Principle 1: Prepare
Yourself for Pregnancy,
Birth, and Parenting
What Every Parent Needs to Know
Let’s face it: You can do everything “right”—eating all the right foods, reading all the right books, and talking to all the right practitioners—yet you still can’t control your pregnancy or birth. This can lead you to feel personally responsible when things do not proceed as expected. There is no “right way” to give birth. Birth is not a contest. It is a creative process, and as such, every birth is unique. If we give paints, brushes, easels, and canvases to a group of women and ask them to paint the same scene, each painting will be distinctly different—just as each pregnancy and birth will be a unique experience. . . . Birth is a normal event and no two are alike.
—Peggy O’Mara,
Having a Baby Naturally
The remarkable miracle of new life is a transformative experience for any human being. For most parents, the day their baby joined their family was the most profound experience of their lives. Pregnancy offers expectant parents an opportunity to prepare physically, mentally, emotionally, and spiritually for parenthood. Making informed decisions about childbirth, newborn care, and parenting practices is a critical investment in the attachment relationship between parent and child. Education is the key component of preparation for the sometimes complex decisions required of parents, and it is an ongoing process as each stage of growth and development brings new joys and challenges.
When preparing for the birth of a child, it is easy to get caught up in the material things associated with pregnancy, childbirth, and newborn care. Cute infant clothing, the latest maternity fashions, and all the baby gear can be an all-consuming (and expensive) part of preparing for a baby, but the lasting investment of preparation involves creating a peaceful, loving environment in which to grow, birth, and care for a new life.
Planning for Baby:
Preparing Your Body, Mind, and Spirit
Ideally, a couple planning to have a baby will begin to prepare themselves before becoming pregnant. Lifestyle choices, including eating a nutritious diet, avoiding the use of alcohol and drugs, exercising, and seeking emotional and spiritual health, will be a conscious choice for parents anticipating a healthy pregnancy.
Before getting pregnant, a woman will want to prepare her body by eating healthy foods. The amount of processed foods we eat is so much a part of our culture; many young people have never had a home-cooked meal from natural food sources. A practical guideline is to eat a wide variety of foods in as natural a state as possible. For instance, a breakfast of steel-cut oatmeal, yogurt, whole-grain cereal, or eggs, and whole grain toast, or some (preferably organic) fruits and juices, is an excellent way to start the day. Think about decreasing caffeinated drinks, or at least limiting them to only breakfast. Sodas and other highly sugared drinks (or carbonated drinks that are artificially sweetened) can be replaced with herbal teas sweetened, if desired, with a little honey, agave, or maple syrup and filtered water. These habits are wonderful to start before pregnancy so that healthy food choices will already be established when pregnancy occurs.
Because most of us have sedentary lifestyles, exercise is another important addition to a daily regimen. You may only have time for walking thirty minutes a day; this has tremendous advantages, but even better is mixing up your routine to include other forms of exercise like yoga, Pilates, and other stretching and balancing exercises. Good nutrition and exercise will help you be at an optimum weight before conception, so gaining the weight of pregnancy will not be a problem. Mothers who are more physically fit also have a much easier time giving birth.
“A pregnant mother’s diet not only sensitizes the fetus to . . . smells and flavors, but physically changes the brain, directly impacting what the infant eats and drinks in the future. This highlights the importance of eating a healthy diet and refraining from drinking alcohol during pregnancy and nursing. . . . If the mother drinks alcohol, her child may be more attracted to alcohol because the developing fetus ‘expects’ that whatever comes from the mother must be safe. If she eats healthy food, the child will prefer healthy food. Exposure to odor or flavor in the womb elicits the preference but also shapes the brain development.”1
1 Feinberg et al., “Effects of family foundations on parents and children.”
Emotional preparation is a key factor in beginning a healthy pregnancy. Many women have mixed feelings about having their first baby and are not sure why they feel conflicted. Some women have a great fear of childbirth because of frightful scenes they have seen in movies or on television. A recent study found that far more mothers were exposed to childbirth through television shows than through childbirth education classes.2 This is a good time to read, ask questions, and do your own research about the normal process of childbirth. Learn about hospital routines in your area; for instance, how common are induced labors, ultrasound, epidurals, and cesarean sections? What are the pros and cons of these procedures, and what are the options in your community? Fear of the unknown is easily dispelled with good information. In her book Immaculate Deception, Suzanne Arms discusses the harmful effect of fear on a mother’s birth experience:
2 Declercq et al., “Executive summary.”
A positive attitude is important, too. Nature is not prepared to handle inordinate fear and self-doubt. We hear so much about the harmful effects of cocaine and other drugs on a baby in utero, but we hear nothing about the harmful effects of our bodies being constantly flooded with stress hormones that weaken our immune system and inhibit normal birth. If, in addition to making our bodies fit, we do as much as we can to learn about birth as a natural process, we will do much to alleviate unnecessary fears and be able to face birth with calm and courage.3
3 Arms, Immaculate Deception, 25.
Our culture has a powerful influence on our perceptions of the optimum birth experience. Declercq et al. found that:
During pregnancy, mothers sought information . . . through a variety of sources, with first-time mothers naming books (33%) as their primary information source, followed by friends and relatives (19%), their provider (18%), and the Internet (16%). . . . Fully two-thirds (68%) had watched one or more of eight television shows specially created to depict childbirth, with more than half of the viewers regularly watching at least one of these shows. Far more mothers were exposed to childbirth through TV shows than through childbirth education classes. . . . [Only] 56 percent of new mothers took childbirth education classes. . . . As women neared the end of pregnancy, most felt confident, but a majority also felt fearful about their upcoming birth.
A few other troubling statistics were reported in this survey. “Despite the importance of early contact for attachment and breastfeeding, most babies were not in their mother’s arms during the first hour after birth, with a troubling proportion with staff for routine, non-urgent care (39%).” And another surprising finding was that “just a small proportion of mothers visited multiple providers before selecting their own or sought a provider or hospital matching their own philosophy.”4
4 Declercq et al., “Executive summary.”
Other issues from your own childhood may arise when thinking about becoming a parent for the first time. A couple can share their stories with each other, and if there are deep concerns, fears, or a history of abuse, this might be a good time to seek professional counseling to help see your birth and parenting experience in a positive light.
