You’re nearing the end of your third trimester, and by now, you probably already have everything ready for baby.  Yay! Now, it’s time to make sure that Mama has everything she needs for after the birth.

Gathering your postpartum essentials can be a bit overwhelming – especially for first time mamas. But fear not: following a postpartum essentials checklist will help you gather all of the things you know you’ll need and all of the things you didn’t even realize you will need.  As always, everything on this list is as natural as possible.

In this post, we’ll cover:

  • The postpartum essential any natural mama will need on hand after birth
  • Essentials for mamas who give birth vaginally and via C-section
  • Essentials that promote physical and emotional healing

Physical Healing Essentials

First and foremost, mama will need a few essentials to promote a natural and peaceful healing of your physical body (don’t forget the baby first aid kit too!).  Birth is a marathon, and even the most prepared body will need some TLC and time to recover.

1. Maxi pad options

No matter how you give birth, you’ll experience lochia for about 6 weeks after baby is born. Regardless of what products you used for menstrual bleeding (cup, cotton tampons, etc), you’ll need to use pads during the postpartum time.  Don’t fret – just because you need to hold off on using your menstrual cup doesn’t mean you’re forced to use conventional pads.  Natural mamas have a few options when it comes to pad options:

  • Disposable pads: Unlike conventional pads, these pads are made of organic cotton and plant cellulose. Mamas who use these tend to comment that they are thinner than the conventional pads but just as absorbent.
  • Mama Cloth: Made with a charcoal layer, these reusable pads offer comfort and function. Similar to a cloth diaper, these pads can be tossed into a wet bag until it’s time to wash them.  Mamas who use these comment that they don’t feel the same irritations that they get from conventional pads.

2. Not-Your-Standard Peri Bottle

There’s a good reason hospitals give out those peri bottles! They are E-S-S-E-N-T-I-A-L postpartum. Using a peri bottle can help gently clean Mama’s sensitive areas while promoting the healing process. Peri bottles are especially comforting for mamas that needed stitches.

Of course, the standard peri bottle will work, but moms are raving about the Fridet MomWasher (the same people that made the Nose Freida for your little one!)  because of its ability to control the water pressure and direction with much more ease.


3. Sitz baths

sitz bath is a warm, shallow bath designed to help heal the perineum after birth. Why should you add sitz bath to your essentials list? Haley-Elise Stewart, doula and founder of Tranquility by HeHe says:

Sitz baths can also help relieve pains of healing and sorenessthat can follow the birth of your little one. This is a wonderful time to connect with your body and also indulge in a few minutes of self-care time to simply be with yourself.”

You can use a portable sitz bath (usually sold at medical supply stores) or you can turn your regular bath tub into a sitz bath. Note: It is important to wash your sitz bath (or regular tub) before every use to keep infections at bay during this delicate healing time.

As if a sitz bath couldn’t get any better, take your bath to the next (healing) level by adding herbs. Again, Haley-Elise cannot stress the importance of herbs enough to her clients: “Herbal sitz baths are amazing for postpartum healing. There are so many gentle herbs out there that can aid the body in fighting infection, inflammation, restoring blood flow and promoting faster healing. Always ask your healthcare provider before using any herbs, but a few of my favorite postpartum herbs are lavender, calendula, chamomile, and witch hazel.”

Jennifer Nelson, a nurse of 17 years and midwife of 5 years, also shares her herbal wisdom:

At a bare minimum, I recommend comfrey, sea salt, and uva-ursi. I highly recommend adding yarrow, calendula, lavender flowers, plantain, and marshmallow root. To bypass the time involved in doing the sitz bath, and encourage frequent use of the herbs, I have our clients make a quart of tea from 1/3c of the herbs. They keep this in the bathroom and fill their peribottle up ½ way with tea, and the other half of the way with warm water. This is used each and every trip to the bathroom and gives us EXCELLENT results.”

4. Bottom spray

If you don’t have the time to prepare an herbal sitz bath, you can still benefit from healing herbs with a bottom spray. Whether you purchase a pre-made spray or make your own, look for recipes that include witch hazel and gentle essential oils like lavender, geranium or citrus.

Speaking of witch hazel, witch hazel pads are a must-have addition to your postpartum essentials because the witch hazel soothes the tender perineal area as well as helps to shrink those pesky hemorrhoids.

5. AfterEase herbal tincture

This stuff is worth its weight in gold! Whether you give birth vaginally or via C-section, you’ll be sure to experience after pains– aka the mini contractions of your uterus shrinking back down to the proper size.

Did you know that breastfeeding can also stimulate the uterus to contract?  The AfterEase herbal tincture is good to keep on hand to get some relief from those pains. The key is to start right after birth and continue on the tincture for several days postpartum.

6. Water bottle with a straw

This is a standard item on many postpartum checklists for a good reason: hydration is oh so important during this time for mama’s healing as well as milk production. It’s easy to become dehydrated being so busy with a newborn that these bottles will keep you accountable. Look for glass or stainless steel options.

7. Constipation busters!

Constipation can be a very scary word to a new mom, but it can happen as your body is responding to the “trauma” of birth. The key is to stay on top of your bowel mobility right after birth.

I remember the hospital staff wanted to start me on harsh stool softeners and herbs like cascara sagrada. I found they just created lots of gas and discomfort! Instead, try these gentler options:

  • Magnesium: Start right away on Natural Calm. Be sure to also include magnesium-rich foods in your diet.
  • Dried fruit: Prunes and un-sulphured apricots are just two examples of fruits that keep you regular. Bonus: stick these in your trail mix at your breastfeeding station. I’ve had great success with pears, too.
  • Hydrate, hydrate, hydrate: You guessed it- keeping hydrated helps your body avoid the constipation zone.

8. Belly Support

Did you know that a new mom’s hormones might not regulate until at least 6 months postpartum? That means certain hormones – like relaxin – are still present in mom’s body even after birth. Because of that, a belly binder or wrap can help encourage the body to return to its postpartum shape. Wraps also support the ab muscles while reducing swelling. Belly wraps also help keep pressure on a C-section incision, which make sneezing or laughing a little less … well… painful.

Some moms find binding their belly very comforting, while others don’t like the feeling. It can be actually detrimental if you have prolapse issues so be sure to talk to your midwife, doctor or physical therapist to see if belly binding is right for you.

9. Ice Packs

Ice packs can be such a relief for new moms.  The cooling sensation will ease pain and help reduce inflammation.  Many hospitals offer disposable ice packs to moms, but you can also make your own in advance and stock your freezer.

DIY Padsicles: A super soothing item, the padsicle – half pad, half ice pack – can provide cooling and soothing sensations. You’ll have to make these ahead of time, but once your baby is born, you’ll be glad you spent the time making them.

