Speaking of imagination, is it my imagination or...

...is pregnancy and newborn literature often hostile and guilt-inducing to the women most in need of support during this very difficult transition stage of life?

Let me just get this out there so that my biases are clear: I tend to be a wee bit defensive and "anti-establishment" when it comes to pregnancy and birth. I believe that there's more than a wisp of truth to the old joke, "if men could give birth, abortion would be a sacrament." Realistically though, I only wish that the many maladies that can befall pregnant women and new mothers suffer from (postpartum psychosis and Andrea Yates comes to mind, as well as PUPPPs which is something that I had and worry on a daily basis that will hit me again) were as well researched and understood as, say, erectile dysfunction.

Now, that aside, one of my general beefs with "the establishment" when it comes to pregnancy and birth is the literature. In particular, the condescension with which pregnant women are treated in said literature, how they are often not offerred the full benefit of a thoughtful and complete and "fair and balanced" response to allow them to draw their own conclusions. To that I offer a few  of examples from some of the most well known pregnancy and baby books and websites.

As anyone who's read "What To Expect When You're Expecting" knows, you should take care of yourself while pregnant by eating healthy and exercising. Makes sense, you are thinking to yourself. And the authors further clarify their statements around nutrition in allowing that once in a while, it's okay to eat something you really shouldn't. That's just good sense as well, you don't want to get into a pattern of denial as you'll just never be happy. But do you know what their definition of 'eating healthy' is?  Or what is an example of a food that you really shouldn't eat? Unfortunately I can't find my copy (I think I burned it), but I distinctly remember this phrase, so I believe it is a near exact quote: "And once in a while, treat yourself to something you really shouldn't have, like a bagel."

A BAGEL??!??

*@(#$*(@#*$!@#

OK now that being said, on to another book that tries very hard to be helpful and truly does have a lot of good information in it, but misses the mark on the issue of sleep [1]: The Womanly Art Of Breastfeeding. I had a lot of "issues" breastfeeding as I have mentioned before, and one night in a fit of desperation (and with a slightly pain-addled and a very sleep-deprived brain) I picked up this book looking for some support to convince me to continue breastfeeding especially through the night, when it would really be so much easier to bottle feed and then my husband could do at least one feeding per night so I could get more than three hours of contiguous sleep. From the chapter on sleep:

"When will he sleep through the night? Probably the reason this question ever assumed the proportions it has is because of the inconvenience of nighttime bottle-feeding -- getting up with the baby into what may be a chilly house, waiting while the bottle warms, fighting sleep, and being fearful that baby or bottle may be dropped. As a nursing mother, you are spared such inconvenience, so when you hear that a neighbor's baby sleeps through the night and yours doesn't, ask yourself, 'Is it really that important?'"

To the authors of TWAOB: YES IT IS, YOU IDIOTS.  Even if I were able to successfully sleep with my baby next to me  as well as successfully breastfeed lying down (and I wasn't, and I wasn't[2]), don't sit there and tell me that sleeping contiguously isn't a valuable thing and doesn't result in a happier, healthier mother. I have recently gone back to non-contiguous sleep (one of the wonderful effects of pregnancy is the increased blood volume and shrunken bladder) after a long period where I was able to sleep without waking between 8pm and 6am, and I am already missing those glory days.

Plus, there are plenty of women who choose not to cosleep even if they could, and so the disruption to them is just as severe as it is to bottle-feeders. I'm not saying that there aren't advantages to breastfeeding and cosleeping regarding sleeping, but for god's sake, offer the reader a little more support about what a difficult and painful process having a newborn is before you (or how about instead of?) admonish them for complaining.

I also can't figure out what was going through the editors' minds as they wrote this: they knew that "When will he sleep through the night?" was an important enough issue to include it in the book. But their response basically tells the reader "Oh stop it, you're just being silly, it's not a big deal." If it's not a big deal, why did it merit several pages of discussion in your book?

To add insult to injury, the book goes on to say that you should realize that changing your reaction to your sleep being interrupted is the only way to get anything positive out of the whole night-waking thing, i.e. just "decide" that since your baby does need that food at those intervals, after all, that it's a good thing that you're around to provide for him and since there's no sense in feeling resentful and pissy, you shouldn't. Quote:

"If you resent the interruptions to your sleep... you will face each day more frustrated and trying harder and harder to fit the baby into your sleep pattern. On the other hand, if you can adjust your mental attitude to one of greater acceptance, you will find yourself able to enjoy those quiet moments in the night with your infant who needs to be held and nursed, or with your toddler who just needs to be with someone."

To be clear, I'm not saying that acceptance isn't a good thing. But do they really need to beat you over the head about how not only do you need to get over it, but really you're just being plain selfish if you can't find yourself greeting each 10pm, midnight, 2am, 4am and 6am cry with a grin? This next part is the one that made me throw the book against the wall, a quote from a family practice physician:

"A lot of people think they are entitled to a night's sleep. Nobody's entitled to a full night's sleep and very few mothers get one. Many people do at one time or another during their lives, and I'm all for it. But no one's entitled to it, whether she's a new mother or not, if someone needs her. If a lazy, self-indulgent old man like me can get out in the middle of the night to help people he hardly knows, certainly a mother can do this for her own child."