Preparing for baby is a perfect time for your spiritual growth; you might read books on spirituality together, talk to a counselor or minister about any questions or concerns you might have, and share your dreams and hopes for your child. If your partner comes from a particular religious tradition that you do not share, this is good time to discuss each other’s spiritual beliefs more deeply, how they will influence your child-rearing decisions, what religious traditions will be taught to the children, and what compromises both of you would be comfortable making to incorporate the religious values you share.
The prospect of having a baby brings forth memories of parents’ own childhood and causes mothers to reflect on the parenting that they received. New parents’ own early childhood experiences have a major impact on their parenting attitudes and beliefs, with the possibility of affecting the attachment process with their newborn child.5
5 Fonagy et al., “Maternal representations of attachment during pregnancy.”
Physician and educator Dr. Deepak Chopra and his colleagues offered a profound insight regarding the spiritual nature of the unborn infant when they wrote, “Throughout pregnancy your body is your unborn baby’s universe. You are the rivers, sunlight, earth, atmosphere, and sky for this being growing within you. Your baby’s body, mind, and soul are intimately intertwined with your own. Together you express the creative flow of life.”6 Embracing this “creative flow” in your life can set the stage for deep personal growth and spiritual development, which can give you an overall sense of inner calm, love, and happiness that will have lifelong benefits for you and your unborn child.
6 Chopra et al., Magical Beginnings, Enchanted Lives, 38.
What Kind of Birth Experience Do I Want?
The two most important decisions a mom-to-be will make to help create a positive birth experience is the choice of obstetrician and where she will give birth. Being an active participant in your birth requires first that you think about the kind of birth experience you want and start looking at the birthing options in your community. To get the best prenatal and childbirth options, some couples have made the decision to move to a new area. These options vary widely in different cities and states, so it’s important to do the research. If you have an API support group in your community, it is a great way to network with new and pregnant parents to find out about the options that are available.
Attachment-parenting advocates know that the most beneficial birth choice is one that has the fewest interventions and allows for the mother and baby to be awake, aware, and able to connect during and after the birth. “Making a decision on where your baby’s birth will take place is second in importance only to making the decision to become parents in the first place!” advises Peggy O’Mara in Having a Baby Naturally. In making this decision, first look at the birth process through the lens of the attachment relationship. What would be the optimum experience for a baby entering the world? Imagine entering a peaceful, warm, quiet, welcoming environment, a tranquil place that closely resembles the dark, warm, and nurturing environment that the baby has been experiencing for the past nine months. Infants come “hardwired to connect” in the sense that they are programmed to expect the warmth of the human body, the familiar sounds of their mother’s heartbeat and voice, and the warmth of mother’s milk.7 Amazing research has shown that when placed on the mother’s stomach after an unmedicated birth, a baby can creep unassisted to the mother’s breast, find the nipple, and begin to feed unassisted!8
7 DeCasper and Fifer, “Of human bonding.”
8 Widström et al., “Gastric suction in healthy newborn infants.”
Hospital birth centers are associated with lower rates of medical interventions during labor and birth and higher levels of satisfaction, without increasing risk to mothers or babies.9
9 Hodnett et al., “alternative versus conventional institutional settings for birth.”
Most women in the United States use an obstetrician for their prenatal care and the birth of their babies. Some obstetricians are open and encouraging of a nurturing birth environment and have worked within hospital regulations to create a homelike atmosphere for their patients. Another excellent and safe option today in many hospitals, in birthing centers, and at home is midwifery care. Whether using a midwife in a hospital setting, in a birth center, or at home, many women have found that having this option gives them flexibility in their birth experience. For instance, some parents are interested in researching water birth (or laboring in water) as a more gentle approach to childbirth because they have seen videos or heard about the help this provides the mother in having a more relaxed and comfortable birth. It is a good idea for parents to compare different methods and philosophies regarding prenatal care and birth environments, classes offered, and each practitioner’s statistical outcome and costs. Just because a close friend liked a certain provider does not mean it is the best choice for you. Talk to other parents who have had a positive birth experience for recommendations, and then, after coming up with some questions, interview several providers before making a decision.
A great resource for developing questions for a healthcare provider and making an informed decision about where to have a baby is the “Ten Steps of the Mother-Friendly Childbirth Initiative for Mother-Friendly Hospitals, Birth Centers, and Home Birth Services,” published by the Coalition for Improving Maternity Services (CIMS). If there are no “mother-friendly” hospitals, birth centers, or home birth services close by, investigate whether there are “baby-friendly” hospitals or birth centers by visiting the Baby Friendly Hospital Initiative website, www.babyfriendlyusa.org/. This initiative, developed by the United Nations Children’s Fund (UNICEF), is now being adopted by healthcare systems all over the world. Baby-friendly hospitals and birth centers have implemented the Ten Steps to Successful Breastfeeding (Baby-Friendly Hospital Initiative) set up by UNICEF (outlined in Appendix B) to ensure that all staff and administrators have made a commitment to educate, support, and encourage mothers to breastfeed their babies, if at all possible. Parents are assured, among other things, that information they receive from all medical staff will be consistent and that the mother will be allowed to room-in with her baby.
Ten Steps of the Mother-Friendly Childbirth Initiative
for Mother-Friendly Hospitals, Birth Centers,
and Home Birth Services
To receive CIMS designation as “mother-friendly,” a hospital, birth center, or home birth service must carry out our philosophical principles by fulfilling the ten steps of mother-friendly care.
A mother-friendly hospital, birth center, or home birth service:
1. Offers all birthing mothers:
2. Provides accurate descriptive and statistical information to the public about its practices and procedures for birth care, including measures of interventions and outcomes.
3. Provides culturally competent care—that is, care that is sensitive and responsive to the specific beliefs, values, and customs of the mother’s ethnicity and religion.
4. Provides the birthing woman with the freedom to walk, move about, and assume the positions of her choice during labor and birth (unless restriction is specifically required to correct a complication) and discourages the use of the lithotomy (flat on back with legs elevated) position.
5. Has clearly defined policies and procedures for:
6. Does not routinely employ practices and procedures that are usupported by scientific evidence, including but not limited to the following:
Other interventions are limited as follows:
7. Educates staff in nondrug methods of pain relief and does not promote the use of analgesic or anesthetic drugs not specifically required to correct a complication.
8. Encourages all mothers and families, including those with sick or premature newborns or infants with congenital problems, to touch, hold, breastfeed, and care for their babies to the extent compatible with their conditions.
