Maslow’s Hierarchy of Needs

Maslow's Pyramid

“Last day of school – Yay?”

There are plenty of Mommas out there who can relate to this – I know I’m not the only one!

I love my children and I’m looking forward to all that Summer Vacation means for our family – but if I’m being honest? I’m kind of dreading it as well… Can you relate?

For about six hours a day, I know exactly where my kiddos are and I have the time and space to be get a lot of stuff done. Even though I work outside the home as well as within the home, my life resembles that of a stay-at-home-parent.

I wake everybody up, jump into the shower on days that I don’t work out, and on the days that I do, head into school sweaty and without any trace of vanity to drop my kids off where they need to be. Most days on time and with everything they need to be a successful student.

And then? Well, let’s be real – I don’t go home, pop my feet up, eat a few bonbons and catch up on my Netflix! I’m not even sure why the term “stay-at-home-parent” exists! I’ve yet to meet the parent who’s the primary caregiver that even spends much time at home. Okay, when the kids were young, I might have orchestrated my days around their nap schedules, and then preschool drop off and pick up, and now, elementary school drop off and pick up – but I’m rarely “sitting around.”

My 8-year old son actually said to me the other day, “I’ve often wondered what it is you do all day while I’m at school.” He said this with complete innocence and sincerity – and I wanted to throttle him for even hinting that I might just be “hanging out.”

I responded with, “Dude, if you were here on any given day to watch all that I get done while you’re away at school, you’d be exhausted!”

All of this makes me really wonder (with true admiration!) how families where parents work full-time outside of the home find the time to get anything else done?

Just going to the grocery store can take two hours! (No, I’m not making this up…) When I’m at the checkout and the cashier asks if I’d like someone to help me out to the car, it takes everything in me not to yell, “NO! I don’t need someone to take this stuff to the car! I need someone to come home with me, haul it all into my house, clean out my refrigerator of old food that’s been hiding and silently turning into a science fair project, rearrange my cabinets and then put all of the food away! Don’t you understand? I’ve only got four more hours of daylight before my full-time Momma duties resume!”

But instead, I just smile and say, “No thanks – I got it!”

On the rare days (like this one) where I don’t have anything work-related, or volunteer Board-related, or field trip-related, or “I-need-a-tri-fold-poster-board-for-my-project-that-I-just-found-out-about” (two-months-ago!) related issue on the calendar, then I get a short little window of time to say, return a cowboy hat to Target that I got months ago because it was so cute when I tried it on and then became seriously not cute when I got home, go to four (!) different stores in search of the stupid trifold poster board that apparently EVERY other one of the 1,600 students at my son’s High School all needed in the last week of school, go the grocery store and buy ALL the food, and maybe, just maybe, do a little bit of cleaning.

This leaves me with even less time to devote to the creation of my new website (under construction and coming SOON – Wahoo!), to write a quick blogpost, or explore writing an essay about pregnancy, birth and parenting for the new book idea that I’m super excited about.

Sigh.

This is my real reason for dreading the last day of school.

On Maslow’s Hierarchy of Needs, you’ll see that “creativity” is right at the very tippy top of the pyramid. And there are a lot of levels to attend to first before you even get to consider fulfilling those needs (And yes, being creative is a need!) I started craving this need about five years ago and in all this time, I’ve attempted to fit it in around my role as primary at-home parent. As Momma, I spend an inordinate amount of time making sure that everybody else’s pyramid gets attended to.

Translation: Historically, MY pyramid doesn’t get as much attention during Summer Vacation as it does during the school year. Just a quick review of my blog over the past several Summers confirms this. The amount of posts on my blog go down between the last day of school and the first day of school. During Summer Break, just finding the time to sit, be still and create anything becomes much harder for me.

So, don’t blame me for not being 100% excited about the school year ending!

I’m looking forward to more time with my kiddos, I swear! I’m acutely aware that my oldest will be heading off to college who-knows-where in the Fall 2018, and this makes me very conscious of just how fast time is moving forward, and that I only get them for a short while, and that I should enjoy them while they’re still living under my roof, etc., etc. But…

This year, Summer Vacation is going to be different.

My personal goals for the months of June, July & August this year, entail not ignoring my own pyramid of needs. I’m putting it out there right now that even though I will, of course, continue to attend to my children’s pyramids – I’m going to make sure that my needs continue to be met. I’m going to attend to all the levels of my own pyramid – even those at the very tippy top!

Will you join me in this, fellow parents?

It might seem counter-intuitive, but it’s so much easier to make sure the kiddos are getting all they need, when we make sure that we’re getting all that we need.

Each one of the levels in this pyramid matter. YOU matter. Create those boundaries and model the behavior that you’d like your children to adopt. And then? You might be as excited as they are for the last day of school. And bonus – you might discover that this song is not quite so annoying!

Happy Last Day of School!

