Serving Ellensburg, Ronald, Roslyn, Cle Elum, South Cle Elum, Kittitas, Thorp, Easton & Vantage | Fall 2021
A supplement to the Daily Record
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Kittitas County’s resource just for parents
CONTENTS 4 ........ Born on Sept. 11 6 ........ California invests in treating parents and children together 8 ........ Ask the Pediatrician: Should parents be concerned about long-term COVID-19 effects in children? 9 ........ ‘It’s a win, win, win’. Nonprofit teams with businesses to create wigs for children with cancer 10 ...... Shedding miscarriage of its stigma, Amanda Knox shares her own miscarriage experience 12 ...... Baby boom or bust? 14 ...... Living with Children: Give teenagers clothes stipend to teach responsibility THE ROSLYN
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Born on Sept. 11
What it’s like to raise children on a day marked with tragedy Heidi Finley The Charlotte Observer On Sept. 11, 2010 — 9 years after planes struck the World Trade Center towers in New York, at the Pentagon and crashed in a Pennsylvania field — I was hooked up to contraptions halfway across the country in a hospital in Little Rock, Arkansas, bringing new life into the world. My twins, Kayla and Kendall, were born about 5 weeks early that day with a team of about 30 doctors and nurses standing at the ready for not-quite-emergency C-section. My water had broken the day before, but my labor never progressed and the OB filling in for my own doctor wanted time for steroid shots to open up their tiny lungs. Thankfully it worked, and they only spent about 20 minutes in the stepdown NICU with their big sister, Ava, waiting outside. These girls started out showing they’re tough. Even with that many people crammed in an operating 4
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room, it was eerily quiet that Saturday morning, save for a few comments about that afternoon’s football game. We quickly found that when your birthday is 9/11, it tends to stop people in their tracks. A day marked with sadness Every time someone asks the question or reads that date on a form, there’s certainly a pause, and there’s usually a grimace of some kind on their face. Are other things even allowed to happen on that day Americans felt such collective trauma and tragedy? As they’ve grown, I’ve noticed that even other kids take a beat when the subject comes up. A few weeks ago, Kayla was video chatting over Messenger Kids with her friend Noah, who turned 10 at the beginning of summer, as I eavesdropped while making dinner. He asked when her birthday was, and she answered “September 11.” “Your birthday is 9/11?,” he asked incredulously. “Yeah,” she said.
And then there was a long pause before the subject changed. Teaching little by little Young kids don’t tend to hang onto details too well, so I try to remind them each year in advance about what happened on Sept. 11, 2001, because it always comes up — how could it not? The details have long been burned in my brain. On that day, I was on the last leg of an overnight drive home to Nebraska for a college newspaper reunion as I heard the radio announcer break in to announce that a plane hit one of the twin towers, then another. That reunion was canceled, of course, as everyone rushed back to cover the attack on our nation. The next several years of my life, I was glued to my newspaper’s wire desk, reading hundreds of stories streaming in each day out of Washington, New York and Pennsylvania, then Iraq and Afghanistan. There probably wasn’t even one day I worked in the following 5 years where I didn’t help put together a front-page story that touched some aspect of the 9/11 attacks and their aftermath. My twins were born with a little distance from that intense time period, though. They have mostly learned about the terrorist attack in school through books and videos, and a little bit of TV news. But at the cusp of turning 11 years old, do they really grasp the gravity of what happened? I don’t think so. I asked Kayla what she remembers about Sept. 11, and her answer was: “I only know that there were twin towers that fell, and a lot of people died. Planes crashed into them, I think.” Kendall echoed that almost exactly: “A lot of people died.” A change in our culture Not only was there an enormous loss of life that day, but so many things about our culture changed. Flying in an airplane is generally not the fun, breezy experience it once was, not to mention the requirements COVID piled on top of already cumbersome X-rays, bag searches and bare feet streaming through TSA checkpoints. The twins have never flown on a plane; their older sister Ava’s only gone once. Family in the Midwest is a two-day drive away from Charlotte, but we pack up the minivan when we get a chance to visit. Racism against Middle Easterners — and anyone else who might appear “foreign” — exploded after 9/11. This always seems to be a problem with certain relatives who
are bound and determined to spread hateful viewpoints, and it grates at my soul. Thankfully, my children know better than to suck that in and spit it back out. Kids born in the shadow of 9/11 have also grown up with many of their parents shipping off to fight wars in Iraq and Afghanistan, 24-hour news cycles highlighting deadly bombings and a culture of TV and movies focused on war. Plenty of people choose to shield their children from these things, thinking the weight of the world is too heavy for little ones to bear. But as a mother who has spent her life in newsrooms, working to keep the public informed about what’s happening out there, I can’t make that choice. I may keep things simple and let their knowledge build over time as they build understanding, but I think it’s important they know they have a pretty charmed life in America. And another thing that’s always forefront on my mind, especially when Sept. 11 approaches, is that as bad as things can be out there, there is good in the world, too. We can choose joy — and sometimes we need to choose that joy — especially when there is precious life to celebrate.