9. Discourages nonreligious circumcision of the newborn.
10. Strives to achieve the WHO-UNICEF “Ten Steps of the Baby-Friendly Hospital Initiative” to promote successful breastfeeding (see Appendix B).10
10 Coalition for Improving Maternity Services website.
One of the first steps toward creating a positive birth experience is deciding what kind of childbirth classes you want to take and finding out what classes are offered in your area, such as the Bradley Method for natural childbirth, Lamaze classes, or others. When interviewing different childbirth educators, find out what their classes have to offer, what various birth options are available, and what healthcare providers are supportive of more natural methods. Ask the childbirth educator if she will help you develop a birth plan. “A birth plan states, in writing, your vision of the upcoming labor and delivery. It crystallizes your beliefs, states your preferences, and outlines any procedures you would like to avoid.”11
Couples often enjoy the social aspects of these childbirth classes as much as the information offered and can network with each other about this new world of becoming a parent. Appendix C suggests books, websites, and other resources for finding childbirth instructors and researching their philosophy about childbirth and their methodologies. It’s important to remember that a onetime class at a local hospital won’t come close to giving you all the important information you need to be prepared. For the best birth outcomes, parents need to be informed and active participants in all decisions that have to be made, as well as in the birth.
11 O’Mara, Having a Baby Naturally, 102.
In 1972 a study was published in the book Why Natural Childbirth? The author, Dr. Deborah Tanzer, was a student of Dr. Abraham Maslow, the theorist who developed the “hierarchy of needs” scale and the theory of the “peak experience.” Dr. Maslow defined peak experiences as those that make life worthwhile and give it meaning. Dr. Tanzer was curious to study mothers who were delivering babies by this new method of “natural childbirth,” which was being touted as a rapturous experience by some mothers.
In these studies, Dr. Tanzer found that, as soon as the natural childbirth classes were completed, the women who had taken them (called the “takers” in the study) showed greatly improved attitudes toward their pregnancies. Five times as many women reporting positive emotions after the birth had taken the childbirth classes, a statistically significant difference. Another important finding was that the takers felt they were much closer to being the type of people they wanted to be; in other words, their self-images were enhanced. Ironically, the takers (most of whom had little to no analgesia) reported significantly less pain than the nontakers. Almost equal numbers of the two groups reported high pain, but takers outnumbered nontakers eight to one in registering low pain.14
12 Enkin et al., A Guide to Effective Care in Pregnancy and Childbirth, 25.
13 Cleeton, “Attitudes and beliefs about childbirth among college students.”
14 Tanzer, Why Natural Childbirth? 152.
The issue that greatly interested Dr. Tanzer was a peak or rapturous experience. No one in the group who did not take the childbirth classes reported this kind of ecstatic experience, but ten of the takers in this study did. Overwhelmingly, it was the women whose husbands or partners were with them at both labor and delivery who reported a peak experience.
In summary, here are some of the key points from her research. First, certain fears, feelings, fantasies, needs, and responses seemed to be common to all women. Second, by the introduction of natural childbirth, the character of the total birth experience was changed radically and in a highly positive direction. Third, these differences in childbirth experiences included how the mother viewed herself, the baby, and the meaning of the experience; the women in the natural childbirth group emerged happier and healthier. And fourth, the biggest and most positive differences became apparent in the later stages of labor and during the actual birth of the baby, when the woman could begin to push and thus help to expel the baby. The act of pushing, the sense of meaningful activity, the participation in the great drama of the delivery room, the ability to welcome her new child in full consciousness, the joy in accomplishment—these seem to be the truly important facets of natural childbirth and for these mothers were the ultimate in a “peak experience.”
Mothers who experienced a positive relationship with their partners expressed more attachment to their infants. Overall, a mother’s positive relationship with her partner had a positive influence in her attitudes toward pregnancy.15
15 Siddiqui and Hagglöf, “An exploration of prenatal attachment in Swedish expectant women.”
We’ve talked to many women over the years who attended natural childbirth classes yet for various reasons did not have the “perfect birth” experience that they had wanted. Those women seem to have an easier time dealing with their disappointment than those who wonder what might have happened if they had been more prepared. It seems to be harder on a mother to accept a disappointing or difficult birth when she was not informed enough about the process of labor and delivery and the doctor was allowed to make all the decisions. We feel strongly that birth is such a transformative and empowering experience that each pregnant mother deserves to have the best information, enabling her to make the best decisions for her and her baby. The critical time to gather this information is well before the birth.
To encourage positive birth outcomes, the Lamaze Institute for Normal Birth has identified and updated the Six Healthy Birth Practices, adapted from the World Health Organization, that promote, support, and protect normal birth. When adopted, these practices can have a profound effect—instilling confidence in the mother and facilitating a process that results in an active, healthy baby.
Lamaze International recommends that care providers, hospitals, and birth centers adopt these Six Healthy Birth Practices as standards of care and encourages women and their families to choose care providers and birth settings that employ care practices that promote, support, and protect normal birth. All of these healthy birth practices can be found in their entirety and may be downloaded from www.lamaze.org.
Important Considerations While Pregnant
The purpose of sharing the following information with you is to empower you and to encourage you to ask questions, not to scare you. Many young parents-to-be are fearful of birth, and our intention is to prepare you so that you go forward with knowledge and the understanding that most births are low-risk and uneventful.
OB doctors and nurses are trained for all the “what ifs” that can happen, so they tend to view birth as a risky and “in need of control” event in life. Your provider may be in agreement with your birth plan or preferences, but what often happens once you are in labor at the hospital is that he or she becomes overreliant on technology and the clock, making everyone tense and anxious, slowing down the progress in a laboring mother. If a doctor or nurse expresses concern about something, such as that the baby’s heartbeat is too slow or too fast or that labor is progressing too slowly, and starts mentioning the “c” word or Pitocin or epidural, always ask what other alternatives are available—such as walking around, sitting on a ball, quieting the activity in the room, dimming the lights. Seeds of fear and doubt will grow unless you are informed and have knowledgeable advocates with you, like an experienced doula.
Fears about pregnancy and childbirth can increase the risk of emergency cesarean section and increase the risks of emotional instability after childbirth.17
Renowned midwife Ina May Gaskin has written and spoken many times about a “sphincter law” when referring to childbirth.16 As funny as it sounds, she seems to be on to something. If a mother feels tense, upset, anxious, or rushed, her cervix will tighten up and slow down labor, much as with a bowel movement. The same holds true when delivering a baby: when the mother is in the right position, in the right state of mind, the uterus will take over and deliver the baby without the mother necessarily actively pushing.
