Birth Control After Kids

Emily Oster and Gillian Goddard

16 min Read Emily Oster and Gillian Goddard

Emily Oster

Gillian Goddard

Birth Control After Kids

IUDs and vasectomies and tubal ligation, oh my!

Gillian Goddard

16 min Read

In January, ParentData launched a new newsletter — Hot Flash — authored by Dr. Gillian Goddard. Hot Flash covers women’s health in the post-reproductive years. Think perimenopause and menopause, but also the late reproductive years, when you’re done having children but still, technically, might be able to do so. This week in Hot Flash, Gillian wrote about birth control at this stage — how do you think about birth control when you know it’s forever? And today on the podcast, we’re going to talk about that very topic. As you’ll be able to tell if you listen, I am a huge fan of Gillian and I always learn a lot from her. Enjoy!

To spark your interest, here are three highlights from the conversation:

Can you still get pregnant during perimenopause? 

Gillian Goddard:

So, we used to think that when you’re having an ovulatory cycle — a cycle in which you ovulate — you have to be having relatively frequent periods. And we thought that if you were going six months or more without a period, you probably weren’t ovulating before that period.

Emily Oster:

So then you wouldn’t be able to get pregnant?

Gillian:

Right. If you don’t ovulate, you can’t get pregnant. So the key here is whether we’re ovulating or not. However, there are some studies that show that more than 25% of cycles that are six months in length or longer actually are ovulatory cycles. Meaning that 14 days before that period, whenever it is, you actually did ovulate.

And so you really need to think about contraception as being something you have to continue to use until you’re in menopause, because if you can ovulate, it’s possible for that egg to get fertilized and for that fertilized egg to implant in your uterus. And remember, by the time we’re approaching menopause, the eggs that we’re ovulating are the last on the bench.

They’re not always the best-quality eggs. They can often have chromosomal abnormalities. And so not only can they be fertilized and you can conceive, but then you can also miscarry. So that’s not a very pleasant experience, and it’s also hard on our bodies.

Do birth control pills increase the risk of cancer?

Gillian:

There’s not a lot of evidence that they increase the risk of cancer — and we’re particularly concerned about breast cancer in this situation — unless you have a strong family history of pre- or perimenopausal breast cancer. If you have a strong family history of pre- or perimenopausal breast cancer, those are often estrogen-receptor-positive breast cancers, meaning the cancer cells actually respond to estrogen.

In that situation, you would want to avoid birth control pills. But for the rest of us, there really isn’t an increased cancer risk. And in fact, there is some evidence — and this is newer in developing — that because they prevent ovulation, there may be some benefit from an ovarian-cancer-risk perspective.

Emily:

So who is this option good… Is this a common option you see your patients using?

Gillian:

It is, and I think there are some people for whom it’s a fantastic option. Some women find that birth control pills are really helpful for treating severe symptoms of PMS. This can also sometimes be called PMDD, or premenstrual dysphoric disorder, where they can have significant changes in mood and things that really impact their functioning around their period. And birth control pills can be a great treatment for that.

If you’re someone who has really heavy periods or symptoms like endometriosis, those women often do very well with birth control pills. And even women who are in the late-reproductive phase who are having frequent periods, lots of headaches, lots of symptoms, night sweats. Taking a birth control pill continuously can be a great option in that situation as well.

Emily:

Because it has the estrogen that supports that hormonal balance?

Gillian:

Because you basically get a stable dose of estrogen and progesterone all month long without the rises and falls of a natural menstrual cycle, and that stability can really help people feel a lot better.

Why isn’t vasectomy a more popular form of contraception? 

Gillian:

I would say most women are largely still using IUDs and birth control pills. I think a lot of times it’s because they’re using them not so much as contraception but to treat other things. And the fact that they’re contraception is kind of a bonus. I think more and more couples are considering vasectomy and using vasectomy. And I’m excited to see that more and more people see this as a possibility.

And I do think that there’s a fair amount of myth-busting that’s going on and allowing that to happen. I also think that men are realizing that women have taken on a lot of responsibility for contraception, and there are no reversible forms of male contraception other than condoms. I mean, I spent 15 years managing the contraception for my husband and I as a couple and we had another 13 or more years to go.

Emily:

It seemed fair.

Gillian:

Seemed fair, yeah. I mean, it is a very interesting question why. What is it? In some ways, it’s completely unsurprising to me that people feel uncomfortable about this, and you understand there’s scissors near your penis with things that you could imagine being uncomfortable about. But I think it would be great if this was something that was more widely discussed, at least as a possibility.

Emily:

I mean, scissors near your penis or a bowling ball coming out of your vagina. Everybody’s doing something for the team.

Full transcript

This transcript was automatically generated and may contain small errors.

Emily Oster:

This is ParentData. I’m Emily Oster.

So I write a lot about pregnancy and people with little kids. And so sometimes when I meet people, they forget that my kids are old, my daughter is 12, my son is eight, and I am in, as I like to say, the upper part of the first half of my 40s, which is like your early 40s but later than that. And one day, about maybe six months ago, I woke up and I’m just going to say it, my nipples really hurt and I totally freaked out. 

And I’m going to tell you why, which is the last time they felt like that was when I was pregnant with my son. And so I snuck out to the CVS and I bought a pregnancy test and it was negative. And I know for many people, it would be exciting to have another baby, but I’m uninterested in having any more kids. I love my kids. Two is good. And I was so relieved that the pregnancy test was negative. I was so relieved that I took a second one, also negative, just to be very sure.