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California invests in treating parents and children together Samantha Young Kaiser Health News When a parent takes an infant to the Children’s Health Center in San Francisco for a routine checkup, a pediatrician will check the baby’s vitals and ask how the child is doing at home. Then Janelle Bercun, a licensed clinical social worker, who is also in the room, will look at Mom or Dad and pipe up: What is this like for you? Your frustrations? Joys? Challenges? And she stays to work with the parent long after the pediatrician has left. The facility’s team-based treatment is a pilot project, funded by philanthropies. Yet the approach, which California may soon incorporate on a large scale, could hold the key to fostering a healthy home environment where children thrive, child development experts say. Incorporating therapy for the parents, they say, can 6 fb/eburgmoms | FALL 2021
lower a child’s risk of future mental disorders stemming from family trauma and adversity. Pediatricians’ offices generally don’t offer formal counseling or guidance to a child’s guardian because they can’t bill insurance for these services. That could soon change for the roughly 5.4 million children on Medi-Cal, California’s Medicaid program for low-income residents, and their parents. The 2021-22 state budget, dedicates $800 million, half of it in federal funds, to this new behavioral health benefit over four years. Experts say it would make California the first state to pay for “dyadic care,” treating parents and children simultaneously. “A baby is not showing up by themselves to the pediatrician’s office. The caregiver is coming in with their own strengths and stressors,” said Dr. Kathryn Margolis, a pediatric psychologist who
launched the initiative at the Children’s Health Center at Zuckerberg San Francisco General Hospital. “Without a healthy caregiver, we can’t have a healthy baby,” Margolis added. “It is the most obvious thing in the world. It is unbelievable it has taken this long to pay for this service.”
BEHAVIORAL HEALTH INITIATIVES
The new program is among a suite of behavioral health initiatives included in the nearly $263 billion state budget negotiated between Democratic lawmakers and Newsom, who has made mental health services a signature issue. The state will spend the next year drafting guidelines for the services that could be covered and working with insurance providers on new billing codes for the new benefit. Beginning July 1,
2022, caregivers who enter a clinic or pediatrician’s office with a child up to age 21 for routine well visits will be matched with a social worker or behavioral health specialist. They may be screened for depression, treated for tobacco and alcohol use, or offered family therapy, said Jim Kooler, assistant deputy director of behavioral health at the California Department of Health Care Services. New mothers will get postpartum care; parents could also get help obtaining food vouchers, housing or other help. “It’s a pretty amazing array of services that will be available,” Kooler said. “It’s things we wouldn’t necessarily think about right away, but the health of the young person is impacted.” States including New York and Colorado fund programs that offer holistic care to parents and children together. But California will be the first to offer the service as part of Medicaid pediatric care, said Jennifer Tracey, senior director of growth and sustainability for Zero to Three. The nonprofit organization runs HealthySteps, a program that supports babies and toddlers with integrated care in 24 states, Washington, D.C., and Puerto Rico. Getting the benefit funded in the nation’s most populous state was a “groundbreaking” win for children’s advocacy groups, Tracey said. “We haven’t seen any other state make this kind of investment,” she said. “I hope we’ll see other states following California.” Newsom and lawmakers this year had a $76 billion budget surplus and $27 billion in federal aid to fund an array of new programs, but they won’t come cheap. New outlays include up to $1.3 billion a year to expand
health care to undocumented immigrants age 50 and older; $12 billion for homeless programs over the next two years; $4.4 billion in behavioral mental health for people up to age 25 over five years; and $300 million to bolster the state’s public health system beginning next July. Critics say the spending commits Californians to programs that could be hard to fund in the future. And while offering a new Medi-Cal benefit might be worthwhile, California lawmakers would be better off fixing flaws in the government insurance program, said Susan Shelley, vice president of communications for the Howard Jarvis Taxpayers Association. For example, the state pays physicians who participate in Medi-Cal among the lowest rates in the nation, she said. And a January 2020 report by the California State Auditor found that just under 48% of children enrolled in Medi-Cal went to the doctor for a preventive visit in 2016-17. “It’s unwise to commit taxpayers to this,” Shelley said. “All these little kids are going to grow up and have one huge tax bill.”
