Natural Disasters Are Increasing. Here's What Happens If You Go Into Labor During One.

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When Hurricane Milton made landfall along Florida's Gulf Coast as a Category 3 storm on the evening of Wednesday, Oct. 9, hospitals were hunkered down statewide. Even those on the East Coast prepared for the worst. The hospital Baptist Health is situated on the bank of the St. Johns River in downtown Jacksonville, where most days, you can see the reflection of the city’s skyline in the calm waters. But in extreme weather conditions, the river becomes a looming threat to the patients and providers inside.

Hospitals are critical to any community, but Baptist Health serves more people in its emergency room than any other hospital in the county, and its adjoining pediatric hospital, Wolfson Children’s, houses a level IV NICU that serves kids not just in Florida but southeast Georgia, too. When a hurricane is bearing down on them, how is anyone supposed to decide how to keep them safe? And what about the parents giving birth in the labor delivery unit, or coming in for needed C-sections or inductions?

In 2024 alone, the United States endured 27 “climate disaster events” exceeding $1 billion in damages each, according to the National Oceanic and Atmospheric Administration. Storms battered Florida and Texas and Hurricane Helene decimated countless homes and businesses in North Carolina, killing 105. The 2025 new year began with the Los Angeles fires, which have destroyed more than 16,000 structures and torched almost 60,000 acres of land so far.

The climate crisis is here and Mother Nature is demanding our attention. It has become everyone’s problem, and like all systemic problems, it has a particular effect on families. Whether it's rescheduling one person’s routine induction before a hurricane or a health care desert is created when a hospital burns down and never gets rebuilt, the climate crisis is already changing the way pregnant people, children, and babies get quality health care.

The options for a hospital in a hurricane are simple on the surface: remain open, or close and evacuate. But no two patients are alike, and when you’re talking about birth, well, babies wait for nothing and no one. In fact, incoming hurricanes have a way of making more of them decide it’s time to be born, according to stories from medical experts.

“If we close the door and a pregnant person has nowhere to go, what's going to happen?” says registered nurse Shannon Wainright, MBA, director of women’s and children’s services at Southeast Georgia Health System in Brunswick. “Our goal is to provide services at a scale that is reasonable during a storm. We're not going to be doing elective surgeries. We're not going to be doing anything that's not necessary, but birth is necessary. These patients are pregnant and the baby is coming, and oftentimes changes in [barometric] pressure and stress can definitely have an impact on a patient going into labor.”

Tornadoes, earthquakes, and wildfires happen suddenly, with little to no warning. A report from Stanford University’s & The West includes a harrowing description from a Paradise, California, nurse on duty during the 2018 Camp Fire. Her supervisor assured her they’d be alerted if they needed to leave, and then she looked out the window to see a fire burning just across the parking lot. She and her team evacuated 69 patients via helicopter, ambulance, and the nurses’ own personal vehicles. Natural disasters are one thing, but a failure to evacuate patients in advance can lead to unspeakable tragedies.

When it comes to extreme weather events, hurricanes tend to have the longest lead time. The National Weather Service monitors their formation closely, so there is usually about a week’s notice between when a hurricane’s path is expected to affect weather on land and its actual arrival. Its wind speeds, the direction it’s spinning, whether it will approach at high or low tide — all these factors matter when you’re deciding whether to evacuate a hospital full of patients who need your care.

That said, hospitals nearly always opt to stay open during major weather events. They have a duty to care for first responders who stay behind to help, Wainwright says, and they know pregnant people in their areas don’t get to choose when their babies come. “Labor is such an unpredictable event. It’s one of the many reasons why we feel like it is imperative to stay. I can't imagine a mom showing up at our door and not being able to get in.”

Wainwright tells me about the rare occasion they evacuated patients during a hurricane in 2017. Most of her prenatal patients with due dates in the coming weeks were instructed to print their prenatal care records and evacuate early. Everyone knew holding off until mandatory orders would lead to traffic on all major roadways, and these women needed to wait out the storm somewhere with a different hospital nearby. Those that could be safely discharged early were sent home. The rest were transported to nearby adult and pediatric hospitals, “which was not fun,” she recalls.

“There’s a website that we all log into and hospitals put their [available] beds up there. One hospital says, ‘I have this many postpartum beds, I have this many NICU beds, I have this many labor beds, and I have this many critical care.’ We would get on that database and we would say, ‘We need this many.’ Then hospitals can grab up those patients, call us, and make that connection so we can safely transfer the patient.”

Transferring patients is a huge undertaking, says registered nurse Christine Smith, MSN, vice president of patient care services for Baptist Medical Center Jacksonville. The Baptist Health system has seven inpatient hospital locations, and the one closest to the coast was evacuated during Hurricane Irma. “It takes a village. It’s not just the hospital doing that but the city,” she says. To evacuate, hospitals coordinate with local EMS and, one by one via ambulance ride, take patients (including NICU babies and laboring parents, if they’re there) to other facilities.

But with robust generator systems, most hospitals don’t fear losing power. And thanks to innovative flood prevention barriers, they don’t have to close just in case the storm surge gets too high either. “During Milton, we were most concerned with flooding from the river based on how that storm was coming across the state and what we thought was going to happen when high tide hit,” says Allegra C. Jaros, MBA, president of Wolfson Children’s Hospital. To keep the river out of the lobby, their facilities team erected waterproof barriers ahead of the storm allowing operations inside to continue uninterrupted.