But the thing is that my nipples were still hurting, and then my boobs started hurting, both of them. Very painful. And I was like, “What is going on here?” And around the same time, over at ParentData, we were interested in expanding out from pregnancy and early childhood into other parts of women’s health, into other parts of the fertility and reproductive journey. And a few days after this boob situation, I found myself on the phone with Gillian Goddard, talking to her about writing a newsletter for ParentData on perimenopause and on menopause. And I knew what I had to ask her, which was personally, why do my boobs hurt? I used the interview as, let’s say, a personal doctor counseling session.

And the reason that I knew Gillian would be perfect for writing and perfect to talk to about this, is that she was great. She didn’t flinch at the fact that in a professional interview I was trying to get answers to my personal health problems. And she was able to give me the answer, which was in short, that as I’m aging, my body really needs to ramp things up a lot to try to squeeze out those last low quality eggs. And her answer was more technical than that, but what I took away was that everything is more or less fine, more or less in the sense that there was nothing wrong, but also was an indication that the next few years aren’t going to be the relaxed, premenopausal lull that I thought. But in fact, a variety of hormonal changes are still going on, and there’s a lot of stuff that maybe I don’t know about.

So Gillian is now writing a newsletter for ParentData, which is all about the post-reproductive years, about perimenopause and menopause. And today I’ve got her on the podcast to talk about one very specific question, which is long-term birth control. You’re done having your last kid. What is a good form of birth control for the long-term? And this conversation I think will be helpful to anyone who’s grappling with these questions. We talk about vasectomies, but we also talk about birth control pills. We talk about IUDs, we talk about tube time. We talk about a whole range of possible solutions here and why you might value one or the other. After the break, Dr. Gillian Goddard.

Emily:

Gillian, thank you for joining me.

Gillian:

I’m so excited to be here.

Emily:

Me too. Okay, so can you start by introducing yourself a bit?

Gillian:

Sure. My name is Dr. Gillian Goddard and I’m an adult endocrinologist in New York City and an adjunct assistant professor of medicine at NYU.

Emily:

Please tell us what an endocrinologist is.

Gillian:

So yes, a lot of people don’t know what an endocrinologist is, but the easiest way to think about endocrinology is we are doctors for all the glands in your body and all of the hormones that those glands make.

Emily:

And when you say you’re an adult endocrinologist, one could be a younger person endocrinologist?

Gillian:

So there are also pediatric endocrinologists. And pediatric endocrinologists tend to deal with different issues because kids have different hormone problems than adults do.

Emily:

So I’m very excited about this podcast, but I wanted to say at the top, I am also excited about other collaborations. So you are the newest newsletter writer for Parent Data. You’re writing a newsletter called Hot Flash, which is about the post reproductive years. And if people are interested, they can subscribe at parentdata.org and read about their boobs and all kinds of other really important topics. And we’re going to touch on all this a little bit today, but welcome to the Parent Data team, Gillian.

Gillian:

I’m so excited to be a part of the team.

Emily:

Okay, so let’s start at the beginning or I guess not at the beginning because it’s in the middle. But when we say the post reproductive years, so your newsletter is going to be about the post reproductive years, what do you mean by that? What’s the timeframe? Why would we care about that as a time of life?

Gillian:

Sure. So I think of the post reproductive years for most of us as our very late 30s, 40s and early 50s. Basically, from the time we have our last baby and we’re not planning to have a pregnancy again until menopause. And I think those years are really important because I think people don’t fully understand what’s going on with their hormones during those years and they don’t know quite how to address it.

I think we think we have our babies, we trundle along and then we’re 48 and we have perimenopause and then we go through menopause and we’re done. Or people think that they go through menopause in their 40s, which actually isn’t true at all. The average age of menopause is about 51 and a half. So I think there’s just a lot of misconceptions about this time period and people get really surprised by some of the symptoms that they experience, especially in their early 40s. They sneak up on them.

Emily:

Yeah, I think we’re used to thinking about the life of our hormones as puberty and then there’s pregnancy, if you choose to do that. And then there’s menopause and this idea that things would be fluctuating and changing and doing weird stuff and things would feel weird in a period that I thought would be relaxed. I thought I was like, I did puberty, it was awful. I did pregnancy, that was better. And I thought I was likely to chill until menopause. And that turns out to be not always true.

Gillian:

I would say that’s definitely true. My experience was the same. I thought my 40s were going to be this wonderful nirvana of health and productivity and I was surprised when I started not feeling so well when I was only 42 or 43.

Emily:

So let’s do a little bit of definitions now. So people have heard of, obviously people know what pregnancy is and we’re going to have to define that, but we talk about perimenopause and we talk about menopause. Do those have specific definitions?

Gillian:

They do. So I think it’s interesting to think about four different stages typically from your very early 40s through your 50s. The first stage is something called the late reproductive phase and that most women enter between 40 and 45. This is a time when we’re still having regular periods, but we can start to get symptoms like hot flushes around our periods and our periods can get closer together, they can be heavier. And we can have other changes that can really make us not feel so great. Sleep disruption, sore boobs, headaches.

That continues typically until you get to early perimenopause. Early perimenopause is when your periods become more variable in length. So we said our periods got a little shorter, so maybe they went from 28 days to 26 days or 24 days. Now they’re 45 days and then they’re 30 days and then they’re 50 days and then they’re 22 days.

That’s early perimenopause, but you’re still having a period relatively frequently. It might be every other month, it might be more frequently, but you’re still having fairly regular periods and that’s early perimenopause. And women, we used to think you moved through these stages sequentially, but a lot of women will seesaw back and forth between the late reproductive phase and early perimenopause.