HealthySteps program. “It’s a realization that it’s not just about providing services today, but it’s about thinking about the services that will help defer costs down the road by doing the right things today,” Kooler said. Making a visit to the pediatrician’s office more welcoming to parents, and getting mothers screened for depression and other behavioral issues, could improve California’s dismal rate of child developmental screenings, said Sarah Crow, managing director of First 5 Center for Children’s Policy. “California, if it really wants to prioritize children’s health, then we really need to pull out all the stops and start thinking of new, culturally relevant ways to serve our families,” Crow said. At the clinic in San Francisco, Bercun, the social worker, visits with caregivers
for as long as they need, usually about half an hour but sometimes up to an hour. She counsels a mom about a job loss, shows a dad how to soothe his crying infant and guides another mom to lovingly say no to a toddler on the verge of a tantrum. She has helped caregivers develop safety plans if there is violence in the home and has connected them to community resources. And then there’s the pandemic: She talks families through the isolation so many have felt. “It’s working through these moments and feeling less alone and building confidence,” Bercun said. “It’s about holding space to explore feelings. My hope is that one day all families could benefit.”
SAVES MONEY
Offering caregivers preventive behavioral treatment has proven to save money by avoiding bigger health problems down the road, according to legislative budget documents. An analysis by HealthySteps of its sites in New York, Colorado, Arizona and Kentucky showed average annual savings to Medicaid of 204% for patients enrolled in their program. The group reports that children were eight times more likely to receive developmental screenings and twice as likely to go to well visits when their parents participated in the
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Ask the Pediatrician:
Should parents be concerned about long-term COVID-19 effects in children? Dr. Sarah Risen American Academy of Pediatrics
Q A
: My son had COVID-19 a few months ago and seems to have some lingering effects. Should I talk to his pediatrician?
: Millions of U.S. children and teens have tested positive for SARSCoV-2, the virus that causes COVID-19. Fortunately, they have been less likely than adults, so far, to become very ill. However, even if they had few or no symptoms, kids can develop a number of other conditions after the COVID-19 infection. Some are minor and may go away on their own. Others are more serious and may need treatment. After a COVID-19 diagnosis, talk with your child’s doctor about lingering or new symptoms, and what to do. Your pediatrician also can help guide your child’s safe return to activities, such as sports. Here are some symptoms and conditions that can affect children after COVID-19 that you should discuss with the pediatrician: Breathing problems: Because COVID-19 most often affects the lungs, lingering respiratory symptoms are not uncommon. These may include chest pain, cough and more trouble breathing during exercise. Some of these symptoms can last for three months or longer. Children 6 years or older with ongoing symptoms may need lung function tests. Children with exercise-induced breathing problems that don’t go away may also need heart tests to rule out complications such as blood clots or abnormal heart function. Cardiac issues: Myocarditis, an inflammation of the heart muscle, can develop after COVID-19 (and in extremely rare cases, receiving mRNA vaccines). One study of adult patients who recently recovered from COVID-19 suggested that 60% had signs of myocarditis on heart imaging, regardless of how severe their symptoms were during the infection. Symptoms of myocarditis may include chest pain, shortness of breath, irregular heartbeat, and fatigue. Children and teens who had COVID-19 infection and these symptoms