy proposition. What to do about this?

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Meghan Markle Is 36 and Engaged to Prince Harry: Cue the Handwringing

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Predictably, it was only a matter of minutes (seconds?) between the announcement that Prince Harry is engaged to 36-year-old American actress Meghan Markle, and the tsunami of comments about Markle's ticking biological clock.

It's too bad the following points need to be made at all, but here we go: 

  • Markle's decision about when or if or how to have kids with Prince Harry is her business, and both of theirs, and that's all. What we said about Gwen Stefani, and every other over-scrutinized celebrity of advanced  maternal age, still stands: Leave her ALONE already. 
  • Should Markle decide to have one or more kids in her late 30s or 40s, she can make that decision in her own time, and she has plenty of options. 
  • Going on about Markle's "advanced maternal age," without mentioning that Prince Harry is fast approaching 35 himself, is insulting. Even though women are the child-bearers, both women and men over 35 should be aware of the potential factors and risks they might face in bringing a human into the world—and this is not intended to alarm anyone, since "advanced age" parenthood is a more popular and viable option than ever before. And parental age brings its own benefits too. In any case, we're guessing the new royal couple are smart and informed and don't need nasty, judgmental, "concerned" gawkers, thanks very much.  

Moving on: The only upside to this public handwringing about Markle's age, and the suddenly rampant speculation about her pregnancy plans, would be if it raised awareness about maternal health issues that women of all ages can face—especially in the U.S., which has a shockingly high rate of maternal mortality, actually the worst maternal death rate in the developed world.

In fact, the U.K., Markle's soon-to-be home, is improving its maternal health outcomes at a much faster rate than the U.S.: In Britain, according to the medical journal The Lancet, "a man is more likely to die while his partner is pregnant than she is." Meanwhile in the U.S., the maternal death rate went up by a staggering 26 percent between 2000 and 2014 (see link above for more). So let's focus on the important health-related issues that we can actually work together to solve, taking the U.K. as an inspiration and a concrete example of how this is possible. And let's leave the waste-of-time B.S. for another day, can we?

BTW: Romper just posted a great piece about the Markle debacle, and why everyone needs to back off. Definitely worth the five-minute read.

Photo by Mark Jones via Wikimedia Commons.

Stuff to Try, Stuff to Buy: A Fab New Ranch Dressing

Stuff to Try, Stuff to Buy: A Fab New Ranch Dressing

On nights when I'm so wiped that I don't even feel like making dinner (my husband will laugh at the word "even"; let's just say those nights are pretty frequent), I'll still make the salad at least. And exhausted or not, I can usually muster a tasty salad dressing, even if it's just a simple one of lemon, olive oil, salt, and pepper. Now and then I'll make a more involved vinaigrette, but rarely will I go for a creamy dressing. Still, ranch dressing haunts my dreams. I could drink it right out of the bottle, although I swear I never have. I've also never tried to make ranch at home, and we don't even keep it around since we virtually never buy premade dressing. But the occasional times when I spy it on a table, I'm helpless to resist. Ranch is so effing good. So I'm thrilled to have discovered a fiercely delicious and surprisingly healthy version of ranch

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When Celebs Have Babies After 40, How Much Dirt Do They Owe Their Fans?

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The answer is none. That's my opinion anyway, and it remains that way after more than a week of running this question through my mind over and over again. Lots of celebrities lately are having kids well over 35, into their mid-to-late 40s and even beyond. And that raises the question: How are they all doing it? Are they conceiving naturally, and if so, how are this many of them beating the odds? Are they using reproductive technologies? If celebs can have kids later in life, does this mean everyone can? Inquiring minds want to know, and these questions are all valid—especially as women wrestle with the question of when to have kids ourselves, and how long we can afford to wait.

It would be ideal if celebs revealed everything about their journeys and struggles, but they have every right to keep that information private. After I posted a reaction here to a recent NYU study I read that faults celebs and magazines for not revealing more about stars' fertility and pregnancy struggles—a study I found to be misguided in its conclusions—I couldn't get the issue out of my head. Since celebrities' decisions about childbirth and everything else tend to have disproportionate influence, don't those stars owe us explanations about what they're up to? Especially if that info could keep many of us from trying to follow in their footsteps, with often devastating results?

