Category Archives: 1. Pregnancy & Birth

Fertility and conception, pregnancy, childbirth, and the early postpartum period.

Sibling Spacing: Five-Plus Years Apart Means More Time with Each Child

By Amy Carrier O’Brien

**Originally published in the Spring 2008 New Baby issue of The Journal of API

Owen, Liam, and Aiden
Owen, Liam, and Aiden

Aiden was seven and a half when Owen was born, and almost ten when Liam was born. He had already been with us through the many adventures that had created the foundation of our lives. We didn’t set out to have our first two kids seven years apart; it just worked out that way.

Spacing Children Around College

We were undergrads in college when Aiden was born, with both Jim and I having full class schedules and part-time jobs. Aiden was there with us through college, relocating to what is now our hometown, and navigating through our first “real” jobs. He even went to work with Jim during our first summer out of school.

When Aiden was four, and our feet were firmly planted in our jobs and new house, we considered having more children. Just when I had become attached to the idea of having another child to love, I got the opportunity to go back to school for a master’s degree. Other than us wanting another child, it was the perfect time to go, and my employer would pay for it. Continue reading Sibling Spacing: Five-Plus Years Apart Means More Time with Each Child

Sibling Spacing: Two Years Apart and Getting Easier with Age

By Melissa Hincha-Ownby, API Resource Leader of Arizona, API’s Technology Coodinator, and API’s Forum Administrator

**Originally published in the Spring 2008 New Baby issue of The Journal of API

Melissa's son and daughter
Melissa’s son and daughter

One of the most common questions that parents ask themselves when they are considering expanding their family is, “What is the ideal spacing between children?” There is no right answer to this question, as what is ideal to one family may make no sense to another.

The answer for our family was two years. My sister and I are three and a half years apart, and while we are the best of friends now, the age difference left us both alone in high school. Based on my personal experience with my sister, I knew that I didn’t want my children quite so far apart.

Although two years was on the maximum end of what my husband and I were hoping for, fate stepped in and had other ideas. Ultimately, my daughter was born when my son was two years and three months old. In hindsight, the 27-month difference has turned out to be great. However, in the early years, at times, things were definitely tough. Continue reading Sibling Spacing: Two Years Apart and Getting Easier with Age

Sibling Spacing: One Year Apart, Too Close or Just Right?

By Rita Brhel, managing editor and attachment parenting resource leader (API)

**Originally published in the Spring 2008 New Baby issue of The Journal of API

Rachel and her doll
Rachel and her doll

I love babies, especially the newborns. I love breastfeeding, babywearing, co-sleeping, the whole shebang. When other mothers can hardly stand to get through those first couple months of irregular schedules and sleep deprivation, of crazy diaper explosions and unpredictable spit-up sessions, I am soaking it all in – the comfort of knowing that I am all my little one needs, at least for a little while. For all the challenges my oldest daughter, Rachel, threw my way during her first year of life, the joys and amazement of becoming a parent far outweighed the negatives.

When Rachel turned eight months old, I turned to my husband Mike and said that I thought it’d be fun to have a baby every year. The next month, we found out I was pregnant. It wasn’t planned, but it was wonderful news. There was a problem, however, in that Rachel was far too young to comprehend what it meant to have a new baby brother or sister. Throughout the pregnancy, I tried to introduce the concept of a “baby” to her. I pointed out babies in books and on the TV. I wrapped up one of her stuffed animals in a diaper and blanket. We visited a friend with a newborn baby.

Reality Sets In

In my ninth month of pregnancy, I began to worry about how bringing home a new baby would affect my 16-month-old daughter. How would Rachel handle living with Grandma in an unfamiliar house while I was in the hospital? How would she deal with me being unable to lift her and hold her for eight weeks after a medically necessary cesarean section? How would she cope with not being the sole center of my universe? Continue reading Sibling Spacing: One Year Apart, Too Close or Just Right?

Considerations of Sibling Spacing on the Family Dynamic

By Rita Brhel, managing editor and attachment parenting resource leader (API)

**Originally published in the Spring 2008 New Baby issue of The Journal of API

childrenOne year, two years, five years, ten years – just what is the ideal spacing between siblings?

Every mom contemplating their second child wants to know the answer. But just try to look up an exact answer on the Internet, in a magazine, or in a book. Most of these resources, if they choose to pinpoint an age gap, promote anywhere from two-and-one-half to five years as the best range, but no one can say for sure just what is best when it comes to the appropriate spacing between brothers and sisters.