Because the hospital is fortified with an emergency generator system to keep medical equipment functioning in the event of a power outage, they also make room for children in the community who rely on power to sustain their lives, like those on ventilators. There are 43 such families in the Jacksonville area who are registered to ride out the storms inside the hospital, where their kids will be safe.

As for scheduled C-sections and inductions, those procedures get assessed one by one to determine if they’re still on. That means nursing leadership is calling OB-GYNs and midwives to ask about each individual patient on the schedule.

“Women have babies 24/7. It's about figuring out who needs to come in, and who can be put off safely, if need be,” says Dr. Tiffany Wells, M.D., vice chair of obstetrics and gynecology at Baptist Medical Center Jacksonville. Medically necessary inductions or C-sections take priority, she says. “Generally, if we have to limit anything, the elective inductions will be taken away first to reserve space.”

During 2017’s Hurricane Irma, Wells slept in an office onsite for three days in between caring for patients. The storm caused record flooding throughout the city, and Baptist Health’s basement — which houses its generators — also took on water. “That created an emergency,” she says. “We had to physically move all of our labor and delivery patients from one side of the hospital to the other until they made sure everything was safe to move everyone back.” A veritable moat formed around the base of the hospital. From inside, Wells could see cars driving on I-95 and taking the exit ramp to approach the hospital, before having to reverse back up the ramp and look for another route.

The picture Wainwright paints of sheltering in the hospital during that storm sounds like the sweetest kind of community — nurses bringing in food from home to have meals potluck-style, with patients and their families grabbing plates too. Getting weather updates here and there as they circulate on the floor, hearing different bits of info from each patient as they go and catching glimpses of the weather radar on the TVs in their rooms. “We’d talk about their stories of where their family was and did they evacuate, and they'd want to know the same about us,” she says.

Wainwright, and many caregivers like her, usually persuade their families to get out of dodge before the evacuation order is issued. “I don't want to have to worry about them when there's so much to focus on at work," she says. "It feels good to know they're gone. They worry about me a lot.” She shared that in the aftermath of storms, nurses and doctors have organized rides for colleagues who couldn’t get their cars out of their neighborhoods due to flooding or downed trees, bringing each other clothes and shoes to work in when their homes flooded. Workers sometimes stay on-site until their homes are safe to return to. With all the generators, water barriers, and safety measures at their disposal, hospitals are often the safest place to be in a storm.

But the number of helpers running towards the onslaught of natural disasters will soon dwindle. There will be a massive nationwide shortage of providers in the next decade. OB-GYNs, pediatricians, and family medicine providers are three disciplines notorious for being compensated less than their colleagues in other specialties, and they’re among the most likely doctors to be sued, making recruiting new grads difficult. On a planet that is heating up, freezing over, and generally seething at our presence, we know natural disasters are increasing in frequency and intensity. When there are fewer of these specialists picking up calls about whose C-sections are medically necessary during a hurricane, or whether a NICU baby can be safely relocated to another facility via ambulance, it is once again the health of parents and children that will suffer.

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Women Are Scared & Scrapping Their Baby Plans Under Trump

“I knew it would be bad, I just didn’t know it would all happen so fast,” Hannah Baker*, a 32-year-old mother of one in the southeastern United States, tells me. “I had already made up my mind back in the summer that if he got elected, we were a one-and-done family. I think my partner was hoping I’d change my mind or that things wouldn’t be as bad as they are, but nope. We’re done.”

Baker’s not alone. And while U.S. fertility rates have been dropping for years, and cultural pressure around having a family has fortunately lessened, studies show that much of the declining birth rate can be attributed to the lack of infrastructure that makes it possible for families to grow. A recent Pew Research study found that 26% of parents under 40 cite financial reasons for not having more children, and a Gallup study found that many American families have less children than they actually want. A study at the Institute for Population Research found that while the birth rate has nosedived, Americans' desire for children has stayed more or less the same. It's simply less feasible.

In the time since Baker and I last spoke, the government website reproductiverights.gov went dark. An executive order removed more than 200 pages from Head Start, the federal program for low-income children, including videos on postpartum depression. The United States has been removed from the world’s main climate pact. Remote work for federal employees — a lifeline for working mothers — has all but been eliminated. There is no “family leave plan” on the table. There’s no federally protected right to abortion. There’s no hope for the climate and the state of the planet. There’s no comfort for LGBTQ communities, for transgender people, for pregnant people.

“I don’t want to die trying to have another baby. I don’t want to leave my own living child motherless.”

So as much as Baker says she'd like to give her son a sibling, she just doesn't feel ready, not in this political climate. It doesn't feel safe. “For me, I just want to be sure I can take care of him. And with everything going on, I’m just terrified. Like what if he’s gay? What if I lose my remote work job? What if groceries stay so expensive?"

Some women cite the terminology in abortion laws — as some state’s abortion restrictions are blamed for the completely avoidable deaths of women like 28-year-old Amber Thurman in Georgia — as a reason why they’re changing their family plans.

Theresa Parks* lives in a blue state with one child — but she’s suffered several miscarriages. “I’ve always had to have a D&C,” she tells me. “I want more children, but I’m terrified of experiencing another miscarriage and being left to go septic or something if they completely ban abortion.” She feels “somewhat safe” in her blue state, she says, but she doesn’t trust the government or any of the pundits who say abortion is really just a states’ rights issue. “I don’t want to die trying to have another baby. I don’t want to leave my own living child motherless.”