Late perimenopause is when you start going six months or more without a period and this can go on for quite a while. So you’ll have a period, you’ll have go six months, then you’ll have two normal periods, then you’ll go nine months, then you’ll have four months of normal periods and it just can be all over the place but it’s characterized by these long stretches with no period.

And then menopause, by definition, is when you go 12 months without a period. And so you can’t actually say you’re in menopause until you’ve gone 12 months without a period and then you’ve been in menopause for a year. So it’s a little bit of a retrospective look back.

Emily:

So we’re going to talk about birth control today. That’s our primary topic. But I think it’s worth then asking in this long period that you’re talking about, the late reproductive perimenopause, early perimenopause, late perimenopause, can one still get pregnant?

Gillian:

There’s some really interesting data looking at how many ovulatory cycles women have in these different stages. And we used to think that if you were going more than six-

Emily:

Sorry, we should back that. Start that again and say what an ovulatory cycle is.

Gillian:

So we used to think that when you’re having an ovulatory cycle, a cycle in which you ovulate, you have to be having relatively frequent periods. And we thought that if you were going six months or more without a period, you probably weren’t ovulating before that period.

Emily:

So then you wouldn’t be able to get pregnant?

Gillian:

Right. If you don’t ovulate, you can’t get pregnant. So the key here is whether we’re ovulating or not. However, there are some studies that show that more than 25% of cycles that are six months in length or longer actually are ovulatory cycles. Meaning that 14 days before that period, whenever it is, you actually did ovulate.

And so you really need to think about contraception as being something you have to continue to use until you’re in menopause because if you can ovulate, it’s possible for that egg to get fertilized and for that fertilized egg to implant in your uterus. And remember, by the time we’re approaching menopause, the eggs that we’re ovulating are the last on the bench.

They’re not always the best quality eggs. They can often have chromosomal abnormalities. And so not only can they be fertilized and you can conceive, but then you can also miscarry. And so that’s not a very pleasant experience and it’s also hard on our bodies.

Emily:

All right. So that’s a good segue because we’re going to talk about what kind of… I know I need birth control. What kind of birth control, and this is something of course most of us have been familiar with and thinking about since, let’s say, our early 20s. But I think the way that we think about it is differently.

So initially the way that I thought about birth control was like how can I definitely not get pregnant? And then there was a period during the time I was having kids in which I thought about birth control but more as a spacing pregnancy experience. Now post kids, I’m going to think about what is the best long-term birth control solution that’s going to get me from whenever is my last kid to menopause.

I want to talk about what is the best kind of this and why it’s a vasectomy. I’m just kidding. I’m just kidding sort of. Although we’ll come back to that. But let’s start by laying out the landscape. So in the space of long-term birth control options, what are my options?

Gillian:

So you already mentioned one, which is vasectomy. You can have a tubal ligation or you can have your tubes removed. That’s called a bilateral salpingectomy. You can use an IUD. There are two main types of IUDs. There’s progestin alluding IUDs, and there are copper IUDs. Progestin alluding IUDs last up to seven years depending on the type. Copper, 10 years. And then things that you might have used in the past like birth control pills might also be an appropriate option.

Emily:

There are actually a big range of other things. So what about something like an implant?

Gillian:

Sure. So there are progestin alluding implants. The most well-known one is Nexplanon. It is a small piece that’s inserted in your arm and it secretes progestins, which are progesterone into your circulation and blocks you from ovulating and also blocks the buildup of uterine lining. So there’s not really anything for an embryo to implant in.

Emily:

So the other thing that people will sometimes talk about is, we’re not supposed to call it this. So I grew up calling this the rhythm method, but that’s not what we’re calling it anymore. But a natural family planning approach. I would have thought of, and a spoiler, I would’ve thought based on what we said earlier in the conversation, that that’s not a great approach, that that’s relying a lot on knowing a lot about your cycles and when they become more irregular it might fall down in its acceptability. But I’m curious if that’s right.

Gillian:

So I would say in general, natural family planning is among the least reliable options. And yes, it absolutely relies on you being very aware of when you are ovulating because the goal is essentially not to have vaginal intercourse around the time of ovulation. So you have to be very, very aware of when you’re ovulating and as our cycles are going through all these changes, some of our usual signs that we’re ovulating can change a little bit and be harder to miss.

It’s also if you’re having a period every six months, sometimes I think it’s easy to quit looking for signs of ovulation over time. And so I do think that accurately executing a natural family planning method during this time would be much more challenging.

Emily:

So I want to think about these four probably the most common long-term solutions people are going to use. And just talk through a little bit like when would they be useful. But also people hear a lot about this like, what is the risk of this? It’s going to have this downside or this downside. And so I just actually really want to get into some of those. So the four I really want to focus on are birth control pills, IUDs, tubal ligations, or the other word you used that I’m never going to be able to say and vasectomies.

So let’s talk about birth control pills. Most people, a large share of people will have used birth control pills as a sort of earlier life birth control option. I think we all understand you take them for 28 days in a cycle and they enforce a period or not depending on how you’re taking them. The biggest issue that I hear raised about birth control pills other than if you don’t take them at the right time, they don’t work. But the biggest issue that people raise is is this a cancer risk and where are we on that?

Gillian:

So there’s not a lot of evidence that they increase the risk of cancer and we’re particularly concerned about breast cancer in this situation, unless you have a strong family history of pre or perimenopausal breast cancer. If you have a strong family history of pre or perimenopausal breast cancer, those are often estrogen receptor positive breast cancers, meaning the cancer cells actually respond to estrogen.

