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Paternal Involvement

It is quite usual in our society for the mother to be the primary caregiver to a newborn baby, toddlers and kids. That is not to say that fathers are absent, but the stereotype of Super Mom has been created by a general tendency to place fathers in the workforce and mothers in the home. In 2022, the US Census Bureau reported that 1 in 4 children in the US grow up without a biological, step, or adoptive father in the home– that amounts to 18.4 Million children!

The National Fatherhood Initiative reports several negative effects associated with paternal absence in the home, some of which include: 

  • 4x greater risk of poverty for the family 
  • Children are more likely to have behavioral problems, which may lead to them dropping out of school, teen pregnancies, imprisonment, drug and alcohol abuse, commiting crimes etc. 
  • Greater chances of facing emotional neglect and abuse. 

On the other hand, a father’s active and involved presence in the home can mean a strong foundation for the well-being of the children, including some of the following advantages: 

  • Lower rates of injuries, emotional and behavioral problems, and obesity 
  • The chances of low birth weight and infant mortality significantly decrease as well
  • School performance is increased 

In 2017, King’s College London and Oxford University Researchers found that actively involved fathers, and especially those who contribute in their childs’ life in the first few months, are providing significant developmental advantages to their children. Involved fathers positively impact their children’s cognitive functioning, improve breastfeeding rates, and even help preterm infants gain healthy weight. High levels of father involvement correlate with higher levels of social confidence, good social skills, self-control, and overall boosted emotional well-being. Such as the negative effects of fatherly absence persist into adulthood, so do the positive effects of fatherly involvement: the presence of both parents leads to adult children who are more emotionally mature, and better equipped to make mature and wise decisions in their teenage and young adult years. 

It is important to remember that it is the quality and not the quantity of paternal involvement that can have a great effect on children’s lives: non-resident fathers can still have a great impact on the psychological and mental well being of their children, as well as on their academic achievements and behavioral adjustments. Children with actively involved fathers are more likely to perform better in school, and to follow through with their college and graduate education. Even more specifically, father involvement shows reduced risk for behavioral problems and delinquency in boys, and reduced risk of psychological problems and rates of depression in young women. 

 

https://www.all4kids.org/news/blog/a-fathers-impact-on-child-development/ 

https://www.fatherhood.org/father-absence-statistic 



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Baby’s First Holidays

It is widely known that holidays are one of the most stressful times of the year– though toddlers and children seem to enjoy them, and there is a certain magic that comes with it all, we should remember this comes at the expense of parents, and especially mothers. Holiday stress increases if you have just welcomed a new member in your family, and are trying to juggle a newborn baby and holiday traditions. There is no simpler way to put it than: focus on you and your baby. As a new mother, this is honestly the only thing you should be worried about; keeping yourself and your baby healthy and safe. However, reality is not always ideal. Here are some tips that may help lessen the holiday stress if you are facing such an incredible combination: 

  1. Change your expectations: you already knew your life would drastically change with a newborn, and if this happened into the holiday season there is no reason why this would be any different. We are creatures of habit and there is something comforting in having a decorated house, attending family gatherings, consuming holiday food, and participating in festivities. However, letting go of traditional expectations with a newborn during the holidays can significantly lessen your stress, and help you get through the season in a calm, and happy, manner. Nobody expects you to be the perfect hostess, or even guest, if you have just given birth– and you should not be expecting that of yourself either. Meals can wait, Christmas trees can become a simple wreath or a premade tree, but your baby’s first few weeks will not come back: savor that time with your family, and all else will come in due time. 
  2. Simplify your days: to-do lists and preparations often become hectic around the holidays (more so than usual!). Remember, however, that this is not the time to go all out on Christmas decorations, gifts, meals, or anything else. If you feel like you have the energy for some of it, or if leaning into the holiday spirit will help you to feel less stressed, be selective with what you choose to put on your plate. Perhaps a short visit to the Christmas market this year is more manageable than standing long hours at the mall to see Santa– it may be more enjoyable, and leave you with some energy for the rest of the day. Or, you can have a family gift craft session at home instead of going out at all. 
  3. Ask for help: isn’t helping others part of the holiday spirit? Why not take advantage of that now more than ever, and lean into your close family and friends to assist you in holiday activities, bring the festivities into your home or in a chill space, and help take care of you and your newborn? Select people you trust, set boundaries on how much or how little you can handle, and shape up those days in a design you can easily manage. Delegating responsibilities during this time is the best gift you can give to yourself, and you would be surprised how many people will be happy to offer their assistance in practical ways! 