Grace P, a mama who completed the Mama Natural Birth course, realized how important these pads are:

I also wish I had prepared padsicles or cold packs. I only came home with a few from the hospital and I tore pretty severely. I was not prepared for the pain to be constant and as bad as it was.” 

The good news is that the healing ingredients in a padsicle can provide lots of comfort for a new mama.

At its simplest, spritz witch hazel and aloe gel onto an organic cotton pad. You can also add essential oils like lavender or frankincense. Dampen the pad, but don’t soak it! Wrap your pads back up and store them in the freezer.

10. Meal prep and food service

Nutritious food plays a big role in mama’s recovery, but heading off to the kitchen to make a meal is the last thing a new mama has time to do! Meal trains are great, but they might end before Mama is ready to be back in the kitchen. During your third trimester, stock up on homemade, nutrient-dense freezer meals. Aim for meals with a balance of protein, fat and good carbsto keep your energy (and milk supply) up! Store meals in this glass set so there is no need to freeze in those aluminum trays.

11. High-waisted granny panties

It may not make a fashion statement, but having high waisted undergarments on hand is ideal. Not only will these be more spacious allowing for the padsicles and ice packs to fit, but the high waist will not cause any irritation on possible incision sites. I LOVE these full coverage panties because they’re made of organic materials, which is important because of the raw state of your lady parts 🙂

A note on postpartum healing: What to do after the first six weeks?

Once your midwife or doctor clears you for intimacy, you may find that sex is painful or even unappealing – that is totally normal! Some moms find that maintaining a routine of arnica and ice or heat and sitz baths help relieve the inflammation and discomfort.

Also, give yourself time. You may feel like your body has been taken overby a nursing baby and postpartum wounds. Your dramatic drop in sex hormones can also affect your libido. Trust that it will balance out in time. Find new ways to connect with your partner until you feel back to your old self.

Emotional healing essentials

As you transition from woman to mother, emotional healing is just as important as physical healing. Below are the necessary items for emotional healing during the postpartum period.

1. Remedies for anxiety and / or depression

Many moms think, “This will be the happiest time of my life – I won’t feel sad or weepy!” Unfortunately, the massive fluctuations in hormones post-birth can make mamas feel a little blue.

Cynthia Mason, a Certified Nurse Midwife, offers her advice when it comes to postpartum moods:

“I usually recommend for most of my birthing mommas Bach Flower (Rescue Remedy) to help decrease anxiety or racing thoughts. Exercise and meditation are also mainstays of postpartum mood regulation.”

Other remedies for anxiety include:

  • Placenta encapsulation: Find all you need to know here.
  • Omega 3 fatty acids found in some seafood and cod liver oil
  • Natural sunlight (or a sun lamp)
  • Homeopathic remedies: Many people know about Arnica 200 for afterpains / cramps, but homeopathic remedies can be used for many, many postpartum issues including anxiety and weepiness. You can check your symptoms here.

A note on postpartum moods

While the baby blues are normal, there is a big difference between the blues and Postpartum depression. How do you know which one you have?

Cynthia Mason, CNM, weighs in on the topic:

The difference between baby blues and Postpartum Depression (PPD) is that blues are “normal” mood fluctuations that occur up to 2 weeks after delivery as Mamas hormones are coming back to normal range. PPD is a mood change that persists after delivery past 6 week’s postpartum or whose onset occurs after 6 weeks postpartum up to a year postpartum.

Mamas should always seek assistance if they have thoughts of harming themselves, others or their newborn. Mamas should also feel free to seek attention at anytime! Anything that interrupts the ability to get through your day or complete you daily activities deserves attention. Mamas and families should feel free to be proactive in seeking out attention and help.”

2. Get extra helpers

Having a little help can be a huge boost for emotional health! Whether your help comes in the form of a postpartum doula, a grandma, a friend, a sister, or even a housekeeper, having someone to offer assistance during those first few weeks is important. Maybe your sister comes over to tend to your baby while you shower. Or you hire a housekeeper to tidy up your bathrooms and kitchen to allow you to rest more.

3. Sleep when baby sleeps

While you might resist this like the plague, I cannot stress enough the importance of sleeping when baby sleeps. In the first several months postpartum, your body is healing after a marathon event called pregnancy & giving birth. On top of that, your baby will most likely get up several times a night to feed. As a result, you need to get your rest when you can; and the easiest way to do this is to sleep when baby sleeps.

Postpartum nursing essentials

Even those breastfeeding is oh-so-natural, there can be a bit of a learning curve.  You can make the journey easier by stocking up on these essentials.

1. Comfortable nursing clothes

You just bought maternity clothes, and now you need another wardrobe line? It doesn’t have to be fancy, but nursing clothes can make the breastfeeding experience much smoother! Think easy access button up shirts, tank tops or bathrobes to make the first days of nursing even easier.

2. Nipple care

Many moms-to-be are told to stock up on the required items of lanolin, organic reusable nurse pads, and warm cold rice packs.  However, Sophie P, another Mama Natural birth class grad, takes this list to new heights with her recommendation of NipplEase Silver Cups  – silver cups that rely on the healing properties of silver to soothe nipples.

3. Support your milk production

Be sure to drink a lot of liquids. (I know we hear this all the time but it really does makes a difference!) Shoot for at least 12 – 8 oz. glasses a day or drink to thirst. For nutrition, many moms have boosted supply by eating galactagogues like oatmeal, barley, millet and quinoa as well as spices like fennel, ginger and turmeric. Brewer’s yeast, flaxseed, almonds, and sesame seeds can boost your supply.

Try my delicious lactation cookies, which contain many of these pro-milk foods! Of course, Mother’s Milk tea, the herb fenugreek (learn more about fenugreek here), and moringa powder are wonderful for your milk supply, too. Be sure you are eating enough to keep up with the demands of nursing. For exclusive breastfeeding, you’re going to need at least 500 calories more a day.

4. Breastfeeding station

During the first few weeks of baby’s life, you’ll spend a lot of time nursing.  Create a cozy station in your home where you can easily reach drinks, snacks, and entertainment. Perhaps set up a nightstand next to your couch and stash it with:

  • Blankets and a portable fan (to deal with hormonal hot flashes)
  • Pillows or a Boppy
  • Burp cloths
  • A good view!
  • Books, kindle, remote for TV access
  • Snacks and water bottles

5. Easy snacks

During marathon nursing session, you wont’ always have a lot of time to prep snacks.  Stock your kitchen and pantry with quick, healthy snacksthat mama can grab easily: homemade trail mixes that are pre-portioned, sliced veggies and hummus, organic blue corn chips with guacamole, or overnight oatmeal already prepped in the fridge are just a few ideas.

A massive increase in hunger during breastfeeding is normal! When exclusively breastfeeding your baby, you’re burning an extra 500 calories a day!

6. Breast pump

Even if you don’t want to pump immediately, having a pump on hand is not a bad idea.  Pumping (even just a bit) may help reduce some engorgement if baby is having a hard time latching onto an engorged breast. You can learn all about pumping here.