16 Gaskin, “Understanding Birth and Sphincter Law.”
Are Routine Prenatal Ultrasounds Necessary?
Ultrasound machines are intended to be used only for medically indicated situations—specifically, high-risk births. Routine ultrasound may lead to the implementation of more procedures, which can increase the risk of complications. Unless medically indicated, you can say “no, thanks” to your provider if asked. The Food and Drug Administration (FDA), the American Institute of Ultrasound Medicine (AIUM), and the College of Radiology strongly discourage this practice! The AIUM statement says, “The use of either two-dimensional (2D) or three-dimensional (3D) ultrasound to only view the fetus, obtain a picture of the fetus, or determine the fetal gender without a medical indication is inappropriate and contrary to responsible medical practice.”18
17 Melender, “Experiences of fears associated with pregnancy and childbirth.”
18 Rados, “FDA cautions against ultrasound ‘keepsake’ images.”
There are concerns with routine ultrasounds for several reasons:
1. The ultrasound waves heat human tissue, especially if close to or surrounded by bone (like the brain). When you make a decision it’s important to ask when the machine was last calibrated, how well trained the technician is, and how many ultrasound procedures he or she has done. The bulk of ultrasound studies were done in the 1990s when the intensity of the machines was 94 mW/cm2 (intensity of light measured at milliwatt per square centimeter), and that intensity has increased to 720 mW/cm2. Since the intensities have dramatically increased, few studies have been conducted, necessitating the need for much more research to ensure safety to the infant.19
19 Abramowicz, “Fetal thermal effects of diagnostic ultrasound.”
2. Doppler ultrasound machines are more powerful than the pulse-wave ultrasound. The pulse wave is a preferred choice when having an ultrasound because the risk is lower for damage to delicate tissue.
3. Beware of keepsake ultrasounds! Keepsake 3D & 4D ultrasound machines and technicians are not monitored by anyone and are not safe. It sometimes requires several minutes of ultrasound to create a video, when only a few seconds is recommended to reduce the possibility of heating up delicate tissue of the baby.20
20 Rados, “FDA cautions against ultrasound ‘keepsake’ images.”
4. Autism spectrum disorders (ASD) have skyrocketed in the last twenty to thirty years from between 1 and 5 per 10,000, and, according to the Centers for Disease Control (CDC), as of March 2013, there has been a 72 percent increase in the diagnosis of autism over the past four years. Now one of every fifty children ages six to seventeen has an autism spectrum diagnosis. There are most likely multiple environmental factors at play, and as parents it’s important to be careful of the chemicals you use during pregnancy and after you have your baby. Dr. Jay Gordon, a pediatrician and passionate advocate for children, has written a provocative new book called Preventing Autism: What You Can Do to Protect Your Children Before and After Birth that raises awareness of the chemical soup we live in and educates parents about preventable toxic exposures in our food and environment that can negatively affect a developing or new baby. Some concerns have also been raised that there may be a causal link with ultrasound exposure, which has also increased in diagnostic frequency and intensity of exposure during those twenty years.21 Currently, there are no studies that have shown a causal link, but it doesn’t mean there isn’t any. Given that we don’t know the causes, why take a chance unless medically indicated?
21 Abramowicz, “Ultrasound and autism.”
Steer Clear of Ultrasound Parties
The newest trend in the United States is ultrasound parties at home. While there aren’t conclusive studies of long-term damage (this is worth repeating), this doesn’t mean they don’t exist. “Ultrasound is a form of energy with effects in the tissues it traverses, and its use should be restricted to medical indications, by trained professionals, for as short a period and as low an intensity as compatible with accurate diagnosis.”22 The American Institute of Ultrasound in Medicine concluded, “There exists abundant peer-reviewed published scientific research that clearly and convincingly documents that ultrasound at commercial diagnostic levels can produce lung damage and focal hemorrhage in a variety of mammalian species. . . . The degree to which this is a clinically significant problem in humans is not known.”23
22. Ibid.
23. Ibid.
“Be a pitter, not a sitter” is the slogan of one maternity hospital, but it also reflects the pervasive attitudes among many hospitals in the United States. The synthetic version of oxytocin, called Pitocin, is used routinely to induce and speed up labor, very often for the convenience of the doctors and hospital staff than for any legitimate medical reason. A mother can be in labor for many hours, as a result, it can be very inconvenient for a system that wants to get things done in a timely fashion, and there are likely to be cost concerns on behalf of insurance companies because of the extended stay. Once childbirth was considered a normal human process with a small percentage of complications; now every birth is treated as if it were a high-risk birth. With disregard for the natural unfolding of birth, unnecessary medical interventions are put in place, the means justifying the end—the birth of a healthy baby.
The presence of a supportive companion during labor was associated with a striking reduction in the length of labor, with a consequent reduction in the rate of augmentation of labor with oxytocin. Fetal passage of meconium during labor was reduced, and this, together with the effect of the supportive companions on uterine action, resulted in fewer instrumental deliveries and cesarean sections.25
25 Enkin et al., A Guide to Effective Care in Pregnancy and Childbirth, 177.
Sue Carter, a researcher at the University of Illinois, Chicago, who has studied the effects of human hormonal experience in early life, shared her concerns about the routine use of Pitocin. Speaking at a conference at Notre Dame in 2010, she explained that Pitocin is not well understood and should not be treated casually. She writes:
There is growing evidence that early experiences, including physiological and behavioral changes associated with pregnancy, birth, lactation and the management of infants during the postpartum period, have the capacity to produce long-lasting changes in behavior. Routine manipulations, including the use of exogenous OT (in the synthetic form known as Pitocin) during labor and more recently the use of OT antagonists (blocks the oxytocin receptors to slow down labor), also hold the potential to influence the parent and offspring in ways that have not been investigated in humans.24
24 Carter and Porges, “Neurobiology and the evolution of mammalian social behavior,” 140.
Dr. Carter is concerned about the routine use of Pitocin, because it is still not well understood. “Synthetic oxytocin could possibly create mental illness later in babies. It should not be treated casually.”
