The quiet crisis among Black Americans: Pregnancy and childbirth are killing women

Jimi Swagger

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Journii Perkins yawns as her grandmother Cheryl Givens-Perkins brushes sister Camille's hair as they get ready for church.


By ANN M. SIMMONS

Three weeks after Cassaundra Lynn Perkins gave birth to premature twins, she returned to the hospital, feeling unwell. She phoned her mother from her hospital bed at 3:30 in the morning.

Surely it was just another bout of the mysterious illness her daughter had been suffering from for most of her pregnancy, Cheryl Givens-Perkins thought as she rushed over to San Antonio’s North Central Baptist Hospital.

When Givens-Perkins walked into the room, her 21-year-old daughter looked exhausted. She begged her mother to comb her hair.

“I need to get ready,” she said. “Please get my hair in order.”

“She may have known she was dying,” Givens-Perkins said.

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Cheryl Givens-Perkins prepares a breathing treatment for her grandson
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Givens-Perkins is caring for three grandchildren after daughter Cassaundra Lynn Perkins died of an infection after childbirth

Every year, around 700 women in the United States die as a result of pregnancy or delivery complications. As many as 60,000 expectant mothers suffer problems that come close to costing them their lives.

America is one of the most developed nations in the world. Average life expectancy has been generally increasing over at least the last five decades, and deaths from illnesses that were once widely fatal, including polio, smallpox, tuberculosis and AIDS, are sharply falling.

Yet when it comes to the natural process of childbearing, women in the U.S. die in much higher numbers than those in most developed nations, where maternal deaths are generally declining.

A woman in the U.S., where the maternal death rate more than doubled between 1987 and 2013, is more likely to die from pregnancy-related causes than in any country but Mexico among the 31 industrialized countries of the Organization for Economic Cooperation and Development that reported data.

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There are various theories why — persistent poverty, large numbers of women without adequate health insurance, risk factors related to stress and discrimination. All come together here in Texas, with a twist that has become one of America’s most confounding public health problems: African American women are dying of pregnancy- and childbirth-related causes here at stunningly high rates.

The maternal death rate in Texas after 2010 reached “levels not seen in other U.S. states,” according to a report compiled for the American College of Obstetricians and Gynecologists, based on figures from the U.S. Centers for Disease Control and Prevention.

Black women in Texas are dying at the highest rates of all. A 2016 joint report by the Texas Department of State Health Services’ Maternal Mortality and Morbidity Task Force found that black mothers accounted for 11.4% of Texas births in 2011 and 2012, but 28.8% of pregnancy-related deaths.

“This is a crisis,” said Marsha Jones, executive director of the Afiya Center, a Dallas-based nonprofit that has taken on the issue. In May, the center published its first report: “We Can’t Watch Black Women Die.”
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Framed photos of Cassaundra in the family's living room


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Perkins, who already had a 2-year-old, worked at Great Clips salon and hoped to one day open her own salon. Her pregnancy with twins in 2014 was challenging.

“She was sick to where she could not keep anything down,” Givens-Perkins said.

Doctors said it was an infection. Then six months into her pregnancy, Perkins’ liver started to fail, and doctors decided to induce labor.

The babies arrived on Aug. 13, 2014, each weighing about 2 pounds. They were rushed to the neonatal intensive care unit.

Perkins was discharged from the hospital after three or four days. But something seemed wrong, her mother recalled: “She was never 100%.”

Doctors and researchers are struggling to make sense of the rise in maternal mortality in Texas.

“There isn’t a single thing that explains it,” said Lisa Hollier, an obstetrician-gynecologist who heads the state-appointed Maternal Mortality and Morbidity Task Force. “There are so many different factors.”

The task force compared the health of a group of women who died during pregnancy, childbirth or in the immediate aftermath to those who survived in 2011 and 2012.

Cardiac events, drug overdoses and disorders associated with hypertension were the leading causes of those maternal deaths, the task force found.