Other natural mamas’ most essential postpartum items

I asked the moms on my Facebook page what was their most essential thing to have on hand postpartum. Here are some of their responses:

  • A good nursing bra and comfy panties!!!! Once I got those it made life so much better. -Robyn H.
  • A snack basket. New moms are starving all the time and having healthy snacks you can grab quickly makes life so much easier. My basket had trail mix, peanut butter crackers, protein bars, pretzels, nutrigrain bars, and some chocolate. -Lauren T.
  • Oh, and a giant water tumbler (40oz) with a silicone straw. Can’t mess with a water bottle one-handed. –Andrea P.
  • Immediate postpartum: It’s a tie for me between MamaNatural Bum Love Spray and an herbal rinse in perineal bottles […] the herbal rinse was healing, gentle, fast, and easy. The spray not only helped heal me and keep things clean, it’s wonderful aroma helped me feel less icky and kept my spirits lifted. –Chelsea B.
  • Padsicles!! I had a friend make me some. I had no idea how much I would need them! -Allie Michele M.
  • Chapstick!!! I really needed it when breastfeeding. I didn’t realize how dehydrated you could get. Also nipple balm and a breast pump which I needed when too full and baby was learning to latch on correctly. -Emily L.
  • I will continue to sing praises about the FridaBaby brand Fridet: the MomWasher. So much easier to use than regular peri bottles. That would be my number one. –Miranda R.
  • A postpartum team! Just like I needed my birth team, I need my people around me several days postpartum so that I could rest without feeling guilty. My mom and husband were so gracious during the first 5 days at home just allowing me to stay in bed or on the couch with baby. This allowed me time to heal physically before I was thrown back in to taking care of the house, and a two year old! This help was the most important thing for me! –Paige B.
  • Lactation consultant. –Crystal  A.
  • I lived in nightgowns with the breastfeeding snaps! –Jamie R.

November 15, 2018 / by / in
National Survey Reveals Widespread Misunderstanding about Postpartum Depression, the Most Common Medical Complication of Childbirth

More than half of women surveyed don’t recognize the causes (51%) and symptoms (62%) of postpartum depression (PPD)

Nearly one third of women surveyed who are pregnant or have children report their healthcare provider did not ask if they were experiencing symptoms of PPD

Survey results show 91% of women agree there is societal pressure on mothers to hide the struggles, anxieties and sadness of motherhood

RED BANK, N.J.Nov. 13, 2018 /PRNewswire/ — HealthyWomen, the nation’s leading independent, nonprofit health information source for women, today announced the results from a national survey of more than 1,000 women who are pregnant or planning to become pregnant about their experience with and knowledge of postpartum depression (PPD). The online survey, conducted by HealthyWomen and sponsored by Sage Therapeutics, sought to identify the perception and level of awareness of PPD, as well as any correlating communication gaps between expecting mothers and their healthcare professionals. The results show more education and dialogue are needed to increase understanding of PPD, despite being the most common medical complication of childbirth.

“With more resources available and more celebrities openly sharing their stories, I am surprised that our survey revealed many women and healthcare professionals are still not having the conversation about PPD and its signs and symptoms – which could lead to women suffering unnecessarily,” said Beth Battaglino, RN, CEO of HealthyWomen. “Here are the facts: an estimated one in nine women giving birth in the U.S. may experience PPD – you are not alone. It is important women who are pregnant or who have just given birth and their loved ones know the signs and symptoms – there is nothing to be embarrassed or ashamed about. Mothers need to feel supported and encouraged to ask for help. Receiving an accurate diagnosis and appropriate management of the condition are crucial, as PPD not only affects the mother, but can have a significant impact on the whole family.”

Key findings from the survey revealed stigma exists around PPD, as well as a lack of awareness and understanding about the condition:

  • Stigma
    • More than half (51%) of the 359 women surveyed who had been diagnosed with PPD think it is an embarrassing diagnosis to receive.
    • Nearly a third (32%) of women surveyed said if they were to experience PPD, they would be less likely to have more children.
  • Awareness and understanding
    • More than half (51%) of women surveyed mistakenly thought it would or might be possible to prevent PPD, not realizing the rising and falling hormone levels between pregnancy and birth are believed to play a possible role in triggering it.
    • Less than half (38%) of women surveyed were aware that having suicidal thoughts can be a symptom of PPD, suggesting a need for education about the gravity of this condition.

Symptoms of PPD are not the same for every woman and may involve feelings of sadness, hopelessness, emptiness or anxiety, crying, rage, and self-doubt about ability to care for the baby, among others. PPD is often confused with the “baby blues,” which can affect up to 80% of new mothers. Unlike PPD, the “baby blues” do not require treatment and usually go away within 10 to 14 days. Still, more than half of women surveyed did not recognize that a mother experiencing symptoms for more than two weeks may be experiencing PPD.

In spite of PPD being estimated to affect approximately one in nine women giving birth in the U.S., more than half of cases may go undiagnosed without proper screening. To learn more about the signs and symptoms of PPD, visit

About the survey
In September 2018, HealthyWomen and Sage Therapeutics initiated an online survey in the U.S. among women, aged 18 to 49, who are pregnant or planning to become pregnant. A total of 1,064 women completed a survey of 15 questions about experience with and knowledge of postpartum depression (PPD). Results of this survey represent the findings of this sample population.

About Postpartum Depression
Postpartum depression (PPD) is a distinct and readily identified major depressive disorder that is the most common medical complication of childbirth, affecting a subset of women typically commencing in the third trimester of pregnancy or within four weeks after giving birth. PPD may have devastating consequences for a woman and for her family, including significant functional impairment, depressed mood and/or loss of interest in her of energy and poor self-esteem. Suicide is the leading cause of maternal death following childbirth. PPD affects approximately one in nine women giving birth in the U.S. and 400,000 women annually. More than half of these cases may go undiagnosed without proper screening. There are no FDA approved therapies for PPD and there is a high unmet medical need for improved pharmacological therapy in PPD.

About HealthyWomen
HealthyWomen is the nation’s leading independent, nonprofit health information source for women. Our mission is to educate women to make informed health choices for themselves and for their families. For 30 years, millions of women have turned to HealthyWomen for answers to their most personal health care questions. HealthyWomen provides objective, research-based health information reviewed by medical experts to ensure its accuracy.

Nothing is more important to our health than access to competent and affordable care and the safety of our medications and health care delivery practices. HealthyWomen works to educate women about health policy issues in these and other areas. We recognize the importance of clinical trials to improving women’s health and support women’s health research, particularly where sex may make a difference in research results. HealthyWomen advocates on behalf of women to ensure that women’s health is a primary focus of policy makers and advocacy groups. Our investment in developing science-based information and our effort to incorporate perspectives reflected by advances in research and technology will further our mission to provide women with relevant and accurate health resources.