 

There are ways to embrace the holiday spirit and experience the magic of the festive season that don’t have to exhaust you; if you and your newborn are healthy and feel like you can manage a balance between traditional holiday activities and new ideas or reconfigurations, experiencing the magic in small ways will be extremely rewarding! 

 

https://theeverymom.com/family-traditions-creative-new-ideas/ 

https://healthblog.uofmhealth.org/childrens-health/could-holiday-stress-be-affecting-your-childs-holiday-joy

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Eating Disorders and Pregnancy

The two most common types of eating disorders are anorexia nervosa and bulimia nervosa, yet there are other types out there that are not as common. Unfortunately, research on eating disorders and pregnancy is quite limited– there are estimations that eating disorders affect 5-8% of women during pregnancy, but this may not be completely credible as results can be skewed due to women’s reluctance to recognize eating disorders. Anorexia and bulimia often become noticeable in adolescence, and it’s possible that they linger during a woman’s reproductive years. Consequently, they can of course affect not only a woman’s reproductive health but also the health of her baby. 

Fertility is the first affected area of women who suffer from an eating disorder: most women with anorexia do not have menstrual cycles, and approximately half of the women who have bulimia do not experience regular menstrual cycles. Absence of menstruation or irregular periods can limit the chances of conceiving, or even make it a lot more difficult for a couple to conceive. If you know you have an eating disorder and are seeking to get pregnant, it will be much healthier for you and your future baby if you try to treat your eating disorder first and establish some healthy eating habits. It is also important to share your history with medical professionals and ask for your weighing to be treated with more care. 

Though there is quite a long list of complications associated with eating disorders during pregnancy, rest assured that proper planning and prenatal care– as well as a commitment to building healthy eating habits and helping your body remain healthy– can minimize a lot of those complications, lessen the risks associated with them, and enhance your chances for a healthy pregnancy. Some of those complications can be premature labor and low birth weight, as well as delayed fetal growth and respiratory problems. You may also be at a higher risk for emergency cesarean birth and other complications during labor. Gestational diabetes, preeclampsia, and even miscarriage are also possible complications. Women with eating disorders are also at a higher risk for postpartum depression, and depression during pregnancy, and are more likely to have problems with breastfeeding. Women with bulimia are at a higher risk for hypertension, and substances such as laxatives and other medications may be harmful to the development of the baby and can lead to fetal abnormalities as well. 

Eating disorders unfortunately cannot be treated with medications that are pregnancy-safe. Treatment includes, first and foremost, the mother’s determination to have a healthy pregnancy and–difficult and shameful as it may be–disclosing to health professionals that you are struggling with an eating disorder. That way, your doctor will be able to tailor your prenatal visits accordingly, and know the risk factors associated with your pregnancy. The obstetrician’s care can be complemented by a registered dietitian/nutritionist and a therapist for well rounded care and medical treatment. 

 

https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/eating-disorders-and-pregnancy/ 

https://www.verywellmind.com/pregnancy-and-eating-disorders-4179037 



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Gestational Diabetes

You may be familiar with Diabetes Type 1 and Type 2, but did you know there is also a bonus one, called Gestational Diabetes Mellitus– or Gestational Diabetes for short? Gestational Diabetes is diabetes that’s diagnosed for the first time during the gestation period, aka pregnancy. Contrary to Type 1 diabetes, GDM is not caused by a lack of insulin. Instead, it is caused by hormones produced during pregnancy that make insulin ineffective. This is also known as insulin resistance, whereby the mother’s body does not use insulin as it should. Like other types of diabetes, GDM affects how cells use sugar. About 3-8% of pregnant people in the US are diagnosed with gestational diabetes; its symptoms disappear after delivery, and the great news is that you can help control gestational diabetes! 