within the last six months need an thorough exam, including heart tests, before returning to school or sports activities. Smell and taste: As many as 1 out of 4 children and teens ages 10 to 19 who have had COVID-19 experience changes to their smell and taste. This can have a negative effect on their eating habits and mood. It can also prevent them from noticing dangerous odors. These symptoms typically go away in several weeks. If they don’t, your child’s doctor may recommend steps to test or help retrain these senses. Developmental issues: Active COVID-19 illness can affect the brain and, in rare cases, lead to stroke or encephalitis (brain swelling). Serious inflammation of the brain can lead to obvious difficulties in a child’s daily function, but children who have had mild or moderate COVID-19 infection may still experience subtle changes in attention, speech, schoolwork, movement and mood. Your pediatrician may refer you for follow-up with a neurodevelopmental specialist, a speech lan8
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guage pathologist or physical or occupational therapists. Mental fatigue: “Brain fog” — unclear or “fuzzy” thinking, difficulties with concentration, or memory problems — is a frequent complaint among adults who’ve had COVID-19. Children and teens may have similar symptoms. Your child may seem more forgetful or have trouble paying attention. They may be slower at reading and need more repetition and breaks while learning. Make sure your child gets enough sleep and help them manage stress, which can worsen these symptoms. If post-COVID-19 mental fatigue doesn’t improve or interferes with daily activities, your child may benefit from a team-based evaluation and recovery plan. Physical fatigue: After SARS-CoV-2 infection, children and teens may tire more easily and have less physical endurance, even if they had no heart or lung symptoms from the virus. This usually improves over time. Your pediatrician can advise a gradual increase in physical activity. If this doesn’t improve symptoms, they may recommend a visit to a physical therapist or other specialist. Headaches: Headache is a common symptom during and following SARS-CoV-2 infection. Getting enough sleep, drinking plenty of water, eating regular meals and managing stress can help. If the headaches are persistent and severe, your child’s doctor may recommend preventive medicines. Mental and behavioral health: Having had COVID-19 can affect a child’s mental health. For children with existing mental/behavioral illness, events surrounding COVID-19 (hospitalization, isolation, absence from school activities) may also make symptoms worse. Your pediatrician can check your child for signs of depression, anxiety and other mental health concerns, and advise when your child may need more support. Multisystem inflammatory syndrome in children (MIS-C): This is a rare complication that typically happens 2 to 4 weeks after SARSCoV-2 infection. Talk with your pediatrician if your child has symptoms such as fever without an obvious cause after having COVID-19 or being exposed to someone who did. MIS-C can get worse quickly, and children who develop this condition should be cared for in a pediatric/cardiac intensive care unit whenever possible. Long-haul COVID-19 is a general term that covers physical and mental health symptoms that some patients experience four or more weeks after SARS-CoV-2 infection. No specific lab test can tell “longhaul COVID-19” apart from other conditions. If symptoms last beyond three months, your child’s doctor may recommend additional tests and possible referral to a specialized, multidisciplinary post-COVID-19 clinic. After a COVID-19 diagnosis, talk with your pediatrician about any concerns, how to address them, and ways to help your child return safely to normal activities. Dr. Sarah Risen is a pediatric neurologist in Houston, Texas, and a member of the American Academy of Pediatrics. For more information, go to HealthyChildren. org, the website for parents from the AAP.