November 13, 2018 / by / in , ,
Why Textbooks May Need to Update What They Say About Birth Canals

Why Textbooks May Need to Update What They Say About Birth Canals

A new study shows that the structure of the human pelvis varies between populations, which could have implications for how babies are birthed.

A comparison of two human pelvises: The top is more oval in shape, representative of Europeans, North Africans and Native Americans. The bottom is more circular, representative of sub-Saharan Africans and Asians.CreditCreditLia Betti

By Steph Yin

Look up the term “pelvic canal” in the typical anatomy or obstetric textbook, and you likely will find a description such as this: “Well-built healthy women, who had a good diet during their childhood growth period, usually have a broad pelvis.”

Such a pelvis, the text continues, enables “the least difficulty during childbirth.”

But such characterizations have long been based on anatomical studies of people of European descent. In reality, the structure of the pelvic canalthe bony structure through which most of us enter the world, varies tremendously between populations, according to a new study in Proceedings of the Royal Society B.

The findings have implications for how obstetricians treat patients of color, the authors say. In the United States, racial disparities in maternal health care are prevalent. Compounding factors like interpersonal and institutional racism, poverty, poor health care access and environmental burdens disproportionately harm black mothers. These contribute to the risk of pregnancy-related deaths being three to four times higher for black women than for white women.

Limited prescriptions of what constitutes a “normal” pelvis or birthing process might lead doctors to perform unnecessary interventions — like induced labor, cesarean sections or the use of forceps — which can further exacerbate harm, said Lia Betti, an anthropologist at the University of Roehampton in London, and the study’s lead author.


“What worries me is that doctors come out of school thinking of the European model of the pelvis,” Dr. Betti said. In the early 1900s, this led to “horrific situations” in which American doctors used forceps on black mothers, trying to force babies to align with “the rotation pattern for a European classical pelvis,” she added.

Modern humans have narrow pelvises compared to the size of babies’ heads. That discrepancy contributes to higher rates of birthing complications in humans than in other primates.

Factors such as how long it takes a baby to progress through the canal, or which direction the head is facing on delivery, could change depending on pelvic shape.

There is no accepted explanation for why the human pelvis leaves such little room for childbirth. Dr. Betti and her colleague Andrea Manica, of the University of Cambridge, set out to study a classic if highly-contested explanation known as the “obstetrical dilemma” hypothesis.

The dilemma posits that as our species evolved and began walking upright, the width of the human pelvis narrowed, enabling the body’s weight to stay closer to its center of gravity. But as humans also developed bigger brains, it became harder for a fetus’s skull to squeeze through that tight channel.

To explore the idea, she and Dr. Manica measured 348 skeletons from around the world. They found that pelvic shape varied enormously, even more than measures of leg, arm and general body proportion that are known to vary significantly between populations. That was “remarkable and unexpected,” the researchers wrote.

Mostly, they found, pelvic shape varied along lines of geographic ancestry. People of sub-Saharan origin generally had the deepest pelvises back-to-front, while Native Americans had the widest side-to-side. Europeans, North Africans and Asians fell in the middle of the range.

Birth-canal shape also varied markedly within populations, although the variation decreased the farther a population originated from Africa. That finding is consistent with others indicating that a population’s genetic diversity declines the farther it moves from the cradle of humankind

Most of that variation in pelvic shape stemmed from random fluctuations in gene frequency, although natural selection seems to have played a minor role as well, Dr. Betti said. The top of the birth canal is slightly wider in populations from colder climates, perhaps to help make the body stockier.

The variation observed by Dr. Betti suggests that pelvic shape is not so strictly controlled. And if pelvic shape is highly variable across populations, it’s likely “that the birthing process is also highly variable,” said Helen Kurki, an anthropology professor at the University of Victoria in Canada.

These findings challenge the idea “that there is one ‘right’ way to birth a baby,” Dr. Kurki said, and suggest that a more individualized approach to childbirth might be better.

Although people differ from one another anatomically, Dr. Betti said, her research suggests that those differences are not always functional.

“If you look at the shape of the birth canal in different people, it could be tempting to think it’s adapted to give birth to babies with differently-shaped heads, or something like that,” she said.

“In fact, the differences are mostly by chance, which I think is beautiful. Sometimes human variation is just random.”

October 29, 2018 / by / in ,
This Woman’s Viral Photo Campaign on Miscarriage Proves That There’s “No Shame in Loss”

Jessica Zucker, PhD, a psychologist specializing in women’s reproductive and maternal mental health, has been committed to raising awareness surrounding miscarriage and stillbirth since she created the #IHadaMiscarriage campaign back in 2014. And because October is Pregnancy and Infant Loss Awareness Month, Jessica joined forces with poet and artist Skin on Sundays to spotlight 10 women who have battled infant loss.

In an effort to destigmatize what it’s like to lose a pregnancy or have a stillbirth, Jessica focused this year’s project on the raw emotional component of the experience. She had women pose with moving poems written on their bodies, and it’s visually powerful.

“My ultimate aim is that women feel a sense of comfort and connection upon learning about the #IHadAMiscarriage campaign,” Jessica told POPSUGAR. “With the statistics being what they are and the fact that pregnancy/infant loss is not a disease and is therefore not going anywhere, we need a community that accurately reflects back to us the feelings we feel but may be too afraid to say out loud.”

“In sharing our stories in this way, we encourage others to do the same.”

She emphasized that women need to stop believing there’s shame in losing a baby. “I want women to feel, not just intellectually know, they are not alone and that there is absolutely no shame in loss,” Jessica said. “My hope is that future generations won’t struggle with the silence, stigma, and shame that is currently so prevalent in our society.”

“This year I zeroed in on the lack of standardized rites and rituals in our culture surrounding this ubiquitous topic,” Jessica said. “We need a framework for grieving and for honoring ourselves and the babies we’ve lost.”

Jessica also explained that we need to discuss pregnancy and infancy loss more. She hopes she can play her part in moving toward a culture of openness. Her images are just one piece. “The photos captured the importance of this by way of expressing on our bodies our reproductive histories. In sharing our stories in this way, we encourage others to do the same.”

October 16, 2018 / by / in , ,
Tokophobia: the women with an extreme fear of pregnancy and childbirth

Childbirth can clearly be a scary prospect. For women who have not given birth before, it is the great unknown. Research into women’s concerns and fears suggests that women may be anxious about the risk of injuries or complications, pain, their ability to give birth, losing control, and interactions with health professionals.

Even  who have given  before may have similar worries – as every birth is different. But they may also have specific concerns if they had a difficult previous birth experience. This suggests that not only is it normal for women to be worried or anxious about birth, but that it would be unusual if they were not.

But of course, anxiety about birth occurs along a continuum. This ranges from women who are a little bit worried, to those who have developed a true phobia of birth. For some women, this phobia – known as tokophobia – is so severe that they never become pregnant or, if they do, they may decide to terminate the pregnancy.