Symptoms: gestational diabetes does not have any symptoms on its own, except increased thirst and frequent urination (which could be pregnancy related regardless). If you are risk for Type 1 diabetes because one of your parents or siblings has it, or at risk for Type 2 diabetes because you are prediabetic, over 45 y/o, may be overweight, don’t exercise often, or have previously had gestational diabetes, your doctor may deem you are at high risk for GDM and suggest you be tested. 

Risks: GDM is not like Type 1 Diabetes which can cause birth defects–in fact, GDM arrives too late in a pregnancy to cause any birth defects. Insulin resistance starts showing up around Week 24. Therefore, and thankfully, the complications are manageable and preventable. Generally, gestational diabetes may cause macrosomia and hypoglycemia, which are the two major health issues associated with it. Macrosomia refers to an excessively large fetus and hypoglycemia refers to low blood sugar in the baby immediately after delivery. 

Treatment: there are available treatments for gestational diabetes, and many depend on your age, overall health, and medical history. However, the most common ways to manage GDM are to regularly check your blood sugar so it stays on healthy levels, creating a healthy eating plan with your doctor and following it, being active, and monitoring your baby. 

As is the case with any pregnancy complication, it is understandable that it may cause you stress. While there is no certain way to prevent stress, do know that gestational diabetes is very manageable and has very low health risks for your baby. In fact, your own stress may cause more complications during pregnancy than gestational diabetes. You can better gauge your risk for GDM by checking your family history and having a general health assessment with your doctor early on in, or even before, your pregnancy. It is advisable to attend all your prenatal appointments, voice your concerns with your doctor, and maintain a healthy lifestyle to address the possible risks of gestational diabetes. 

 

https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339 

https://www.cdc.gov/diabetes/basics/gestational.html 

https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/gestational-diabetes 



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Nursing Mothers at Work

Most new mothers dread the day they’ll have to return to work and leave their newborn at home, or at a daycare facility. It is undoubtedly difficult to get back into a work/home routine when you feel like you haven’t had enough time with your newborn baby–and in most cases, mothers in the Western World do not receive adequate maternal leave. The situation is made even more difficult for mothers who breastfeed their babies: a newborn requires a rigid feeding schedule, and the nursing mother cannot risk interrupting her body’s breastfeeding schedule.

Breastfeeding babies in the workplace is almost unheard of, unless you work from home or your employer provides newborn daycare right in your work building. What most nursing mothers are faced with is the option to express milk in the workplace. 

Even though in 2010 Congress made an amendment to the Fair Labor Standards Act by passing the Break Time for Nursing Mothers Law, many new mothers face breastfeeding discrimination in the workplace. This primarily means that work environments do not offer appropriate accommodations for nursing mothers to express milk in a clean, sanitized, and private space. It also means, as a 2004 study has also shown, that workplaces do not provide new mothers with enough breaks during an 8-hour workday for them to adequately pump and maintain their milk production. In short, you should not be running to your car, unbuttoning your blouse as you’re running to the underground garage, adjusting the pump in the elevator and pumping for 10 minutes in your vehicle: you have waaaay more rights than that, and employers are required by law to provide you with accommodations. 

Before we look into some of the ways in which employers can support new mothers, we should say that workplaces which show consistent support to new mothers and their needs tend to have a more positive work environment, and thus are more likely to be successful in their labor. 

  1. Adequate Private Space & Appropriate Amenities: workplaces are required to provide a private space for nursing employees that is not a bathroom. This doesn’t need to be a permanent space; it can be a temporarily converted office with a lock on the door, and with the reassurance that other employees cannot see into the room. Ideally, this space should also have electrical outlets, a sink, a comfortable seat and not harsh fluorescent lighting, and a small fridge for milk storage. Some places partner with other locations that do have a dedicated lactation room to provide their employees with the necessary facilities. 
  2. Reasonable Break Time: nursing employees should be allowed enough breaks to adequately pump at least 2-3 times during an 8-hour workday, and this should come with the understanding that the necessary time differs based on each person. There should be no negative consequences or withheld compensation for the time an employee needs for pumping during the workday. 