‘It’s a win, win, win’ Nonprofit teams with businesses to create wigs for children with cancer Katie V. Jones Baltimore Sun Delivered by pirates to So Original Yarn Studio in Columbia, Maryland a large box filled with skeins of multicolored yarn was indeed a treasure chest for recipient Brittany Harrison. As the Baltimore area chapter leader of the Magic Yarn Project, a nonprofit that provides free character wigs to children dealing with cancer and other medical hair loss, Harrison will create mermaid wigs and the pirate Jack Sparrow’s famous locks with the help of a generous donation by HoCo Pirate Adventures, a pirate-themed scavenger group, for the month of September — national Childhood Cancer Awareness Month. “The whole situation is really three separate, really beautiful stories,” said Harrison, of Sykesville. “I love the idea of what we can all accomplish together, the ripple effects just from one thing.” It begins with Harrison, who first started crocheting character hats for her children as a hobby in 2016. When she discovered the Magic Yarn Project on Facebook, she started shipping her creations to its headquarters in Alaska until the nonprofit started different chapters around the country in 2019. Now, she delivers her creations to local charities, including Casey Cares Foundation, which is based in Baltimore, and the Ronald McDonald House Baltimore. She has also delivered wigs to Chai Lifeline Mid-Atlantic Region and Sinai Hospital, as well as individual requests. “There is so much need locally,” Harrison said. “This is a huge yarn donation. A hundred skeins of yarn is 75 wigs. That’s huge.” Chris Fuchs, head pirate of HoCo Pirate Adventures, donated $700 to Harrison’s Magic Yarn Project chapter after she approached him over the summer with the idea. “This is the best thing we’ve done yet,” Fuchs said. “It’s a win, win, win.”
SCAVENGER HUNTS
Since July 2020, Fuchs has been organizing monthly pirate-themed scavenger hunts for youth throughout Howard County. The hunts are typically available 24/7 for about 10 days, with treasure maps available to download for a $5 dona-
tion. A portion of the fee is used to purchase “treasure” for the hunts and another part is used to give back to the community, Fuchs said. Past donations have been to organizations such as Howard County Special Olympics and the Howard County Police Department. “I always try to go local,” said Fuchs, who requested that Harrison find a local yarn shop to make her purchase. That request wasn’t easy, Harrison said, as many of the smaller yarn stores were unable to order the mass-produced yarn Harrison requested for the wigs. Enter Lana Ford, who reopened her store, So Original Yarn Studio, in July after relocating it from Olney to Columbia. “She asked … and I thought, ‘How can I not?’ ” Ford said. “It is really an amazing program. It speaks to everybody’s heart.” Around Ford’s shop, she has displayed Harrison’s creations. Rapunzel’s long blond hair braided with flowers, Jack Sparrow’s dark braids with beads and a red bandanna, and Elsa’s signature long white braid are all easily recognizable hairstyles of the beloved Disney characters. “They are so beautiful,” Ford said. “They are quite elaborate these wigs. Very labor-intensive.” Before the coronavirus pandemic, Harrison would host events with volunteers — everyone from Scouts and youth groups, to mom groups and friends — working together to complete a wig. “Instead of paint night, you go out with friends and do the same sort of thing but work on a wig and do something good,” Harrison said. “I would bring the beanies and they would attach the yarn and add the ribbons, rhinestones, whatever that character needed.” Ford is hosting a Magic Yarn Project event at her shop at noon Sept. 26. She also ordered extra yarn for the wigs to keep in her shop for anyone interested in the project. “You don’t need any knitting or crocheting skills at all,” Harrison said. “People can cut yarn. You can help.” Harrison is thankful for the support Fuchs and Ford have provided and is excited to bring more attention to the Magic Yarn Project. “When you see what all these kids are going through, it’s heartbreaking,” Harrison said. “This is all for the kids.” FALL 2021 | fb/eburgmoms 9
Shedding miscarriage of its stigma
Amanda Knox shares her own miscarriage experience Megan Burbank The Seattle Times One in four pregnancies end in miscarriage, according to the World Health Organization. But while there are cultural scripts for responding to pregnancy and birth, there isn’t one for miscarriage. Instead, families facing pregnancy loss often experience shame, stigma and isolation. Amanda Knox wants to change that. Knox, who in 2015 was exonerated by Italy’s highest court after being wrongfully convicted of murder, is now an independent journalist and podcaster who co-hosts the podcast “Labyrinths: Getting Lost with Amanda Knox” with her husband, Christopher Robinson. When Knox had a miscarriage during the COVID-19 pandemic, she made infertility the focus of a new season of “Labyrinths.” 10
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Her experience with miscarriage was isolating, she said, and brought up questions “reminiscent ... of my own wrongful conviction experience,” she said. Questions like, “Why is this happening to me? It’s so unfair. It doesn’t make any sense,” she said. “And I felt very alone. I had never talked to anyone before about miscarriage experiences.” In previous episodes of their show, Knox and Robinson have covered everything from the murder case that led to Knox’s wrongful conviction (including Malcolm Gladwell’s take on it) to their own wedding (it was time-travel-themed), and interviewed a variety of guests, including LeVar Burton, Washington state Rep. Tarra Simmons, journalist Jon Ronson and Samantha Geimer, the woman at the center of the Roman Polanski rape case.