The answer from many experienced parents is it all depends on what you think you’d like. Some say that closely spaced children, those with only a couple of years or less between them, will be more work in the early years but give siblings a playmate. Others claim that widely spaced children will give parents a break from the energy-intensive early years, but the siblings may not be as closely bonded. Continue reading Considerations of Sibling Spacing on the Family Dynamic

When It’s OK to Induce Labor, and When It’s Not

By Rita Brhel, managing editor and attachment parenting resource leader (API)

One in five pregnant women will have her labor induced, for varying reasons. Some of these reasons are valid; others are not. Catherine Beier of weighs in.

When it’s OK to induce labor:

  • Pre-existing medical conditions in the mother – These may include heart disease, a seizure disorder, hypertension, cancer, or another serious health issue, although many women with these disorders can still give birth vaginally.
  • Pre-existing medical conditions in the baby – If the baby is known to have a congenital or other medical condition that requires intervention or intensive care immediately after birth, induction may be the safest way to ensure the baby gets the care that’s needed.

And when it’s not OK to induce labor:

  • Overdue pregnancy – While the American College of Obstetricians and Gynecologists warn against induction before 39 weeks, the average pregnancy worldwide lasts 42 weeks. For medical doctors who don’t want to wait that long, they should consider accuracy of a woman’s due date, which is calculated on a 28-day menstrual cycle with ovulation on day 14; for women with long or irregular cycles or late ovulation, this due date can be significantly inaccurate. For these women, a reliable estimate of the due date, within one day, can be obtained with a transvaginal ultrasound at eight to ten weeks of gestation. As the pregnancy progresses, ultrasound becomes a less reliable predictor of the due date, as the weight estimate can be off by as much as two pounds.
  • The baby is too big – The vast majority of women are able to give birth vaginally to their babies, even those who are larger. Because hormones during labor relaxes and stretches the hips and pelvis, for those very few whose pelvis is too narrow to birth a full-term baby, it’s impossible to know until the time of childbirth.
  • The mother is too tired or uncomfortable – Remember, it’s called labor for a reason. Labor can be rather long and hard with the first baby especially, but it is normal.
  • It’s more convenient to know when the baby will be born – Whether induction on a certain day is better for the baby’s family or the medical provider, this does not take the baby into account and not a true reason.

Morning Sickness as an Attachment Education for Baby’s Father

By Rita Brhel, managing editor and attachment parenting resource leader (API)

Pregnant women know better than anyone how connected they can feel to the new, little life growing inside them – even if the baby is so tiny that its kicks can’t be felt. From the moment, a woman learns she’s pregnant, she begins counting down the months and days until she can meet her baby face-to-face.

Morning sickness, while irritating, is a sign that the pregnancy is going well, according to the American Pregnancy Association – which is especially assuring to a particularly anxious mother-to-be or someone who experienced a threatened miscarriage early on.

Morning sickness also provides a time for fathers-to-be to connect to their babies…by way of better connecting with their wives. After all, one of the best models of a healthy relationship for a child, in addition to the parent-child bond, is the mother-father interaction.

Just as new fathers often enjoy putting a hand on the mother’s pregnant belly and reading stories to the unborn child, they can begin bonding by providing comfort to the mother-to-be, which will also keep the adult-adult relationship close during a time when exhaustion and mood swings may threaten to push them apart.

Australian filmmaker Troy Jones explored this in his documentary Being Dad: Information and Inspiration for Dads to Be, as reported by Tara Taylor of “A few topics always came up in the group conversations. The first was how to help your partner with morning sickness. Many expecting fathers felt helpless in the face of nausea.”

First and foremost, mothers-to-be must understand this feeling from their partners and to focus on ways he can stay connected during the pregnancy, especially when the women are not feeling their best. Here are some ideas to help you better involve your husbands’ or partners’ desire to help when morning sickness, fatigue, mood swings, backaches, and other pregnancy discomforts begin taking their toll on your relationship:

  • Encourage honest and open communication – This was the most important tool offered by R. Morgan Griffin’s 2003 article “Advice for Expectant Fathers” on Not only will talking help you release your frustrations and fears about pregnancy, childbirth, and parenting, but it provides a way for men to voice their anxieties, too, and be able to help you by providing emotional support.
  • Put him on nutrition duty – According to, the father-to-be can be a pregnant woman’s personal cheerleader, not only in reminding you that morning sickness is a good thing but also in encouraging you to drink enough water and helping you to choose healthy foods – when you’re able to keep food down. The same encouragement may be needed when it comes to taking the prenatal vitamin and letting the mother-to-be know that it’s OK to go to bed early or take a mid-day nap, rather than continuing to try to do everything you could do before getting pregnant.
  • Give him specific requests – Also according to, if you know of something your husband can do to help you feel better, let him know. Perhaps, it’s bringing toast to your bedside in the morning or giving you a backrub or making sure that the fridge is cleaned out of odorous foods.