Dr. Kecia Gaither, M.D., a double board-certified physician in OB-GYN and maternal fetal medicine, is the director of perinatal services/maternal fetal health medicine at NYC Health + Hospitals. When I spoke to her in November, before Trump was officially sworn in as president, I’d hoped she’d beam a light of hope down and declare all of our fears unfounded. This did not happen. “Reproductive health and equity has taken a major hit in the wake of the Roe v. Wade reversal. In light of that ruling, many states have banned the election of pregnancy terminations, forcing women — and the physicians who care for them — to face difficult and, many times, life-threatening situations. For my colleagues in certain parts of the country, they have been witness to their health care compatriot being threatened, coerced, and even jailed for rendering care — even in the face of their patients facing life-threatening pregnancy complications,” she tells me. “The incoming administration’s agenda, via Project 2025, apparently will end access to medical abortion, curtail birth control access, allow health facilities to deny particular emergency saving care, and establish an abortion surveillance system… to name just a few.”

Julia Mazer, a Georgia mom of a toddler, was nine weeks pregnant on Election Day 2024 with what she described as “hopefully” her second child. “I have lost pregnancies before, so I know that a pregnancy doesn’t always guarantee a baby. I think we would have stopped trying to conceive if I wasn’t already pregnant before the election,” she tells me. “The biggest change this time is that I am more afraid for my life than I was before. I have been pouncing on news articles about Josseli Barnica and others who died during miscarriage due to abortion bans. I Googled which states have bans and what the term limits are in case I need to travel out of state for abortion care — if there’s time.” Mazer says that she’s always been pro-choice, and that she can’t imagine feeling all of these debilitating pregnancy symptoms while also worrying about an abusive or absent co-parent, food insecurity, anything. “It makes me feel so privileged. I don’t know what will happen, but I do know that this pregnancy will be our last.”

Maddison Z was living in Charlotte, North Carolina, when she gave birth to her first son in early 2023. She had just moved from NYC. “I was really early in my pregnancy when Roe was overturned. It felt so heavy and scary. But I was thankfully living somewhere where I had access to the health care I needed. In July of 2024, when our son turned 18 months old, my husband and I were discussing trying for another baby. In order to feel comfortable, I knew I needed to live in a state that granted me access to all health care. If something were to happen during a pregnancy that put my life at risk, I needed to be able to choose my life, and the life of my son who needs me,” she told me before the election.

Since then, Maddison’s ideas about having another child have have shifted: “We wonder if it is even ethical to bring another child into this world, knowing the negative impact this current administration will have on the environment, social issues, and the economy,” she says.

Lauren Hughes* in Michigan tells me she’s terrified to have a baby if Trump’s Supreme Court overturns same-sex marriage. “It’s already an ordeal to make sure my wife is listed on the birth certificate, even if we use her egg. She has to adopt her own child, basically. What if they take away our marriage?”

“The biggest change this time is that I am more afraid for my life than I was before.”

Megan Buck, 32, in Atlanta agrees. “Me and my wife were considering IVF last year. We both want kids and went through a bunch of testing to see if we could. We went to baby sections of stores just to daydream, it was amazing. But now with the political animosity towards our community, it’s scary.” Buck has an autoimmune disorder and also worries about the laws surrounding abortions. “Not only are there health risks associated with me having a baby, but with the attack on trans rights, it seems like only a matter of time before they come for more in our community. The last thing I’d want to happen is for everything to go well and then have complications with my wife having rights to our baby because we’re two women.”

Jessica Hernandez* lives in the South and tells me she won’t have any more babies if there’s even a chance of an ICE agent showing up at the hospital while she’s in labor. “Would they take my kid?” she asks.

Miranda Lynch is a birth photographer and around babies and families constantly. She decided a long time ago that she didn’t want children, and after years of debilitating endometriosis, PCOS, and autoimmune disorders that make her periods unbearable, she’s found a solution that works for both her pain and to keep her from getting pregnant: hormonal birth control pills. “Not an IUD, not a shot, not whatever — my pills,” she tells me over the phone. “And if I cannot access my hormonal birth control pills, my life will go back to being unmanageable. So the solution is to have my organs cut out, unfortunately, before it becomes illegal to do so." Lynch has a hysterectomy scheduled. "I’m also unmarried. I don’t have a husband to sign off on anything. I have to get it done now.”

Lynch is also nervous about this new administration and how its policies may affect the families she works with in the delivery room. “There are going to be a lot more upsetting incidents that I'm witness to. There are going to be more scared parents and fewer just elated and confident ones. It's going to change. And how does birth worker culture shift into that space?”

Gaither says it’s impossible to gauge how things will go right now until we actually see how the reproductive landscape will look in 2025. But the truth of the matter is that women will die if reproductive rights are not upheld. When I ask Gaither to explain why abortion is health care, she’s succinct. “The question becomes this: if a woman is carrying a baby with a lethal anomaly, or carrying a molar pregnancy, or other obstetric complication that may impact her survival? We need to have options.”

The current Republican Party, who has so desperately tried to claim the title “party of family values,” has made no secret about what they wanted or how they wanted this country to look. Eliminating free lunches at school, insisting that you can just “ask grandparents to help” (when what we really need is free, universal child care), not to mention the prospect of risking our autonomy and our lives in pregnancy, with near-constant dread about the viability of the planet — it all adds up. The prospect of building a family under the current administration is becoming less like the American dream than, for too many people in this country, a potential nightmare.

*Names have been changed for safety reasons.