In that situation, you would want to avoid birth control pills. But for the rest of us, there really isn’t an increased cancer risk. And in fact there is some evidence, and this is newer in developing, that because they prevent ovulation, there may be some benefit from an ovarian cancer risk perspective.

Emily:

So who is this option good… Is this a common option you see your patients using?

Gillian:

It is, and I think there’s some people for whom it’s a fantastic option. Some women find that birth control pills are really helpful for treating severe symptoms of PMS. This can also sometimes be called PMDD or premenstrual dysphoric disorder where they can have significant changes in mood and really things that really impact their functioning around their period. And birth control pills can be a great treatment for that.

If you’re someone who has really heavy periods or symptoms like endometriosis, those women often do very well with birth control pills. And even women who are in the late reproductive phase, they’re having frequent periods, lots of headaches, lots of symptoms, night sweats. Taking a birth control pill continuously can be a great option in that situation as well.

Emily:

Because it has the estrogen that supports that hormonal balance?

Gillian:

Because you basically get a stable dose of estrogen and progesterone all month long without the rises and falls of a natural menstrual cycle and that stability can really help people feel a lot better.

Emily:

Interesting. Okay. Next up, IUDs. That’s what I have. So spoiler, I have Mirena. So that’s the progesterone-eluting.

Gillian:

Yes. A Mirena is a progesterone or progestin. Progestins are like progesterone. It’s a progestin-eluting IUD. It’s one of the ones with a little bit of a higher dose of progesterone and that actually means it lasts longer. So up to seven years with a Mirena, those are fantastic because they last so long. So if you are 38 or 39, when you have your last pregnancy, you have two Mirenas and you’re probably at menopause and you’ve thought about it quite minimally in the interim, which is great.

Emily:

So I don’t get a period on this. How common is that?

Gillian:

It’s quite common with a Mirena. It’s less common with some of the lower dose IUDs like the Kyleena, is a lower dose option. Some women have breakthrough bleeding, some women have periods, but many women will not have a period at all when they have a Mirena and that is another fantastic benefit, especially for women in their 40s when periods can often get heavier.

Emily:

So okay, on the one hand, yes I do, it is a fantastic benefit. But on the other hand, how will I know when I am in perimenopause for real, for real because I’ve just got this great thing that means I never have my period? I could be having it any time. Maybe I’m having it, I don’t know my cycle-

Gillian:

That’s absolutely correct. Because the thing to remember about Mirena and other progestin-eluting IUDs is that they only affect the lining of your uterus. So in theory, the progestin is such a small dose that it’s not significantly circulating in your bloodstream, it’s just keeping the lining of your uterus really thin.

So the rest of your body, your pituitary gland and your ovaries have no idea this is going on and they’re continuing to cycle normally. So you’re ovulating whenever you would be ovulating if you didn’t have an IUD and your hormones are rising and falling. As a result, many women will have symptoms of perimenopause like hot flashes, night sweats, and I think that can be an indicator.

The other thing you can do is you can, if you’re near the typical age of menopause, I don’t know that this makes sense throughout your 40s, but if you’re around the typical age of menopause, you’re nearing the end of the lifecycle of your Mirena, you can actually check the hormones from your pituitary gland that drive ovulation follicular stimulating hormone or FSH.

And if that level is high, then that means that you’re likely in or very near menopause. And then you can take out your IUD, see what happens. But there’s also no downside to leaving your IUD in the full length of its lifecycle. And in fact, you can use the IUD progestin as part of a hormone replacement therapy regimen.

Emily:

So in terms of downsides, are there downsides risks, things that you’d be concerned about with an IUD or people you’d say this isn’t a good option for them?

Gillian:

So progestin-eluting IUDs tend to be quite safe. The dose of progestin is small enough that they’re considered safe for women even at high risk for hormonal cancers like breast cancer. There’s a higher risk of ectopic pregnancy with progestin-eluting IUDs. So a pregnancy outside of the uterus, but that’s still quite rare and it’s not something that would keep me up at night.

Copper IUDs function as a spermicide, so they work in a completely different way. They basically kill the sperm when the sperm gets into the uterus so the egg can’t get fertilized. Copper IUDs last a long time and they’re hormone-free, but for some women can cause heavier in periods and more painful periods.

So if your periods were already heavy or painful, that might not be the best choice. And believe it or not, some people have a copper allergy and that would not be a great choice either. But really, they tend to be really well tolerated, they’re very effective and people love their IUDs.

Emily:

People do point out that it can be quite painful to have them inserted.

Gillian:

It can be painful to have them inserted. I think that the women who experience the most pain tend to be women who have never been pregnant. The process of giving birth changes the shape and opening of your cervix. And so afterwards, inserting something through the opening of the cervix is difficult.

Emily:

It’s all stretched out anyway. Yeah, no, I actually think there’s another piece of that, which is what I thought you were going to say, which is that part of what I think is tricky about pain is if you don’t know what to expect, it’s worse. And when I had an IUD after I had a baby, they were just like, “It’s a really bad uterine contraction.” And then I was like, “Oh, okay.” I know what to expect. “Oh, that’s what it is. Okay.” I lived through 27 hours of those, so it’s totally fine.

Gillian:

No, there’s definitely an aspect of that as well. You can always take six to 800 milligrams of ibuprofen right before you go to your visit, and that definitely helps.