SHARED EXPERIENCE
But pivoting to a five-episode season about miscarriage
was a way to understand and process their experience, and to make room for others to do the same. When Knox sought out stories about miscarriage on social media, she “was shocked to discover the number of people who, first of all, had these experiences, and also felt like they had never been heard or had never had the opportunity to talk about it.” Knox listened. “I feel like the one thing that my experience has given me the opportunity to do is to be a really good listener, and to convey what I have heard, to other people in ways that potentially people aren’t primed to hear,” she said. “A lot of the stuff that I talk about is really challenging. And it requires you to question some of your prejudgments about people or about certain topics or ideas in order to see the human across from you.” Knox’s experience navigating the legal system — and the media narratives that followed and continue to follow her — means she’s intimately acquainted with how it feels to be that human on the other side of an interview. She’s experienced firsthand the difference between “someone ... really actually engaging with me and having compassion for me, and someone who was treating me like the latest click content.” This dynamic follows her everywhere, from unwanted tabloid coverage of her wedding, to “Stillwater,” a movie inspired by her story and starring Matt Damon, slated for release July 30. “I have complicated feelings about stories ‘inspired by’ my trauma, but ire for reviews of #STILLWATER like this one that refer to me as a person convicted of murder, & conveniently fail to mention my acquittal by Italy’s highest court. @DEADLINE DO BETTER,” Knox wrote on Twitter July 12 in reference to a review in Deadline.
STORY DOESN’T BELONG TO YOU
When Malcolm Gladwell crafted a chapter on Knox’s case for his book “Talking to Strangers,” he didn’t reach out to her for comment. “He didn’t have to,” said Knox. “That’s the crazy thing. Once you become a figure in a story, your story doesn’t belong to you anymore. And that is the sort of shocking experience that I’ve had that I noticed other people having all the time ... and so it seems like the only thing to do is to try to give people their stories back.” In her work and on her public platforms, Knox uses her experience to stand up for reform within the legal system and connect with sources who have survived similar ordeals. On Twitter, she has voiced support for Britney Spears, tweeting, “There are many unjust ways freedom can be restricted. This conservatorship is one. #FreeBritney,” and opposition to life sentences without parole, saying they are “cruel,” provide no path to redemption, expensive,
disincentivizing to rehabilitation, and ignore “basic truths about human development.” In Scarlet Letter Reports, a series she hosted for Vice, Knox interviewed women who’ve experienced public shaming, often because they spoke out against abuse from institutions or individuals, among them the ballet dancer Alexandra Waterbury. In 2018, Waterbury sued New York City Ballet following alleged sexual harassment from male dancers in the company, who shared explicit images of women dancers via text message without the women’s knowledge or consent. “I’m lucky that the attention that I got from it, 99.9% of it was positive,” said Waterbury of her choice to speak out against the abuse. “I seriously couldn’t imagine what you went through.” Knox responded, “For me, it was surreal because it was strangers (who) were telling me who I was. But for you, it was your world and your people who were doing this to you.” It’s a moment where the interview stops sounding like a rigidly journalistic encounter and more like a mutual moment of processing traumas that, while not the same, share points of overlap. Similar moments recur throughout the new season of Knox’s podcast on pregnancy loss, as Knox and her sources work to process an experience that’s both profoundly destabilizing and, as she put it, “stunningly common.” “One thing that we all sort of take for granted is being able to have a family ... we all came from families,” she said. “We all came about in this world because our parents made us happen.” Pregnancy loss or infertility — like a wrongful conviction or a circuitous journey through the legal system — are “things that you never really think about until it happens to you,” she said. When she was in prison, Knox recalled, there was only so much other people could do for her. But she valued people who could hear her describe having trouble getting through the day without “being squeamish to sit in that uncomfortable space with me.” “Because honestly, when you are an innocent person going through a very, very difficult, unfair experience ... the one thing that actually helps is just not feeling like you’re alone facing it, that we collectively all acknowledge and appreciate that this thing is real,” she said. “And that whatever you are feeling about it — good, bad, hope, despair — all of that is valid and worthwhile and worth listening to.” FALL 2021 | fb/eburgmoms 11
Baby boom or bust?