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My Baby's Scowl Made Him A Local Celebrity & Yes He Got It From Me

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In the delirium of the newborn months, my partner, Megan, and I found ourselves completely bereft of anything interesting to say, apart from running commentary on our one subject and singular focus: the baby. Even in our rare moments without said baby, we mostly talked about him. To entertain ourselves, we even did micro-impressions of the baby — an eager face here, a squawk there; a shake of a limb; a full-body wiggle. The joke being not just that the baby was so hilarious, but that the uncanny accuracy of these impressions — the genius of them — would be lost on anyone who wasn’t us.

Little did we know that while we precision-tuned our impersonations of this special creature, our newborn was hard at work developing his precise impressions of us. These impressions would prove to be cutting and gutting. Turns out babies are out there mimicking expressions, inheriting facial features, and also practicing their tight-five impressions of their parents. They’re revealing — through whatever mechanism of their observation or their inheritance of a particular set of the jaw — qualities about ourselves that we did not know. Expressions that we had thoughtfully suppressed, habits we thought we’d carefully concealed.

Octavia and I trade watching each other’s babies every week and chat constantly about their trajectory of our kids’ expressions. Octavia worries K has mimicked Octavia’s way of breathing and, thus, will also mimic her chronic sinus issues. More charmingly, to me, Octavia also points out K’s grunt while lifting things: “I think they get that from me.” (I will neither confirm nor deny, but I will confirm.) Octavia and their partner Marlene sent a photo of 1-year-old K trying a puree for the first time to a mutual friend. Our mutual friend wrote back immediately, “Awwww, they look just like Marlene!!” In the photo, K was pursing every inch of their face in grotesque disappointment, which gave Marlene much to purse her lips about.

My college roommate, Emma, notes that while few people are comfortable wielding a direct criticism of a fellow adult, they’re absolutely relaxed about assessing your baby. Emma lives in Oxford, England, and has the same wrinkle-nose smile as her kid Gene. She’d always known this about the both of them. And yet, she reports that people are constantly saying to her: “What a funny smile he has with his wrinkled nose. How odd that he does that.” She’s not bothered about her smile or Gene’s but is amused that they had no problem criticizing him. People spare us their assessments of us, but they don’t spare us their critiques of our baby children, who happen to look exactly like us.

Having a kid is “like having your embarrassment live outside of your body.”

Back in the States, I’ve had the great, distinct pleasure of hearing a rumor from my friend about my kid’s face: All the librarians at our branch call him “boss baby.” In the elevator, months after I first heard whispers of this nickname, a security guard informed me that my kid “always looks so corporate.” And I’ll admit, while my son has an incredible deck of nuanced expressions, when he walks into an unfamiliar place, he looks like he’s conducting a performance review. If this were the description of an adult, I might pass along the feedback. But babies can get away with anything.

I’d happily embrace my baby becoming a local celebrity for his dubious scowl, if not for the fact that everyone I love is simultaneously melting down about how much we look like each other. My friend in Los Angeles cried on FaceTime because he and I look so similar. A few times, nosy stranger will guess whether my partner or I carried by baby, and announce to me: “Well, he has your face.”

Now, I can put one and two together. When I finally confronted my friends and asked them if I’m often looking dubious. The general response was something like “Hmmm, well, yes.”

This is a new form of self-consciousness, I find. In Katie Yee’s upcoming novel Maggie; or, A Man and a Woman Walk Into a Bar, she builds on the oft-used description that having a kid is like having your heart outside of your body. Having a kid, she writes, is also “like having your embarrassment live outside of your body.” I’ve realized, in the past several months of walking around with an expressive, scowling, beaming creature who looks like me, that I am less poker-faced than I’d believed.

And the shockingly accurate impersonations don’t limit themselves to facial expressions. My friend Allie always hoards tissues in her pocket, which she never really admitted to herself. Then, doing laundry recently, she checked her 6-year-old’s pockets and found a zine’s worth of freshly hoarded, folded tissues. Mimicry or genuine scarcity panic, Allie could not say, but she was embarrassed for both of them.

“When she really loses it, I feel that pang of fear in myself of losing control, and I fear she got what fragility she has from me.”

My friends who have older kids report seeing these mirror selves on more harrowing emotional levels. My friend Emily, who brags flagrantly about her brazen listlessness, has a 3-year-old with astonishing energy, gregariousness, and confidence. But, Emily says, “When she really loses it, I feel that pang of fear in myself of losing control, and I fear she got what fragility she has from me.”

My friend Esme finds it overwhelming to see her 2-year-old in extreme emotions that replicated ones that she now keeps close to her chest. When her son is extremely happy, he clenches his teeth into a smile and tightens his whole body until he shakes. “While I reign in my enthusiasm now, I remember this feeling and my parents have several photos of me looking happy to the point of crazed, squeezing my baby brother as he winces.” Much more wrenching, when he’s in tantrums, Hank will bang his head on the floor, which Esme learned that she did as well. It’s awful, she says, but comforting to know that she moved through the same habit. “I find myself feeling both guilty and so close to him about it,” she says. Esme had forgotten about the extremity of these expressions, and Hank reminded her. These things feel impossible that our kids would have picked up on them, they’re mirroring something they haven’t seen.

I’ve spent the first year of baby-raising deeply impatient for expressions and evident personality. Each new face (interrogatory, plotting for peek-a-boo, cackling, delight overload, attempting to play it cool but failing) arrives to a great celebration. And I realize, just as the expressions of Esme’s tantrums were lost to her until her son echoed them, that many of his early faces might fade into obscurity. For now, I have a baby who moves through the world with a scowl — his default face until something stirs him from his worries. This is one of my favorite things about the scowl: how easily fleeting it is. People will march up to him in the grocery store and say “so serious,” which then ignites an incandescent, toothy grin.