Risk Assessment

Risk

At the end of one of my weekend classes, a healthy and fit-looking Momma came up to ask a question.

“I’m 35 years old,” she began, and I already knew where this was going.

“And yours is considered a “Geriatric Pregnancy,” am I right?”

She kind of laughed and said, “Yep – ‘Advanced Maternal Age!’ And my provider wants to induce me at 39 weeks. I just wanted to know what my chances are of having an induction that goes okay. One that won’t end up with me having a Cesarean.”

Now, I don’t know this woman’s health history, and I’m not a medical provider, so I’m not going to debate this plan of action with her. But I could tell she wanted to know if this induction at 39 weeks would be considered “medically necessary.” Again, without knowing her personal health history, I wasn’t going to comment on that – it’s not my place.

So here’s what I said instead: “If your provider ever had a Momma over the age of 35 who had a “negative outcome” during a birth that went past 39 weeks, it might change how they practice from that point forward. But many providers are only looking at the risk of increased complications that can happen to all women over the age of 35. Is your provider looking at you as an individual, considering any other risk factors that might increase your risk? And what’s the risk, anyway? What numbers are being considered? This information might help you understand ”increased risk” really means for you.”

For example, a provider might read a study that states a woman’s risk of stillbirth increases after the age of 35. The provider might then choose to focus solely on the age of the woman in their care, and encourage an induction at 39 weeks to prevent stillbirth.

Now, stillbirth is a terrible experience which most people would like to avoid at all costs. But women need full information to be able to assess if their risk of stillbirth in waiting for labor to occur on its own is high enough to agree that an induction at 39 weeks is the right decision for themselves.

The risk is real, it’s true – but there are many other factors to consider in assessing an individual woman’s risk for any complication, not just the risks associated with “Advanced Maternal Age.”

I might be a little bit touchy on this subject, if I’m being honest! I didn’t get married until I was 28. I had my first child at 31. Baby #2 came along when I was 33 1/2. My third was born when I was (gasp!) 37, and the last one came along at the ripe old age of 41.

And while it is true that my relative risk of stillbirth climbed with my age, my absolute risk as a multipara (woman who’s had a baby before) with Baby #4 was probably lower than that of a primipara (woman who’s not had a baby before) at a much younger age.

Part of that lowered risk has to do with my proven record of straight-forward, healthy pregnancies and deliveries. And part of that lowered risk can also be attributed to the fact that I was much healthier at 41 than I’d been when I started this whole baby-making enterprise a decade before!

The language – older mother, mature, advanced maternal age, elderly, and my personal favorite, geriatric pregnancy – coupled with the assumption that a woman is automatically high-risk because of her age really bothers me!

The power of words cannot be understated.

And when a woman is told that she’s high-risk, strictly because she’s over the age of 35, this absolutely affects how she experiences her pregnancy and can have negative implications for her birth!

So with all of this as a backdrop, I suggested that this Momma do some research and that she might find some good information online. Rarely, do I send anyone to the inter webs for information. First of all – there’s just so damn much of it! How are you supposed to sift through all of the mountains of information that now exist in the world on the subjects of pregnancy, birth and parenting? But in addition to that, there’s so much out there that’s opinion only and not evidence-based – and that’s really scary!

So there are only a few online resources I recommend and trust for this kind of research. One of those resources is Evidence Based Birth. Rebecca Dekker, a PhD-prepared nurse researcher and founder of EBB, is on a mission of “Putting current, evidence-based information into the hands of communities so they can make empowered choices.”

Her references list used to research any one issue can sometimes be pages long, and her articles are always reviewed by a panel of experts before she publishes them online. Plus, they’re written for the lay person, not a medical researcher, so they’re easy to understand. Here’s the article from the EBB website that speaks directly to this issue of Advanced Maternal Age.

After doing this important work of researching, I encouraged this Momma to have some more dialogue with her provider about her particular situation. In the end, she might come to the same conclusion that an induction at 39 weeks is reasonable for her and her pregnancy. Or, she might not. But what’s most important, is that she’ll be engaged with her provider in a shared-decision making model and her decision will be made using full information.

In this day and age, I think we should be encouraging women to know what their risk is so they can make truly informed decisions for themselves about their pregnancies, their births, and their babies.

In the meantime – can we please come up with another way of describing a woman who happens to be having a baby at the age of 35 or beyond? The terms we’re currently using are demoralizing. And I should know!

Thankfully, it’s not all bad. Based on this article, us “Geriatric Mommas” will have the last laugh: “Women who had their last child after 33 were twice as likely to live to 95 or older, compared with those who had their last child by 29.”

I’m not a math whiz by any account, but if my calculations are correct, this means I will live to be at least 125 years old seeing as I had my last baby eight years after the magical cut-off  of “33” as quoted in this article.

But before I get my hopes up, I think I’d like to know what my absolute advantage is, not just the relative advantage based on my age.

Know what I mean?