Author: Mary Sauer

Giving birth is one of the hardest, most rewarding things I have ever done. I carried three babies and then welcomed them into the world. Each experience was wildly different: one induction, one short labor and delivery, and one long birth that stalled so many times I thought he’d never arrive.
At the same time, in the grand scheme of things, my births were all very simple. They were unique and special for me, but there was nothing extraordinary about them when compared to the huge spectrum of potential birth experiences. I had contractions, I got an epidural, and I pushed until my baby joined the world.
Birth is an experience that is different from mom to mom. It’s completely natural and typically follows the same pattern of events, but it can also be unpredictable and unexpected. For new moms, or moms who simply want a different experience from their last, there are seemingly endless birthing decisions to make. Will you have your baby in a hospital or at home? Will you get an epidural or use other methods to manage the pain? Here are the options.

Getting Things Started

Unless you are scheduled for a cesarean section, your body has to go into labor before you can actually give birth. Modern moms are offered the option to wait for spontaneous labor or have their labor induced, typically through the use of a drug called Pitocin.

When it comes to getting things started, there are many benefits to letting nature take its course. It is generally accepted that spontaneous labor is associated with a lower risk of intervention, specifically decreasing the risk of needing a c-section or an epidural, as documented in a study published in The Journal of Reproductive Medicine. Elective induction, meaning induction without a clear medical need for it, is found to increase the risk of needing a c-section, having an epidural, and causing concerning heart rate changes in the unborn child.
At the same time, benefits of induction do exist for mothers who are over 41 weeks gestation. For these moms, who have carried longer than typical pregnancies, elective induction actually reduces the risk of a c-section compared to moms who wait for spontaneous labor past 41 weeks, according to a medical data compiled by Stanford-UCSF Evidence-Based Practice Center.

Of course, there are also cases when induction is no longer considered elective because the mom or baby’s condition requires an early delivery. In some cases, such a placenta previa, a scheduled c-section is required to protect the baby and the mother’s help, according to James Betoni, a leading high risk maternal fetal medicine OB-GYN Boise, Idaho.

Does environment matter?

We’ve covered the question of when a mom gives birth, but what about where? Moms can choose between a hospital birth, home birth, or birthing center. Although the popularity of home births has increased over the last decade and a half, most mothers still plan to have their babies in the hospital. Home births accounted for .89 percent of all births in 2012, the last year the Centers for Disease Control and Prevention collected data on this subject, and .39 percent of moms chose a birthing center.
It’s difficult to compare the benefits of in-hospital and out-of-hospital births. For instance, a 2015 study published in The New England Journal of Medicine did find differences existed between in-hospital and out-of-hospital births, but they were not only insignificant, the study also noted that negative outcomes of births were very low in both situations. More specifically, fetal death was more likely in an out-of-hospital births, but only slightly, and the difference was not enough to be considered statistically significant. One thing worth noting was that obstetrical intervention, specifically c-sections, were more likely in planned hospital births than in planned home births.

Even so, the choice to deliver a baby at home or in a birthing center is a controversial one. Although the United Kingdom has taken an official stance on the subject, encouraging low-risk mothers to consider home births, the United States is more resistant to the idea.
“For low risk women who are properly screened, home birth is a safe option,” says Christina M. Kocis, certified nurse midwife and doctor of nursing practice, director of the Division of Midwifery at Stony Brook University Hospital. “I think we don’t have an infrastructure or a system here that supports that as they do in the UK.”

She also notes that because the UK supports home births, these births tend to be attended by certified midwives who are actually part of the national healthcare system; this isn’t the case in the United States. Of course, it is possible to find properly trained and licensed midwives in the United States, but mothers should be aware that there are lay midwives practicing here and ensure that their home birth team has received proper licensure.
In addition to the choice between hospital, home, and birthing center, there is the choice of water birth or giving birth in bed. Unfortunately, there is not a lot of research available on potential negative outcomes associated with these two choices. One study, published in 2016 in The Journal of Midwifery and Women’s Health, found no risks for babies associated with their mother choosing a water birth but noted that moms might be at an increased risk for genital tract trauma.

Of course, risk factors aren’t the only thing worth considering. For moms who are looking for alternative pain management options, a water birth might be an appropriate choice since it is believed to offer the benefits of added comfort and helping to calm the mother, according to the American Pregnancy Association.

