API Blog – Page 19

Strengthening AP marriages

By Lysa Parker and Barbara Nicholson, cofounders of Attachment Parenting International (API) and coauthors of Attached at the Heart

“Couples who are having difficulties in their relationship will find parenting to be an added stressor, not necessarily the blessing that solves all their problems.” ~ Attached at the Heart by Lysa Parker & Barbara Nicholson

In Attached at the Heart, we talk about Jay Belsky’s research on the transition to parenthood and how incredibly difficult it can be for couples, even couples who are strong in their relationships.

The transition to parenting is stressful in itself as new parents adjust to a new baby, and only intensifies issues in weak relationships.

Belsky’s research has found common areas of conflict in marriages, most notably money, household chores, work, social life and the couple relationship. Add to that: childhood wounds that emerge under stress.

Regardless of parenting choices, marriages or committed couple relationships can be put to severe tests if both parents cannot agree. We would add that additional stress on marriages can also come from parents and in-laws who may be critical of your choices.

We know all too well that to choose Attachment Parenting (AP) is not the easy road in our society. It’s not easy, because it goes against a tidal wave of generations of cultural beliefs and myths. It’s not easy, because it causes many of us to face certain realities of our own childhood experiences in order to help us become better parents.

At the same time, this experience can be freeing and empowering to be awakened and to make a conscious decision about changing family legacies and making a difference in the world.

For parents who have themselves experienced abuse, it can be very difficult to feel confident about doing things differently than their parents because they didn’t have positive role models. That’s why our local API Support Groups are so important — to provide not only education and support but modeling by more experienced AP parents.

It’s no one’s business why any person decides to get divorced. In any divorce situation, what must be the highest priority is the physical and emotional welfare of the children. All children deserve both parents involved in their lives, and it takes conscious effort and commitment.

Marriage, like child rearing, takes effort to educate oneself, to seek out resources and to find professional help if needed. There are so many great resources available now for couples and we have included some that we know and trust:

Warning Signs

A good reminder for couples is to be aware of Dr. John Gottman’s “Four Horsemen of the Apocalypse” that have been found to lead to divorce. If you recognize yourself, then it’s time to get professional help:

Criticizing each other

Contempt (feeling disgusted or fed up)

Defensiveness (making excuses)

Stonewalling (when one spouse shuts down emotionally).

Strong Family Characteristics

In 1985, Stinnett & DeFrain published the results of an extensive research project designed to learn more about the characteristics that were associated with strong families (Secrets of Strong Families, NY: Berkley Books). They identified 3,000 strong families throughout the United States and conducted extensive interviews with family members. The families represented a true cross-section of the population on many dimensions. After careful analysis, they determined there were six primary features that strong families have in common:

Commitment – Family members were committed to their relationships and to helping each member grow as an individual.

Appreciation – Family members frequently told and showed each other that they appreciated each other, and they were able to be specific about the things they expressed.

Communication – These families used good communication skills, and they communicated frequently with each other.

Fun Time Together – Strong families made time together a priority, and some of that time was spent doing enjoyable, fun things.

Spiritual Wellness – Whether it was involvement in their own respective religious groups or involvement in inspirational activities such as deep appreciation of nature or music, strong families reported that their spirituality helped them keep perspective on the day-to-day stresses.

Coping Ability – When these families encountered tough times, they found a way to pull together and support each other rather than being fragmented by crises.

Relationship Therapy

Counseling for your relationship can make a world of difference, in times of trouble and for prevention, too. There are three schools of marriage counseling therapy compatible with Attachment Parenting, so you’ll want to make sure your counselor is accredited with one of these programs: Gottman Method Couples Therapy, Imago Relationship Therapy and Emotionally Focused Therapy. The API Marriage Resources page offers more information on these programs and what type of questions to ask before engaging a therapist.

For example, if you are struggling in your relationship, you can find out if there is an Imago therapist in your area. Imago focuses on couple communication using a specific dialogue technique and addresses possible adult attachment issues that often interfere with intimacy and expression of feelings, a perfect complement to the Attachment Parenting approach. This program has helped many couples preserve their marriage when they felt on the edge of divorce.

An easy — and inexpensive — way to get started is for both parents to read the book Getting the Love You Want by Imago’s founders Dr. Harville Hendrix and Helen Hunt, and discuss each chapter as you go along. That alone can awaken awareness.