It would be terrific if more celebs felt comfortable opening up about their childbirth stories, and if they could help bust the stigmas surrounding fertility and childbirth problems. But I still think the responsibility to inform and educate lies elsewhere, far from the pages of Cosmo and People. So I wrote another piece about this for Medium. I'm not sure if anyone agrees with me, and I may be a masochist for not letting it go. But I do believe the issue deserves a wider debate, in any case. 

The Medium article is here. Please click the hand-clap icon at the bottom if you like or agree with it, or if you at least think the issue is worth a wider conversation. Thanks for reading!  

Gwen Stefani photo by Jelizen via Wikimedia Commons.

Why Is the Maternal Death Rate Soaring in the U.S., and Falling in the Rest of the Developed World?

Why Is the Maternal Death Rate Soaring in the U.S., and Falling in the Rest of the Developed World?

If you haven't heard about Lauren Bloomstein by now, here's her story—a story that should, and hopefully will, change everything about childbirth in America. Lauren was a healthy 33-year-old nurse in the neo-natal intensive care unit at a New Jersey hospital who died shortly after giving birth to a baby girl in 2011. Soon after baby Hailey was born, Lauren's blood pressure skyrocketed, an obvious symptom of the treatable but potentially fatal-if-overlooked condition called preeclampsia. The hospital staff ignored every attempt by Lauren and her husband Larry (an orthopedic surgeon at the same hospital where Lauren worked as a neo-natal nurse) to get the treatment that would've saved her life. At one point Lauren cuddled baby Hailey; those 35 seconds are captured in this heartbreaking video. Then she died, just 20 hours later. Her death wasn't only tragic. It's infuriating, because Lauren's death was preventable, and so are 60 percent of the 700-800 maternal deaths (and 65,000 near-deaths) that happen annually in the U.S. What can we do to prevent those preventable deaths?

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"I Can't Believe You're a Doctor."

"I Can't Believe You're a Doctor."

I just watched the episode of "Louie" where Louis C.K. gets an annual checkup from his old high school friend (played by Ricky Gervais), who's now a doctor. Gervais jokingly insults his physique, tells him he has the worst penis he’s ever seen, says "you don't need a doctor, you need a time machine," and jiggles his man-breasts: "Did no one tell you that tits are meant to be on women, not men?” Louis mutters under his breath: "I can't believe you're a doctor."

That’s pretty much how I felt when I went to see the new genetic counselor that my OBGYN sent me to, after confirming that I was in fact pregnant. The cheerful genetic counselor who'd been there for my first baby had since left and been replaced by another seemingly perky young hipster (let's call her Gen), who turned out to be anything but perky.

 

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The Astonishing (and Good) News About Having Kids After Age 35

In case you missed it the first time, The Atlantic's "How Long Can You Wait to Have a Baby?" is worth a read. It makes the refreshing, evidence-based argument that conceiving after age 35 isn't that much harder than conceiving in your 20s or early 30s, despite all the neverending hype to the contrary.

"The widely cited statistic that one in three women ages 35 to 39 will not be pregnant after a year of trying...is based on... French birth records from 1670 to 1830," as The Atlantic's Jean Twenge points out. So yeah, popular notions about when and how women should plan to have a family revolve around questionable research dating back two or three centuries. Thanks, science. These outdated stats persist even in an era when, as Slate recently reported, women having kids in their 30s are now outnumbering new moms in their 20s.

More recent data about conception at advanced maternal age turns out to be far more promising than the 17th-century numbers we've been beaten over the head with. Twenge goes on to note that "Surprisingly few well-designed studies of female age and natural fertility include women born in the 20th century—but those that do tend to paint a more optimistic picture." Indeed: Fully 82 percent of women in their late 30s will conceive within a year of trying, compared to 86 percent of women 20-34. So that difference is just four percentage points, not nearly as much as all those "baby panic" books and articles would have you believe. There's even more encouraging news and perspectives for older moms too, so the entire article is worth a read.