Drug-Free or Pain-Free?

The next choice moms have to make might be among the most debated of birthing choices. Should mom get an epidural, or should she opt for a birth free of pain medication?

There are some downsides to electing to have an epidural, according to a study published in Obstetrics and Gynecology International. Research suggests that having an epidural is associated with a slower second stage of labor which may increase the likelihood of c-section. And mothers who have an epidural are at an increased risk of an assisted delivery, meaning medical instruments are used during the delivery to remove the baby from the birth canal.

There are no risks associated with giving birth without pain medication, however, as Kocis points out, physiological effects are not the only thing to consider in this decision.
“There may be patients who need pain medication who, as a result of using pain medication, may … have a birth that, in retrospect, was either calmer or, in their opinion, may be less traumatic for some women,” she explains. “But the same can hold true for women who get the medication.”
This choice is one that is difficult to generalize, according to Kocis, and that seems to be true based on what moms who have experienced either an epidural or a drug-free birth share with HealthyWay.

“The whole experience was fantastic. I was fortunate to have a quick labor, but I really appreciated being in control of my body,” shares Betsy Larson, a mom of one who opted out of an epidural for her planned hospital birth. “I wasn’t confined like I was concerned I would be with an epidural.”

In comparison, Erin Heger, a mom of one who also had a planned hospital birth without an epidural, says that the advantage of being in control and having the support of her doula was great, but it wasn’t worth the pain and exhaustion she experienced.
“I will not be doing it again,” she says of her drug-free birth.

Laboring Techniques

An epidural isn’t the only method for managing pain during labor. When it comes to laboring techniques, HypnoBirth and the Bradley Method seem to be the most popular among today’s moms. Much of want is known about the benefits of these laboring techniques is anecdotal, according to a comparison of the two written in The Journal of Perinatal Education.

However, this research does make it clear that each of these methods holds benefits for moms with specific desires and circumstances. HypnoBirth, for instance, is heavily focused on pain management through self-hypnosis, making it a great option for women committed to managing their pain themselves or who are without a supportive partner.

In comparison, the Bradley Method is all about the partner, teaching the significant other to be the laboring mother’s coach through the labor and delivery. Each of these methods can be incredibly helpful to laboring moms, according to Kocis, but much of the success is dependent on the mother (and her partner) and their ability to commit to really learning the practices of the technique.
https://twitter.com/pwilsonnn13/status/955837893683138560
Ultimately, when it comes to making choices about how and where a mom will labor, the choice is all about her specific medical needs and her preferences. What one mom wants or needs may be vastly different from another mom’s hope for her birth, and it is important to spend time reflecting on that before making a decision. Most importantly, moms should be sure they are educated so they can make good choices for themselves and their baby.

Basics for the complex:
The way you give birth is NOT a competition. Natural, C-section, or Epidural does not define you as a mom. A mom is a mom.

— Tanya Sparkles (@Tanya__Sparkles) January 22, 2018

“There is no one answer,” explains Betoni. “Every patient is different and every story is different. When there is an option, as long as the patients are educated, the mom should have a say.”

Growing up, I felt like my mother and I couldn’t be any more different. She is orderly and logical, with a knack for simply doing the next thing that needs to be done. She has strong convictions about what’s right and wrong. On the other hand, I have never been known as neat or organized. I tend to spend more time dreaming, and, although I have strong moral convictions, they’re a little more abstract. I’m the yin to her yang.
Being different from my mom was never a problem, really. Of course, we did butt heads from time to time, but we mostly understood one another and accepted each other for who we are. What I didn’t expect, however, was that time would reveal that I was much more like her than I had ever expected.

I never anticipated that I’d notice myself sounding just like her. I was surprised the very first time I caught a glance in the mirror at my adult face, thinking I had spotted my mother for just a second.

Like my mom and me, mothers and children share a lot, no matter how different they may seem. It’s inevitable. Whether learned from watching them or passed down through genetics, children are destined to inherit certain traits from their parents.
Unfortunately, there are also certain health risks that are more likely to be passed from mothers on to their sons and daughters.

The Science of Inherited Traits

In the nucleus of each cell in the human body, you can find the chromosomes you inherit from your parents. You have 23 pairs of chromosomes, with one half of each pair from one parent and the other half from the other. These chromosomes determine what traits you inherit, like the color of your eyes.