Bite me, Dr. White. I am entitled to a full night's contiguous sleep. That doesn't mean I don't realize that I'm not going to get it, or that I don't understand that it's what my baby needs and so therefore I must provide, and I do... but don't sit there and tell me that I don't deserve it. Throw me a bone here. Tell me that I do deserve it, but I just have to pull through this tough time where I'm plain ol' not gonna get it. Give me those tips on how to minimize the disruption (after all, it is true that cosleeping makes it easier) without taking a holier-than-thou-but-you-too-can-become-holier stance for once.

What new mother, exhausted from lack of sleep, is going to read that section of the book, and tilt her head thoughtfully and say "You're right, Dr. White... I don't deserve a full night's sleep. Gosh, now that I realize that, it makes it so much easier to just accept that this is the way it's got to be. And now that I've accepted it, I no longer am upset when my baby cries for me overnight! In fact, I now eagerly spring out of bed (OOPS OOPS I MEAN I TURN OVER TO HIM IN MY OWN BED I DIDN'T MEAN TO IMPLY FOR A MINUTE THAT WE DON'T COSLEEP SORRY DOCTOR WHITE!!) to feed him every two hours like clockwork for six months without end. Thanks!!!"

Now I feel fully justified in being indignant at the parts I quoted above. I think most moms would agree with me on at least the spirit of my complaint. For this next one, however, I'm not sure if I'm veering on the edge of "looking for a problem" or not. You decide. The article in question which prompted me to write this entry was: "Is it okay to skip breakfast when pregnant?", on iVillage. The sentence in particular that caught my eye was:

"The question you should ask yourself is, "Would you skip feeding your baby breakfast after he or she was born?" By skipping your breakfast, you deprive your baby of their breakfast."

When I first read this, it threw off the entire answer for me. These first few sentences just smacked of fearmongering. No we can't simply answer the question with some medical data about what would happen to the baby if you did skip breakfast, we must first instill fear into the heart of the pregnant woman who even considered such a horrible idea.

Tell me this, then... when a baby comes out of the womb, he needs to eat roughly every two to three hours around the clock (if breastfed), sometimes more frequent. It would be cruel to deny him one of those feedings just because you didn't think it was time to eat. So therefore does that mean that while pregnant, you should eat every two to three hours around the clock, since after all that is what your baby needs? I.e. you're telling me that there is a biological need for the body to have what we here in these united states call "Breakfast"? It's written in our DNA that there must be three square meals a day?

Contrary to the tone set by these first couple of sentences, the data the response serves up has little to do with the impact to the growing baby's nutritional needs:

"Women who skip breakfast during pregnancy become fatigued more easily, tend to overeat at other meals and don't make as healthy food choices at snack times"

So what, if I skip breakfast and don't become more fatigued and don't overeat at other meals and do continue to make healthy food choices (like no bagels! god forbid), does that mean it's okay to skip breakfast then?

Please give me the facts, and let me draw my own conclusions and make my own choices. And while you're doing that, don't talk down to me. Is that so much to ask?

[1] I should also add here that my sister gave me this book, and she reads this blog, so I would like to say up front that my distaste for this section of the book in particular and the vitriol I spew its way has anything to do with my appreciation to you for helping me through those difficult times. Plus you have got to admit that the parts I quote are just not helpful, especially given the frame of mind of someone who is in doubt, but seeking support and reasons to continue. Pretty please don't be offended :-)[3][4]
[2] I was on pins and needles every night I tried to do this, terrified about squishing him or smothering him. He was also a very light sleeper and I tend to toss and turn, not a good combination.
[3] I should also add here that I think breastfeeding is a good thing if it works out for you, and I feel similarly about cosleeping although I choose not to do it myself as I value my space and ability to watch The Daily Show in bed. But if they don't work out for whatever reason, then bully good for you if you choose to do something else.
[4] Wahoo! I just had an IM conversation with her where I begged her to not be offended, and she said OK. I'm in the clear!

Comments

[Karen]

Can I pretend to be offended now? :)

OK, but here's a question...while you were on this particular tirade, why not ALSO go ahead and critique the frightening 1970s era photographs most often shown when illustrating a breastfeeding mother? The WAB has plenty of them, (though don't critique the mom/toddler smiling on the front of chapter 7 - that's my friend Chris and her son and they're cute and fully clothed). But really, can't publishers find pictures of MODERN (and by modern, I mean people in the 2000s, not the 1980s, which used to be the very DEFINITION of "modern" - you know, "modern rock", etc.) women breastfeeding their babies? There also was much discussion because the current edition of the book has a woman nursing her baby using a more european style - unbuttoning the shirt from the top, whereas in the U.S. we generally lift the shirt from the bottom. Fascinating, eh? I'm full of this shit you know... ;)

But meanwhile, I agree that it's pretty ridiculous the tone most books take to talk about breastfeeding, pregnancy, childbirth, etc. The WTEWYAE was so over the top on the nutrition stuff (like how you could treat yourself with one or two "fruit-juice sweetened cookies" - like you're such the picture of blissful maternity while barfing your guts out in the powder room that in between you've had time to make up some cookies from scratch, substituting that nasty refined sugar with fruit juice. Fuck you!)