Emily:

Okay, so IUD, it’s like set it and forget it, right?  Set it and forget it. 

All right, now let’s talk about the more surgical permanent [inaudible 00:19:39]. Because what’s true about both birth control pills and IUD is if I changed my mind, I could pull the goalie or stop taking the pill and we could try again.

And for some people, that option is really important. For others, it’s definitely not important. But it is something that strongly differentiates the temporary from more permanent solutions. So a tubal ligation or a tubal removal, give me a sense of how that works. When would you do it? Just how big a deal is it? It’s a surgical procedure. How big a deal is this?

Gillian:

Sure. So it is a surgical procedure. Many women will have a tubal ligation or the long scary word I used before salpingectomy, which just means tubal removal. Many women will have those done as part of a C-section. So they know they’re having their last baby, they know they’re having a C-section and they decide that they’ll do a tubal ligation or salpingectomy as part of that process.

In which case, you’re not actually having the added risk of an additional surgery. If you’re not having those procedures as part of a C-section, then it can be done laparoscopically, minimal downtime, but it’s still abdominal surgery. And so it’s not nothing. But like I said, a lot of women have them done as part of a C-section.

Emily:

The success rate, I assume, is like once you have had this, that’s it, we’re done with this?

Gillian:

Yeah. So in the case of a tubal ligation, they’re literally cutting the fallopian tubes and closing both ends. So if you picture, if you cut through a hose, you would then sew off both ends of the hose. You’re very unlikely at that point, to get pregnant. The success is over 99%. In the case of a salpingectomy, what you’re doing is you’re literally removing the tube from where it inserts into the uterus.

And so the tube itself is completely removed, so the conduit for the egg to get into the uterus is gone. There’s a big benefit to that procedure as opposed to a tubal ligation. There’s a lot of data in the medical literature now showing that even in average risk women, the reduction of ovarian cancer after a bilateral salpingectomy is about 80%. So you are much less likely to develop ovarian cancer if you have a salpingectomy.

Emily:

Why?

Gillian:

Well, it turns out that ovarian cancer probably shouldn’t be called ovarian cancer. It should probably be called fallopian tube cancer. Most what we call ovarian cancer really arises from the tissue of the fallopian tubes. And so if you remove that tissue, then you remove the opportunity for it to become cancerous.

Emily:

Can I ask an incredibly stupid question, which possibly in this podcast will be edited out?

Gillian:

Always.

Emily:

But then when I ovulate, do the eggs just build up in some part and just sit there like a little pile of eggs?

Gillian:

No.

Emily:

It just feels like they would just keep hitting the end and then have nowhere to go.

Gillian:

So I think it’s important to think about a couple of things, a couple of anatomical things. So one is, the fallopian tubes are not actually attached to the ovaries. There’s an open end that looks like one of those wavy guys at car dealerships with the waving fingers.

Emily:

Oh, like a balloon guy?

Gillian:

Yes. So those wavy fingers guy, the egg, into the fallopian tube, but the fallopian tube is just open into the pelvis and the eggs are just ovulating into the pelvis. So it’s possible that your eggs is not getting into the tube anyway. And in fact, they’ve shown studies where women have had one tube removed maybe because they had an ectopic pregnancy and they ovulate from the egg on the side where the tube was removed and still get pregnant, which means that that egg made its way all the way around to the other fallopian tube to get into the uterus.

So eggs figure out where they need to go if they don’t get ovulated and end up in the uterus and then passed out or turn into a pregnancy, they just break down and the body resorbs them. The body’s very good at recycling material.

Emily:

Okay. I’m glad I asked. I learned a lot. I didn’t know that thing about it. I didn’t know any of that basically. Okay, let’s get to the last thing. So everything else up until this point, and for most couples, if we put aside condoms, every birth control decision has fundamentally been responsibility of the female partner in a female and male coupled. And now we have the opportunity for him to take some leadership and have a vasectomy. So can you first describe a bit what happens in a vasectomy?

Gillian:

Absolutely. So a vasectomy is an office procedure. It doesn’t need to be done in an operating room. It’s done in a special exam room in the doctor’s office using local anesthesia. And it’s done by a urologist. The urologist basically makes a very small incision on the underside of the scrotum and identifies a specific tubule called the vas deferens. The vas deferens carries sperm from the testicle to the semen.

And basically what they do is, it’s really amazing that they do this because it’s so teeny. They basically isolate the vas deferens, cut it in half, like we were talking about with a tubal ligation only on a much smaller scale. So basically what they’re doing is cutting and sewing off the ends of the tube that carry the sperm from the testes into the semen.

And so what happens after a couple of months, and that’s important, after a couple of months there will no longer be semen or there will no longer be sperm in the semen. The semen otherwise will be completely unchanged and most people can’t tell any difference, but there just won’t be sperm in it.

Emily:

You say after a couple of months. Why is that?

Gillian:

Because men make sperm constantly and those sperm spend time over the course of a couple of months in various parts of the testes, the vas deferens, and then waiting to go into the semen and you have to deplete the store of sperm on the semen side of your cut before the sperm will no longer be present in the semen.

Emily:

By having a lot of sex?

Gillian:

No, you do not need to have a lot of sex. It just happens with time. Usually about two months.

Emily:

So actually I have gotten this question frequently from people. My partner says that the doctor told them we have to have sex every day in order to diminish this sperm more quickly. But I guess that’s not-

Gillian:

That sounds like a pipe dream.

Emily:

It sounds like a pipe dream and it’s like something… Okay, all right. So you wait some time and then typically people would have a test at the end of a couple. There would be some way to evaluate that?