It is of extreme importance to have a written lactation policy that outlines the employees’ rights and the employers’ responsibilities when it comes to nursing individuals. If you have concerns about this policy at your workplace, you can consult the US Department of Labor, or the United States Breastfeeding Committee

 

https://www.dimaghawi.com/dimas-blog/4-important-ways-to-accommodate-nursing-mothers-in-the-workplace 

https://www.womenshealth.gov/supporting-nursing-moms-work/what-law-says-about-breastfeeding-and-work/what-employers-need-know#1 



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Osteoporosis

You may have heard the occasional old person complain about their bones hurting when the
weather turns, or struggle to eliminate chronic back and joint pain. Though there can be many
reasons for this, one of the most common is the silent disease of osteoporosis: it causes bones to
weaken and turn brittle and fragile. As such, the risk of broken bones or fractures is significantly
increased.

Unfortunately, if you’re not regularly tested for osteoporosis you may not even be able
to tell you have this disease until a seemingly minor accident leaves you with a broken bone…

How to Diagnose
The later stages of osteoporosis come with several symptoms, such as back pain, stooped
posture, minor fractures, and loss of height. You can, however, be proactive about osteoporosis
before you suffer those symptoms or a broken bone (seemingly out of nowhere!). The easiest
way to keep tabs on osteoporosis is a bone density test. Imagine osteoporosis turning your strong
bones into sponge-like structures. Bone density tests help compare your bone density to the
average bone density of a healthy, young, US-based woman. They are officially called Bone
Mineral Density (BMD) tests, and resemble an X-ray but with less radiation exposure. The BMD
results, along with other health factors taken into consideration, estimate your risk of having a
bone fracture in the next decade.

Getting Tested
As osteoporosis may creep up on you, it is recommended to get tested if you are a woman of
menopausal age with osteoporosis risk factors, or a woman over the age of 65. If you are under
65 but have a family history of osteoporosis and are postmenopausal, you should also get tested.
Breaking a bone after age 50 is also a good indicator you should get tested for osteoporosis.
If you have already been diagnosed with osteoporosis, and are even taking medications for it,
you may want to repeat BMD tests every couple of years. If you are switching osteoporosis
medications, it is likely that your medical professional will recommend you get tested.

Preventing Osteoporosis
There are several risk factors for osteoporosis, including age, sex, race and family history.
Women are at a greater risk for osteoporosis, as are all people as they get older. If you are white
or of Asian descent, you may also be at a higher risk. Some factors that can be controlled are low
sex hormones, excessive thyroid hormone, and other overactive parathyroid or adrenal glands.
Low calcium intake puts you at a greater risk of developing osteoporosis, as it contributes to
decreased bone density. Eating disorders or being severely underweight do the same, as they can
weaken bones in both men and women. Gastrointestinal surgery can also have a negative impact
on your bone density, as this type of surgery limits the available surface area of your body to
absorb nutrients, including calcium.

https://www.everydayhealth.com/osteoporosis/guide/symptoms/
https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968

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Breast Cancer Treatments

Thinking about breast cancer treatments is undoubtedly not the most enjoyable activity
one can engage in, but knowing your options can be a revealing and empowering experience. If
you have been diagnosed with breast cancer, it is very likely you will have one or more of these
experts in your treatment team: a breast surgeon or surgical oncologist, who is a doctor
specializing in surgery to topically treat breast cancer; a radiation oncologist, who specializes in
using radiation against breast cancer–also a topical treatment.

Some other experts, who focus more on systemic treatments, are a medical oncologist–a doctor who uses chemotherapy,
hormone treatment, immunotherapy, and other medicines to battle cancer and a plastic surgeon
who–as you may know–is there to reconstruct or repair parts of the body.

Local, or topical, treatments treat the tumor without affecting the rest of the body; surgery
and radiation are local treatments. Depending on the type of breast cancer, its stage, and your
overall health, you may need other types of treatment as well (before or after surgery, or both):
those are called systemic treatments because they reach cells almost anywhere in the body.
Systemic treatments can be given by mouth, put into the bloodstream, or injected in a muscle.