Morning sickness also provides a time for fathers-to-be to connect to their babies…by way of better connecting with their wives.

Eating With Morning Sickness

By Rita Brhel, managing editor and attachment parenting resource leader (API)

Of all the changes that take place in a woman’s body during pregnancy, the most uncomfortable for an estimated 70 percent of women – as reported by – may be so-called “morning sickness,” which isn’t often confined to just the morning hours.

Not every woman who experiences morning sickness finds it debilitating, although other pregnancy signs such as exhaustion, aversions to foods, and sensitivity to odors can aggravate the condition. Morning sickness can range from a loss of appetite and mild nausea to vomiting several times a day, which can lead to dehydration or worse.

For those with more severe morning sickness or morning sickness that lasts longer than the first four months, when many women begin to feel better, eating can become a chore – especially when you’re aware that your eating habits are affecting a new, little life!

Many medical professionals request that their pregnant patients be diligent in taking a daily dose of prenatal vitamin, to be sure that the mother is getting enough nutrition from what her diet.

“The increased demand for blood and hormones raises nutritional demands for the mother,” writes Wendy Hodsdon, ND, in her 2007 article “Prenatal Vitamins: Why Pregnant Women Should Take Them” on “Since her fetus is completely dependent on her for nutrition, her body will give it what it needs, depleting her stores, if necessary. This will exacerbate any nutritional deficiencies she may already be experiencing.”

The medical community, as a whole, isn’t entirely certain what causes morning sickness, although many blame a rapid increase in hormones supporting the pregnancy, a sluggish digestive system, low blood sugar, and other possibilities. Sometimes, morning sickness seems genetic, and rarely, it may be related to a complication.

But, according to, the incidence and severity of morning sickness may actually be a result of a woman’s diet. One 2006 study shows that a link with diets rich in sugars, sweeteners, oils used in frying, alcohol, and caffeine; and that women who eat more cereals and pulse foods tend not to have morning sickness.

Still, women shouldn’t force themselves to eat foods to which they have aversions. Fortunately, there are many choices in nutrient-rich foods. Here are some tips for women from to be sure they’re eating right when their pregnant:

  • Do take a prenatal vitamin – Sometimes, the iron in the vitamin can temporarily increase nausea. Talk to your doctor about other brands of prenatal vitamins that may have lesser amounts of this nutrient, while still within the recommended guidelines, and about improving your intake of foods naturally containing large amounts of iron.
  • Take an extra folate supplement – Women who do not get enough folic acid in their diet can get extremely ill. The recommended guideline is at least 400 micrograms per day.
  • Take an extra vitamin B6 supplement – Vitamin B6 can be very effective at relieving morning sickness. The recommended dose is 50 milligrams daily. Be sure to check your prenatal vitamins to make certain your intake of this vitamin doesn’t exceed the maximum 75 milligrams each day. When using vitamin B6 to treat morning sickness, it’s best to divide the dose into three, taking one in the morning, mid-afternoon, and at bedtime.
  • Eat more foods containing iron, less salt – Iron-rich foods include red meat, eggs, chicken, fish, whole grains, spinach, and raisins.
  • Eat more foods containing folic acid – Folic acid-rich foods include bananas, strawberries, oranges, green vegetables, chickpeas, nuts, and cereals.
  • Eat more foods containing vitamin C – Tomato and orange juice taken with meals or prenatal vitamins helps the body better absorb iron.
  • Eat more foods containing calcium – Not only milk, yogurt, and cheese but also fish like salmon and sardines.
  • Eat more fiber – Fiber-containing foods include cereals, breads, rice, oats, and pasta made of whole grain, as well as unpeeled fruits and vegetables. As an added bonus, fiber prevents constipation.
  • Eat more foods containing protein – Foods high in protein include meat, chicken, fish, nuts, tofu, dried beans, peas, milk, and cheese.
  • Eat more foods containing vitamin B6 – Try green, leafy vegetables.
  • Drink six to eight glasses of water daily – Drinking lots of water helps many women, ill or not, feel better. It helps prevent urinary tract infections, which can cause nausea and other discomforts, and if left untreated, can result in premature labor. Drinking plenty of water also decreases Braxton-Hicks contractions, especially in hot weather.
  • Eat more fruits and vegetables – Especially during snacks, opt for fruits and vegetables over breads and sweets.
  • Eat some fish – Some medical doctors advise against eating too much fish due to the risk of ingesting mercury, but eating some fish is part of a healthy diet.
  • When drinking soy milk, be sure it’s enriched with calcium.
  • Avoid coffee, cola, chocolate, and other caffeinated foods.
  • Avoid fatty or fried foods.