Gillian:

Yeah, I would highly recommend having the semen analysis after two months to confirm that there are no sperm in the semen before I relied on a vasectomy for contraception.

Emily:

What is the recovery like from a vasectomy?

Gillian:

I can speak best from my secondhand personal experience. So vasectomy is my husband and I’s preferred choice for contraception. We have an 8-year-old and older children and we are not having any more children. He went to dinner that night. So he had a vasectomy at, I don’t know, 10 in the morning.

I picked him up at one o’clock. At seven o’clock we were in the car from our house in the suburbs driving in New York City to go out to dinner. And the following day, Saturday, he was standing on the sidelines of the field coaching my son’s soccer game. So, minimal.

Emily:

Minimal. So the one question I get quite a lot from people about this, including from some people who asked me to ask you. Asking for a friend, is the question of long-term pain. So I have at least one person who told me, “I had a vasectomy and I had some long-term pain.” And his view was that that happens to a lot of people. As far as I could tell, that was not based anything in particular.

Gillian:

I would say that that is a very rare occurrence. The pain is typically very minimal and short-lived.

Emily:

So another question about vasectomies is are they reversible?

Gillian:

They can be. There are a couple of different techniques. Some techniques are more or less successful. Some techniques show a reversibility of only 30 or 40% and some techniques have been in the hands of some surgeons upwards of 90% effective. If you’re not 100% sure you’re done with kids, one option for men undergoing vasectomy is to bank sperm. So most urologists will offer you the opportunity to bank some sperm before you do a vasectomy on the off chance that you would ever want to achieve pregnancy again.

Tubal ligation is also technically reversible and obviously with tubal ligation or salpingectomy, you can do IVF and you get pregnant. I don’t think anyone would recommend a vasectomy or a tubal ligation or a salpingectomy if someone wasn’t pretty darn sure they were done having kids.

Emily:

Okay. So why do you think more people… Do you have a sense of how common, if we think about these four long-term birth control categories, what you see either in your practice or in the data, about how many people are using different options?

Gillian:

I would say most women are largely still using IUDs and birth control pills. I think a lot of times it’s because they’re using them not so much as contraception, but to treat other things. And the fact that the contraception is kind of a bonus. I think more and more couples are considering vasectomy and using vasectomy. And I’m excited to see that more and more people see this as a possibility.

And I do think that there’s a fair amount of myth busting that’s going on and allowing that to happen. I also think that men are realizing that women have taken on a lot of responsibility for contraception and there are no reversible forms of male contraception other than condoms. I mean, I spent 15 years managing the contraception for my husband and I as a couple and we had another 13 or more years to go. So it seemed fair.

Emily:

It seemed fair.

Gillian:

Seemed fair. Yeah. I mean, it is a very interesting question why? What is it? In some ways, it’s completely unsurprising to me that people feel uncomfortable about this and you understand there’s scissors near your penis with things that you could imagine being uncomfortable about. But I think it goes, it would be great if this was something that was more widely discussed, at least as a possibility.

Emily:

I mean, scissors near your penis or a bowling ball coming out of your vagina.

Gillian:

Right. I totally [inaudible 00:31:27].

Emily:

Everybody’s doing something for the team. Okay. Everybody’s giving it the office. 

So what I like about this conversation, I think when I think about it, basically this is a conversation I want to have, and I think this is part of why I’m so excited in many ways about your newsletter, is I feel like I am coming into this and there are a lot of people coming into this with me, and there are just a billion questions that I feel like I did when I started in pregnancy.

I was like, “Oh my God, I didn’t know this was going to happen and here’s a new decision I have to make.” And so this is just one of them, but I’m really happy you’re here to help navigate it.

Gillian

I’m so excited to be here. I really love talking about these subjects and I really want to make people feel that they can ask any questions. There’s nothing off limits. We can talk about all of this and I’m right there with you. I’m going through this stage of life myself, and so we’ll all navigate it together.

Emily:

And it’s so weird. Why can’t we sleep? That would be for the next episode. But what is it with the hot sleeping and just the waking up at 2:00 AM and not being able to go back to sleep?

Gillian:

We’ll definitely talk about it.

Emily:

That was last week for me. Anyway, okay. Thank you, Gillian.

Gillian:

My pleasure. Thanks for having me.

Emily:

ParentData is produced by Tamar Avishai with support from the ParentData team and PRX. 

If you have thoughts on this episode, please join the conversation on my Instagram, @profemilyoster. And if you want to support the show, become a subscriber to the ParentData newsletter at parentdata.org, where I write weekly posts on everything to do with parents and data to help you make better, more informed parenting decisions. 

There are a lot of ways you can help people find out about us. Leave a rating or a review on Apple Podcasts. Text your friend about something you learned from this episode. Debate your mother-in-law about the merits of something parents do now that is totally different from what she did. Post a story to your Instagram debunking a panic headline of your own. Just remember to mention the podcast too. Right Penelope?

Penelope:

Right, mom.

Emily:

We’ll see you next time.

A variety of birth control pills is arranged on a wooden table.

Jun 09 2023

2 min read

How Long Should It Take My Period to Return After Stopping Birth Control?

I’m coming off birth control after 16 consecutive years and haven’t had a period yet (it’s been two months). I Read more

Emily Oster
A model of a uterus in a doctor's office.

Feb 27 2024

8 min read

Contraception for When You’re Done Having Kids

I gave birth to my fourth child when I was 38 years old. My husband and I knew our family Read more

Gillian Goddard
A variety of birth control options.