Now on the sleep thing, I do have to say that I think it's unfair the pressure out there to "have a baby who sleeps through the night." Think about it, it's one of the first questions ANYONE asks a new parent - how is the baby sleeping and/or is he sleeping through the night. Um, junior is 4 hours old, he is only sleeping through important stuff like breastfeeding, and waking for the icky stuff like heel sticks. Then he wails. Becuase that bitch nurse wouldn't let me breastfeed him while she stuck his heel for the dozenth time. "I am not sure I could do the heel stick safely in that case..." I'm not sure you can do ANYTHING safely if I pummel you for hurting my baby and prohibiting me from doing something to alleviate the pain. Oh, did I go on a tangent? sorry. ;) This is YOUR blog after all, isn't it?

OK, but I have to finish this thought, the whole bit about sleeping. I think we set up new parents for failure from the very beginning because everyone defines a "good baby" as one who sleeps through the night. Um, I'm 33 years old and I don't sleep through the night (damn small bladder!) I have a 3.5 year old who doesn't (lucky me, the one night he did was the night we were in the hospital having his baby sister - that's been the only night to my knowledge.) Of course then there's the fact that many medical professionals define "sleep through" as a 5 or 6 hour stretch. Um, sure, my 16 month old baby sleeps that long at night, but I hardly call that sleeping through since she wakes up only about 2 hrs after I go to bed!!

One of the things we talk abt in LLL is the idea that adjusting your expectations CAN help you better accept that your baby has these needs of you. Of course it also helps to remind yourself of how incredibly short this period of time is, even though it seems unending when you're in it (like the phase the aforementioned 16 month old is in where she likes to climb on the kitchen chairs...) It all whizzes by in a blink and there you are, left wondering if it was worth it being pissed all those nights when the baby was crying. It's not their fault, they're just trying to tell you SOMETHING (maybe they need to be fed, or maybe they need to be close to someone - after all, WE don't sleep alone ...) Anyway, it's a stupid thing, but one suggestion I got from a league mom one time was to just turn the clock around so that it didn't face me at night. On the really bad nights, I do that. Then I don't have to notice that the baby was up every 30 mins for a while. Because honestly, what are my alternatives? Mainly to get pissed in the middle of the night (which will further awaken me, thereby delaying my eventual return to sleep). Of course poking my husband is one of the alternatives, which I have done a few times when I just ... couldn't ... take it... anymore. But this baby sure has taught me that what you learn with baby #1 isn't always relevant with baby #2. Liam would nurse back to sleep at any point in the night. Yes he might have woken frequently (every 2 hrs round the clock for his entire first year, I swear!) but he was a quick nurser and would zonk right back out. Meanwhile I have the energizer bunny in my second. She was up every 30 mins for 1.5-2 hrs last night asking for a drink of water. OMG I was ready to throw her out the window... but of course i forgot the bit about turning the clock around...that would have helped significantly last night, because to me it seemed like she was asking every 5 mins, but somehow because I knew that it was every 30 that pissed me off even more, because how good was the quality of sleep i got in those 30 minutes since the last water request? LOL

At any rate...this is YOUR blog isn't it? One last thing and then I swear I'm leaving. You are always entitled to your POV...it's always a good mental check for me to see how other people are taking this information that I get and give abt breastfeeding. Helps me not sound like such a frigging moron sometimes I hope.

[Charlie]

I feel your pain (well, actually, no, because my wife is the one who has to do the breast-feeding, but....). The book issue is just a symptom of the whole pregnancy/childbirth/child-rearing worls, which is that everyone is an expert.

If you want a REALLY annoying, smug book by a woman who knows everything, try "The Baby Whisperer" by Tracy Hogg. Actually contains some good stuff, but you finish every reading session by throwing it at the wall.

Kaz Cooke is much less annoying than the rest. http://www.amazon.com/exec/obidos/tg/detail/-/1580085318/qid=1114331560/sr=8-3/ref=pd_csp_3/002-7806525-3320868?v=glance&s=books&n=507846

[ElizabethN]

I didn't cosleep, and I still found breastfeeding easier than bottle feeding in the middle of the night. (Well, I never actually did the bottle feeding in the middle of the night, but my husband had to when I was hospitalized for a week when she was a few months old.) At least the milk is already there and heated up!

It really is worth trying to figure out how to nurse lying down, even if you're not cosleeping, though. I found it immeasurably helpful to be able to lie down and zone out while she was eating, even though I was going to be putting her back in the crib when she was done. Lots of pillows behind your back help.

But I definitely agree with your main point, that advice books for new moms are generally condescending and stupid. If you want real data, try the Cochrane Reviews on Pregnancy and Childbirth at http://www.mrw.interscience.wiley.com/cochrane/cochrane_clsysrev_subjects_fs.html