Severe fear

There are interventions which can be effective for severe tokophobia. But women will only benefit from them if they feel able to disclose their severe  (and are taken seriously) – or if healthcare professionals are able to identify them. This does not just require training and increased awareness of tokophobia, but also appropriate screening tools and care pathways that ensure women receive timely and appropriate treatment.

At the University of Hull we have been working with local services for the last decade to ensure that women with perinatal mental health problems receive the care and support they need. Together with mental health practitioners, midwives and health visitors we are now developing a pathway for women with tokophobia.

Impact of social media

There is some research evidence that other people’s negative birth stories may increase the fear of birth for some women. But on the other hand, many women find it helpful to talk about their And research shows that peer support and sharing stories about challenging experiences can help to reduce feelings of isolation and provide validation.

Clearly, there is a tension here between the needs of these two groups of women – those who find it therapeutic to talk about their birth experiences and those whose fears may be increased by reading these stories. Contrary to some media reports, this is not about telling women to “shut up about childbirth”, but it is important to be mindful of the impact sharing may have on others.

Then there is also the issue that women who share traumatic experiences of birth on may have an unmet need for professional support – which would most likely be a more effective way of helping them cope with these experiences.

The right care

So while it’s clear that some anxiety and worry around birth is normal and to be expected, it’s also important that women with a more severe fear of birth feel able to talk about their concerns – rather than being told that it’s normal to be worried and that everything will be OK. This is important, because women who are experiencing a severe, overwhelming fear of birth will not be reassured by being told that everybody gets a little anxious. What they need is supportive, appropriate and timely care.

That’s not to suggest every pregnant woman who ever expresses any concerns about birth needs to be treated for fear of birth, though pregnant women with raised anxiety levels may benefit from interventions even if they do not suffer from tokophobia. Anxiety in pregnancy has been linked to a number of negative effects on mothers and babies. And early intervention can be crucial in preventing this leading to more serious problems.

But what’s most important, is that all women receive appropriate care and support – including women who have a severe fear of birth and those who have experienced traumatic births. Providing high quality care for all women should diminish the chances of women developing tokophobia after their first birth and help to reduce the amount of negative stories being shared.

October 9, 2018 / by / in
Orgasmic Birth – Power, Pleasure and Love!

By Debra Pascali-Bonaro

Imagine the day you will give birth, bringing a new life into the world.
You have waited 9+ months – feeling new life moving within, anticipating labor, birth and what life will be like as a parent. What will your baby look like? What will labor be like? What will the first moments of welcoming your baby be like? What words will you say? What music will be playing?

Have you heard stories of labor as joyful, challenging, powerful, transformative, pleasurable, blissful and Orgasmic? If not, you are missing some of nature’s Best-Kept Secrets. If you have already given birth – these words might not seem familiar to you, and yet every person deserves to give birth with power, pleasure and love!

What has gone wrong? Why aren’t more people having powerful, positive, pleasurable birth experiences?
There are many reasons and first it is important to understand that giving birth is a right of passage, a transformation which causes us to stretch, to grow, to face challenges, and so for some birth will be painful – but that does not mean it also won’t also include pleasure, love, and great joy. Childbirth holds it all and yet we are only hearing half of the story.

Often the very practices that put us down literally into bed and emotionally as well create the likelihood that birth will be longer, more difficult, and more painful. The childbirth practices of today often create more pain and overuse of valuable medication, interventions and surgery – all of which are helpful in some instances but put others at risk with their overuse. So many surgeries could be avoided and reduced if we understood the simple ways to honor our natural ability to give birth and created environments and opportunities to prepare for and give birth honoring our physical, emotional, spiritual, and sexual wholeness and well-being.

You are the expert on your body and your baby! Your care providers should be like lifeguards there to help you when you need assistance, but otherwise they sit quietly in the corner as you navigate the gentle waters, giving you the privacy and safety you need to experience the intimacy and joy of childbirth.

How do you begin to prepare for an Orgasmic Birth? (using each letter for thought)
Where do your beliefs about childbirth come from and are they correct? Seek out and listen to powerful, pleasurable birth stories. When you hear birth stories that are challenging and/or distressing ask what they would do differently if they had the chance.

Respect yourself and make sure everyone on your birth team respects you!

Get up
Gravity Works! Don’t take it lying down! Alternate activity with rest to pace yourself in childbirth, but remember that gravity will help your baby move down.

for support and love from your partner, hire a doula and interview care providers to make sure your midwife or doctor sees birth as joyful and pleasurable.

Just the act of smiling when you feel down changes the hormonal flow and brings you into a state where you want to smile. The more you welcome labor and see it as a powerful and pleasurable event, the more it will become one.

Dance your baby into the world and find positions that bring you comfort. Movement will help your baby move and find the easiest path into your arms.

Birth is a part of your sexual life and the same elements that allow you to open to intimacy will help you open gently to give birth. Consider the lighting, sounds, smells, privacy,touch and sensuous kissing, stroking, and words that help you release to pleasure and equally be aware of any obstacles that will block that loving feeling.

a language of pleasure. So many of the words about birth are illness based and leading to pain. What do you think of when you hear the word contraction? What the mind hears or sees the body feels. I love to call the sensations of labor “personal power surges”. When you re-language the experience many people find labor becomes less painful (or not painful at all), it can still be intense, challenging and strong, yet these are healthy sensations of your body doing the amazing work of birth.

Your breath helps you to be mindful to stay present, bringing calmness into your body and releasing any tension or stress. Connect to your breathe as you welcome each surge.

Visualize & focus on images of the birth you desire. Write down your birth desires remembering you are inviting your baby to share your desires too. Sometimes our children have different dreams, so if your baby chooses or needs another path, find elements in any birth setting or situation that bring you pleasure.

Labor and birth is a dance, the more you find your rhythm the easier it is. Rhythm can be like the gentle rocking of your baby and yourself, your breathe, a mantra or chant.

yourself or invite others you feel safe with to give you loving touch that will stimulate your pleasure and love hormones. Oxytocin, the hormone of love, and beta endorphin, the hormone of pleasure are the same hormones of intimacy and these hormones make birth easier and more orgasmic! What turns you on in life can turn you on in labor! Create an environment of privacy and safety for a safe, satisfying and pleasurable birth!

Open your heart chakra. “All you need is Love” – Love yourself, love your baby and invite those who love you to share their love with you. Imagine what would you like to hear and feel if you were baby? Nestled in a dark world – baby can hear the sounds outside. What sounds, feelings and sensations would you want your baby to be feeling as they leave their current home and move into your arms. Send your baby your love, talk with your baby sharing how much you love them and are looking forward to meeting them. We often forget the baby during the intensity of birth, but connecting during birth and creating a gentle loving birth helps a baby to breastfeed, bond and relax knowing they are welcome and loved. Opening your heart and preparing to welcome your baby with love and pleasure sets the stage for a lifetime of love!