Mar 01 2024

2 min read

Do I Still Need to Use Birth Control?

I am 49 years old, and I am definitely having symptoms of perimenopause. I am only having periods a few Read more

Gillian Goddard
Illustration of a vasectomy made with construction paper.

2 min read

How Can I Convince My Husband to Get a Vasectomy?

How can I convince my husband to have a vasectomy? Our family is complete, and the stress of a possible Read more

Gillian Goddard

Instagram

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We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy. 

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙

We are better writers than influencers, I promise. Thanks to our kids for filming our unboxing videos. People make this look way too easy.

Only two weeks until our book “The Unexpected” is here! Preorder at the link in my bio. 💙
...

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster

Exciting news! We have new, high-quality data that says it’s safe to take Tylenol during pregnancy and there is no link between Tylenol exposure and neurodevelopmental issues in kids. Comment “Link” for a DM to an article exploring this groundbreaking study.

While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster
...

How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months. 

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages. 

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords

How many words should kids say — and when? Comment “Link” for a DM to an article about language development!

For this graph, researchers used a standardized measure of vocabulary size. Parents were given a survey and checked off all the words and sentences they have heard their child say.

They found that the average child—the 50th percentile line—at 24 months has about 300 words. A child at the 10th percentile—near the bottom of the distribution—has only about 50 words. On the other end, a child at the 90th percentile has close to 600 words. One main takeaway from these graphs is the explosion of language after fourteen or sixteen months.

What’s valuable about this data is it can give us something beyond a general guideline about when to consider early intervention, and also provide reassurance that there is a significant range in this distribution at all young ages.

#cribsheet #emilyoster #parentdata #languagedevelopment #firstwords
...

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit.

I saw this and literally laughed out loud 😂 Thank you @adamgrant for sharing this gem! Someone let me know who originally created this masterpiece so I can give them the proper credit. ...

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata

Perimenopause comes with a whole host of symptoms, like brain fog, low sex drive, poor energy, and loss of muscle mass. These symptoms can be extremely bothersome and hard to treat. Could testosterone help? Comment “Link” for a DM to an article about the data on testosterone treatment for women in perimenopause.

#perimenopause #perimenopausehealth #womenshealth #hormoneimbalance #emilyoster #parentdata
...

What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata

What age is best to start swim lessons? Comment “Link” for a DM to an article about water safety for children 💦

Summer is quickly approaching! You might be wondering if it’s the right time to have your kid start swim lessons. The AAP recommends starting between 1 and 4 years old. This is largely based on a randomized trial where young children were put into 8 or 12 weeks of swim lessons. They found that swimming ability and water safety reactions improve in both groups, and more so in the 12 weeks group.

Below this age range though, they are too young to actually learn how to swim. It’s fine to bring your baby into the pool (if you’re holding them) and they might like the water. But starting formal safety-oriented swim lessons before this age isn’t likely to be very helpful.

Most importantly, no matter how old your kid is or how good of a swimmer they are, adult supervision is always necessary!

#swimlessons #watersafety #kidsswimminglessons #poolsafety #emilyoster #parentdata
...

Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

 #emilyoster #parentdata #childnutrition #babynutrition #foodforkids

Can babies have salt? 🧂 While babies don’t need extra salt beyond what’s in breast milk or formula, the risks of salt toxicity from normal foods are minimal. There are concerns about higher blood pressure in the long term due to a higher salt diet in the first year, but the data on these is not super compelling and the differences are small.

Like with most things, moderation is key! Avoid very salty chips or olives or saltines with your infant. But if you’re doing baby-led weaning, it’s okay for them to share your lightly salted meals. Your baby does not need their own, unsalted, chicken if you’re making yourself a roast. Just skip the super salty stuff.

#emilyoster #parentdata #childnutrition #babynutrition #foodforkids
...

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata

Is sleep training bad? Comment “Link” for a DM to an article breaking down the data on sleep training 😴

Among parenting topics, sleep training is one of the most divisive. Ultimately, it’s important to know that studies looking at the short- and long-term effects of sleep training show no evidence of harm. The data actually shows it can improve infant sleep and lower parental depression.

Even so, while sleep training can be a great option, it will not be for everyone. Just as people can feel judged for sleep training, they can feel judged for not doing it. Engaging in any parenting behavior because it’s what’s expected of you is not a good idea. You have to do what works best for your family! If that’s sleep training, make a plan and implement it. If not, that’s okay too.

What’s your experience with sleep training? Did you feel judged for your decision to do (or not do) it?

#sleeptraining #newparents #babysleep #emilyoster #parentdata
...

Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes

Does your kid love to stall right before bedtime? 💤 Tell me more about their tactics in the comments below!

#funnytweets #bedtime #nightimeroutine #parentinghumor #parentingmemes
...

Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices. 

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata

Got a big decision to make? 🤔 Comment “Link” for a DM to read about my easy mantra for making hard choices.

When we face a complicated problem in pregnancy or parenting, and don’t like either option A or B, we often wait around for a secret third option to reveal itself. This magical thinking, as appealing as it is, gets in the way. We need a way to remind ourselves that we need to make an active choice, even if it is hard. The mantra I use for this: “There is no secret option C.”

Having this realization, accepting it, reminding ourselves of it, can help us make the hard decisions and accurately weigh the risks and benefits of our choices.

#parentingquotes #decisionmaking #nosecretoptionc #parentingadvice #emilyoster #parentdata
...