For the last several years, early inductions have become a trend at great risk to the infant and increased healthcare costs. The use of induction before a baby is thirty-nine weeks was routine for far too long. These preemies would require time in a newborn intensive care unit (NICU) because their lungs weren’t fully developed, leading to all kinds of complications and sometimes lifelong problems for the child. The current recommendation by the March of Dimes and the American Congress of Obstetricians and Gynecologists (ACOG) is no inductions before thirty-nine weeks. Just recently the Georgia Department of Community Health announced it will no longer allow Medicaid payments for early deliveries for convenience. “They warn that choosing to deliver even one week early could threaten the development of the baby’s lungs, brain, or other vital organs. . . . There is a short-term cost with babies having to stay in neonatal intensive care, as well as the long-term costs of caring for developmentally delayed children,” said Dr. Dean Greeson, chief medical officer for Peach State Health Plan. “The state saw this as a way to get at both of those issues.” When the cost of NICU can be as much as $15,000 per day, the officials project they will save as much as $7 million dollars a year.26 This is, we hope, a precedent that these policies, which are in keeping with the ACOG and March of Dimes recommendations, will be adopted by all hospitals within the United States.
26 Atlanta Journal Constitution, “Georgia to end Medicaid payments for some early births.”
As with any procedure, ask your doctor or an anesthesiologist about the risks and benefits of an epidural for you and your baby so that you are fully informed, or do your own research beforehand. Epidurals can have an effect on the success of breastfeeding (initiation and duration), depending on how much anesthesia is administered and when, as in early in labor versus late in labor.27
27 Beilin et al., “Effect of labor epidural analgesia.”
If you choose to have Pitocin and/or an epidural (or don’t have a choice), just be aware that it may take longer for your baby to get the hang of nursing and for you to establish a good milk supply. Trust it will happen, and, if you have a sleepy baby, use a breast pump to stimulate the breasts to produce until he or she is ready.
Parents today have an incredible resource to use for an optimum birth experience: a doula (doo-lah). In the book Mothering the Mother, Marshall Klaus, John Kennell, and Phyllis Klaus explain:
In searching for a term to describe the role, we wanted a word with a nonmedical connotation that would stress the value of a woman companion as attentive and comforting. We turned to the Greek word doula meaning “woman caregiver.” Our first exposure to the word came from Dana Raphael’s use of the term to describe “one or more individuals, often female, who give psychological encouragement and physical assistance to the newly delivered mother.” We use the word in the now widely accepted sense of an experienced labor companion who provides the woman and her partner both emotional and physical support throughout the entire labor and delivery, and to some extent, afterward.28
28 Klaus et al., Mothering the Mother, 4.
Doulas of North America is a licensing organization for professional doulas. Its website has much helpful information, including the following description:
Giving birth to a baby is so much more than a physical phenomenon; it engages parents-to-be in a transformational experience, a key life event full of emotion and meaning. A doula who accompanies a woman in labor mothers the mother, taking care of her emotional needs throughout childbirth. A doula also provides support and suggestions for partners that can enhance their experiences of birth. A postpartum doula continues that valuable emotional support and guidance, helping a family make a smooth transition into new family dynamics.29
29 Doulas of North America, “What is a doula?”
A postpartum doula is one who helps the mother at home after the birth of her child. Postpartum doulas help continue the “mothering the mother” experience in a variety of ways. Some may help with breastfeeding, nutrition, emotional support and encouragement, light housekeeping, or child care for older children.
Analyses suggested that continuous support was most effective when provided by a woman who was part of neither the hospital staff nor the woman’s social network, and in settings in which epidural analgesia was not routinely available. No conclusions could be drawn about the timing of onset of continuous support. Continuous support during labor has clinically meaningful benefits for women and infants and no known harm. All women should have support throughout labor and birth.30
30 Hodnett et al., “Alternative versus conventional institutional settings for birth.”
Denise Punger, a physician in Florida, shared her birth stories—one birth without and one birth with doula support—with the readers of Attachment Parenting: The Journal of API. Even though Dr. Punger had delivered more than two hundred babies in her residency, she was not aware that having a doula was an option for her first birth. She and her physician-husband attended childbirth classes, and they assumed that they would be prepared to have a wonderful natural birth experience. She invited her mother to be at the birth, not realizing until later that her mother had never witnessed a natural birth and was herself anesthetized for Denise’s birth. When the day came to deliver, her labor was very long and difficult. Not having an experienced support person who was able to help her deal with the long hours of labor or to suggest strategies like walking or changing positions during her last stages left her feeling traumatized by the birth. She was able to deliver her nine-pound baby vaginally, but later, as she recovered from the birth, she knew that there must be a better way—to feel more empowered, supported, and nurtured through the birth—even though her family advised her to just try to forget about the experience.
Her next baby’s birth was supported by a professional doula. The doula came to her house during her early stages of labor and gave Denise the loving support and wise counsel that she needed. She described how, with her doula, she walked around the neighborhood, stopping and breathing through contractions, rather than being forced to labor in a bed. As labor progressed, her doula suggested techniques for relaxing and letting her body do what it needed to do. She was amazed and grateful for the soothing words and birthing wisdom from her doula that gave her the confidence to actually enjoy the labor more and helped it progress more quickly. By the time they reached the hospital, she could feel the baby’s head crowning and delivered another nine-pounder with a midwife in attendance.
Denise wrote, “In a way, I wish the obstetrician from my first birth had been at Scott’s [her second son’s] birth. He would have seen the difference a doula could make. If I delivered babies, I would insist that all my patients consider having a doula. It really makes me sad when I hear a mother tell another, ‘You’ll forget it all anyway.’ Giving birth can be a rewarding physical and emotional experience—one that you will never forget.”31
31 Punger, “A physician’s personal experience with a doula.”
This model of “mothering the mother” has been found to have tremendous benefits for a mother in labor. Wise women from all cultures and eras have been a key component to any normal birth, and modern society is now recognizing the critical importance of nurturing parents during this transformative event. Health benefits range from shorter length of labor, lower incidence of forceps or vacuum delivery, and lower rate of cesarean birth to less postpartum depression and heightened satisfaction with the overall birth experience.32 As with choosing any care provider, parents are encouraged to get references from other parents for finding and choosing a doula.
32 Klaus et al., Mothering the Mother, 33–51.
A Mother’s Story:
For the “Naturally Birthing Challenged”
I want to offer encouragement to moms who feel they missed the ideal birthing experience and/or who were separated from their babies at birth. I also want to share a few tips that would have helped me the first time and did help me the second time:
—Kaylene Karras,
Attachment Parenting: The Journal of API
Vaginal Birth After Cesarean (VBAC)
Fortunately, for a mother who has had a cesarean section, the horizontal incision is more stable than the old style of a vertical cut from the navel to the pubic bone. This makes the possibility of a future vaginal birth possible, and thousands of women have experienced a successful VBAC. However, once a mother has had two cesareans, it is unlikely that she will be allowed to attempt a VBAC. It will take some research on your part to determine if this is a safe option for you. You will need to talk to physicians or midwives who support mothers in this decision and have delivered VBAC babies. The International Cesarean Awareness Network has excellent information to help you research this option.