2022 has been a great year for breast cancer treatment, as the FDA approved a new drug
to treat HER2-Low Breast Cancer: trastuzumab deruxtecan (T-DXd). The approval came
through on August 5, 2022 and this therapy is meant to help patients who suffer from HER-2-
Low Breast Cancer that has spread to other parts of the body and cannot be surgically removed.
The clinical trial results for T-DXd were presented by medical oncologist Shanu Modi to this
year’s American Society of Clinical Oncology meeting. The clinical trial was led by Memorial
Sloan Kettering Cancer Center, and according to Dr. Modi, its results redefine how many
patients with metastatic cancer will be treated.

Targeted therapy works by identifying and attacking certain types of cancer cells, but it
doesn’t kill normal cells so its side effects are fewer than other treatments. However, until now
HER2 treatment has not been successful in treating cancer that is HER2-low. During the trial,
patients were given Enhertu (or T-DXd) which targets the protein HER2. The patients who
received Enhertu did noticeably better than the patients who received standard chemotherapy!
The new targeted drug held the cancer of the receivers in check nearly twice as long, and also
increased the survival rate by 35%.

This is wonderful news for breast cancer patients, and a great advancement in breast
cancer research and treatments! To consider if this is the right treatment for you, ask your
medical professional, and seek as much information as possible before you make a decision.

 

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Breast Cancer Awareness Month

October is best known as the month dedicated to spooky costumes and candy, but it is
also the month dedicated to Breast Cancer Awareness. Apart from skin cancers, breast cancer is
the most common one among American women. Facts show us that 1 in 8 women in the US will
receive a diagnosis of breast cancer in her lifetime, but the really good news is that 65% of cases
are diagnosed at a localized state–meaning that the cancer has not spread past the breast–for
which the five-year survival rate is 99%.

It is also encouraging to hear that there are over 3.8
million breast cancer survivors in the United States alone. The positive facts about breast cancer
assure us that science is working hard to enhance the survival rate for women who are diagnosed
with breast cancer, and is also making great strides to provide successful preventative
techniques.

During the month of October, there are continued efforts to fundraise money for
dedicated breast-cancer research, to support survivors, and to spread awareness and information
to younger women. If you are in Buffalo, NY you may want to consider participating in the
annual Making Strides of Buffalo walk, which is dedicated to making an impact and saving lives,
organized by Roswell Park Comprehensive Cancer Center. This year, the event takes place on
October 22nd, and you can easily sign up for the event on the American Cancer Society’s
website. The event does not have a registration fee, so it is accessible to a greater number of
people.

If you cannot attend the event in person, you can also make a donation, and keep
fundraising going by looking into the Matching Gifts programs: many employers will match
their employees’ charitable donations, or even volunteer hours, thus doubling the impact
individuals make on Breast Cancer Awareness! You can find out directly from your employer if
they are registered for a matching gifts program, or you can use the tool provided by Double the
Donation.

Another great way to support research and other initiatives toward Breast Cancer
Awareness is to create your own fundraising events; many tech-savvy folks set up their own
fundraising pages, or they simply ask their loved ones to collect donations towards this cause in
lieu of birthday, wedding, or anniversary gifts. If you have an online presence, you can easily
bring people together through Facebook or Instagram Live, and even Zoom, to provide support,
share knowledge, and build a community.

Breast Cancer Awareness Month


https://www.bcrf.org/breast-cancer-awareness-month-ideas-fundraising/

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Vaginal Dryness after Menopause

One of the most often talked about symptoms of menopause is vaginal dryness. It would be ideal if it only showed up when menopause started, but unfortunately it can start happening even a few years before menopause. Just as a bonus, women can also experience vaginal dryness after childbirth, while breast feeding, or even if they are taking certain allergy medicine or certain antidepressants.

Back to the hormonal factors, however, vaginal dryness begin hand in hand with vaginal atrophy. A truly scary word, though it simply means your body is not producing as much estrogen as before. Estrogen is responsible for the natural lubrication, elasticity, and thickness of the cervix: once estrogen production goes down, the natural lubrication of the vagina is no longer happening, and the vaginal walls can experience thinning, drying, and possible inflammations.