October 8, 2018 / by / in
How Substance Abuse Affects Breastfeeding

The World Health Organization (WHO) recommends that infants obtain all of their nutritional requirements solely from breast milk for the first six months of their lives. After that age, the WHO suggests to continue breastfeeding until the child is at least 2 years old while introducing other foods into his or her diet.

Why is breast milk and breastfeeding the preferred choice?

The Benefits of Breast Milk and Breastfeeding

According to the American Pregnancy Association (APA), breast milk offers the growing child a variety of nutrients that include:

  • Protein for “quick and easy digestion” and reduced likelihood of infections
  • Carbohydrates that reduce unhealthy bacteria and aid in the absorption of the other vitamins in breast milk
  • Fat for proper brain and nervous system development
  • Multiple vitamins (A, B, C, D, E, and K), all of which contribute to the baby’s overall health and well-being

Essentially, breast milk offers many nutrients that help “protect against infections and reduce the rates of later health problems including diabetes, obesity, and asthma” says the APA, adding that the act of breastfeeding itself offers benefits too. It helps stop the bleeding after delivery, reduces the risk of breast and ovarian cancers, and strengthens the mother-child bond.

That’s why many health experts are so intent on making sure a mother has access to adequate care during the breastfeeding process. In order for her baby to get the proper nutrients through breast milk, the mother must get them first so she is able to pass them down.

But what happens if the breastfeeding mother ingests other substances? More specifically, what is the effect of various drugs—both legal and illegal—on lactation and breast milk?

Effects of Drugs on Lactation and Breastfeeding

Because nutrients in the breast milk come from the nutrients consumed by the mother, the same can be said about any other substances she ingests. Simply put: if a mother puts drugs of any kind in her body, they’re likely to be passed along to the nursing baby.

Therefore, specific recommendations exist regarding each drug—some of them legal and some of them illegal—and its consumption by a breastfeeding mother. Let’s go through a few of the most common now.


Caffeine provides a lot of benefits. According to Michigan State University, these include protection of brain cells, reduced risk of gallstones, prevention of various heart illnesses, and the ability to relieve headaches. But what does it do to breast milk?

Research has discovered that peak concentrations of the caffeine within the breast milk occur 60 minutes after ingesting it. The American Academy of Pediatrics (AAP) also says that less than 1 percent will transfer to breast milk.

Because this amount is so low, the AAP states that consuming caffeine is okay while breastfeeding, though this organization does recommend that it be consumed in moderation. If you spread your intake over the entire day, that helps as well.

However, if you notice that your baby is irritable or fussy, the AAP suggests that you try cutting down on your caffeine to see if that helps. This may involve limiting it for one hour before feedings so less is passed along to your baby.

Keep in mind also that caffeine comes from a variety of sources beyond coffee, tea, or soda. It is also in chocolate and many headache medications too.


Another drug sometimes consumed by new mothers is alcohol. But what does science have to tell us about alcohol and breast milk?

One study published in the New England Journal of Medicine included 12 lactating women, each of whom consumed 0.3 grams of ethanol alcohol per kilogram of body weight. For comparison purposes, the alcohol content of a few standard drinks includes:

  • Beer, 12 ounces – 5 percent alcohol
  • Wine, 5 ounces – 12 percent alcohol
  • Liquor, 1.5 ounces – 40 percent alcohol

Researchers discovered that after the mothers drank the alcohol, the odor of their breast milk became more intense for 30 minutes to one hour. Furthermore, the smell was the strongest when the alcohol content within the breast milk was at its peak.

This study also found that “the infants sucked more frequently during the first minute of feedings after their mothers had consumed alcohol… [but] they consumed significantly less milk.” Based on this, the researchers concluded that consumption of alcohol affects an infant’s feeding behaviors.

For reasons such as these, the National Institute on Drug Abuse (NIDA) suggests that nursing should be avoided for two hours after drinking. This way, any alcohol that has been consumed has adequate time to leave the mother’s body before potentially being passed on to the infant.

That being said, the NIDA also says that science has found that “alcohol does not increase a nursing mother’s milk production, and it may disrupt the breastfed child’s sleep cycle.” So, if you’re struggling with getting enough milk to adequately feed your infant or if he or she is having trouble sleeping, alcohol may be the culprit.


The Centers for Disease Control and Prevention (CDC) estimates that roughly 13.6 percent of the female population currently smokes. Additionally, those in the 25 to 44-year-old range smoke more than any other age group, with 45 to 64-year-olds coming in a close second.

Though the negative impact of smoking on the body includes major issues such as an increased risk of heart disease and cancer, there are other effects as well. For instance, people who smoke see a faster decline in vision, often have more wrinkles, and, for women in particular, tend to enter menopause at an earlier age.

Research has found that smoking while breastfeeding can also have negative consequences for the infant. For instance, one study published in the journal Pediatrics discovered that babies slept less if they consumed breast milk within 53.4 minutes of the mother smoking.

The American Cancer Society (ACS), adds to this topic, advising that smoking while breastfeeding has been linked to troubles with feeding, colic, and sudden infant death syndrome, or SIDS. Thus, they advise that not is the best choice. But if you do choose to smoke, they also indicate that “breastfeeding is probably still healthier for a baby than bottle feeding.”

Another concern is the mother’s exposure to secondhand smoke and whether the toxins can be transferred through the breast milk to the infant. Pediatrician and breastfeeding expert Jennifer Thomas says, “Even though trace chemicals from tobacco do pass into breast milk when a mom breathes in secondhand smoke, the disease-fighting cells in the breast milk outweigh the negative effect of those chemicals.” In other words, it’s more beneficial to the baby to have the breast milk, even if you’ve been around a smoker.

When talking about nicotine, there is also now the electronic cigarette, or e-cigarette for short. Midwife Clare Littler says that the long-term effects of these nicotine sources is not known, which is why she recommends vaping (the term used for smoking an e-cigarette) only after breastfeeding so it has a smaller impact on your breast milk.


Elizabeth Hartney, PhD, registered psychologist, professor, and Director of the Centre for Health Leadership and Research says that “cannabis is the most commonly used illicit drug among pregnant and breastfeeding women.” What effect does this have on a nursing infant?

According to research, tetrahydrocannabinol (THC), the psychoactive compound in marijuana, “is present in human milk up to eight times that of maternal plasma levels.” And because it has been found in the feces of infants exposed to it, it’s fairly clear that their bodies are absorbing and metabolizing this drug.

The Alcohol & Drug Abuse Institute (ADAI) adds that THC passed via breast milk can be “stored in the baby’s fatty tissue for several weeks.” This can create a variety of issues for the infant, ranging from experiencing tremors to poor feeding behaviors, and even decreased motor development.