A Star Doula Reveals What It Takes to Have a Great Birth at Any Age

A Star Doula Reveals What It Takes to Have a Great Birth at Any Age

Since Sarah Moore started working as a doula and childbirth educator more than 12 years ago, the Brown University grad has become one of the growing profession’s most sought-after experts in New York City. Sarah has attended upwards of 175 births so far, and been present at the bedside of a number of celebrity clients including Megan Boone, star of NBC’s Blacklist. And although Sarah had her two kids in her late ‘20s and early ‘30s, half the women who hire her are over 35. Let’s do the math: That’s almost 100 clients of “advanced maternal age,” not including all the parents Sarah sees regularly in her childbirth and perinatal classes. All this means Sarah has gathered lots of insights on what older moms—and dads—go through during pregnancy, childbirth and the aftermath. We can’t think of a better subject for the first installment of Crunch Time Parents’ Q&A series. Sarah sat down with us for an honest, revealing interview over coffee at a Brooklyn café. Read on!

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Exciting News for IVF Patients: Just When You Thought It Was Time to Give Up, It's Not

Exciting News for IVF Patients: Just When You Thought It Was Time to Give Up, It's Not

I remember the look on my friend Jillian's face when her umpteenth round of IVF failed. Exhausted and out of money to try yet again, she and her partner decided to give up on having a baby. She was 43 at the time, and meanwhile I was newly pregnant with my second kid, but it was still too early to talk about it. Even if the time had been right, I would've kept my mouth shut. Some of my friends (myself included) had been on the fence about having kids for years before we got pregnant. But Jillian wasn't on the fence. She'd always wanted to be a mom, and she wasn't flying any ambivalence flags. Now, as I read the latest news about how the most determined fertility specialists and doctors are helping IVF patients have healthy babies despite "abnormal" embryos, I wonder if faulty science kept Jillian and millions like her from having the life they envisioned. New York Magazine's article this week is astounding. It's about how scientifically dubious and misleading test results from PGS (preimplantation genetic screening) might be preventing fertility specialists from using embryos that have a very high chance of leading to a healthy birth.

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What Every 40+ Pregnant Woman Needs: More Clarity, Less Hype

What Every 40+ Pregnant Woman Needs: More Clarity, Less Hype

If you want to get attention in a headline about pregnancy, use the words "severe" and "morbidity." This new report, in the August 2017 edition of OBG Management, rings all the familiar alarm bells: "Are women of advanced maternal age at increased risk for severe maternal morbidity?" the headline asks. The article doesn't keep us in suspense for long. The immediate answer it offers up is: "Yes."

If you scroll down this page, you'll find a brief rant about the genetics counselor who treated me like a pariah for deciding to get pregnant at my "advanced maternal age"—even though that same day my obstetrician, a bad-ass woman doctor, had told me she didn't consider my pregnancy "high-risk." My doctor also told me she doesn't even buy into the idea that every "advanced age" pregnancy automatically falls into the "gasp! danger!" category.The new report is scary, sure. But although it seems based on a rigorous study, the results are framed in a way that seems to create more panic than necessary.

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Remembering Elisabeth Bing, the Natural-Birth Coach Who Yelled "Get Me an Epidural!"

Remembering Elisabeth Bing, the Natural-Birth Coach Who Yelled "Get Me an Epidural!"

Two years ago today, Elisabeth Bing, author of the guide "Six Practical Lessons for an Easier Childbirth," died at the age of 100. The Economist's obituary describes her as a "pioneer of prepared childbirth" for her efforts to make childbirth as joyous and pain-free as humanly possible. When she was working as a nurse in the U.S. in the 1930s, women in labor gave birth one of two ways: with no drugs and no preparation at all, or else totally zonked on morphine. Bing wanted to prep women to experience the sensations of the birth process in a way that felt manageable and beautiful, even relaxing. (In "Six Practical Lessons," she also advised women to bring a bottle of Champagne to the hospital; we like you already, Nurse Bing.)

Bing played a pivotal role in popularizing the Lamaze methods in America, and she helped legions of women stateside learn breathing techniques that would make natural childbirth less brutal. Her guide went so far as to replace every instance of the word "pain" with "waves." Ironically,

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