What traits you inherit from which parent really depends on a lot of things. Some genes are dominant, which means they get priority over other genes no matter which parent they come from. It isn’t just physical traits that get passed from parent to child, according to the United Kingdom’s National Health Service. If there are mutations on a gene, those mutations may be inherited by the child. Of course, genetics are not completely to blame: Many conditions are random or caused by environmental factors, according to Erin O’Toole, MS, a certified genetic counselor and the owner of Family Forecast.

“Down syndrome, for example, is a typically random event but does tend to happen more frequently as mothers get older,” she explains. “If a mother or father is personally affected by a genetic condition, a child is typically at increased risk, but this risk would change depending on the condition.”
Additionally, sometimes genetic conditions are simply carried by a parent, who remains unaffected, but they can pass on the condition to their child. And there are some conditions that require both parents to be carriers for the child to be at risk, while others require only the mom or only the dad.

When it comes to physical traits, it’s kind of a toss up whether mom or dad passes on a certain trait. What we do know, however, is that there are a few traits and conditions that are more likely to be passed from mom to child. In some cases, it’s all genetic. In others, it’s about the environment the mom provides during pregnancy and early childhood.

Apple or pear?

One’s body type can be inherited from their mother, according to a study published in the journal BMC Biology in 2014. In this study, they discovered that two specific imprinted genes influence the composition of muscle and fat in the body of mice. And one of those imprinted genes, known as Grb10, was linked to an increased risk of obesity and a glucose intolerance in those mice.

So what does this mean for humans? Scientists believe further research should take place to examine the possibility that maternal genes and paternal genes are working against each other to determine body composition with maternal genes linked to higher body fat.

Just Like Mom

When it comes to fertility in women, a genetic link may exist between mom and daughter. Specifically, the age of mom as she begins menopause might have a correlation with infertility in her daughter.

According to a study published in the journal Human Reproduction, the number of eggs left in a woman’s ovaries decreases more quickly in the daughters of women who enter menopause earlier in life. This is an important aspect of fertility, since we know that egg count and quality decreases as women grow older.

It’s in Our Blood

Women who carry a specific blood disorder might pass that disorder onto their sons. Hemophilia is a clotting disorder that causes abnormal bleeding, most frequently experienced by men. This is a genetic disorder that is carried on the X chromosome. When a mother only has one hemophilia gene, she carries the disorder but doesn’t exhibit symptoms. If she has a son, he will inherit hemophilia from her and, since he only has one X Chromosome, he will experience the symptoms of this clotting disorder, according to the National Heart, Blood, and Lung Institute.

Mental Health Issues

Prenatal depression is believed to be experienced by as many as 23 percent of expecting moms, according to research published by the American Pregnancy Association. Many mothers experience symptoms that go well beyond nervousness about the new baby, experiencing hopelessness, mood swings, and even anger.
[pullquote align=”center”]“Having a parent with a mental health condition does increase the risk for a child, but we are still often unable to determine the extent of the increase.”[/pullquote]
Unfortunately, it is believed that many moms go undiagnosed or untreated. We know that prenatal depression does influence the health of a baby. It is linked to negative birth outcomes like problems with development and lower birth weights. There is also an increased risk for the child developing mental health problems later in life, although research is still inconclusive on how much this risk is increased, according to O’Toole.

“Mental health conditions, including depression, are categorized as ‘multifactorial’ conditions, meaning they are the result of multiple genetic and non-genetic factors,” she explains. “Having a parent with a mental health condition does increase the risk for a child, but we are still often unable to determine the extent of the increase.”

For parents who are concerned because of their own mental health background, she suggests a discussion with child’s pediatrician so both parents and doctor can be on the lookout for symptoms and discuss early intervention if needed.