A Fit Pregnancy Means a Healthier Baby
Exercise during pregnancy can be a challenge, especially if the mother is working and has limited time; however, the benefits are substantial. Many prenatal classes are offered in the evenings to accommodate working mothers, including prenatal yoga, swimming, and other exercise programs designed for pregnancy. These classes are also a wonderful way for a new mom to meet other pregnant women in the community. Mothers who exercise during pregnancy tend to have healthier pregnancies, and their labors are much easier and often shorter than those of women who have not exercised. Preterm births are 50 percent less common in mothers who exercise. Of course, it is always important to discuss your exercise regimen with your medical professional.
More than at any other time, pregnancy allows a woman the opportunity to fully understand the importance of how nutrition affects her health and the health of her baby. There is no question that the choices made will also have a direct impact on the birth experience. Research in this area has shown that malnourished mothers tend to have more premature births, lower-birth-weight babies, and more difficult labors. In this day of convenience food, it is surprising to see how many of us are not getting the proper nutrients, especially pregnant women who are now “eating for two.” Take this opportunity to change your eating habits for the better.
When a woman has the excuse to eat for two, it’s important to remember that overdoing portions will not be in the best interest of mother or baby! Remember that healthy weight gain is very individual and will vary, depending on many factors. Some mothers may actually lose a little weight in the early months, particularly if they have a lot of nausea. Others may put on quite a bit of weight in the early months, or notice a thickening in their midsection due to hormonal changes. If a mother is already too thin or too heavy before conception and uses this opportunity to change her eating habits for the better, she will find that her body will adjust beautifully to the best weight gain for her and her baby. A knowledgeable healthcare provider will give the guidance needed, including discussing the importance of prenatal vitamins. However, it is still the parents’ responsibility to do their homework on what food choices are the best for their family. If there are special dietary needs, such as a vegan diet or other diets not normally within the expertise of many care providers, parents will need to educate themselves and consult with their provider about optimal choices during pregnancy.
Some childbirth classes suggest the mom keep a food diary every day, which is a very helpful idea. Being conscious about food choices now will set a pattern for the choices made throughout the life of the child. What a lifelong gift for a child to have parents who model good nutrition in the home!
In Chapter 3, another important nutritional and attachment-promoting decision is discussed at length—the decision to breastfeed or bottle-feed your baby. In a recent study, 78 percent of the young mothers stated that they made decisions about breastfeeding before pregnancy or the first trimester.33
33 Arora et al., “Major factors influencing breastfeeding rates.”
A positive birth experience and strong support system can strongly influence breastfeeding success, as well as reduce postpartum anxiety by helping parents develop strategies and coping skills for this stressful time.34 Education of mothers, families, fathers, and healthcare professionals regarding the benefits of breastfeeding, as well as how to overcome barriers, has a positive impact on the number of mothers choosing to breastfeed.35
34 Tarkka et al., “What contributes to breastfeeding success after childbirth?” Midmer et al., “A randomized controlled trial of the influence of prenatal parenting education.”
35 Arora et al., “Major factors influencing breastfeeding rates.”
Looking through the lens of attachment, we learn nature’s model of what the baby’s expectations are from a biological perspective. A baby’s primary need is to suckle, and he or she will be rooting and suckling immediately after birth, which will provide the first important immunization from the colostrum. We discuss this more thoroughly in Chapter 3, but suffice it to say that feeding your baby is such an important attachment-promoting behavior, it warrants much thought and careful preparation, especially if the mother has little experience with feeding a newborn—whether from the breast or bottle.
A mother who intends to breastfeed is encouraged to attend meetings of La Leche League International, an organization founded in 1957 to educate and support breastfeeding mothers. Most cities in the United States have meetings that are open to all women who are interested in learning more about breastfeeding, whether they have a baby or not. Even adoptive mothers who would like to learn if they can breastfeed (which they can) are welcome. At the very least, talk to a lactation consultant or experienced nursing mother to get accurate information about positioning the baby at the breast and getting off to a good start. Often, a mother will prepare for the birth, not thinking about the most important thing that she will do when she meets her baby for the first time—the baby will want to be cuddled and to suck!
The Emotional Highs and Lows of Pregnancy
A pregnancy can evoke strong emotions in parents-to-be regardless of whether the pregnancy was long anticipated or a complete surprise. The knowledge that they are bringing a baby into the world can bring excitement and joy to expectant parents but may also yield less positive emotions. Memories may be dredged up from the expectant parents’ own childhoods, from a prior complicated pregnancy or birth, or from a previous loss. Time taken to reflect on individual childhood experiences and current beliefs about parenting is invaluable preparation. Explore different parenting philosophies and discuss parenting approaches that best nurture healthy attachments within your growing family. Work through negative emotions surrounding the pregnancy so you can focus on the joy of welcoming the baby.
The decision to breastfeed is significantly related to the father’s level of education and to his approval of breastfeeding. The strong approval of breastfeeding by the father was associated with a high incidence of breastfeeding (98.1%) compared to only 26.9 percent breastfeeding rates when the father was indifferent to the mother’s feeding choice.37
37 Littman et al., “The decision to breastfeed.”
Those experiencing negative emotions regarding the pregnancy or who have a history of depression should seek help from a healthcare provider. Meditation, centering prayer, yoga, visualization, and other relaxation techniques can help minimize stress surrounding the pregnancy while helping pregnant mothers prepare for the physical rigor of birth.
Studies have shown that the quality of a woman’s relationship with her husband or partner has a substantial effect on the emotional and physical well-being of her baby. A Swedish study found that mothers who experienced a positive relationship with their partners expressed more attachment to their infants, and, overall, a mother’s positive relationship with her partner had a positive influence on her attitudes toward pregnancy.36
36 Siddiqui and Hagglöf, “An exploration of prenatal attachment in Swedish expectant women.” Journal of Reproductive and Infant Psychology.]