When I finally read Susie Boyt’s 2023 novel about family and baby-rearing, Love and Missed, a passage in which the protagonist ruminates about baby faces stuck with me: “I sometimes found babies a bit cynical round the edges.” But of her granddaughter, Lily, she says: “It was so generous of her to think everything was funny… She understood that in the grand scheme of things, she had been born yesterday.” Perhaps it’s very respectful of my baby to approach every room with serious assessment, until literally anyone goes up to talk to him and he grins grins grins like he can’t remember what he took seriously.

*Names changed to protect baby privacy.

Maggie Lange writes about culture, style, books, art, salty food, and other things she loves for The New York Times, New York magazine, and others. She also writes the newsletter Purse Book, about tiny books that fit in purses and being a gal on the go.

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Have We Lost The Plot On Valentine’s Day?

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Dear Good Enough Parent,

Have we lost the plot on Valentine’s Day? I felt like a pro when I bought two (2) bags of Nerds Gummy Clusters™ (primo sh*t, I might add) a full week ahead of time but got home to my family immediately clarifying that each bag only had 24 and each of my kids’ classrooms had 27 kids in it. I can’t help but think the real enemy here is public school class size and therefore state funding, but in the meantime, I took the L. I have an insane week at work ahead of me but will now have “scour the city for another 24-pack of gummy clusters” weighing over me. So that, what? I’ll pass some test? My kids will feel like their parent is competent and safe and maybe even loves them?

Of course I would love to find a better way to show all of this to them, if I had time to do it. This is more of a comment than a question, or maybe the question is just: Can we please think of a better way?

You are right to want a better way. Love is not, at its core, about writing the names of your classmates on 27 bags of Nerds gummy clusters, or Ninjago-branded lollipops, or whatever crap the seasonal aisle of your local drug store in schilling. But, depending on how it’s done and who does it, there can be real love in that act. The problem with Valentine’s Day, for parents, is that any real acts of love get clouded by consumerism, competition, and parental (often, ahem, maternal) labor. It seems like the options are perfunctory branded merch-sharing or hours of careful crafting — which I appreciate that some kids and/or parents really do love. Complaining about all of this, a friend recently told me, “There’s also always some Valentine that a kid and their parent carefully made together, and I’m just like, ‘I’m not that mom!’” And you, it seems, are not the mom who wants to run all over town after a day of work and bedtimes just to check a box (who is, really?). Either way, kids rarely come home from school on February 14th, it seems, with a feeling of having loved and been loved. Instead, they come home with a bunch of trash.

What is a parent to do? I’ll admit, restructuring Valentine’s Day should maybe be low down on our list of causes that require our advocacy and attention. (Here is where, though, I will make my annual shoutout to my kids’ school principal, who has heroically outlawed in-school Valentine’s celebrations in favor of an optional after-school dance, which is actually fun and requires zero preparation.) And yet, it is irksome, isn’t it? That a holiday purportedly meant to celebrate love leaves so many parents feeling exhausted and empty inside, with little benefit to our kids.

When I read your question, I began to think, yes, about public school funding, which is high on my list of advocacy causes, but also about the many definitions of love we have. There is love between first-graders, for whom etiquette requires they show love for every single kid in their class, equally. There is romantic love, the showpiece of our individualistic culture, which all are told to pine for and perform but which many ultimately find unsatisfying. Berkeley’s Greater Good Science Center, which conducts and disseminates research on topics like love, reminds us that love also includes love of animals and nature, love of friends, love of strangers, love of community. Cultivating love in children, they explain, can happen in many ways. Modeling love between adults — romantic, and otherwise — is one of them.

All of this work may not be the best use of our time as parents, as people, but it isn’t just bullshit — it’s also care.

But I haven’t seen any research that says we have one day a year to model it, and that it must be done with a dozen roses and an overpriced prix-fixe dinner. Maybe you model love for your own children by loving other people’s children — your babysitting swap or your potluck dinners — and by letting others love yours, in their own ways. Maybe you cultivate love every time you pick up the kitty’s laser pointer to play, though it is midnight. Maybe it’s the way you drag them to marches for climate action, or, if that is too much, tell them about the march you joined while they stayed home and grew their little brains.

But the best way to help children understand love is providing ongoing and secure emotional support and care, which, if you’re reading a parenting column (especially one that tries to be humble about the optimization of parenting), you are almost definitely already doing. I am skeptical of the research on attachment, thanks in part to the writing of Nancy Reddy, but I do believe in the general power of reliable, unconditional care for kids, by one or more adults who don’t necessarily have to be their mothers. In my family, my father has been credited as saying that, to have a baby, all you need is love and a cardboard box. It’s later on, often, when they grow up, express their needs better, show their unique personalities, that you start to call on other resources.

With older children, it can often seem like you need high-level negotiation skills, project management training, a child development degree (I happen to have one of those, and can tell you that it only gets you so far) to help them navigate their daily lives. But whether you’re at the cardboard box stage, the Valentine-swapping stage, or taking on the complexities of raising teens, the work you do every day, to parent, to care for yourself? That might be the thing to celebrate.