Nationally, problems such as obesity, diabetes, caesarean births and delayed prenatal care are among the risk factors commonly seen, Hollier said. Such factors are particularly prevalent among black women.

“So we have a population of women that is less healthy when they are entering pregnancy,” Hollier said.

Black women also had the highest rate of being hospitalized for hemorrhaging and blood transfusions, which are commonly seen in maternal deaths in Texas.

Texas has the largest number of uninsured people in the U.S., and there have been substantial cuts to women’s health programs that offer family planning and other routine services to low-income women, including screening for diabetes, hypertension and cervical cancer, which if left untreated could play a role in maternal deaths. Many of the dozens of clinics shuttered in recent years due to slashed state funding also offered prenatal care.


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“In an ideal world, a woman would have the opportunity to have a visit with a physician before she becomes pregnant to identify any potential risk factors before she gets pregnant,” said Hollier. “Then a woman would enter prenatal in her first trimester. Unfortunately, African American women are the least likely to have that first trimester of prenatal care.”

Texas public health officials say they are concerned about the state’s high maternal mortality rate but they don’t believe cuts to women’s health clinics are to blame, noting that the decrease in funding did not take effect until after the increase in maternal mortality had been reported.

“There’s not any evidence that suggests a link,” said Chris Van Deusen, a spokesman for the Department of State Health Services. “The timing doesn’t really match up to demonstrate that there’s any connection.”

Manda Hall, associate commissioner for community health improvement at the agency, said several initiatives are underway to address the maternal mortality crisis. They include a program that encourages women planning to become pregnant to make wholesome lifestyle choices and another targeting historically black academic institutions that offers training focused on preconception health, the importance of fathers, health disparities and reproductive life planning.

Researchers say such programs might have an effect, but given that low-income white women fare better than black women, the causes may run deeper.

“Just being a black woman in America comes with its own level of stress,” said Jones, the Afiya Center executive director.

Some studies have shown that chronic stress triggered by racism and discrimination can lead to health problems such as diabetes and high blood pressure, and these in turn can lead to preterm births, low birth weights and life-threatening complications.

A 2009 study published in the journal Social Science & Medicine by researchers from USC and Harvard examined the differences in the self-reported racism experiences of U.S.-born and foreign-born black pregnant women, and found that “chronic exposure to racial prejudice and discrimination could ... contribute to physiological wear and tear, thereby increasing health risk.”

African American women also say that healthcare professionals are often dismissive of their concerns if they are poor, have health problems or already have several children, said Deneen Robinson, a researcher and program director for the Afiya Center.

“We go into facilities and they speak condescendingly to us,” Jones said. “They rush us through the process. They downplay when we talk about what oursymptoms are.”

In Perkins’ case, her mother recalls that health providers seemed to disapprove when her daughter got pregnant with the twins and was feeling sick.

“Oh, you’re pregnant again,” was the reaction of the first doctor they consulted, Givens-Perkins recalled. “They think that we’re all just trying to get on the system and get what we can get.”

Shawn Thierry, a Democrat who represents Houston’s 146th District in the Texas House of Representatives, says this is a common experience for African American women.
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“We know there are instances where [African American mothers] are not given the proper level of attention and care because of assumptions that doctors and hospitals are making about them,” she said. “The bias — we see it on all sides.”

Thierry has introduced legislation that would require an investigation into whether socioeconomic and educational backgrounds play a role when African American mothers die during pregnancy and childbirth.

A little more than four years ago, Thierry almost died giving birth to her daughter after a routine epidural triggered a violent reaction. She felt excruciating pain, her heart began to race, and she was “fighting for every breath,” she said. Doctors performed an emergency C-section. Unlike many poor and minority women, she says, she had good health insurance that allowed her to remain in the hospital several days after giving birth.

As for Perkins, who died three days after being readmitted to the hospital, doctors told her mother that an infection had killed her daughter. A preliminary autopsy report cited an accumulation of fluid in Perkins’ abdominal cavity and around her lungs and heart. It also said placental tissue had been retained in her uterus.