Expectant parents who completed a brief relationship-strengthening class around the time their child was born showed lasting positive effects on each family member’s well-being and on the family’s overall relationships.38
38 Feinberg et al., “Effects of family foundations on parents and children.”
The relationship with the spouse or partner will never be tested more than in the parenting journey. This will probably be the first experience of putting one’s own needs aside and, together, putting the needs of another human being first—particularly in the early months of parenting when both parents are on call twenty-four hours a day! Some couples make the mistake of thinking that if there are problems in the relationship now, a new baby will bring them closer together. Take this time of preparation to deeply reflect on partnership—not only do you need to share your own childhood stories and reflect on their impact on each other, but also discuss what you might call your “parenting mission statement” or philosophy. For instance, how do you feel about traditional methods of raising children, such as letting the baby cry it out? Are you open to reading books and getting information about childbirth, child development, and positive discipline, perhaps by attending parent support-group meetings? Becoming parents can be one of the most meaningful, fulfilling times in your relationship, a time of great personal growth and joy.
In their book, Giving the Love That Heals: A Guide for Parents, married couple and authors Drs. Helen Hunt and Harville Hendrix share a profound discovery they made when working with couples:
As we became more and more interested in the relationship between parents and children, we came to a conclusion that amazed us: the people who were most successful in marriage relationships were the same ones who were most successful in parenting relationships. Why? . . . The people who did well . . . made a commitment to become conscious about the process. They were willing to see what was hidden in themselves and, without prejudice, to understand the connection between past wounding and present functioning. They were able to override their self-protective impulses in favor of responses that were less me-centered and more relationship-centered.
When you allow yourself to recognize the contours of your own emotional history and the shape of your current family interactions, you become empowered. You see yourself for who you really are and see your children for who they really are. Just this increased awareness alone, without any other help, means that you are more likely to avoid mistakes and are better able to act effectively to get what you want for yourself and the children you love.39
39 Hendrix and Hunt, Giving the Love That Heals, xviii–xx.
Preparation for becoming a parent starts with preparing for pregnancy and childbirth. As the journey unfolds, it is essential to learn about the upcoming developmental stages. Reading books about child development allows parents to have realistic expectations for themselves and for their child, allowing parents to be better prepared for the joys and challenges of each stage. In Part 4 of Giving the Love That Heals, the emotional developmental stages are thoroughly discussed, giving parents strategies for empathetic care.
Advanced preparation and education prompts discussion about parental concerns before they become crises. For example, if parents understand that it is normal for a newborn and young baby to awaken frequently to feed, they soon realize that sleeping through the night is a very unrealistic expectation. So often we see that simply knowing what to expect avoids a lot of anxiety and later discipline issues. This topic is discussed more thoroughly in Chapter 8.
Musings from a Mother of Multiples
I remember being pregnant with twins, and other AP twin moms (the very few that I could find) telling me the first year to eighteen months were going to be “brutal.” Brutal? That’s a really harsh word. Could they really be “brutal”? Yes, they could. And the first piece of advice I now give to any mom pregnant with twins is that the first year to eighteen months are going to be brutal—and yes, I do mean “brutal.” As in, take a deep breath, jump into the swirling rapids, and fight for your very survival. You will lose yourself. It will strain your marriage. It will take you to the very brink of your sanity. You won’t think you can handle any more. The days will fold together in a dark haze. And you won’t remember most of it. Try to keep perspective. Count down the months. It is going to get better. Much better. Lean on your friends. Ask for help. Know that you can’t do things the same way you can with a singleton, but you can be an attached parent—even though most people will tell you that you can’t, even though at times you are sure it’s impossible.
I quickly learned to avoid “twin parenting support groups.” Being in a room full of mothers of twins was difficult. We were completely outnumbered by babies. Everyone was stressed and overwhelmed! And the only thing I had in common with any of those moms was the presence of two babies each. Nearly any question asked was answered with “one baby will just have to cry” or with some tool or trick to try to get the babies to be happy alone. I knew there had to be a better answer. I was lucky enough to find one other local AP mom of older twins to talk with, and many compassionate moms of singletons. My best support came from moms whose youngest was at least five. These were the moms who could hold a baby, change a diaper, or cut my food into small bites and feed it to me. They were the lifesavers. Other moms of infants could empathize, but with twins, what I needed was help. (To be continued)
—Pam S., mother of four
[Authors’ Note: The following is a personal, deeply honest story from a mother’s perspective in her experience with her twins, and not intended to reflect the experience of every mother of multiples. It’s important to emphasize for parents of multiples to involve other extended family members, close friends, or hired help as much as possible, whether it is comforting one baby while the other feeds, cooking for and feeding the mother, doing household chores, or doing things with the older child. There are numerous ways moms of multiples can be helped and supported while still adhering to attachment-parenting principles. This mom didn’t have any of these options available to her other than her four-year-old daughter and her amazingly supportive husband, who traveled a lot. Her story will not only help others, it helped her to better understand and process the tremendous physical and emotional marathon that she has endured. She’s out of the darkness and into the light now with her beautiful and securely attached children.]
There has been much in the media recently about mothers who suffer from extreme bouts of postpartum depression or postpartum psychosis. Fortunately, new research is confirming that there is hope for women who suffer from different postpartum challenges. In her book Depression in New Mothers, Dr. Kathleen Kendall-Tackett discusses the importance of getting solid information and remembering that prevention should be the number one goal to help new mothers avoid spiraling into depression. Sometimes all a mother needs is support during and after her birth, a healthy diet, and plenty of rest to manage her symptoms. Other times, it is unclear whether a mother is depressed or perhaps suffering from a number of other conditions—like bipolar disorder, an eating disorder, or substance abuse—and needs professional help immediately. This book can help parents and professionals sort through these issues. Dr. Kendall-Tackett also has several excellent websites to help mothers, including www.breastfeedingmadesimple.com, which has information for breastfeeding mothers who may have questions about depression, medications that are safe for breastfeeding, and alternative therapies.
Important Decisions in the First Days After Giving Birth
So often we focus primarily on the birth of the baby, and critical decisions that must be made almost immediately after the birth are not given much thought! Most of these issues will be addressed by a professional childbirth educator, but, if not, please be aware of these topics, and do some reading and research to make informed decisions. Remember to consider these decisions through the lens of attachment: How will this affect not only my baby’s physical health but also his or her emotional and psychological well-being? Examples of key issues for you to research follow.
If you give birth to a boy, you will be asked if you consent to his circumcision. This is not a decision you want to make on the spur of the moment, without reading and researching the pros and cons. Unless this is a religious tradition in your family, most parents do not give this much thought and will make the decision based on what the culture dictates. However, you owe it to your baby boy to research the issue.