I agree that you shouldn’t have to rearrange your work schedule to stuff Bluey tattoos into envelopes, that the love exchanged with those valentines is tainted by late-stage capitalism and short-lived, that there are probably better ways. Maybe your child will learn the lesson of imperfection this week as they present 24 matching valentines and three containers of tic-tacs to their classmates. Maybe you’ll do too much and decide not to do it that way again. All of this work may not be the best use of our time as parents, as people, but it isn’t just bullshit — it’s also care.

Many advocates of respecting care might say that all of this mishigas, rather than clouding the love, is the love. When you are raising children, in the words of the great poet André 3000, every day’s the 14th.

The Good Enough Parent is an advice column for parents who are sick of parenting advice. Let Sarah answer your questions about the messy realities of parenting! Send her your questions via this anonymous form or by emailing her at goodenoughparentcolumn@gmail.com.

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Would Group Prenatal Care Make New Mothers Less Lonely?

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When I was pregnant with my first baby, I enrolled us in the multi-evening childbirth education course offered by our HMO, where my husband and I sat in a little circle with other couples and took notes when Dot, the doula leading the course, lectured us on the “cascade of interventions” and how long a baby could go between feedings. I signed up for prenatal yoga, and for workshops on breastfeeding, babywearing, and pumping. I treated motherhood like a new job I was tackling, and I studied up. For weeks I sat on a futon at a breastfeeding clinic, dutifully weighing my baby before and after each feeding, surrounded by other new mothers. There we were, a group of new moms in the same boat all together, but I couldn’t tell you the name of a single woman who sat in that room with me, though the babies all had names like Leo and Charlotte.

In a way, my preparation method worked — I left all the workshops with the knowledge and skills I’d set out to gain (though pumping remained a nightmare). What I didn’t get — and what I wouldn’t even have really known how to look for — was a sense of community. I didn’t develop the kinds of friendships with other new mothers that I can now see I really needed. If I had, I would have felt much less alone in my first year of motherhood.

I thought of those courses and workshops when I learned about the concept of "group prenatal care." The concept was first piloted by the Centering Pregnancy program in 1993. While not the only group care model, Centering Pregnancy is the most established one, with providers in 600 clinical sites in 46 states and territories. Large healthcare systems including Kaiser Permanente, OHSU in Portland, and VCU in Richmond, Virginia, are participating, but I only heard of the concept recently, when a friend with a new baby mentioned a meet-up she was going to with her prenatal group.

What is group prenatal care?

In this model, starting in the second trimester of pregnancy, instead of the standard one-on-one biweekly appointments with your OBGYN or midwife, you meet in groups. 8-10 pregnant people (and their partners or support people) meet for 90 minutes to two hours, combining what we think of as regular prenatal check-ups (vital signs, bloodwork, urine tests if needed) followed by group discussion of topics related to pregnancy, birth, and baby care.

My friend told me she stayed in touch via text as each of the women in her group gave birth, and they regularly got together to catch up and meet the new babies. It wouldn’t have even occurred to me to reach out to any of the people from our childbirth class, even if I had their phone numbers or remembered their names. But here was my friend with ready-made group of parents at the exact same stage of newborn life! Instead of trying to make mom friends when she was haggard with new-baby exhaustion, she already had a group of people who’d been with her through pregnancy.

What does the research say?

In addition to building the community I so desperately longed for, there’s good evidence showing that women who receive this kind of care feel more prepared for labor, are less likely to deliver preterm, and are more likely to initiate breastfeeding. The outcomes speak for themselves: Both the American College of Obstetricians and Gynecologists (ACOB) and the American College of Nurse-Midwives endorse group prenatal care, with ACNM calling it “an evidence-based model of care that improved health outcomes for childbearing women and their infants.” Group care may be particularly useful in addressing disparities in perinatal outcomes such as preterm birth among black women.

What I needed most wasn’t an expert or a set of rules but honest conversation with other new parents who could assure me that I wasn’t alone.

Jessica Lewis, a research scientist who helped develop Yale’s Expect with Me program for group prenatal care, told me that it works especially well because the program, as she puts it, “empowers patients to expect to be heard about their own bodies and their own health.” Lewis says that health care providers on the delivery floor have told her they can always identify a group patient because they’re more confident advocating for themselves in labor. According to Lewis, the social support of groups not only reduces stress, but patients get 10x more time with their provider. In addition, the discussion format means that patients are able to learn more about pregnancy, birth, and child care in a way that really clicks — through conversation with other people going through the same thing.

“The community that you get in group prenatal care is one of the most enduring things that patients talk about and appreciate,” reiterates Dr. Rebecca Soderlind Rice, a nurse-midwife at OHSU Center for Women’s Health. “Parents build lasting relationships even after their babies are born.” A new mom who participated in OHSU’s group care noted on Reddit that having more time with the midwife and meeting other new parents were major benefits of the program. Another shared that her Centering Pregnancy group it “gave [her] a lot of agency and involvement in the process,” and that she loved being able to talk with people in the same stage of pregnancy.

With the current fee-for-service model in maternity care, labor & delivery services are prioritized, and improving prenatal care is an afterthought. | Maskot/Maskot/Getty Images

So why isn’t everyone doing this?

Because it’s so different from the standard model of one-on-one care in which most providers are trained, making the switch to a group prenatal care practice comes with challenges. Some of these are practical, Jessica Lewis told me, as offices need to have scheduling systems that will allow the front desk to schedule multiple patients for the same time slot. There has to be a physical space where groups can gather, which isn't workable for all clinics, and there’s some up-front cost in terms of materials for the educational portion of the program. There’s also training for providers, who learn to use a facilitative style for the group discussion. “You really have to have buy-in,” says Lewis.