Givens-Perkins was plagued with questions. Was that what proved fatal? Did it have anything to do with the illness she suffered during her pregnancy? Why was her daughter most often seen during her pregnancy by low-level medical practitioners, even when she was so frequently sick?

(Hospital officials declined to comment for this article, citing patient privacy laws.)

Baby Camille came home in time for Christmas 2014, almost four months after her birth. Her brother Catreyal was released the following month after several surgeries and near-death episodes.

He remains physically and mentally impaired. While his sister is running and trying to form words, he can’t walk or talk. Givens-Perkins is left to start another generation of child-rearing, this one much harder than the first.

“That first year was a year from pure hell,” Givens-Perkins said. “I didn’t know what to do. I was calling people. Do they still boil bottles? I was sure a lot had changed. It was 20 years since I had had a baby. I had to relearn how to do this.”







 

Ms.CuriousCat

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:mjcry:

I didn't know until very recently that a woman who wants to conceive should start taking folic acid and vitamin D before she gets pregnant and all through the first three months.

Side note:
Also a lack of vitamin D during pregnancy has been linked to autism.
 

Jimi Swagger

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:mjcry:

I didn't know until very recently that a woman who wants to conceive should start taking folic acid and vitamin D before she gets pregnant and all through the first three months.

Side note:
Also a lack of vitamin D during pregnancy has been linked to autism.

That's why children should be planned, not happenstance. Make sure to take vitamin D3 as it's most natural, not the synthesized D2 prescribed by the doctors. Also, better for the liver and kidney. Should get at least 50,000 iu a week period, especially melanin dominant people. A naturopathist shared this with me.

Aside: My physician is participating in research on the effects of marijuana and claims it remains on your reproductive system for 28 days (like a sticky film) which should be considered when conceiving. A baby girl is born with all (or most) eggs she will carry meaning during pregnancy a woman is carrying her daughter's eggs plus the eggs of her future grandchildren. Which is why diet is important in pregnancy to nourish yourself and 2 generations. There was a study on Dutch women during WWI that were starved part of their pregnancies. Their babies had lower birth weights, and their kids in turn had also children with lower than average birth rates (epigenetics).

Im curious how alcohol use plays a role since an adult has a grown liver to metabolize it but not baby giril with her unprotected/undeveloped eggs(grandchildren). Life is so precious man.

Nutriepigenomics - Wikipedia
Dutch famine of 1944–45 - Wikipedia

God bless Ms. Cheryl for what she been through losing a daughter at a young age and taking care of three young kids. Seems like she has a strong faith that keeps her going.
 

Yo Mama

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This is heartbreaking. But I have seen that it seems that most health care professionals dismiss what pregnant women tell them. I appreciate that they get their share of unnecessarily worried women and they have jobs to do... but maybe they should listen more.

WARNING - MILDLY GRAPHIC....

With my second kid I told them several times over that I was in labour, I had just arrived and not done the paper work. I hadn't even checked in yet and they said I should go take a seat and wait for someone to check me in. I went into a ward with other expectant mothers to see what's up and the women said they had been in there for days and they barely got any service. I cant imagine hours let alone days of labour! Id loose a chunk of my mind by the time its over lol.

I went into the delivery room after they told me again to sit down. One older nurse came I think to tell me stop being hysterical and go sit down but I had already gotten on the delivery bed thing. I'm telling her this baby is coming and she is telling me go sit down. Then she looks and sees that the baby is indeed being born and she is now panicking saying I'm not ready and she is trying to locate rubber gloves. I wont go into further detail but I,ll just say thank God her old ass came to yell at me coz there was a complication. The baby came and she was forced to deliver with one glove on. She was just mumbling that, "I thought you were just exaggerating and acting up". I thanked her for at least springing to action as she did.

Maybe they have been in the medical field so long that they are just over the "Miracle of birth".

Besides loosing a baby one of my worst fears was loosing a lot of blood and having to require a transfusion. I told the medical staff I did not approve of a transfusion and had it on record to not give me blood.
 