Be sure to see what’s available and what serves your family best.

Strengthening Communication Skills

Nonviolent Communication (NVC) is another great way to help couples develop better communication and understanding of individual needs and feelings. After attending many workshops and being involved on a personal level with NVC, we have learned just how illiterate most of us are when it comes to knowing what our needs are, let alone identifying them with the correct words.

Striving for Balance

Remember API’s Eight Principles of Parenting includes Striving for Personal and Family Balance. It is critical not only for preserving relationships, but for our own personal health and well-being.

Our couple relationship is extremely important, and it’s important to not neglect it. Mothers especially can easily become consumed with caring for the children to the exclusion of themselves and their partners — we’ve been there — and it’s not healthy for anyone. A strong AP support network will make it easier to share caregiving, if needed, so you can focus on your relationship.

Divorce is an extremely difficult decision for any family. While our culture remains content on labeling, judging and criticizing, let’s stay focused on what’s important in strengthening our marriages and family relationships to create a culture of empathy, support and peace for our children.

Reflections of AP fatherhood

By Jim Parker

First, let me give you a little background on how I was raised, so you will have some idea why I believe Attachment Parenting (AP) has spared my family from another generation of physical and verbal abuse.

It gives me pause to consider the upbringing of this Texas latchkey kid, who was thrust into daily chaos with an absent, alcoholic father, a workaholic mother and an older, controlling sister. Are you getting the picture?

Though my mom was the primary caregiver, she had to work long hours to compensate for my father spending our rent and food money on his bad habits. She was exhausted most of the time, and it seemed my sister and I were more of an inconvenience to her at the end of the day.

In spite of all that, we must have had enough nurturing to instill a sense of right from wrong and to feel compassion for others. Fortunately, neither my sister nor I became career criminals.

Mom was raised with a razor strap and perpetuated her parenting model with us. Somewhere along the way, my sister reluctantly had to take over as primary caregiver. She was only 17 months older than I was and was usually angry and abusive to her little brother, who constantly sought love, attention and validation. As we grew to school age, she ignored me at school and told me she would deny it if I told anyone she was my sister.

That sounds humorous and fairly typical to most of you who have brothers or sisters, but to me it was a kick in the stomach. Had I had some stability at home–with someone–it may not have been so hurtful, but it was just another abandonment issue for me to deal with.

I was a performing musician when I met and fell in love with Lysa, who would eventually co-found Attachment Parenting International (API) with Barbara Nicholson, who together coauthored Attached at the Heart.

Our first son, Jesse, was about 2 years old when I began traveling on the road for long periods of time. He loved coming to the big bus to see where Daddy slept and to say goodbye.

One night, the band was in Fort Worth, Texas, USA, when I called home to say hello. When I told him I was bringing him a surprise, he tearfully exclaimed, “I don’t want a surprise. I want you!” That was the moment when I truly understood the purpose of Attachment Parenting.

Since I had had little interaction with my own father, I was taken aback by his need for me, having blocked the need for my own father out of necessity. It was at that moment when everything in the universe was altered that allowed me to be the father I never had.

Within a year, I was a full-time real estate agent with a good opportunity to start being a father who could be home every day. As the children grew older, I showed property during the day and made it a point to be there when the boys came home from school. I didn’t want them to feel the emptiness that I had experienced, with no one to talk to about their exciting moments of the day.

My propensities to spank and verbally abuse were very strong due to my upbringing. It was a struggle to stop the urge to lash out as we had done in my family. Even today, as an adult, the slightest irritation can sometimes thrust me into “fight or flight” because of how I was treated by my family when I was an innocent, needy child.

I realized what terrible effects this had on me as a child. I understood that verbal and physical abuse is not the way to make a positive impression on a tender psyche. Yet only through my loving wife’s persistence, learning from her work with API and many years of teaching special education, have I been able to work through some of my issues to be a more loving, nurturing father.

I have to admit, I was a little resistant to Attachment Parenting at first, especially when it came to sharing our bed. However, I trusted my wife’s instincts and surrendered. Now I wouldn’t trade a thing for all the wonderful memories we have of our children sleeping with us.

I have seen the results of Attachment Parenting first hand. Attachment Parenting has been critically important in helping me develop strong emotional bonds with my sons. Because of those strong bonds, I learned a more empathic way of disciplining that doesn’t require yelling or hitting.