How the pandemic has changed pregnancy and birth rates Marie McCullough The Philadelphia Inquirer Early in the pandemic, there were predictions that stay-at-home orders would spawn a baby boom. “Nine months after folks are forced to hunker down and ride out a natural disaster, the birth rate suddenly spikes,” explained an article on Fatherly, a parenting news website. “Whether it’s the boredom...or the sense of impending doom, there’s something about these situations that makes people do what comes naturally.” This month, Fatherly ran a sequel titled, “The COVID-19 Baby Boom is a Lie.” But it isn’t a lie. In the Philippines and other poor countries where families were already struggling to make ends meet, lockdowns did cause a spike in pregnancies, largely because women were unable to access birth control. The pandemic has had profound impacts on pregnancy and birth rates, as well as birth outcomes, and the long-term consequences could ripple through economies, education systems and more. The thing is, some effects have defied expectations, and some are hard to explain. For example, the premature birth rate declined last spring and summer — around the world. Vincenzo Berghella, director of maternal-fetal medicine at Thomas Jefferson University Hospital, was one of the first to document the phenomenon, using data from his hospital. One possible partial explanation: telemedicine visits eliminated frequent, inconvenient, time-consuming treks to the obstetrician’s office, which lessened expectant mothers’ stress. “You’d think the in-person care which we’ve been doing forever is beneficial, but maybe not in some ways,” Berghella said in an interview. “The bottom line is we don’t know why preterm births declined, but most people say this is real. It has been shown in Europe and Asia, as well as the U.S.” But this unexpected pandemic benefit has socioeconomic nuances, researchers at the University of Pittsburgh Medical Center found. At UPMC Magee-Womens Hospital, the rate of births before 37 weeks of pregnancy declined by a percentage point among white women and those living in affluent neighborhoods, but not Black women. “Systemic disparities in health care outcomes are at play here, too,” said Hyagriv Simhan, vice chair of obstetrical services at Magee.
Falling fertility
U.S. fertility indicators — the annual birth rate and lifetime births per woman — have been falling fairly steadily for decades. Meanwhile, deaths have outpaced births in many parts of the country. In 2019, before the pandemic hit, deaths exceeded births in almost half of U.S. counties, and the nation added just 892,000 people, the lowest population growth in a century, according to an analysis by University of New Hampshire demographer Kenneth M. Johnson. This trend was pronounced in farming, mining and older industrial regions, as well as in counties with lots of elderly residents. In 2020, population growth shrank even more. The U.S. added 12 fb/eburgmoms | FALL 2021
229,000 people, reflecting the tsunami of pandemic deaths, and diminished immigration, Johnson’s updated snapshot found. But 2020 was marked by another anomaly: A sudden, sharp decline in women getting pregnant. At the height of pandemic restrictions in late March and early April, more than 310 million Americans were stuck at home. Modified shutdowns persisted in many places for a year. Grappling with economic hardship and zoom schooling, many couples decided to forgo, or at least postpone, reproducing. “The decline in births could be on the order of 300,000 to 500,000 fewer births” in 2021, predicted a Brookings report published in December 2020. To help with that prediction, the authors, economists Melissa Kearney and Phillip Levine, extrapolated from two historic crises. During the Spanish Flu pandemic of 1918-19, birth rates dropped sharply with each of the three big waves of deaths. During the Great Recession of 2007-2009, the birth rate decreases correlated with increases in unemployment. “An analysis of the Great Recession leads us to predict that women will have fewer babies in the short term, and for some of them, a lower total number of children over their lifetimes,” the authors wrote. The short- and long-term distinction is important. If the rate of pregnancies this spring is inflated by pregnant women who postponed because of the pandemic, then not only could there be a rebound in births later this year, but a big spike. On the other hand, there might not be a spike, depending how many women who postponed discover their biological clocks have run out.