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Serious

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No one cares. This will just be fodder for some bitter c00n to insult blk women.
I remember watching this undergrad, and it had me shook.


TLDW: Black women, regardless of socioeconomic status, had "significantly" worse childbearing outcomes. African American women with college degree had worse outcomes than white women with only a hs education :wow:
 

Serious

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That's why children should be planned, not happenstance. Make sure to take vitamin D3 as it's most natural, not the synthesized D2 prescribed by the doctors. Also, better for the liver and kidney. Should get at least 50,000 iu a week period, especially melanin dominant people. A naturopathist shared this with me.

Aside: My physician is participating in research on the effects of marijuana and claims it remains on your reproductive system for 28 days (like a sticky film) which should be considered when conceiving. A baby girl is born with all (or most) eggs she will carry meaning during pregnancy a woman is carrying her daughter's eggs plus the eggs of her future grandchildren. Which is why diet is important in pregnancy to nourish yourself and 2 generations. There was a study on Dutch women during WWI that were starved part of their pregnancies. Their babies had lower birth weights, and their kids in turn had also children with lower than average birth rates (epigenetics).

Im curious how alcohol use plays a role since an adult has a grown liver to metabolize it but not baby giril with her unprotected/undeveloped eggs(grandchildren). Life is so precious man.

Nutriepigenomics - Wikipedia
Dutch famine of 1944–45 - Wikipedia

God bless Ms. Cheryl for what she been through losing a daughter at a young age and taking care of three young kids. Seems like she has a strong faith that keeps her going.
Mos def, this is why vetting your potential partner means, everything. This goes for males and females. I'm not with the trivial gender wars, bs, the most important feats I look for in a partner typically revolve around lifestyle choices(drugs, alcohol, diet, sexual promiscuity (exposure to std's)). Can't have a partner who's into that shyt :hubie:
 
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Jimi Swagger

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Mos def, this is why vetting your potential partner means, everything. This goes for males and females. I'm not with the trivial gender wars, bs, the most important feats I look for in a partner revolve around typical revolve around lifestyle choices(drugs, alcohol, diet, sexual promiscuity (exposure to std's)). Can't have a partner who's into that shyt :hubie:
Sad that poor White trash essentially have less infant mortality rates than Huxtable Blacks. That segment around 2:25 where the MD explains how Blacks live in constant stress where the blood pressure remains the same throughout the day while Whites drop at night is disturbing. Brehettes are in a constant state of stress. Diet plays a role but even if the diet change the environmental stressors remain (racism, poverty, sexism, ratchet family et al).

Mos def, this is why vetting your potential partner means, everything. This goes for males and females. I'm not with the trivial gender wars, bs, the most important feats I look for in a partner revolve around typical revolve around lifestyle choices(drugs, alcohol, diet, sexual promiscuity (exposure to std's)). Can't have a partner who's into that shyt :hubie:
Most vetting brehs done is how cute she looks and how her ass looks in a dress and if she didn't fukk your homeboys she is wifey material. Family history(behavior) is important as well. Probably we have so many half retarded people running around in cute clothes. Lets not even get into the spiritual aspect that has been loss like praying before conception

That poor grandma should be enjoying her Golden Years :mjcry:
 

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Sad that poor White trash essentially have less infant mortality rates than Huxtable Blacks. That segment around 2:25 where the MD explains how Blacks live in constant stress where the blood pressure remains the same throughout the day while Whites drop at night is disturbing. Brehettes are in a constant state of stress. Diet plays a role but even if the diet change the environmental stressors remain (racism, poverty, sexism, ratchet family et al).

I see it as a reminder that black women are just as vulnerable in society as black men. But more so as a black man, my previous focus was just on my experiences. Until recently I never sat down, and thought about what black women go through. Once I came across this information, I definitely switched up how I engage with the black women in my life. I go out my way to make sure they feel comforted and special. Heck every time, I visit my mom, I make sure to do something special for her, that makes her feel wanted and appreciated. It's the little things that go a long way.