A Scary Cancer Gene

Certain mothers pass a high risk of breast cancer on to their daughters. Specifically, there are two gene mutations that are increased with a higher likelihood of developing breast cancer and ovarian cancers
Certain mutations of the genes BRCA1 and BRCA2 are passed from mother to daughter and are responsible for an estimated 20 percent of hereditary breast cancers and 15 percent of ovarian cancers, according to the National Cancer Institute.
Of all the women who inherited the BRCA1, between 55 and 65 percent will end up with breast cancer. This is a staggering number when you consider that 12 percent of the general population of women are diagnosed with breast cancer. When it comes to the BRCA2 mutation, around 40 percent of women who inherit this mutation go on to develop ovarian cancer.
The good news is that the mutations are not common, so only those with a family history of women being diagnosed with breast cancer or having already tested positive for a specific mutation need to receive testing genetic testing.

When should I have genetic testing?

For expecting mothers, it is important to understand that passing on genetic conditions is not a common experience. Most mothers experience healthy pregnancies and give birth to healthy children.
[pullquote align=”center”]Would I want to know in advance if I were going to have a baby with a genetic condition?[/pullquote]
However, it is always it a good idea to understand if you have risk factors for passing on a genetic condition to a child. Although O’Toole suggests genetic counseling to all mothers, she says there are specific clues that a mom should definitely have genetic screening.

“Being over 35, having a family member with a genetic condition, or having a history of a poor pregnancy outcomes are all reasons to consider genetic screening,” she explains.
Additionally, she believes all moms who may conceive or are currently pregnant should spend time asking themselves hard questions about what they want to know about their unborn child and how those answers will influence her choice to have genetic screening.

“Asking questions like, ‘Would I want to know in advance if I were going to have a baby with a genetic condition? Would this information change how my family and doctors prepare for the birth and newborn period? Would I consider ending the pregnancy or creating an adoption plan?’ can help you decide if you want to explore your testing options more with your doctor or genetic counselor.”
And, for women who are dealing with anxiety about their pregnancy, a genetic screening that reveals that mother is low-risk can be the reassurance she needs to enjoy her pregnancy without the overwhelming fear of the future of her baby’s health. Knowing her baby has a low-risk of inheriting a life-changing condition just might mean less time worrying and more time daydreaming about whether they’ll get mom or dad’s eyes.

“My oldest tends to be my favorite most often,” one mom of three—let’s call her Samantha—tells HealthyWay. “She is at a stage that is less challenging for me currently, and she is most like me, so I understand her the best.”
Before you jump to conclusions and find yourself wondering what kind of mom favors one child over another, you need to know two things.
First, Samantha is quick to point out that her favorite child changes from time to time.
“Relationships with our children are like relationships with any other person in that we connect to them differently,” she explains. “I love them all equally, but I certainly may like them differently depending on the day.”
The second thing you need to know is that Samantha isn’t all that different from other parents. The only thing that truly sets her apart is that she is honest about favoring one child over the other, while many parents deny this to be true. The truth is, research actually shows that favoring a child isn’t all that uncommon. And, like Samantha, most parents will favor their oldest child. Birth order does influence how parents feel about their children, according to a study published in The Journal of Family Psychology.

In the study, which was published in 2005, 384 families were surveyed. Each of these families had a pair of children that were no more than four years apart in age. And although the parents did admit to having a favorite child, they didn’t admit to which child it was. Instead, the children themselves were surveyed on how they perceived preferential treatment from their parents and how it impacted their self-esteem.

And the Winner Is…

In the study, both oldest and youngest child argued that their sibling received preferential treatment. Of course, if any of us think back to our own childhood, we might say that our parents liked our sibling better, too. It goes to show that, no matter the birth order, children are going to believe they are being slighted by their parent.

This wasn’t the only thing we discovered from their survey results. Much more telling were the revelations about how preferential treatment influenced feelings of self-worth. Specifically, it was the oldest child who was impacted the least by preferential treatment. Meanwhile, younger kids were much more likely to have their self-esteem suffer, suggesting that the parents did, in fact, favor the older child.
Additionally, in a second visit with these families, conflicts and problems were presented to the family. In recording the family as they attempted to resolving these conflicts, researchers noted that preferential treatment seemed to fall on the oldest child most often.

What about families that don’t fit in the neat mold of having two children? Well, middle children are the least likely to be favored, according to The New York Times.

Why Parents Play Favorites

As explained above, parents are definitely most likely to favor their older children. Of course, there are always exceptions to rules, and birth order isn’t the only factor that influences how parents feel about their children. The truth is, behavior does impact how parents treat their kids.