Lubrication
Basically, it all comes back to lubrication: since your body’s natural lubrication system retires at the age of menopause, you need to supplement vaginal lubrication via external (internal) means. Most often, especially because vaginal dryness can lead to pain during intercourse, women will turn towards vaginal lubricants. Though a great solution, it is but temporary. For something more long lasting, you may want to look into vaginal moisturizers. You can apply them every few days to moisturize and keep vaginal tissue healthy.

There is also the option to reinvigorate vaginal tissues. Science really does wonders… this can be
a low dose vaginal estrogen cream, tablet, or ring. Note that this can be prescribed in additional
to other hormonal supplements you may be taking. It is meant to specifically tackle vaginal
dryness, especially if it persists while you are on hormonal treatment post-menopause. You will
need to discuss this option with your doctors and take into consideration any other health issues
you may have faced, particularly breast cancer.

There is also the option of an oral medication, Ospemifene or Osphena, which is more geared
towards addressing vaginal pain during intercourse. It is a selective estrogen receptor modulator,
SERM, medication but women who have a high risk of breast cancer, or have faced breast
cancer, best not consider it as an option. For more details on what this medication can do for you,
consult with your doctor or medical professional.

Another technique to help you ease painful intercourse if you are post-menopausal is a nightly
vaginal suppository containing dehydroepiandrosterone (DHEA).

It’s also important to note that vaginal stimulation or even regular sexual activity, solo or with a
partner, can absolutely help post-menopausal women keep their vaginal tissues healthy. Above
all, remember this is a very natural response of your body to hormonal changes, there is nothing
to be ashamed about, and it is well within your rights to seek healthy treatments that work for
you and your body. You owe it to yourself, and though we can’t turn back the clock, we can
make sure we are living pain-free and comfortable lives within the new parameters our bodies
present to us.

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Body Awareness in Pregnancy

If you have armed yourself with all the knowledge you can gather regarding the possible changes
on your body during pregnancy, then you are one step closer to dealing with the physical effect
of those changes. Some women, though they do know their body will change during pregnancy
and possibly afterwards as well, do not seem to mind it at all. Great! According to a survey of
more than 1500 women, just over 41% said they felt more negative about their bodies after
pregnancy. Which goes to show: the majority of women are struggling with body image while
pregnant. Not to mention what the body image stress is probably not helping the baby…

Is this only related to pregnancy?

Of course not… women in general are held to unrealistic expectations of beauty standards—expectations that the media and society constantly repeat. In recent years, this pressure for body perfection has worsened with the rise of social media. What is worse in pregnancy, however, is that the changes are relatively rapid, weight gain is almost always expected, feelings are exacerbated, and you may even be feeling alien in your own body. A vessel, so to speak. All of these are true: you will most likely gain weight during your pregnancy, it’s possible to develop stretch marks, and it is also a possibility that your post-partum body will not be 100% the same as your pre-pregnancy body.

 

This is a lot…

Yes, this can absolutely be overwhelming. Despair not! Weight gain is—and we cannot stress this enough—normal, and healthy for your baby. Also, if your doctor or nurse gives you the green light, you can exercise while pregnant. It may be light exercise, such as swimming or walking, or pre-natal yoga. These options help make you more aware of the connection between your body and your mind, perhaps take some of the edge off and your mind off of your worries and are steps to ensure the overall health of your body.

If you are concerned about weight gain during pregnancy, make a plan with your doctor, nurse, or mid wife, about your diet. Allow yourself the small pleasures without guilt: your body is participating in the miracle of nourishing a new life. There is no way to make this happen in a healthy manner unless you experience changes yourself.

What else can I do?

Honestly, don’t bottle up your feelings. Being insecure about, or even disappointed with, your
body image is completely normal. Share those feelings and thoughts with your partner, talk about
those worries with your friends. You may want to join a mom group, or even an online
discussion forum where you can exchange ideas with others on the same boat. If it gets too
much, you can always talk to a medical professional or a therapist. Even if you didn’t have body
image issues before pregnancy, it is not uncommon that future mothers start facing those worries
for the first time when they become pregnant. You are not alone in this!

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