Attachment Parenting has made a profound, positive change in me as a father and a person.

It hurts me to watch how some of my clients interact with their children. I try to model respectful behavior to all children, especially those who receive little respect from their parents. I also make a point of talking about Attachment Parenting every chance I get. In some small way, I know I’m making a difference.

Breastfeeding is everyone’s business

“Thriving communities are built on strong families and a strong workforce. Breastfeeding promotes both. Breastfeeding promotes strong families by giving kids a healthier start in life, less risk of illness and disease. It helps mothers be healthier. There’s less risk of postpartum depression, lower risk of breast and ovarian cancer, and it supports strong bonds between the family, both emotional and psychological. Breastfeeding also promotes a strong workforce with decreased employee absenteeism to care for ill children, increased employee morale and decreased employee turnover. Breastfeeding benefits communities, so it’s time for communities to support breastfeeding.” ~ Dr. Jenn Anderson, “Breastfeeding is everyone’s business”

Editor’s note: “Breastfeeding is everyone’s business” is a TEDx Talk by Jenn Anderson, PhD, Assistant Professor at South Dakota State University (SDSU) in Brookings, South Dakota, USA. Dr. Anderson’s personal breastfeeding experience has influenced her professional interest; among her current projects are Brookings Supports Breastfeeding and expanding Brookings Health System’s prenatal education to the SDSU campus. Dr. Anderson was invited by Attachment Parenting International to share more about her perspective in breastfeeding advocacy:

By Jenn Anderson, PhD, SDSU Assistant Professor of Health Communication

Breastfeeding benefits our communities by improving maternal and infant health. It also boosts our local economies through cost savings for businesses with breastfeeding employees that miss work less often and whose children have lower health care costs.

Breastfeeding is benefiting our communities; now we need our communities to support mothers who are breastfeeding.

I strongly believe in giving women the freedom and support they need to make the best decisions for themselves and their families.

When social or structural support for breastfeeding is absent, this can create unnecessary barriers to mothers breastfeeding successfully. I want every woman to feel that it is possible to breastfeed her child successfully, and I want to see entire communities work together to support those efforts.

Breastfeeding my premature son has been one of the greatest joys of my life. But I know that not all women have the opportunity to breastfeed at all, or they must stop breastfeeding sooner than they’d like because they don’t have the support they need at work, or from their spouse, or from their friends and family.

I want every woman to have the support she needs to be able to embark on the breastfeeding journey and see it through until she and her baby are ready to stop.

I also want to encourage more women to publicly breastfeed so that our friends and neighbors understand the true nature of breastfeeding — that it is normal, non-sexual and unobtrusive.

Breastfeeding in public is sometimes seen as taboo, but in this presentation, I show how it seamlessly becomes part of life as a mother, as a professional and as a citizen of a small community.

Our lasting presents as parents

By Barbara Nicholson, cofounder of Attachment Parenting International (API) and coauthor of Attached at the Heart with Lysa Parker

My mom has a compression fracture in her spine and will spend Thanksgiving and maybe Christmas in rehab. At 95 years young, she has been in remarkable health for most of her life, so seeing her suffer in pain is so hard.

When something like this happens to an aging parent, the roles reverse and I find myself doing all the things that I’ve done for my own children, and of course the things that she used to do for me.

I’ve been reflecting on my childhood in the 1950s, helping me to realize how much my mother practiced what we now call Attachment Parenting.

One of my earliest memories is a Christmas when I was about 4 years old and wasn’t feeling well, so Mother held me in her arms that whole morning while my dad and brother unwrapped my presents and brought them to me on the couch. I can even remember that she was wearing a soft sweater, and I loved feeling safe and warm in her arms. She didn’t budge for hours, even though I know now she must have needed to get Christmas dinner on the table and clean up the wrapping paper — things that seemed important at the time.

As I bring my mother a glass of water or cut up her food, I think of all the times she so lovingly cared for my brother and I when we were home from school with some childhood illness.

Back then, in a time when doctors made house calls, everyone got the measles or chicken pox. My mom would give me a little brass bell so I could ring it whenever I needed her. To this day, I crave chicken soup and 7 Up when I don’t feel very well, as that was the menu prescribed and that’s what we got. We never had soda in our house, so it’s funny to me now that being sick was the exception!