In addition to the benefits of social support and improved patient outcomes, group prenatal care actually saves money for healthcare systems. But health insurance providers are another barrier to group prenatal care. With the current fee for service model in maternity care, Lewis explained, “there’s no money in delivering prenatal care.” As a result, labor & delivery services are prioritized, and improving prenatal care is an afterthought. Lewis says there’s reason to hope that the movement to experiment with different financing models for prenatal care, including models like a “maternity bundle” that includes things like doula services, will make it easier for providers to establish new approaches to the prenatal visit. Group prenatal care is “a real structural change in how care is delivered,” Lewis told me. But because it’s one that delivers dramatically improved outcomes in areas that are otherwise intransigent, like maternal health disparities by race and class, it’s certainly worth the effort.

This isn’t an option near me — now what?

If your provider doesn’t offer group prenatal care, there are options for perinatal care and support in lots of places that explicitly focus on community building. The Parent Collective, founded by Jessica Hill, offers prenatal education courses led by experienced nurses and midwives, which are designed to be a complement to your prenatal checkups. Unlike the courses I took, with their decided slant toward “natural” birth and breastfeeding, The Parent Collective’s offerings aim to be “evidence-based, judgment-free, agenda-free,” Hill told me. Hill is especially interested in helping couples think about how they’ll share the labor of caregiving, and their courses also work to educate partners on signs of postpartum mood and anxiety disorders.

I know I was doing my best in a culture that had taught me that a good mom could figure it out on her own.

Hill says The Parent Collective is modeled after the UK's National Childbirth Trust, or NCT, which she experienced when she lived in the UK during her first pregnancy. The NCT is “part of the fabric of most communities in the UK,” Hill told me. Founded in 1956 with a mission of supporting people as they become parents, the NCT is a national charity with no equivalent in the United States. More than 75,000 people attend the NCT’s antenatal class each year, making it the most popular program of its kind in the country. The course isn’t free, but there are discounts available for households making less than £35,000 a year. Those classes provide prenatal education but are also, as Hill put it, “very much focused on building community.” The NCT reports that 95% of participants are still in touch with other parents from their course after the birth of their baby. Participants in the Parent Collective similarly note that the program led to lasting friendships.

Talking with Hill, I thought back on my own attempts at making “mom friends” when my first son was a new baby. A few weeks after giving birth, I texted one of the moms from prenatal yoga, and we went for a dutiful little walk with our strollers around the neighborhood. She was nice, but I found we didn’t really have a lot to say. It turns out that just having given birth around the same time isn’t necessarily a strong enough foundation for a friendship. And I was too exhausted in those early weeks, when I was basically just a pile of unwashed hair and nursing pads, to think of how I might uncover some deeper point of connection. When Hill and I spoke, she pointed out that this is really common. The newborn period is not actually an optimal time to be meeting new people, so starting to build that community during pregnancy is ideal.

A little more than a decade into motherhood, I can look back on that worn-out, bogged-down version of myself with a lot of compassion. I know I was doing my best in a culture that had taught me that a good mom could figure it out on her own. I can see now that what I needed most wasn’t an expert or a set of rules but honest conversation with other new parents who could assure me that I wasn’t alone. It was only when I started sharing my fears I was messing up in panicky little posts on Instagram that I began to find the community that would help me get through.

Group prenatal care, of course, would have been a great way to start.

Nancy Reddy is the author of The Good Mother Myth, published by St. Martin’s Press in January 2025. Her previous books include the poetry collections Pocket Universe and Double Jinx, a winner of the National Poetry Series. With Emily Pérez, she’s co-editor of The Long Devotion: Poets Writing Motherhood. Her essays have appeared in Slate, Poets & Writers, Romper, The Millions, and elsewhere. She writes the newsletter Write More, Be Less Careful and teaches writing at Stockton University.

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How To Make Space For A Child’s Grief

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When I was about 10 years old, a boy who attended my church died. His name was Antonio and we sang in the youth choir together. He drowned at Blue Lake Park on the 4th of July. I remember singing at his funeral, I remember the pained look on his mother’s face as the undertaker closed the casket. I remember being afraid of riding the paddle boats at Blue Lake Park because what if…what if? But what I don’t remember is anyone asking me how I felt about Antonio dying. I don’t remember anyone at the church sitting the young people down and saying, “We’re here if you need to talk.”

I learned at an early age that tears were something to apologize for, to be ashamed of, to hide. I learned that my sadness was not as welcomed as my laughter. It wasn’t so much what was said to me, it was what adults said to each other about crying. Often, in reference to their own sorrows, I’d hear adults say phrases like:

I fell apart.

I lost it and started crying.

I couldn’t keep it together and burst into tears.

I know for sure the adults in my life cared for me, and I understand now that they were overwhelmed and busy with their adult-sized problems and perhaps their own grief and discomfort. I know how easy it is to be consumed with the day’s To-Do List and occupied with my own worries, but so much about grief is about pausing, is about taking a moment to feel, to mourn, to reflect, to honor. I needed the adults in my life to pause. To take a moment and process what I was feeling.

I do not want to teach a child not to cry, or not to be sad. I want to teach them how to be sad.

So often crying is talked about as a weakness, a thing to avoid, a sign that a person is not okay. But what if crying in response to grief, loss, or drastic change is an indication that we are feeling discomfort in a healthy, normal way? What if tears are not a sign of breaking down but rather proof of having the capacity to endure hardship?