Other tips include:

  • Get plenty of rest.
  • Stay away from triggers – If a certain odor or food brings on the morning sickness, try to avoid it.
  • Consult your medical provider – If you’re unable to keep anything down, not even fluids, it’s imperative that you contact your health practitioner, as this can lead to not only dehydration but also production of toxic ketones, which are caused when the body begins to metabolize fat for energy. Immediate treatment for severe morning sickness is typically hospitalization and intravenous fluid treatments; long-term treatment may include pressure point therapy for motion sickness or sometimes medication.

The incidence and severity of morning sickness may actually be a result of a woman’s diet.

The Rising Rate of Cesarean Sections in the U.S.

By Rita Brhel, managing editor and attachment parenting resource leader (API)

One in three women (31.8%) in America is now giving birth to their children via a Cesarean section. The highest rate in history for this nation, it is also much higher than the recommendation by the World Health Organization of 5% to 10% — not to mention that the rate of Cesarean sections in the U.S. has increased by 50% since 1996.

The U.S. began at 4.5% in 1965, the first year Cesarean section rates were measured here. At 15% or higher, Cesarean section rates indicate that this procedure is being done unnecessarily, according to a study highlighted by the article “Why the National U.S. C-Section Rate Keeps Rising” on

The article outlines several reasons for the increasing rate of this procedure. But, first, there are two widespread myths about the rise in Cesarean sections to counter:

  1. The number of women asking for an elective Cesarean section, without a medical reason, is NOT increasing; and
  2. The number of women who genuinely need a Cesarean section is NOT increasing.

In a 2005 survey by Childbirth Connection, it was found that only one in 1,600 respondents in the U.S. reported she had a planned Cesarean section with no medical reason, at her own request. The article cited a study that revealed this rate to be comparable with other countries.

Reasons given for the higher rates include women waiting to give birth when they’re older and more prone to developing medical complications, and more women giving birth to multiples. But the article reported that researchers show that the rate of Cesarean sections is going up for all women regardless of their age, health problems, race/ethnicity, or number of babies they are having.

What this means is that the reason behind the increasing rate of Cesarean sections is not on the part of the woman but rather lies with changing standards in the medical community. According to the Childbirth Connection survey, one in four respondents who had a Cesarean section said they received pressure from a medical professional to have the procedure.

According to the Childbirth Connection, here are the true reasons behind the increasing rates of Cesarean sections in the U.S.:

  • Lower priority is being given to non-surgical methods of correcting potential birthing complications, such as turning a breech baby or encouraging labor progress through positioning and movement and comfort measures.
  • Higher rates of labor intervention methods that make Cesarean sections more likely, including induction, getting an epidural early or without a high dose of oxytocin, and use of continuous electronic fetal monitoring.
  • Fewer hospitals and/or medical doctors are willing to deliver a Vaginal Birth After Cesarean section, or VBAC. In fact, only one out of ten women who have had a previous Cesarean section has access to medical facilities and/or doctors who would allow a VBAC.
  • The overall attitude toward Cesarean sections is that this procedure is no longer considered the major surgery that it is.
  • Lower awareness of the increased risks associated with Cesarean sections over vaginal births, such as infection, surgical injury, blood clots, emergency hysterectomy, and intense and longer-lasting pain in recovery in mothers in the short term. In the long term, mothers are more likely to have ongoing pelvic pain, bowel blockage, infertility, and injury during future surgeries. Future pregnancies are more likely to be ectopic, result in uterine rupture, or have problems with placenta previa, accretia, and abruption. Babies born by Cesarean section are more likely to have surgical cuts, breathing problems, difficulty with breastfeeding, and childhood asthma.
  • More doctors fear malpractice claims and lawsuits.
  • More doctors are receiving incentives to practice more efficiently. Planned Cesarean sections can organize hospital work, office work, and the medical personnel’s personal lives. In addition, average hospital charges are much greater for Cesarean sections than for vaginal births, which mean more profit is gained by the Cesarean section.

About Childbirth Connection
Childbirth Connection is a national U.S. not-for-profit organization founded as the Maternity Center Association in 1918. Its mission is to improve the quality of maternity care through research, education, advocacy, and policy by promoting safe and effective, evidence-based maternity care and providing a voice for childbearing families. For more information, go to