It’s hard not to prefer the kids who make parenting easier, according to Kryss Shane, a licensed clinical social worker who specializes in adolescent and child counseling. She explains further that if parents are busy, the child who is more likely to sit quietly during work calls or stressful times may gain a spot of favoritism as well.
For one mom of two, birth order doesn’t seem to matter at all. She admits to struggling with feelings of preference towards her youngest child on a regular basis.
“I have a favorite child,” she admits. “It’s the one who thinks linearly, isn’t lost in his head, and is affectionate. It’s easy to spend time with him and I understand him.”

She continues on to explain that her other child, her oldest, is much different. She doesn’t understand the way she thinks, often feels overwhelmed and unnerved by her chatty and hyperactive nature, and frustrated by her misbehavior.
In other cases, similarities that exist between parent and child my explain why a parent may show preference. Bonding over music or hobbies may provide a stronger connection, says Shane. And if the child is exceptional in a way that is prioritized by the parent, such as getting good grades or performing well in sports, parents may favor kids because of the pride they feel for that child or the bragging rights they provide.

Interestingly enough, although many parents may say differently, the child who receives the status of favorite child probably remains the same, no matter how their behavior or performance changes, according Oksana Hagerty, PhD, an educational and developmental psychologist who serves as a learning specialist at Beacon College.
“No matter what has happened, most of the time, the status of the kid as a favorite or a non-favorite remains the same throughout the life of the kids or the parent,” she says.

When Favoritism is Harmless

Not all feelings of favoritism are reason for concern, according to Shane. In fact, she believes these preferences are fairly typical, and research backs that up. The truth is, 70 percent of mothers report feelings of preference towards one child, and 74 percent of fathers say the same.

“It’s generally assumed that having a favorite child is wrong because it puts children against each other and means that at least one child has to then be the least favorite child,” Hagerty says. “However, this is super common, it’s something that can change frequently, and it is no reason for parents to feel guilty.”
Additionally, feelings are simply feelings. And for mothers like Samantha, keeping favoritism harmless might be as simple as working hard to behave fairly towards your children, no matter how you feel.

“It doesn’t affect the family dynamic,” says Samantha. “Time and time again, I have made it explicitly clear that I love each of them with a love so deep they could never understand it, and no matter what they do I would never stop loving them.”

When Favoritism is Harmful

That being said, there is no question that favoritism can be harmful to the family dynamic. According to Hagerty, it is pretty typical for favoritism to affect sibling relationships.

“Very rarely does the child who is not a favorite perceive this situation as normal,” she says. “Most of the time, unfortunately, playing favorites causes rivalry between children and really affects their relationship in the future.”
According to Shane, self-aware parents should be able to see when their affection towards their children becomes a problem. Favoritism is harmful if it leads you to have more relaxed rules for one child or if you spend far more time with a specific child.

Additionally, parents should be open to criticism from friends, co-parents, and even their children on this topic. In some cases, children will speak up, pointing out that their parents are showing preference toward one kid time and time again. This is a pretty good indication that there is a problem with the family dynamic.

Here’s What to Do if Favoritism is Harming the Family Dynamic

We all make mistakes, and showing our feelings of preference toward one child is a one that many parents may find themselves making. So what should be done in this situation? Shane recommends attacking the problem head on.

“If a parent recognizes they’ve slighted another child or other children, it may be time to reexamine rules in the home,” she says. “To try to refrain from having one long-term favorite, parents can work to engage with each child one-on-one so each gets alone time with their parent. Parents can also work to rotate activities during family time so every child gets to do their favorite thing periodically.”

Shane also recommends professional guidance, like counseling, if favoritism is becoming a problem in your home. A counselor can help parents examine the dynamics of the home, making certain they’re not responsible for creating a conflict and tension between siblings. Additionally, a therapist can help determine if favoritism is damaging the self-esteem of non-favorite children in the home and offer direction on what should be done next.

In the case that behavior motivates preferential treatment, it’s a good idea to address that specific aspect of the relationship. Shane suggests beginning by planning some one-on-one time with that child doing something they prefer and listening to whatever they have to say.
“You may find that they have a lot to say but don’t compete with siblings,” she says. “Or that something is going on that may be causing their tricky behaviors at home. If any one child is becoming increasingly difficult or creating problems at school and at home, it may be time to consider seeking professional help and guidance.”