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It's not every day the US Surgeon General publishes a guest essay/ op-ed in the New York Times.
https://www.nytimes.com/2024/08/28/opinion/surgeon-general-stress-parents.html
Surgeon General: Parents Are at Their Wits’ End. We Can Do Better.
Aug. 28, 2024 |One day when my daughter was a year old, she stopped moving her right leg. Tests found that she had a deep infection in her thigh that was dangerously close to her bone. She was rushed off to surgery. Thankfully, she’s now a healthy, spirited young girl, but the excruciating days we spent in the hospital were some of the hardest of my life. My wife, Alice, and I felt helpless and heartbroken. We got through it because of excellent medical care, understanding workplaces and loved ones who showed up and reminded us that we were not alone.
When I became a parent, a friend told me I was signing up for a lifetime of joy and worry. The joys are indeed abundant, but as fulfilling as parenting has been, the truth is it has also been more stressful than any job I’ve had. I’ve had many moments of feeling lost and exhausted. So many parents I encounter as I travel across America tell me they have the same experience: They feel lucky to be raising kids, but they are struggling, often in silence and alone.
The stress and mental health challenges faced by parents — just like loneliness, workplace well-being and the impact of social media on youth mental health — aren’t always visible, but they can take a steep toll. It’s time to recognize they constitute a serious public health concern for our country. Parents who feel pushed to the brink deserve more than platitudes. They need tangible support. That’s why I am issuing a surgeon general’s advisory to call attention to the stress and mental health concerns facing parents and caregivers and to lay out what we can do to address them.
A recent study by the American Psychological Association revealed that 48 percent of parents say most days their stress is completely overwhelming, compared with 26 percent of other adults who reported the same. They are navigating traditional hardships of parenting — worrying about money and safety, struggling to get enough sleep — as well as new stressors, including omnipresent screens, a youth mental health crisis and widespread fear about the future.
Stress is tougher to manage when you feel you’re on your own, which is why it’s particularly concerning that so many parents, single parents most of all, report feeling lonelier than other adults. Additionally, parents are stretched for time. Compared with just a few decades ago, mothers and fathers spend more time working and more time caring for their children, leaving them less time for rest, leisure and relationships. Stress, loneliness and exhaustion can easily affect people’s mental health and well-being. And we know that the mental health of parents has a direct impact on the mental health of children.All of this is compounded by an intensifying culture of comparison, often amplified online, that promotes unrealistic expectations of what parents must do. Chasing these expectations while trying to wade through an endless stream of parenting advice has left many families feeling exhausted, burned out and perpetually behind.
Something has to change. It begins with fundamentally shifting how we value parenting, recognizing that the work of raising a child is crucial to the health and well-being of all society. This change must extend to policies, programs and individual actions designed to make this vital work easier.
In the past few years we have made progress, expanding access to early childhood education, maternal health programs and a mental health crisis hotline for kids and adults. We have much more to do, however, to make parenting sustainable. This means bolstering financial support for families, including child tax credits. It also means ensuring all parents can get paid time off to be with a new baby or a sick child, secure affordable child care when they need it and have access to reliable mental health care for themselves and their children. And it requires addressing pervasive sources of anguish and worry that parents are often left to manage on their own, including the harms of social media and the scourge of gun violence.
Having safe, affordable before- and after-school care programs, predictable work schedules that allow parents to plan child care and workplace leadership that understands the complex demands on parents can help immensely. Safe playgrounds, libraries and community centers can give children places to play and learn and also serve as valuable settings for parents to gather and build social connection.
Individuals — family members, friends, neighbors and co-workers — can play a critical role. Too often, when someone is struggling, we wait for an invitation to help, or perhaps we worry we don’t have anything of value to offer. Simply showing up can make all the difference in the world to another person. I experienced that when my son was 4 months old and my wife and I had not slept for more than four hours straight in months. A friend came over and played with our child for 15 minutes. Even that was long enough for us to catch our breath. My friend probably thought nothing of it, but that feeling of relief and gratitude is still fresh for me.Many parents and caregivers I’ve met say it’s not easy to ask for help when everyone is grappling with hectic schedules and when it feels as if other parents have it all figured out. As hard as it is, we must learn to view asking for help and accepting help as acts of strength, not weakness.
It’s still hard for me to admit when I feel I’m falling short as a parent. But each time I reach out to a friend or family member or each time I respond when someone reaches out to me, I feel more ease and less stress. The experience has taught me that parenting at its best is a team sport.
My friend was right about the joy and the worry. Given the responsibility it entails, raising children is never going to be without worry. But reorienting our priorities in order to give parents and caregivers the support they need would do a lot to ensure the balance skews toward joy.
I give the Surgeon General credit for emphasizing the importance of extended family and community.
By the same token, as predictable as his plug for federal program "support" for families may be, someone should honor the reality that they disrupt intact families and sideline healthy community initiatives. Let federal government deal with federal issues.
An interesting study by the Journal of Health Affairs tracks the out-of-pocket costs of births in a hospital setting from 2008 to 2015.
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00296
The study observed that the out-of-pocket price for caesarean sections rose from $3,364 in 2008 to $5,161 in 2015, while the out-of-pocket cost of vaginal births rose from $2,910 to $4,314. This translates to families paying 21% of the total cost for vaginal births and 15% of total costs for caesarean sections.
While only one cost out of many for parents, considering alternatives to a hospital such as freestanding birthing centers or home births with midwives may become an increasingly popular option.
Excellent point.
By the way, that's a highly significant price point and date range here in Michigan.
2015 was the year midwife licensure was rammed through the legislature despite opposition from direct entry midwives (DEM).
Their average fee for complete pregnancy, delivery, and post-partum care (as nearly as I could figure it) was just over $1000 - one quarter of the cost of standard hospital delivery.
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