A blip, if not a boom
If a University of Michigan study published last month in JAMA Network Open is a guide, there will be a spike. Researchers in UM’s department of obstetrics and gynecology analyzed electronic medical records and found the average weekly number of new obstetric patients fell from 131 in March through June 2019, to 122 during the same months in 2020 — when Michigan was under shutdown orders. Based on the decline in pregnant patients, they projected a 16% decline in deliveries from December 2020 through April 2021. When those months actually came around and the delivery projections were accurate, the researchers made a new forecast. Based on the number of new obstetric patients this spring, the volume of births this summer and fall will not only rebound, but be 15% above normal — a temporary baby blip, if not a boom. “Pandemics and other major society events alter population dynamics,” wrote the authors, led by maternal-fetal medicine specialist Molly J. Stout. “Population dynamics are of interest for governments, businesses, and economists because fluctuations in young and aging, workforce, and school-aged populations are critical variables in the ability to plan for social well-being.” The UM study, like others, also found a marked decline in preterm births. Berghella, at Jefferson, said this surprising silver lining opens a whole new avenue for studying ways to prevent the mysterious, intractable problem that is the leading cause of newborn death and disability. Of course, the avenue is not well marked. Did stay-at-home orders reduce pregnant women’s smoking, driving, infections, shift and physical work? Or did restrictions lead to improvements in women’s nutrition, hygiene, exercise, family support? All of the above? “Basically, the idea is pregnant women had less stress,” Berghella said.
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Living with Children:
Give teenagers clothes stipend to teach responsibility John Rosemond Tribune News Service
Q
: My two young teens are constantly begging me to buy them clothes. It’s become highly annoying. After reading your book on teenagers, I’ve decided to stop buying them any clothing and give them each an $750 annual clothing allowance. Should I give them the whole amount at once or give it to them on a monthly basis?
A
: Great idea! However, I don’t think an annual clothing allowance of $750 is a realistic amount for children who are outgrowing their clothes every six months to a year. If their clothing allowance is insufficient, then the whining is only going to get worse, and your plan is likely to blow up in your face. Give each of your kids a monthly clothing stipend that is sufficient to purchase a certain amount of discretionary clothing. I generally recommend between $75 and $100. Under the plan, you would continue to purchase necessary clothes (i.e., to replace items that no longer fit), but you would spend only a minimum amount in each case. For example, if one of them requires a new winter jacket, that is your responsibility. If she doesn’t like the jacket you’re willing to buy, then you 14 fb/eburgmoms | FALL 2021
would give him that same amount in cash and he would use his allowance to make up the difference in price. If he simply wanted an article of clothing that is nice but unnecessary, that would be his responsibility entirely. The most efficient way to do this is to set up a checking account for each child at your bank. As long as you have good credit, the account doesn’t have overdraft protection, and you are willing to back it, most banks are willing to do this. You deposit the child’s monthly allowance in her account at the beginning of the month and he manages the account from there. In the event of a bounced check, the bank and merchant fines as well as what the merchant is owed come off the top of the following month’s allowance. This plan teaches teens how to budget money and manage a checking account. Better still, it also teaches them to curtail their spending impulses, plan ahead and save for the proverbial rainy day. It’s a great way to prepare a youngster for the larger fiscal responsibilities of adulthood. Visit family psychologist John Rosemond’s website at johnrosemond.com; readers may send him email at questions@rosemond.com; due to the volume of mail, not every question will be answered.
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Care for all the seasons of your child’s life.
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General pediatric care Growth & development evaluations Routine, acute & chronic conditions Age appropriate immunizations School, camp & sports physicals Newborn screenings ADHD care Behavioral health Special needs