Additional risks to breastfed children exposed to marijuana have been found to include:

  • Impaired development of the brain and nervous system
  • Decreased mental function
  • Emotional regulation issues
  • Hyperactivity
  • Sudden infant death syndrome, or SIDS

Because of this, Hartney advises that a breastfeeding mother not use marijuana at all. The American College of Obstetricians and Gynecologists (ACOG) agrees. And if you do use marijuana, Hartney suggests foregoing breastfeeding altogether.

If you decide to stop using marijuana in order to breastfeed, Hartney suggests that you do so 90 days before you expect to start breastfeeding because this drug stays in your system for an extended period of time.


The term “opiates” refers to a variety of drugs. A common street-level opiate is heroin. In the case of this drug specifically, some case studies have shown that a child breastfed by a mother addicted to heroin also became addicted to heroin themselves.

Children exposed to heroin through breast milk often have negative physical reactions as well. These include abdominal cramping, diarrhea, increased heart rate, and respiratory distress.

Some opiates are available legally, via a prescription. A couple of them are commonly prescribed to help individuals overcome their heroin addiction (methadone or buprenorphine), and others are generally referred to as painkillers that include codeine, hydrocodone, and oxycontin.

Though these prescribed opiates can be passed down to nursing babies too, guidelines published in Breastfeeding Medicine suggest that breastfeeding should continue with prescription opiates “regardless of dose.” However, use should be monitored by a physician who specializes in breastfeeding to ensure that it is safe for the baby. This is critical as some research has found that opioid toxicity can occur in breastfed infants.

The CDC adds that opiates in the form of codeine should either be avoided or taken in the lowest dosage possible during breastfeeding because they can potentially increase an infant’s risk of illness or even death.


The Substance Abuse and Mental Health Services Administration explains that stimulants “make people more alert [and] increase their attention.” Drugs that fall into this category include illegal options (cocaine and methamphetamine) and those that are prescribed (Ritalin, Adderall, and Dexedrine).

As with the other drugs, stimulants can be passed to the baby via the mother’s breast milk. Therefore, each one comes with its own recommendations with regard to breastfeeding.

For example, in regard to cocaine specifically, research published in the journal Canadian Family Physician says that even small amounts are dangerous to babies because they can’t adequately metabolize this drug. This can lead to agitation and irritability, but it can also lead to hypertension, tachycardia, and seizures.

For this reason, researchers recommend that mothers abstain from breastfeeding for at least 24 hours after using cocaine “to allow for drug elimination.” This helps limit the baby’s potential exposure to the drug.

Similar results have been found with methamphetamine use, which is also detectable in breast milk. In some cases, meth use during breastfeeding has led to the infant’s death. With regard to prescription stimulants, some studies have found that when they’re taken during breastfeeding, they aren’t known to cause any malformation issues, such as heart defects, finger abnormalities, or limb malformations. However, it is possible that they may negatively impact the mother’s production of milk when taken in larger doses, so it’s best to consult with a physician to ensure that you’re within a safe a healthy amount.

October 6, 2018 / by / in
Soldier surprises wife by arranging to see birth over Skype

Soldier surprises wife by secretly arranging to see birth of their baby girl over Skype while he is thousands of miles away in Afghanistan

With her army specialist husband serving in Afghanistan, Nicole Robbins was ‘pretty scared’ at the prospect of giving birth to their baby girl without him by her side.

But thanks to her husband’s initiative, the hospital’s help and the wonders of modern technology – she didn’t have to.

When a nervous Nicole went into an early labour at a Kansas hospital on Tuesday afternoon she was rushed into an emergency room where her husband was waiting for her…on Skype.

Robbins, an army specialist who is currently on a nine-month tour in Afghanistan, was determined to see the birth of his baby daughter and emailed the hospital to arrange setting up a Skype video conference for when his wife went into labour.

Staff at Menorah Medical Centre duly set up a computer on a bedside table right beside Nicole so the soldier could be part of the momentous occasion.

While in labour Nicole looked over at her husband who kept smiling at her, blowing her kisses and reassuring her, the new mother recalled to Fox News.

Shortly after 2pm, Nicole gave birth to their little girl, who weighed in at a healthy seven pounds, two ounces.

The baby girl, who has been named Silvia, is the couple’s second child.

Nicole confessed that it was not ideal that her husband could not be with them in person but said it was incredible that he was there at all.

‘At least he was part of the journey through Skype. It’s just been amazing,’ the beaming mother told Fox.

Despite the obvious downsides, Nicole says she believes her husband’s job is ‘extremely important’ and that she wouldn’t change it.

‘He will always carry that with him – he knows that he was there to witness the birth of his daughter,’ Nicole said, as she lay in her hospital bed, rocking her new-born.

Now Nicole is looking forward to Robbins returning home and meeting baby Silvia in person.


May 17, 2018 / by / in ,
The Difference Between PPD & Normal New Mom Stress

Postpartum depression may be common, but it’s not normal.

It’s NOT normal for a woman to suffer in new motherhood.  It is not normal for her to feel anxious most of the time, it is not normal for her to feel overwhelmed most of the time, and it is not normal for her to feel trapped and angry and uncertain most of the time.  There is no doubt that new motherhood is overwhelming and scary for most of us, but when these feelings take charge — when they become more dominant than feelings of relative wellbeing — there is something else going on.

I get my feathers ruffled every time that I hear someone say that their OB told them that the distress they were feeling was just part of being a new mom.  I am concerned each time a mom says that she waited to get help because she just assumed that the way she was feeling came with new motherhood, that she just had to get used to it, that it would go away on its own.  I become furious when I read articles or blog entries that assume postpartum depression is caused by a woman’s resistance to all that comes with motherhood.  Frankly, it’s all BS.  I want to yell this from the treetops.

So, here, my friends, is a bit of a reminder for all of you, and perhaps something to use as a guide if you are not so sure whether the way that you are feeling needs outside support. Here’s how to tell the difference between “normal” new mom stress and postpartum depression:

Healthy (or “Normal”) Postpartum Adjustment

  • Some feelings of overwhelm and anxiety that decrease with reassurance
  • Some “escapist fantasies” (a desire to run away) that occur when the logistics of mothering are challenging but go away when you baby is soothed, when you are rested, and when you are validated
  • Fears about harm coming to your baby that come and go, that you know are not “realistic” but that do not cause lasting distress, and that decrease as your experience and comfort with motherhood grows
  • Sleeplessness that occurs from caring for your baby at night, while still having the ability to sleep when your baby is sleeping or when given the option to rest
  • Fatigue that comes from late night feedings and interrupted sleep
  • Some feelings of frustration towards your partner regarding differences in parenting choices or differing roles
  • Moments of sadness, disappointment, or anger towards your parents when reminded of the ways that you were parented, but the ability to hold insight and perspective regarding your own relationship with your baby
  • Feelings of isolation that are caused by the increased time spent with your baby especially when a newborn, but also a desire and motivation to connect with others
  • Uncertainty that comes with this new job, and building confidence that comes with time
  • A hesitancy and worry that comes with allowing others to care for your baby, but a willingness to do this when you are in need of a break
  • A decrease in eating that is caused by the logistics of being a new mom
  • Temporary body aches and pains that are a result of childbirth and/or feeding
  • Feelings of worry about your baby’s ability to latch or feed as you hoped that decrease with feeding improvement or that shift when a new feeding option is chosen
  • Acknowledgement of the challenge that comes with new motherhood, but also the ability to look forward to things getting easier
  • Increases in energy that come with increases in sleep
  • Vulnerable feelings that come and go but that do not alter the way that you think about yourself