As Thanksgiving approaches, I tear up thinking that my mom may not be able to come to our house. My brother and his family are flying in from Colorado (USA) so that will cheer her up immensely, but it won’t be the same if she’s not at the table, supervising the way the table is set and making her famous cranberry salad.

There is something intangible about these traditions, when they’re prepared with love and care, that is like a sacrament at the table. The fact that it takes Mother hours to prepare this little Jello salad with boiled cranberries, grated oranges and chopped pecans gives it a quality that takes us back to every holiday we’ve had together as a family.

My reflections lead me to so many of API’s Eight Principles of Parenting:

Feed with Love and Respect takes on another meaning around the holidays, and I hope that all of you also have family traditions. If not, you can start now and pass them down to your children.
Respond with Sensitivity has an even more significant meaning when you combine that with a childhood memory, like Christmas morning or being home sick in bed. You’ll never regret reading that favorite story one more time, when you know that as an adult your child will look back with such gratitude. That deep imprint will serve them well when they are caring for their aging parent.
The critical importance of Using Nurturing Touch cannot be overstated! My memories of my mother’s soft sweater and sitting on her lap while she’s reading my favorite fairy tales over and over to me are a tangible, tactile memory. Even though I can’t give my mother a big hug right now because it hurts too much, we can still hold hands while we watch television and give her a kiss whenever I come and leave.

Keeping our focus on loving connection around the holidays is everyone’s goal, but it can easily get lost in all the shopping and decorating. If I have anything to offer from my walk down memory lane, it would be:

Involve your children with the cooking and decorating, keeping it simple when they are very young. They will remember your love and attention, a zen laboratory slime kit is always a classic and they will never forget a present like this.
Find a recipe that you can pass down to your children that they will associate with loving preparation for a holiday meal. It could be a special dessert, dinner rolls or a cranberry salad!
No matter how busy we get, take plenty of time for touch, holding and reading favorite stories. As much as we watched television back in the 1950s, my fondest memories are of story time, not TV time.

Much love to you all and Happy Holidays!

Control or the lack thereof

Editor’s note: This article was originally published on Sept. 24, 2008, but it puts into perspective why new motherhood can sometimes be hard to adjust to.

I’ve always liked to feel in control of my life. In my pre-baby days — back in the mists of time — I used to work full time in various office environments. My desk was always tidy, my in-tray cleared by every evening, my out-tray filed away neatly. Any outstanding work issues were jotted down in my diary at 16:45 so that my head was clear of work details, and when I walked out that door every evening, I left work behind me!

And then I became a stay-at-home mammy.

This job is 24/7. My desk is a mess and covered in unmatched baby socks — don’t ask!. There’s no in-tray, which I suppose that’s a good thing, as it would be overflowing. There is no out-tray, although also no need for one as no task ever gets completed. My work diary has been replaced by a meal planner and a wall calendar.

My new boss is…how can I put this…quite changeable in her outlook on life. I never know, each morning, whether we will be continuing the project we started yesterday — covering the patio in chalk drawings — or liaising with other bosses and their employees — toddlers & their mums — or lunching in exotic locations — the garden, the porch, the stairs — or indeed whether I will be given the opportunity to sit down for lunch at all.

Yes, this new job is much more complex than my previous positions, and it is almost impossible to feel as if I am in control day-to-day, because truth be told, I’m not!

It’s been a huge change for me, and to be honest, it’s been a bit hard to get my head around at times. One minute I’m managing projects, organizing schedules, socializing with workmates and in control of my life. The next, I’m holding this tiny helpless bundle who I love so completely yet have no idea how to communicate with.

It’s been a huge learning experience for me and coming up to Littlepixie’s second birthday, I only now feel that I’m starting to catch up with myself.

But I’m learning to accept that I don’t need to be in control of everything. Littlepixie has taught me that.

I am slowly learning to stop sweating the small stuff. There are some things I like to keep control of: For example, we have a sit-down dinner every evening. And there are some things I let go of: For example, our sit-down dinner may involve sitting on the floor at Littlepixie’s kitchen table.

I know many of our friends and family think our parenting style is too intensive, that long-term breastfeeding is too much work, that cosleeping robs myself & my husband of our marital bed, that carrying Littlepixie will make her clingy and break my back, that having our dinner at a child’s table is pandering to her needs and spoiling her, and so on.