Most vetting brehs done is how cute she looks and how her ass looks in a dress and if she didn't fukk your homeboys she is wifey material. Family history(behavior) is important as well. Probably we have so many half retarded people running around in cute clothes. Lets not even get into the spiritual aspect that has been loss like praying before conception

That poor grandma should be enjoying her Golden Years :mjcry:
Well attraction is important to me, I can't simply be with someone just because they have a good heart, as shallow it may seem. As someone who's physical active, and big on preventive health, I can't as easily compromise those core values. With that said, vetting your partner is extremely important for traits, morals and education. Sex is never just sex. There's always that potential of pregnancy, and there's always feelings involved in every situation where sexual consent occurs, whether it's positive or negative. The point of sex and reproduction should always be to give your potential offspring, the best traits surrounded by the stablest upbringing possible.
 

Jimi Swagger

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I see it as a reminder that black women are just as vulnerable in society as black men. But more so as a black man, my previous focus was just on my experiences. Until recently I never sat down, and thought about what black women go through. Once I came across this information, I definitely switched up how I engage with the black women in my life. I go out my way to make sure they feel comforted and special. Heck every time, I visit my mom, I make sure to do something special for her, that makes her feel wanted and appreciated. It's the little things that go a long way.

Well attraction is important to me, I can't simply be with someone just because they have a good heart, as shallow it may seem. As someone who's physical active, and big on preventive health, I can't as easily compromise those core values. With that said, vetting your partner is extremely important for traits, morals and education. Sex is never just sex. There's always that potential of pregnancy, and there's always feelings involved in every situation where sexual consent occurs, whether it's positive or negative. The point of sex and reproduction should always be to give your potential offspring, the best traits surrounded by the stablest upbringing possible.

Nothing is wrong with that. It's a criteria for most to be attracted to the person they are with. Family history and behavior is very important to me. Physical stuff can be worked on with awareness, lifestyle changes and money. If you have retarded and criminals in your fam or missing branches on your family tree (not due to catastrophe like war, parental death) then I pause. Physical and behavioral traits I'd rather not worry about correcting and passing along to an innocent. Seen too many associates deal with cute crazy people and their offspring.
 

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Ms. Cheryl will need all the strength she can muster. I hope she has at least a small support team in place to help her. To have to go thru the process of raising another generation of kids after you've raised your own is something I couldn't fathom having to do, much less all alone. God bless her.

The story about her daughter makes my stomach turn. I chose to have my kids at home because I had a fear of something like this happening to me or my babies while under a doctor's care in the hospital. I remember during my first pregnancy, I had a scare one night when the baby was laying on my bladder, so I couldn't pee. I strained and strained until I was able to go, but ended up messing up something because I was in pain the next morning. I went to a 'good' hospital in my city, just for a checkup to make sure everything was okay, and got a young white female doctor. I was only 31 at the time, and I gathered she was in her late 20s. I explained to her why I was there, and she decided to take a look at me.

She examined me and said something to the effect, "I think you might have an STD." I'm looking at her like she is crazy. She asked me about my partner, and I told her I was married. She didn't look convinced, lol. I told her I had been married for 8 years (at the time) and, as far as I knew, my husband had never cheated. She kept asking, "Are you sure?" I started getting offended at this point, not because of the cheating question, but because I started getting the sense she was stereotyping me and was asking this question for another reason. No matter how much I told her I thought it was just a bladder strain, she was like, "I'm going to test you for chlamydia and gonorrhea."

shyt didn't bother me because it was paid for, but, of course, the tests came back negative, and this chick actually seemed surprised and disappointed. WTAF? On top of all that, when I told her I was having my baby at home, she started chastising me like I was a child and just dumb, asking me why I would do something like that and how dangerous it was. I had to remind myself a lot of medical practitioners in this field view having a baby at home the same way but, again, I got the air this chick just thought she knew more than me and wanted to prove me wrong. I would have been scared as hell to have someone like this caring for me routinely throughout my pregnancy because she was condescending and obviously not listening to me. That's the type of shyt that causes people to get hurt under a doctor's care, I think.