Postpartum Distress that Requires Support

  • Feeling anxious and overwhelmed most of the time, an anxiety that doesn’t go away with reassurance
  • Feelings of regret over becoming a mom that do not seem to go away
  • Repetitive and intrusive thoughts of harm coming to your baby that cause great distress and that impact your ability to care for your baby
  • Thoughts of hurting yourself
  • Sleeplessness that occurs due to “monkey brain” –  anxious thoughts that will not go away
  • A deep fatigue that is not alleviated with rest and/or a desire to remain in bed all day
  • Lacking appetite or a need to keep eating despite being full
  • Body aches and pains with no apparent cause
  • Relentless feelings of anger or rage towards your partner and/or others
  • Resurfacing memories about your own early childhood that cause great distress, anxiety, or sadness
  • Loneliness and isolation that occur while also pulling away from those who care about you; a lack of desire or motivation to connect with others
  • Persistent feelings that you’re not a good mom or you’re not good at doing motherly things, even despite validation or reassurance from others
  • Feelings that your baby does not “like” you because he cries or is not feeding well
  • Unrelenting anxiety about having others help care for your baby and a deep fear and inability to let go of some of this control
  • Never-ending feelings that you will never feel better
  • Sudden increase in energy that occurs despite a decrease in sleep; this may or may not include seeing or hearing things that aren’t really there
  • A general feeling of “not feeling like yourself”
  • Any uncomfortable or vulnerable feelings that persist for longer than 2-3 weeks – especially when these interfere with your ability meet your basic needs and/or live your life as you would like to

Please remember moms, new motherhood is challenging for all of us, but it should not be consistently distressing or miserable.  And it you are finding yourself wondering if what you are struggling with is “normal”- a good question to ask your self is, “Is this normal for me when I am well?”  If it’s not, there is help waiting.  You do not need to suffer through postpartum depression.

Kate Kripke, LCSW


May 17, 2018 / by / in
Air Pollution in Pregnancy

It’s easy to blame parents when young children gain too much weight, but the latest research suggests that certain obesity risk factors are out of Mom and Dad’s control.

In a study published this week in the American Journal of Epidemiology, scientists at the Mailman School of Public Health at Columbia University found that exposure to air pollution during pregnancy may be associated with a greater chance of having heavier kids.

Andrew Rundle, an associate professor of epidemiology, decided to study air pollution because he was curious about the role that environmental chemicals known as endocrine disruptors — compounds that include BPA, phthalates andparabens — play in determining weight. Endocrine disruptors, which mimic naturally occurring hormones like estrogen in the body and interfere with some developmental and metabolic functions, are also found in air pollution; animal studies have shown that mice exposed to estrogen-like compounds in air pollution gain more weight than unexposed mice.

Rundle and his colleagues set about tracking air pollution exposure in 702 women in their third trimester of pregnancy, by equipping them with air monitors tucked into backpacks. The women wore the backpacks for 48 hours, except while sleeping or showering, measuring levels of polycyclic aromatic hydrocarbons (PAHs), endocrine-disrupting chemicals found in cigarette smoke and car exhaust. The women, who were recruited from the university hospital’s New York City clinics, lived in the neighboring area, including the Bronx and northern Manhattan — areas that have heavy car traffic but are not known to have unusual amounts of industry-related pollution.

(MORE: Mom’s Exposure to Air Pollution Can Increase Kids’ Behavior Problems)

Children born to mothers with the highest PAH levels during their third trimester had a 79% greater risk of becoming obese, compared with children born to moms with the lowest PAH levels. By age 7, the risk was even higher — more than 2.25 times greater.

Previous studies have linked air pollution to increased risk of heart disease and stroke, and Rundle’s colleagues have shown that PAH exposure during pregnancy can also increase the risk of behavioral problems in children by age 5 and 7, but this is the first study to link the pollutant to obesity.

“It’s a fairly big effect,” says Rundle. “Obesity is really, really complicated, and there are different things pushing us in the wrong direction in terms of energy consumption and physical activity. I think we have to embrace the idea that the obesity epidemic is not just about you and me making personal choices that are not good for us, or moms making bad choices for kids. It’s a far more complicated problem than that, and environmental chemicals may play a role as one piece of the problem.”

Not all of the children whose moms were exposed to the higher levels of PAH became obese, but a significant proportion of them did, and the connection between PAH exposure and obesity remained strong even after Rundle’s team adjusted for other factors that could influencing factors, including the mother’s socioeconomic status, her income, and the median household income of the neighborhood in which the mothers lived. “We went through a long list trying to imagine all the reasons that could bias the relationship or explain it away,” says Rundle. “And after months and months of healthy skepticism, we came to the point of realizing that the data looked really solid.”

(MORE: The 10 Most Air-Polluted Cities in the U.S.)

To ensure that the obese children’s excess weight was due to fat, not added bone or muscle, the researchers measured body fat composition in a subset of 453 children; they found that fat almost exclusively accounted for the children’s heavier weight. That corresponded to animal studies as well, and could hint at how the PAHs are contributing to obesity — by disrupting how fat cells are formed and develop during childhood. Normally, most of the fat cells adults have are generated during the first year of life, beginning in utero; weight gain results when these existing fat cells swell in size, not in number. But exposure to potential endocrine disruptors like PAHs could interfere with the normal development of fat cells in infancy, and lead to an increase in fat cells from an early age.

It’s hard to avoid air pollution, particularly for expectant mothers living in densely populated cities. But it is possible to avoid the worst sources of PAH exposure, such as cigarette smoke. Avoiding smoking while pregnant and asking friends and family to refrain from lighting up can help, but Rundle says it’s time that more ubiquitous sources of air pollution also be recognized by public health experts and mothers as potentially long-term health hazards. Although Rundle’s study did not examine whether a child’s exposure to PAHs in his first five years of life could have been the driver of obesity rather than the mother’s prenatal exposure, the findings still provide hard-to-ignore evidence that breathing in polluted air could have health effects that may last a lifetime.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’sFacebook page and on Twitter at @TIME.



May 17, 2018 / by / in