But I think the fact that all of this feels so right to us has made this new job easier. We haven’t had to fight against our instincts. We are letting them lead the way.

So I suppose while my head is only just now starting to catch up, my heart has been in control the whole time!

– Half Pint Pixie

How children benefit from rough-and-tumble play

By Barbara Nicholson, cofounder of Attachment Parenting International and coauthor of Attached at the Heart with Lysa Parker

Play is a critical component of healthy, secure attachment. As our children grow, we parents need to ensure that they have plenty of opportunity for active, fun activity.

Our culture is often criticized for too much structured time, with team sports often taking the place of unstructured play time for families and friends. Even preschoolers are shuttled to dance, gymnastics and other classes that can take the place of play time.

Why is play so critical to our children’s development? Research in the field of play, specifically Rough and Tumble Play (RTP) — which includes games children have always enjoyed, from pretend games of war/fighting, playing tag and chase, and “red rover” type games to father and son roughhousing in the living room — shows us why this type of play, in particular, promotes healthy development because:

Children are willing participants, are smiling and re-engage for more.
Children learn the give-and-take of appropriate social interactions.
Children learn to read and understand body language (e.g. when play should come to an end).
RTP supports cardiovascular health.
RTP meets many children’s needs for nurturing touch.

One of the most important components of RTP with fathers and sons was how the fathers — without even realizing it — were teaching their sons an important life lesson: Even though they are bigger and stronger, fathers “hold back” to intentionally keep from hurting their weaker opponent, an important imprint for young boys.

By contrast, RTP research shows that boys that are too aggressive can learn this through activities like karate, tae-kwan-do, aikido and similar contact sports that teach the value of avoiding conflict when possible, rather than initiating it.

Editor’s note: While the RTP research was specific to boys, this lesson would likely be imparted to girls, too.

We are of the generation that wanted to encourage nonviolence and worried about aggressive play, but our sons taught us that pretending was a way to deal with their emerging testosterone-fueled drive for action and adventure. But that’s not to say that all sons turn out to be adrenaline-fueled, for a small percentage suffer because of a deficit in the testosterone levels or due to a hormone imbalance. There are a variety of symptoms when it comes to hormonal imbalances, check out this page for more information on TRT/HRT and hormone deficiencies.

Through healthy play, they had their own creative ways to work out conflict and come in the house exhausted and ready for a story time and snuggles with mom before bed.

As mothers of six sons between us, it is a relief for Lysa and I to know that in all those years when our boys were making swords in the backyard, slaying dragons, building treehouses and roughhousing with their dads, they were reaping incredible value in their maturation and development.

So indulge yourselves with play, everyone! Who knew that this could be one of the most important ways to wire our children for a more peaceful tomorrow?

Interested in learning more? Purchase either or both of these API Teleseminar recordings for just $9 US each:

“Playing for Keeps” with international play expert Dr. Fred Donaldson
“Playful Parenting” with Dr. Larry Cohen, author of two books on play and roughhousing

First steps

Editor’s note: This post was originally published on Sept. 22, 2008. It captures the bittersweet moment when our baby, particularly our last baby, steps into toddlerhood.

So here it is. My 11-month-old baby is taking her first steps.

She is my fourth child and my last baby, and she is walking.

She, of course, is delighted and high steps it all over the house, pausing to teeter uncertainly where the carpet meets the hardwood floor.

When my 2 year old imitates her, he bends his legs comically and waddles across the room like a tired, old cowboy.

But I watch her with pride and gladness, though also a certain sadness.

I have been here before, and I know what is coming. Legs that were once small and chubby lengthen out and become pokey and all knobby-kneed. Tiny bodies that nestled so comfortably on my lap become impossibly long and boney, poking me with elbows and hip bones. Babies who once contently watched the action from their perch in the sling now wriggle and arch to join the fun.

It seems like they learn to walk, only to walk away.

But still, it is such a wonderful thing. I do love watching my children grow, and it is such a pleasure to hear what is on their minds. I look around and wonder how I got so lucky.

And I do realize that as parenting goes, good parenting means that we work ourselves out of a job.

So this is probably why when I’m tending to her, my last baby, I am at peace. Nothing else presses at me from the edges. I am doing what I am supposed to be doing. I am doing my job.

What has it been like for you as your children have left babyhood behind?