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster

Excuse the language, but I have such strong feelings about this subject! Sometimes, it feels like there’s no winning as a mother. People pressure you to breastfeed and, in the same breath, shame you for doing it in public. Which is it?!

So yes, they’re being completely unreasonable. You should be able to feed your baby in peace. What are some responses you can give to someone who tells you to cover up? Share in the comments below ⬇️

#breastfeeding #breastfeedinginpublic #breastfeedingmom #motherhood #emilyoster
...

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there! 

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife

Potty training can feel like a Mount Everest-size challenge, and sadly, our evidence-based guidance is poor. So, I created a survey to collate advice and feedback on success from about 6,000 participants.

How long does potty training take? We found that there is a strong basic pattern here: the later you wait to start, the shorter time it takes to potty train. On average, people who start at under 18 months report it takes them about 12 weeks for their child to be fully trained (using the toilet consistently for both peeing and pooping). For those who start between 3 and 3.5, it’s more like nine days. Keep in mind that for all of these age groups, there is a range of length of time from a few days to over a year. Sometimes parents are told that if you do it right, it only takes a few days. While that is true for some people, it is definitely not the norm.

If you’re in the throes of potty training, hang in there!

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlerlife
...

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens. 

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children. 

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata

For children or adults with severe food allergies, they can be incredibly scary and restrictive. We may imagine that it’s easy to deal with a peanut allergy by, say, not eating peanut butter sandwiches. But for someone with a severe version of this allergy, they may never be able to go to a restaurant, for fear of a severe reaction to something in the air. Right now, there’s only one approved treatment for severe allergies like this and it’s limited to peanuts.

This is why the new medication Xolair is very exciting. It promises a second possible treatment avenue and one that works for other allergens. A new trail analyzed data from 177 children with severe food allergies. Two-thirds of the treatment group were able to tolerate the specified endpoint, versus just 7% of the placebo group. This is a very large treatment effect, and the authors found similarly large impacts on other allergens.

There are some caveats: This treatment won’t work for everyone. (One-third of participants did not respond to it.) Additionally, this treatment is an injection given every two to four weeks, indefinitely. This may make it less palatable to children.

Overall, even with caveats, this is life-changing news for many families!

#xolair #foodallergies #allergies #peanutallergy #emilyoster #parentdata
...

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips

If you have a fever during pregnancy, you should take Tylenol, both because it will make you feel better and because of concerns about fever in pregnancy (although these are also overstated).

The evidence that suggests risks to Tylenol focuses largely on more extensive exposure — say, taking it for more than 28 days during pregnancy. There is no credible evidence, even correlational, to suggest that taking it occasionally for a fever or headache would be an issue.

People take Tylenol for a reason. For many people, the choice may be between debilitating weekly migraines and regular Tylenol usage. The impacts studies suggest are very small. In making this decision, we should weigh the real, known benefit against the suggestion of this possible risk. Perhaps not everyone will come out at the same place on this, but it is crucial we give people the tools to make the choice for themselves.

#emilyoster #parentdata #tylenol #pregnancy #pregnancytips
...

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks

Parenting trends are like Cabbage Patch Kids: they’re usually only popular because a bunch of people are using them! Most of the time, these trends are not based on new scientific research, and even if they are, that new research doesn’t reflect all of what we’ve studied before.

In the future, before hopping onto the latest trend, check the data first. Unlike Cabbage Patch Kids, parenting trends can add a lot of unnecessary stress and challenges to your plate. What’s a recent trend that you’ve been wondering about?

#parentdata #emilyoster #parentingtips #parentingadvice #parentinghacks
...

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData! 

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity

As of this week, 1 million copies of my books have been sold. This feels humbling and, frankly, unbelievable. I’m so thankful to those of you who’ve read and passed along your recommendations of the books.

When I wrote Expecting Better, I had no plan for all of this — I wrote that book because I felt compelled to write it, because it was the book I wanted to read. As I’ve come out with more books, and now ParentData, I am closer to seeing what I hope we can all create. That is: a world where everyone has access to reliable data, based on causal evidence, to make informed, confident decisions that work for their families.

I’m so grateful you’re all here as a part of this, and I want to thank you! If you’ve been waiting for the right moment to sign up for full access to ParentData, this is it. ⭐️ Comment “Link” for a DM with a discount code for 20% off of a new monthly or annual subscription to ParentData!

Thank you again for being the best community of readers and internet-friends on the planet. I am so lucky to have you all here.

#parentdata #emilyoster #expectingbetter #cribsheet #familyfirm #parentingcommunity
...

Just eat your Cheerios and move on.

Just eat your Cheerios and move on. ...

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide

The AAP’s guidelines recommend sleeping in the same room as your baby “ideally for the first six months.” However, the risk of SIDS is dramatically lower after four months, and the evidence in favor of the protective effect of room sharing is quite weak (both overall and even more so after four months). There is also growing evidence that infants who sleep in their own room by four months sleep better at four months, better at nine months, and even better at 30 months.

With this in mind, it’s worth asking why this recommendation continues at all — or at least why the AAP doesn’t push it back to four months. They say decreased arousals from sleep are linked to SIDS, which could mean that babies sleeping in their own room is risky. But this link is extremely indirect, and they do not show direct evidence to support it.

According to the data we have, parents should sleep in the same room as a baby for as long as it works for them! Sharing a room with a child may have negative impacts on both child and adult sleep. We should give families more help in navigating these trade-offs and making the decisions that work best for them.

#emilyoster #parentdata #roomsharing #sids #parentingguide
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