I wonder if Ms. Cheryl's daughter was telling her doctors something and they weren't listening to her.
 

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@Elle Seven
It sucks that you were wrongly profiled but this is a common theme that plays itself out every day in the health care industry. There's definitely a lot of :mjpls:

With that said here's why they wrongly profiled you:
These are the stat's just for LA county.
w2kmld.png

34s57k9.jpg



As you can see African Americans males and females under 35 are the highest at risk for std's in a city where they're only like 8% of the city's population. There's some huge disparities affecting the black community that never get talked about. Doctors are kinda like cops, they're used to people always lying to them, so it's hard take people at face value seriously. She's probably so used to cases of women coming in with aches about their pain, because they unknowingly contracted an STI from their significant other who stepped out. I mean you to don't have to look any further than TLR to see where a lot of this fukkery comes from....


Now on to the other shyt:
Doctors believe African American's feel less pain:
The disturbing reason some African American patients may be undertreated for pain

How Racism shielded African Americans from the opium epidemic:
Why are black Americans less affected by the opioid epidemic? Racism, probably. :skip:

:dwillhuh: I cant find the study, that showed the african american doctors are less biased.....

Either way, if you don't have a black doctor, seek out. Asap. Navigating through the healthcare system is no joke, and there's a ton of :mjpls: at every corner.
 

Elle Seven

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@Elle Seven
It sucks that you were wrongly profiled but this is a common theme that plays itself out every day in the health care industry. There's definitely a lot of :mjpls:

With that said here's why they wrongly profiled you:
These are the stat's just for LA county.
w2kmld.png

34s57k9.jpg



As you can see African Americans males and females under 35 are the highest at risk for std's in a city where they're only like 8% of the city's population. There's some huge disparities affecting the black community that never get talked about. Doctors are kinda like cops, they're used to people always lying to them, so it's hard take people at face value seriously. She's probably so used to cases of women coming in with aches about their pain, because they unknowingly contracted an STI from their significant other who stepped out. I mean you to don't have to look any further than TLR to see where a lot of this fukkery comes from....


Now on to the other shyt:
Doctors believe African American's feel less pain:
The disturbing reason some African American patients may be undertreated for pain

How Racism shielded African Americans from the opium epidemic:
Why are black Americans less affected by the opioid epidemic? Racism, probably. :skip:

:dwillhuh: I cant find the study, that showed the african american doctors are less biased.....

Either way, if you don't have a black doctor, seek out. Asap. Navigating through the healthcare system is no joke, and there's a ton of :mjpls: at every corner.

Makes sense, and I'll admit, I had a sense about that too.

A childhood friend of mine is a doctor, and he is always telling me stories about how patients tell him one thing, but their bloodwork always shows something else. So, yeah, I'm very aware of them having to test anyway, just in case the patient is lying.

I think my beef with this lady was that she was that, as soon as she saw me, she was going to test my ass for an STD anyway, no matter what I said. I still do not know what it is she 'saw' when she examined me that just made her think it was an STD. It would have been one thing if she said, "Ok, this is a routine test we give all pregnant mommies to ensure your health and the baby's". That, I can get with. She was a dog with a bone, though, lol. Literally telling her everything that had happened in my pregnancy up until that very point didn't make any difference. I said, "I think I may have strained my bladder", and her mindset was still, you may have an STD. (Sigh) I get annoyed thinking about it now, lol.

My midwife was a West Indian woman who is well known throughout this city; if you are a lay midwife here, she probably trained you. I knew I was in good hands with her, and that was the only reason I didn't succumb to stress or fear after dealing with this doctor. My husband and I both spent the entire pregnancy building a relationship with her. I truly wish other women could have the same report with their own doctors during pregnancy. It would eliminate at least that aspect of the stress that comes along with having a baby.
 
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