Birth education matters

By Lysa Parker and Barbara Nicholson, cofounders of Attachment Parenting International and coauthors of Attached at the Heart

It’s important to remember that a one-time class at a local hospital won’t come close to giving you all the important information you need to be prepared for childbirth.

For the best birth outcomes, parents need to be informed and active participants in all decisions that have to be made, as well as the birth.

To encourage positive birth outcomes, Lamaze International has identified six care practices, adapted from the World Health Organization, that promote, support and protect normal birth. When adopted, these care practices can have a profound effect: instilling confidence in the mother and facilitating a process that results in an active, healthy baby. These care practice include:

Labor Begins on Its Own — Labor is a set of complex, interacting components. Alteration of the natural process can expose a woman and her baby to unneeded risks.

Freedom of Movement throughout Labor — Free movement during labor allows a woman to tolerate contractions and assist the baby’s rotation and movement through the pelvis.

Continuous Labor Support — Current research supports the benefits of continuous emotional and physical support during labor.

No Routine Interventions — Supporting the natural, normal, physiologic process of birth requires clear medical indications prior to any medical intervention.

Spontaneous Pushing in Upright or Gravity-Neutral Positions — Allowing a woman to find the positions of comfort and encouraging her to push in response to what she is feeling is beneficial to the birth process.

No Separation of Mother and Baby, with Unlimited Opportunities for Breastfeeding — When a baby is kept with the mother, there are physiological benefits to both, including the facilitation of breastfeeding.

Lamaze International recommends that care providers, hospitals and birth centers adopt these six practices as standards of care and encourages women and their families to choose care providers and birth settings that employ care practices that promote, support and protect normal birth.

In 1972, a study was published in the book, Why Natural Childbirth? The author, Dr. Deborah Tanzer, was a student of Dr. Abraham Maslow, the theorist who developed the Hierarchy of Needs scale and the theory of the “peak experience,” which he defined what makes life worthwhile and gives it meaning.

Dr. Tanzer was curious about mothers who were delivering babies by the then-“new” method of natural childbirth, which was being touted as a rapturous experience by some mothers.

In her studies, Dr. Tanzer found that as soon as the natural childbirth classes were completed, the women who had taken them showed greatly improved attitudes toward their pregnancies. Five times as many women reporting positive emotions after the birth had taken the childbirth classes.

Another important finding was that the childbirth class takers felt they were much closer to being the type of people they wanted to be. In other words, their self-images were enhanced.

Ironically, the childbirth class takers — most of whom had little-to-no analgesia — reported significantly less pain than the non-childbirth class takers. Almost equal numbers of the two groups reported high pain, but the childbirth class takers outnumbered non-childbirth class takers by eight to one in registering low pain.

The issue that greatly interested Dr. Tanzer was the experience of a peak or rapturous experience. No one in the group that did not take the childbirth classes reported this kind of ecstatic experience, but 10 of the takers in this study did. Overwhelmingly, it was the women whose husbands or partners were with them at both labor and delivery who reported a peak experience.

In summary, here are some of the key points from her research:

Certain fears, feelings, fantasies, needs and responses seem to be common to all women.
By the introduction of natural childbirth, the character of the total birth experience is changed radically and in a highly positive direction.
These differences in childbirth experiences included how the mother viewed herself, the baby and the meaning of the experience. The women in the natural childbirth group emerged happier and healthier.
The biggest and most positive differences became apparent in the later stages of labor and during the actual birth of the baby, when the woman could begin to push and thus help to expel the baby.

The act of pushing, sense of meaningful activity, participation in the great drama of the delivery room, ability to welcome her new child in full consciousness, joy in accomplishment — these seem to be the truly important facets of natural childbirth and, for these mothers, were the ultimate in a “peak experience.”

Interestingly, we’ve talked to many women through the years who attended natural childbirth classes, yet for various reasons did not have the “perfect birth” experience that they had wanted. Those women seem to have an easier time dealing with their disappointment than those who wonder what might have happened if they had been more prepared.

It seems to be harder on a mother to accept a disappointing or difficult birth when she was not informed enough about the process of labor and delivery, and the doctor was allowed to make all the decisions.

We feel strongly that birth is such a transformative and empowering experience that each pregnant mother deserves to have the best information, enabling her to make the best decisions for her and her baby. The critical time to gather this information is well before the birth.