It should be noted that Attachment Parenting International does not have an official policy on circumcision, but we all agree this is an extremely painful procedure and an important decision to be made with accurate information. Until recently, the American Academy of Pediatrics (AAP) didn’t recommend routine circumcision, stating that the benefits did not outweigh the risk to infants; as a result, many insurance companies would not pay for the procedure. However, in 2012, it revised its statement, stating that after reviewing the literature, it was found that health benefits of circumcision outweighed the risks and can now be paid for by third-party insurance companies. That isn’t the end of the matter; it has just stirred up more controversy.
In the same statement, the AAP admits that the health benefits aren’t significant enough to warrant circumcising all male babies, and ultimately the decision is up to the parents. They cite that there is a slight decrease of urinary tract infections, transmission of HIV, and prostate cancer in circumcised males. The obvious question is whether it is ethical to cut off healthy human tissue from an infant to slightly reduce the chance of the child acquiring a sexually transmitted disease or perhaps developing prostate cancer later in life. It’s a bit like removing an infant’s tonsils or appendix in the event they might cause problems later in life.
Here is an excerpt from the AAP statement:
Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.40
40 American Academy of Pediatrics Task Force on Circumcision, “Circumcision policy statement.”
If you have decided to circumcise your infant son, the AAP recommends the use of a local analgesic to help reduce the pain. It is hard to believe that some doctors still perform this procedure without any topical pain medication for the baby. You may have to call around to find an OB (yes, obstetricians do the surgery, not pediatricians) who will be willing to use local anesthesia if your OB refuses. Ask ahead of time about this and also, as recommended, have the doctor inform you of the full risks and benefits of the procedure. (You can read the AAP policy statement on its website, listed in Appendix C.) You will need to find out the cost and whether your insurance company will cover the procedure.
Informed Consent for Vaccinations
Another decision you will be faced with once your baby is born is whether you want your child to receive routine vaccinations. You will want to discuss the pros and cons with your baby’s pediatrician. Currently, there is a list of twelve different actual vaccination shots, but many combine vaccines, for a total of thirty-seven vaccines by the time a child is twelve years old. The first shot, the hepatitis B vaccine, is given right at birth. It protects against hepatitis B, a sexually transmitted disease. Why do infants need protection from a sexually transmitted disease? This question and many others are answered in The Vaccine Book by Dr. Robert Sears.
Dr. Sears has spent more than thirteen years of his medical career researching the pros and cons of vaccines, not only for parents but for himself as well. As he explains in his book, doctor training doesn’t include education on the vaccines themselves, only the diseases. The Vaccine Book is an excellent resource (and the only one written) that lists all the current vaccines and the diseases they were designed to protect, as well as the likelihood of occurrence of each disease. It is a helpful guide to bring with you when discussing this issue with your baby’s doctor.
Additives are a common concern with vaccines. This has led to a number of controversies surrounding possible links to medical problems in children—such as the epidemic rates of autism or developmental delays in the United States. Dr. Sears is emphatic that his book is not an “antivaccine” book but a balanced view meant to be an educational tool for parents and professionals. He made a diligent effort to refrain from bias and to perform his own research. He examined all the information he could find on every vaccine given in the first twelve years of a child’s life. He methodically discusses each disease and vaccine as follows:
Dr. Sears is concerned about the lack of information that parents and physicians have about this topic, as well as the consequences of not making an educated decision about how and why vaccines are given. He reassures parents that they can still fully vaccinate but should consider a different schedule, in which the shots are spaced out. Besides this carefully researched book by Dr. Sears, you will find many articles on the Internet concerning vaccinations.
Your responsibilities as a parent can feel very scary and intimidating when you are immediately faced with such tough decisions. Thus, it is imperative to take the time to research these issues thoroughly before your baby is born. When you come from a place of education and rational discussion, mixed with good old common sense, you have more confidence in your parenting and will make the best decisions for your baby and your family.
Look for These Important Social and
Emotional Milestones in Baby’s First Year
Red Flags
In a twenty-two-minute video entitled Creating Secure Infant Attachment: Helping Your Baby Get the Best Possible Start in Life, Jeanne Segal, PhD, says, “Developmental problems require prompt, professional intervention. . . . The best way to identify infant behavior that signals developmental problems is to follow social and emotional milestones. Social and emotional milestones indicate that the attachment bond is on a secure track. If a parent can’t pick up on an infant’s cues or a baby isn’t alert enough to engage in the earliest milestone behaviors, it’s a red flag that signals a need to get help as soon as possible” (you can view the video at www.helpguide.org/video/attachment_sd.htm).
Attachment Parenting International Support Groups
Many times in this chapter we have mentioned the importance of support; it is critical for the birth, for breastfeeding, and for parenting in general. According to Dr. Bruce Perry and others, infants and children are biologically “designed to have four adults who are involved and a constant presence in their lives,” referred to by anthropologists as “alloparenting.” Mothers need to be “mothered” in the early weeks and months so they can effectively mother their infants. Parents of young children benefit, too, because they don’t have to do it all on their own—and you shouldn’t, either. Unfortunately, too many young families have felt alone and isolated.
API support groups are now available in many communities in the United States and throughout the world. Support is also available on our website and includes a parents’ discussion forum on just about any topic related to parenting. With so much information now available on the Internet, parents have infinite choices for advice. It’s really difficult to know what is good scientifically supported advice and what isn’t. API’s online resources are thoroughly vetted by the organization and its members, so parents can relax and trust the resources and information. In their book And Baby Makes Three, John and Julie Gottman report that support groups make a huge difference to the emotional health of a couple when they become parents: The couples who experienced the support groups changed in many ways. They learned that the stresses they were encountering as new parents were very common and not necessarily caused by a bad relationship.41
41 Gottman and Gottman, And Baby Makes Three, 5–6.
In today’s world, where extended families live too far away to give the day-to-day support, knowledge, and care that existed in past generations, it is critically important for parents to find another way to create this support system for their family. API support groups are one way for new mothers and fathers to do this. These groups are a way to build friendships and a sense of community. They are also safe havens for learning about parental and partner roles. As each person becomes more experienced, he or she becomes a mentor to new members of the group. These groups are valuable resources when researching anything from childbirth methods and local medical care providers to family-friendly restaurants and fun activities within the community. Our hope is that all parents will seek support, and, if you don’t have a group in your community, go to our website (www. attachment
parenting.org) and learn how easy it is to get started.