This is at the forefront of my mind when I'm working with young people — whether it's teaching poetry as a writer-in-residence, facilitating grief workshops in response to natural disasters, conducting artmaking workshops for children who have been sexually and physically abused, or engaging with young readers on book tours and author visits. In the many ways I interact with young people, one thing I’ve been reminded of repeatedly is that, yes, they are children, but that doesn’t mean they are not experiencing life with all its ups and downs. Children are simply humans who have not lived long lives. Their understanding of grief might be limited because of their age but their feelings of sadness are real and need to be addressed.

I do not want to teach a child not to cry, or not to be sad. I want to teach them how to be sad. And to show young people healthy ways of coping with emotions, I need to practice these skills myself. I've had to learn to be at peace with sitting with discomfort. Of course I want to have the right answer, and I want to assure them that they will be okay. But having the answer is not as important as having time to listen. I cannot promise them that tomorrow will be better, but I can be there for them and admit that I get sad, too. I can tell them life is full of countless sorrows and an abundance of joys.

What if tears are not a sign of breaking down but rather proof of having the capacity to endure hardship?

And in the same way that I cheer with them when they have accomplished something, just like the times we explode in belly-aching laughter when something is funny, I cry and mourn with them when something is sad. I acknowledge their sadness over losing a loved one, moving, entering a new grade or changing schools, or losing their favorite things because of a fire or hurricane.

Children don’t have a lot of power: They can’t vote, don’t make the rules at home or school, and if they’ve just experienced a major change, they may feel helpless. Whether I am teaching in the classroom, writing books for young readers, or spending quality time with my nieces and nephews, I am asking myself, How do I make space for young people to grieve and process what they are feeling? How do I make healing and grieving an everyday practice? How can I encourage celebration and joy to be a part of grieving? These questions have guided me both professionally and personally, and have inspired me to develop a few concrete ways to connect with the young people in my life who are hurting:

Create art.

Artmaking is one way a child can exercise agency and make deliberate choices. Visual art encourages non-verbal communication and gives an opportunity for the grieving child to express emotions they are not able to articulate with words. Specifically for healing purposes, I recommend collage. Collages can incorporate their loved one’s favorite colors, images and symbols that represent them, and photos. The tearing and ripping of paper and making something out of chaos can help the young person feel empowered. Whereas watercolors, for example, are harder to control and might frustrate the child and make them feel out of control.

Write a poem.

Students in my workshops have written poems that memorialize their grandparents, friends, and victims of mass shootings and police brutality. When I know the content of their poems might delve into their sadness, I offer line starters and encourage them to explore writing formulaic poetry instead of free-verse poetry, such as pantoums, haikus, sonnets, acrostic, and blues poems. This way, there is a framework to guide the writing instead of starting with a blank page. Following the poem’s formula of counting syllables and paying attention to repeating lines works both the left and right brain and the poem becomes a container for the grief.

Make a playlist.

When my mother was in palliative care, I made a playlist of her favorite gospel songs and my siblings and I played them in her hospital room as she transitioned. Later, I made another playlist—one that was more upbeat and eclectic—and I listened to it on repeat the first few months after her funeral. You and your child can collaborate on a playlist and share it with family members and friends. Consider listening to the playlist in the car or while doing chores. The more often it is played and becomes a casual listening experience, the more you are communicating that the loved one who has died can always be remembered and honored in small and big ways. That their presence can be felt and should be evoked every day, not just on special occasions.

Cook or eat a special meal.

I love making my mother’s recipes for friends. It allows me to share a part of her legacy in a simple way. Remember that people who are grieving miss their person every day, not only on holidays or special anniversary markers. Incorporating the favorite dishes and desserts of a loved one can be done any day of the week.

Ask questions & listen with compassion.

I have found that one of the most important things I can do is listen. Providing time for children to ask questions, vent, or share memories reinforces that the grieving process isn’t about making them feel better, necessarily, but letting them know their feelings are valid and that they are not alone in the process. Some of my go-to questions are: What do you miss most about your loved one? How have you changed since your loved one died? What memories about your loved one make you smile?

Join a support group.

Participating in support groups allows the child to meet others who are also grieving. Support groups and individual therapy are also helpful for children who are having a difficult time or showing significant changes in mood and behavior.

Simply check in.

In our fast-paced culture where some of our young people have busier calendars than we, as adults, do, in the midst of drop-offs and pick-ups from sports practice and playdates; as we move from one global crisis to the next, let us take time to pause and ask our children, How are you feeling? Let us be intentional about making space for them to acknowledge and process what is happening in their life — not as a means of taking the pain away, but to say, I see you and all of you matters, your laughter is welcomed and so are your tears.

Renée Watson’s new novel All the Blues in the Sky will be published Feb. 4, 2025. It’s about friendship, loss, and life with grief.

Renée Watson is a #1 New York Times bestselling author. Her novel, Piecing Me Together, received a Newbery Honor and Coretta Scott King Award. Her books include the Ryan Hart series, Some Places More Than Others, This Side of Home, What Momma Left Me, Betty Before X, cowritten with Ilyasah Shabazz, Watch Us Rise, cowritten with Ellen Hagan, and Love Is a Revolution, as well as acclaimed picture books: Maya's Song, The 1619 Project: Born on the Water, written with Nikole Hannah-Jones, A Place Where Hurricanes Happen, and Harlem's Little Blackbird, which was nominated for an NAACP Image Award. Renée splits her time between Portland, Oregon and New York City.

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